• 제목/요약/키워드: Electronic health record

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Secondary Analysis on Ventilator-Associated Pneumonia and Pressure Injury

  • Hyun, Sookyung;Moffatt-Bruce, Susan;Newton, Cheryl;Kaewprag, Pacharmon
    • International Journal of Advanced Culture Technology
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    • 제6권3호
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    • pp.211-215
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    • 2018
  • Ventilator-associated pneumonia (VAP) is a lung infection that develops in patients receiving mechanical ventilation. VAP contributes to about 50% of hospital-acquired pneumonia in ICU settings. One of the recommendation of the Institute of for Healthcare Improvement ventilator bundle is HOB elevation. HOB elevation affects shearing forces and makes higher risk for pressure injury development. Pressure injury (PI) is localized damage to the skin over a bony prominence. PI prevention guidelines recommend that HOB positioning should be lower to reduce risk for PI development which contradicts VAP prevention guidelines for the HOB between 30 and 45 degrees for ICU patients. This presents a care dilemma and tension. The purpose of this study was to perform a secondary data analysis using cumulative electronic health record data in order to determine the association of HOB elevation with VAP and PI in ICU patients. A secondary data analysis was conducted to determine whether HOB elevation is associated with VAP and PI. HOB elevation was not likely to be associated with VAP prevention whereas it was likely to be related to PI development. This is somewhat contrary to popular data and publications. Prospective cohort study is desired to inform us in an evidence-based fashion what actually is optimal HOB elevation for ventilated patients in ICU settings.

논문분석과 구축사례 조사를 통한 한의학 온톨로지 연구동향 분석 (A Study of Tendency Analysis to Ontology Research about Korea Medicine Using Paper and Case Study)

  • 김철;김상균;송미영
    • 한국한의학연구원논문집
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    • 제14권2호
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    • pp.121-129
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    • 2008
  • The fusion research subjects of Oriental medicine and Information-Technology are actively advanced. These researches provide Oriental medicine the objectivity and support the infra to all study area of Oriental medicine. This paper considers the inside and outside of the country technical development trend of ontology research by analyzing papers and going through case study. It executed information analysis about changes to number of research papers, present state and star higher officer of research facility from the dissertation which it sees. It is known that our country research result is slight so far in quantity and quality as result of analysis. But hereafter it contains many developmental possibilities. Also it reflects the appearance and a growth of new field like bio-informatics biology. In the area of medicine, ontology used to define the terminology for information documentation and the medical terms linked up by high correlation. Also medical information system developed briskly using ontology technology. The ontology of traditional korean medicine play an important role in base infra of traditional korean medicine EHR(Electronic health record).

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체온측정용 온도 센서 및 모니터링 텔레메트리 시스템 구현 (Development for body temperature sensor and monitoring telemetry system)

  • 이정현;성기웅;김명남;조진호
    • 센서학회지
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    • 제19권6호
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    • pp.435-442
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    • 2010
  • Typically, the vital signs that are representing the state of human body, are the body temperature, sphygmus, respiration and blood pressure. The body temperature is the result of metabolic regulation and human steady-state body temperature is maintained from 35.9 to $37.4^{\circ}C$ by heat regulatory center. The body temperature is indicative of infection and especially it should be monitored to requiring intensive care patients or after surgical patients. But, measuring of body temperature to a heavy workload on nursing staff has been recognized. And, the health service of nurse is limited by simple tasks such as the measurement and record of vital sign. In this paper, the body temperature monitoring telemetry system was proposed to prove the recoding and transmission of body temperature patch system according the standard(ISO TS11073-92001). We proposed the transmission protocol to suit the MFER(medical waveform format encoding rules). The telemetry patch system was implemented and it was verified by experiments.

초기사정을 위한 간호정보조사지의 임상내용 모델 개발 (Development of Detailed Clinical Models of Nursing Information for Initial Assessment)

  • 김영란;박현애;민열하;이명경;이영지
    • 임상간호연구
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    • 제17권1호
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    • pp.101-112
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    • 2011
  • Purpose: The purpose of this study is to develop a detailed clinical model for recording initial nursing assessment items, and to test the applicability of the model to facilitate semantic interoperability for sharing and exchanging nursing information. Methods: First, the researchers extracted items by analyzing initial nursing assessment records. Second, defining characteristics were identified by analyzing nursing records and reviewing the literature. Third, value sets for defining characteristics were identified and types and cardinalities of defining characteristics were defined based on the value sets. Finally, the detailed clinical model was tested through evaluation by experts and comparison with the initial nursing assessment in a clinical setting. Results: Sixty-one detailed clinical models were developed with 178 defining characteristics and value sets. The experts evaluation and comparison with the initial nursing assessment in a clinical setting showed that the detailed clinical model developed in this study was valid. Conclusion: Use of this detailed clinical model can ensure that the Electronic Health Record contains meaningful and valid information and supports semantic interoperability of nursing information. This use will promote quality in the nursing records and eventually quality of nursing care.

Standard Terminology System Referenced by 3D Human Body Model

  • Choi, Byung-Kwan;Lim, Ji-Hye
    • Journal of information and communication convergence engineering
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    • 제17권2호
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    • pp.91-96
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    • 2019
  • In this study, a system to increase the expressiveness of existing standard terminology using three-dimensional (3D) data is designed. We analyze the existing medical terminology system by searching the reference literature and perform an expert group focus survey. A human body image is generated using a 3D modeling tool. Then, the anatomical position of the human body is mapped to the 3D coordinates' identification (ID) and metadata. We define the term to represent the 3D human body position in a total of 12 categories, including semantic terminology entity and semantic disorder. The Blender and 3ds Max programs are used to create the 3D model from medical imaging data. The generated 3D human body model is expressed by the ID of the coordinate type (x, y, and z axes) based on the anatomical position and mapped to the semantic entity including the meaning. We propose a system of standard terminology enabling integration and utilization of the 3D human body model, coordinates (ID), and metadata. In the future, through cooperation with the Electronic Health Record system, we will contribute to clinical research to generate higher-quality big data.

전라북도 지역 동물병원에 내원한 반려견의 주요 품종별 질환 양상 조사 (Prevalence of common medical disorders among dog breeds examined in primary-care veterinary clinics at Jeollabuk-Do, Republic of Korea)

  • 김은주;최창용;류재규;오상익;정영훈;조아라;김수희;도윤정
    • 한국동물위생학회지
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    • 제41권2호
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    • pp.97-104
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    • 2018
  • Recently, demographic studies of veterinary medical database have been conducted to understand patterns of disease occurrence. Understanding incidence of breed-related disease would provide appropriate guidance for future health care strategies and offer useful information for early diagnosis of disease. However, in veterinary medicine, theses research has not yet been investigated in the Republic of Korea. The purpose of this study was to investigate the prevalence of common medical disorders among dog breeds examined at primary-care veterinary clinics in Jeollabuk-Do, Republic of Korea. The data were analyzed based on World Health Organization's International Classification of Disease. A total 13,176 medical records of canine patients were analyzed from six primary veterinary clinics in Jeollabuk-Do from January to December 2016. Results showed that the most common health problems were 'disease of skin' (17.7%); followed by 'diseases of digestive system' (12.26%), 'preventive medicine' (10.08%), and 'diseases of ear and mastoid process' (10.4%). In seven out of ten breeds, the most common medical disorder was skin disease. For poodle such as Pomeranian and Chihuahua, digestive system disease was most prevalent. On the other hand, respiratory system disease was found to be higher in Pomeranian than other breeds; while ear and mastoid process disease was most common for Maltese and Poodle. This study can help owners, breeders, and veterinarians prevent and manage various diseases of popular breeds in Jeollabuk-Do in the future.

소아 두부 전산화단층촬영 선량지표 분석을 통한 피폭선량 모니터링: 일개병원 사례 중심으로 (Analyzed the Computed Tomography Dose Index (CTDI) to the Pediatric Brain CT by Reason of the Observation for the Exposure Dose: Base on a Hospital)

  • 이재승;김현진;임인철
    • 한국콘텐츠학회논문지
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    • 제15권6호
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    • pp.290-296
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    • 2015
  • 본 연구는 일개병원에서 시행된 년간 소아 두부 CT 검사에 대한 CT 선량지표(CTDI)를 국내 진단참고 준위와 비교하여 분석함으로써 제안점을 도출하고 피폭 방사선량 저감화 방안을 제시하고자 하였다. 이를 위하여 2014년 1월부터 12월까지 두부 손상으로 소아 두부 CT 검사를 의뢰 받은 10세 미만의 소아 231명을 후향적으로 조사하였다. 조사 방법은 선량 보고서와 의료전자차트를 참조하여 일반적 특성, 관전압(kVp), 관전류(mA), 검사 범위, $CTDI_{vol}$, DLP를 조사하여 분석하였다. 결과적으로 $CTDI_{vol}$은 전체 연구대상자의 7.4%(17명)가 국내 진단참고준위를 초과한 것으로 나타났으며 DLP의 경우 41.6%(96명)가 초과 되어 $CTDI_{vol}$ 보다 비교적 높게 나타났다. DLP는 한국식품의약품안전처에서 제시한 CT 선량 지표보다 대부분 약 60% 이상 초과되었으며 건강보험심사평가원에서 제시한 기준 검사 범위보다 약 30%이상 증가된 검사 범위가 DLP가 높게 나타난 원인으로 분석되었다. 결론적으로 임상에서 CT 검사 시 건강보험심사 평가원에서 제시하는 소아 두부 CT 검사의 기준 검사 범위를 준수하여 검사하고 프로토콜을 적절히 조절한다면 피폭선량을 상당히 낮출 수 있을 것으로 판단된다.

한국 고등학생의 인구학적 특성 및 일탈행동 요인과 스트레스와의 관계에 관한 고찰 (Association of Demographic Characteristics and Delinquent Behaviors and Level of Stress among Korean Senior High School Students)

  • 박지현;김광선;김광회;남길우;민경원;이삼순;정찬희;이현숙;이홍직
    • 한국전자통신학회논문지
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    • 제8권6호
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    • pp.971-977
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    • 2013
  • 본 연구는 청소년건강행태 온라인조사 자료를 토대로 고등학생의 인구사회학적 특성 및 일탈행동요인에 따른 스트레스 수준의 차이를 t-검증과 F-검증을 통해 비교하였다. 연구결과, 인구학적 특성 요인에 있어서는 여학생이 남학생보다, 양 부모와 동거하지 않는 경우에, 가계의 경제수준이 낮은 경우에, 전문계 고등학생의 경우에, 고학년인 경우에, 학업성적이 낮은 경우에, 일탈행동요인에 있어서는 인터넷 중독인 경우에, 문제음주를 한 경우에, 흡연을 한 경우의 고등학생이 그렇지 않은 경우에 비해 통계학적으로 유의하게 높은 스트레스 수준을 보였다. 본 연구에서는 이러한 결과를 토대로 고등학생의 스트레스 완화 방안에 대해 논의하였다.

단축형 노인 낙상위험 사정도구의 타당도 (Validation of the Short Form Bobath Memorial Hospital Fall Risk Assessment Scale at a Specialized Geriatric Hospital in Korea)

  • 송경애;박미화;정승교;박혜자
    • 한국보건간호학회지
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    • 제28권3호
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    • pp.495-508
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    • 2014
  • Purpose: This study was conducted in order to evaluate the reliability, validity, sensitivity, and specificity of the Short Form of Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS-SF). Methods: A validation study was conducted on 207 elderly patients aged over 65 who were admitted to Bobath Memorial Hospital. Fall risk scores of BMFRAS, composed of eight subscales (age, fall history, physical activity, consciousness level, communication, fall risk factors, underlying disease, and medications) were assessed from the electronic medical record. BMFRAS-SF was derived from eight subscales of the BMFRAS representing the significance between fallers and non-fallers (fall history, physical activity, fall risk factors, underlying disease, and medications). Internal consistency reliability and interrater reliability were assessed by Cronbach's alpha and kappa coefficient. Validity was assessed by Spearman correlation analysis, factor analysis. Sensitivity, specificity, positive predictive and negative predictive values, and a receiver-operating characteristic curve (ROC) were generated. Results: Fallers had significantly higher risk scores than non-fallers in fall history, physical activity, fall risk factors, underlying disease, and medication scales. The BMFRAS-SF demonstrated acceptable Cronbach's alpha (.706) and kappa coefficients of .95. The BMFRAS-SF subscales showed good convergent validity and construct validity. The BMFRAS-SF presented good sensitivity(86.7%), specificity(67.9%), positive predictive value(42.9%) and good negative predictive value(94.8%) at a cut-off score of 5. Areas under the ROC curves were .860 for the BMFRAS and .861 for the BMFRAS-SF. Conclusion: The BMFRAS-SF was proved to be reliable and valid. It could be used for time-saving assessment and evaluation of the high risks for falls in clinical practice settings.

노인층에서 Clostridium difficile 감염 약물사용평가 및 비호전군에 대한 영향인자 (Drug Use Evaluation of Clostridium difficile Infection in Elderly Patients and Risk Factors of Non-improving Group)

  • 노현정;함정연;이자균;이정연
    • 한국임상약학회지
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    • 제28권3호
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    • pp.174-180
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    • 2018
  • Objective: Clostridium difficile Infection (CDI) is one of the common nosocomial infections. As elderly population increases, the proper treatment has been emphasized. We investigated the risk factors associated with CDI unimprovement in elderly patients. Furthermore, we performed drug use evaluation of old CDI patients and oldest-old CDI patients. Methods: It was a retrospective study using electronic medical record at Kangbuk Samsung Medical Center (KBSMC) from January 2016 to December 2017. Seventy three patients aged 65 years or older, diagnosed with CDI by Clostridium difficile Toxin B Gene [Xpert] were screened and they were assessed for risk factors regarding unimprovement status. We also evaluated drug use evaluation in old patients ($65{\leq}age$<80) and oldest-old patients ($80{\leq}age$) by assessing the use of initial therapy, severity, dose, route, treatment course, days of use, total days of use and treatment outcome of initial therapy. Results: Out of 73 patients aged over 65 years, four patients were excluded because they did not receive any treatment. There were 31 improved patients and 38 unimproved patients after initial therapy. We were able to find out patients with surgical comorbidity or endocrine comorbidity (especially, diabetes mellitus) had 2.885 more risk of becoming unimproved than those patients without surgical comorbidity or endocrine comorbidity. Drug use evaluation for CDI was generally fair, but vancomycin as initial therapy is more recommended than metronidazole. Conclusion: Although age, antibiotics exposure, use of antacids are all important risk factors for CDI, our result did not show statistical significance for these risk factors. However, the study is meaningful because the number of elderly population keeps increasing and recently updated guideline suggests the use of vancomycin as drug of choice for CDI.