• Archives of Plastic Surgery
• /
• v.48 no.3
• /
• pp.295-304
• /
• 2021

Clinical photography is an essential component of patient care in plastic surgery. The use of unsecured smartphone cameras, digital cameras, social media, instant messaging, and commercially available cloud-based storage devices threatens patients' data safety. This paper Identifies potential risks of clinical photography and heightens awareness of safe clinical photography. Specifically, we evaluated existing risk-mitigation strategies globally, comparing them to industry standards in similar settings, and formulated a framework for developing a risk-mitigation plan for avoiding data breaches by identifying the safest methods of picture taking, transfer to storage, retrieval, and use, both within and outside the organization. Since threats evolve constantly, the framework must evolve too. Based on a literature search of both PubMed and the web (via Google) with key phrases and child terms (for PubMed), the risks and consequences of data breaches in individual processes in clinical photography are identified. Current clinical-photography practices are described. Lastly, we evaluate current risk mitigation strategies for clinical photography by examining guidelines from professional organizations, governmental agencies, and non-healthcare industries. Combining lessons learned from the steps above into a comprehensive framework that could contribute to national/international guidelines on safe clinical photography, we provide recommendations for best practice guidelines. It is imperative that best practice guidelines for the simple, safe, and secure capture, transfer, storage, and retrieval of clinical photographs be co-developed through cooperative efforts between providers, hospital administrators, clinical informaticians, IT governance structures, and national professional organizations. This would significantly safeguard patient data security and provide the privacy that patients deserve and expect.

• Journal of Digital Convergence
• /
• v.10 no.8
• /
• pp.257-264
• /
• 2012

This study was conducted to arrange the basic data for the ways to operate the effective nursing programs and reduce job stress by grasping the awareness, satisfaction and job stress of the nurses due to the introduction of EMR(EMR : Electronic Medical Record) system and clarifying the relationship among them. Methods: Of the hospitals which introduced EMR, the study was conducted for 356 nurses who used EMR in a university hospital in D city and the data was collected from June 1 to June 30. The collected data was analyzed with real number, percentage, T-test, ANOVA, and Pearson correlation coefficient. Results: The results of the study above, it could be certified that the higher the satisfaction and awareness of the users of EMR were, the more the job stress of them decreased. Therefore, the qualitative nursing should be provided to the patients by reducing job stress with the improvement of the awareness and satisfaction of the nurses of EMR, and shortening the time in keeping the records of patients, in order to enhance the satisfaction of EMR, there should be a proper management, such as a regular EMR education, and there must be the ways to reduce the job stress of the nurses and strengthen the satisfaction of EMR.

• Journal of the Korea Convergence Society
• /
• v.9 no.7
• /
• pp.337-346
• /
• 2018

The purpose of this study was to identify the characteristics and the attributes related to Internet use in patients with Internet addiction. This study is a descriptive secondary analysis study, at Internet addiction clinics used the data of 63 patients diagnosed with Internet addiction. Data were obtained from Internet addiction clinic Electronic Medical Records(EMR), there was included the Korean Internet addiction scale(K-scale), Beck Anxiety Inventory(BAI), Beck Depression Inventory(BDI), Barratt Impulsivity scale(BIS), Conners ADHD Rating Scale(CAARS), Lubben Social Network Scale(LSNS). K-scale had significantly correlations with Internet use time per day, anxiety, impulsivity, Attention deficit Hyperactivity Disorder(ADHD) symptom. In stepwise multiple regression, factors significantly affecting ADHD symptom (${\beta}=.37$), Internet use time per day(${\beta}=.29$), Impulsivity(${\beta}=.25$), which accounted for 44% of the variance. Results indicate that patients with Internet addiction had psychological difficulties and suggest that children with ADHD needed to intervention for appropriate internet use.

• Journal of muscle and joint health
• /
• v.27 no.3
• /
• pp.219-228
• /
• 2020

Purpose: This study was a comparative analysis of stroke-related factors between recurrent patients and non-recurrent patients. Methods: A retrospective cohort study design was used, and data were collected from March 2020 to April 2020 using electronic medical records. 244 patients (221 first-timers and 23 recurrent) were included in this study. Results: The stroke recurrence rate in 5 years was 9.4%, the readmission rate was 39.3%, and the mortality rate was 2.0%. The number of patients hospitalized for stroke was greater among men than among women. Of the patients, 60.7% had an underlying disease. With regard to daily life abilities, over 70% of participants needed more than moderate dependence and about 40% of participants had more than mild cognitive impairment. More than 50% were moved to wheelchairs or stretcher cars. The difference in the stroke readmission rate between recurrent and non-recurrent patients was statistically significant. Conclusions: Based on our findings, a program to prevent recurrence of stroke should be developed to considering age, ability of daily living, place of discharge, gait ability at discharge, and place of discharge.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.20 no.9
• /
• pp.167-174
• /
• 2019

The propose od this study was to examine the extent of using physical restraint on elderly patients (over 65 years old) and who were patients in long-term care hospitals. The data was collected, from March 3 2018 to March 29 2018, from the electronic nursing records by using a recording tool, and clinical observation was also used for assessing the use of physical restraint and the related factors. Descriptive statistics, Pearson correlation coefficients and logistic regression were then performed. The usage rate for physical restraints in long-term care hospital was 83.7%, and the most common type of physical restraint was side rails. The use of physical restraints showed a positive correlation with the fall risk scores and a negative correlation with the MMSE. Logistic regression analysis showed that the Fall Risk Score (OR=1.02, 95% CI=1.01~1.03), MMSE (OR=0.94, CI=0.88~0.99) and the use of medical devices (OR=0.80, 95% CI=0.65~0.98) were related with using physical restraints. Therefore, it was confirmed that physical restraint was used in cases of a high risk of falling, severe cognitive impairment and the use of complex and fragile medical devices to treat the patient. Clinical nursing practice should be changed so that treatment alternatives can be applied for elderly patients rather than using too many physical restraints.

• The Journal of the Korea Contents Association
• /
• v.19 no.12
• /
• pp.279-288
• /
• 2019

The purpose of this study was to compare the health behaviors and health indices according to whether a percutaneous coronary intervention(PCI) was performed due to chest pain. This is a secondary data analysis study of nursing information questionnaires and electronic medical records of 247 chest pain patients in a hospital from January 2010 to December 2017. The participants were divided into non-PCI and PCI groups, and the health behaviors, blood pressure, and blood lipid levels were collected at the first hospital admission and re-admission. Collected data were analyzed using SPSS 24.0. As a result of the study, smoking and lipid levels were significantly healthier than the participants in PCI group during re-hospitalization. Non-PCI group had a high risk of smoking despite the high risk of coronary artery stenosis. It was found that continuous integrated management to promote health behavior is needed. The significance of this study was to identify the importance of health behavior in patients with the risk of cardiovascular disease.

• Acute and Critical Care
• /
• v.33 no.4
• /
• pp.252-259
• /
• 2018

Background: The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time ($26.7{\pm}25.1$ vs. $12.1{\pm}16.0days$, P=0.003), length of stay in the general ward ($70.6{\pm}89.1$ vs. $40.5{\pm}42.2days$, P=0.008), length of total hospital stay ($107.5{\pm}95.6$ vs. $74.7{\pm}51.2days$, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010). Conclusions: Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.

• Journal of Hospice and Palliative Care
• /
• v.26 no.2
• /
• pp.69-79
• /
• 2023

Purpose: This study aimed to investigate the involvement of patients who died from hematologic neoplasms in the decision-making process surrounding the withdrawal of life-sustaining treatment (LST). Methods: A total of 255 patients diagnosed with hematologic neoplasms who ultimately died following decisions related to LST during their end-of-life period at a university hospital were included in the study. Data were retrospectively obtained from electronic medical records and analyzed utilizing the chi-square test, independent t-test, and logistic regression. Results: In total, 42.0% of patients participated in the decision-making process regarding LST for their hematologic neoplasms, while 58.0% of decisions were made with family involvement. Among these patients, 65.1% died in general wards and 34.9% in intensive care units (ICUs) as a result of decisions such as the suspension of LST. The period from the LST decision to death was longer when the decision was made by the patient (average, 27.15 days) than when it was made by the family (average, 7.48 days). Most decisions were made by doctors and family members in the ICU, where only 20.6% of patients exercised their right to make decisions regarding LST, a rate considerably lower than 79.4% observed in general wards. Decisions to withhold or withdraw LST were more commonly made by patients themselves than by their families. Conclusion: The key to discussing the decision to suspend hospice care and LST is respecting the patient's self-determination. If a patient is lucid prior to admission to the ICU, considerations about suspending LST should involve the patient input.

• Journal of Hospice and Palliative Care
• /
• v.19 no.2
• /
• pp.119-126
• /
• 2016

Purpose: This study analyzed the difference in survival time of patients with delirium according to sedative medication. Methods: From January 2012 through December 2013, a retrospective cohort study was performed using the electronic medical records (EMR) of Pusan National University Hospital. Among 900 patients who died from cancer, we selected 240 who suffered delirium based on the EMR. The Nu-DESC delirium screening test was used to diagnose delirium. Results: The median length of delirium period was five days. Delirium characteristics were dominated by inappropriate behaviors (35.0%). Sedatives were administered in 72.1% of the cases. The most frequently used sedative was haloperidol which was used in 59.6% of cases. The delirium period significantly differed by patients' age (F=3.96, P=0.021), cancer type (F=3.31, P=0.010), chemotherapy (t=-3.44 P=0.001). The average survival time was 16.85 days for the sedative medication group and 9.37 days for the non-medication group, which, however, was not significant (t=1.766, P=0.079). Conclusion: In this study, the use of sedatives did not affect patients' survival time. Thus, appropriate sedative medication can be positively recommended to comfort terminal cancer patients and their families.

• Journal of Hospice and Palliative Care
• /
• v.20 no.2
• /
• pp.93-99
• /
• 2017

Purpose: This study investigated changes in life-sustaining treatments in terminally ill cancer patients after consenting to a do-not-resuscitate (DNR) order. Methods: Electronic medical records were reviewed to select terminally ill cancer patients who were treated at the oncology unit of the Asan Medical Center, a tertiary hospital in South Korea and died between January 1, 2013 and December 31, 2013. Results: The median (range) age of the 200 patients was 59 (22~89) years, and 62% (124 persons) were male. Among all patients, 83.5% were aware of their medical condition, and 47.0% of the patients had their DNR order signed by their spouses. The median of the patients' hospital stay was 15 days, and time from admission to DNR decision was 10 days. After signing a DNR order, 35.7~100% of the life-sustaining treatments that had been provided at the time of the DNR decision making were administered. The most commonly discontinued interventions were transfusion (13.5%), blood test (11.5%) and parenteral nutrition (8.5%). Conclusion: It is necessary to define the scope of life-sustaining treatments for DNR patients. Treatment guidelines should be established as well to secure terminal patients' death with dignity after their consent to a DNR order, thereby avoiding meaningless life-sustaining treatments and allowing administration of active terminal care interventions.