• Title/Summary/Keyword: Electronic records management

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The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward

  • Jung, Yooun-joong;Kim, Younghwan;Kyoung, Kyuhyouck;Keum, Minae;Kim, Taehyun;Ma, Dae seong;Hong, Suk-Kyung
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.252-259
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    • 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.

A single injection of saphenous nerve block reduces postoperative bleeding after total knee arthroplasty (무릎전치환술 환자에서 일회성 복재신경차단술이 수술 후 출혈량 감소에 미치는 영향)

  • Choi, Yun Suk;Yun, So Hui;Cho, Seung Yeon;Song, Seung Eun;Kim, Sang Rim
    • Journal of Medicine and Life Science
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    • v.18 no.1
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    • pp.11-15
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    • 2021
  • In elderly patients, the vital parameters tend to fluctuate based on the blood volume status, which may cause sudden hypovolemic shock if the postoperative bleeding continues. Particularly, those who undergo surgery for arthritis needs to pay extra attention because the bleeding may persist over the joints after the surgery. Therefore, appropriate pain control is required to reduce the postoperative blood loss. This retrospective chart review study was conducted to assess the postoperative pain control and reduction of blood loss with a single injection of saphenous nerve block (SNB) in elderly patients with osteoarthritis. We reviewed the electronic medical records of patients who underwent knee total arthroplasty with spinal anesthesia between January and May 2016. A total of 51 patients participated in this study. All patients were treated with intravenous patient-controlled analgesia for the postoperative pain control, and additional analgesic agents were administered at a visual analogue scale above a score of 6. In 25 patients, SNB was performed using ultrasound with the administration of 0.75% ropivacaine (15 mL) after the surgery. Patients who received additional analgesics were significantly low in the nerve block group (P=0.009). Additionally, the volume of blood loss from catheter drainage was significantly low at 2 and 3 days postoperatively (P=0.013 and P=0.041, respectively) in the nerve block group. In patients who underwent total knee arthroplasty with osteoarthritis, only a single injection of saphenous nerve block was sufficient for the postoperative pain control and reduced bleeding.

Analysis of Characteristics of Thoracic Injury Patients and Nursing Interventions Using Nursing Intervention Classification by Emergency Room Type (응급실 유형에 따른 흉부외상환자의 특성과 간호중재분류체계를 활용한 간호중재 분석)

  • Kim, Kiung;Kim, Yunhee
    • Journal of Korean Biological Nursing Science
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    • v.23 no.4
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    • pp.257-266
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    • 2021
  • Purpose: The purpose of this study was to analyze the content of nursing interventions applied to patients with thoracic injury who visited a trauma emergency room (TER) or an emergency room (ER). Methods: Of 3,938 trauma patients admitted to this hospital between January 1, 2019 and December 31, 2020, 320 adult patients with thoracic injury (94 to TER, 226 to ER) who met the inclusion criteria were enrolled. Patients' data were acquired from their electronic medical records. General and clinical characteristics of these subjects along with nursing interventions were analyzed. Results: There were statistically significant differences in the length of stay, treatment outcome, and level of consciousness between thoracic injury patients who visited TER and ER. Average thoracic Abbreviated Injury Scale score and average Injury Severity Score of thoracic injury patients who visited TER were 3.13 and 13.54, respectively, which were significantly higher than those of patients who visited ER. The numbers of nursing actions applied was 4,819 for TER and 3,944 for ER, which were classified into five domains, 18 classes, and 56 interventions. The most domain of interventions carried out in both TER and ER was physiological: complex. Classes including Crisis management and Thermoregulation were not carried out in ER. On average, 16 more types of interventions were carried out in TER than in ER. Conclusion: This study demonstrated characteristics of thoracic injury patients and nursing interventions by emergency room type. Based on results of this study, standardized nursing interventions need be applied to thoracic injury patients visiting TER and ER.

Feline Demographics and Disease Distribution in the Republic of Korea

  • Lee, Jongseok;Pak, Son-il;Lee, Kija;Choi, Hojung;Lee, Youngwon;Park, Inchul;Choi, Sooyoung
    • Journal of Veterinary Clinics
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    • v.39 no.5
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    • pp.217-225
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    • 2022
  • The population of pet cats has increased significantly, from 0.3% in 2002 to 5.6% in 2017. Large-scale feline demographic and disease data from Korea are lacking. The aim of this study was to investigate the demographic data (breed, sex, and age) and disease distribution of cats who visited private veterinary practices in Korea. Data including breed, sex, age, and disease, were compiled from 32,728 electronic medical records from 30 selected private veterinary practices, between January 1, 2016, and December 31, 2017. Diseases were classified based on the International Classification of Diseases 11 by the World Health Organization, and then compared and cross-analyzed according to breed, sex, and age. Korean shorthair was the most common breed. There was a high distribution of young cats, with 77.6% of the cats under 4 years of age, and an average age of 2.5 years. Diagnoses related to preventative medicine were the most frequent and diagnoses common to young cats had higher incidence. This demographic data and information about disease distribution can be used as a basis for future research and may be helpful for determining priorities in the diagnosis of diseases and establishing strategies for health management in cats.

Association of lifestyle with periodontal pathogens on dental patients with periodontitis (retrospective study) (치주질환 환자의 생활양식과 치주 병원균의 연관성에 관한 후향적 연구)

  • Mu-Yeol, Cho;Se-Rim, Cho;Dal-Nim, Park;Sang-Yi, Lee
    • Journal of Korean Academy of Dental Administration
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    • v.10 no.1
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    • pp.42-52
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    • 2022
  • This study aimed to investigate the association of lifestyle with the copy number of periodontal pathogens. This retrospective study collected electronic health records of 102 subjects with periodontitis, including reports of bacterial genetic tests and lifestyle questionnaires. The five pathogens were analyzed as follows: Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Prevotella intermedia, and Fusobacterium nucleatum. The lifestyle questionnaire included age, sex, oral hygiene management, smoking, drinking, exercise, dietary, snacks, water intake, and sleeping time. An independent t-test or ANOVA was performed to compare the copy number of periodontal pathogens according to lifestyle (α=0.05). The copy numbers of P. gingivalis and F. nucleatum were significantly higher than those of other strains. The copy number of T. forsythia in patients who exercised was 54% lower than in those who did not (p=0.009). Other lifestyle factors did not affect the number of bacteria. Exercise habits among the lifestyles showed a association with the number of specific oral bacteria. This result suggests that a lifestyle questionnaire is essential in clinical situation and necessary to prevent and treat the periodontal disease effectively.

Deep learning method for compressive strength prediction for lightweight concrete

  • Yaser A. Nanehkaran;Mohammad Azarafza;Tolga Pusatli;Masoud Hajialilue Bonab;Arash Esmatkhah Irani;Mehdi Kouhdarag;Junde Chen;Reza Derakhshani
    • Computers and Concrete
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    • v.32 no.3
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    • pp.327-337
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    • 2023
  • Concrete is the most widely used building material, with various types including high- and ultra-high-strength, reinforced, normal, and lightweight concretes. However, accurately predicting concrete properties is challenging due to the geotechnical design code's requirement for specific characteristics. To overcome this issue, researchers have turned to new technologies like machine learning to develop proper methodologies for concrete specification. In this study, we propose a highly accurate deep learning-based predictive model to investigate the compressive strength (UCS) of lightweight concrete with natural aggregates (pumice). Our model was implemented on a database containing 249 experimental records and revealed that water, cement, water-cement ratio, fine-coarse aggregate, aggregate substitution rate, fine aggregate replacement, and superplasticizer are the most influential covariates on UCS. To validate our model, we trained and tested it on random subsets of the database, and its performance was evaluated using a confusion matrix and receiver operating characteristic (ROC) overall accuracy. The proposed model was compared with widely known machine learning methods such as MLP, SVM, and DT classifiers to assess its capability. In addition, the model was tested on 25 laboratory UCS tests to evaluate its predictability. Our findings showed that the proposed model achieved the highest accuracy (accuracy=0.97, precision=0.97) and the lowest error rate with a high learning rate (R2=0.914), as confirmed by ROC (AUC=0.971), which is higher than other classifiers. Therefore, the proposed method demonstrates a high level of performance and capability for UCS predictions.

A Research for Revising the Korean Archives Law with Interviews (공공기록물 관리에 관한 법령 개정을 위한 면담 연구)

  • Hyun, Moonsoo;Chung, Sanghee;Park, Min-Young;Hwang, Jin-Hyun;Lee, So-Yeon
    • The Korean Journal of Archival Studies
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    • no.51
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    • pp.279-306
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    • 2017
  • This study aims to identify issues with regard to practicing the current Korean Archives Law and, by doing so, to boost a community-wide discussion for revising it. Five researchers collaboratively interviewed five groups of stake-holders. Each group was consisted of practitioners in central government agencies, provincial governments, and educational district offices, as well as instructors of archival education programs. To uncover diverse issues from various perspectives, the interview was initiated by a common question: "Do you have any idea in terms of revising the current law?" After all interview sessions were completed, the researchers discussed among themselves and established a framework for analysis. The study is expected to provide a starting point for the Korean archival community to reinvent the law so that the archival culture and practice in Korea could open a new era.

The Trends and Prospects of Health Information Standards : Standardization Analysis and Suggestions (의료정보 표준에 관한 연구 : 표준화 분석 및 전망)

  • Kim, Chang-Soo
    • Journal of radiological science and technology
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    • v.31 no.1
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    • pp.1-10
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    • 2008
  • Ubiquitous health care system, which is one of the developing solution technologies of IT, BT and NT, could give us new medical environments in future. Implementing health information systems can be complex, expensive and frustrating. Healthcare professionals seeking to acquire or upgrade systems do not have a convenient, reliable way of specifying a level of adherence to communication standards sufficient to achieve truly efficient interoperability. Great progress has been made in establishing such standards-DICOM, IHE and HL7, notably, are now highly advanced. IHE has defined a common framework to deliver the basic interoperability needed for local and regional health information networks. It has developed a foundational set of standards-based integration profiles for information exchange with three interrelated efforts. HL7 is one of several ANSI-accredited Standards Developing Organizations operating in the healthcare arena. Most SDOs produce standards (protocols) for a particular healthcare domain such as pharmacy, medical devices, imaging or insurance transactions. HL7's domain is clinical and administrative data. HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. The ASTM specification for Continuity of Care Record was developed by subcommittee E31.28 on electronic health records, which includes clinicians, provider institutions, administrators, patient advocates, vendors, and health industry. In this paper, there are suggestions that provide a test bed, demonstration and specification of how standards such a IHE, HL7, ASTM can be used to provide an integrated environment.

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Medical Information Privacy Concerns in the Use of the EHR System: A Grounded Theory Approach (의료정보 프라이버시 염려에 대한 근거이론적 연구: 전자건강기록(EHR) 시스템을 중심으로)

  • Eom, Doyoung;Lee, Heejin;Zoo, Hanah
    • Journal of Digital Convergence
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    • v.16 no.1
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    • pp.217-229
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    • 2018
  • Electronic Health Record (EHR) systems are widely adopted worldwide in hospitals for generating and exchanging records of patient information. Recent developments are moving towards implementing interoperable EHR systems that enable information to be shared seamlessly across healthcare organizations. In this context, this paper explores the factors that cause medical information privacy concerns, identifies how people react to privacy invasion and what their perceptions are towards the acceptance of the EHR system. Interviews were conducted to draw a grounded theory on medical information privacy concerns in the use of EHRs. Medical information privacy concerns are caused by perceived sensitivity of medical information and the weaknesses in security technologies. Trust in medical professionals, medical institutions and technologies plays an important role in determining people's reaction to privacy invasion and their perceptions on the use of EHRs.

Comparison of Health Behaviors and Health Indices According to Percutaneous Coronary Intervention in Patients with Chest Pain -Analysis of Nursing Information Chart and Electronic Medical Record- (흉통환자의 관상동맥중재술 시행 여부에 따른 건강행위 및 건강지표 비교 - 간호정보조사지와 전자의무기록 분석-)

  • Kweon, Mi-Soo;Lee, Sook-Jeong
    • The Journal of the Korea Contents Association
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    • v.19 no.12
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    • pp.279-288
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    • 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.