• Title/Summary/Keyword: Emergency Nursing

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Development of Safety Monitoring Program for Psychiatric Emergency Using Google Teachable Machine (구글 티처블머신을 활용한 정신과적 응급 대상자의 병실 안전 모니터링 프로그램 개발)

  • Eun-Min Lee;Tae-Hun Kim
    • The Journal of the Convergence on Culture Technology
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    • v.9 no.1
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    • pp.613-618
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    • 2023
  • In this paper, a monitoring program that can automatically determine whether a patient admitted to an isolation room acts out of a stable state through a screen photographed in real time is described. The motion recognition model of this program was built by learning through transfer learning. 900 images were used for the three movements, and this program was developed for the web to support all environments. The model was determined with high accuracy to determine the state of the subject hospitalized in the isolation room, and can be applied by applying it to the existing isolation room monitoring system.

Field Study For The Improvement of Medication System and Method for Inpatients at General Hospital (입원환자의 투약체계와 방법의 개선을 위한 현장연구)

  • Yoo, Hyung-Sook;Kuwan, Young-Mi;Song, Mi-Sook;Kim, Hyung-Ae;Park, Kyung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.147-211
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    • 1995
  • Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.

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Knowledge and Performance of Universal Precautions by Nursing Students (일부 간호대학생의 혈액매개질환 예방 지침에 대한 지식과 실천 정도)

  • 김경미;김민아;정여숙;김남초
    • Journal of Korean Academy of Nursing
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    • v.29 no.4
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    • pp.929-939
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    • 1999
  • The purpose of this study was to identify knowledge of universal precautions and its performance in practice. The research was conducted from November 2 to 30, 1998. A total 515 student nurses ; 249 from a baccalaureate nursing college and 266 from second and third year of a 3-year community nursing college were surveyed. The results are as following : 1. The average score for universal precautions knowledge was 270.41$\pm$19.43/300(range 150-300). The results showed that 99.2% of students avoid injury from used needles, 98.6% answered that they always wash their hands if they had contact with the patient's blood and they always dispose of used needles in special collectors (97.7%) for needles. But, 39.2% responsed that they dispose of used needles after recapping them. 2. The average score for universal precautions knowledge of the senior students in the 4-year college was the highest (277.65$\pm$13.99). 3. The average score for the performance of universal precautions knowledge was 53.18 $\pm$5.91(range 14-70). The items : ‘I cautiously avoid injury from the used needles’(4.92$\pm$0.33), ‘I always wash my hands if there has been contact with the patient's blood’(4.91$\pm$0.34), and ‘I always disposed of used needles in the appropriate collector’(4.89$\pm$0.42) showed the highest performance. However ‘I always dispose of used needles after recapping them’(2.19$\pm$1.39) and ‘I always use protection goggles when in danger of contamination’(2.19$\pm$1.20) showed low performance level. 4. The highest average score for universal precautions performance was shown among the second year students in 3-year nursing college (54.19$\pm$6.92) between the groups. It showed that the level of the universal precautions performance was higher for those who had education on university precautions prior to performance of the universal precautions than for those without any prior education. 5. The percentage of students who reported the experience of direct contact with patients' blood and/or body fluids was 42.30%. The experience of direct contact with blood and/or body fluids of the educational group was significantly higher than those were not educated. 6. The most frequent cause of the direct contact was ‘needle pricking and/or skin cut’(63.04%). The most frequent substance with which the students contact was ‘blood’(59.85%). The majority of the sample had answered that the mode of contamination was ‘unknown’(63.54%). The majority of the sample answered that strategies used after contamination included ‘washing with soap’(33.61%). Reviewing the chart of patients or asking other health professionals(28.85%). 7. The number of students who had the experience of a needle stick and/or skin cut was 145(28.16%). The clinical practice places where the incidents occurred were mainly in the internal medicine unit (45.07%) and the surgical unit (31.92%) followed by the intensive care unit and the emergency unit in order. The experience of a needle stick and/or skin cut happened during on intra-muscular injection 47.34% and intravenous injection 21.81%. The causes of the needle stick and/or skin cut were ‘putting the needle cap back on 77(35.81%)’. The number of students who took an appropriate post management blood test and/or vaccination was 27(18.62%). 8. The Pearson Correlation Coefficient between the knowledge of universal precautions and performance of universal precautions in practice showed a positive correlation.

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Compensation of Error in Noninvasive Blood Pressure Measurement System Using Optical Sensor (광학 센서를 이용한 비관혈적 혈압 측정의 오차 보정)

  • Ko, J.I.;Jeong, I.C.;Lee, D.H.;Park, S.W.;Hwang, S.O.;Park, S.M.;Kim, G.Y.;Joo, H.S.;Yoon, H.R.
    • Journal of Biomedical Engineering Research
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    • v.28 no.2
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    • pp.178-186
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    • 2007
  • This study is attempted to correct an error of electronic blood pressure meter with an optical sensor. In general, for a hospitalized patient, ECG, blood pressure, oxygen saturation, and respiration are basically measured to monitor the patient's condition. Opening of a blood vessel after it is occluded by pressurizing the cuff influences the blood flow of peripheral blood vessels as well as oscillation changes in the cuff. Blood vessels are occluded and peripheral blood flow disappears at cuff pressure above the examinee's blood pressure, while blood vessels are opened and peripheral blood flow appears again at cuff pressure under the examinee's blood pressure. Then Disappear-Appear Point Length(DAPL) of peripheral blood flow can be judged with the signal of peripheral blood flow, thus is available as a factor of error correction for electronic blood pressure meter. Also, systolic or diastolic blood pressure can be corrected with Appear-Point-Pressure(APP) of cuff pressure at a point where blood flow occurs and Appear-Maximum Pressure(AMP) of cuff pressure at the maximum amplitude point of peripheral blood flow after peripheral blood flow appears again. For verification, 27 examinees were selected, and their blood value was obtained through experimental procedure of 4 stages including induction of blood pressure change. The examinees were divided into two groups of experimental group and control group, regression analysis was conducted for experimental group, and correction of a blood pressure error was verified with optical signal by applying the regression equation calculated in experimental group to control group. As an experimental result, mean of the whole measurement errors was 5mmHg or more, which did not meet the standard fur blood pressure meter. As a result of correcting blood pressure measurements with data of DAPL, APP, and AMP as drawn out of PPG signal, systolic blood pressure, mean blood pressure, and diastolic blood pressure were $-0.6{\pm}4.4mmHg,\;-1.0{\pm}3.9mmHg$ and $-1.3{\pm}5.4mmHg$, respectively, indicating that mean of the whole measurement errors was greatly improved, and standard deviation was decreased.

The Use of Inappropriate Antibiotics in Patients Admitted to Intensive Care Units with Nursing Home-Acquired Pneumonia at a Korean Teaching Hospital

  • Kim, Deok Hee;Kim, Ha Jeong;Koo, Hae-Won;Bae, Won;Park, So-Hee;Koo, Hyeon-Kyoung;Park, Hye Kyeong;Lee, Sung-Soon;Kang, Hyung Koo
    • Tuberculosis and Respiratory Diseases
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    • v.83 no.1
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    • pp.81-88
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    • 2020
  • Background: Use of appropriate antibiotics for the treatment of pneumonia is integral in patients admitted to intensive care units (ICUs). Although it is recommended that empirical treatment regimens should be based on the local distribution of pathogens in patients with suspected hospital-acquired pneumonia, few studies observe patients admitted to ICUs with nursing home-acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER). Methods: We performed a retrospective cohort study of 83 pneumonia patients with confirmed causative bacteria admitted to ICUs via ER March 2015-May 2017. We compared clinical parameters, between patients who received appropriate or inappropriate antibiotics using the Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests. We investigated independent factors associated with inappropriate antibiotic use in patients using multivariate logistic regression. Results: Among 83 patients, 30 patients (36.1%) received inappropriate antibiotics. NHAP patients were more frequently treated with inappropriate antibiotics than with appropriate antibiotics (47.2% vs. 96.7%, p<0.001). Methicillin-resistant Staphylococcus aureus was more frequently isolated from individuals in the inappropriate antibiotics-treated group than in the appropriate antibiotics-treated group (7.5% vs. 70.0%, p<0.001). In multivariate analysis, NHAP was independently associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via ER. Conclusion: NHAP is a risk factor associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the ER.

Correlation between Self-Evaluation Factor, Satisfaction, Utilization Frequency and Academic Achievement in Cyber Anatomical Education according to Major (전공에 따른 해부학 가상강의의 자기평가요인, 가상강의실 활용도, 학업성취도 간의 상관관계 비교)

  • Kim, Kwang-Hwan;Kim, Jee-Hee;Lee, Young-Il;Park, Jeong-Hyun
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.12 no.1
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    • pp.281-287
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    • 2011
  • In anatomical education, cyber class has been studied as a strong strategy coincided with academic characterestics. In the present study, we investigated the correlation between self-evaluation factors, use of cyber classroom and academic achievement of health allied undergraduate students according to application of cyber class in the anatomical education. The subjects of study were totally 231 students who were majored in nursing science (n=143) and sports science (n=88) in last 3 years (2007-2009). Based on frequency of log-in, survey and grade of score, we analyzed correlation of their factors and their scores using frequency analysis, T-test and analysis of variance. Regardless of their major, most of students gave high scores in all of self-evaluation factors, convinience of cyber classroom, suitability of assignment. The frequency of log-in correlated highly with academic achievement(r=0.246, p<0.01, nursing science; r=0.234, p<0.05 sports medicine). The academic achievement also had a high correlation of 0.218(p<0.01) with the level of difficulty in nursing science students, 0.499(p<0.05) with the levels of satisfaction difficulty and interest. in sports science students. This study suggested that cyber class was very useful and would be a promising strategy in anatomical education.

Effects of Simulation-based Education focusing on Cardiopulmonary Resuscitation on Attitude, Self-efficacy and Satisfaction of the Elderly in Rural Community (시뮬레이션 기반 심폐소생술교육이 노인의 태도, 자기 효능감, 만족도에 미치는 효과)

  • Yoo, Je-Bog;Jeong, Jeong-Hee;Bang, Sul-Yeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.3
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    • pp.460-468
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    • 2017
  • The purpose of this study was to compare the effects of class-based and simulation-based CPR education for the rural elderly on their attitudes toward CPR, self-efficacy, and satisfaction. Using a quasi-experimental design with a nonequivalent control group, this study used a pretest-posttest method with a sample of 43 elderly people aged 65 or older in rural areas. The twenty-two elderly people in the control group received class-based CPR education, while the experimental group underwent both class-based and simulation-based education. Both groups were given surveys to complete before and after the education. The statistical analysis was based on the $X^2$-test, Fisher's exact test, paired t-test, and ANCOVA. The study found no significant differences between the two groups in terms of their attitudes (F=0.89, p=.353). However, statistical differences were found in the self-efficacy (F=5.54, p=.025) and satisfaction (F=4.66, p=.039) between the two groups. This study provides the baseline data indicating that the education methods implemented in this study were effective for the elderly living in rural areas. Thus, it is necessary to make efforts to ensure that the elderly are able to manage emergency situations by boosting their CPR self-efficacy and educational satisfaction through simulation-based education.

Effect of the Information Providing Program Provided by Operating Room Nurses on Anxiety and Self-Efficacy of Arteriovenous Fistula and Angioplasty Patients (수술실 간호사의 정보제공프로그램이 동정맥루 및 혈관성형술 환자의 불안과 자기효능감에 미치는 효과)

  • Lee, Hea-Won;Park, Sung-Ju
    • Journal of Digital Convergence
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    • v.18 no.2
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    • pp.447-453
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    • 2020
  • This study used a nonequivalent control group pretest-posttest design to develop an information provision program for arteriovenous fistula and angioplasty patients and to examine the effects of the information provision program offered by operating room nurses. The research subjects were selected trough convenience sampling who had come to hospitals to have an arteriovenous fistula and angioplasty surgery, and an experimental group and a control group of 40 persons. The information provision program consisted of two sessions, each conducted on the day of surgery and after surgery. The content included surgery information, pain management after surgery, management of dialysis blood vessels, how to handle emergency, and management of complications. The results of the study showed that the experimental group, which was offered an information provision program by nurses, a decrease in trait and state anxiety and an increase in self-efficacy on a statistically significant level. In conclusion, the information provision program provided by operating room nurses helped to reduce anxiety in arteriovenous fistula and angioplasty patients and increase their self-efficacy. This will improve end-stage renal disease patients' self-management ability after surgery, and thus, contribute to improving the prevention of complications and the level of self-nursing care.

The Evaluation of the Korean Advance Directives (K-AD) (한국형 사전의료의향서 평가)

  • Kim, KiSook;Kim, Shinmi;Hong, Sunwoo;Kim, JinShil
    • Journal of Hospice and Palliative Care
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    • v.19 no.2
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    • pp.109-118
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    • 2016
  • The purpose of this study was to evaluate Korean advance directives (K-AD) by examining the degree of adults' acceptance and reliability of the directive itself. Methods: Survey was performed with 181 adults aged 20 or older who were recruited from three regions. A questionnaire used to examine the participants' acceptance of their K-AD in terms of visual analogue scale score of complexity, difficulty, necessity, satisfaction, recommendation. Then, a retest was carried out by asking participants to write up a K-AD again to confirm the reliability of the directives. Results: On a scale of 100, the average acceptance score was 70 or above, which represents rather high level of acceptance in all five categories. The test-retest reliability kappa values ranged from 0.592 to 0.950, and the conformity degree was moderate or high. Regarding K-AD components such as values, treatment preference, proxy appointment, differences among age groups were observed in each component. Conclusion: The results of this study suggest that K-AD is a feasible instrument to analyze its acceptability and reliability for adult population. K-AD could be utilized to help people make their own decision on their end-of-life care. Further studies are needed to confirm this study results and promote widespread use of K-AD.

Predictive Factors for City Dwellers' Attitudes toward Death with Dignity (일개 도시주민의 품위 있는 죽음 태도에 대한 예측 요인)

  • Jo, Kae Hwa;An, Gyeong Ju;Kim, Gyun Moo;Kim, Yeon Ja
    • Journal of Hospice and Palliative Care
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    • v.15 no.4
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    • pp.193-204
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    • 2012
  • Purpose: This correlation study was performed to examine Korean adults' perceptions and attitudes towards death with dignity and the withdrawal of life sustaining treatment and to identify factors that predict their attitude towards death with dignity. Methods: The study was conducted using convenience sampling of 291 adults from three towns of a metropolitan city in Korea. Data were collected using structured questionnaires which surveyed people's perception about and attitudes towards withdrawal of life sustaining treatment and scaled their attitude towards death with dignity. Data were analyzed by using descriptive statistics, Pearson correlation coefficients and multiple regression. Results: The attitude towards the withdrawal of life sustaining treatment and death with dignity showed a significant positive correlation (r=0.49, P<0.001). For attitudes towards death with dignity, significant predictors were attitudes towards the withdrawal of life sustaining treatment, age, religion, a proper withdrawal process and advanced medical directives, which explained 49.3% of total variance. Conclusion: The results of this study may contribute to development of a new medical decision-making system including nurses' appropriate roles in the process of withdrawing life sustaining treatment and advanced medical directives.