• 임상간호연구
• /
• 제25권3호
• /
• pp.237-250
• /
• 2019

Purpose: The aim of this study was to investigate the satisfaction of newly graduated nurses with educational programs and their experiences in role transition. Methods: Data were collected from November 1 to December 15, 2018 and 483 new graduate nurses working at 15 tertiary hospitals and 10 general hospitals participated. For data collection, self-report questionnaires including the Casey-Fink Graduate Nurse Experience Survey tool and satisfaction with education were used. Data were analyzed using descriptive statistics, t-test, and one-way analysis of variance. Results: Satisfaction with education ranged from 3.09 to 3.27, and satisfaction with preceptors was 3.45(maximum 4). The skill that new nurses ranked as most difficult during the first 3 months was charting/documentation, and throughout a whole year, the top 4 difficult skills were cardiopulmonary resuscitation/emergency response, ventilator care, end-of-life care, and prioritization/time management. In comfort/confidence, new graduates felt most comfortable with support and least comfortable with patient safety. More than 50 percent of new graduates experienced stress during role transition, and the most frequently experienced stressors were related to job performance and personal life. Levels of satisfaction with education and comfort/confidence differed according to the hospital type and number of preceptors for new nurses. Conclusion: In order to facilitate the transition of new graduate nurses to professional nurse, an extended period of education, systematic and standardized transition programs, and continuous support during the first year of practice are required.

• 대한두개안면성형외과학회지
• /
• 제12권1호
• /
• pp.33-36
• /
• 2011

Background: In a frontal sinus reconstruction, the literature primarily recommends a surgical approach for definite treatment with the exception of for anterior wall fractures with no dislocation. Many studies have assessed a range of methods for the reduction of frontal sinus fractures. This paper presents a case, in whom the anterior wall of the frontal sinus was reconstructed using an outer table calvarial bone graft in an en bloc manner. Patient and methods: A 36-year-old male visited the emergency room with a heavy injury to the forehead. He was diagnosed with fractures of the anterior and posterior wall of the frontal sinus. The neurosurgeon removed the fractured area and repaired the meninges. Afterwards, cranialization was performed and the opening of the nasofrontal duct was obstructed. After fixing the removed bone to its original location, all fragments of fractured anterior wall were purged out and the anterior wall reconstructed using an en bloc calvarial bone graft. Results: In the post-operative 8 months period, there were no complications, the round contour of the forehead was expressed well and the patient was satisfied with the result. Conclusion: There are many methods for reconstructing the anterior wall of the frontal sinus. On the other hand, in cases of large fracture sites with many fractured bone fragments, en bloc harvesting of the outer table calvarial bone could be a better choice than making use of only plates and screws because this method shows a good results in terms of aesthetics with a low complication rate.

• Journal of Yeungnam Medical Science
• /
• 제26권1호
• /
• pp.24-29
• /
• 2009

결과적으로 영남대학교 의과대학에서는 3학년 학생을 대상으로 2008년도에 처음으로 해외임상실습을 시행하게 되어 2년간 새로운 경험을 하게 되었으며 외국의 병원까지도 교류의 기회를 넓히게 되었다. 향후에는 좀 더 영역을 넓히고 전 학생이 참가할 수 있는 프로그램을 개발하여 글로벌 의사양성이라는 교육목표를 완수하려는 지속적인 관심과 노력이 필요할 것으로 생각한다.

• Journal of Trauma and Injury
• /
• 제34권3호
• /
• pp.177-182
• /
• 2021

Purpose: Traumatic pancreatic injuries are rare, but their diagnosis and management are challenging. The aim of this study was to evaluate and report our experiences with the management of pancreatic injuries. Methods: We identified all adult patients (age >15) with pancreatic injuries from our trauma registry over a 7-year period. Data related to patients' demographics, diagnoses, operative information, complications, and hospital course were abstracted from the registry and medical records. Results: A total of 45 patients were evaluated. Most patients had blunt trauma (89%) and 21 patients (47%) had pancreatic injuries of grade 3 or higher. Twenty-eight patients (62%) underwent laparotomy and 17 (38%) received nonoperative management (NOM). The overall in-hospital mortality rate was 24% (n=11), and only one patient died after NOM (due to a severe traumatic brain injury). Twenty-two patients (79%) underwent emergency laparotomy and six (21%) underwent delayed laparotomy. A drainage procedure was performed in 12 patients (43%), and pancreatectomy was performed in 16 patients (57%) (distal pancreatectomy [DP], n=8; DP with spleen preservation, n=5; pancreaticoduodenectomy, n=2; total pancreatectomy, n=1). Fourteen (31%) pancreas-specific complications occurred, and all complications were successfully managed without surgery. Solid organ injuries (n=14) were the most common type of associated abdominal injury (Abbreviated Injury Scale ≥3). Conclusions: For traumatic pancreatic injuries, an appropriate treatment method should be considered after evaluation of the accompanying injury and the patient's hemodynamic status. NOM can be performed without mortality in appropriately selected cases.

• 대한소화기학회지
• /
• 제72권6호
• /
• pp.304-307
• /
• 2018

Gastric tuberculosis accounts for approximately 2% of all cases of gastrointestinal tuberculosis. Diagnosis of gastric tuberculosis is challenging because it can present with various clinical, endoscopic, and radiologic features. Tuberculosis manifesting as a gastric subepithelial tumor is exceedingly rare; only several dozen cases have been reported. A 30-year-old male visited emergency room of our hospital with hematemesis and melena. Abdominal CT revealed a 2.5 cm mass in the gastric antrum, and endoscopy revealed a subepithelial mass with a visible vessel at its center on gastric antrum. Primary gastric tuberculosis was diagnosed by surgical wedge resection. We report a rare case of gastric tuberculosis mimicking a subepithelial tumor with acute gastric ulcer bleeding.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제25권1호
• /
• pp.17-27
• /
• 2019

Purpose: Clinical laboratory in hospital has taken a great role in protection of chronic disease. as well as diagnosis and treatment, And laboratory layout has been considered by the management and laboratory section more than the function and workflow. Methods: So this study figures out the workflows of laboratory sections in the recently upgraded Laboratory Medicine, and searches the functional relationships and spatial block diagram between each disciplines as follows. Literature review and expert adviser has been conducted. Results: 1) Laboratory type of Laboratory Medicine is divided into routine and specialized laboratory according to the workflow by automated or specialized test. 2) The general workflow consists of specimen collection, specimen classification, test by discipline, test report, and specimen disposal. 3) Though the function of each laboratory section is very complicated and specific, the characteristics and the workflow can be shown in detail by each lab through [Figure 4], [Figure 5], [Figure 6], [Figure 7], and [Figure 8]. 4) Functional relationship diagram can be displayed to the adjacency and relation between each laboratory and support spaces. 5) The spatial block diagram could be presented as shown in [Figure 10], in which the emergency lab lay in front side, routine lab in the central open area, and specialized lab in the behind side. Implications: This study can be used as a useful data in planning and designing a Laboratory Medicine Department.

• 한국컴퓨터정보학회논문지
• /
• 제24권3호
• /
• pp.175-179
• /
• 2019

This study is a descriptive research of paramedic students who could be exposed to blood and body fluids during the clinical practicum to analyze the risk factors. From June 1 to June 30, 2018, 172 paramedic students who attended the University in Jeolla-do region were analyzed. The collected data were analyzed by using the SPSS WIN 21.0 program. The general characteristics of subjects, the exposure level of blood and body fluids, and etc were obtained for frequency and percentage analysis. The study found that 72.7 percent of students had experience to blood or body fluids exposure during the clinical practicum. Except for any needle injury, 70.4 percent of student were exposed to blood or body fluids. 28.8 percent of them which was the highest percentage of injection injury were exposed during the venous blood draw. 36.5 percent of exposure were related to wound dressings which was the highest percentage related to clinical procedures. 71.2 percent of students mentioned that they did not report this exposure because 68.5 percent students thought that it has no danger. According to the survey on hepatitis B, 50.6% of students had antibodies, but 31.8 percent of students did not confirm that the antibodies were formed. Even though paramedic students do practical training in a hazardous environment with repeated exposure to blood and body fluids due to the nature of job characteristics, the systemic infection control education program is insufficient. In order to prevent exposure and to protect paramedic students who do practical training with patients, it is necessary to make more systematic and active efforts in the continuous monitoring and the preventive education.

• Pediatric Infection and Vaccine
• /
• 제25권3호
• /
• pp.170-175
• /
• 2018

방선균은 피부, 구강, 위장관 및 하부 여성 생식기에 정상균무리로 존재하며 증식속도가 느린 사상체의 형태를 한 혐기 그람 양성균이다. 방선균증은 방선균 감염에 의한 질환으로 대부분 경부 안면 감염증, 복부, 골반 감염증, 그리고 흉부 감염증의 임상 형태로 나타난다. 저자들은 급성 충수염으로 충수절제술을 받은 건강한 6세 남아에서 수술 후 조직검사에서 복부 방선균증을 진단하고 장기간 항생제 치료한 1예를 경험하고 보고하는 바이다. 복부 방선균증은 소아에서는 드문 질환이고 증상이 비특이적이며 균동정을 위한 배양검사가 까다로운 점이 있어 초기 진단이 잘 되지 않고 주로 임상 검체에서 특징적인 조직소견으로 진단되는 경우가 많다. 이를 통해 방선균의 특징을 이해하고 복통을 주소로 내원한 환자에서 정상균무리가 체내로 침입할 수 있는 선행 요인 등을 가진 경우 감별진단에 복부 방선균증도 염두에 두는 것이 바람직하겠다.

• 한국컴퓨터정보학회논문지
• /
• 제24권2호
• /
• pp.139-147
• /
• 2019

A false alarm, which is an incorrect report of an emergency, could trigger an unnecessary action. The predictive maintenance framework developed in our previous work has a feature whereby a machine alarm is triggered based on sensor data evaluation. The sensor data evaluator performs three essential evaluation steps. First, it evaluates each sensor data value based on its threshold (lower and upper bound) and labels the data value as "alarm" when the threshold is exceeded. Second, it calculates the duration of the occurrence of the alarm. Finally, in the third step, a domain expert is required to assess the results from the previous two steps and to determine, thereby, whether the alarm is true or false. There are drawbacks of the current evaluation method. It suffers from a high false-alarm ratio, and moreover, given the vast amount of sensor data to be assessed by the domain expert, the process of evaluation is prolonged and inefficient. In this paper, we propose a method for automatic false-alarm labeling that mimics how the domain expert determines false alarms. The domain expert determines false alarms by evaluating two critical factors, specifically the duration of alarm occurrence and identification of anomalies before or while the alarm occurs. In our proposed method, Hierarchical Temporal Memory (HTM) is utilized to detect anomalies. It is an unsupervised approach that is suitable to our main data characteristic, which is the lack of an example of the normal form of sensor data. The result shows that the technique is effective for automatic labeling of false alarms in sensor data.

• 디지털융복합연구
• /
• 제17권1호
• /
• pp.219-227
• /
• 2019

본 연구는 보건계열 학생을 대상으로 환자안전 지식과 환자안전 수행자신감을 파악하기 위해 수행되었다. 보건계열학생 349명이 참여하였고, 자료분석은 SPSS 21.0을 이용하여 분석하였다. 연구결과 환자안전지식 정답률은 평균 65.7%였다. 환자안전 수행자신감은 평균 $7.11{\pm}1.74$점이었으며 문항별로 살펴보면 환자확인이 높았으며 효과적 의사소통이 낮게 나타났다. 환자안전지식과 환자안전 수행자신감의 하부영역인 환자확인, 의사소통, 수술시술, 낙상, 환자안전사고보고는 양의 상관관계였고, 환자안전지식과 감염관리, 시설환경은 음의 상관관계였다. 보건계열학생들에게 임상실습 전 환자안전에 대한 중요성을 높이고 안전한 임상실습이 수행될 수 있도록 환자안전교육프로그램을 개발하는 것이 필요하다.