• 제목/요약/키워드: General Hospital Out-patient

검색결과 383건 처리시간 0.029초

한국 병원 영양실의 환자 영양 교육 실행 현황에 관한 실태조사 (Assessment of the Dietary Consultation and Patient Education Practices in the Hospital Dietetics)

  • 옥혜운
    • Journal of Nutrition and Health
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    • 제13권1호
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    • pp.9-14
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    • 1980
  • A total of 35 hospitals throughout Korea were surveyed for the assessment of the educational function of dietitians. The current situation and the depth of practices were diagnosed in such areas as: 1. The continuing education for the hospital dietitians 2. The characteristics of patient consultation performed by the hospital dietitians 3. Systems and methods of patient instruction practiced by the dietitians, and 4. Prospectives in establishing the nutrition education center for the in-and out-patients. The major findings are: 1. Approximately half of the hospital dietitians feel positive about the practicality of their college education for the job. Extremely small number of them are on any kind of continuing education program 2) The monthly average of only 20 patients at one hospital receive diet consultation or nutrition education service from dietitians. The 50% of the consultation cases is taken up by the patients with diabetes and various circulartory diseases followed by the tube feedings, liver and renal diseases with less frequencies 3) Not even a single hospital has an office for the diet consultation and nutrition education for the in-or out-patients. Very few hospital dietetics have educational aids and/or any feedback system to evaluate the effect of the consultation. Charting is not practiced by most dietitians leaving no record of their contributions to the patient care. 4) Although the necessity of the nutrition education center in the hospital is strong1y recognized among dietitians the progress has been blocked by such obstacles as the poor system in the hospital administration in general, short in funds, lack of preparation in the dietetics and the lack of recognition both by the hospital administration and by the dietitian themselves.

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일반외과 환자의 환자위험지수에 따른 수술창상감염 발생률 (Surgical Site Infection Rates according to Patient Risk Index after General Surgery)

  • 이혜령
    • 한국직업건강간호학회지
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    • 제11권1호
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    • pp.44-51
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    • 2002
  • Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

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원발성 무월경 여성에서 관찰된 Pseudoisodicentric X 염색체 (Pseudoisodicentric X chromosome in a female with primary amenorrhea)

  • 박상희;심성한;진미욱;강수진;배성미;손수민;차동현;윤태기;조정현
    • Journal of Genetic Medicine
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    • 제5권1호
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    • pp.61-64
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    • 2008
  • 24세의 무월경을 주소로 내원한 여성에게서 세포유전학적 검사를 시행하였다. GTG-분염법 결과, 환자의 핵형이 46,X,der(X)로 관찰되어 LSI Kallmann(KAL) 형광소식자[probes for Xp22.3 (KAL)과 CEP(X) for control]로 FISH 분석을 시행하였다. 비정상 X 염색체에서는 KAL (Xp22.3)에 대한 형광이 보이지 않았고, CEP(X)에 대한 형광이 두 개씩 관찰되었다. 간기세포 FISH 분석 결과, CEP(X) 형광소식자에 대해 분석한 세포의 90%에서 세 개의 형광이, 10%의 세포에서 하나의 형광이 관찰되어 두가지 cell line이 혼재되어 있는 모자이시즘을 확인하였다. 이들 결과들을 통해 환자의 핵형이 45,X/46,X,psu idic(X)(p22.1)이며, 이는 Xqter${\rightarrow}$Xp22.1 부분은 중복되어 있고, Xpter${\rightarrow}$Xp22.1 부분은 결실된 상태로 터너 증후군의 변형된 형태임을 판명하였다. Idic(X)와 낮은 비율의 모자이시즘을 확인하는데 CEP(X) 형광소식자로 FISH를 시행하는 것이 유용하였다.

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수정에 실패한 인간 난자에 있어서의 염색체의 수의 이상 (Chromosomal Abnormalities in Human Oocytes Fail to Fertilize after Insemination In Vitro)

  • 손원영;이경아;박상희;한세열;윤태기;정형민;곽인평;차광열
    • Clinical and Experimental Reproductive Medicine
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    • 제22권2호
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    • pp.203-210
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    • 1995
  • Many oocytes fail to fertilize and cleave in vitro and many embryos transferred back to uterus fail to implant or maintain implantation. Chromosomal abnormalities in the male and female gametes may contribute to this loss. The higher incidence of meiotic chromosomal abnormalities bas been found in oocytes than in sperm. The wide range of incidence of chromosomal abnormalities in unfertilized oocytes has been reported in human IVF program (26-63%). However, factors affecting chromosomal abnormalities are not well understood. The present study has been conducted to investigate effects of the method for ovarian hyperstimulation, women's age, and the number of oocytes retrieved per patients on the incidence of numerical chromosomal abnormalities. Five hundred eighty four unfertilized metaphase II oocytes were subjected to chromosomal analysis. Included unfertilized oocytes were from 220 patients (mean $age=32.7{\pm}3.0$) and three hundred thirty oocytes were legible for analysis. Two hundred fourty five oocytes out of 330 (73.3%) were normal, while 38 (11.5%) were hyperploidy, 35 (10.6%) were hypoploidy, and 12 (3.6%) were diploidy. Significant difference in chromosomal abnormalities was not found between two patient groups stimulated by follicular stimulating hormone/human menopausal gonadotrophin (FSH/HMG) (25.9%) and gonadotrophin-releasing hormone agonist/follicular stimulating hormone/human menopausal gonadotrophin (GnRHa/FSH/HMG) (28%). There was a tendency of increasing chromosomal abnormalities in unfertilized oocytes from older patients (<30 yrs: 20.3%, 30-34yrs: 26.9%, >34 yrs: 35.3%). The number of oocytes retrieved per patient had no effect the incidence of chromosomal abnormalities (1-5: 31. 4%, 6-10: 29.8%, 11-15: 28.6%, > 15: 16.5%). These results from the present study suggest that the chromosomal abnormalities observed in the unfertilized oocytes has not affected by the stimulation methods, patient's age, and the number of oocytes retrieved per patients.

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전자의무기록(EMR)의 활용과 환자정보보호 (EMR System and Patient Medical Information Protection)

  • 전영주
    • 보건의료산업학회지
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    • 제7권3호
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    • pp.213-224
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    • 2013
  • The purpose of this study is to find out the most successful way for the protection of medical information focusing on the electronic medical record(EMR). In this study, every aspect of the EMR is reviewed in terms of the hospital management. In particular, definitions, major functions, strengths and weaknesses of the EMR are considered. This study also examines the general development of the EMR as well as the current situation of applying the EMR. Important issues such as the protection of patient Medical information, informed consent, and the customer-oriented hospital information system are discussed and interpreted in light of the introduction of the EMR into the area of the hospital management. Finally, in this paper Protection of medical information by major Issues on Patient medical information.

The Algorithm-Oriented Management of Nasal Bone Fracture according to Stranc's Classification System

  • Park, Ki-Sung;Kim, Seung-Soo;Lee, Wu-Seop;Yang, Wan-Suk
    • 대한두개안면성형외과학회지
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    • 제18권2호
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    • pp.97-104
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    • 2017
  • Background: Nasal bone fracture is one of the most common facial bone fracture types, and the surgical results exert a strong influence on the facial contour and patient satisfaction. Preventing secondary deformity and restoring the original bone state are the major goals of surgeons managing nasal bone fracture patients. In this study, a treatment algorithm was established by applying the modified open reduction technique and postoperative care for several years. Methods: This article is a retrospective chart review of 417 patients who had been received surgical treatment from 2014 to 2015. Using prepared questionnaires and visual analogue scale, several components (postoperative nasal contour; degree of pain; minor complications like dry mouth, sleep disturbance, swallowing difficulty, conversation difficulty, and headache; and degree of patient satisfaction) were evaluated. Results: The average scores for the postoperative nasal contour given by three experts, and the degree of patient satisfaction, were within the "satisfied" (4) to "very satisfied" (5) range (4.5, 4.6, 4.5, and 4.2, respectively). The postoperative degree of pain was sufficiently low that the patients needed only the minimum dose of painkiller. The scores for the minor complications (dry mouth, sleep disturbance, swallowing difficulty, conversation difficulty, headache) were relatively low (36.4, 40.8, 65.2, 32.3, and 34 out of the maximum score of 100, respectively). Conclusion: Satisfactory results were obtained through the algorithm-oriented management of nasal bone fracture. The degree of postoperative pain and minor complications were considerably low, and the degree of satisfaction with the nasal contour was high.

수술 후 통증조절 목적으로 펜타닐과 병용되는 네포팜 vs. 케토롤락의 사용현황 (Concurrent Use of Nefopam vs. Ketorolac with Opioid Analgesic for Post-operative Pain Management)

  • 김윤희;김영원;최경숙;이정화;이은숙;김승연;최영록;김은경
    • 한국임상약학회지
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    • 제28권4호
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    • pp.279-284
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    • 2018
  • Objective: To compare the analgesic effects and adverse drug reactions (ADRs) of fentanyl intravenous patient-controlled analgesia (ivPCA) with nefopam, a centrally acting analgesic agent with demonstrated opioid sparing activity, as compared to ketorolac in a tertiary teaching hospital. Methods: A retrospective evaluation of electronic medical records was conducted on patient records including either nefopam or ketorolac with opioid ivPCA for post-operative pain management in general surgery department from January to December 2014. The status of pain control and ADRs were collected. Results: Out of 6,330 general surgery cases, nefopam was given in 153 prescriptions (6.9%) and ketorolac in 81 prescriptions (3.6%). The level of pain control was not different between two groups (70.9% vs. 75.3%; p = 0.51), but ADRs were more frequently reported in nefopam group (9.8% vs. 2.5%; p < 0.05). New ADRs of hot flushes (n = 1) and paresthesia in hands (n = 1) were reported in nefopam group and they were unlisted in the approved package insert. No serious ADRs were reported in both groups. Conclusion: Our findings presented that nefopam showed a similar analgesic effect and higher ADR rates compared to ketorolac as an adjuvant to fentanyl iv PCA for post-operative pain management in general surgery patients in South Korea.

견부통 환자에 대한 물리치료방법의 적용 시간을 중심으로 한 기술적 연구 (Physical Therapy Session Duration in patients with Shoulder pain: Descriptive Research)

  • 김선엽;채정병;권재확
    • 대한물리치료과학회지
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    • 제9권4호
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    • pp.119-130
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    • 2002
  • Objective: The purpose of this research was to use data for furnish quality physical therapy service. The research subjects were admitted shoulder pain patients treated with physical therapy that was to grasp physical therapy method as distinguishing application time. Subject: Total number of distributed questionnaire was 563 persons that was to utilized physical therapy room of 56th medical institution and distributed it to each physical therapist in charge. Method: The research used questionnaire in order to research itemized treatment application time that is according to physical therapy method to applicated with shoulder pain patient. The research contents is to received shoulder pain diagnosis period, total duration of utilizing physical therapy room, the number of times per week to used physical therapy room, etc. And we had physical therapist recording the time of application physical therapy method come under the items. Result: The average treatment time was 59.2 minutes at all patients. During this time, 39.7 min was modality treatment. Active movement treatment was only 7.1 min. Total treatment time was longest in general hospital at 64.9 min, it was shortest in clinical hospital at 53.3 min. Treatment time was difference as hospital scale(p<0.001). Active movement treatment time was longest in general hospital at 11.5 min. The average treatment time was 4.5 min in clinical hospital. Therefore, it was related to hospital scale(p<0.05). The average of manual therapy time by physical therapist was 7.5 min. General hospital was linger at 8.6 min than clinical hospital at 6.7 min(p<0.05). Patient of 90.2 % were treated to hot pack, ultra-sound treatment was next as 50.1%. Active strengthening exercise was most carrying out of the active treatment as 25.4 %. Active sensorimotor exercise was practiced only 28 persons of 5.0 %. Most joint mobilization (38.4 %) was used of the passive manual therapy items, next to soft tissue mobilization (33.0 %), and next to manual distraction therapy(14.0 %).

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국소마취 수술환자의 불편감에 관한 연구 - 도구개발을 중심으로 - (A Study of Perceived Discomfort of The Patients Under Local Anesthesia - Centering Around the Development of Measures -)

  • 김경숙;김미자;박순미;백순영;이양숙;배상도;최정훈
    • 한국의료질향상학회지
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    • 제7권1호
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    • pp.6-17
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    • 2000
  • Background : This study was attempted to provide a basic information necessary for the development of measures evaluating perceived discomfort of the patients under local anesthesia and the developments of nursing intervention and nursing standard. Method : The study subjects were a convenience sample of 100 surgical patients under local anesthesia. The researcher visited the patients directly and explained the purpose of the study to them. Then they were asked to fill out questionnaires which were developed and structured by the researcher, under their prior permission. Out patient's data were collected at recovery room after operation. Results : Factor analysis on measures evaluating the patients under local anesthesia showed that the measures consisted of eight factors including "explanation", "humane treatment", "motion limitation", "pain", "no togetherness", "waiting", "the environment of operating room", and "unkindness". When analyzing each of the factors regarding their degree of contribution to perceived discomfort, it was found that "waiting" was highest in terms of the degree. According to general chara-cteristics of the sampled patients, the factor of "explanation" contributed to perceived discomfort more in male patients than female ones. Regarding parts of medical examination, the patients of otorhinolaryngology felt perceived discomfort most because of the factor of "pain". Conclusion : To relieve perceived discomfort the patients under local anesthesia require providing individually systematized nursing services which can reduce perceived discomfort according to each of the factors. In doing so, an unlimited attention and much effort should be given to realize CQI reaching the dimension of increase in comfort as well as decrease perceived discomfort.

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개인정보 보호를 위한 의료영상 복사발급 지침에 대한 고찰 (Study for Guideline of CD copy Issue to Secure Personal Information)

  • 이종웅;강지연;김은정
    • 대한디지털의료영상학회논문지
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    • 제10권2호
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    • pp.11-16
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    • 2008
  • Images of medical treatment on PACS environment are digitized and they make saving and transmission of patient's information easy with CD format causing increase of patients transfer rate between hospital and data transmission as well. Figuring out the configuration of confining status of copied images of medical treatment with CD format and present the appropriate way of identification for personal information. 20 general hospital over 500 beds which are utilizing PACS currently. Questionnaire investigation focusing on PACS operation center and it's management people. In accordance with the law of securing personal information of public organizations, it says "Anyone who wants to see his or her information via representative he or she needs to make a letter of attorney and turn in this to the president of it's possessing facility" in the article 16. Based on the investigation of general hospital for CD copy issue status near metropolitan area, 8 out of 20, were issuing CD copy through personal identification process(the person oneself and representative) and 10 general hospital were doing by getting signature of receiptor only without identification of the person oneself and 2 general hospital confirmation process is not at all. By the law of securing personal information of public organization, article 16, confirmation process is supposed to mandate lawfully with a letter of attorney when there is any request of reading and/or copies of one's information. But in reality, there were no consistent rules on reading, the process and coverage of copy issue, rejection coverage of copy issue of CD copy in each general hospital PACS operation center. Therefore there is a big need for consolidated format which is applicable by law when the representative requests to issue of CD copy that is storing medical treatment images. By issue through this consolidated format, securing medical information of individual and systemic operation and management will be valid and effective.

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