• Journal of Korean Neurosurgical Society
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• v.49 no.1
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• pp.37-42
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• 2011

Objective: The author measured levels of fluoroscopic radiation exposure to the surgeon's body based on the different beam directions during kyphoplasty. Methods: This is an observational study. A series of 84 patients (96 vertebral bodies) were treated with kyphoplasty over one year. The patients were divided into four groups based on the horizontal and vertical directions of the X-Ray beams. We measured radiation exposure with the seven dosimetry badges which were worn by the surgeon in each group (total of 28 badges). Twenty-four procedures were measured in each group. Cumulative dose and dose rates were compared between groups. Results: Fluoroscopic radiation is received by the operator in real-time for approximately 50% (half) of the operation time. Thyroid protectors and lead aprons can block radiation almost completely. The largest dose was received in the chest irrespective of beam directions. The lowest level of radiation were received when X-ray tube was away from the surgeon and beneath the bed (dose rate of head, neck, chest, abdomen and knee: 0.2986, 0.2828, 0.9711, 0.8977, 0.8168 mSv, respectively). The radiation differences between each group were approximately 2.7-10 folds. Conclusion: When fluoroscopic guided-KP is performed, the X-Ray tube should be positioned on the opposite side of the operator and below the table, otherwise the received radiation to the surgeon's body would be 2.7-10 times higher than such condition.

• Journal of Korean Neurosurgical Society
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• v.45 no.3
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• pp.192-195
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• 2009

We present a case of an acute psoas muscle hematoma following percutaneous endoscopic lumbar discectomy. A 60-year-old female who presented with far lateral lumbar disc herniation underwent endoscopic discectomy on the right side at the L4-5 level. On the second postoperative day, the patient complained of severe right flank and leg pain and her blood pressure decreased. A computed tomography scan showed a large acute psoas muscle hematoma at right L4-5 level. The patient was transfused with packed red blood cells and placed at absolute bed rest. After observing the patient in intensive care, the severe flank and leg pain subsided, but the mild back pain persisted. Although percutaneous endoscopic lumbar discectomy is an effective minimally invasive surgical technique for the treatment of lumbar disc herniation, this case highlights the inherent risks of acute lumbar segmental vessel injury.

• Journal of Korean Academy of Nursing
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• v.39 no.2
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• pp.298-309
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• 2009

Purpose: To develop a web-based program on blood-borne infection control and to examine the effect of the newly developed program on perceived threat of diseases, knowledge, preventive health behaviors for blood-borne infections, and incidence rates of accidental needle sticks and other sharp object injuries in nurses. Methods: The program was developed through the processes of analysis, design, development, implementation, and evaluation. The research design involved a nonequivalent control group for pretest and posttest experiments. The setting was a 745-bed general hospital located in Korea. Results: The program was designed and developed after consulting previous studies. After development of the program was completed, it was evaluated and revised by a panel of experts. The total score for perceived threat of diseases, knowledge, preventive health behaviors in the experimental group was significantly higher compared to the control group (p<.05). The incidence rates for needle sticks and other sharp object injuries in the experimental group were significantly lower compared to the control group (p<.05). Conclusion: Application of a Web-based, blood-borne infection control program is effective, and can be expanded to other healthcare workers who also have a high risk of blood-borne infections.

• Child Health Nursing Research
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• v.4 no.2
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• pp.265-273
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• 1998

The purpose of this study was to identify the children's sleeping patterns, such as the sleeping hours and the nature of sleep disruptions following hospitalization and its accompanying factors. The data were collected from December, 1997 to March, 1998 using a questionnaire developed by researchers. The subjects were 76 children in a hospital. The results of this study were summarized as follows : 1. The average sleeping hours (sleep duration) at night were 10 hours and 10 minutes and 9 hours and 9 minutes before and after hospitalization respectively. There was a significant difference (p<0.01). The average sleeping hours in the day time were 1 hour 28 minutes and 2 hours and 26 minutes before and after hospitalization respectively. There was a significant difference(P<0.01). 2. The mean bed time(sleep onset) was 10: 22 pm and 10 : 28 pm before and after hospitalization respectively. There was no significant difference. 3. The mean hour of rising(sleep termination) was 7: 54 am 7 : 08 am before and after hospitalization respectively. There was a significant difference (p<0.01). 4. The mean number of sleep disruption was 0.72 and 1.94 before and after hospitalization respectively. There was a significant difference(P<0.01). The sleep disruptions were influenced by crying of other children(53.9%), lights(28.9), nursing procedures(18.4%), noise of TV(17.l%) and noise of visitors (15.8%).

• Archives of Reconstructive Microsurgery
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• v.9 no.1
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• pp.44-48
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• 2000

The advent of free bone flaps has made successful replacement of extensive areas of bone loss in the upper and lower extremities. The microvascular free bone flaps have faster healing without bony absorption or atrophy and can heal in the hostile environment of scarred bed or infection. Since the fibula free flap introduced by Taylor and colleague in 1975, it has been used extensively for skeletal reconstruction of extremities. In 1988, the folded vascularized fibula free flap was first described as a technique to reconstruct significant long bone defect of upper and lower extremities. During the same time, the fibular free flap has evolved to become most preferred choice of mandibular reconstruction. Up to present day, few reports have been made on the fibular free flap used for reconstruction of injured hand containing metacarpal bone and soft tissue defect. We present here our new and unique experiences with vascularized fibular osteocutaneous free flap as useful and satisfactory one for reconstruction of hand with composite defects.

• The Korean Journal of Health Service Management
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• v.11 no.4
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• pp.239-250
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• 2017

Objectives : The purpose of this study was to analyze the types of hospitals participating and the factors influencing comprehensive nursing service. Methods : Data were gathered from 231 hospitals offering the comprehensive nursing service in 2016. Collected data were analyzed using the multinomial logistic regression with the SPSS 24 version program. Results : First, factors influencing the types participating comprehensive nursing services were identified as hospital type, number of beds, medical doctor and, nurses per bed. Second, if all tertiary hospitals, general hospitals and hospitals participated in the service, approximately 122,022 ~ 166,274 nurses would be needed for the service. Conclusions : Hospitals providing the comprehensive nursing service will be expanded gradually. As such, thoughtful policy considerations are required to successfully establish services, such as improvement in hospitals, required nurse staffing level and demand and supply of nurses. Therefore, it is necessary to control the participation ratio of hospitals in consideration of the various circumstances.

• Physical Therapy Korea
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• v.17 no.2
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• pp.51-59
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• 2010

The Functional Independence Measure (FIM) is widely used to determine the dependency of activity of daily living in rehabilitation patients. The purposes of this study were to evaluate the unidimentionality of the FIM physical items and to analyze the validity of cross-functional levels in stroke survivors in Korea. Thirteen physical items of FIM were rated according to an ordinal scale of a 7-level classification. Two hundred and seventy-nine patients participated in the study (age range 18~92 years and 57% male). Six items-eating, bladder control, bowel control, transfer to and from the bed/wheelchair, transfer to and from the toilet, and bathing-showed misfits with the Rasch model. The most difficult item was 'bathing', the easiest item was 'bowel control'. Although there were several differences within functional levels, the hierarchical order of item measures was rather similar. 'Bathing' was the most difficult in high level patients (above 60), however 'stairs' was most difficult in the middle level (41~60) group. In the low level group (below 40), 'toileting' was the most difficult. In conclusion, the present study has shown several differences of item difficulty among functional levels. This result will be useful in planning interventions, and developing rehabilitation programs for stroke survivors.

• International Journal of Advanced Culture Technology
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• v.6 no.3
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• pp.211-215
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• 2018

Ventilator-associated pneumonia (VAP) is a lung infection that develops in patients receiving mechanical ventilation. VAP contributes to about 50% of hospital-acquired pneumonia in ICU settings. One of the recommendation of the Institute of for Healthcare Improvement ventilator bundle is HOB elevation. HOB elevation affects shearing forces and makes higher risk for pressure injury development. Pressure injury (PI) is localized damage to the skin over a bony prominence. PI prevention guidelines recommend that HOB positioning should be lower to reduce risk for PI development which contradicts VAP prevention guidelines for the HOB between 30 and 45 degrees for ICU patients. This presents a care dilemma and tension. The purpose of this study was to perform a secondary data analysis using cumulative electronic health record data in order to determine the association of HOB elevation with VAP and PI in ICU patients. A secondary data analysis was conducted to determine whether HOB elevation is associated with VAP and PI. HOB elevation was not likely to be associated with VAP prevention whereas it was likely to be related to PI development. This is somewhat contrary to popular data and publications. Prospective cohort study is desired to inform us in an evidence-based fashion what actually is optimal HOB elevation for ventilated patients in ICU settings.

• Journal of The Korea Institute of Healthcare Architecture
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• v.24 no.3
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• pp.7-15
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• 2018

Purpose: The purpose of this study is to suggest the improvement of the architectural planning of public hospitals by analyzing the contents of the architectural planning and the trend of the recent ward planning. Methods: The study method was the drawing analysis of the wards in the public hospitals where facilities were improved including the ward-related literature survey. The scope of the study was the general wards. Results: As a result of the study, the area composition of the ward area, the number of beds per nursing unit, the floorplan types, and the unit space planning which is included the room composition, the room size, the bed clearance areas, and the improvements of the nursing space were suggested. Implications: The result of this research would be useful as a reference to design nurse area in the wards.

• Journal of Korean Academy of Nursing Administration
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• v.18 no.2
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• pp.244-250
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• 2012

Purpose: The purpose of this study was to investigate the effect of a short message service intervention on adherence to maximal barrier precautions (MBP) and catheter-related blood stream infections. Method: The data were collected from March to September, 2008, at an 826-bed university-affiliated hospital in Daejeon. The study participants were 24 physicians who were inserting central catheters and 133 patients (control group 78 and intervention group 55) with central catheter insertions. The researcher sent the message (adherence to MBP and optimal recommendations) to each internal medicine doctor using the short message service (SMS) for cellular phones. Messages were sent monthly for 3 months. Data were analyzed by chi-square test and t-test using SPSS 12.0 windows program. Result: Adherence to maximal barrier precautions was significantly increased from 44.9% to 69.1% (p=.006) after the SMS intervention. But changes in the rate of CRBSI (catheter related blood stream infection) between the intervention group (1.89) and the control group (4.45) were not significant (p=.323). Conclusions: The results indicate that the SMS intervention is effective in increasing the adherence to maximal barrier precautions and the SMS intervention can be recommended for utilization in infection control nursing practice.