Background: A tracheal stenosis is caused by mucosal ischemic injury related to a high cuff pressure ($P_{cuff}$) of the endotracheal tube. In contrast, aspiration of the upper airway secretion and impaired gas exchange due to cuff leakage is related to a low $P_{cuff}$. To prevent these complications, the $P_{cuff}$ should be kept appropriately because the appropriate $P_{cuff}$ appears to change according to the patient's daily respiratory mechanics. However, the constant cuff volume($V_{cuff}$) has frequently been instilled to the cuff balloon on a daily basis to maintain the optimal $P_{cuff}$ instead of monitoring the $P_{cuff}$ directly at the patients' bedside. To address the necessity of continuous $P_{cuff}$ monitoring, the change in the $P_{cuff}$ was evaluated at various $V_{cuff}$ levels on a daily basis in patients with long-term mechanical ventilation. The utility of mercury column sphygmomanometer for the continuous monitoring $P_{cuff}$ was also investigated. Method: The change in $P_{cuff}$ according to the increase in $V_{cuff}$ was observed in 17 patients with prolonged endotracheal intubation for mechanical ventilation for 2 week or more. This maneuver measured the change in $P_{cuff}$ daily during the mechanical ventilation days. In addition, the $P_{cuff}$ measured by mercury column sphygmomanometer was compared with the $P_{cuff}$ measured by an automatic cuff pressure manager. Results : There were no statistically significant changes of $P_{cuff}$ during more than 14 days of intubation for mechanical ventilation. However the $V_{cuff}$ required to maintain the appropriate $P_{cuff}$ varied from 1.9 cc to 9.6 cc. In addition, the intra-individual variation of the $P_{cuff}$ was observed from 10 $cmH_2O$ to 46 $cmH_2O$ at constant 3 cc $V_{cuff}$. The $P_{cuff}$ measured by the bedside mercury column sphygmomanometer is well coincident with that measured by the automatic cuff pressure manager. Conclusion: Continuous monitoring and management of the $P_{cuff}$ to maintain the appropriate $P_{cuff}$ level in order to prevent cuff related problems during long-term mechanical ventilation is recommended. For this purpose, mercury column sphygmomanometer may replace the specific cuff pressure monitoring equipment.
An analysis of nursing activities in a in-patient ward and its management was observed in order to assess necessary number of nursing hands and find out reasonable work management with them. The study was performed with two wards of St. Mary′s Hospital, Catholic Medical Center, for the period from July to December 1970. The results and conclusions were as the following 1. The role of the nurses are determined by doctor′s order in 57.7% in kind, 80.0% in amount. and by nurses decision 20.0% in amount. 2. Works related to patient care are found to be 20.6% in the internal medicine ward and 20.4% in the surgical ward while works related to treatment are 4.7% in the former and 27.2% in the letter. Medication occupies 40.0% in the internal medical ward while 26.6% in the surgery ward, and observation occupies 34.7% in the former while 25.8% in the letter. These can be said to reflect characteristic differences bet ween the two wards. 3. When nursing functions were evaluated by importance "A" level in the amount of works to be done occupied 67.6% in the surgical ward and 62.8% in the internal medical ward. In the kind of the important works, "B"level is found to be most frequent with 50% while "A"level 43%. When evaluated by difficulty, "B"level was found to be most frequent in amount in both internal medicine and surgical wards (52.6%, 38.2%). 4. Works needing professional knowledge and skills occupied 92% in the both wards while unprofessional works 2.8% and 4.2% respectively. There are indications, however, that unprofessional works have an increasing tendency. 5. When evaluated by the amount of works, the surgical ward has 11 nurses less and the internal medicine ward 3 nurses less then the necessary number of nursing staffs. There are shortage of 12 and 6 nurses respectively when evaluated by the number of patients and 18 nurses in the both wards when evaluated by the medical regulations of the Government. 6. The ratio of the nursing staff to patient was found to be 1:11.5, 1:23.0 and 1:34.5 in the morning, evening and night turn in the surgical ward. In the medical word the ratio was 1:9.4, 1:22.0 and 1:33.0. 7. The deficiency of necessary equipment and tension accompanying management of those equipment were found to lower the effective functioning of the head nurse who is a junior manager of the ward. They also consume much of the time and energy of the nurses at work who are over burdened in most of the cases. 8. The high rate of the number of nurses who leave the job impairs the functioning of team work which is considered to be most important in the effective performance of nursing activities and thus contributes to lower the efficiency of nursing functions.
This study is a descriptive research conducted to provide basic resources for the production course and programs by identifying knowledge and attitudes toward dementia of nursing students and social welfare students. The participants were 451 students of nursing science and social welfare in four-year university at J-do. Data were collected from October 1, 2012 to October 20, 2012, by using structured questionnaires and analyzed by using SPSS 20.0 program. The participants showed relatively high level of knowledge. Nursing students($16.42{\pm}1.77point$, range 0~20) showed higher level of knowledge than social welfare students($16.02{\pm}2.3029point$, range 0~20)(p=.015). Both students showed relatively positive attitudes(nursing $40.48{\pm}4.29point$, social welfare $40.54{\pm}4.6229point$, range 10~50). The higher the participants' knowledge and interests in dementia, attitudes toward dementia were more positive. Based on the result, it is required to develop various education program and research to promote knowledge and attitudes toward dementia.
The present empirical research examines the effect of team leader's ethical leadership on team members' in-role behavior and psychological capital. This study also predicts that management decoupling and personal decoupling will moderate the effect of ethical leadership negatively. A growing body on leadership research highlights the role of team leader's moral manager in team settings. Ethical leadership also becomes a salient issue in the situation of unethical decision making and misuse of management power which have done by unethical leaders all around the world. In order to identify the effect of ethical leadership, I collected data of 922 team members from bank, semiconductor manufacturer, and university hospital. Our findings show that ethical leaderships have a positive effect on team members' in-role behavior and psychological capital. In addition, I also found the significant moderation effect of management decoupling which team members perceive their top management team's inauthenticity. Contrary to the prediction, however, the result doesn't support the moderation effect of personal decoupling. I discussed implications of confirming and disconfirming findings in details.
Background: Recently, several studies have reported that elevated platelet counts may be associated with the poor prognosis of colorectal cancer. However, conclusions remain controversial. This meta-analysis was therefore designed to analyze and evaluate the prognostic role of preoperative or pretreatment thrombocytosis in patients with colorectal cancer. Materials and Methods: We searched PubMed, EMBASE, the Cochrane Library and Web of Science to March 29th, 2015. The citation lists of included studies were also hand-searched to identify further relevant trials. To investigate the association between thrombocytosis and prognosis of colorectal cancer, the 1-year, 3-year and 5-year survival of each studies were obtained. The odds ratio (OR) with its 95% confidence interval (CI) was used to evaluate the relation of overall survival (OS) between thrombocytosis and normal platelet counts (PLT). Likewise, disease free survival (DFS) was obtained and evaluated. The analysis was performed and assessed using Review Manager 5.2. Results: A total of 14 studies (N=5,566 participants, 11 including 4,468 for OS, 6 including 1,533 for DFS) were included in this meta-analysis, of which seven (N=3810) defined thrombocytosis as a platelet count ${\geq}400{\times}10^9/L$, and 375 (9.8%) patients exhibited pretreatment thrombocytosis. Thrombocytosis have a close relationship with the poor OS of colorectal cancer compared with normal PLT, with the pooled ORs of 1-year, 3-year and 5-year survival being 0.41 [95% CI 0.34-0.51; P<0.001], 0.28 [95% CI 0.21-0.38; P<0.001] and 0.26 [95% CI 0.20-0.34; P<0.001], respectively. For DFS, the same results were showed as the pooled ORs of 1-year, 3-year and 5-year survival respectively being 0.34 [95% CI 0.24-0.50; P<0.001], 0.31 [95% CI 0.23-0.43; P<0.001] and 0.25 [95% CI 0.18-0.34; P<0.001]. Conclusions: This meta-analysis indicated that thrombocytosis may predict poor prognosis for patients with colorectal cancer, and platelet counts may be a cost-effective and noninvasive marker.
Clinical nurses have tendency to change their job while providing care to patient, experiencing extreme stress with shift work, increased demands for technique, and heavy workload. At this point, it is time for investigating resilience in nursing part, and resilience affect to increase organizational commitment and decrease stress and exhaustion at organization. This study is a correlation study to investigate effects resilience on stress, exhaustion, and organizational commitment of clinical nurses. The results are as follows; The participants' resilience level is 3.38(${\pm}.38$), at the maximum of 5, stress level is 3.73(${\pm}.50$) at the maximum of 5, burnout level is 2.74(${\pm}.68$) at the maximum of 6 and organizational commitment level is 4.22(${\pm}.68$) at the maximum of 7. Ftom this study, resilience, stress, and burnout showed negative correlation, and resilience and organizational commitment revealed positive correlation. In order to decrease the clinical nurses' stress, burnout and enhance nurses' organizational commitment, nurse managers have to manage nurses' resilience. For increasing resilience of nurses, nurse manager has to develop resilience program, and training for managing nurses' stress and burnout.
Journal of Korean Academy of Nursing Administration
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v.14
no.1
/
pp.51-62
/
2008
Purpose: Integrated curriculum has been considered as a desirable method in health related school course. The present study was conducted to develop practice curriculum which integrates nursing management and community health nursing and measure the education effect. Method: Literature review and scores of professional meeting were carried out to generate main educational goals, contents, operating principle, and evaluation item. Student evaluation was done by survey and in-dept interview in right after practicum and three months respectively. Results: Six concepts were derived as main component of the integrated curriculum. From 2 to 3 sub-categories were matched to each main component as well. Subsequently, practice contents were suggested on the basis of sub-categories. Attainment of practicum goal scores ranged from 2.82 to 3.54 in four points index. Students expressed that they found nursing manager's role in the community setting. Conclusion: This new approach encouraged students to ascertain relationship between hospital oriented and community based practice. Additionally, they can be prepared to comprehend diverse health care environment.
Journal of Korean Society of Archives and Records Management
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v.13
no.3
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pp.151-171
/
2013
To comprehend the importance and necessity of record management metadata standard implemented in an electronic medical records system, a survey was undertaken to 50 medical records managers in charge of 5 major hospitals in Seoul. Analysis of the survey results was performed by averaging the responses given by those who answered the survey. SPSS was utilized for statistical analysis. Managers of medical records placed importance on metadata that are related to security of records, such as "levels of security", "types of access to medical records", "levels of authorization granted to personnel", and "users accessing medical records". It shows that these managers need the functions of privacy protection in ERMS. Metadata on "external disclosure" had the lowest level but those surveyed with more than 7 years of experience placed greater importance in this area more those surveyed with less than 7 years of experience in a hospital. This shows that managers need the functions of external disclosure to meet the needs of third partiesfor medical research and medical education.
Journal of Korean Society of Occupational and Environmental Hygiene
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v.29
no.3
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pp.322-335
/
2019
Objectives: The goal of this study is to standardize industry, process, and job within work environment measurement information. Methods: We selected 180 work environment measurement reports on 30 industries from a database monitored from 2014 to 2016 by the Korea Industrial Health Association. Ten industrial hygienists, each with over five years of experience in measurement, conducted a primary standardization of 180 reports. Two professional industrial hygienists with more than 20 years of experience each reviewed and revised the results of the primary standardization. We also examined the validity on the usefulness of the standardized database by the two industrial hygienists. Results: The final standardization results were classified into eight major categories, 23 sub-major categories, 39 minor categories, 53 unit categories and 70 sub-unit categories in the Korean Standard Industrial Classification (KSIC) 10th revision. A total of 161 processes were standardized, and there were 148 processes with K2B codes. Standard job was coded into 13 job groups including operator, automobile maintenance, nurse, maintenance, manager, excavating machine operator, forklift driver, radiologist, clinical pathologist, signer, researcher, kitchen assistant, and concrete reinforcement ironworker. Conclusions: Although the standardized information in this study may be only a part of the total information, it can be useful for improvement of the K2B system. Additional research is needed for an ongoing clean-up of data in the K2B and re-calibration and reclassification of standard processes until the future national exposure monitoring system is fully established.
Journal of the Korea Academia-Industrial cooperation Society
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v.19
no.12
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pp.836-846
/
2018
The purpose of this study was to evaluate nursing educational objectives achievement, critical thinking disposition, and clinical competence and their relationships in nurses within five years after graduation. Subjects were 82 nurses who graduated one nursing college within five years and 68 managers in nursing unit of hospital. Questions were given to nurses. They reported their achievement of educational objectives of the nursing college, critical thinking disposition and clinical competence. Nursing unit managers received the same questions to evaluate nurses working at their unit. Data were collected from January to march 2014 and analyzed by descriptive statistics, t-test, ANOVA, Pearson correlation and multiple regression with SPSS/WIN 23.0 program. Mean scores for achievement of educational objectives, critical thinking disposition, and clinical competence were $3.60{\pm}0.60$, $3.46{\pm}0.28$, and $4.17{\pm}0.56$, respectively. Educational objectives achievement showed significant correlations with critical thinking disposition (r = 0.52, p <. 001) and clinical competence (r = 0.52, p < .001). Regression analysis showed that critical thinking disposition (${\beta}=.30$, p = .018) and clinical competence (${\beta}=.26$, p = .029) were significant factors for predicting educational objectives achievement. Manager's evaluation score for educational objectives achievement and clinical competence was higher than graduated nurses' report (p < .001). This could be used as a feed- back to reset educational objectives and upgrade the curriculum. These study results could be used to, establish strategies to improve educational objectives achievement.
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