• Title/Summary/Keyword: Hospital discharge

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A Study on Wound Care Knowledge and Concerns of Patients at Discharge (퇴원하는 환자의 상처관리에 대한 지식과 염려에 관한 연구)

  • Han, Il-Kyoung;Lee, Myung-Seon;Kim, Jung-A;Ha, Won-Choon;Kim, Myung-Hee;Hwang, Sun-Kyung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.11
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    • pp.3434-3443
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    • 2009
  • This study was done to examine patients' wound care knowledge and concerns prior to discharge from a tertiary hospital. The participants in this descriptive survey were 112 patients having wounds. During interview, a structured self-administered questionnaire was filled out. The participants were 71 males and 41 females. Wound types were surgical incision (52.7%), percutaneous wound (26.8%), pressure ulcer (9.8%) and diabetic foot and arterial ulcers (5.4%). Their wound care knowledge was 52.0% of correct answer and the mean of concerns (range 1-7) was 2.79. There was no significant correlation between their knowledge and concerns of wound care. The factors influence on wound care concerns were fear of wound care, wound pain, length of hospital stays, and perceived health condition. This findings showed that discharge patients with a wound had some incorrect knowledge and various concerns about wound care. They may help to direct patient teaching in discharge plan.

A Systematic Review on Nurse-Led Transitional Care Programs for Discharged Patients from Hospital to Home (퇴원환자를 위한 간호사 주도 전환 프로그램의 내용과 효과에 관한 체계적 문헌고찰)

  • Lee, Hyun Joo;Kim, Yukyung;Oh, Eui Geum
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.376-387
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    • 2017
  • Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

Association between defoliant exposure and survival to discharge after out-of-hospital cardiac arrest (고엽제 노출과 병원 밖 심정지 후 생존 퇴원과의 연관성)

  • Kim, Dong Wook;Kye, Yu Chan;Lee, Jung Youp;Jung, Eui Gi;Kim, Dong Sung;Choi, Hyun Jung;Lee, Young
    • Journal of The Korean Society of Clinical Toxicology
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    • v.19 no.1
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    • pp.38-43
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    • 2021
  • Purpose: We investigated the association between defoliant exposure and survival to discharge after out-of-hospital cardiac arrest. Methods: This is a retrospective case-control study based on the cardiopulmonary resuscitation (CPR) registry. The electronic medical records of out-of-hospital cardiac arrest victims from 6/9/2008 to 12/31/2016 were analyzed statistically. The case patients group had a history of defoliant exposure while the control group did not. Among the 401 victims studied, a total of 110 patients were male out-of-hospital cardiac arrest patients. Baseline characteristics and the parameters involved in cardiac arrest were analyzed and compared between the two groups after propensity score matching. The primary outcome was survival to discharge, and secondary outcomes were sustained return of spontaneous circulation (ROSC) and survival to admission. Results: After propensity score matching a total of 50 patients (case=25, control=25) were analyzed. Primary outcome (survival to discharge) was not significantly different between case and control groups [(OR, 1.759; 95% C.I., 0.491-6.309) and (OR, 1.842; 95% C.I., 0.515-6.593), respectively]. In the subgroup analysis, there were also no significant differences between the control group and subgroups in primary and secondary outcomes according to defoliant exposure severity. Conclusion: There is no statistically significant association between defoliant exposure and survival of out-of-hospital cardiac arrest.

Long-term Fistula Formation Due to Retained Bullet in Lumbar Spine after Gunshot Injury

  • Jeon, Se-Il;Im, Soo Bin;Jeong, Je Hoon;Cha, Jang Gyu
    • Journal of Trauma and Injury
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    • v.30 no.2
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    • pp.51-54
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    • 2017
  • We here report a case of long-term fistula formation due to bullet retention for 30 years in the lumbar spine after a gunshot injury, and describe its treatment. A 62-year-old male visited our hospital due to pus-like discharge from his left flank. The discharge had been present for 30 years, since his recovery from an abdominal gunshot injury. A spine radiography showed radiopaque material in the body of the third lumbar vertebra. Foreign body was removed using an anterolateral retroperitoneal approach. The postoperative course was uneventful. The patient was discharged 7 days after the operation and was followed-up for 8 months, during which time, the fistula did not reoccur. A bullet retained long term in the vertebral body may cause obstinate osteomyelitis and fistula formation. A fistula caused by a foreign body in the spine can be effectively treated by surgical removal.

Survey on the Discharge Planning of Occupational Therapists (국내 작업치료사의 퇴원계획 개입에 대한 실태 조사연구)

  • Hwang, Na-Kyoung;Yoo, Eun-Young
    • Therapeutic Science for Rehabilitation
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    • v.9 no.2
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    • pp.55-71
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    • 2020
  • Objective : The purpose of this study was to investigate the necessity of occupational therapist's involvement in patient discharge planning, the areas that should be considered for discharge screening and planning, and to provide the basic data required for the development of a discharge assessment tool. Methods : We conducted an online questionnaire survey of 60 occupational therapists who were working at medical institutions and had agreed to participate in the study. The questionnaire was composed of 36 questions regarding the general characteristics of the current discharge planning process and the necessity of discharge assessment and planning. Descriptive statistics, an independent t-test, and a one-way ANOVA were conducted using SPSS 20.0. As for the post-hoc test, Scheffe's test was used. Results : The awareness of occupational therapist's role in discharge planning and the necessity of a discharge assessment tool were high, but the occupational therapist's awareness of discharge-related knowledge was low. The difficulties in discharge planning showed high response rate in the absence of adequate fee-for-service in the patient interview and assessment and the lack of team approach and appropriate assessment tools for discharge planning. The high-needs areas for evaluation during discharge were fall risk and BADL, and the low-needs areas were well-being and functional level prior to onset. Conclusion : This study is expected to provide preliminary information necessary for the development of a discharge assessment tool for effective discharge planning.

Comparison of Discharge Learning Needs between Nurses and Liver Transplantation Patients (간이식환자와 간호사의 퇴원교육 요구 중요도 차이 비교)

  • Koo, Mi Jee;Kim, Dong-Hee;Kim, Kyoung Nam
    • Journal of Korean Critical Care Nursing
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    • v.7 no.2
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    • pp.1-13
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    • 2014
  • Purpose: The purpose of this study was to determine the difference in reported discharge learning needs between nurses and liver transplantation (LT) patients. Methods: The participants of this study were 40 patients discharged after LT at P University Hospital in Y City and 42 nurses in intensive care units and the ward. The data were collected for two months from December 1, 2012, to January 31, 2013, and were analyzed using descriptive statistics, Student's t-test and analysis of variance (ANOVA). Results: Patients earning a low income (p=.041), having no experience of hospitalization after LT (p=.023), and receiving information about LT from nurses (p=.003) indicated higher discharge learning needs. Among the items evaluated regarding discharge learning needs, "rejection symptoms or signs" were regarded to be more important by nurses than LT patients (p=.038). However, "management of other diseases after LT" (p=.003), "risk of recurrence" (p=.001), "food choices" (p<.001), "obesity prevention" (p=.020), "amount of exercise" (p=.007), and "ways to receive financial help"(p=.033), were thought to be more important by LT patients than nurses. Conclusion: There exist differences between LT patients and nurses with respect to their perceptions of LT discharge learning needs. Therefore, an individualized education program reflecting patients' conditions and learning needs rather than providing information uniformly needs to be developed.

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The Outcomes of Early Discharge Program for Extremely Low Birth Weight Infants (초극소미숙아를 위한 조기 퇴원 프로그램의 운영 성과)

  • Lee, Eun-Jung;Yi, Young-Hee
    • Journal of Korean Critical Care Nursing
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    • v.4 no.1
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    • pp.25-35
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    • 2011
  • Purpose: The purpose of this study was to evaluate the actual outcomes of early discharge program for extremely low birth weight (ELBW) infants. Methods: Medical records of 122 ELBW infants admitted in the neonatal intensive care unit from January 2000 to June 2006 and those of their 112 mothers were analyzed retrospectively. Results: After being applied early discharge program to ELBW infants' mothers, their infants' lengths of stay, gestational age and body weight at discharge, duration of completion of oral feeding, number of emergency room visits after discharge were decreased and number of breast milk feeding was increased. Conclusion: Early discharge program for ELBW infants can be an effective intervention for parents and their ELBW infants contributing to neonatal nursing practices.

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A study on the Difference of Disease Related Knowledge Level, Compliance of Health Behavior, and Educational Needs according to Time in Percutaneous Coronary Intervention Patients (관상동맥중재술 시행 환자의 질병관련지식, 환자역할행위이행 및 교육 요구도에 대한 시기별 비교 연구)

  • Kang, Kyung-Ja;Yoo, Hyun-Jung;Lee, Hee-Joo
    • Korean Journal of Adult Nursing
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    • v.22 no.2
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    • pp.190-199
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    • 2010
  • Purpose: The purpose of this study was to determine the differences in the level of disease related knowledge, compliance of health behavior, and educational needs in relation to time (at discharge and 6 months after discharge) among patients underwent percutaneous coronary intervention (PCI). Methods: Data were collected from January 1, 2006 to September 30, 2006 and a total of 60 patients participated in the study. The survey was conducted in patients underwent PCI at the time of discharge right after discharge education was provided and at a follow up visit which was 6 months after discharge. Results: The level of disease related knowledge (p<.001), the compliance of health behavior (p<.001), educational need (p=.496), the sub-item of sexual life (p<.001), follow up (p<.001), diet (p=.021), stress (p<.001) in compliance of health behavior, and the sub-item of specific character of disease in educational needs (p=.015) were significantly different between discharge and 6 months after discharge. Conclusion: The results of this study suggested that further education should be provided to the patients underwent PCI regarding medication, smoking cessation, daily life and exercise at a time of 6 months after discharge in order to increase patient compliance of health behavior.

An application of datamining approach to CQI using the discharge summary (퇴원요약 데이터베이스를 이용한 데이터마이닝 기법의 CQI 활동에의 황용 방안)

  • 선미옥;채영문;이해종;이선희;강성홍;호승희
    • Proceedings of the Korea Inteligent Information System Society Conference
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    • 2000.11a
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    • pp.289-299
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    • 2000
  • This study provides an application of datamining approach to CQI(Continuous Quality Improvement) using the discharge summary. First, we found a process variation in hospital infection rate by SPC (Statistical Process Control) technique. Second, importance of factors influencing hospital infection was inferred through the decision tree analysis which is a classification method in data-mining approach. The most important factor was surgery followed by comorbidity and length of operation. Comorbidity was further divided into age and principal diagnosis and the length of operation was further divided into age and chief complaint. 24 rules of hospital infection were generated by the decision tree analysis. Of these, 9 rules with predictive prover greater than 50% were suggested as guidelines for hospital infection control. The optimum range of target group in hospital infection control were Identified through the information gain summary. Association rule, which is another kind of datamining method, was performed to analyze the relationship between principal diagnosis and comorbidity. The confidence score, which measures the decree of association, between urinary tract infection and causal bacillus was the highest, followed by the score between postoperative wound disruption find postoperative wound infection. This study demonstrated how datamining approach could be used to provide information to support prospective surveillance of hospital infection. The datamining technique can also be applied to various areas fur CQI using other hospital databases.

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The Effect of Physical and Occupational Therapy on Activities of Daily Living in Stroke Inpatients at Least 3 Months After Stroke (발병 후 3개월이 경과한 뇌졸중 환자의 일상생활동작에 물리치료와 작업치료가 미치는 영향)

  • Kim, Won-Ho;Hwang, Myoung-Ok;Park, Eun-Young
    • Physical Therapy Korea
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    • v.14 no.1
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    • pp.74-81
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    • 2007
  • The purpose of this study was to investigate effect of hospital-based physical and occupational therapy on Modified Barthel Index (MBI) score in stroke inpatients at least 3 months after stroke, to predict MBI score at discharge from subscales of MBI, and determine the characteristics of stroke at admission. Forty-five stroke inpatients participated and received physical and occupational therapy for two months. All participants were assessed on MBI at admission and discharge. The collected data was analyzed by dependency level (MBI${\leq}$74 and MBI${\geq}$75) at admission. The results revealed that the MBI score at discharge was significantly improved compared to the MBI score at admission in the group with more than moderate dependency level (MBI${\leq}$74). In particular, personal hygiene, dressing, ambulation, and chair/bed transfer were improved. But only ambulation was improved significantly in the group with a less than mild dependency level (MBI${\geq}$75). The chair/bed transfer, dressing, ambulation, and Mini-Mental State Exam-Korea score at admission were important factors in the MBI score at discharge. Eighty-six percent of the variation in MBI score function at discharge can be explained. Therefore, it is suggested that hospital-based physical and occupational therapy in subacute stroke improve independent living status, especially for patients with a more than moderate dependency level.

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