• Title/Summary/Keyword: Hospital medication system

검색결과 201건 처리시간 0.024초

홧병 연구에 관한 고찰 (Literatures Review in Hwabyung Research)

  • 박영숙;채선옥
    • 지역사회간호학회지
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    • 제12권3호
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    • pp.705-715
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    • 2001
  • This study examined 19 papers published from 1977 to 2000 based on the objective frame evaluation. This purpose of this study was to examine the trend of Hwabyung research and to serve as a guide for the future 'Hwabyung' study. The results of studies were as follow. In the design of research, clinical studies are definitely dominant. As for the fields of research, the concept of Hwabyung was studied more frequently than the others. As for the authorship. psychiatrists prevailed but nursing professionals are on the increase. Research subject in clinical and survey study, patient was definitely dominant and the place of study was almost always a hospital (75%), data collection was higher on interview (58.3%). Hwabyung was considered unique culture bounded syndrome related to Korean culture. Frequent etiologic factor of Hwabyung were a husband's extra-marital affair, conflicts between houses wives and mothers-in-laws, and financial loss and suffering. From the incidence of Hwabyung, a greater number of patients with Hwabyung were middle aged women in the low economic and educational classes, and these were connected with the culture and the family system. The symptoms of Hwabyung included psychological and physical symptom, neurological disorder and disease behavior. Defense mechanisms and coping strategies for Hwabyung were somatization, suppression, orality, withdrawal, isolation, regression, help-seeking, complaining, and wreaking anger. Treatment of Hwabyung were medication, effort by herself, communication with families, consultation with psychologist, acupuncture, negative therapy, moxa, and Qi-kong. Psychiatric therapy, behavior therapy, nursing intervention on multi-interdisciplinary approach and psychiatric nursing approach were recommended for the nursing care of a Hwabyung patient.

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천식의 한약치료에 관한 문헌고찰 - 국내 한의학 임상연구를 중심으로 (Review on Herbal Medications of Asthma in Domestic Clinical Research on Traditional Korean Medicine)

  • 박청수;홍미나;반재진;정한솔;최준용
    • 동의생리병리학회지
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    • 제32권6호
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    • pp.361-369
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    • 2018
  • The purpose of this study was to review the herbal medications of asthma through clinical studies in Korea and to be utilized in the treatment of asthma and in other clinical studies. All clinical researches about asthma published up to 13th February 2018 were found in two domestic electric databases, Oriental Medicine Advanced Searching Integrated System(OASIS) and National Discovery for Science Library(NDSL). Twenty-seven articles were selected and of these, there were 14 articles of before and after studies(BAS), 8 of case series(CS), 4 of case reports(CR) and 1 of the randomized controlled trial(RCT). The most frequently used prescription was "Cheongsangboha-tang(淸上補下湯)". There were various TCM patterns, and Tae-Eum-In(太陰人) was the most common Sasang constitution(四象體質). Frequently used evaluations to assess treatment effects were lung function tests such as Forced expiratory volume at one second (FEV1) and Quality of Life Questionnaire for Adult Korean Asthmatics(QLQAKA) questionnaire responses. We have found that herbal medicine treatment can be an effective treatment to improve the symptoms and the quality of life of asthmatic patients. But we consider that large-scale systematically designed clinical researches are needed additionally.

Long-Term Management of Seizures after Surgical Treatment of Supratentorial Cavernous Malformations : A Retrospective Single Centre Study

  • Dziedzic, Tomasz A.;Koczyk, Kacper;Nowak, Arkadiusz;Maj, Edyta;Marchel, Andrzej
    • Journal of Korean Neurosurgical Society
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    • 제65권3호
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    • pp.415-421
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    • 2022
  • Objective : Seizure recurrence after the first-ever seizure in patients with a supratentorial cerebral cavernous malformation (CCM) is almost certain, so the diagnosis and treatment of epilepsy is justified. The optimal method of management of these patients is still a matter of debate. The aim of our study was to identify factors associated with postoperative seizure control and assess the surgical morbidity rate. Methods : We retrospectively analysed 45 consecutive patients with a supratentorial CCM and symptomatic epilepsy in a single centre. Pre- and postoperative epidemiological data, seizure-related patient histories, neuroimaging results, surgery details and outcomes were obtained from hospital medical records. Seizure outcomes were assessed at least 12 months after surgery. Results : Thirty-five patients (77.8%) were seizure free at the long-term follow-up (Engel class I); six (13,3%) had rare, nocturnal seizures (Engel class II); and four (8.9%) showed meaningful improvement (Engel class III). In 15 patients (33%) in the Engel I group; it was possible to discontinue antiepileptic medication. Although there was not statistical significance, our results suggest that patients can benefit from early surgery. No deaths occurred in our study, and mild postoperative neurologic deficits were observed in two patients (4%) at the long-term follow-up. Conclusion : Surgical resection of CCMs should be considered in all patients with a supratentorial malformation and epilepsy due to the favourable surgical results in terms of the epileptic seizure control rate and low postoperative morbidity risk, despite the use of different predictors for the seizure outcome.

Association Between Persistent Treatment of Alzheimer's Dementia and Osteoporosis Using a Common Data Model

  • Seonhwa Hwang;Yong Gwon Soung;Seong Uk Kang;Donghan Yu;Haeran Baek;Jae-Won Jang
    • 대한치매학회지
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    • 제22권4호
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    • pp.121-129
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    • 2023
  • Background and Purpose: As it becomes an aging society, interest in senile diseases is increasing. Alzheimer's dementia (AD) and osteoporosis are representative senile diseases. Various studies have reported that AD and osteoporosis share many risk factors that affect each other's incidence. This aimed to determine if active medication treatment of AD could affect the development of osteoporosis. Methods: The Health Insurance Review and Assessment Service provided data consisting of diagnosis, demographics, prescription drug, procedures, medical materials, and healthcare resources. In this study, data of all AD patients in South Korea who were registered under the national health insurance system were obtained. The cohort underwent conversion to an Observational Medical Outcomes Partnership-Common Data Model version 5 format. Results: This study included 11,355 individuals in the good persistent group and an equal number of 11,355 individuals in the poor persistent group from the National Health Claims database for AD drug treatment. In primary analysis, the risk of osteoporosis was significantly higher in the poor persistence group than in the good persistence group (hazard ratio, 1.20 [95% confidence interval, 1.09-1.32]; p<0.001). Conclusions: We found that the good persistence group treated with anti-dementia drugs for AD was associated with a significant lower risk of osteoporosis in this nationwide study. Further studies are needed to clarify the pathophysiological link in patients with two chronic diseases.

일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정 (Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital)

  • 김경운
    • 간호행정학회지
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    • 제6권3호
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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퇴원시 환자의 간호요구도 조사 (A Survey on Patients도 Nursing Needs Following Discharge from Hospital)

  • 이은옥;이선자;박성애
    • 대한간호학회지
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    • 제11권2호
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    • pp.33-54
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    • 1981
  • The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

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간호사의 간호업무 전산화 활용에 대한 조사연구 (A Survey on Nurses' Utilization of Computerization in Nursing Practice)

  • 이인순
    • 간호행정학회지
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    • 제5권2호
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    • pp.209-224
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    • 1999
  • I have practiced this reserch for the purpose of proposition of basic data for amendment and addition of computer system after I surveyed the degree of abilities and satisfaction on the computerization in nursing\ practice. Subjects were collected from September 1 to September 30, 1998. Study subjects are 151 clinical nurses who are working at university hospital in Chonbuk area. Study instrument consists of 116 questionnaire which was developed by Kim H. K(1998). The data were analized number, mean ,t-test, ANOVA by using SPSS. The study results are as follows: 1. Most of the nurses who answered the questions were educated computerizing(96%). The abilities of computer program utilities were the most in inputting data(74%). The program nurses wanted computerizing education was wordprocess, dealing internet and statistics. 2. As for applying parts of computer system in nursing, the most nurses were Dr's order check (96%), treatment activity(91.4%), medication(89.4%), lab. test(87 .4%), transfering department(85.4%), transfering room(79.5%), diet(71.8%), discharge (70.2%), Barcord Sticker(70.2%) , reservation(62.2%) in order that were all conected order system mutually to other part. It showed that computer system was not applied for treating the original nursing work such as nursing record (13%), duty scheduling(6.0%) , nursing process(4.6%) , Q.I(1.3%), nursing research(1.3%), education(1.3%), 3. As for the benefit when computer system is applied for, the most respondence was promptness of work and convenience(90.6%) , exactness of work (82.8%), offering information exactily and efficiently(36.3%), offering good quality of nursing (6.0%) in order. 4. The degree of contentment on computerizing in nursing practice showed average 3.24%. The best marking item is that they are eager to participate in the computer education. Next, the automatic output of label and giving the number automatically is to prevent loss and mentioned items of patient registration from being changed(3.95) and to prevent mistakes possibly happening because of doctor's difficult order(3.85). 5. The problems which may happen to in nurses' utilization of computerization for the nursing practice showed average 3.18. The most problem is that the practice may stop because of the problem of computer itself(3.67), and the next, the indication of act can be imperfect(3.66) , manual training may overlap because of incomplete computerization (3.60), practical education for the computerizing is lack(3.41), and the computer literate nurses are lack(3.40) . 6. Study subject's contentment by age was significant difference(F=3.10,P=0.0119). Study subject's contentment by job posision was significant difference(F=6.001P=0.0034) I will propose the following according to the above results. The domain of original nursing practice is urgernt. Manual and indication of act should be made before long in computer obstacle. Nursing department should support the nurses so that they could receive the education needed for the nurses themselves.

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전문약사 자격 보유여부에 따른 전문성 및 직무만족도 영향 분석 (Analysis of the Influence of Holding Pharmacist Specialization for Professionalism and Job Satisfaction)

  • 정선회;최경희;권경희;유기연
    • 병원약사회지
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    • 제35권4호
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    • pp.441-452
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    • 2018
  • Background : The prevalence of the chronic metabolic disease is increasing due to the aging society. Therefore, Korean Society of Health-system Pharmacists (KSHP) has a specialty pharmacist system to improve the professionalism of pharmacists. The purpose of this study is to suggest the difference between specialty pharmacist and non-specialty pharmacist with regards to their knowledge, delivery of information on medication, service provision, and job satisfaction. Methods : An online survey research was conducted for hospital pharmacists. The reliability of the questionnaire items was presented using Cronbach's ${\alpha}$ test. The t-test or ANOVA analysis was used for evaluating differences in continuous variables. Results : A total of 171 pharmacists responded to the questionnaire, and 87.7% of the respondents were aged less than 30 years (76.6%) and four-year graduates (86.0%). Typically, 108 (63.2%) were candidates for the pharmacist's specialty certificate, and the remaining 63 (36.8%) were not enrolled. Considering the field of specialty with overlapping, the total number of certificated patients was 140 (26.3% of the total of 532 in 2016). The results of the reliability analysis of the specific questionnaire showed that the Cronbach's ${\alpha}$ value was over 0.78. There was no significant difference in customer directionality between the two groups. However, there was a significant difference (p<0.05) with respect to overall knowledge about the treatment process, drug efficacy, and side effects, information about medicines and adverse drug reactions, and in providing appropriate information to medical staff including patients and physicians. Conclusions : The pharmacist with specialization showed a positive result of self-evaluation of items such as knowledge about drugs, communication of information on medications, and service provision, compared to other pharmacists, and the result was in correlation with the numbers of specialization. There was no difference in job satisfaction related to working environment. Henceforth, it is hypothesized that there is a necessity for continuous improvement in the working environment to suit the purpose of the pharmacy specialist system.

Management of asymptomatic to mild COVID-19 patients with Cheongpebaedok-tang on the telemedical basis: A retrospective observational case series

  • Sung-Woo Kang;Kwan-Il Kim;Mideok Song;Jinhwan Roh;Namhun Cho;Heung Ko;Sung-Se Son;Minjeong Jeong;Jun-Yong Choi;Ojin Kwon;Seojung Ha;Hee-Jae Jung;Beom-Joon Lee
    • 대한한의학회지
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    • 제44권4호
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    • pp.41-58
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    • 2023
  • Objectives: This retrospective observational study aimed to investigate the efficacy and safety of Cheongpebaedok-tang, a traditional Korean herbal medicine, provided via telemedicine to patients with asymptomatic to mild COVID-19 in Korea. Methods: From February to April 2020, a retrospective analysis investigated COVID-19 patients treated via Korean telemedicine. The study involved asymptomatic to mild cases receiving Cheongpebaedok-tang more than three times, along with continuous Korean medicine care in convalescence. Diagnoses and treatment adhered to the telemedicine guidelines of the Association of Korean Medicine, with varied Cheongpebaedok-tang prescriptions based on symptom severity. Symptom evaluation involved a detailed assessment using a 15-item tool at initial and final sessions. Results: The study included 27 patients, with a mean age of 48.7 ± 2.3 years (mean ± standard error). Patients began self-administering oral Cheongpebaedok-tang for an average of 19.4 ± 1.8 days after the date of COVID-19 diagnosis confirmation and continued the medication for 15.8 ± 1.2 days. The reported side effects of the Cheongpebaedok-tang included palpitations (11.1%), insomnia (7.4%), dizziness (3.7%), and diarrhea (3.7%). All side effects disappeared after adjusting the prescription according to standard treatment guidelines. The occurrence of all COVID-19-related adverse symptoms, except fatigue and myalgia, decreased. Fatigue was the most common chronic symptom persisting after 6 months (51.9%), followed by ocular symptoms (37.0%) and sore throat (22.2%). Conclusions: This study implies Cheongpebaedok-tang may offer a potentially safe, symptom-alleviating approach for managing mild COVID-19 cases via telemedicine, although further comprehensive research is warranted.

Naltrexone과 ondansetron의 병합투여가 C57BL/6형 생쥐의 알코올 섭취량에 미치는 영향 (Effect of Ondansetron Alone and Combination of Naltrexone and Ondansetron on Alcohol Intake in C57BL/6 Mice)

  • 김현경;김성곤;강철중;박상익;김원호
    • 생명과학회지
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    • 제17권11호
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    • pp.1576-1581
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    • 2007
  • 알코올 의존의 음주 행동에 VTA에서 NA로 뻗어 있는 도파민 대뇌 보상 경로가 중요하다. 이러한 경로의 토파민 활성도가 $5-HT_3$계 신경에 의하여 조정되고 있으며, $5-HT_3$ 수용체 길항제인 ondansetron (OND)이 알코올리즘 환자에서 음주량을 감소시키고 금주률을 높인다는 보고가 있다. 이에 생쥐의 섭취량에 대하여 $5-HT_3$ 수용체 길항제인 ondansetron의 투여 효과와, 이러한 ondansetron 및 비 특이적 아편계 수용체 길항제인 naltrexone (NTX)과의 병합 투여 효과를 검증하는데 목적이 있다. 알코올 의존화 된 C57BL/6형 수컷 생쥐를 4군으로 나눈 뒤, 10일간 각 군에 vehicle, OND 0.01 mg/kg 단독, NTX 1.0 mg/kg 단독, 및 OND 0.01 mg/kg과 NTX 1 mg/kg 병합 투여하면서 2시간 알코올의 섭취량, 22시간 물 섭취량, 24시간 사료 섭취량 및 체중을 조사하였다. 본 연구의 결과로 2시간 알코올 섭취량의 10일간 변화에 대해 vehicle 투여 군과 나머지 3군의 약물 투여군과 repeated measure ANOVA를 이용하여 각각 비교하였을 때, vehicle 투여군과 NTX 단독 투여군간에 유의한 교차가 관찰되었으나 (p=0.042), OND 단독 투여군과 NTX과 OND 병합 투여군은 vehicle 투여군과 유의한 차이가 없었다. 일별 2시간 알코올 섭취량에 대하여 NTX 투여군과 vehicle 투여군의 군간 비교시 vehicle 투여군에 비하여 NTX 투여군에서 약물 투여 4일부터 10일까지 유의하게 감소하였다(4일 p=0.010; 6일 p=0.050; 8일 p=0.017; 10일 p=0.005). 그리고 NTX과 OND 병합 투여군과 vehicle 투여군의 양군을 비교하였을 때에는 2시간 알코올 섭취량이 4일과 10일에만 유의하게 감소하였다(4일 p=0.049; 10일 p=0.022). 그러나 22시간 물 섭취량, 24시간 사료 섭취량 및 체중의 10일간 변화에 대해 vehicle 투여군과 나머지 3 군의 약물 투여군과의 repeated measure ANOVA를 이용하여 각각 비교하였을 때, 모두 유의한 교차효과가 없었다. 이상의 결과는 생쥐의 섭취량에 대하여 OND의 투여 효과는 없었으며, OND과 NTX의 병합 투여시에는 NTX의 알코올의 섭취량 억제 효과가 감소되었다. 따라서 앞으로 $5-HT_3$ 신경계와 도파민 및 아편 신경계와의 상관관계에 대한 연구가 필요할 것으로 생각된다.