• Korean Journal of Clinical Pharmacy
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• v.15 no.2
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• pp.149-159
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• 2005

Purpose: To determine the extent and rate of prescription drug therapy, especially polypharmacy and the prevalence of potentially inappropriate medication use in Korean elderly ambulatory patients based on an explicit criterion. Methods: Performed a retrospective study of 65 years or older ambulatory patients visiting a university hospital based clinic from January 2002 to April 2004. Study determined the patterns of drug prescription per Anatomical Therapeutic Chemical Classification and the potentially inappropriate medication usage based on explicit Beers criteria. Results: Of the 4,042 elderly patients the mean number of prescription was $2.2{\pm}2.0$, which was similar between genders and all age groups within the elderly. 10.7% of patients were prescribed with more than 5 medications concurrently. The most frequently prescribed medication was the drugs used for treating nervous system diseases (44.3%), followed by alimentary tract/metabolism disorders (27.6%), cardiovascular disease (10.7%), blood/blood forming disorders (4.3%), respiratory disorders (6.5%), and musculoskeletal diseases (3.2%). A total of 511 elderly (13%) was prescribed with medication that met the criteria for=1 potentially inappropriate drugs for the elderly. This proportion was similar between genders and all age groups within the elderly. Among these 511 elderly patients the mean number of potentially inappropriate drugs prescribed was $5.1{\pm}3.3$ drugs. Potentially inappropriately prescribed drugs included amitriptyline (76 cases), diazepam (69 cases), ketorolac (57 cases), short acting nifedipine (44 cases), triazolam (38 cases), and hydroxyzine (38 cases). Conclusion: Potentially inappropriate drug prescribing in Korean ambulatory elderly patients are common. Education programs and interventions aimed at optimizing the prescribing and dispensing of the most appropriate drugs are needed.

• Korean Journal of Adult Nursing
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• v.12 no.4
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• pp.727-740
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• 2000

It is well recognized that case management is required to survive in the rapidly changing medical environment. One of the case management is the critical pathway(CP) which is assumed to increase the quality of care and at the same time to decrease the length of stay in hospital. The purpose of the study was to develop a CP for the management of patients with postero-lateral fusion for lumbar spinal stenosis. Through review of literature and medical records of patients with spinal stenosis, a pilot CP was designed, including 8 different care components such as medication, laboratory tests, assessment etc., from one day before surgery to 6 days of postoperative care. Every item of the pilot CP was evaluated by a panel of experts to test the content validity. The items not agreed on by more than 4 out of 6 experts were deleted or modified to be integrated in the CP. To apply the modified CP to a clinical environment, the items reflecting treatment, medication and lab work were entered into an order communication system(OCS), and doctors and nurses were taught to use the CP. Finally, the development of CP for the patients with posterolateral lumbar fusion was completed after the application and variance analysis of the CP.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.32 no.1
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• pp.10-16
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• 2021

Objectives: The aim of this study was to compare the compliance, efficacy, and satisfaction associated with methylphenidate and atomoxetine for treating attention-deficit/hyperactivity disorder (ADHD). Methods: The subjects were 44 patients who met the Diagnostic and Statistical Manual of Mental Disorder-5 diagnostic criteria for ADHD and were treated with methylphenidate or atomoxetine. The methylphenidate formulations included immediate release (IR), extended release (ER), and osmotic-controlled release oral delivery system (OROS). Patients and parents reported the average number of days per week the medication was taken. Efficacy was assessed using the ADHD Rating Scale. Satisfaction with medication scale (SAMS)-parent report form and SAMS-self-report form were used to evaluate parents' and patients' satisfaction, respectively. Results: Patients and parents were more satisfied with methylphenidate than with atomoxetine. There were no significant differences in the compliance with and efficacy of methylphenidate and atomoxetine. Compliance with methylphenidate IR and ER was markedly lower than that with OROS methylphenidate or atomoxetine. Conclusion: Methylphenidate OROS formulation can be considered a suitable option given its high rates of compliance, satisfaction, and efficacy.

• Korean Journal of Clinical Pharmacy
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• v.29 no.1
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• pp.25-32
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• 2019

Objective: South Korea made a list of potentially inappropriate medications (PIMs) for elderly patients in 2015 and has prompted medical professionals to prescribe proper medication by using the drug utilization review (DUR) system. It has been three years since the system was introduced, but related studies have rarely been conducted. This study aimed to evaluate the effect of the DUR system on the prescription of PIMs for elderly patients. Methods: The data on the prescription of PIMs for elderly patients (${\geq}65$ years) who received medical treatment between March 1st and May 31st in 2015 (before introduction of the DUR system) and who received medical treatment between March 1st and May 31st in 2018 (after introduction of the DUR system) were retrospectively collected from electronic medical records. Results: The prescriptions of PIMs decreased from 3,716 (7.7%) to 3,857 (6.9%) (p < 0.001). The prescription of escitalopram and paroxetine, among selective serotonin reuptake inhibitors, increased significantly, and that of short-acting benzodiazepines also increased significantly from 454 (0.93%) to 624 (1.2%). Conclusion: Prescription of PIMs for elderly patients significantly decreased (p < 0.001) after the DUR system was introduced. Further expanded studies of PIMs need to be conducted for the safety of elderly patients.

• The Korean Journal of Pain
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• v.26 no.2
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• pp.191-194
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• 2013

Pseudoaneurysm of the abdominal wall is a possible but very rare clinical entity. It is a known complication of surgery, trauma, or arterial puncture, but it is rarely spontaneous. Even though it can usually present with a wide range of local symptoms, it can cause referred pain via spinal cord, which is cross-excited with afferent sympathetic nervous system. We report a case of right arm pain which was referred from a small abdominal pseudoaneurysm like a referred pain from gall bladder. This rare entity should be considered in the differential for pain management in case that the pain does not resolve with medication or interventional pain management.

• Quality Improvement in Health Care
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• v.18 no.1
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• pp.79-87
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• 2012

문제: 투약오류는 의료기관 전반에서 가장 많이 발생하는 오류의 하나이며, 환자에게 중대한 위해를 초래하기도 한다. 특히 고농축전해질은 문제발생의 가능성과 위험성이 높아 지속적인 관리 및 교육을 필요로 하고 있다. 목적: 발생한 투약오류 건에 대한 근본원인분석을 시행함으로써 유사사례가 발생하는 것을 예방하여 환자안전을 도모하고자 한다. 의료기관: 연세대학교 세브란스병원 질 향상 활동: 투약오류 건에 대해 근본원인분석 시행 후 고위험약물 관련 내규를 보완하였고, 고위험약물에 대한 Alert System 개발, 고위험약물 라벨 부착, 약 처방 관련 의료진 교육을 시행하였다. 개선효과: 고위험약물 투여와 관련된 시스템 개선 활동 이후 유사사례는 발생하지 않았고, 의료진 교육을 통하여 환자안전에 대한 인식과 중요성을 더욱 증가시켰다.

• Journal of agricultural medicine and community health
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• v.14 no.1
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• pp.16-29
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• 1989

The general objective of this study is to grasp the treatment expenses of common diseases by character of medical care institutions. The specific objective is to find out the treatment expenses for selected common diseases by type of medical care institutions and also by level of symptom. A record review method was employed to obtain required information for the analysis of expenses. A total of 40,000 cases treated by 85 medical care institutions were selected by the study team during the period 22 June to 14 July 1988. The 85 medical care institutions were sampled by stratified proportionate random sampling method. The major findings obtained from the information collected by the study team are as follows ; 1) Treatment expenses were composed of physical examination, medication, injection anesthesia, rehabilitation surgical intervention, lab test, X-ray and diagnosis. The highest expenses was for medication, accounted for 36.7% of the total: 13.9%, injection; Lab, tests respectively: 10.5%, physical examination : 8.6% surgical intervention; 7.9% admission : 6.3%, X-ray and diagnosis: 1.5%, rehabilitation. 2) Treatment expenses per case of common diseases were quite different from not only type of medical care institutions, such as university hospital, general hospital, hospital and clinic, but also from level of symptom. 3) Treatment expenses per case for the aged were higher than that of the young. The treatment cases for over 60 years of age accounted for 19.4% of the total, however the proportion of treatment expenses accounted for 23.8% of the total. 4) Duration of treatment and visits for same diseases varied from type of medical cara institutions. Based on these study findings, the following further research should be conducted: (1) Establishment of health care delivery system. (2) Feasibility of the development of health care programme for the aged. (3) Strengthening for primary health care approach.

• Korean Journal of Adult Nursing
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• v.14 no.2
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• pp.265-275
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• 2002

Pursose: The purpose of this study was to evaluate the selected nursing interventions and to describe the most common nursing interventions used by neurosurgery unit nurses. Method: The data was collected from 65 nurses of 5 general hospitals from Jan. 8, 2001 to Feb. 28, 2001. The instrument for this study was the Korean translation of 486 nursing intervention classifications, developed by MacClosky & Bluecheck in 2000. In the 486 nursing interventions 310 nursing interventions were selected, 8 from among the 10 professional nurses group in the neurosurgery care unit. The 310 nursing interventions were used in a secondary questionnaire. In the secondary questionnaire, all 310 intervention lables and definitions were listed. The data was analysed with SPSS program. Result: The results of this study are as follows. 1. The most frequently used nursing intervention domains were "physiological: complex", "physiological: basic", "Health system", "Behavior", "Safety", "Family". 2. Neurosurgery care unit core nursing interventions were performed several times a day by 50% or more of the Neurosurgery care unit. Neurosurgery core nursing intervention, 5 domain ("physiological: complex", "physiological: basic", "Health system", "Safety", "Behavior"), 16 class, 48 core nursing intervention. The most frequently used Neurosurgery core nursing interventions were Intravenous Therapy, Pressure ulcer prevention, Documentation, Airway suctioning, Medication: intravenous, Pain management, Medication: intramuscular, Shift report, Intravenous insertion, Positioning, Aspiration precaution, Pressure management, Physician support, Pressure ulcer care. 3. Compared with carrier and age of nurses, the more effective nursing interventions were "Family", Compared with the nursing place and the use of nursing interventions of nurses the most effective nursing interventions were "Health system" performed by nurse in university hospital. Conclusion: The purpose of this study was to analysis the nursing intervention performed by neurosurgery unit nurses. This study analyses nursing intervention and core nursing interventions performed by neurosurgery unit nurses. Basis on this study result, neurosurgery nursing interventions will be systematized, and progression of qualitative nursing, data of computerized nusing information system will be utilized.

• Journal of Digital Convergence
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• v.19 no.3
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• pp.313-318
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• 2021

In order to treat a disease, it is necessary to take the medication on time, but many people often violate or forget the time they take the medicine. Applications are emerging to solve these problems using information technology. However, for existing applications, it is difficult to use because it provides only a notification functions, user interface is inconvenient, and photo registration of the medication is impossible. To solve these problems, the study developed a smart medicine management application that allows users to set up their taking routines, check if they are taking them, search hospitals and pharmacies, and attach images of medicines they are taking. Through this appliaction, it is possible to reduce the frequency of forgetting the time taken and to take accurate medication by checking the actual image. It also supports the setting of a taking routine to support multiple medications with different taking cycles. It can also provide information about hospital and pharmacies close to their current location to increase access to hospital and pharmacies.

• Journal of Korean Clinical Nursing Research
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• v.18 no.2
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• pp.251-263
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• 2012

Purpose: It was necessary for developing a neonatal classification system based on nursing needs and direct care time. This study was, thus, aimed at identifying nursing activities and measuring the standard nursing practice time for developing a neonatal patient classification system in Neonatal Intensive Care Unit (NICU). Methods: The study was taken place in 8 general hospitals located in Seoul and Kyungi province, South Korea from Dec, 2009 to Jan, 2010. By using 'the modified Workload Management System for critical care Nurses' (WMSN), nursing categories, activities, standard time, and task frequencies were measured with direct observation. The data were analyzed by using descriptive statistics. Results: Neonatal nursing activities were categorized into 8 areas: vital signs (manual), monitoring, activity of daily living (ADL), feeding, medication, treatment and procedure, respiratory therapy, and education-emotional support. The most frequent and time-consuming area was an ADL, unlike that of adult patients. Conclusion: The findings of the study provide a foundation for developing a neonatal patient classification system in NICU. Further research is warranted to verify the reliability and validity of the instrument.