• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제1권2호
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• pp.17-27
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• 1996

This study is on the suitability of unit plan of out-patient department of general hospital. In this study, we make a survey and behavioural check of a general hospital in Seoul and a conclusion was derived from the research.

• 한국의료질향상학회지
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• 제4권1호
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• pp.50-63
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• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

• 한국의료질향상학회지
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• 제8권1호
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• pp.84-94
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• 2001

Background : in order to adapt to changes of the medical environm interests that is drawn in ambulatory surgery are increased as a method of approaching a patients' satisfaction and cost-effective management. The purpose of this study is to a assess the operation which is able to perform through ambulatory care unit, to identify the problem in ambulatory surgery, and to increased the opportunity of ambulatory surgery with safety. Methods : Between May 13th, 1998 and June 30th, 2000, we performed surgical treatment through ambulatory care unit, and evaluate the results of them. The sorts of operation, duration of stay in the hospital, total cost of treatment, satisfaction of patients and safety if anesthesia were assessed. Results : We performed ambulatory surgery without serve complications and the patients were satisfied with surgical treatment through ambulatory care unit. In comparison of ambulatory and admission surgery, there was a reduction of cost to 16.7~25.3% in ambulatory surgery. Also, the duration of admission was 2 days shorter than admission surgery. Conclusions : According to our results, the surgical treatment through ambulatory care unit is safe and useful method that increase the quality of medical service, satisfaction of patients and reduce the cost of treatments.

• 대한간호학회지
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• 제52권2호
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• pp.134-143
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• 2022

Purpose: The study aimed to understand the delirium experience of intensive care unit (ICU) patients. Methods: We performed a qualitative study using Colaizzi's phenomenological method. Eleven patients, who experienced delirium according to the Confusion Assessment Method for ICU, participated after transferring to general wards from the ICU. Individual in-depth semi-structured interviews ranging from 30 minutes to 2 hours in length were conducted between November 2018 and August 2019. Results: Nine themes and four theme clusters emerged. The four theme clusters were: 1) "Overwhelmed by fear," which describes the experience of a patient close to death and the feeling of difficulty in understanding disorganized thinking; 2) "Anxious about not understanding the situation," which means that patients' sense of time and space were disordered in the ICU; 3) "Being deserted," which indicates the feeling of being separated from others and yourself; and 4) "Resistance to protect my dignity," which indicates that the dignity and autonomy of an individual in the patient's position at the ICU, are ignored. Conclusion: Nursing interventions are needed that would enable patients to maintain orientation and self-esteem in the ICU. In addition, healthcare providers need to provide information about the unfamiliar environment in the ICU in advance.

• Journal of Korean Biological Nursing Science
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• 제15권1호
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• pp.15-23
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• 2013

Purpose: The purpose of this study was to identify the relationship among the attitudes on exercise, physical activity and quality of life (QOL) in hemodialysis patients. Methods: A total of 42 patients in a hemodialysis unit participated in this study. Physical activity level was measured directly by 6 minute walking test and grip strength test. Structured questionnaires were also used for measuring their attitudes on exercise, physical activity and QOL. Participants' medical records were reviewed for obtaining their biochemical and clinical information. Statistical analysis was performed using Pearson correlation, and multiple liner regression. Results: A significant positive correlation between participants' attitudes and physical activity level measured by International Physical Activity Questionnaire (IPAQ) was found. And the physical activity level measured by Korea Activity Scale/Index (KASI) was significantly related to QOL. Conclusion: This study shows that QOL of the hemodialysis patients was significantly associated with their physical activity level.

• BMB Reports
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• 제45권9호
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• pp.489-495
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• 2012

Ischemia is a blockage of blood supply due to an embolism or a hemorrhage in a blood vessel. When an organ cannot receive oxygenated blood and can therefore no longer replenish its blood supply due to ischemia, stresses, such as the disruption of blood glucose homeostasis, hypoglycemia and hypoxia, activate the AMPK complex. LKB1 and $CaMKK{\beta}$ are essential activators of the AMPK signaling pathway. AMPK triggers proangiogenic effects through the eNOS protein in tissues with ischemic conditions, where cells are vulnerable to apoptosis, autophagy and necrosis. The AMPK complex acts to restore blood glucose levels and ATP levels back to homeostasis. This review will discuss AMPK, as well as its key activators (LKB1 and $CaMKK{\beta}$), as a central energy regulator and evaluate the upstream and downstream regulating pathways of AMPK. We will also discuss how we can control this important enzyme in ischemic conditions to prevent harmful effects in patients with vascular damage.

• 디지털융복합연구
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• 제14권6호
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• pp.355-362
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• 2016

본 연구의 목적은 3차 의료기관 1개소에 재직 중인 간호사를 대상으로 간호사의 이직의도에 대한 간호단위별 간호근무환경의 영향을 파악하기 위함이다. 서울 소재 의료기관의 24개 간호단위, 간호사 267명을 대상으로 서술적 관계 조사연구를 시행하였다. 자료수집은 2013년 11월에 수행되었으며, 분석은 SPSS/WIN 23.0 프로그램을 이용하여 실시하였다. 연구결과, 간호사의 이직의도는 간호단위 차원의 간호근무환경과 관련이 있는 것으로 나타났다. 또한, 간호사의 이직의도 예측요인으로 연령, 간호근무환경이 유의한 변수로 도출되었으며, 23.0%의 설명력을 보였다. 본 연구결과를 토대로 의료기관은 간호사의 병원운영 참여, 간호 관리자의 리더십 향상, 간호사와 의사의 협력적 관계형성 등 간호단위별 간호근무환경의 개선을 통해 간호사의 확보수준 향상 및 이직의도 감소를 위한 전략을 수립할 수 있다.

• The Korean Journal of Physiology and Pharmacology
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• 제25권4호
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• pp.281-296
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• 2021

The beneficial effects of hypoxic preconditioning are abolished in the diabetes. The present study was designed to investigate the protective effects and mechanisms of repeated episodes of whole body hypoxic preconditioning (WBHP) in db/db mice. The protective effects of preconditioning were explored on diabetes-induced vascular dysfunction, cognitive impairment and ischemia-reperfusion (IR)-induced increase in myocardial injury. Sixteen-week old db/db (diabetic) and C57BL/6 (non-diabetic) mice were employed. There was a significant impairment in cognitive function (Morris Water Maze test), endothelial function (acetylcholine-induced relaxation in aortic rings) and a significant increase in IR-induced heart injury (Langendorff apparatus) in db/db mice. WBHP stimulus was given by exposing mice to four alternate cycles of low (8%) and normal air O₂ for 10 min each. A single episode of WBHP failed to produce protection; however, two and three episodes of WBHP significantly produced beneficial effects on the heart, brain and blood vessels. There was a significant increase in the levels of brain-derived neurotrophic factor (BDNF) and nitric oxide (NO) in response to 3 episodes of WBHP. Moreover, pretreatment with the BDNF receptor, TrkB antagonist (ANA-12) and NO synthase inhibitor (L-NAME) attenuated the protective effects imparted by three episodes of WBHP. These pharmacological agents abolished WBHP-induced restoration of p-GSK-3β/GSK-3β ratio and Nrf2 levels in IR-subjected hearts. It is concluded that repeated episodes of WHBP attenuate cognitive impairment, vascular dysfunction and enhancement in IR-induced myocardial injury in diabetic mice be due to increase in NO and BDNF levels that may eventually activate GSK-3β and Nrf2 signaling pathway to confer protection.

• Child Health Nursing Research
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• 제25권3호
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• pp.255-261
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• 2019

Purpose: This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity. Methods: Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination. Results: The infants' mean gestational age and weight at birth were $33.1{\pm}2.1$ weeks and $1,842{\pm}470g$, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups. Conclusion: Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.

• 대한임상약리학회:학술대회논문집
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• 대한임상약리학회 1994년도 정기총회 및 추계학술대회
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• pp.37-37
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• 1994