• Title/Summary/Keyword: Hospital unit

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A study on the degree of need of the knowledge of pathophysiology, clinical microbiology and mechanisms and effects of drugs in clinical nurses (기초간호자연과학의 병태생리학, 병원미생물, 약물의 기전과 효과 내용별 필요도에 대한 연구)

  • Choe, Myoung-Ae;Byun, Young-Soon;Seo, Young-Sook;Hwang, Ae-Ran;Kim, Hee-Seung;Hong, Hae-Sook;Park, Mi-Jung;Choi, S-Mi;Lee, Kyung-Sook;Seo, Wha-Sook;Shin, Gi-Soo
    • Journal of Korean Biological Nursing Science
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    • v.2 no.1
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    • pp.1-19
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    • 2000
  • The purpose of this study was to define the content of the requisite knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for clinical knowledge for nursing practice. Contents of knowlege on pathological physiology, clinical microbiology, and mechanisms and effects of drugs were constructed from syllabus of basic nursing subjects in 4 colleges of nursing, and textbooks. The degree of need of 72 items was measured with a 4 point scale. The subjects of this study were college-graduated 136 nurses from seven university hospital in Seoul and three in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, and hospice ward. The results were as follows : 1. The highest scored items of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice were side effects of drugs, anticoagulants, mechanisms of drugs, antihypertensive drugs, tolerance and addiction of drugs, interactions among drugs, hospital infection in the order of importance. The lowest scored item was structure of microorganisms. 2. The highest order of need according to unit was repair in tissue injury unit, definition etiology classification of inflammation in inflammation unit, transplantation and immunologic response in alterations in immunity unit, thrombus and thrombosis in disorders of cardiovascular function unit, gene disorders in genetic disorders unit, hospital infection in infection unit, virus in microorganisms unit, side reactions of drugs in introduction unit, anticonvulsants in drugs for central nervous system unit, local anesthesia in anesthesia unit, anticoagulants in drugs for cardiovascular system unit, anti-inflammatory drugs in antibiotics unit, anti-ulcer drugs in drugs for digestive system unit, and bronchodilators in drugs for respiratory system unit. 3. The common content of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for all clinical areas in nursing were side effects of drugs, anticoagulants, interactions among drugs, and hospital infection. However, the degree of need of each pathological physiology, clinical microbiology, clinical microbiology, and mechanisms and effects of drugs was different depending on clinical areas. 4. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as tissue changes due to injurious stimuli, degenerative changes of tissue, alterations in metabolism of carbohydrates, ischemia, hyperemia and congestion, hospital infection, structure of microorganism, classification of microorganism, bacteria, virus, antidepressants, antipsychotic drugs, antiemetic drugs, antiparkinsonism drugs, antianxiety drugs, antibiotics, tuberculostatics, antiviral drugs, antifungal drugs, parasiticides, antiulcer drugs, antidiarrheais, and anti constipation drugs were shown according to the work area. 5. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as transplantation and immunologic response, alterations in the metabolism of uric acid, structure of microorganism, classification of microorganism, immunosuppressants, drugs for congestive heart failure were demonstrated according to the duration of work. Based on these findings, all the 72 items constructed by Korean Academic Society of Basic Nursing science should be included as contents of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs.

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Incidence and Predictors of Inadequate Bowel Preparation before Elective Colonoscopy in Thai Patients

  • Bhanthumkomol, Patommatat;Siramolpiwat, Sith;Vilaichone, Ratha-Korn
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.24
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    • pp.10763-10768
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    • 2015
  • Background: The incidence of inadequate bowel preparation before elective colonoscopy in this region has never been studied. Materials and Methods: The authors prospectively described the incidence and factors related to inadequate bowel preparation in Thammasat university hospital. Bowel preparation quality was accessed by using Aronchick scale. Factors associated with inadequate bowel preparation were also recorded. Results: Two hundred patients undergoing elective outpatient colonoscopy were enrolled. Inadequate and fair bowel preparation was documented in 9 and 43%, respectively. Factors associated with inadequate bowel preparation were incomplete cleansing agent ingestion (odds ratio 7.7; 95%CI 1.62-36.64) and patient's unrecognization of vegetable avoidance (odds ratio 3.26; 95%CI 1.14-9.28). Conclusions: Compared with previous reported, inadequate bowel preparation was seen less in our study, however, more patients with fair bowel preparation was documented. Further study aiming at investigating the type and amount of fiber contained in diet before elective colonoscopy should be commenced.

Impact of Socioeconomic Status on 30-Day and 1-Year Mortalities after Intensive Care Unit Admission in South Korea: A Retrospective Cohort Study

  • Oh, Tak Kyu;Jo, Jihoon;Jeon, Young-Tae;Song, In-Ae
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.230-237
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    • 2018
  • Background: Socioeconomic status (SES) is closely associated with health outcomes, including mortality in critically ill patients admitted to intensive care unit (ICU). However, research regarding this issue is lacking, especially in countries where the National Health Insurance System is mainly responsible for health care. This study aimed to investigate how the SES of ICU patients in South Korea is associated with mortality. Methods: This was a retrospective observational study of adult patients aged ${\geq}20$ years admitted to ICU. Associations between SES-related factors recorded at the time of ICU admission and 30-day and 1-year mortalities were analyzed using univariable and multivariable Cox regression analyses. Results: A total of 6,008 patients were included. Of these, 394 (6.6%) died within 30 days of ICU admission, and 1,125 (18.7%) died within 1 year. Multivariable Cox regression analysis found no significant associations between 30-day mortality after ICU admission and SES factors (P>0.05). However, occupation was significantly associated with 1-year mortality after ICU admission. Conclusions: Our study shows that 30-day mortality after ICU admission is not associated with SES in the National Health Insurance coverage setting. However, occupation was associated with 1-year mortality after ICU admission.

Evolution of trauma care and the trauma registry in the West Australian health system

  • Iddagoda, Mayura Thilanka;Burrell, Maxine;Rao, Sudhakar;Flicker, Leon
    • Journal of Trauma and Injury
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    • v.35 no.2
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    • pp.71-75
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    • 2022
  • Trauma care is evolving throughout the world to meet the demand resulting from rapidly increasing rates of mortality and morbidity related to external injuries. The State Major Trauma Service was designated to Royal Perth Hospital in 2004 to provide comprehensive care for trauma patients in Western Australia (WA), which is the largest state by area in the country. The State Major Trauma Unit, which was established in 2008, functions as a level I center and admits over 1,000 major trauma patients per year, making it the second busiest trauma center in Australia. The importance of recording data related to trauma was identified by the trauma service in WA to inspire higher standards of patient care and injury prevention. In 1994, the service established a trauma registry, which has undergone significant changes over the last two decades. The current State Trauma Registry is linked to a statewide database called the Data Linkage System. The linked data are available for policy development, quality assurance, and research. This article discusses the evolution of the trauma service and the registry database in the WA health system. The State Trauma Registry has enormous potential to contribute to research and quality improvement studies along with its ability to link with other databases.

Male Breast Carcinoma: Epidemiology, Risk Factors and Current Therapeutic Approaches

  • Zygogianni, Anna G.;Kyrgias, George;Gennatas, Costantinos;Ilknur, Aytas;Armonis, Vassilios;Tolia, Maria;Papaloukas, Christos;Pistevou, Gompaki;Kouvaris, John;Kouloulias, Vassilios
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.15-19
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    • 2012
  • Male breast cancer is a very rare disease with an incidence of about 0.5-1% comparing with the one of female breast cancer but relatively little is known about its cause. Treatment strategies for breast cancer in males are derived from studies performed among females. The probable reasons behind the frequent, late diagnoses presented at stages III or IV might be the lack of awareness. The rarity of the disease precludes large prospective randomized clinical trials. This study reviews male breast cancer and its risk factors, recommendations for diagnosis and the management of patients with male breast cancer.

Calculation of Optimum Number of Nurses Based on Nursing Intensity of Intensive Care Units (중환자 간호단위의 간호강도에 근거한 적정 간호사 수 산출)

  • Ko, Yukyung;Park, Bohyun
    • Korea Journal of Hospital Management
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    • v.25 no.3
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    • pp.14-28
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    • 2020
  • Purpose: The purpose of this study was to calculate the total daily nursing workload and the optimum number of nurses per intensive care unit (ICU) based on the nursing intensity and the direct nursing time per inpatient using the patient classification. Methods: Two ICUs at one general hospital were investigated. To calculate the nursing intensity, patient classification according to the nursing needs was conducted for 10 days in each unit during September 2018. We performed patient classifications for a total of 167 patient-days in the Medical Intensive Care Unit (MICU) and 86 patient-days in the Surgical Intensive Care Unit (SICU). The total number of person-days for nurses who responded to the Nursing Time survey was 151 for MICU and 85 for SICU. In each unit, direct and non-direct nursing hours, nursing intensity score, and direct nursing hours were analyzed using descriptive statistics such as frequency, percentage, and average calculated using Microsoft Excel. The amount of nursing workload and the optimum number of nurses were calculated according to the formula developed by the authors. Findings: For the MICU, the average direct nursing time per patient was 5.59 hours for Group 1, 6.98 hours for Group 2, and 9.28 hours for Group 3. For the SICU, the average direct nursing time per patient was 5.43 hours for Group 1, 7.21 hours for Group 2, 9.75 hours for Group 3, and 12.82 hours for Group 4. Practical Implications: This study confirmed that the appropriate number of nurses was not secured in the nursing unit of this study, and that leisure time such as meal time during nursing work hours was not properly guaranteed. The findings suggest that to create working environments where nurses can serve for extended periods of time without compromising their professional standards, hospitals should secure an appropriate number of nurses.

Development of the Core Task and Competency Matrix for Unit Managers (병원 간호단위관리자의 핵심직무 ­- 핵심역량 매트릭스 개발)

  • Lee, Tae Wha;Kang, Kyeong Hwa;Lee, Seon Heui;Ko, Yu Kyung;Park, Jeong Sook;Lee, Sae Rom;Yu, Soyoung
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.2
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    • pp.189-201
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    • 2017
  • Purpose: The aim of this study was to develop the nursing management core task and competency matrix for hospital unit managers. The perceived level of importance and performance of identified core competencies by unit managers were also investigated. Methods: Literature review and expert survey identified nursing management core task and competencies. Subsequently, the core task and competency matrix was developed and validated by expert panel. A survey of 196 nurse managers from 3 cities identified perceived importance and performance of core competiences. Results: Thirty-eight nursing management core task and thirty-seven nursing management core competencies were identified comprising five categories; Clinical practice knowledge, Evidence-based practice, Employee development, Strategic planning and Initiative. Based on the core task and competencies, the task and competency matrix for unit managers was developed. In the analysis of importance and performance of core competencies, the mean score of importance ($3.50{\pm}0.30$) was higher than the mean score of performance ($3.03{\pm}0.34$). Conclusion: The development of core task and competencies for unit managers in hospitals provides a guide for the development and evaluation of programs designed to increase competence of unit managers.

Analysis of Decision-Making Situations and Alternatives for Clinical Nurses in a University Hospital (일 대학 병원 임상간호사의 의사결정상황과 대안에 관한 분석)

  • Kim, Myung-Hee;Choi, Won-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.4
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    • pp.449-457
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    • 2004
  • Purpose: This study seeks to identify situations where nurses are required to consider alternatives, for the delivery of nursing care, appropriate to the needs of a medical care unit, surgical care unit, and intensive care unit in a university hospital. Method: Data was collected from 100 nurses using an open questionnaire, during a one week period in May, 2003. These nurses all had at least two years of experience within a medical care unit, surgical care unit, or intensive care unit at a university hospital. Results: The situations that nurses typically faced were categorized into 21 problems for nurses including : respiratory problems(26.8%), pain(23.6%), problems in relation to bowel habit(23.2%). In cases where nurses were faced with making decisions in relation to solving respiratory problems, the alternatives included ; applying oxygen(29.3%), physical assessment and monitoring(14.7%), refining and modifying order and suggestion order(9.3%). Ventilator care(9.3%), was chosen to solve pain problems ; doing pm orders(30.3%), placebo medication(27.3%), and to refine and modify orders and suggestions(18.2%). To solve problems in relation to bowel habits ; enemas accounted for 32.3%, and laxative medication 30.8%. Conclusion: To improve the quality of nursing, the outcome of nursing care associated with 21 problems for nurses including : respiratory problems, pain, and problems in relation to bowel habit, should be identified and the best alternative nursing care should be developed.

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Quality Over Volume: Modeling Centralization of Gastric Cancer Resections in Italy

  • Lorenzon, Laura;Biondi, Alberto;Agnes, Annamaria;Scrima, Ottavio;Persiani, Roberto;D'Ugo, Domenico
    • Journal of Gastric Cancer
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    • v.22 no.1
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    • pp.35-46
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    • 2022
  • Background: The correlation between hospital volume and postoperative outcomes has led to the centralization of complex procedures in several countries. However, the results reported in relation to gastric cancer (GC) are contradictory. This study aimed to analyze GC surgical volumes and 30-day postoperative mortality in Italy and to provide a simulation for modeling centralization of GC resections based on district case volumes. Methods: A national registry was used to identify all GC resections, record mortality rates, and track the national in-border GC resection health travel. Hospitals were grouped according to caseload. Centralization of all GC procedures performed within the same district was modeled. The outcome measures were a minimal volume of 25 GC resections/year and the 30-day postoperative mortality. Results: In 2018, 5,873 GC resections were performed in 498 Italian hospitals (mean resections per hospital per year: 11.8); the postoperative mortality rate (5.51%) was tracked from 2016-2018. GC resection health travel ranged from 2% to 50.5%, with a significant (P<0.001) difference between northern and central/southern Italy. The mean mortality rate was 7.7% in hospitals performing one to 3 GC resections per year, compared with 4.7% in those with >17 GC resections/year (P≤0.01). Most Italian districts achieved 25 procedures/year after centralization; however, 66.3% of GC cases in southern Italy vs. 42.2% in central and 52.7% in the northern regions (P<0.001) required reallocation. Conclusion: Postoperative mortality after GC resection correlated with hospital volume. Despite health travel, most Italian districts can reach a high-volume threshold, but discrepancies in mortality rates are alarming.Trial RegistrationResearch Registry Identifierresearchregistry6869

A Study on Nursing Unit Culture, Efficiency on Nursing Performance, Job Satisfaction and Turnover Intention (간호단위문화와 간호업무수행, 직무만족 및 이직의도와의 관계)

  • Kim, So-In;Kim, Jeong-Ah
    • Journal of Korean Academy of Nursing Administration
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    • v.3 no.2
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    • pp.17-40
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    • 1997
  • The purpose of this descriptive, correlational study was to identify, describe the patterns of nursing unit culture, nursing performance, job satisfaction and turnover intention in the hospital setting, and to analyze the relationships between nursing unit culture, nursing performance, job satisfaction and turnover intention among the characteristic of the subjects The subject consisted of 223 nurses who were employed in medical & surgical units of 3 different University hospitals in Seoul. Data collection was done in November, 1996 by means of questionnaire. The instruments used for this study were the questionnaire based on the Nursing unit cultural assessment tool developed by Coeling(1993), Nursing performance scale used by Yoon(1991), Job satisfaction scale developed by Slavitt, et al.(1978) and Turnover intention scale used by Lee(1995). The data were analyzed by percentage distribution. Pearson correlation coefficient and ANOVA. The summarized results were as follows: 1. There was significant differences in the nursing unit culture between individual cultural behavior and group cultural behavior. 2. There was positive correlation between nursing unit culture, nursing performance and job satisfaction. 3. There was negative correlation between nursing unit culture and turnover intention. 4. There was significant difference in nursing performance efficiency according to the age, educational level, professional carrier in the nursing unit, in the hospital. 5. There was significant difference in turnover intention according to the age, educational level. According to these results, the following implications can be made ; 1. It needs to study on the nursing unit culture in other size hospitals and compare them to these results. 2. It is necessary to assess nursing unit culture and endeaveor good climate for the nursing organizational outcomes and prepare the training course of leadership of nurse manager. 3. In nursing administration, there should be an emphasis on assessment of staff nurses' cultural behavior in case of nurses' orientation, allocation, recruitment, continuning education, so that staff nurses' performance and job satisfaction will be increased and trunover intention will be decreased.

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