• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.3
• /
• pp.85-93
• /
• 2017

The urinary tract infection (UTI) is one of the most important infections in hospital. The overuse and misuse of antimicrobial agents and the resulting emergence of resistant microorganisms have made choices regarding antimicrobial therapy more difficult. This study examined the changes in the antibiotic susceptibility to the causative organisms of urinary tract infections to provide useful information on the choice of adequate drugs in the treatment of urinary tract infections. The medical records of 2,707 patients with more than $10^5/ml$ microorganism in urine culture between January 2010 and December 2015 were reviewed retrospectively. The most common pathogenic organism was E. coli (28.1%). In the case of E.coli, there were no differences in frequency from 2010 to 2015 in men, but since 2014, the frequency decreased gradually since 2014 in women. For E. coli, the resistance rates to antibiotics were 72.2% in ampicillin, 44.9% in trimethoprim/sulfamethoxazole (TMP/SMX), and 41.3% in ciprofloxacin, but the 2nd, 3rd, and 4th cephalosporin (5%) had low antibiotic resistance rates. The pathogens of urinary tract infection are becoming diverse and their frequencies are also changing over time. These results suggest that the recommended drugs for UTI should be selected more carefully for in-patients and out-patients.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.5
• /
• pp.160-168
• /
• 2017

This study examined the awareness of the healthcare accreditation system, job stress, organizational commitment, and the turnover intention to determine the effects of these factors on the turnover intention of small and medium sized hospitals. A total of 202 nurses who worked in hospitals with less than 500 beds located in Gyeonggi-do, participated in this study. Questionnaires were given to the nurses who experienced healthcare accreditation, and data were collected between 1 December 2015 and 30 March 2016. As a result, the factors and general characteristics, influencing the turnover intention were found to be age (F=4.68, p<.001), marital condition (F=3.92, p<.001), and department of work (F=3.23, p<.008). The turnover intention was negatively correlated with the awareness of the healthcare accreditation system (r=-.46, p<.001) and nursing organizational commitment(r=-.35, p<.001), but positively correlated with the job stress (r=.21, p=.002). Regression analysis showed that the turnover intention of nurses from small and medium sized hospitals had 22.0% on the organizational commitment, department type, and job stress. Therefore, to decrease the nurses' the turnover intention, managers of small and medium sized hospitals need to draw up measures to support job involvement and policy improvement. The results also showed the difference in turnover intention according to the department type. Accordingly, there is a need for a differentiated approach according to the department of work, such as a special unit, ward, and outpatient department.

• YAKHAK HOEJI
• /
• v.54 no.4
• /
• pp.270-281
• /
• 2010

Total parenteral nutrition (TPN) is necessary to neonates in neonatal intensive care unit (NICU) for survival and growth because of impossible of enteral feeding. Long-term TPN can be associated with a broad spectrum of hepatobiliary disorder, ranging from mild hepatic dysfunction to severe end-stage liver disease. Cholestasis developed most commonly in neonate, ursodeoxycholic acid (UDCA) is widely used in adult with cholestatic and non-cholestatic liver diseases but there have been limited data on the effects in neonate with PNAC. This study was performed retrospectively to review all medical histories of the total 30 neonates with was administrated UDCA for treatment to parenteral nutrition associated cholestasis (PNAC) at Chungbuk National University Hospital NICU from April 2002 to December 2008. UDCA was administrated at bilirubin is over 2 mg/dl. The criterias for drug evaluation were included hepatic biochemical marker such as direct bilirubin, total bilirubin, AST, ALT, ALP and GGT, TPN therapy period, cholestasis development period, UDCA treatment period, UDCA dosage and adverse effect. In the results, Post-UDCA treatment significant was decreased direct bilirubin, total bilirubin, AST and ALP (p<0.05), and was decreased GGT (p>0.05) and slightly was increased ALT (p>0.05). Reffective timect biDCA was appear at mean $10.5{\pm}1.3$ days, iDCA administration period was mean $64.4{\pm}5.9$ days, cholestasis period was mean $71.9{\pm}6.4$ days and UDCA dosage was mean $22.9{\pm}0.9$ mg/kg/day. Common adverse effects is diarrhea, 5 patients arised mild diarrhea but it possible also related with increased enteral feeding. In conclusion, iDCA can decrease direct bilirubin that major parameter t bcholestasis and oher hepatic biochemical makers. UDCA is effective on PNAC without any serious side effect and cost-effective. Although no greatly shortening cholestasis period, but can protect to develop into severe liver disease and other complication or death. Based on these result, UDCA is recommended for treatment of cholestasis at direct bilirubin is over 2 mg/dl.

• Journal of Korean Academy of Nursing Administration
• /
• v.9 no.1
• /
• pp.89-101
• /
• 2003

Purpose : this study was to examine the effect of using a nursing standards for the quality of nursing care in musculo-skeletal patients. Method : The approach to nursing quality assurance evaluation was selected process-outcome framework. The subjects ware 100 case of musculo-skeletal patients in orthopedic surgery nursing care unit of E. university hospital in seoul. The data of a control group were collected from 23 December 2001 to 20 March 2002 and an experimental group were collected from 1 June to 25 August 2002. The instruments used for this study were a nursing care standards in musculo-skeletal disorder patients developed by the investigator and an evaluation tool for the quality of nursing care in orthopedic surgery patients developed by soon-ook Choi in 1995. It's reliability is Cronbach alpha=.8628. The data were analyzed by means of $x^1$-test, t-test, ANOVA with SPSS program. Results : This study are as fellows : 1. Scores of the quality of nursing care in standard 1 in the experimental group were higher than those of the control group with no significant difference(t=-8.793, p=.000), scores of the quality of nursing care in standard 2 in the experimental group were higher than those of the control group with significant difference(t=-8.793, p=.000) and standard 3 in the experimental group were higher than those of the control group with significant difference(t=-10.550, p=.000). scores of the quality of nursing care in standard 4 in the experimental group were higher than those of the control group with significant difference(t=-8.793, p=.000). scores of the quality of nursing care in standard 4 in the experimental group were higher than those of the control group with no significant difference(t=-1.833, p=.070). 2. Scores of the quality of nursing care in criteria 28 of 33 criteria in the experimental group were higher than those of the control group with significant difference in 12 criteria(p<.05 ). 3. Scores of the quality of nursing care in standard 1 to standard 4(process evaluation); the experimental group were higher than those of the control group with significant difference(t=-10.704, p=.000). scores of the quality of nursing care in standard 5(outcome evaluation); the experimental group were higher than those of the control group. but no significant difference(t=-1.833, p=.070). 4. Scores of the quality of nursing care in experimental group were higher than those of the control group with significant difference(t=-10.794, p=.000). Conclusion : Through this study, I'm sure that using a nursing care standards in musculo-skeletal disorder patients improve quality of nursing care and nursing care standards are effective nursing care.

• Journal of Korean Academy of Nursing
• /
• v.21 no.1
• /
• pp.89-116
• /
• 1991

The purpose of this study was to describe mother -infant interacting behavior patterns related to newborn infant feeding and to explore the mother's cultural belief about their infant. The data collection was conducted by observation and interview. Twenty-five mothers and their newborn infants who were normally delivered and were also planned to breast feed were comprised as the subjects of this study. All subjects were interviewed and observed individuaily at 1 to 5 days after the delivery at the hospital, mid -wife's clinic, Maternal Child Health Center and their home throughout the country from remote area to big city, The observation data were recorded with symbolic letter on a recording sheet newly developed as a result of preliminary study. The interview data were taperecorded and then recorded in narrative form. Mother - infant interaction behaviors in early feeding period were analyzed based on 19 analytic sub-categories and their composing elements. Unit of analysis were mother, infant and mother -infant dyad. 8 analytic categories draw from the data. Each were preparation, instrument, interaction inducing, evaluation referred to mother's behavior, preparation, instrument, interaction inducing referred to infant's behavior and synchronic behaviors referred to mother - infant dyad. Frequencies of behavior items based on the categories were converted to percent. The result showed that in mother's preparation behavior, the breast condition of Korean mother can be an affecting factor for mother - infant interaction during feeding, and vocalization behavior was observed most frequently in interaction inducing behavior while the least frequent behavior observed was contacting. Subcultural characteristics of mother - infant interaction behaviors were analyzed for their relationships between groups of mothers who have lived in remote area vs urban area, and who were multipara vs primipara. Using a chi -square test, there were statistically significant relationships in the activity of psychological readiness in preparation behavior and the movement of extremities for the position of instrumental behavior in both groups. However, interaction inducing behaviors were not related with statistical significance in any set of groups. Accomplishment of marriage, bonding and emotional mediation of family members were the categories related to mother's cultural belief about the infant in aspect of functional values. Infant at birth is considered little more than a biological organism without social capabilities. Although the newborn infant is still be attached to his mother, he makes his mother extend her territoriality. The mother's interacting behavior toward her infant based on those beliefs appeared task oriented, separative behavioral series. On the other hand, it was seen that infant reacted independently to his mother's behavior by the in-nate perceptual abilities. Those independent behavioral series of mother and infant on the feeding situation were synchronized at any moment. Nurses are In a unique position to teach mothers about their infant's capabilities and help reducing some of uncertainty about infant's behaviors. Study results indicated that the informations infant's social capabilities and breast feeding should be given to the mothers. The results of this study have several implications for nursing. First, the study results will be used as fundamental resources for the development of the assessment tool about the early mother - infant interaction. Second, the results could be a relevant information in the fied. I of maternal child nursing education as real and useful data. Third, the behavioral patterns of early mother - infant interaction which were classified based on the qualitative analysis could be used for nursing theory development as very fundamental data.

• The Journal of Advanced Prosthodontics
• /
• v.3 no.4
• /
• pp.229-235
• /
• 2011

PURPOSE. The aim of this retrospective study was to evaluate cumulative survival rate (CSR) of Implantium implants followed for 5 years and association between risk factors and the CSR. MATERIALS AND METHODS. A total of two hundred forty-nine Implantium Implants System (Dentium, Seoul, Korea) placed in ninety-five patients from 2004 to 2009 were investigated with several identified risk factors (sex, systemic disease, smoking, alchohol, reason of tooth loss, length, arch (maxilla or mandible), replace tooth type (incisor, canine, premolar or molar) Kennedy classification, prosthodontic type, prosthodontic design, opposite dentition, abutment type, occlusal material, occlusal unit, splint to tooth, cantilever, other surgery). Clinical examination (mobility, percussion, screw loosening, discomfort, etc.) and radiographic examination data were collected from patient records including all problems during follow-up period according to protocols described earlier. Life table analysis was undertaken to examine the CSR. Cox regression method was conducted to assess the association between potential risk factors and overall CSR. RESULTS. Five of 249 implants were failed. Four of these were lost before loading. The 5-year implant cumulative survival rate was 97.37%. Cox regression analysis demonstrated a significant predictive association between overall CSR and systemic disease, smoking, reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The screw related complication was rare. Two abutment screw fractures were found. Another complications of prosthetic components were porcelain fracture, resin facing fracture and denture fracture (n=19). CONCLUSION. The 5-year CSR of Implantium implants was 97.37 %. Implant survival may be dependent upon systemic disease, smoking reason of tooth loss, arch, Kennedy classification and prosthodontic design (P<.05). The presence of systemic diseases and combination of other surgical procedures may be associated with increased implant failure.

• Tuberculosis and Respiratory Diseases
• /
• v.70 no.5
• /
• pp.416-422
• /
• 2011

Background: Inhaled corticosteroids (ICSs) are the most essential medication for asthma control. Many reports suggest that the usage of ICSs improves not only the control of asthma symptoms but also prevents exacerbation. We investigated whether increases in ICS prescriptions are associated with decreases in asthma exacerbation in the clinical practice setting. Methods: We retrospectively analyzed the database of adult asthma patients who had visited a tertiary referral hospital, the Asan Medical Center between January 2000 and December 2009. The number of emergency department (ED) visits, admissions, intensive care unit (ICU) care, deaths, and ICS prescriptions were analyzed to evaluate the time trend of asthma exacerbation as a function of the ICS prescription rate during the ten years. Results: The numbers of ED visits, admissions, and episodes of ICU care decreased during the ten years (p<0.001, p=0.033, p=0.001, respectively) while the number of ICS prescriptions increased (p<0.001). We found a correlation between the number of ICS prescriptions and the number of ED visits, admissions, or ICU care. For these outcomes, the correlation coefficients were r=-0.952, p<0.001; r=-0.673, p=0.033; r=-0.948, p<0.001, respectively. Conclusion: The number of ICS prescriptions increased during the past ten years while the number of asthma exacerbations decreased. Our results also showed a negative correlation between the ICS prescription rate and asthma exacerbation in the clinical practice setting. In other words, an increase in ICS prescription may be a major cause of a decrease in asthma exacerbations.

• Journal of Korean Academy of Nursing
• /
• v.23 no.4
• /
• pp.664-677
• /
• 1993

The purpose of this study was to provide basic data for the development of educational material in Korean for patient3 being discharge after open heart surgery. The subjects were 45 adult patients who were seen in the out -patient department of the thoracic surgery unit of P University hospital between February 1993 and May 1993. The data were collected through a chart review and interview. Nursing needs, and the patients status related to diet, activity, medication, physical and psychoemotional limitations were analyzed. The results are summarized as follows ; 1. Mitral valve replacement was the most frequent type of surgery(91.2%). In most cases, a mechanical valve was used (91.0%) . The duration of admission after the operation was two to four weeks for most of the patients(48.9%). The follow-up period was between one and two years for 28.9% of the patients and below 6 years for all of the patients. 2. Many Patients didn’t know the importance of a low salt diet(57.8%), and did not get any education on low salt diet (66.7%). Gimchi was included as one of the most commonly ingested foods (77.8%). All of the patients indicated nursing needs related to education about low salt diets and further they indicated a major interest in foods that are harmful (57.7%) or foods that are safe(51.1% ). 3. Most patients did not recognize the need for limitations on physical activity(84.4%). Further, 31.1％ of them could not return to work at the time of the study. All patients had nursing needs related to physical activity, with the most frequent questions being about the permissble degree of activity and special cautions dictated by their illness (60.0%). 4. Many patients were ignorant of the necessity of medication(55.6%) . Forty percent of the patients were taking additional drugs, usually herb drugs. The time and duration of medication and the side effects of drugs were common concerns (57.7%) related to nursing. needs about medication and were mentioned by all of the patients. 5. All of the patients complained of physical discomfort including the following : memory disturbance(62.2%), weight gain(60.0%), chest tightness (55.6%), hair loss(51.1%), sleep disturbance(46.7%) and other symptoms in that order of frequency. Nursing needs related to physical condition were a concern for all of them. The viability and function of the replaced valve(53.3%) and weight gain(60.0%) were mal or concerns. 6. Looking at their psychoemotional condition it was found that 36 patients(80.0%) were emotionally unstable. The causes were physical discomfort(17 patients), insufficient knowlege of open heart surgery(6 patients), fear of death(6 patients), familial over protection(2 patients ) and lack of support (5 patients).

• Journal of Korean Academy of Nursing
• /
• v.15 no.3
• /
• pp.74-80
• /
• 1985

This study was attempted to identify the difference between body image of the patients with lower limb fracture and that of normal persons, and to examine if supportive group care could offer an apportunity for positive change in body image of the patient with lower limb fracture under the Quasi-experimental design. The subjects for this study were obtained by ta-king convenient sample of soldiers; the experimental group were 44 lower limb fractured patients hospitalized on the orthopedic Surgery unit in S Army General Hospital, while the control group were 44 normal enlisted men serving in the B Army regiment. Supportive group nursing care was given to the lower limb fractured patients who belong to the experimental group. Pre-and post-tests were administered to the experimental and the control group. The instruments to measure body image of the subjects were body Cathexis Scale developed by Scord and Jourard (1953) and Body Meaning Scale dove-loped by the reseacher. The reliability coefficients by Cronhach's u-test were .95 in body Cathexis Scale and .89 in Body Meaning Scale in this study. Data for this study were collected over a period 12 days from the 12th to the 24th of October, 1984 by the questionnaire. Data were analyzed by computer. Frequency, Percentage and x²-test were used to examine general chacteristics of the subjects. t-test was used to analyze the hypotheses. Analysis of variance was used to test difference in body image between groups classified by the general characteristics. Pearson Correlation Coefficient was used to identify the correlation between Body Cathexis Scale and Body Cathexis Scale and Body Meaning Scale. The results of this study were as follows: 1. No significant difference was found between the experimental and the control group on general characteristics of the subjects (p> .05). 2. Hypothesis I:“There will be a difference in body image between patiens with lower limb fracture and normal persons,”was supported(Body Cathexis t=6.91, p<.001, Body Meaning t=5.66, p< .001). 3. Hypothesis Ⅱ;“The will be a difference in body image of patients with lower limb fracture bet-ween after and before, supportive group nursing care was provided,”was supported (Body Cathexis t=5.90, p<.001, Body Meaning t=4.45, p <.001). 4. There was no significant difference in body image between groups classified by the general characteristics (p> .05). 5. The correlation between Body Cathexis Scale and Body Meaning Scale: It was reported that Body Cathexis Scale correlated with Body Meaning Scale in total subjects of the experimental and control group (r=.744, p<.001). That is, there was relatively high correlation between two scales. body Cathexis Scale correlated with Body Meaning Scale in the experimental group(r=.738, p <.001) and in the control group (r=.352, p <.001). That is, there was more than moderate correlation between two scales. In conclusion, it was found that there was a difference in body image between patients with lower limb fracture and normal persons, and supportive group nursing care offered an opportunity for positive change in body image of the patient with lower limb fracture.

• Journal of Korean Academy of Nursing
• /
• v.12 no.2
• /
• pp.57-66
• /
• 1982

This study was undertaken to delineate the relationship between numerical score and the amount of nursing hours required in the nursing process. Score was a numerical description of the patients functional nursing needs. Therefore this study focused on standard nursing hours required by patient's self-care status. This study observed the 62 patients and 15 R.N. in H. university hospital from Aug. 7, 1982 to Aug. 13, 1982. 1. For the first time, each head nurse assessed self-care status by Schoening's self-care score-Minimal care patient (self-care score: 23, 24) was placed in Group Ⅰ, intermediate care patient (self-care score: 11∼22) was Group Ⅱ, and special care score: 0∼10) was Group Ⅲ. 2. We observed and recorded the nursing care received from nurses according to patient's group. (8AM∼4PM) 3. And, We observed and recorded the activities of nurses in order to determine standard nursing hours required. (8AM∼4PM) 4. If we apply the content of paragraph 3 to paragraph 2, we will predict the number of patient that nurse can care during day time by self-care status. The following results were obtained: 1) Patient's mean self-care score were Group I : 23.9 score Group Ⅱ：17.8 score Group Ⅲ : 1.6 score 2) Nursing hours required by patient's physical function(self-care status) status were Group I : 35 min. Group Ⅱ: 47.5 min. Group Ⅲ : 104.6 min. 3) Nurse's nursing time and distribution required in nursing activities during day duty were A.D.L. : 84.3min. (17.56％) Functional nursing activities : 279.9min. (58.31 ％) Education ＆ Emotional support : 11.3min. (2.35%) Task unrelated patients : 54min. (11.25%) Non Productive nursing care : 50. 5min. (10.52％) 4) Mean nursing hours required by each patient and the number of patient that nurse can rare during day duty by self-care status were Group I : 38.6min. 11.1 patients/1 nurse Group Ⅱ : 51.1min: 8.4 patients/1 nurse Group Ⅲ： 108.2min. 4 patients/1 nurse It seems reasonable that this could be done effectively as each-unit has an established standard for hours required, This not only allows time for planning of staff but helps to avoid the very human inclination to predict excessive staffing requirements by placing the majority of patients in high care group.