• Title/Summary/Keyword: Hospital unit

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A Comparison of Shared Governance and Nursing Unit Culture in Three Hospitals (공유관리와 간호단위문화에 대한 조사;세개 종합병원 대상)

  • Kang, Sun-Joo
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.17-33
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    • 1996
  • The primary purpose this descriptive study was to identify, describe, and compare the patterns of shared governance and nursing unit culture in the hospital settings. The secondary purpose of the research was to identify, describe whether the participation style or responsibility style of nursing management activities shared through nurses in a consistent way. Methodology included survey and in-depth interviews with a total 145 members of 15 nursing units in 3 hospitals. One was a national hospital, another was a corporation hospital and the other was a teaching hospitals. Conclusions from this research included the following: 1. The degree of shared governance in nursing management activities was the highest in the corporation hospital. 2. In the participation style of nursing management activities, 'all participation' was the highest in the corporation hospital. 'Nursing administration only' was the highest in the national hospital. 3. Distribution of responsibility style differed from that of participation style. Three hospitals showed high in nursing management activities such as 'nursing administration only' and 'head nurse only' style. 4. Five experts surveyed showed that the ideal level of nurses' participation in nursing management activities was a traditional nursing governance pattern. 5. There was a distinct difference in the nursing unit culture throughout the institutions in the professional growth. 6. There was no significant difference in the same nursing units of three hospitals in nursing unit culture. According to these results, the following implications can be made; 1. In nursing administration, there should be an emphasis on preparing staff nurses' potential decision-making ability through continuing education so that staff nurses' autonomy and responsibility will be developed and increased. 2. It is necessary to develop a strategic nursing unit for improving nursing quality in hospital setting. 3. The relationship of shared governance, nursing unit culture and nursing outcome should be researched further.

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The Role of the Teaching Hospital in the Effective Clerkship (효과적인 임상실습을 위한 교육병원의 역할)

  • Baek, Sun Yong;Yun, So Jung;Kam, Beesung;Lee, Sang Yeoup;Woo, Jae Seok;Im, Sun Ju
    • Korean Medical Education Review
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    • v.17 no.1
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    • pp.5-9
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    • 2015
  • A teaching hospital is a place where both patient care and learning occur together. To identify the role of the teaching hospital in an effective clerkship, we first determined the features of workplace learning and the factors that affect learning in the workplace, and then we proposed a role for the teaching hospital in the clinical clerkship. Features of learning in a clerkship include learning in context, and learning from patients, supervising doctors, others in the team, and colleagues. During the clerkship, medical students learn in three-way learner-patient-teacher relationships, and students' participation in the tasks of patient care is crucial for learning. Factors that influence learning in the workplace are associated with tasks, context, and learner. Tying the three factors together, we proposed a role for the teaching hospital in the three categories: involvement in the tasks of patient care, engagement in the medical team, and engagement in the learning environment and system. Supervising doctors and team members in a teaching hospital support students' deep participation in patient care, while improving the learning environment through organizational guidelines and systems. Gathering both qualitative and quantitative data for the evaluation of a teaching hospital is important.

Lympho-Vascular Space Invasion Indicates Advanced Disease for Uterine Papillary Serous Tumors Arising from Polyps

  • Ilker, Selcuk;Elmas, Korkmaz;Emre, Ozgu;Mengu, Turker;Erkaya, Salim;Tayfun, Gungor
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.10
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    • pp.4257-4260
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    • 2015
  • Background: Uterine papillary serous tumors are rarely seen and behave aggressively. Our aim was to evaluate uterine papillary serous tumors arising from polyps. Materials and Methods: Clinicopathological data of patients with uterine serous cancer arising from a polyp at the Gynecological Oncology Department of Zekai Tahir Burak Women's Health Education and Research Hospital were reviewed retrospectively. Results: We analyzed patients according to FIGO 2009 staging system as stage 1A and higher than stage 1A (3 and 6, respectively). All the patients were postmenopausal. Mean CA-125, CA-19.9 and CA15.3 levels were elevated in higher than stage 1A group. However we did not find a statistical difference between age, parity, polyp size, CA-125, CA-15.3, CA-19.9 and CEA levels. Lympho-vascular space invasion (LVSI) showed predictivity for advanced disease (p=0.025). Conclusions: The histopathologic nature of uterine serous carcinoma is a unique entity. LVSI is a prognosticator for defining an advanced stage uterine papillary tumor.

Comparative Study of Multimodal Therapy in Facial Palsy Patients

  • Neville, Catriona;Gwynn, Tamsin;Young, Karen;Jordan, Elizabeth;Malhotra, Raman;Nduka, Charles;Kannan, Ruben Yap
    • Archives of Plastic Surgery
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    • v.49 no.5
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    • pp.633-641
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    • 2022
  • Introduction In chronic facial palsy, synkinetic muscle overactivity and shortening causes muscle stiffness resulting in reduced movement and functional activity. This article studies the role of multimodal therapy in improving outcomes. Methods Seventy-five facial palsy patients completed facial rehabilitation before being successfully discharged by the facial therapy team. The cohort was divided into four subgroups depending on the time of initial attendance post-onset. The requirement for facial therapy, chemodenervation, or surgery was assessed with East Grinstead Grade of Stiffness (EGGS). Outcomes were measured using the Facial Grading Scale (FGS), Facial Disability Index, House-Brackmann scores, and the Facial Clinimetric Evaluation scale. Results FGS composite scores significantly improved posttherapy (mean-standard deviation, 60.13 ± 23.24 vs. 79.9 ± 13.01; confidence interval, -24.51 to -14.66, p < 0.0001). Analysis of FGS subsets showed that synkinesis also reduced significantly (p < 0.0001). Increasingly, late clinical presentations were associated with patients requiring longer durations of chemodenervation treatment (p < 0.01), more chemodenervation episodes (p < 0.01), increased doses of botulinum toxin (p < 0.001), and having higher EGGS score (p < 0.001). Conclusions This study shows that multimodal facial rehabilitation in the management of facial palsy is effective, even in patients with chronically neglected synkinesis. In terms of the latency periods between facial palsy onset and treatment initiation, patients presenting later than 2 years were still responsive to multimodal treatment albeit to a lesser extent, which we postulate is due to increasing muscle contracture within their facial muscles.

Bilateral optic neuropathy related to severe anemia in a patient with alcoholic cirrhosis: A case report and review of the literature

  • Humbertjean-Selton, Lisa;Selton, Jerome;Riou-Comte, Nolwenn;Lacour, Jean-Christophe;Mione, Gioia;Richard, Sebastien
    • Clinical and Molecular Hepatology
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    • v.24 no.4
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    • pp.417-423
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    • 2018
  • Anemia appears frequently in patients with alcoholic liver disease (ALD) but has never been linked to bilateral nonarteritic anterior ischemic optic neuropathy (NAION). A 65-year-old woman with a medical history of alcoholic cirrhosis was admitted for bilateral NAION. On admission, she was found to have a low arterial pressure and severe normocytic anemia (48 g/L). The anemia was related to chronic bleeding due to antral gastritis along with other factors associated with ALD. The applied treatment consisted of urgent transfusion followed by high doses of proton-pump inhibitors, iron and vitamin supplementation, and support in lifestyle measures. Her hemoglobin levels remained stable after 2 years but the patient still suffered from visual loss. This case highlights the link between anemia and bilateral NAION in ALD patients. The optic nerve head is prone to infarction in this context due to the vascularization characteristics of ALD. Hemoglobin levels should be monitored in ALD patients to avoid the severe complication of NAION.

Robotic Intraoperative Tracheobronchial Repair during Minimally Invasive 3-Stage Esophagectomy

  • Marano, Alessandra;Palagi, Silvia;Pellegrino, Luca;Borghi, Felice
    • Journal of Chest Surgery
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    • v.54 no.2
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    • pp.154-157
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    • 2021
  • Tracheobronchial injury (TBI) is an uncommon but potentially fatal event. Iatrogenic lesions during bronchoscopy, endotracheal intubation, or thoracic surgery are considered the most common causes of TBI. When TBI is detected during surgery, concomitant surgical treatment is recommended. Herein we present a case of successful robotic primary repair of iatrogenic tracheal and left bronchial branch tears during a robot-assisted hybrid 3-stage esophagectomy after neoadjuvant chemoradiotherapy. A robotic approach can facilitate the repair of this injury while reducing both the potential risk of conversion to open surgery and the associated increased risk of postoperative respiratory complications.

Intraoperative pulmonary embolism in shoulder arthroscopy in a patient with previous SARS-CoV-2 infection: a case report

  • de Lizana, Alejandro Holgado-Rodriguez;Izquierdo-Fernandez, Alberto;Mendez-Sanchez, Jesus Manuel;Diaz-Minarro, Jose Carlos
    • Clinics in Shoulder and Elbow
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    • v.25 no.3
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    • pp.236-239
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    • 2022
  • The objective of this article is to describe intraoperative pulmonary embolism during shoulder arthroscopy in a patient with previous severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Further, we describe how the pandemic has influenced the population by increasing the rate of embolisms. Awareness of such cases will help to increase knowledge regarding SARS-Cov-2 and to determine if such patients should receive routine antithrombotic prophylaxis.