• 제목/요약/키워드: Intensive management program

검색결과 135건 처리시간 0.032초

카바페넴분해효소 생성 장내세균속균종(CPE)이 획득된 내과계 중환자실 환자의 생존 영향 요인 (Survival Factors among Medical Intensive Care Unit Patients with Carbapenemas-Producing Enterobacteriaceae)

  • 최지은;전미양
    • Journal of Korean Biological Nursing Science
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    • 제22권4호
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    • pp.249-259
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    • 2020
  • Purpose: Carbapenemase-producing Enterobacteriaceae (CPE) are associated with considerable mortality. This study was aimed to identify survival factors among medical care unit patients with CPE. Methods: We conducted a retrospective cohort; data were collected from September 2017 to June 2019 through electronic medical records. The data collected were general characteristics, disease-related characteristics, severity-related characteristics, and treatment-related characteristics. Data were analyzed based on frequency, mean, standard deviation, Chi-square test, Fisher's exact test, t-test, Pearson's correlation coefficient, and Cox proportional hazard model using SPSS/WIN 21.0 program. Results: Seventy-seven patients were included (59 survivors and 18 deceased) in the study. Univariate analysis identified factors for survival associated with acquired CPE as age (t= -1.56, p= .037), simplified acute physiology 3 (SAPS3) score of admission date (t= -2.85, p= .006), Glasgow coma scale (GCS) of CPE acquisition date (t= 2.38, p= .020), artery catheter at CPE acquisition date (χ2= 4.58, p= .032), vasoconstrictor agents use at CPE acquisition date (χ2= 6.81, p= .009), platelet at CPE acquisition date (t= 2.27, p= .025), lymphocyte at CPE acquisition date (t= 2.01, p= .048), calcium at CPE acquisition date (t= 2.68, p= .009), albumin at CPE acquisition date (t= 2.29, p= .025), and creatinine at CPE acquisition date (t= 2.24, p= .028). Multivariate Cox proportional hazard model showed that GCS at CPE acquisition date (HR= 1.14, 95% CI= 1.05-1.22), lymphocyte at CPE acquisition date (HR= 1.05, 95% CI= 1.00-1.10), and creatinine at CPE acquisition date (HR= 1.25, 95% CI= 1.04-1.49) were independent survival factors among medical intensive care unit patients with CPE. Conclusion: Based on the study results, it is necessary to develop nursing interventions that can aid in the management of patients with CPE and identify their effects.

경관급식을 공급한 중환자실 환자의 영양상태 평가 (Nutritional Assessment of ICU Inpatients with Tube Feeding)

  • 김유진;서정숙
    • 대한영양사협회학술지
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    • 제21권1호
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    • pp.11-24
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    • 2015
  • This study investigated the general status of tube feeding for intensive care unit (ICU) inpatients and evaluated the consequent nutritional status of patients. This study was approved by the Institutional Review Board (IRB) of a general hospital located in Daegu metropolitan city. The subjects of this study were 80 adult patients who had been admitted to the ICU of a hospital, received fed tube feeding, and then been discharged. The differences in nutrition screening indicators, including percentage ideal body weight (PIBW), serum albumin, hemoglobin, total lymphocyte count, and total cholesterol, before and after tube feeding according to body mass index (BMI) or nutrient feeding levels were investigated. The ratios of actually provided amounts to calorie and protein requirements of patients were $72.8{\pm}15.8%$ and $72.6{\pm}19.8%$, respectively. The change in PIBW before and after tube feeding was significantly different among the BMI groups (P<0.01). The change in hemoglobin concentration before and after tube feeding was also significantly different among the BMI groups (P<0.01). When subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided calories to required calories, there was no significant difference in nutrition screening indicators before and after tube feeding. When the subjects were divided into three groups (<60%, 60~79%, ${\geq}80%$) according to the ratio of actually provided protein to required protein, serum albumin concentration showed a significant difference among the groups before and after tube feeding (P<0.05). Therefore, an intensive nutrition intervention program would be needed for the nutritional improvement of ICU inpatients receiving tube feeding.

비계획적 발관 예방을 위한 교육프로그램 적용효과 (Study on an Unplanned Extubation Prevention Program (UEPP) for Intubated Patients in Intensive Care Unit)

  • 강경자;유미
    • 디지털융복합연구
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    • 제12권3호
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    • pp.331-338
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    • 2014
  • 본 연구는 내과계 중환자실에 입원한 기관삽관 환자의 비계획적 발관 예방프로그램을 개발하여 비계획적 발관율을 감소시키고 간호사들이 실무에서 비계획적 발관에 적극적으로 대처할 수 있도록 도움을 주기 위해 수행되었다. 조사기간은 사전기간이 2008년 5월부터 2009년 4월이었고, 프로그램 적용기간은 2009년 5월부터 2010년 4월로 각각 1년씩이었다. 기간 내 조사 대상 총 삽관환자는 사전시기와 중재 시기에 각각 330명, 332명이었으며, 이들 중 비계획적 발관을 경험한 사전 29사례와 적용기간 23사례에 대해 발관경험 환자와 담당간호사의 발관 관련 제 특성을 추가적으로 살펴보았다. 통계분석은 SPSS 18.0을 이용하였다. 비계획적 발관을 경험한 환자와 간호사의 제 특성은 유의한 차이를 보이는 것은 없었으나 두 시기에 신규 간호사의 진입비율에 유의한 차이가 있었다(p=.039). 기관내관 삽입 1000일당 비계획적 발관율은 신규 간호사 진입이 많았음에도 적용 기간의 평균이 8.8을 보여 사전 관찰시기의 평균 발관율 12.3과 비교하여 유의하게 감소(t=-2.333, p=.040)하였으므로 본 연구의 결과는 중환자실 삽관환자의 비계획적 발관예방 활동을 통해 환자 안전에 기여할 수 있는 프로그램이라 사료된다.

심장수술 받은 영아의 영양중재프로그램 개발 및 적용 (Development and Application of a Feeding Program for Infants Postoperatively following Cardiac Surgery)

  • 문주령;조용애;민선인;양지혁;허준;정연이
    • 대한간호학회지
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    • 제39권4호
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    • pp.508-517
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    • 2009
  • Purpose: Despite recent advances in the surgical and postoperative management of infants with congenital heart disease, nutritional support for this population is often suboptimal. The purpose of this study was to develop a nutritional program for the postoperative period for infants who have had cardiac surgery and to evaluate effects of the program. Methods: A quasi-experimental design with pretest and posttest measures was used. A newly developed nutritional program including a feeding protocol and feeding flow was provided to the study group (n=19) and usual feeding care to the control group (n=19). The effects of the feeding program were analyzed in terms of total feed intake, total calorie intake, gastric residual volume, and frequency of diarrhea. Results: Calorie intake and feeding amount in the study group were significantly increased compared to the control group. However, the two groups showed no significant differences in gastric residual volume and frequency of diarrhea. Conclusion: The results indicate that the nutritional program used in the study is an effective nursing intervention program in increasing feeding amount and calorie intake in infants postoperative to cardiac surgery and does not cause feeding-related complications.

웨어러블 기기를 사용한 심정지 환자 지원 시스템의 설계 및 구현 (Design and Implementation of a Cardiac Arrest Supporting System Using Wearable Device)

  • 장진수;이서준;이광인;이태노
    • 디지털융복합연구
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    • 제15권1호
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    • pp.227-238
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    • 2017
  • 급성 심정지는 갑작스러운 심장 기능의 상실로 인하여 수 분 안에 뇌를 비롯하여 온 몸에 혈액 공급이 되지 않아 사망으로 이어지는 대표적인 중증응급질환이다. 특히 병원 밖에서 발생하는 병원외 심정지 환자는 생존율이 매우 낮다. 그 이유는 갑작스런 발병으로 인해 주변사람들이 심정지 환자라는 것을 인식하지 못할 뿐만 아니라 인식한다 하더라도 전문 의료지식이 없어 정확한 응급조치를 취하는 것이 어렵기 때문이다. 기존의 심정지 관련 연구는 대부분 심정지 발생 후의 치료법 방안에 집중되어 있었으나, 이는 근본적인 문제해결이 어려워 생존율을 높이는데 한계가 있었다. 이러한 문제를 해결하기 위해 본 논문에서는 널리 보급된 스마트폰을 활용하여 급성 심정지 환자를 위한 알림, 사전예방, 응급조치 등의 기능을 갖춘 솔루션을 개발하였다. 이 솔루션을 활용하면 급성 심정지를 사전에 예방할 수 있고, 설사 발병한다고 하더라도 주변사람에게 신속하게 알려 최대한 골든타임(4분)을 지킬 수 있으며, 1차 발견자가 신속하고 정확한 심폐소생술을 실시할 수 있어 생존율을 한층 더 높일 것으로 기대한다.

Analysis of virulence traits of Staphylococcus aureus isolated from bovine mastitis in semi-intensive and family dairy farms

  • Guzman-Rodriguez, Jaquelina J.;Leon-Galvan, Ma. Fabiola;Barboza-Corona, Jose E.;Valencia-Posadas, Mauricio;Loeza-Lara, Pedro D.;Sanchez-Ceja, Monica;Ochoa-Zarzosa, Alejandra;Lopez-Meza, Joel E.;Gutierrez-Chavez, Abner J.
    • Journal of Veterinary Science
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    • 제21권5호
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    • pp.77.1-77.14
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    • 2020
  • Background: Staphylococcus aureus is one of the main microorganisms that causes bovine mastitis, and its well-known virulence characteristics and interactions with the environment are used to aid the design of more efficient therapies. Objectives: To determine whether the virulence traits, such as antibiotic resistance and biofilm-forming and internalization abilities, of S. aureus isolated from bovine mastitis are related to dairy production system types. Methods: The study was performed in the Mexican states of Guanajuato and Michoacan. Semi-intensive dairy farms (SIDFs) and family dairy farms (FDFs) (454 and 363 cows, respectively) were included. The 194 milk samples from mastitis affected quarters were collected and 92 strains of S. aureus were isolated and identified by biochemical and molecular tests. Antibiotic resistance, biofilm and internalization assays were performed on 30 randomly selected isolated strains to determine virulence traits, and these strains were equally allocated to the 2 dairy production systems. Results: All 30 selected strains displayed a high degree of resistance (50%-91.7%) to the antibiotics tested, but no significant difference was found between SIDF and FDF isolates. S. aureus strains from SIDFs had an average biofilm forming capacity of up to 36% (18.9%-53.1%), while S. aureus strains from FDFs registered an average of up to 53% (31.5%-77.8%) (p > 0.05). Internalization assays revealed a higher frequency of internalization capacity for strains isolated from FDFs (33.3%) than for those isolated from SIDFs (6.7%) (p > 0.05). fnbpA gen was detected in 46.6% of FDF strains and 33.3% of SIDF strains, and this difference was significant (p < 0.05). Conclusions: Our findings show that the virulence traits of S. aureus isolates analyzed in this study, depend significantly on several factors, such as phenotype, genotype, and environmental conditions, which are significantly related to dairy production system type and daily management practices.

Evaluation of the tributaries by influence index on the mid-lower portion of the Nakdong River basin

  • Lee, Shun-Hwa;Jung, Seung-Gyu;Park, Seoung-Muk;Lee, Byung-Dae
    • Environmental Engineering Research
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    • 제23권2호
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    • pp.150-158
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    • 2018
  • The deteriorating role of Nakdong River due to the Four Major Rivers Project has caused a series of problems, including water pollution, drying streams, aggravation of the hydroecology. Geumho River and Gyeongseong-cheon had a higher concentration index and is believed to impact the water quality of the main stream. The influence index of Geumho River and Nam River between 2015 and 2016, which have a large amount of discharge, was the highest among the tributaries in terms of the load material balance. Showing the highest average concentration and average load in the index assessment, Geumho River is believed to require an intensive management for improving the water quality of the main stream. Furthermore, when the cumulative percentage of the average concentration and average load was compared based on the water quality improvement of the tributaries mixed to Nakdong River, which was set to 60%, Geumho River, Nam River, Topyeong-cheon, and Cha-cheon, which showed the highest ratio in that order, were determined to require a water quality management program as a priority.

비정규직 호텔 조리종사원의 감성지능이 조직몰입, 업무성과에 미치는 영향에 관한 연구 (A Study on the Effect of Emotional Intelligence on Organizational Commitment and Work Performance of Non-regular Hotel Culinary Staff)

  • 김동규;이연정
    • 한국조리학회지
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    • 제23권4호
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    • pp.43-55
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    • 2017
  • The purpose of the study is to provide data for an efficient human resources management of hotel corporation by examining if the emotional intelligence with affective involvement and continuous involvement could impact work performance. For the field test and verification, the non-regular hotel staffs from November $1^{st}$ to $30^{th}$, 2016 were selected as the research objects. The research result is summarized as follows. First, the emotional intelligence of non-regular hotel staff impacted positively on affective involvement and continuous involvement. Second, the continuous involvement had a positive influence on work performance. Lastly, the emotional intelligence of non-regular hotel staff appeared to have a positive effect on the work performance. With this research, it may have an opportunity to utilize this study result as an educational material to enhance emotional intelligence of hotel corporation. In conclusion, it may need to introduce an emotional intelligence enhancement program in the hotel corporation. Also, in order to improve work performance, intensive efforts in organizational level would be required by enabling employees to make an affective involvement. Finally, to cope with rapidly changing circumstances, additional empirical study should be conducted that the affective involvement of non-regular hotel staff impacts the work performance.

대·중소 상생형 스마트공장 구축 지원 사업 도입기업에 대한 성과분석 (Support Project for the Establishment of a Smart Factory for the Win-win between Large and Small Businesses Performance Analysis of the Adopting Company)

  • 서홍일;김태성
    • 대한안전경영과학회지
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    • 제24권2호
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    • pp.135-142
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    • 2022
  • The smart factory is an important system that can reduce defects, maximize productivity, and respond to customer needs, from the labor-intensive era of traditional small and medium-sized manufacturing companies through the automation era to CPS using ICT. However, small and medium-sized manufacturers often fall short of the basic stage due to economic and environmental constraints, and there are many companies that do not even recognize the concept of a smart factory. In this situation, to expand the smart factory of small and medium-sized enterprises, the project to support the establishment of a smart factory for the win-win between large and small enterprises. The win-win smart factory construction support project provides a customized differentiation program support project according to the size and level of the company for all domestic manufacturing SMEs regardless of whether or not they are dealing with Samsung. In this study, we analyze the construction status and introduction performance of companies participating in the win-win smart factory support project to find out whether they have been helpful in management and to find efficient ways to improve support policies, and to suggest the direction of continuous support projects to improve the manufacturing competitiveness of SMEs in the future.

팜파티 속성에 대한 중요도-만족도 분석(IPA) 연구 (A Study on the Importance-Performance Analysis of Farm Party Participants)

  • 김선희
    • 농촌지도와개발
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    • 제22권1호
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    • pp.69-78
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    • 2015
  • This study conducted IPA of each item related to the farm party operation aiming at the participants to farm parties. The survey was carried out on the participants to the farm parties held in Damyang County from October 11th to November 22nd, 2014, and 103 questionnaires were used for the final analysis. The specific results of the IPA are as follows. In the first quarter of 'maintenance and management performance' are included the total of seven items. They are a harmonious view with the surrounding environment, friendliness of the farmer and the party staff, posting the event schedule and providing the program, proper disposition of the staff in the farm, an exchange among farm party participants, food that makes use of farm produce and the convenience of gaining information. In the second quarter of 'intensive improvement' are included eight items. They are cleanliness of the facilities such as restroom and basin, providing the pamphlets or promotion materials of the farms in the farm party, things to experience utilizing the farm produce grown in the host farm, various events, smooth progress of the farm party program, inclusion of the indigenous native food, variety of things to buy including farm produce and information delivery about the farm produce on sale.