• Quality Improvement in Health Care
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• v.28 no.2
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• pp.39-49
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• 2022

Purpose:The infection and isolation program used at a university hospital in A city was assessed and improved to provide medical staff with easy-to-understand information on isolation precautions and infectious diseases. Methods: Based on the results of the root cause analysis, the infection and isolation alarm computer program was improved. Subsequently, a survey was conducted with infection control leaders and unit managers (n=98) within the department to evaluate the degree of improvement. Results: The isolation registration and release procedures were simplified and unified to prevent confusion among the relevant departments. Additionally, the screen composition was improved so that various information related to infection can be easily accessed. After improvement in the program, the rate of isolation registration (53.0% to 100.0%, p<.001) and user satisfaction (67.6% to 92.2%) improved. Conclusion: This study will help improve the program so that other medical institutions can comply with the isolation precautions in accordance with the type of infections.

• Korean Journal of Radiology
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• v.22 no.4
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• pp.525-534
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• 2021

Objective: To assess the effect of left atrial appendage (LAA) isolation on LAA emptying and left atrial (LA) function using cardiac MRI in patients who underwent successful catheter ablation of atrial fibrillation (AF). Materials and Methods: This retrospective study included 84 patients (mean age, 59 ± 10 years; 67 males) who underwent cardiac MRI after successful catheter ablation of AF. According to the electrical activity of LAA after catheter ablation, patients showed either LAA isolation or LAA normal activity. The LAA emptying phase (LAA-EP, in the systolic phase [SP] or diastolic phase), LAA emptying flux (LAA-EF, mL/s), and LA ejection fraction (LAEF, %) were evaluated by cardiac MRI. Results: Of the 84 patients, 61 (73%) and 23 (27%) patients showed LAA normal activity and LAA isolation, respectively. Incidence of LAA emptying in SP was significantly higher in LAA isolation (91% vs. 0%, p < 0.001) than in LAA normal activation. LAA-EF was significantly lower in LAA isolation (40.1 ± 16.2 mL/s vs. 80.2 ± 25.1 mL/s, p < 0.001) than in LAA normal activity. Furthermore, LAEF was significantly lower in LAA isolation (23.7% ± 11.2% vs. 31.1% ± 16.6%, p = 0.04) than in LAA normal activity. Multivariate analysis demonstrated that the LAA-EP was independent from LAEF (p = 0.01). Conclusion: LAA emptying in SP may be a critical characteristic of LAA isolation, and it may adversely affect the LAEF after catheter ablation of AF.

• Korean Journal of Air-Conditioning and Refrigeration Engineering
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• v.23 no.7
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• pp.520-527
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• 2011

Recently, Influenza(AI, PI) patients have been increasing rapidly. But, there is a lack of isolation hospitals. In particular, according to increase the rate of patients with airborne infection, in order to prevent the spread of pathogens, design of layout plan and air conditioning system of isolation hospitals becomes more important to maintain patient's room as negative pressure. In this study, the spread of pathogens are analyzed as room differential pressure, moving time of medical staff and patients, and moving way in isolation hospitals by multizone simulation; CONTAM 2.4. Through the analysis, the ways to improve isolation hospital considered at the design step are reached to prevent the spread of pathogens effectively. Also, it verifies that HVAC system for isolation hospital is suitably designed as standard.

• Smart Structures and Systems
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• v.2 no.4
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• pp.329-337
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• 2006

This paper illustrates an analytical investigation of the vibration parameters of buildings on sliding seismic isolation bearings with elastic limiters of the relative displacement. The installation scheme of sliding bearings and elastic limiters for the separate unit of a 4 storey hospital building with brick walls is designed. The analysis of the vibrations of the hospital building is conducted for harmonic base excitation.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.1
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• pp.46-57
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• 2018

Purpose: The purposes of the study were to examine the knowledge and practice about Middle East Respiratory Syndrome (MERS) isolation precaution, and to explore influencing factors of the isolation practice among hospital nurses. Methods: A total of 182 nurses were recruited from four general hospitals where MERS patients had been treated. The knowledge and practice of MERS isolation precaution were measured by the scales developed based on the CDC guidelines. The collected data were analyzed by SPSS/WIN 22 with descriptive statistics, T-test, One-way ANOVA, Pearson correlation coefficients, and hierachical multiple regression analysis. Results: The nurses were 30 years old in average, and half of them had less than 5 years of clinical experience. and knowledge on droplet precautions (${\beta}=.171$, p=.019) were the significant predictors, explaining 19.6% of variance in the MERS isolation guideline practice. Clinical experience (${\beta}=.225$, p=.002), working at infection unit (${\beta}=-.203$, p=.011). Conclusion: The knowledge on droplet precaution and general knowledge on MERS were the important modifiable factor to improve the MERS isolation guideline practice among hospital nurses, even after adjusting clinical experience and demographic variables. It is necessary to develop an efficient education program on specific guidelines for prevention and management of infection by improving the knowledge on infectious disease such as MERS as well as droplet precaution which are modifiable factors.

• Journal of the Architectural Institute of Korea Planning & Design
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• v.33 no.12
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• pp.19-28
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• 2017

The purpose of this study is to propose a design methodology to build temporary isolation rooms when infectious diseases suddenly occur in a certain region, such as the case of MERS-Cov in South Korea in 2015. Although most big hospitals usually have isolation rooms, they are expensive and dangerous to run such facilities on normal and typical days. To deal with these problems in this research, shipping containers are chosen as devices used to build the temporary isolation rooms near the original hospital. To do so, firstly, a prototype for the temporary isolation room was designed with the three part modules. The first part is for the medical team; the second part including the isolation rooms is for patients; the third part is for medical selection rooms to test the specimens. Secondly, the plan was compared with the MERS-Cov infection control guidelines. Finally this prototype is applied into the Yong-in Yon-sei severance hospital and then evaluated through a CFD simulation using STAR-CCM+(ver.9.06) for checking infectious bacterium movement in this prototype. The result showed that the prototype is effectively safe for patients tested as negative, patients waiting to be tested, and the medical team.

• Tuberculosis and Respiratory Diseases
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• v.86 no.1
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• pp.47-56
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• 2023

Background: There is a global increase in isolation of nontuberculous mycobacteria (NTM). The aim of the study was to analyze longitudinal trends of NTM identification and pattern of antimicrobial susceptibility testing. Methods: NTM recovery rates, distribution of NTM species identification, and antimicrobial susceptibility pattern of NTM at Pusan National University Yangsan Hospital between January 2016 and December 2020 were retrospectively analyzed. Results: A total of 52,456 specimens from 21,264 patients were submitted for mycobacterial culture, of which 2,521 from 1,410 patients were NTM positive over five years (January 2016 to December 2020). NTM isolation showed an increasing trend from 2016 to 2020 (p<0.001, test for trend) mainly caused by Mycobacterium avium complex. The vast majority of M. avium complex were susceptible to key agents clarithromycin and amikacin. For Mycobacterium kansasii, resistance to rifampin and clarithromycin is rare. Amikacin was the most effective drug against Mycobacterium abscessus subspecies abscessus and Mycobacterium subspecies massiliense. Most of M. subspecies massiliense were susceptible to clarithromycin, while the majority of M. abscessus subspecies abscessus were resistant to clarithromycin (p<0.001). Conclusion: There was an increasing trend of NTM isolation in our hospital. Resistance to key drugs was uncommon for most NTM species except for M. abscessus subspecies abscessus against clarithromycin.

• Journal of Korean Clinical Nursing Research
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• v.24 no.2
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• pp.209-226
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• 2018

Purpose: This purpose of this study was to develop evidence-based practice guideline for isolation in health care settings to prevent transmission of infectious diseases utilizing guideline adaption process. Methods: The process of guideline adaptation was performed according to the Korean hospital nurses association's guideline adaptation manual which consisted of three main phases, 9 modules, and 24 steps. Results: The adapted isolation guideline consisted of introduction, overview of isolation guideline, summary of recommendations, recommendations, references, and appendices. The guideline includes 224 recommendations in 4 sections which are organizational administration, standard precautions, transmission-based precautions, and education/counselling. Conclusion: The adapted isolation guideline is recommended to be disseminated and utilized by nurses and clinicians nationwide to improve the isolation practices for infected or colonized patients with communicable diseases and to decrease the transmission of infections in the healthcare settings.

• Physical Therapy Rehabilitation Science
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• v.12 no.1
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• pp.43-47
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• 2023

Objective: To present a case study of a 69-year-old woman with COVID-19 who developed neurological complications due to Extracorporeal Membrane Oxygenation (ECMO) therapy and highlight the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU. Design: A case report Methods: The patient received ECMO therapy, followed by neurological monitoring and rehabilitation in an isolation ICU. Daily neurological examinations were conducted to monitor the patient's neurological symptoms. Computed tomography was performed to confirm the presence of a hematoma in the left hamstring, which was identified as the cause of the neurological complication. Ultrasound-guided aspiration was immediately performed, and sciatic neuropathy predominantly involving the peroneal division was identified after aspiration. Results: Successful recovery was made possible by the early detection of neurological complications and rehabilitation in an isolation ICU. Although electrodiagnostic tests were not performed due to limited access to the isolation ICU, the appropriate intervention time could be determined through daily neurological examinations and rehabilitation, thereby minimizing neurological sequelae. Conclusions: ECMO-related neurological complications are well known, and their recognition in the ICU can be challenging. The presented case highlights the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU, which can minimize neurological sequelae.

• Korean Journal of Clinical Laboratory Science
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• v.39 no.2
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• pp.76-85
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• 2007

The total number of clinical materials collected from Dec 1, 2005 to Nov 30, 2006 in C. hospital was 63,133. Among these materials, the isolation of Staphylococcus spp. was 5,252 strains. The proportions of Staphylococcus species infection were as follows ; 46.7% in S. aureus, 39.3% in S. epidermidis, 4.7% in S. hominis, 3.8% in S. haemolyticus, 2.9% in S. capitis and 2.5% in others. Seventeen strains of Staphylococcus species were identified with an isolation range of 0.02-46.7%. The isolation ratios of Staphylococcus species were 7.8% (2,134/27,362) in female, 8.7% (3,118/35,807) in male and 8.3% (5,252/63,133) in both. The age-related frequencies of Staphylococcus species were 22.1% in the 60-69 year group, 19.3% in the 70-79 year group and 17.1% in the 50-59 year group. The isolation ratio of the 0-49 year group to the 50-over 80 year group were 1.74 times in female, 1.92 in male and 1.85 in both. The isolation frequency of Staphylococcus spp. was at its highest in April (9.9%) and at its lowest in February (6.8%) according to monthly analysis. According to seasonal variation, the isolation frequencies of Staphylococcus spp. were 27.0% in Summer, 25.9% in Spring, 23.9% in Fall and 23.2% in Winter. The clinical departments showing over 9% isolation rate against Staphylococcus spp. were critical care medicine (12.9%), department of pediatrics (11.6%), department of urology (9.8%) and department of neuro-surgery (9.1%). On the other hand, the lowest number was observed in the department of family medicine. The clinical material showing over 15% isolation rate against Staphylococcus spp. were 32.1% in urine (random urine and catheterized urine), 20.6% in blood and 16.0% in sputum.