• International Journal of Advanced Culture Technology
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• v.7 no.2
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• pp.28-33
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• 2019

Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.

• Journal of muscle and joint health
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• v.22 no.3
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• pp.205-218
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• 2015

Purpose: This study was performed to analyze the visiting nurses' job using Developing a curriculum (DACUM). Methods: The DACUM committee with 6 visiting nurses participated in the workshop. In this workshop, the visiting nurses role was defined and their duties and tasks were identified. After content validation via the experts, the pilot test was conducted to 78 nurses. Results: A total of 13 duties and 82 tasks were identified on the DACUM chart which represented the importance, difficulty, and frequency of tasks with alphabet A, B, and C as its higher degree. Regarding duties, 'visiting nursing for high risk group' is the highest, while the lowest was 'public welfare events'. Regarding to tasks, 'discovering a new patient' was the highest, while 'selecting patients and offering medical supplies (nutritional supplement, patch)' was the lowest one. Conclusion: The results showed that visiting nurses working in the visiting health care service center were doing more various duties and tasks than those working according to 'Act on Long-term Care Insurance for the Aged'. The results can be used to develop training programs for visiting nurses and evaluation-scale of their job performance.

• Women's Health Nursing
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• v.24 no.4
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• pp.379-391
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• 2018

Purpose: To describe nursing students' experience of sexual harassment during clinical practicum. Methods: An interpretive phenomenological qualitative approach was used to understand contextual experiences of participants. Individual in-depth interviews were conducted to collect data from thirteen nursing students who experienced sexual harassment during clinical practice in general hospitals at D metropolitan city. All interviews were recorded and transcribed into Korean and English. Transcripts were analyzed using the data analysis method described by Diekelmann, Allen, and Tanner. Results: The following 12 themes emerged from the data: 'unprepared to respond', 'lack of education', 'unsure about when behavior crosses the line', 'power differential for nursing students', 'balancing self-preservation with obligations to patients', 'shame', 'feeling responsible for not being able to prevent the harassment', 'impact on patient care', 'fear of what might have happened', 'fear of repercussions', 'long term impact', and 'peer support'. Conclusion: Participants in this study described feeling an obligation to care for their patients. However, they seemed to be unable to balance this while feeling vulnerable to sexual harassment with strong negative feelings. Helping students recognize and effectively deal with sexual harassment is a critical element to assure quality learning for participants and maintain quality of care during clinical practice.

• Health Policy and Management
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• v.8 no.1
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• pp.232-265
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• 1998

Taiwan has experienced rapid economic growth during the past two decades. As a result, the demand for health care in Taiwan has increased rapidly. To meet the rising demand, Taiwan implemented a National Health Insurance (NHI) program on March 1, 1995. This program now covers more than 96 percent of Taiwan's citizens. Implementation of the NHI in 1995 represents fulfillment of a primary social and health policy goals of Taiwan. The goals of the NHI program is to eliminate financial barriers of health care for the citizens, to improve the quality of care. To achieve these goals, the NHI was designed on the following principles: 1. All Taiwan citizens are compul내교 joined the NHI program by law; 2. The NHI program provides comprehensive services; 3. The NHI is run by one single govt' subsidy; 5. The NHI adopt fee-for-services scheme to pay medical expenses and copayment to avoid abouse of medical services. However, the scheme did not bring in the efficient use of health care C. National Health Council, 1986 NARC, Aging in Japan, International Publication Series 1991;2 Kahana EF. Kiyak HA. Attitude and behavior of staff in facilities for the aged, 1984 Naoki I, John CC. Health polic report japan's medical care system, New England Joumal of Medicine 1995; 333(19) National Economic Research Associates, The Health CAre System in Japan, NERA, 1993. National Federation of health Insurance Societies (KEMPOREM), Health Insurance and Health Insurance Societies in Japan, 1995. Owe Ahlund, Aging and housing in sweden, Paper presented at the International Symposium, Long term Care Facility, 1993. Statisitics Jahrbuch, Statistisches Bundesamt, 1992. Stein S. Linn, MIW. and Stein EM. Patient's anticipation of stress in nursing home care, 1985. U. S. Senate Special Committee on Aging, A Report of the special Committee on Aging, Washing D. C, 1992. U.S. Bureau of the Census, 1994.

• Journal of Korean Biological Nursing Science
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• v.6 no.1
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• pp.33-42
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• 2004

Background : Intravenous(IV) access is becoming an increasingly important part of health care today. The current drive for clinical effectiveness and cost-effective health care serves to increase the need for reliable vascular access. Venous access devices were developed to overcome problems associated with limited peripheral access and frequent venipuncture in patients with long-term therapy. Although the peripherally inserted central catheter(PICC) have become popular during recent years in USA, its procedure is rare in Korea. Purpose : The goal of this study was to analyze the PICC inserted patient data by IV CNS intervention. Method : A Total of 62 PICCs were inserted into 51 patients by the IV CNS during a 10-month period form November, 14, 2002, to October 2, 2002. Data was obtained retrospectively through chart review. Result : The patient population included 34(54.8%) men and 28(45.2%) women, with a mean age 50.6 years. The main indication for PICC placement was to access vein in poor peripheral venous status(40.3%). The mean served interval for PICC insertions was 16.7 days(range, $2{\sim}61$ days). The reasons for removal were completed therapy in 18 cases(29.0%), patient death in 13 cases(21.0%), and mechanical or functional PICC problem in 10cases(16.1%). The three PICCs removed for presumed infection, and one had only positive tip cultures(0.2%). Conclusion : PICCs are rapidly growing popularity and required an extended course of IV therapy.

• Journal of Korean society of Dental Hygiene
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• v.14 no.3
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• pp.353-362
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• 2014

Objectives : The purpose of the study is to investigate the xerostomia in the chronic severe psychiatric patients in Korea because there were few reports on xerostomia in the psychiatric patients. Methods : The subjects were 61 psychiatric patients in the mental hospital by convenience cluster sampling. A self-reported symptom questionnaire was filled out by the three researchers on the basis of medical records by the informed consent. The stimulated salivary flow rate of the patients was measured by saliva sampling. Results : The subjects consisted of 45.9% of male and 54.1% of female. High school graduation accounted for 40.0% and 20.0% did not attend the school. The majority of the patients were medicaid recipients. Schizophrenia accounted for 86.9% and most patients were long term care recipients. A total of 68.9% of the patients suffered from salivary dysfunction. The medication in schizophrenia seemed to decrease the stimulated salivary flow rate and made the patients difficult in chewing and swallowing due to xerostomia and low saliva secretion(p<0.05). Conclusions : Medication in schizophrenic patients caused the salivary dysfunction. So the collaboration between the psychiatry doctors and dental hygienists is very important to improve the salivary secretion in the schizophrenic patients. The continuous and long term care of the xerostomia will help the patients maintain the good oral hygiene.

• Journal of Periodontal and Implant Science
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• v.48 no.1
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• pp.3-11
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• 2018

Purpose: This study utilized a strong quasi-experimental design to test the hypothesis that the implementation of a policy to expand dental care services resulted in an increase in the usage of dental outpatient services. Methods: A total of 45,650,000 subjects with diagnoses of gingivitis or advanced periodontitis who received dental scaling were selected and examined, utilizing National Health Insurance claims data from July 2010 through November 2015. We performed a segmented regression analysis of the interrupted time-series to analyze the time-series trend in dental costs before and after the policy implementation, and assessed immediate changes in dental costs. Results: After the policy change was implemented, a statistically significant 18% increase occurred in the observed total dental cost per patient, after adjustment for age, sex, and residence area. In addition, the dental costs of outpatient gingivitis treatment increased immediately by almost 47%, compared with a 15% increase in treatment costs for advanced periodontitis outpatients. This policy effect appears to be sustainable. Conclusions: The introduction of the new policy positively impacted the immediate and long-term outpatient utilization of dental scaling treatment in South Korea. While the policy was intended to entice patients to prevent periodontal disease, thus benefiting the insurance system, our results showed that the policy also increased treatment accessibility for potential periodontal disease patients and may improve long-term periodontal health in the South Korean population.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.27 no.5
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• pp.267-273
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• 2024

Helicobacter pylori infection is often acquired in early childhood. While most infected children remain asymptomatic, H. pylori can cause chronic gastritis, gastric ulceration, and, in the long term, gastric cancer. This article aimed to review different diagnostic and treatment options and discuss the challenges associated with applying the current guidelines in the real world. Relevant articles published from 2015 to August 2023 in the English language in PubMed and Medline electronic databases were extracted using subject headings and keywords of interest to the topic. References of interest in the selected articles were also considered. Invasive and noninvasive diagnostic tests have advantages but also disadvantages and limitations according to the clinical setting and age of the child. Guidelines recommend not performing diagnostic testing in children with long-lasting or recurrent abdominal complaints or cases of a family history of severe disease caused by H. pylori. However, parents regularly consult with the explicit demand to test for H. pylori because of them or a close family member experiencing severe gastric disease caused by H. pylori. In some situations, it may be challenging for the healthcare professional to stick to evidence-based guidelines and not consider "patient-centered care," with the risk of putting a trustful relationship in danger. Physicians may find it challenging not to perform diagnostic tests for H. pylori and prescribe eradication treatment in specific clinical settings when maintaining a trusting patientphysician relationship by applying this "patient-centered care" method when evidence-based guidelines recommend differently.

• Health Policy and Management
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• v.29 no.2
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• pp.228-236
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• 2019

Background: This study investigates the impact of weekend admission with a patient safety indicator (PSI) on 30-day mortality among long-term insurance beneficiaries. Methods: Data were obtained from the National Health Insurance Service-Senior claim database from 2002 to 2013. To obtain unbiased estimates of odds ratio, we used a nested case-control study design. The cases were individuals who had a 30-day mortality event after their last medical utilization, while controls were selected by incidence density sampling based on age and sex. We examined the interaction between the main independent variables of weekend admission and PSI by categorizing cases into four groups: weekend admission/PSI, weekend admission/non-PSI, weekday admission/PSI, and weekday admission/non-PSI. Results: Of the 83,400 individuals in the database, there were 20,854 cases (25.0%) and 62,546 controls (75.0%). After adjusting for socioeconomic, health status, seasonality, and hospital-level factors, the odds ratios (ORs) of 30-day mortality for weekend admission/PSI (OR, 1.484; 95% confidence interval [CI], 1.371-1.606) and weekday admission/PSI (OR, 1.357; 95% CI, 1.298-1.419) were greater than for patients with weekday admission/non-PSI. Conclusion: This study indicated that there is an increased risk of mortality after weekend admission among patients with PSI as compared with patients admitted during the weekday without a PSI. Therefore, our findings suggest that recognizing these different patterns is important to identify at-risk diagnosis to minimize the excess mortality associated with weekend admission in those with PSI.

• Journal of Korean Biological Nursing Science
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• v.24 no.4
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• pp.243-252
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• 2022

Purpose: The purpose of this longitudinal study was to identify the relationship between the readiness for hospital discharge and self-care changes in an early stage of liver transplantation after discharge. Methods: Data of 75 liver transplant recipients within one year of surgery from a transplantation center from May 2019 to May 2020 were collected for this study. Their readiness for discharge was measured before discharge. Self-care after liver transplantation was evaluated at one week, one month, and three months of discharge at outpatient visits. Linear mixed model was used to evaluate the statistical relationship. Results: The readiness for hospital discharge was significantly higher when the caregiver was a spouse (p=.027), with fewer post-transplantation days (p=.027), absence of acute rejection (p=.004), or high self-efficacy (p<.001). As a result of the linear mixed model analysis, the higher the discharge readiness score, the higher the self-care score (β=0.29, p<.001). However, after three months, their self-care had decreased regardless of their level of readiness for hospital discharge compared to one week after discharge. Conclusion: Improving the readiness before discharge is essential to enhance self-care. Also, active intervention at 3 months of discharge should be performed to check and promote their long-term self-care.