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Analysis of Hazard Factors for Domestic General Purpose Ventilator using Usability Assessment (사용적합성 평가를 적용한 국산 범용인공호흡기의 위험요인 분석)

  • Gyeongmin Kwon;Seung hee Kim;You Rim Kim;Won Seuk Jang
    • Journal of Biomedical Engineering Research
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    • v.45 no.1
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    • pp.10-19
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    • 2024
  • The purpose of this study is to conduct a summative evaluation of the usability of a general-purpose ventilator to determine whether it can be used for its intended purpose in the intended environment by the intended user and to find possible errors in use. The importance of ventilators has increased due to the accelerated aging of the population and the impact of the pandemic. In addition, patients who require ventilators are often in critical condition, so even a small error in use can be fatal. Therefore, it is important to ensure that the ventilator has sufficient stability and can be used satisfactorily without inconvenience to the user. In this study, we conducted a usability test with 17 respiratory nurses with more than 3 years of experience using the ventilator. We analyzed the task success rate, satisfaction, and opinions of the intended users while going through a total of 17 scenarios. Satisfaction was captured through an ASQ questionnaire and subjective opinions were captured through a detailed opinion questionnaire. The results showed a high level of satisfaction with an average score of 6.3 for the use scenarios. Evaluators expressed satisfaction with the overall visibility and versatility of the features, but noted that improvements were needed for calibration tasks with low task success rates. As the calibration method is different from other equipment, it was suggested that specific explanations of the calibration method and the picture that appears when calibrating are needed, and that if relevant training is provided, the equipment can be used without problems. If the usability evaluation is not limited to securing efficiency and satisfaction from the intended users, but also continuously receives feedback from users to prepare for use in emergency environments such as pandemic situations, it will be very helpful to seize opportunities such as emergency authorization in future situations, and ultimately contribute to patient safety by reducing use errors.

Incidence and Risk Factors of Nausea and Vomiting after Exposure to Low-Osmolality Iodinated Contrast Media in Children: A Focus on Preparative Fasting

  • Ji Young Ha;Young Hun Choi;Yeon Jin Cho;Seunghyun Lee;Seul Bi Lee;Gayoung Choi;Jung-Eun Cheon;Woo Sun Kim
    • Korean Journal of Radiology
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    • v.21 no.10
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    • pp.1178-1186
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    • 2020
  • Objective: To evaluate the incidence and risk factors of emetic complications associated with the intravenous administration of low-osmolality iodinated contrast media (ICM) in children undergoing computed tomography (CT). Materials and Methods: All children who underwent contrast-enhanced CT between April 2017 and July 2019 were included. Pediatric patients were instructed on the preparative dietary protocol at our institution. Experienced nurses in the radiology department monitored the children during the CT scans and recorded any emetic complications in their electronic medical records. These data were used to calculate the incidence of emetic complications. Various patient factors and technical factors, including fasting duration, the type and volume of ICM, and ongoing chemotherapy, were evaluated to identify risk factors for emetic complications using univariate and multivariate logistic regression analyses. Results: Among the 864 children (mean age, 8.4 ± 5.7 years) evaluated, 18 (2.1%) experienced emetic complications (6 experienced nausea only and 12 experienced nausea and vomiting). None of the children developed aspiration pneumonia. The mean fasting duration of patients with emesis was 7.9 ± 5.7 hours (range, 3-21 hours), whereas that of patients without nausea was 8.7 ± 5.7 hours (range, 0-24 hours). Fasting duration was not associated with the development of nausea and vomiting (p = 0.634). Multivariate logistic regression analysis revealed that ongoing chemotherapy (odds ratio [OR] = 4.323; 95% confidence interval [CI] = 1.430-13.064; p = 0.009), iomeprol use (OR = 7.219; 95% CI = 1.442-36.146; p = 0.016), and iohexol use (OR = 5.241; 95% CI = 1.350-20.346; p = 0.017) were independent risk factors for emetic complications. Conclusion: Only a small proportion (2.1%) of children experienced nausea or vomiting after exposure to low-osmolality ICM. Many children underwent excessive fasting; however, fasting duration was not associated with nausea and vomiting. Moreover, ongoing chemotherapy and the use of iomeprol or iohexol were identified as potential risk factors for emetic complications in children.

Effects of Non-face-to-face Sleep Programs Combined with Aroma Necklaces on Sleep Quality, Sleepiness, Depression, and Stress in Insomnia with College Students (아로마 목걸이를 병용한 비대면 수면 프로그램이 불면증 대학생의 수면의 질, 주간졸림증, 우울 및 스트레스에 미치는 효과)

  • Yeong-Ju Shin;Jaegap Ko;Minseo Kim;Yuna Kim;Ui-Hyeon Kim;Jiho Kim;Boseong Kim;Ju Namgung;Hanbin Yoon;Sang-Gyu Hyun;Eun-Kyoung Han
    • Journal of the Korean Applied Science and Technology
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    • v.41 no.1
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    • pp.96-106
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    • 2024
  • This study aimed to examine the effects of non-face-to-face sleep program combined with aroma necklace on quality of sleep, daytime sleepiness, depression, and stress in insomnia with college students. A nonequivalent control group pre-post test design was used. The experimental group(n=21) underwent non-face-to-face sleep program combined with aroma-necklace while the control group(n=21) received a sleep booklet. Sleep quality, daytime sleepiness, depression, and stress were measured to identify the effectiveness of the program. Data were analyzed using descriptive statistics, Fisher's exact test, χ2-test, and independent t-test with the SPSS 24.0 program. In the homogeneity test of the general characteristics and study outcome variables there were no significant differences between the two groups. Significant group differences were found in sleep quality (t=-5.87, p<.001), daytime sleepiness(t=-4.28, p<.001), and depression(t=-4.40, p<.001). No differences were found in the stress. Non-face-to-face sleep improvement program combined with an aroma-necklace was effective in improving insomnia in college students. Nurses can contribute to improving sleep and depression by applying this program to college students experienced insomnia living in various environments.

An Analysis of The Relationship Among Nursing Students' Perception of Target Vulnerability and Target Advocacy, Child Rights Awareness, and Child Abuse Reporting Intention (간호대학생이 지각한 대상자 취약성 및 옹호, 아동권리인식, 아동학대 신고의도 간의 관계 분석)

  • Ji-Ah Song;Jae Woo Oh
    • Journal of Industrial Convergence
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    • v.22 no.3
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    • pp.155-163
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    • 2024
  • Nursing students, as prospective nurses, are expected to act as child abuse reporters and advocates for child targets. Therefore, this study aimed to provide a basis for developing a child abuse prevention education program for nursing students by determining the extent of nursing students' perceived target vulnerability and target advocacy, child rights awareness, and intention to report child abuse, and analyzing the relationships among the variables. This study is a descriptive survey study to identify the effects of target vulnerability, target advocacy, and child rights awareness on intention to report child abuse among 154 nursing students, and the data collection period was from July 3 to July 31, 2023, and the collected data were analyzed using SPSS 25.0 program. As a result of identifying the influential factors on nursing students' intention to report child abuse, child abuse education, championing social justice as a sub-variable of target advocacy, and target vulnerability, the explanatory power of these variables was 35.8%. Based on the results of this study, it is suggested that it is necessary to increase activities through the development and application of simulation education based on actual clinical cases in order to increase nursing students' interest in and education about child abuse.

2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation

  • Hong Jun Park;Byung-Wook Kim;Jun Kyu Lee;Yehyun Park;Jin Myung Park;Jun Yong Bae;Seung Young Seo;Jae Min Lee;Jee Hyun Lee;Hyung Ku Chon;Jun-Won Chung;Hyun Ho Choi;Myung Ha Kim;Dong Ah Park;Jae Hung Jung;Joo Young Cho;Endoscopic Sedation Committee of Korean Society of Gastrointestinal Endoscopy
    • Clinical Endoscopy
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    • v.55 no.2
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    • pp.167-182
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    • 2022
  • Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

Incidence of breast milk jaundice in healthy full-term infants (건강한 만삭아에서 모유황달의 발생 빈도)

  • Yoon, Yong Ho;Choi, Kyong Eun;Kim, Kyung Ah;Ko, Sun Young;Lee, Yeon Kyung;Shin, Son Moon
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1072-1077
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    • 2007
  • Purpose : It has been described that the incidence of breastfeeding jaundice is 13% and that of breast milk jaundice is 2%. The incidence in Korea was believed to be higher, but there were no studies to prove this assumption. The purpose of this study was to investigate the incidence of jaundice of healthy breastfed full-term infants in Korea. Methods : 839 infants were enrolled who were admitted to the Postpartum Care Center of the Cheil General Hospital between January 1 and December 31, 2005, and were followed up for more than 7 days. Those infants were divided into 3 groups; Exclusive breastfeeding group; Partial breastfeeding group; Formula feeding group. If they became icteric, transcutaneous bilirubin (TcB) was measured by research nurses with JM-103 Jaundice meter (Konica Minolta sensing, Inc., Osaka, Japan). Using this method we investigated the incidence of breast milk jaundice of healthy breastfed full-term infants. Results : There were no significant differences in sex, birth weight, Apgar score, or obstetric risk factors among 3 groups but there were higher rates of vaginal delivery in the exclusive breastfeeding group. The incidence of breast milk jaundice was 10.8% in the exclusive breastfeeding group and 4.4% in the partial breastfeeding group. The incidence of breast milk jaundice in the breastfed infants was 6.3%. The incidence was significantly higher in the exclusive breastfeeding group than in the partial breastfeeding group. Conclusion : The incidence of breast milk jaundice of healthy breastfed full-term infants was 6.3%. It was found that the incidence of breast milk jaundice was higher in this study than in other countries. But it was not a population-based study, so further study with the large sample sizes is needed.

A Study of a Pattern of the Stress Perceived by Stroke Patients through the Rehabilitative Process (뇌졸중 환자의 재활과정에 따른 스트레스 변화 양상)

  • Lee, Jung-Min
    • Journal of East-West Nursing Research
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    • v.1 no.1
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    • pp.82-98
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    • 1997
  • The purpose of this study was to determine pattern of the stress perceived by stroke patients over time. The ultimate goal of the research is to provide data to help nurses to design the plan of nursing care of the stroke patients both in the hospital and at home. A total of 57 admitted stroke patients were collected from one general hospital in Seoul from June, 12 to September, la, 1993. The data were collected for three phases(within one week after leaving the hospital). The tools for this study, three scales were used ; Stress scale developed by the investigator. Constitution classifing scale designed by Kho(1984), and Self-care measuring scale by Kang(1984). Data were analyzed in four steps using statistical analysis. First, demographic data were determined by descriptive statistics. Second. the pattern of stress perceived by stroke patients across three phases was measured using repeated measures ANOVA. Third, stress of stroke patients classified by constitution, paralyzed area. and attack frequency were measured using ANOVA or t-test, and the pattern of stress by group over time was determined using paired t-test in post hoc test. Fourth. Pearson correlation coefficients were calculated to determine the relationship between the stress and self-care activities. The results of this study are ; 1. The pattern of stress across three phases ; There was a decrease of the stress across three phases. In general. psychological stress as the highest among three phases(F=36.92. P=.000). There was a statistically significant difference of the physical stress(F=34.55, p=.000), the psychological stress (F=15.49, p=.0005) and the social stress (F=24.71. p=.000) among three phases. There was a statistically significant difference of the stress between the first phase (on admission) and the second phase(before leaving the hospital) and was a decrease of the stress (t =6.36. p=.000). 2. The pattern of stress of stroke patients classified by constitution across three phases ; Stroke patients classified as So-Eum perceived the highest stress among three groups(Tae-Eum, So-Eum. So-Yang). There was no statistically significant difference of stress according to the constitution of stroke patients among three phases. Hence. stress was not influenced by the constitution of stroke patients, but there was a statistically significant difference of stress over time. 3. The pattern of stress of stroke patients classified by the paralyzed area across three phases ; Right paralyzed stroke patients perceived higher stress than left paralyzed stroke patients. There was, however, no statistically significant difference of stress between two groups except 2nd phase. There was no statistically significant difference of the perception of stress bet ween the right and left paralyzed stroke patients. 4. The pattern of stress of stroke patients classified by the frequency of the relapse of the disease across three phases ; Stress was higher in stroke patients who had the relapse of the disease twice more than the first time. There was, however, no statistically significant difference of stress between two groups. There was no statistically significant difference of stress of stroke patients according to the relapse of the disease among three phases. Hence, stress was no influenced by the relapse of the disease. 5. The relationship between the stress and self-care activities ; There was a negative relationship between the stress and self-care activities each phase(on admission, r= -.1563 ; before leaving the hospital, r= -.4030 ; after leaving the hospital, r= -.5291). Hence, the higher the self-care activities, the lower the stress. This study has three important findings. First finding was that psychological stress perceived by stroke patients was the highest among three phases. The second finding was that factors such as the constitution, the paralyzed area, and the relapse of the disease did not have an influence on the stress perceived by stroke patients across three phases(on admission, before leaving the hospital, after leaving the hospital). There was a statistically significant decrease of the stress perceived by stroke patients across three phases. The third finding was that there was a negative relationship between the self-care ability and stress. In this study, these findings have implications for nursing care for the rehabilitation of stroke patients and suggest the need of nursing intervention to promote the self-care ability and to support the psychological self-esteem of stroke patients.

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A Study on the Utilization Level of Traditional Medicine by Residents - On the basis of Use of Folk Medical Techniques - (주민(住民)의 전통의술(傳統醫術) 이용도(利用度) 조사연구(調査硏究) - 민속요법(民俗療法) 이용(利用)을 중심(中心) 으로 -)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.13 no.1
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    • pp.3-18
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    • 1988
  • The general objective of this research is to study behavioral pattern of health care utilization and to measure the level of utilization of the traditional medicine. The specific objective is to study utilization pattern and content of folk medicine which is the indegenous medical technology recognized part of traditional medicine. This research was under taken to generate valid information that will provide basis data for formulating general direction for health education activities and for designing service package for general population. A social survey method was employed to obtain required information for the research activities, The survey field team consisted of 20 surveyors who all participated is an intensive 2 day training course. A total of 3091 households were visited and interviewed by the field team during the period 7 September to 6 October 1987. The major findings obtained from the information collected by the field survey are as follows ; 1) General characteristics of the study households 2562 households out of 3091 households visited were selected for final data process, 80.2 of the selected households were nuclear families ; 17.4%, extended families ; others 2.4%. Only 4.3 percent of the study population in the urban households indicated "no schooling" whereas 14.2% of the rural household members falls within this category. Study population in the urban areas are more protected against diseases by the national medical insurance system than those in rural areas. In their self appraisal of living standard, those who responded with low group are 39.6% and 50.3% respectively by urban and rural households. 2) Morbidity status Period prevalence rate for all diseases during the preceding 15 days before the date of the household interview v as 243,0 per 1,000 study population. For cases with the illness duration of within 15 days, the initial points of medical entry were diversied ; 56.9%, drug stores ; 30.9%, clinics and hospitals ; 4.6% folk medicine ; 1.7% clinics of Korean oriental medicine. Among the chronic case; with illness duration of over 90 days, 34.6% of these people utilized clinics and hospitals of modern medicine ; 31.6%, drug stores ; 18.6% clinics of Korean oriental medicine ; 6.8% folk medical techniques. Noticeable is the almost ten fold increase from the mere 0.9% in the utilization of Korean oriental medicine, whereas in the utilization of folk medicine, it is short of two-fold increase. 3) Folk medicine and its utilization Households that use folk medicine for relief and care of signs and symptoms commonly encountered in daily life, number 1969 households, which accounts for 76.9% of all the study households. This rather high level use of folk medicine is not different from rural to urban areas. The order of frequency of utilizing folk medicine among the study people are : the highest 14.3% for the relief of indigestion ; 8.6% for burns ; 5.1% for common cold ; 4.7% for hiccough ; and 4.2% for hordeolum. A present various procedures of folk medicine is being used to relieve all kinds of symptoms. 192 symptoms are identified at present. The most frequently used procedures of folk medicine appear to be based either on principles of the Korean oriental medicine or of scientific knowledge. Based on these survey findings, proposals for utilizing folk medicine are as follows First, this survey's findings will be feed back to both on the job training and on the spot guidance of community health practitioners, public health nurses and other peripheral work force in the health field, who are in daily contacts with community. This feed back will assure that the health personnel carry out their health education and information activities that are based on the utilization pattern of folk medicine as found in the survey result. Second, studies will be soon implemented that are designed to measure the efficiency and potency of these procedures and to improve these procedures of folk medicine were most frequently used by the community. Third, studies will continue to systematize medicinal plants and skills of Korean oriental medicine that are easily available at minimal cost in daily life for the prevention of diseases and management of emergency cases.

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Long-term oxygen therapy in patients with chronic respiratory failure in one university hospital (호흡부전환자의 재택산소치료 실태: 한 대학병원에서의 관찰)

  • Huh, Jin Won;Lee, Jung Yeon;Hong, Sang-Bum;Oh, Yeon Mok;Shim, Tae Sun;Lim, Chae-Man;Lee, Sang Do;Kim, Woo Sung;Kim, Dong Soon;Kim, Won Dong;Koh, Younsuck
    • Tuberculosis and Respiratory Diseases
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    • v.58 no.2
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    • pp.160-166
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    • 2005
  • Background : Although home oxygen therapy in hypoxemic patients with chronic lung disease has been increasing over the decade in Korea, the present state has not been known well. This study was done to know the situation of home oxygen therapy in a Korean university hospital. Methods : Between January 1, 2000 and August 31, 2003, 86 patients prescribed home oxygen therapy by the pulmonary physicians of Asan Medical Center were investigated using their medical record and questionnaire. Results : Patients (52 men, mean age of 61 years) with home oxygen therapy were increasing by every year. Underlying diseases were COPD (n=29), tuberculous destroyed lung (n=18), bronchiectasis (n=15), ILD (n=12), and others. Baseline $FEV_1/FVC$, FVC, and $FEV_1$ of patients were $58.4{\pm}25.2%$, $54.5{\pm}17.1%$ of predicted, and $41.7{\pm}20.6%$ of pred. Mean oxygen flow was 1.5 L/min and mean duration per day was 14.5 hours. During therapy, mean $PaO_2$ values have increased from 51.2 to 77.7 mm Hg and $PaCO_2$ values have increased from 47.5 to 49.6 mm Hg. Only 16.5% of the subjects were monitored by visiting nurses or pulse oximeter. Three year survival rate was 56.6% and hypercapnic patients showed better prognosis. Conclusion : The patients with home oxygen therapy were increasing yearly and a part of them were monitored. The hypercapnea respiratory failure patients would have better prognosis.

Effect of Shift Interval for the Clinical Nurse on the Circadian Rhythm (임상 간호사의 교대근무 기간이 circadian rhythm 변화에 미치는 영향)

  • 황애란;정현숙;임영신;이혜원;김조자
    • Journal of Korean Academy of Nursing
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    • v.21 no.2
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    • pp.129-149
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    • 1991
  • Circadian rhythm is entrained in the 24-hour time interval by periodic factors in the environment, known as zeitgeber. But most rotating work schedules are outside the range of the entrainment of the pacemaker timing the human circadian sleep - wake cycle. It has been postulated that physiological and emotional disturbances occur in most human functions when the circadian rhythm is disturbed. So application of circadian principles to the design of shift schedules can aid in maintaining the temporal integrity of the circadian system and thereby minimize for the shift worker any detrimental consequences of circadian disruption. This study was a quasi-experimental study to test the effect of shift intervals for the clinical nurse on the circadian rhythm. Twenty nurses newly employed in general units of two hospitals were selected as an experimental group and twelve college nursing students as a control group. Both groups were selected according to an established criteria using a purposive sampling technique. Ten subjects were assigned to a weekly shift group and another ten to a biweekly shift group engaged in a semi -continuous shift schedule(sunday off) with a backward direction, that is, morning -evening - night shift. The control group worked a morning shift for 42 days. Oral temperature rhythm, waking tim, sleep - wake cycle, fatigue, and mental performance were measured during the experimental period. The data collection period was from April 30, 1990 to June 10, 1990. MANOVA, paired t-test, ANOVA, and Student Newman Keuls method were used for statistical analysis. The results are summarized as follows. 1. Phase delay in the acrophase of temperature rhythm was shown according to the backward rotating shift. A complete adaptation to work on the night shift was achieved between the sixth and ninth day of the night shift. 2. There was no difference in either waking time or sleep- wake cycle according to the duration of the working day for every shift group. Significant difference was found in the waking time and the sleep -wake cycle for subjects on the morning, evening, and night shift in both of the shift groups(weekly shift group : λ=0.121, p<0.01, λ=0.112, p<0.01, biweekly shift group : λ=0.116, p<0.01, λ=0.084, p<0.01). 3. There was no difference in fatigue between the first working day and the last working day for the control group and for the biweekly shift group. In the weekly shift group, physical fatigue was significantly different for the first day and the sixth day of the night shift(t=-2.28, p<0.05). Physical fatigue and total fatigue on the first day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=5.79, p<0.01, F=4.56, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05), Physical fatigue, neurosensory fatigue and total fatigue on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=12.65, p<0.01, F=7.77, p<0.01, F=9.68, p<0.01). There was a significant difference between the shift groups and the control group(p<0.05). 4. No difference in mental performance was seen between the first day and the last day of work in each case. An arithmatic test on the first day of the night shift revealed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.79, p<0.05). There was a significant difference between the shift groups and the control group(p<0.05) . The digital symbol substitution test and the arithmetic test on the last day of the night shift showed a significant difference among the control group, the weekly shift group, and the biweekly shift group(F=3.68, p<0.05, F=5.55, p<0.01), and both showed a significant difference between the shift groups and the control group(p<0.05). Accordingly, this study showed that during night duty, the waking time, sleep- wake cycle, and fatigue increased and mental performance decreased compared with morning and evening duty. It was also found that the weekly shift group had a higher fatigue score on the sixth day of night duty as compared to the -first day, but the waking time, sleep- wake cycle, and mental performance revealed no difference for the duration of the night duty or between shift groups, and complete adaptation of temperature rhythm was achieved between the sixth and ninth day of night duty. It is possible to conclude from these results that for intermediate circadian type in a healthy young woman, a biweekly shift system is more compatible with the circadian timing system than weekly shift system.

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