Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.
Kwon, Mi Kyung;Park, Ji Sun;Park, Hyun Mi;Kang, Hyun Ju;Woo, Jung E;Lee, Hye Youn;Kim, Ye Seul;Sim, Mi Young
Journal of Korean Clinical Nursing Research
/
v.26
no.2
/
pp.175-185
/
2020
Purpose: This study was performed to develop a valid and reliable Pediatric Patient Classification System (PPCS). Methods: The study was conducted in a children's hospital which included various ward settings. Content validity was analyzed by Delphi method and to verify intraclass correlation reliability, 7 nurse managers and 29 staff nurses classified 216 patients. To verify construct validity, the staff nurses classified 216 patients according to PPCS comparing differences by age, days of stay, type of stay and medical department. Results: The developed PPCS has 12 categories, 55 nursing activities and 80 criterions. High agreement among nurses (r=.90) suggested substantial reliability. Construct validity was verified by comparing differences in age, days of stay, type of stay and medical department (p<.05). The entire patient group were classified to four groups using PPCS. Conclusion: The findings suggest that PPCS would be a useful tool for estimating nursing demands related to medications and the complexity of pediatric patients.
Kim, Kyoung Hwi;Jung, Yong Gi;Kim, Myung Gu;Eun, Young Gyu
Korean Journal of Bronchoesophagology
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v.17
no.2
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pp.104-107
/
2011
Background and Objectives Scope classification is designed to classify acute epiglottitis according to laryngoscopic findings. There is no report about the utility of classification; the difference between the diagnosis and the prognosis by the Scope classification was not found. The aim of this study was to evaluate the utility of Scope classification in patients with acute epiglottitis. Subject and Method 127 patients who had been admitted to our hospital were diagnosed with acute epiglottitis. The patients were classified by the Scope classification. We compared demographic characteristics, clinical symptoms and signs, laboratory findings, and clinical course among the patient groups and divided the results according to the Scope classification. Results There are no significant differences among the groups in demographic characteristics, clinical symptoms and signs, laboratory findings, and clinical course. Conclusion The Scope classification of acute epiglottitis does not seem to be a method to evaluate the severity of acute epiglottitis. Thus, we need to develop multidisciplinary approaches for acute epiglottitis.
Classification in biomedical applications is an important task that predicts or classifies an outcome based on a given set of input variables such as diagnostic tests or the symptoms of a patient. Traditionally the classification algorithms would have to digest a stationary set of historical data in order to train up a decision-tree model and the learned model could then be used for testing new samples. However, a new breed of classification called stream-based classification can handle continuous data streams, which are ever evolving, unbound, and unstructured, for instance--biosignal live feeds. These emerging algorithms can potentially be used for real-time classification over biosignal data streams like EEG and ECG, etc. This paper presents a pioneer effort that studies the feasibility of classification algorithms for analyzing biosignals in the forms of infinite data streams. First, a performance comparison is made between traditional and stream-based classification. The results show that accuracy declines intermittently for traditional classification due to the requirement of model re-learning as new data arrives. Second, we show by a simulation that biosignal data streams can be processed with a satisfactory level of performance in terms of accuracy, memory requirement, and speed, by using a collection of stream-mining algorithms called Optimized Very Fast Decision Trees. The algorithms can effectively serve as a corner-stone technology for real-time classification in future biomedical applications.
The Journal of Korean Academic Society of Nursing Education
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v.5
no.1
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pp.72-85
/
1999
The paper presents a review of three data sets(Uniform Hospital Discharge Data Set, Nursing Minimum Data Set, and Nursing Management Minimum Data Set) and six major nursing classifications(the North American Nursing Diagnoses Association Taxonomy I, Omaha System, Nursing Interventions Classification, Nursing Intervention Lexicon and Taxonomy, Nursing Outcome Classification, Nursing Outcomes Classification, and Classification of Patient Outcome). The reviewed data sets and nursing classifications were different from each other in the purpose, structure, and user. Nursing Interventions Classification and Nursing Outcomes Classification were linked to North American Nursing Diagnosis Association, but others not. The data set and nursing classifications need to be linked to other data sets and classifications.
Lee, Hyun Ju;Park, Su Bock;Kim, Su Jin;Ko, Seung Yeon
Quality Improvement in Health Care
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v.12
no.2
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pp.84-92
/
2006
Background : To examine the difference between ICD-10 and The Korean standard classification of disease(oriental medicine), and to aim at improve the practical use as statistical data. It is one of the reason of disease classification. On that account we convert the many to many correspondence presenting classification of oriental medicine into many to one correspondence. Method : The study tracked out 155 patients discharged from the university hospital which is located in Gyeonggi Province and managing hospital and oriental medicine hospital from July to October this year. The period of this study was from August 1 to November 18. We compared correspondence between the two services' diagnosis(hospital services and oriental medicine hospital services) at the same time and attempted many to one correspondence classification. That is for production of statistical data. Result : We investigated the group which have had medical treatment experience of two kinds of services at the same time. The result of this investigation was that the same oriental medicine diagnosis used differently in western medicine diagnosis. 44.5% was accorded with western medicine diagnosis. Correspondence of the western medicine diagnose with the top of the Korean standard classification of disease(oriental medicine) list's western medicine diagnosis was 13.5%. For many to one correspondence classification for statistics, one western medicine diagnosis was selected for one oriental medicine diagnosis. In case of the main diagnosis(I sign) was not enough to explain oriental medicine diagnosis' characteristic, we chose multiple other diagnosis, so other diagnosis(II sign) about patient's cause of disease could be selected for supplement after we examined the patient's records. The statistics was possible with this many to one correspondence. Conclusion : The result of this study about correspondence between western medicine diagnoses and those of oriental medicine confirms that The Korean standard classification of disease(oriental medicine) is hard to be standardized with western medicine diagnosis. Therefore, according to this study, we use new many to one correspondence classification, multiple oriental medicine diagnoses with one ICD-10, which can be used by statistical data.
The purpose of this study is to classify elderly patient in long-term care facilities using RUG(Resource Utilization Group)-III. It is designed by measuring patient medical characteristics and medical staff time. Elderly patients are classified into 7 categories by clinical(medical and behavioral) hierarchical typology of patients. Through the tertiary split, all 44 groups are formulated. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). Major findings are as follows; 1. The objects in this study were classified into 35 groups out of 44 groups. The most frequent category is clinical complex category(CCC; 38.9%). And extensive service category(ESC; 18.8%), reduced physical function category(RPC; 13.1%), special rehabilitation category(SRC; 12.8%), and impaired cognitive category(ICC; 0.00%) are followed. 2. The mean of total CMI was $1.02{\pm}0.36$, ranging from 0.68 to 1.44(1 vs 2.12). The mean of CMI of SRC is only 1.17 which should be the highest. The means of ESC and see are equally 1.20. The means of CMI of CCI, ICC, BPC, and RPC were 0.90, 0.75, 0.83 and 0.96, respectively. 3. The validity of this classification was tested. Trend-test using Regression Analysis was done in the secondary split level. SCC, CCC, ICC, and RPC which covered 68.4% of this research objects showed linear trend of CMI in interim classification. This results were statistically significant. 4. In clinical hierarchy, the trend were showed linearity. But the multiple comparison of categories using Scheffe-test showed that SRC, ESC and see had same level of CMI means and CCC and ICC, too. This results were statistically significant. Classifying elderly patients with RUG-III, the results showed partly linear trend in clinical hierarchy and in interim classification in conclusion. But, in clinical hierarchy, it was failed to show the consistent order of CMI. It can be explained by two reasons. One is that this research subjects were overlapped in each clinical hierarchy group. And the other is that the some of the characteristics for clinical hierarchy is not appropriate for them. For the further study, it needs to have proper sample size and to modify RUG-III to K-RUG to consider our.. medical environment.
A nursing activity classification for hospitalized patients was performed based on an article review regarding nursing definition and nursing activity classification system. The study was conducted as follows: 1) Taxonomy was developed by the research team through the Delphi process and review article. The taxonomy consists of four nursing processes, (assessment, diagnosis, intervention and evaluation) and twelve nursing activity domains space (resperation, nutrition, elimination, exercise/alignment maintenance, comfort, hygiene, safety, spiritual support, counseling/ education, medication, communication, patient and information management). 2) First, nursing activities of the intervention process were listed and then classified by the nursing process of assessment, diagnosis, intervention and evaluation. The list consists of twelve nursing activity domains and 136 nursing activities. 3) A pilot study was conducted in two hospitals to verify validity and appropriateness of nursing activities. 4) The content validity index, which was calculated by 6 clinical practice experts, was 0.95. Also, a nursing activity classification system should also be developed in the department of community nursing and home health care nursing.
The classification of periodontal disease in 1999 has been widely used for determining a diagnosis, establishing a treatment plan, and evaluating the prognosis of the patient with periodontal disease. However, scientific evidence from many studies indicates the need for a new classification system for periodontal and peri-implant disease. Summary at 2017 world workshop as follows: 1) Periodontal health and peri-implant health was defined; 2) Chronic periodontitis and aggressive periodontitis were unified as periodontitis; 3) Periodontitis was further classified by staging and grading to reflect disease severity and management complexity, rate of disease progression, respectively; 4) Periodontal disease as manifestation of systemic disease is based on the International Statistical Classification of Diseases and Related Health Problems-10 (ICD-10) code; 5) Periodontal biotype and biologic width was replaced to periodontal phenotype and supracrestal tissue attachment, respectively; 6) The excessive occlusal force was replaced by a traumatic occlusal force; 7) ≥3 mm of radiographic bone loss, ≥6 mm of pocket probing depth and bleeding on probing indicates peri-implantitis in the absence of radiograph at final prosthesis delivery.
This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.
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