• Title/Summary/Keyword: Patient Related Management

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Nursing Competency And Indicator Development By Emergency Nurse's Clinical Ladder (응급실 간호사의 임상 등급(clinical ladder)에 따른 간호역량 및 행동지표 개발)

  • Youk, Shin-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.3
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    • pp.481-494
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    • 2003
  • Purpose: This study was to develop nursing competencies, sub-competencies and behavior indicators according to the clinical ladder of emergency nurses. Method: index of content validation was used by 21 clinical experts. Results: This study had three phases to develop nursing competencies, sub-competencies and behavior indicators. In first phase: 12 nursing competencies and 33 sub-competencies were developed through the literature review on nursing competency and emergency nurses' job description. The content of 12 competencies and 33 sub-competencies were reviewed by 3 nursing professors. The 12 competencies and 33 sub-competencies were followed: clinical judgement and measures(6 sub-competencies), processing ability of ward works(2 sub-competencies), flexibility(2 sub-competencies), resources management(2 sub-competencies), confidence(3 sub-competencies), cooperation(2 sub-competencies), professional development power(2 sub-competencies), patient service orientation(3 sub-competencies), inclination toward ethical value(5 sub-competencies), influence power(2 sub-competencies), developing others(2 sub-competencies), self control(2 sub-competencies). In second phase, 132 behavior indicators were developed according to nurse clinical ladder: novice, advanced novice, competent, proficient. In Third phase, content validity was examined on 132 behavior indicators by 21 clinical experts. 126 among 132 indicators had over 70% agreement among experts and 6 indicators under 70% were revised. Conclusion: nursing competencies, sub competencies and behavior indicators can be used nurses' clinical performance as well as establishing proper directions for professional growth related to reward system.

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A Case of Acute Liver Injury Caused by Comfrey and so on with Oriental Medicine (Comfrey 등으로 발생한 독성 간손상 환자의 한방치료 1례)

  • Park, Bong-Ky;Jung, Tae-Young;Cho, Jung-Hyo;Son, Chang-Gue
    • The Journal of Internal Korean Medicine
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    • v.30 no.1
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    • pp.249-255
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    • 2009
  • Currently, drug-induced liver injury (DILl) has been reported to be common cause of acute hepatitis, and oriental medicine and folk remedies are no exception. However, because many studies about DILl have been reported by western medical society. they has taken the initiative of DILl not only for western drugs but also herbs. So, academia of oriental medicine should make an effort to progress herb-related DILl studies. We describe a patient of acute liver injury which had been caused by comfrey, albizzia julibrissin, ulmus davidiana var. japonica, red ginseng. We hope that this report helps for studying the diagnosis and management of herb-derived DILl. and for establishing a standard of oriental therapy to DILL.

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Arthroscopic Excision of Medial Knee Plica: A Meta-Analysis of Outcomes

  • Gerrard, Adam Daniel;Charalambous, Charalambos P.
    • Knee surgery & related research
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    • v.30 no.4
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    • pp.356-363
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    • 2018
  • Purpose: A meta-analysis was performed to assess the outcomes following surgical intervention for medial knee plica. Materials and Methods: A literature search of Medline, EMBASE, CINAHL and Cochrane CENTRAL was performed using relevant key words. The primary outcome was patient-reported postoperative scores of "good" and "excellent". Meta-analyses were performed using a random effects model. Results: The literature search identified 731 articles. After removing duplicates and those not meeting the inclusion criteria, 12 articles reporting on a total of 643 knees were included for analysis, and of these, 7 articles including 235 knees were used for meta-analysis. The overall rate of good and excellent outcomes following surgery was estimated at 84.2% (95% confidence interval [CI], 72.8-91.4). In those cases that had non-surgical therapy prior to surgery, the rate of good and excellent outcomes of surgery was estimated at 76.1% (95% CI, 60.1-87). Conclusions: Arthroscopic surgical management of symptomatic medial knee plica results in favourable outcomes. Our results suggest that arthroscopic surgical excision should be considered as a treatment modality in patients with pathological medial plica disease of the knee either as a first-line treatment or when symptoms have not responded to non-surgical interventions. Level of Evidence: IV.

Lymphaticovenular anastomosis for Morbihan disease: a case report

  • Jung Hyun Hong;Changryul Claud Yi;Jae Woo Lee;Yong Chan Bae;Ryuck Seong Kim;Joo Hyoung Kim
    • Archives of Craniofacial Surgery
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    • v.24 no.3
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    • pp.124-128
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    • 2023
  • Morbihan disease (MD) is a very rare condition characterized by rosaceous or erythematous lymphedema on the upper two-thirds of the face. A definitive management strategy for MD is lacking, and treatment is challenging. Herein, we present a case of persistent bilateral eyelid edema treated by lymphaticovenular anastomosis (LVA) and lymph node-vein bypass surgery. The patient experienced persistent bilateral eyelid edema. Indocyanine green lymphography was performed, and the diagnosis of bilateral facial lymphedema was confirmed. On the right side, a preauricular lymphatic vessel was anastomosed to a vein. On the left side, lymphostomy on the preauricular lymph node was done, with anastomosis to the transected proximal end of the concomitant vein of the transverse facial artery. Furthermore, a preauricular lymphatic vessel was anastomosed to a vein. Eyelid edema decreased and progressively improved on both sides. The outcome of this case suggests that LVA and lymph node-vein bypass surgery are appropriate for treating persistent eyelid edema related to MD.

Systematic Review of Research Progress on Borderline Resectable Pancreatic Cancer: A Bibliometric and Visualized Analysis (경계성 절제가능형 췌장 연구 동향에 대한 체계적인 문헌 고찰: 계량서지학적 분석 및 시각화된 분석)

  • Jae Keun Park;Ji Woong Hwang
    • Journal of Digestive Cancer Research
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    • v.12 no.1
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    • pp.23-30
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    • 2024
  • Borderline resectable pancreatic cancer, an intermediate stage between a completely resectable state and an unresectable state, requires a multidisciplinary treatment approach. This study aimed to elucidate the main characteristics and recent research trends regarding borderline resectable pancreatic cancer to gain further insights into them. Data from published papers about borderline resectable pancreatic cancer were collected from Web of Science (2014-2023) for the analysis. This study included 355 papers; data on major countries, publishing organizations, and keywords were collected and analyzed. Furthermore, R studio and VOSviewer were used for the qualitative and quantitative analyses of keywords. Publication of papers on borderline resectable pancreatic cancer was observed to be increasing annually by 12.8%, with the United States and Japan being the main publishing countries. In 2014, keywords related to surgery and chemotherapy were dominant; however, a shift toward more integrative approaches, such as neoadjuvant therapy, was observed over time. This study demonstrates rapidly evolving trends and paradigm changes in the research and management of borderline resectable pancreatic cancer. Thus, the results of this study are expected to contribute to establishing future research strategies and improving patient treatment outcomes.

A Study on the Teachers' Health Problems and Their Visiting Frequencies of School Clinics (교직원 건건문제(健建問題) 및 양호실(養護室) 이용실태(利用實態)에 관(關)한 연구(硏究))

  • Choi, Jae Sun
    • Journal of the Korean Society of School Health
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    • v.1 no.1
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    • pp.160-177
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    • 1988
  • This study is an analysis of the teachers' health problems that focuses on the frequencies and types of their visiting to school clinics and the management of health-related problems. The participants for this study are consisted of 1,650 teachers employed at 30 public schools in the Seoul area. Data for the study came from diagnostic records for 1986, the results of a questionaire-type survey conducted between June 20th and of the same year an from other documents recorded by school nurses. The main results of this study are as follows: 1. The teachers' health problems. a) According to health diagnosis records, 6.1 % of all teachers had a health problem. Liver-related ailments topped the list, followed by circulatory and diabetic problems. b) The survey data had 71.9 % of the respondents indicating that trey suffered from some health problem. The most frequent response concerned respiratory problems, followed by gastro-intestinal and nervous system problems. c) A check of clinic utilization records revealed that the main reasons for visiting are concerned with fatigue (30.5 %), gastro-intestinal(18.7 %) and respiratory(18.2 %) ailments. These three categories accounted for 67.4 % of total use. 2. Frequencies of their visiting to school clinics 40.5 % of the teachers indicated that they have visited the school clinic. And 62.0 % visited it with a self-diagnosed ailment and 15.3 % utilized the facility after a problem had been detected in a health examination. Clinics were visited a total of 1,458 times which breaks down to 0.9 times per month per teacher. For a patient, the figures are 2.2 times on the average with a range from 1 to 19. 3. Health management problems a) Of those respondents. 53.4 % stated that they didn't have enough time to consult about their health problems and diagnose their disease b) Also, 47.3 % of the respondents indicated that school nurses should give health counsels and health education. c) When questioned about improvements in the current system, the teachers placed importance on the prevention and management of chronic diseases (35.2 %) and pre- and posteducation concerning periodic health examinations In conclusion, the following points must be considered: First, school administrators need to pay more attention to the health problems of the teachers. Second, school nurses should be more active in managing a health program for teachers. Finally, education and training for nurses should be continually upgraded so that they can dispense proper and timely care for teachers.

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A Study on Self Care Compliance Related to Infection Management for Continuous Ambulatory Peritoneal Dialysis Patients (복막투석환자의 감염예방과 관련된 자가간호 이행에 관한 연구)

  • Lee Eun-Young;Kim Jung-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.5 no.2
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    • pp.313-323
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    • 1998
  • This study was a descriptive research on the level of self-care available to continous ambulatory peritoneal dialysis patients (hereinafter referred to as 'CAPD patient') related to the specific area of infection management. The method employed for the collection of data was a modified instrument of the self-care survey essentially based on Young Sook Choi's instrument. The relevant data was collected from september 1, 1996 to september 30, 1996. The subjects were provided with an open-ended question regarding the reasons behind why they did not seek self-care. The answers provided about self-care compliance were analyzed by SPSS for frequency, percentage, mean, t-test, ANOVA. Reasons for non-compliance were analyzed by content analysis. The results of the study were as follows : 1. The percentage of patients engaging in self-care were according to the following self performed tasks : preparation of dialysis : 30.58 points Dialysate exchange procedures : 49.40 points - Two bag type : 50.50 points - Spike type : 48.80 points - Neo type : 48.90 points Catheter exit site care : 25.13 points More specifically, in relation to the preparation of dialysis as referred to above, those patients engaging in self care was relatively high with respect to the cleaning of the dialysis before use and for the preservation of peritosol. However, in dialysate exchange procedures, data revealed that those patients engaging in self-care are relatively low with respect to putting on a mask during the performance of peritosol exchange. Similary in peritosol exchange procedure and catheter exit care, low levels of self-care performance were found in the area of putting on a mask during the peritosol exchange procedures and catheter line testing procedures, respectively. 2. In general characteristics, there appeared to be no distinction in self-care compliance among CAPD patients. 3. The main reasons for non-compliance were based in the following factor : intellectual, attitude, enviromental surrounding and physical. As a result of the foregoing finding, nurses should provide adequate assistance to promote self-care compliance by CAPD patients by checking the preparation of dialysis, dialysate exchange procedure, and catheter exit site care which recieved low point in this research.

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Pharmacists' Perceptions of Barriers to Providing Appropriate Pharmaceutical Services in Community Pharmacies (지역약국 약료서비스 제공의 장애요인: 약사 대상 설문조사)

  • Sohn, Hyun Soon;Kim, Seong-Ok;Joo, Kyung-Mi;Park, Hyekyung;Han, Euna;Ahn, Hyung Tae;Choi, Sang-Eun
    • Korean Journal of Clinical Pharmacy
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    • v.25 no.2
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    • pp.94-101
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    • 2015
  • Background: In order to achieve the goals of community pharmacy practice, its legal, labour-related, and economic barriers need to be identified. This study examined pharmacists' perceptions of constraints on providing optimal pharmacy services in order to identify underlying factors and analyse the associations between barriers and pharmaceutical services in community pharmacies. Methods: A survey targeting pharmacy owners was conducted from May to June 2012 using a structured questionnaire including nine pharmaceutical service items. According to the service provision level, we classified pharmacists as inactive (fewer than 5 items among the listed 9 service items) and active providers (5 or more items). Principal component analysis was used to group significant factors for barriers into four thematic components. Associations between the participants' demographics and pharmacy characteristics and the services provided were explored by logistic regression analyses. Results: Participants were 402 pharmacists. Over 60% provided disease management services for hypertension, diabetes, and hyperlipidaemia. Variables that affected pharmaceutical services included the lack of separate areas for patient counselling (OR: 2.12, 95% CI: 1.18-3.80), and clinical knowledge and information-related barriers (OR: 0.59, 95% CI: 0.36-0.97). Conclusion: Strategies for improving clinical knowledge and providing expeditious information are necessary in order to improve community pharmacy services.

Literature Review of Postoperative Delirium in Geriatric Patients After Elective Gastrointestinal Cancer Surgery

  • Park, Da-In;Choi-Kwon, Smi
    • Journal of Korean Biological Nursing Science
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    • v.20 no.3
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    • pp.177-186
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    • 2018
  • Purpose: Increasing number of older adults are receiving cancer surgeries especially for gastrointestinal cancers, which brings forth attention to age-related postoperative complication prevention. Postoperative delirium (POD) is a common complication that rises after surgical procedures involving general anesthesia, largely in the elderly population. Due to its sudden onset and fluctuating symptoms, POD often goes underdiagnosed and undertreated even though it may lead to various adverse outcomes. POD in GI cancer surgical elderly patients is poorly understood in terms of prevalence, pathophysiology, assessment, treatment and nursing management. We aimed to identify available literature and investigate study results to broaden our understanding of geriatric GI cancer POD. Methods: The search process involved six databases to identify relevant studies abided by inclusion criteria. Results: Eleven studies were selected for this review. Geriatric POD is closely related to frailty and surgical complications. Frailty increases vulnerability to surgical stress and causes cerebral changes that affect stress-regulating neurotransmitter proportions, brain blood flow, vascular density, neuron cell life and intracellular signal transductions. These conditions of frailty result in increased risks of surgical complications such as blood loss, cardiovascular events and inflammation, which all may lead to the POD. Mini Metal State Examination (MMSE), Confusion Assessment Method (CAM) and Delirium Rating Scale-revised-98 (DRS-R-98) are recommended for POD assessment to identify high-risk patients. Conclusion: The POD prevalence ranged from 8.2% to 51.0%. The multifactorial causative mechanism suggests nurses to identify highrisk elderly GI-cancer surgical patients by reviewing patient-specific factors and surgery-specific factors.

The Effect of topical EMLA Cream for venipuncture on Patients' Pain and Anxiety (엠라크림이 정맥천자 시 통증과 불안에 미치는 영향)

  • Kim, Jung-Kyoung;Shim, Moon-Sook;Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.9
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    • pp.4065-4072
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    • 2012
  • The purpose of this study was to examine the effect of topical EMLA Cream on venipuncture related pain and anxiety of surgery patient from oct. 27 to nov, 13, 2011, EMLA Cream was applied to the experimental group(n=40) 1hour before the procedure, but was not applied to the control group (n=37). The collected data were analyzed with the SPSS WIN 15.0 program. The percentage, mean and standard deviation were figured statistic, ${\chi}^2$-test, t-test, ANOVA, Correlation analysis were performed. Consequently, Pain in the EMLA applied experimental group was significantly lower than that of the control group. also state anxiety in the experimental group was lower than that of the control group. correlation of pain and anxiety after EMLA was related. EMLA cream was considered to be an effective local anesthetic for preoperative venipuncture on pain and anxiety.