• Title/Summary/Keyword: Patient care team

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Exposure to Blood and Body Fluid in Operating Room Personnel in One Acute Care General Hospital (일개 종합병원 수술실 의료인의 혈액 및 체액 노출 실태조사)

  • Shin, Young Ran;Park, Kwang Ok;Jeong, Jae Sim;Kim, Kyung Mi
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.115-126
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    • 2009
  • Purpose: The purpose of this study was to assess the frequency and characteristics of occupational blood and body fluid exposure for operating room personnel during surgical procedures and identify risk factors. Methods: A self-report questionnaire was used to survey 519 operating room personnel who participated in 132 surgeries in an acute care hospital in Seoul between April 12 and 20, 2006. Results: The response rate was 82% (530/646) and analyzed total 519 except for improper 11 questionnaires. Exposure rate was 45.5% (60/132) during operations and 20.4% (106/519) for operating room personnel. By job categories, the exposure rate was as follows; anesthesiologists and nurses 31.2% (44/141), operators and assistants 22.1% (32/145), circulating nurses 12.0% (11/92), scrub nurses 11.4% (14/123). The mucous membrane-eye exposure with a high risk of transmitting infection was 6.6% (7/106) and the most frequent route of exposure was blood and body fluid touching unprotected skin. In multivariate analysis, the risk factors of exposure were services, duration of operation, a patient who had a peripheral arterial catheter line, and job category. Conclusion: Educational programs and appropriate use of personal protective equipment are necessary to prevent operating room personnel from being exposed to blood and body fluid.

The Effect of Case Management Program for Hypertensive Patient (보건소 등록 고혈압 환자에게 실시한 사례관리 프로그램의 효과)

  • Chung, Jung-Soon;Lee, Sun-Ock
    • The Journal of Korean Academic Society of Nursing Education
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    • v.20 no.2
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    • pp.321-331
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    • 2014
  • Purpose: The purpose of this study was to investigate the effects of case management service for hypertensive elderly patients through the customized visiting home health care program. Method: Non-equivalent control group pretest-posttest design was employed. Data were collected from April 2007 to January 2009. Among a total of fifty subjects, 25 subjects were belonged to the case management group and the others were belonged to the general management group. Results: 1) In experimental group, significant increasing rate of number of people within normal blood pressure by time, but no significant increasing rate of number of people within normal blood neutral fat, total cholesterol, HDL, & LDL. 2) In experimental group, the score of knowledge about disease and healthy life practice were increased on 8 week period but decreased on follow up period. Number of people within normal blood HDL and mean score of healthy life practice were significantly higher than control group on follow up period. Conclusion: Case management service was effective on controlling blood pressure but partly effective on blood lipid, knowledge about disease, and healthy life practice in hypertensive patients. Further study is needed to conduct a periodic re-evaluation of the effect of case management and to verify an optimal interval to provide the case management service.

Development of Key Indicators for Nurses Performance Evaluation and Estimation of Their Weights for Management by Objectives (목표관리를 적용한 간호사 성과평가 핵심 지표개발과 가중치 산정)

  • Lee, Eun-Hwa;Ahn, Sung-Hee
    • Journal of Korean Academy of Nursing
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    • v.40 no.1
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    • pp.69-77
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    • 2010
  • This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. Methods: The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using $X^2$-test, factor analysis, and the Analytical Hierarchy Process. Results: Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. Conclusion: PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.

Fertility preservation in women with cancer

  • Lee, Sanghoon;Song, Jae Yun;Ku, Seung Yup;Kim, Sun Haeng;Kim, Tak
    • Clinical and Experimental Reproductive Medicine
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    • v.39 no.2
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    • pp.46-51
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    • 2012
  • Fertility preservation (FP) is an effort to retain the fertility of cancer patients, and as an emerging discipline, it plays a central role in cancer care. Because of improvement in diagnostic and therapeutic strategies, an increasingly large number of patients are surviving with cancer. FP specialists should make an effort to spread the significance of FP among reproductive women with cancer and provide appropriate education both for associated physicians and for cancer patients who wish to preserve their fertility. Physicians who take part in the initial diagnosis and management of cancer should consider the importance of early referral of young cancer patients to FP specialists and take care of those patients by providing timely information and appropriate counseling. Individualized treatment strategies should be delivered depending on the patient's situation with appropriate team approach.

Evaluation of Efficiency of Outpatient Clinic in a General Hospital using Data Envelopment Analysis (DEA) (일 종합병원 외래간호단위의 효율성 평가 -자료포락분석법(Data Envelopment Analysis)의 적용)

  • Im, Hye-Bin;Lim, Ji-Young
    • Journal of Home Health Care Nursing
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    • v.19 no.1
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    • pp.11-18
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    • 2012
  • Purpose: The aim of this study is to evaluate the efficiency of the outpatient clinics in a hospital, using DEA. Methods: Data were collected using an activity-based costing system, medical information system, and annual reports of customer satisfaction management team of a general hospital in a city. The input variables were the number of doctors, the number of nurses, and the number of staffs. The output variables were the number of treatment times, the number of outpatient clinic patients, the total profits from outpatient clinic, the patient's satisfaction score, and the number of re-visit appointments. EMS Window version 3.1 was used to measure the efficiency score and benchmarking analysis. Results: The average efficiency score of 24 outpatient clinics was about 82.01%. Thirteen outpatient clinics had 100% efficiency score among them. The lowest efficiency score was 57.56%. Conclusion: According to these results, we found that, generally, outpatient clinics were operated very efficiently. However, some outpatient clinics had low efficiency and they needed specialized outcome improvement strategies. To increase the efficiency of inefficient outpatient clinics, we will recommend using results of DEA, as a benchmark point of the most efficient outpatient clinics.

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Plastic surgery in a trauma center: a multidisciplinary approach for polytrauma patients

  • Kyung-Chul, Moon;Yu-Kyeong, Yun
    • Journal of Trauma and Injury
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    • v.35 no.4
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    • pp.261-267
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    • 2022
  • Purpose: With the increasing number of polytrauma patients treated at high-level trauma centers, plastic surgery has entered the specialty of traumatology. Plastic surgeons specialize in the simultaneous surgical care of patients with facial or hand trauma and soft tissue injuries requiring microsurgery. The purpose of this study was to introduce the role of plastic surgery in a high-level trauma center. Methods: Between January 2020 and December 2020, 5,712 patients with traumatic injuries were admitted to the emergency department of a tertiary hospital. Of these 5,712 patients, 1,578 patients were hospitalized for surgical treatment and/or critical care. Among the 1,578 hospitalized trauma patients, 551 patients (35%) required at least one plastic surgery procedure. The patient variables included age, sex, etiology, the injured area, and injury characteristics. We also retrospectively investigated surgical data such as the duration of the operation, hospital stay, length of time from injury to surgery, and collaboration with other departments. Results: The most common injury referred to plastic surgery was facial trauma (41%), followed by hand trauma (36%), and soft tissue injuries requiring microsurgery in various parts of the body other than the hand (7%). The majority of facial and hand traumas were concomitant injuries. Sixteen percent of patients underwent collaborative surgical management for polytrauma involving both plastic surgery and another department. Conclusions: The role of plastic surgery in multidisciplinary teams at high-level trauma centers has become increasingly important. The results of this study may help in the development of multidisciplinary trauma team strategies and future workforce planning.

A study on the clinical application of the comprehensive dental hygiene care process (포괄치위생관리(CDHC) 과정 임상 적용 관련 연구)

  • Geum-Chae Youn;Hye-Eun Cho
    • Journal of Korean society of Dental Hygiene
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    • v.24 no.4
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    • pp.333-341
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    • 2024
  • Objectives: This study aimed to identify the key components and tools for Comprehensive Dental Hygiene Care (CDHC) among dental hygienists and provide foundational data for widespread implementation in dental institutions. Methods: A third Delphi survey involving experts derived the CDHC components and materials. Dental hygienists' characteristics and the CDHC application status were analyzed for frequency. The perceived need for and willingness to apply the CDHC components based on general characteristics were assessed using t-tests. Results: The results of the Delphi survey identified the following CDHC components: 11 for medical history; three, dental history; five, oral hygiene practices; seven, dental conditions; three, occlusion conditions; six, periodontal conditions; and, three, other examinations. Planning included 3 items for healthy gums and 4 for gingivitis and mild periodontitis. Evaluation included 7 items for mild periodontitis, 5 for patient education, and totally 27 CDHC-related materials. Dental hygienists' needs and willingness varied, with higher levels among those in clinics, university graduates, those in counseling or managerial roles, team leaders or those at higher positions, and those with >6 years of experience (p<0.05). Conclusions: The Delphi survey identified the CDHC clinical application process, confirming the strong desire of dental hygienists to apply it in practice.

Effect of Kegel Exercise on Urinary Incontinence after Radical Prostatectomy: Systematic Review of Randomized Controlled Trials (근치적 전립선적출술 후 요실금에 대한 케겔운동의 효과: 무작위 대조군 실험연구의 체계적 문헌고찰)

  • Park, Seong-Hi;Cho, Yun Su;Kwack, Mi Jeong;Lee, Hee Seon;Kang, Chang-Bum
    • Korean Journal of Adult Nursing
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    • v.25 no.2
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    • pp.219-230
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    • 2013
  • Purpose: This study is reviewed of the available literature to identify the evidence of the value of Kegel exercise programs as an intervention to decrease urinary incontinence and the improvement of the quality of life following a radical prostatectomy in localized prostate cancer. Methods: We searched studies of randomized controlled trials that utilized the Kegel exercise programs with patient with a radical prostatectomy. The review was conducted electronic bibliographic database of Ovid-Medline, Embase, Scopus, KoreaMed and NDSL, etc. Of 630 publications identified, seven studies that met the inclusion criteria, and all studies analyzed by meta-analysis. To ensure the quality of the studies, we used Cochrane's Risk of Bias. Results: Kegel exercise helped patient to achieve continence more quickly (after 1, 3, 6, 12 months) than men not using Kegel exercises. Especially, Kegel exercise significantly reduced the development of urinary incontinence at one month after prostatectomy. The effectiveness of Kegel exercise after prostatectomy was found to improve the quality of life at a significant level. Conclusion: Based on available evidence, Kegel exercise that nurses can teach improved the return to continence more than usual care in men with prostatectomy urinary incontinence.

Validity and Reliability of a Clinical Performance Examination using Standardized Patients (호흡기계 표준화 환자를 이용한 간호대 학생의 임상수행능력평가 타당도와 신뢰도 검증)

  • Choi, Ja-Yun;Jang, Keum-Seong;Choi, Soon-Hee;Hong, Mi-Soon
    • Journal of Korean Academy of Nursing
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    • v.38 no.1
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    • pp.83-91
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    • 2008
  • Purpose: The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing. Method: 70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station. Result: There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048). Conclusion: Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.

A Case Study of Home Health Care for Postpartum Women and their Newborns (산욕부와 신생아의 가정간호 사례연구)

  • Jun, Eun-Mi
    • 모자간호학회지
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    • v.4 no.1
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    • pp.3-11
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    • 1994
  • Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

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