• Title/Summary/Keyword: Patient outcome

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Development of Documentation System in Hospital-based Home Health - in one general hospital in the U.S.A. - (병원중심 가정간호 기관의 기록체계개발 - 미국 일개 종합병원을 대상으로 -)

  • Kang Chang-Hee
    • Journal of Korean Public Health Nursing
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    • v.6 no.2
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    • pp.58-69
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    • 1992
  • The purposes of this study were 1) to assess the currunt documentation system 2) to identify the problems in communication regarding to documentation 3) to develop new documentation system 4) to suggest effective communication channel using new documentation system Research was conducted by direct observation, chart review, staffs interview and servey. Results were as follows: 1) nursing care plans were not used in ongoing care 2) documentation format was primarily narrative and charting was time consuming 3) documentation did not reflect the nursing process 4) patient records were not used as effective communication tool between case manager and part time nurse 5) difficult access to patient record for nurse manager created inefficiency in coordinating 6) documentation of patient education did not describe the precise contents of education, and the responses of the patients and evaluation To solve these problems, new documentation format was developed. With new formats nurses : 1) use standardized care plan which contains nursing diagnosis, ecpected outcome, time frame for evaluation, flow sheet for updating the plans 2) leave one copy of care plan at patient home for mutual agreement with patent and communication among nursing staffs 3) carry one copy of care plan for updating 4) document and evaluate the patient education using education check list keeping in patient's home 5) document nursing process in focus charting visit report 6) carry one copy of visit report 7) have one copy of visit report which was deligated to part time nurses 8) use documentation in direct communication with part time nurse 9) use beeper and memo to promote communication

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A Study on Needs of the Spinal anesthesia Patients (척추마취 수술환자의 간호요구)

  • Nam, Soung Mi;Kim, Myung Hee
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.666-677
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    • 2000
  • The purpose of this study was to identify the needs which were perceived by patients who were received spinal anesthesia for surgery. The subjects consisted of 50 adult patients who were admitted to 2 university hospitals and 2 general hospitals in Pusan city and 1 general hospital in Koje City for surgery under spinal anesthesia. Thirty eight percent of subjects received information about anesthesia before the operation. The instrument for this study was developed by the researcher based on literature and a pretest. Data were collected from December 10, 1999 to February 10, 2000 and were analyzed by content analysis. The results were that there were 533 meaningful statements in the needs of spinal anesthesia patients. The needs of spinal anesthesia patients had 51 items (preoperation (6), induction of anesthesia(5), intraoperation (27), postoperation(13)) and 6 categories (information, emotional welfare, physical welfare, post anesthetic management, control of physical environment, humane treatment). From the results, it can be concluded that: 1. In the pre-operation period, we have to explain anesthesia procedures, adequate position of anesthesia, duration before anesthesia wears off and sensation of paralysis. We have to supply emotional support to relieve anxiety because of anesthesia. 2. In induction of anesthesia, we have to support patient's position for anesthesia, and relieve anxiety so that patients participate in induction of anesthesia well. 3. In intra-operative period, we have to check the level of anesthesia, and keep up a comfortable position for operation and care for physical discomfort such as thirst, nausea, vomiting, dyspnea and to maintain body temperature of the patient. Since the patient is conscious, we have to communicate with the patient to relieve anxiety, maintain privacy, inform the patient of the process of the operation and encourage the surgeon to explain the outcome of the operation. The operating team needs the careful about what they say and to place the instrument well. We have to ventilate the room air and reduce noise. 4. In the post-operative period, we have to explain the purpose and duration of bed rest, complications of anesthesia and care for physical discomfort such as pain, dysuria, headache, backache. Also we have to maintain body temperature of the patient and maintain privacy.

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Development of a novel nomogram for predicting ongoing pregnancy after in vitro fertilization and embryo transfer

  • Kim, Seul Ki;Kim, Hyein;Oh, Soohyun;Lee, Jung Ryeol;Jee, Byung Chul;Kim, Seok Hyun
    • Obstetrics & gynecology science
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    • v.61 no.6
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    • pp.669-674
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    • 2018
  • Objective This study aimed to develop a nomogram that predicts ongoing pregnancy after in vitro fertilization and embryo transfer (IVF-ET) using patient age and serum hormonal markers. Methods A total of 284 IVF-ET cycles were retrospectively analyzed. At 14 days post-oocyte pick-up (OPU), the serum human chorionic gonadotropin (HCG) and progesterone levels were measured. The main predicted outcome was ongoing pregnancy. Results Patient age and serum of HCG and progesterone levels at 14 days post-OPU were good predictors of ongoing pregnancy. The cut-off value and area under the curve (AUC) (95% confidence interval) were 36.5 years and 0.666 (0.599-0.733), respectively, for patient age; 67.8 mIU/mL and 0.969 (0.951-0.987), respectively, for serum HCG level; and 29.8 ng/mL and 0.883 (0.840-0.925), respectively, for serum progesterone level. When the prediction model was constructed using these three parameters, the addition of serum progesterone level to the prediction model did not increase its overall predictability. Furthermore, a high linear co-relationship was found between serum HCG and progesterone levels. Therefore, we developed a new nomogram using patient age and HCG serum level only. The AUC of the newly developed nomogram for predicting ongoing pregnancy after IVF-ET cycles using patient age and serum HCG level was as high as 0.975. Conclusion We showed that ongoing pregnancy may be predicted using only patient age and HCG serum level. Our nomogram could help clinicians and patients predict ongoing pregnancy after IVF-ET if the serum JCG level was ${\geq}5IU/L$ at 14 days post-OPU.

Patient-physician interaction education in Korea: a systematic review

  • Hwan Ho Lee;Yu Ra Kim;Hye Jin Park
    • Journal of Yeungnam Medical Science
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    • v.41 no.2
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    • pp.74-79
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    • 2024
  • Patient-physician interaction (PPI) is an important area in medical education, but in-depth discussions on the content of the outcome of patient-doctor education are rare. Therefore, in this study, we will systematically analyze the research on PPI education in Korea. In this study, papers searched with keywords related to PPI education from Korea's academic journal service were targeted according to a systematic literature analysis method. The scope of the study was to include papers published in academic journals that are candidates for Korea Citation Index registration, excluding dissertations, research reports, posters, conference presentations, books, and internet materials. The content included papers targeting medical education and medical school students was set as the range. As a result of the analysis, although communication between PPI has many positive effects in the PPI in medical education at medical schools, obstacles do occur, and various ways to overcome them were suggested. Therefore, although medical interview training between patients and doctors in medical schools is necessary, it was analyzed as being based on overseas research or lacking in specific content. The core of PPI education appears to be medical interviews, and it seems necessary to discuss whether empathy or patient-centered medical care are appropriate as the main principles of PPI education in Korea. Therefore, education on the patient-doctor relationship is an important element in medical humanities and medical humanities education, and it is expected that research and education on this will progress more actively.

Two Cases of Pseudo-Gynecomastia Treated with Wild Ginseng Pharmacopuncture (가성여성형유방에 산삼약침 시술 2예)

  • Shin, Hyun Taeg;Pang, Ji Hyeon;Kim, Ji Yoon
    • Journal of Korean Medicine for Obesity Research
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    • v.13 no.2
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    • pp.84-87
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    • 2013
  • Wild ginseng pharmacopuncture was administered to 2 patients with pseudo-gynecomastia. Each patient received the treatment once a week, total 5 times. Outcome was measured by the comparison of photos which were taken before and after the treatment. One case showed significant difference in the breast shape and size after the treatment and the patient was satisfied with the result. However, the other case did not show noticeable change but subtle one, and satisfaction degree of the patient was also low. From the above cases, to figure out the effect of wild ginseng pharmacopuncture on pseudo-gynecomastia, further studies and reports on other affecting factors should be followed.

Knowledge Discovery in Nursing Minimum Data Set Using Data Mining

  • Park Myong-Hwa;Park Jeong-Sook;Kim Chong-Nam;Park Kyung-Min;Kwon Young-Sook
    • Journal of Korean Academy of Nursing
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    • v.36 no.4
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    • pp.652-661
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    • 2006
  • Purpose. The purposes of this study were to apply data mining tool to nursing specific knowledge discovery process and to identify the utilization of data mining skill for clinical decision making. Methods. Data mining based on rough set model was conducted on a large clinical data set containing NMDS elements. Randomized 1000 patient data were selected from year 1998 database which had at least one of the five most frequently used nursing diagnoses. Patient characteristics and care service characteristics including nursing diagnoses, interventions and outcomes were analyzed to derive the meaningful decision rules. Results. Number of comorbidity, marital status, nursing diagnosis related to risk for infection and nursing intervention related to infection protection, and discharge status were the predictors that could determine the length of stay. Four variables (age, impaired skin integrity, pain, and discharge status) were identified as valuable predictors for nursing outcome, relived pain. Five variables (age, pain, potential for infection, marital status, and primary disease) were identified as important predictors for mortality. Conclusions. This study demonstrated the utilization of data mining method through a large data set with stan dardized language format to identify the contribution of nursing care to patient's health.

Effect of Complex Korean Medicine Treatment on Sacral Insufficiency Fracture: A Case Report

  • Jung, Ga Hyeon;Lee, Hyun;Ryu, Hwa Yeon;Kang, Jae Hui
    • Journal of Acupuncture Research
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    • v.37 no.3
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    • pp.187-192
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    • 2020
  • Sacral insufficiency fractures (SIF) are a common, but often underdiagnosed source of lower back pain without apparent trauma. This report presents the clinical outcome of a 75-year-old female with SIF, and an underlying medical history of osteoporosis and rheumatoid arthritis. She was treated non-operatively, in-hospital, with Korean medicine. Patient progress was assessed using the numerical rating scale and self-reported symptoms. Post-treatment, the numerical rating scale score for pain in her hip decreased from 7 to 2. At admission, the patient was unable to sit, and could only walk 3 m with assistance. At discharge, she could sit for longer than 1 hour and walk further than 200 m unassisted. On the follow-up visit, the patient was asymptomatic, and x-ray scans showed ossification of the sacral and pubic fractures. These results suggest that, Korean medicine can effectively reduce pain and aid rehabilitation in patients with SIF, without the need for surgery.

Impact of Nurse Staffing Level and Oral Care on Hospital Acquired Pneumonia in Long-term Care Hospitals (요양병원의 간호인력 확보수준과 구강간호 실시여부가 노인 환자의 폐렴발생에 미치는 영향)

  • Chae, Jung Mi;Song, Hyunjong;Kang, Gunseog;Lee, Ji Yun
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.2
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    • pp.174-183
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    • 2015
  • Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.

Full mouth rehabilitation of mandibular edentulous patient using implant hybrid prosthesis (하악 무치악 환자에서 임플란트 하이브리드형 보철물을 이용한 전악 수복 증례)

  • Kim, Hyun-Suk;Kim, So-Hyun;Oh, Namsik
    • The Journal of Korean Academy of Prosthodontics
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    • v.56 no.1
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    • pp.25-30
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    • 2018
  • In edentulous patients, the advantages of prosthodontic therapy using oral implants include both stability and comfort. Advantages suggested for this approach include the prevention of mandibular bone resorption and increased masticatory function. Implant hybrid prostheses place 4 to 6 implants between the mental foramens, and cantilevers are used to replace the posterior teeth at both ends. The 85 - year - old female patient visited our clinic with complete edentulism in the maxilla and mandible. This article reports a satisfactory clinical and esthetic outcome of full mouth rehabilitation using removable complete denture in the maxilla and implant hybrid prosthesis in the mandible.

봉독약침을 이용한 반사성 교감신경 이영양증의 치료 -치료 전후 적외선체열영상 비교-

  • Lim, Myung-Jang;Kang, In;Song, Joo-Hyun;An, Keon-Sang;Jang, Hyoung-Seok
    • Journal of Pharmacopuncture
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    • v.9 no.3 s.21
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    • pp.139-145
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    • 2006
  • Objectives : The purpose of this case in so report the patient with Reflex sympathetic dystrophy, who is improved by Bee venom. Method : We treated the patient with Bee venom who was suffering from Reflex sympathetic dystrophy, using Digital Infrared Thermographic Imaging and Verbal Numerical Rating Scale(VNRS) to evaluate the therapeutic effects. We compared the temperature of the patient body before and after treatment. Result and Conclusion : We found that Bee venom had excellent outcome to relieve pain, atrophy and ankle joint ROM, and that Bee venom also had clinical effect on hypothermia on the Digital Infrared Thermographic Imaging.