Intracranial pial arteriovenous fistula (AVF) is a rare cerebrovascular lesion that has only recently been recognized as a distinct pathological entity. A 41-year-old woman (Patient 1) presented with the sudden development of an altered mental state. Brain CT showed an acute subdural hematoma. A red sylvian vein was found intraoperatively. A pial AVF was revealed on postoperative angiography, and surgical disconnection of the AVF was performed. A 10-year-old boy (Patient 2) presented with a 10-day history of paraparesis and urinary incontinence. Brain, spinal MRI and angiography revealed an intracranial pial AVF and a spinal perimedullary AVF. Endovascular embolization was performed for both lesions. The AVFs were completely obliterated in both patients. On follow-up, patient 1 reported having no difficulty in performing activities of daily living. Patient 2 is currently able to walk without assistance and voids into a diaper. Intracranial pial AVF is a rare disease entity that can be treated with surgical disconnection or endovascular embolization. It is important for the appropriate treatment strategy to be selected on the basis of patient-specific and lesion-specific factors in order to achieve good outcomes.
Journal of Korean Academy of Nursing Administration
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v.3
no.1
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pp.107-118
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1997
This study was designed to obtain basic data for development of evaluation tool which would be needed to measure the outcome of general quality nursing care of individual patient. The purpose of this study was to analyze and classify the outcome indicators of quality nursing care. The 29 articles of quality nursing care and outcome measures were selected coveniently, and analyzed to classify the outcome indicators of quality nursing care using open coding method. The results of this study were as follows: 1. Quality nursing care was defined as level of excellence of nursing care to achieve good patient outcome. 2. The 6 domains of which were health status, satisfaction, self care, patient progress and prognosis, and compliance were identified in outcome indicators of quality nursing care 3. Seven indicators of health status domain which were perceived health status, quality of life, well-being, daily activities, physical-physiological status, psychoemotional status, and social role functioning were identified. 4. Two indicators of satifaction domain which were patient satisfaction and family satisfaction were identified. 5. Three indicators of self care domain which were skill, knowledge, and home management were identified. 6. Seven indicators of patient progress and prognosis domain which were change of clinical status, resolution of nursing diagnosis and problem, days of stay, dicahrge state, recovery state, survival were identified. 7. compliance with therapeutic direction compliance was identified as an indicator of compliance domain. 8. It was sugested that studies for development of evaluation tools for outcomes of quality nursing the results of this study could be executed
Purpose: To study aimed to examine the impact of the Nursing and Care=giving Integrated Service on nursing work performance, nurse' job satisfaction, and patient safety. Methods: A total of 66 nurses were selected as participants, comprising 30 nurses working in Nursing and Care=giving Integrated Service hospital ward, and 33 nurses working in a general hospital ward with a similar patient and disease group and distributed moderately. For data analysis, t-tests, ANOVA, and $X^2$ tests were conducted. Results: Nursing work performance in the Nursing and Care=giving Integrated Service ward was higher than that in the general hospital ward, but this difference was not statistically significant. Conversely, job satisfaction was lower among nurses in the Nursing and Care=giving Integrated Service ward, although again the difference was not significant. However, the Nursing and Care=giving Integrated Service ward had a significantly lower rate of safety-related accidents in patients compared to the general hospital ward. Conclusion: In order to expand and improve patient safety and other aspects of the Nursing and Care=giving Integrated Service, there is a need to establish a mediation strategy for increasing nurses' work performance and job satisfaction.
Purpose: The purpose of this study was to develop a tool to evaluate patient safety culture in nursing homes and to test its validity and reliability. Methods: A preliminary tool was developed through interviews with focus group, content validity tests, and a pilot study. A nationwide survey was conducted from February to April, 2011, using self-report questionnaires. Participants were 982 employees in nursing homes. Data were analyzed using Cronbach's alpha, item analysis, factor analysis, and multitrait/multi-Item analysis. Results: From the results of the analysis, 27 final items were selected from 49 items on the preliminary tool. Items with low correlation with total scale were excluded. The 4 factors sorted by factor analysis contributed 63.4% of the variance in the total scale. The factors were labeled as leadership, organizational system, working attitude, management practice. Cronbach's alpha for internal consistency was .95 and the range for the 4 factors was from .86 to .93. Conclusion: The results of this study indicate that the Korean Patient Safety Culture Scale has reliability and validity and is suitable for evaluation of patient safety culture in Korean nursing homes.
Purpose: The purpose of this study was to measure patient satisfaction among injured workers and determine the factors that affect satisfaction of the hospital services. Methods: The subjects of this study were 231 injured workers hospitalized in I WC Hospital and D WC Hospital located in one of the major cities in Korea, all of whom agreed to participate in this research. The questionnaires were selected as literature suggested for explaining satisfaction of the hospital services, general characteristics of injured workers, characteristics of the hospital services. The data were analyzed with descriptive statistics, t-test, ANOVA, multiple regression analysis by SPSS/WIN 18.0. Results: The patient satisfaction level is at 3.2 point, which is lower than general patient satisfaction in previous study. There were significant differences in satisfaction scores, depending on the gender, degree of medical treatments, the specialty of medical team, staff's kindness, medical treatment process, the cleanliness of hospital and the convenience of facilities. It was found that the patient satisfaction among injured workers is affected by the characteristics of the hospital services. Conclusion: It is necessary to promote medical facilities, specialization of doctors and nurses, staff's kindness, medical treatment process and hospital cleanliness for developing Workers' Compensation hospital services.
Background: The fear of needle insertion and pain during anesthesia is a source of patient dissatisfaction in dentistry. Inferior alveolar nerve block (IANB) remains the most common type of block and is in itself painful. Computer-controlled local anesthetic delivery (CCLAD) has been proven to reduce the pain associated with injection of anesthetics in various blocks. However, the efficacy of CCLAD for IANB in adults remains unknown. Methods: Sixty-four adult patients requiring bilateral IANB were selected and divided into two groups: group A (50 patients receiving IANB via CCLAD) and group B (50 patients receiving IANB using a conventional cartridge syringe). Pain perception and patient comfort were assessed using the visual analog scale and the 5-point semantic scale, respectively. Results: The pain perception was compared between the two groups using the Mann-Whitney U-test, and the P value was 0.003. The patient comfort was also compared using the same test, and the P value was 0.484. Conclusion: A significant difference was observed in the pain perception of the patients during CCLAD. The patient comfort was grossly equal for both techniques.
Recently elevated plasma homocysteine concentration is considered an independent risk factor for atherosclerosis and thrombosis with coronary artery disease. Folate and vitamin $B_{12}$ are cofactors and closely related with metabolism of homocysteine. The purpose of this study is to evaluate the correlation between homocysteine and folate and vitamin $B_{12}$ in patients with ischemic heart disease. Twenty-six patients, in whom coronary angiographic finding revealed more than $50\%$ of stenosis at least in one coronary vessel were enrolled as the patient group, and thirty subjects, in whom angiographic finding revealed in not significant stenosis, but complained of chest pain, were selected as the control group. Fasting venous blood was obtained and measured the concentration of plasma total homocysteine, folate and vitamin $B_{12}$ by high performance liquid chromatography and fluorescence detection method. We examined the correlation between homocysteine and folate and/or vitamin $B_{12}$ in the control group and the patient group, respectively. Compared with the control group, the patient group had relatively higher plasma total homocysteine concentration ($10.7\pm4.2\;vs\;9.6\pm3.5$ umol/L), but showed no significant difference. Folate and vitamin $B_{12}$ concentration are low in the patient group, but showed no significant difference between patient and control group. Plasma total homocysteine concentration showed negative correlation with folate and vitamin $B_{12}$ in both the control group and the patient group, and showed significantly negative correlation in patient group {r = -0.550 (p < 0.01) vs r = -0.609 (p < 0.01)}. We knew that the plasma total homocysteine concentration were relatively elevated in patient group compared with the control group. Because plasma total homocysteine concentrations are closely negative correlated with folate and vitamin $B_{12}$ in the patient group, folate and vitamin $B_{12}$ supplement can lower the mortality and morbidity of ischemic heart disease. (Korean J Community Nutrition 10(6) : $963\∼970$, 2005)
Journal of Korean Academy of Dental Administration
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v.10
no.1
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pp.53-65
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2022
The Primary Care Patient Measure of Safety (PC-PMOS) is a measure of safety that allows patients to evaluate contributing factors related to patient safety in primary care. This study aimed to examine which questionnaire items of the PC-PMOS could be used in Korean dental institutions. A survey of the Korean translation of the PC-PMOS, a self-reported questionnaire, was conducted in August 2022 by 400 adults who had used dental-care services within the last three years. Of the 77 items, 34 were selected using principal component analysis and two experts' evaluations based on face validity. Five domains were identified from factor analysis: patient centeredness, patient information update, complaint processing, communication, and information about the complaint process. The Cronbach's alpha of the data was 0.913, indicating high reliability. As a result of the generalized multiple regression analysis, regression coefficients were not statistically significant, except for household income. This indicated that there was no bias in the patient safety scores of dental institutions evaluated by patients within the range of independent variables used in this study. The five domains with 34 items identified in this study suggested the factors that contribute to the safety of patients who used dental care services in Korea. However, validation of this study result is still important to refine questionnaires suitable for dental institutions in Korea so as to further improve the quality of dental care.
Park, SoMi;Hur, Hea Kung;Kim, Ki Kyong;Song, Hee-Young
Journal of Korean Academy of Nursing
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v.47
no.4
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pp.526-539
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2017
Purpose: This study was undertaken to develop and test a mastery learning program of nursing skills for undergraduate nursing students. Methods: In this methodological study, first, the preliminary draft of a mastery learning program to provide training for nursing skills was developed based on Bloom's framework for mastery learning. Second, to test the developed program, a single-blinded, nonequivalent control group nonsynchronized study was conducted on 50 senior nursing students in a University selected by convenient sampling. Thirteen students were assigned to a control group; 13, 12, and 13 of them were assigned to intravenous therapy, transfusion, and patient transfer groups, respectively. The achievement levels and performance scores of the selected nursing skills were measured before and after the completion of the program in all the groups. Lastly, the final program was confirmed based on the results of the program testing. Results: Intravenous therapy, transfusion, and patient transfer were selected as essential nursing skills for the program based on the priorities rated by clinical instructors and staff nurses. The achievement levels of selected nursing skills were determined by Angoff scores. After participating in the program, the proportion of passers and performance scores of the nursing skills in the experimental groups were significantly higher than those in the control group. The final program was confirmed which included a diagnostic test, enrichment activities for the passers and three repetitions of corrective activities and formative assessments for non-passers. Conclusion: The results suggest that a mastery learning program for undergraduate students can lead to better improvement and performance of essential nursing skills.
Purpose: The objective of this study was to identify the relationship between knowledge of patient safety, nursing professionalism and patient safety management activities of nursing students with clinical practical experience. Methods: Self-administered questionnaires survey on knowledge of patient safety, nursing professionalism, and patient safety management activities were conducted for the $3^{rd}-year$ and $3^{th}-year$ nursing students. 139 questionnaires were distributed, of which, 131 were used for data analysis. Results: The scores of nursing students' knowledge of patient safety, nursing professionalism and patient safety management activities were $6.76{\pm}1.26$, $65.11{\pm}7.97$ and $67.99{\pm}7.26$, respectively. Knowledge of patient safety differed significantly according to the grade. Nursing professionalism had a difference with major satisfaction, clinical practical satisfaction, and experience of patient safety accident. Patient safety management activities were positively correlated (p<.01) with knowledge of patient safety and nursing professionalism. Patient safety management activities increased significantly with increase in the scores of knowledge of patient safety and nursing professionals. The factors that were related to patient safety management activities of nursing students were knowledge of patient safety and nursing professionalism. Knowledge of patient safety and nursing professionalism were selected as significant variables for explaining the patient safety management activities of nursing students, of which the coefficient of determination was 9.8%. Conclusion: To promote patient safety management activities of nursing students, training programs for patient safety management activities are required. Also, there is the need to increase the knowledge of patient safety and nursing professionalism of nursing students using various educational method.
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