• Title/Summary/Keyword: Pre-hospital care

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Effect of Preoperative Warming on Prevention of Hypothermia during Surgery in Patients with Total Hip Replacement Arthroplasty under Spinal Anesthesia (척추마취하 고관절 전치환술 환자의 수술 전 가온이 수술 중 저체온 예방에 미치는 효과)

  • Lee, Min Ji;Jeong, Jeong Hee
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.3
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    • pp.365-373
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    • 2020
  • Purpose: The purpose of this study was to evaluate the effect of preoperative warming to prevent hypothermia in surgery for patients undergoing total hip replacement arthroplasty under spinal anesthesia. Methods: A randomized experimental study was conducted. Data were collected at an S University hospital in Gyeonggido from December 3, 2019 to March 31, 2020. A random allocation program was used to randomize participants into intervention and control groups. A total of 90 participants were assigned to the study: 30 people were randomized to a pre-warming group using Bair Hugger forced-air warming blankets(Model 505) 30 minutes before surgery, 30 to a pre-warming group 15 minutes before surgery, or 30 to a control group. The findings from 88 participants were analyzed. For data analysis, χ2 test and ANOVA were used utilizing the SPSS 21.0 program. Results: The pre-warming group 30 minutes before surgery had significantly higher body temperature than the control group, from 30 minutes after inducing anesthesia to the end of anesthesia. Body temperature over anesthesia time showed significant differences among the three groups, but there were no statistically significant differences in interactions between time and groups. Conclusion: Warming patients' body for 30 minutes before surgery was effective in maintaining normal body temperature while preventing intraoperative hypothermia.

CRITICAL PATHWAY ON GENERAL ANESTHESIA FOR DISABLED CHILDREN (장애아동 전신마취에 대한 Critical Pathway적용)

  • Kum, Jin-Eun;Lee, Su-Jin;Huh, Jeong-Ae;Jeong, Tae-Sung
    • The Journal of Korea Assosiation for Disability and Oral Health
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    • v.3 no.2
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    • pp.80-86
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    • 2007
  • A critical pathway (CP) defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical/dental staff after implementation of a critical pathway for dental treatment of disabled children under general anesthesia and its cost effectiveness. Ten patients who underwent dental treatment under general anesthesia were included in the CP group between August and December 2006. The pre-CP group included 20 patients who underwent the same procedure from February 2003. The satisfaction of parent of child patient and medical staff members were compared between two groups. The parents' satisfaction was significantly improved after the implementation of CP and medical/dental staff members were highly satisfied with the usefulness of the critical pathway. In conclusion, the critical pathway for the dental treatment of disabled treatment under general anesthesia can highly improve the satisfaction of parents and medical/ dental staff members.

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Job Analysis of Maternal Fetal Intensive Care Unit Nurses Using DACUM Technique (DACUM을 이용한 고위험 산모·신생아 통합센터 간호사의 직무분석)

  • Kim, Hee Jeong;Kim, Jeung-Im;Ahn, Sukhee;Kim, Myoung-Hee;Kim, Yunmi;Cho, Kyung Sook;Hwang, Namsuk;Choi, Jung Sun;Park, Soo Hye;Lee, Eun Hee
    • Journal of Korean Clinical Nursing Research
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    • v.24 no.1
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    • pp.10-22
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    • 2018
  • Purpose: This study was performed to establish the role and to analyze the job of MFICU (Maternal Fetal Intensive Care Unit) nurses using DACUM (Developing a curriculum). Methods: A DACUM workshop was held to define MFICU nurses' role and identify their duties and tasks. A DACUM committee was consisted of 7 nurses, 2 nursing professors and 1 medical doctor and as a result, a survey was developed which contained duties and tasks of MFICU nurse. Pre-test was carried out for the validity, finally collected the data from 97 nurses who worked at 7 MFICU and 10 delivery room. Results: A total of 60 duties, 115 tasks and 822 elements of tasks were defined on the DACUM chart and survey. The importance, frequency and difficulty of the tasks were presented the determinant coefficient (DC), the highest DC duty was 'Manage maternal ventilator' (15.09) and the lowest DC was 'Provide nursing care for leisure to gestation extension mother' (6.52). Twenty-eight tasks were differentiated between MFICU and delivery nurses significantly. And the most important, frequently, difficulty task perceived by MFICU nurse was 'Check fetal heartbeat with electronic fetal heart monitor'. Conclusion: The organized educational program and policy was needed to develop for MFICU nurses.

Effect of Auricular Acupressure on Fatigue and Depression in Patients Undergoing Chemotherapy for Breast Cancer (이압요법이 항암화학요법을 받은 유방암 환자의 피로 및 우울에 미치는 효과)

  • Kang, Mi-Ae
    • The Korean Journal of Health Service Management
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    • v.12 no.4
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    • pp.229-239
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    • 2018
  • Objectives: This study aimed to investigate the effects of auricular acupressure on fatigue and depression among patients undergoing chemotherapy for breast cancer. Methods: A nonequivalent control group nonsynchronized design was employed. Data were collected from December 2017 to May 2018, in the cancer center at a hospital located in B city. The experimental group received auricular acupressure four times a day, for 5 days, followed by a 2-day rest period. The control group received routine nursing care. The data were analyzed with independent t-tests, using the SPSS 21.0 program. Results: The level of fatigue and depression was lower in the experimental group as compared to that in the control group(t=5.29, p<.001; t=2.21, p=.038, respectively). However, depression scores increased post-intervention in the experimental group, as compared to the pre-intervention scores. Conclusions: The findings confirmed that auricular acupressure decreased fatigue however, depression scores increased post-intervention in the experimental group, as compared to the pre-intervention.

An exploratory study on the development of a device for isolation unit in CBRNE disaster (CBRNE 재난 시 격리이송을 위한 장치 개발에 관한 탐색적 연구)

  • Ham, Seung Hee;Park, Namkwun;Yoon, Myong O
    • Journal of the Society of Disaster Information
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    • v.14 no.1
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    • pp.65-71
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    • 2018
  • In this study, it is aimed to prevent the spread of pollutants in the event of a major disaster caused by CBRNE accidents and attacks and build up system to provide optimal transport environment for each patient condition By identifying characteristics of existing products and make them immediately applicable in the field. The purpose of this study is suggesting essential consideration in both functional and performance in the development of the isolation unit. As a result of the study, it suggests (1) basic function, (2) efficient field utilization, (3) isolation unit interface and combination of modules in development of isolation unit.

The Effect of Action on the Balance and the Trunk Control Ability in the Sit Position of Chronic Stroke Patients (동작관찰훈련이 만성 뇌졸중 환자의 앉은 자세에서 균형과 몸통조절능력에 미치는 영향)

  • Hwang, Junhyun;Lee, Yangjin;Joo, Mincheol;Kim, Seongryeol
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.3
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    • pp.1-9
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    • 2019
  • Purpose : To find out how action observation training for chronic stroke patients affects their balance and body control abilities in the posture seated in the rehabilitation of stroke. Methods : This study was conducted on 30 subjects who were diagnosed with stroke. The group conducted motion observation training through video clips, while the control group only conducted physical training, and the general physical therapy was performed equally by both counties. The static balance was measured using Biorescue and the dynamic balance was measured using Modified Functional Reach Test (MFRT), Postural Assessment Scale for Stroke, and Trunk Impairment Scale. Results : Static balance showed statistically significant difference in foot pressure (p<.05) as a result of comparison between pre and post exercise training. Dynamic balance was statistically significant (p>.05) as a result of comparing pre and post differences using modified functional reach test. The trunk control ability was statistically significant (p>.001). Comparison between the results of before and after motion observation training showed a statistically significant difference. Conclusion: This study confirmed that exercise training in sitting position was effective for static, dynamic balance ability and trunk control ability of hemiplegic patients due to stroke. These results suggest that the use of motion monitoring in stroke patients may have a positive impact on the diversity and function of rehabilitation.

Effectiveness of a Clinical Pathway for Breast Cancer Patients Undergoing Surgical Operation on Clinical Outcomes and Costs

  • Jeong Hyun Park;Danbee Kang;Seok Jin Nam;Jeong Eon Lee;Seok Won Kim;Jonghan Yu;Byung Joo Chae;Se Kyung Lee;Jai Min Ryu;Yeon Hee Park;Mangyeong Lee;Juhee Cho
    • Quality Improvement in Health Care
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    • v.30 no.1
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    • pp.120-131
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    • 2024
  • Purpose: This study aimed to evaluate the impact of implementing a clinical pathways (CPs) on the clinical outcomes and costs of patients undergoing breast cancer surgery. Methods: This retrospective cohort study included patients who were newly diagnosed with primary breast cancer at the Samsung Medical Center between 2014 and 2019 (N=8482; 2931 patients in the pre-path and 5551 patients in the post-path). Clinical outcomes included reoperation during hospitalization, readmission, and emergency room visits within 30 days of discharge. The cost data for each unit were obtained from an activity-based management accounting system. We performed an interrupted time series analysis. Results: The post-path period showed a significantly shorter hospital length of stay (LOS) than the pre-path period (6.3 days in pre-path vs. 5.0 days in post-path; -1.3 days' difference; p=.001), and fewer reoperations during hospitalization and within 30 days after discharge than the pre-path period. After adjusting for inflation rates and relative value scores, the model demonstrated savings of $146 per patient in the post-path for total costs, and $537 per patient for patient out-of-pocket costs (p=.001). Conclusion: CPs can help reduce costs without compromising the quality of care by reducing the number of reoperations, readmissions, and complications.

The Effects of Foot Massage on Anxiety and Sleep Satisfaction Response in Preoperative Patients Undergoing Abdominal Surgery (발마사지가 복부수술 전 환자의 불안과 수면만족도에 미치는 효과)

  • Kim, Geum-Ran;Oh, Sang-Eun
    • Journal of Home Health Care Nursing
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    • v.16 no.2
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    • pp.108-114
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    • 2009
  • Purpose: This study utilized a nonequivalent control group pre-post test design to test the effects of foot massage on anxiety and sleep satisfaction response in preoperative patients undergoing abdominal surgery. Method: There were 40 subjects in the study (20 in the experimental group and 20 in the control group). The experimental group received foot massage once a day for 2 days before their operation. Data were analyzed with descriptive statistics including mean, percentage, Chi-square, and t-test. Results: There were significant differences between experimental group and control group in the level of the state anxiety, pulse rate, and sleep satisfaction. Conclusions: Foot massage was effective in reducing anxiety and improving sleep satisfaction in abdominal surgical patients before their operation. Thus, foot massage may be used as an independent nursing intervention. This intervention can be performed anywhere, requires no special equipment, is noninvasive, and does not interfere with patients' privacy.

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Considerations for Invasive Dental Treatment in Disabled Patients

  • Eun-Jung Kwak
    • Journal of Korean Dental Science
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    • v.16 no.1
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    • pp.1-8
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    • 2023
  • Dental treatment for the disabled should be a customized that considers the characteristics and degree of cooperation of each disabled patient. There are additional considerations during implant treatment and tooth extraction in disabled patients. Since some brain lesion disorder or cardiac disease patients may be taking antiplatelet or anticoagulant medications, it is necessary to evaluate whether these medications should be discontinued before an invasive procedure. Precautions should be taken for patients with heart valve disease considering the risk of infective endocarditis, especially during invasive dental procedures. Moreover, disabled patients may have difficulty in following instructions and cautions. There are specific considerations for each stage of implant treatment in disabled patients. In the case of patients who are in the pre- or post-transplant state, it is necessary to assess their general condition and oral disease due to the risk of infection. Since disabled patients with various systemic diseases may visit the dental clinic, it is important to understand their characteristics and treatment process in order to flexibly adjust the dental treatment plan accordingly.

Standardization of Sample Handling Methods to Reduce the Rate of Inadequate Sampling

  • Yo-Han Seo
    • Quality Improvement in Health Care
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    • v.29 no.2
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    • pp.85-93
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    • 2023
  • Purpose: The predominant approach for mitigating inadequate sampling rates has primarily involved bolstering the volume of education. This study aimed to curtail inadequate sampling rates through the implementation of continuous quality improvement (CQI) activities, tailoring effective methods to the unique needs of each institution. Methods: We developed a sample handling guidebook and implemented QI activities to address this issue. Results: These measures resulted in a 4.7% decrease in inadequate sampling rates, concurrently improving knowledge of sample handling and overall nurse satisfaction. We addressed the root causes of inadequate sampling before laboratory pre-processing by: 1) focusing on systematic rather than erratic errors through CQI activities, 2) revising the sample handling guide, and 3) delivering face-to-face education based on the specific needs of the nursing department. These changes resulted in an additional 0.6% decrease in the inadequate sampling rate. Conclusion: This study demonstrates that the implementation of CQI activities based on evidence derived from a multifaceted causal analysis significantly reduced the inadequate sampling rate compared to previous studies.