• 제목/요약/키워드: Readmission

검색결과 131건 처리시간 0.024초

관상동맥질환자의 식품섭취와 가족지지 (A Study on Food Intake and Family Support in Patients with Coronary Artery Disease)

  • 이선자;김애리;이영희
    • 성인간호학회지
    • /
    • 제21권1호
    • /
    • pp.1-12
    • /
    • 2009
  • Purpose: This study was to examine the food intake and family support of patients with Coronary Artery Disease(CAD). Methods: 90 hospitalized patients who received CAD medical treatment were randomly selected. The food intake frequency and family support instrument were utilized. Collected data was analyzed by SPSS/WIN 14.0: t-test, $x^2$-test and Pearson's correlation coefficient. Results: The mean score of food intake frequency was 5.65(total mean score 97.50) which was relatively healthy food intake based on the CAD treatment guidelines. Undesirable food intake items were fruit, fish, milk etc. The mean score of family support was 2.44(range: 1 - 4). Food intake showed a significant(p < .001) positive correlation with family support. There was significant difference(p < .05) on family support according to exercise. There was significant difference(p < .05) on LDL level, one of the CAD risk factors, between first admission patients and readmission patients. Conclusion: These findings suggest that nursing intervention education programs should be developed to appropriately care for CHD patients for needed changes.

  • PDF

일 대학병원 정신분열병 환자의 퇴원 후 경과에 미치는 치료적 요인 (The Therapeutic Factors Affecting Post-discharge Course of Schizophrenia Patients in a University Hospital)

  • 남정현;노성원;최준호;이경우
    • 생물정신의학
    • /
    • 제13권1호
    • /
    • pp.26-31
    • /
    • 2006
  • Object : To evaluate how the therapeutic factors affect post-discharge course of patients with schizophrenia, we analyzed relationship between each therapeutic factor and outcome of inpatients with schizophrenia in Hanyang University Hospital. Methods : This study is a retrospective report. Subjects were schizophrenic inpatients who were discharged from Hanyang University Hospital from January 1, 2003 through December 31, 2004. We obtained demographic and clinical data from review of inpatient and outpatient charts. Results : We analyzed the records of 104 patients with schizophrenia(44 males and 60 females). Patients who had longer first admission days have fewer number of readmission. There were no significant correlation between psychiatric rehabilitation and course of schizophrenia. Courses, such as duration of outpatient department follow-up and number and duration of rehospitalization, did not differ according to the existence of extrapyramidal symptoms or types of antipsychotics prescribed. Conclusion : Among the therapeutic factors, longer duration of the first admission only affected better post-discharge course of patients with schizophrenia.

  • PDF

한방병원 입원 시 관례적 흉부 X선 검사의 유용성 (The Utility of Routine Chest X-Ray on Korean Medicine Hospital Admission)

  • 최인우;유호룡
    • 대한한방내과학회지
    • /
    • 제42권4호
    • /
    • pp.622-627
    • /
    • 2021
  • Objective: This study was designed to analyze the utility of routine chest X-ray on Korean medicine hospital admission. Methods: The chest X-ray reports and medical records of 618 patients who were admitted to Daejeon Korean Medicine Hospital from May 1, 2021 to June 30, 2021 were retrospectively reviewed. Results: Of the 618 patients newly hospitalized from May 1, 2021 to June 30, 2021, 560 patients (excluding readmission) were analyzed. The mean age of 560 patients was 53.26±17.20 years. There were 52 patients with abnormal findings, and their mean age was 69.62±15.59 years. Many of these patients had chest symptoms and a history of chest disease. There was no case that showed a significant diagnostic result by chest X-ray examination. Conclusion: The diagnostic usefulness of routine chest X-rays in Korean medicine hospital admission is low. But this does not mean that there is no need to perform routine chest X-rays upon admission.

중환자실 환자의 환경적 스트레스 요인이 외상후 스트레스장애 위험도와 삶의 질에 미치는 영향 (Impact of Environmental Stressors on the Risk for Posttraumatic Stress Disorder and Quality of Life in Intensive Care Unit Survivors)

  • 차효정;안숙희
    • 중환자간호학회지
    • /
    • 제12권1호
    • /
    • pp.22-35
    • /
    • 2019
  • Purpose : This study was to determine the levels of environmental stressor, posttraumatic stress disorder, and quality of life in intensive care units (ICU) survivors after intensive care, and to explore the factors affecting posttraumatic stress disorder and quality of life. Methods: With a longitudinal survey design, data were collected from 116 patients who were discharged from the ICU of a university hospital. The environmental stressor, posttraumatic stress disorder, and quality of life were measured immediately following and 1 month after the ICU discharge. Results: Of all the subjects, 16.4% experienced posttraumatic stress disorder after discharge. Multiple regression analysis revealed that ICU environmental stressors, experience of ICU readmission, using psychotropic drugs and narcotic analgesics, and ICU admission after surgery or cardiac intervention accounted for 22.2% of posttraumatic stress disorder. Posttraumatic stress disorder and sedation status when entering ICU accounted for 28.3% of the quality of life 1 month after ICU discharge. Conclusion: Nursing interventions focused on ICU environmental stressors would not only reduce environmental stress but also contribute to the reduction of posttraumatic stress disorder and later improvement of quality of life.

Outcome of Children with Severe Acute Malnutrition and Diarrhea: a Cohort Study

  • Bhatnagar, Sakshi;Kumar, Ruchika;Dua, Richa;Basu, Srikanta;Kumar, Praveen
    • Pediatric Gastroenterology, Hepatology & Nutrition
    • /
    • 제22권3호
    • /
    • pp.242-248
    • /
    • 2019
  • Purpose: Severe acute malnutrition (SAM) is an important public health problem which contributes to significant number of under five deaths. Protocol based management significantly decreases risk of deaths in children with medical complications. Methods: Outcome of children aged 2 months-5 years admitted and fulfilling definition of SAM having diarrhea (group A) was compared to children with SAM having medical complications other than diarrhea (group B). Both groups were managed according to standard recommended protocols and monitored and followed up for 12 weeks after discharge. Results: The average weight gain, defaulter rate, primary failure, secondary relapse rate and readmission rate were similar in both groups. Length of stay in group A was three days longer (p-value=0.039). Discharge rate was comparable with overall 68% of children successfully discharged and 50% of children reaching weight/height > -2 standard deviation at follow-up of 12 weeks. Conclusion: The current management protocol is equally effective for managing children with SAM having diarrhea. Good adherence to management protocol of dehydration and timely modification of therapeutic feeds in children with persistent diarrhea results in satisfactory weight gain.

중환자실 섬망예방을 위한 근거중심 간호중재 프로토콜 개발 (Development of an Evidence-Based Protocol for Preventing Delirium in Intensive Care Unit Patients)

  • 문경자;이선미
    • 임상간호연구
    • /
    • 제16권3호
    • /
    • pp.175-186
    • /
    • 2010
  • Purpose: Delirium can be a highly prevalent symptom in intensive care units but it may still be under-recognized despite its relation with inclined morbidity, mortality, cost, and readmission. Therefore, this study aimed to develop a protocol that covers risk factors and non-pharmacological interventions to prevent delirium in ICU patients. Methods: This study was conducted using methodological design, and it followed the Scottish Intercollegiate Guideline Network (SIGN) guideline development steps: 1) the scope of protocol was decided (population, intervention, comparison, and outcomes); 2) guidelines, systematic reviews, and protocols were reviewed and checked using methodology checklist; 3) the level of evidence and recommendation grades was assigned; 4) the appropriateness of recommendations was scored by experts; 5) the final protocol & algorithm was modified and complemented. Results: The evidence-based delirium prevention protocol was completed that includes predisposing factors, precipitating factors and recommendations with evidenced grades. Conclusion: This protocol can be used as a guide nurses in screening patients with high risk factors of delirium as well as in intervening the patients non-pharmacologically to prevent delirium.

Infective Costochondritis after Augmentation Mammoplasty: A Rare Case Report and Review of the Literature

  • Sally Min;Jinil Choi;Kwon Joong Na;Ki Yong Hong
    • Archives of Plastic Surgery
    • /
    • 제50권5호
    • /
    • pp.488-491
    • /
    • 2023
  • Silicone breast implant insertion is a commonly performed surgical procedure for breast augmentation or reconstruction. Among various postoperative complications, infection is one of the main causes of patient readmission and may ultimately require explantation. We report a case of infective costochondritis after augmentation mammoplasty, which has rarely been reported and is therefore difficult to diagnose. A 36-year-old female visited the clinic for persistent redness, pain, and purulent discharge around the left anteromedial chest, even after breast implant explantation. Magnetic resonance imaging showed abscess formation encircling the left fourth rib and intracartilaginous and bone marrow signal alteration at the left body of the sternum and left fourth rib. En bloc resection of partial rib and adjacent sternum were done and biopsy results confirmed infective costochondritis. Ten months postoperatively, the patient underwent chest wall reconstruction with an artificial bone graft and acellular dermal matrix. As shown in this case, early and aggressive surgical debridement of the infected costal cartilage and sternum should be performed for infective costochondritis. Furthermore, delayed chest wall reconstruction could significantly contribute to the quality of life.

전자허약지수(electronic frailty index)를 활용한 만성질환 노인의 허약평가와 건강결과 간의 관계: 체계적 고찰 (Frailty assessed by the electronic frailty index and its impact on health outcomes in older adults with chronic diseases: a systematic review)

  • 신정욱;유민영;손연정
    • Journal of Korean Biological Nursing Science
    • /
    • 제25권4호
    • /
    • pp.229-242
    • /
    • 2023
  • Purpose: The electronic frailty index (eFI), which is derived from electronic health records, has been recommended as screening tool for frailty due to its accessibility and ease of use. The objective of this systematic review was to identify the prevalence of frailty assessed by the eFI and its influence on health outcomes in older adults with chronic diseases. Methods: We searched PubMed, Embase, Web of Science, CINAHL, SCOPUS, Cochrane, Google search, and nursing journals in Korean from January 2016 to December 2022. Results: Twelve studies were analyzed. The eFI score, based on routine clinical data, was associated with adverse health outcomes. The most frequent outcome studied was mortality, and the eFI was associated with increased mortality in nine studies. Other outcomes studied included hospitalization, length of stay, readmission, and institutionalization in relation to hospital care usage, and cardiovascular events, stroke, GI bleeding, falls, and instrumental activities of daily life as health conditions. Conclusion: Early identification of frailty in older adults with chronic diseases can decrease the burden of disease and adverse health outcomes. The eFI has a good discriminative capacity to identify frail older adults with chronic diseases.

Optimizing Heart Failure Management: A Review of the Clinical Pharmacist Integration to the Multidisciplinary Health Care Team

  • Esteban Zavaleta-Monestel;Sebastian Arguedas-Chacon;Alonso Quiros-Romero;Jose Miguel Chaverri-Fernandez;Bruno Serrano-Arias;Jose Pablo Diaz-Madriz;Jonathan Garcia-Montero;Mario Osvaldo Speranza-Sanchez
    • International Journal of Heart Failure
    • /
    • 제6권1호
    • /
    • pp.1-10
    • /
    • 2024
  • Heart failure (HF) stands as a prevalent chronic ailment, imposing a substantial burden on global healthcare systems due to recurrent hospitalizations, intricate management, persistent symptoms, and polypharmacy challenges. The augmentation of patient safety and treatment efficacy across various care stages, facilitated by a multidisciplinary HF team inclusive of a clinical pharmacist, emerges as paramount. Evidence underscores that the collaborative engagement of a physician and a clinical pharmacist engenders proficient and secure management, forestalling avoidable adversities stemming from drug reactions and prescription inaccuracies. This synergistic approach tailors treatments optimally to individual patients. Post-discharge, the vulnerability of HF patients to re-hospitalization looms large, historically holding sway as the foremost cause of 30-day readmissions. Diverse strategies have been instituted to fortify patient well-being, leading to the formulation of specialized transitional care programs that shepherd patients effectively from hospital to outpatient settings. These initiatives have demonstrably curtailed readmission rates. This review outlines a spectrum of roles assumed by clinical pharmacists within the healthcare cohort, spanning inpatient care, transitional phases, and outpatient services. Moreover, it traverses a compendium of studies spotlighting the affirmative impact instigated by integrating clinical pharmacists into these fields.

Validation of the ACS NSQIP Surgical Risk Calculator for Patients with Early Gastric Cancer Treated with Laparoscopic Gastrectomy

  • Alzahrani, Saleh M;Ko, Chang Seok;Yoo, Moon-Won
    • Journal of Gastric Cancer
    • /
    • 제20권3호
    • /
    • pp.267-276
    • /
    • 2020
  • Purpose: The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) risk calculator is useful in predicting postoperative adverse events. However, its accuracy in specific disorders is unclear. We validated the ACS NSQIP risk calculator in patients with gastric cancer undergoing curative laparoscopic surgery. Materials and Methods: We included 207 consecutive early gastric cancer patients who underwent laparoscopic gastrectomy between January 2018 and January 2019. The preoperative characteristics and risks of the patients were reviewed and entered into the ACS NSQIP calculator. The estimated risks of postoperative outcomes were compared with the observed outcomes using C-statistics and Brier scores. Results: Most of the patients underwent distal gastrectomy with Roux-en-Y reconstruction (74.4%). We did not observe any cases of mortality, venous thromboembolism, urinary tract infection, renal failure, or cardiac complications. The other outcomes assessed were complications such as pneumonia, surgical site infections, any complications requiring re-operation or hospital readmission, the rates of discharge to nursing homes/rehabilitation centers, and the length of stay. All C-statistics were <0 and the highest was for pneumonia (0.65; 95% confidence interval: 0.58-0.71). Brier scores ranged from 0.01 for pneumonia to 0.155 for other complications. Overall, the risk calculator was inconsistent in predicting the outcomes. Conclusions: The ACS NSQIP surgical risk calculator showed low predictive ability for postoperative adverse events after laparoscopic gastrectomy for patients with early gastric cancer. Further research to adjust the risk calculator for these patients may improve its predictive ability.