• Journal of The Korea Institute of Healthcare Architecture
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• v.24 no.3
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• pp.49-57
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• 2018

Purpose: The increase in patients requiring hemodialysis has resulted in an increase dialysis-associated infections risk. but there are no Renal Dialysis unit design standard meet specified safety and quality standards. Therefore, appropriate Establish standards and legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Methods: Literature survey on the design guideline and standards of Renal Dialysis unit design in Korea, U.S, Germany, Singapore, Hongkong, Dubai. Results: There are no established standards for facilities in dialysis units in Korea. To prevent infections in dialysis patients, necessary establish standards. Considering the domestic and overseas Health-care facilities standards, the major factors to be considered in the medical environment for Renal Dialysis Unit are as follows. First, planning to separate Clean areas(treatment area) from contaminated areas(medical waste storage area). Second, ensure sufficient space and minimum separation distance. Although there may be differences depending on the circumstances of individual institutions, renal dialysis unit consider the space to prevent droplet transmission. Third, secure infrastructure of infection prevention such as sufficient amount of hand hygiene sinks. Hand washing facilities for staff within the Unit should be readily available. Hand hygiene sinks should be located to prevent water from splashing into the treatment area. Fourth, Heating, ventilation and air conditioning (HVAC) system for Renal Dialysis Unit is all about providing a safer environment for patients and staff. Implications: The results of this paper can be the basic data for the design of the Renal Dialysis Units and relevant regulations.

• Clinical and Experimental Pediatrics
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• v.50 no.10
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• pp.938-947
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• 2007

Many dialysis modalities such as peritoneal dialysis (PD), hemodialysis (HD) and continuous hemofiltration or hemodialysis (CRRT) are available for the management of pediatric patients with acute renal failure (ARF). PD is a relatively simple, inexpensive modality and can be used in hemodynamically unstable patients. But, it may not be the optimal therapy for patients with severe volume overload or life threatening hyperkalemia. HD is the preferred modality for the treatment of severe volume overload, severe hyperkalemia, but it needs vascular access. Improvements in the HD equipment have allowed HD to be performend in small children. Recents technological improvements in CRRT therapies have enabled pediatric patients who are less stable to be treated. CRRT is becoming the preferred method of acute therapy in pediatric intensive care units. A sound knowledge of the underlying principles of dialysis and awareness of recent technological advancements in differnet dialysis modalities will hopefully result in improved management of children with ARF.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.4
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• pp.474-482
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• 2007

Purpose: This study was done to provide fundamental data for nursing interventions to prevent and reduce fatigue and to identify fatigue and kidney disease symptoms in female patients on hemodialysis and evaluate factors associated with this fatigue. Method: A cross-sectional study design was used with self-administered questionnaires which included general characteristics and the fatigue scale developed by Brown, Dittner, Findly, & Wessely(2005)(Cronbach's $\alpha=0.98$ and for present study $\alpha=0.96$) and a review of laboratory data. From eight dialysis units, 84 women were enrolled. Data were analyzed using the SAS program. Results: Mean score for fatigue was 49.4(range $16{\sim}78$) and fatigue by research variables was significantly different by age(0.046), employment status(0.041), menopause(0.009), hypoalbuminemia(0.022), length of time on dialysis(0.48) and kidney disease symptoms(0.000). Correlations between fatigue and lack of strength, dizziness, and cramps after dialysis were significantly higher. Factors affecting fatigue were kidney disease symptoms and length of time on dialysis, explaining 49.2% of fatigue. Conclusion: A comprehensive approach considering kidney disease symptoms, length of time on hemodialysis, age, menopause, and hypoalbuminemia are required for interventions to reduce fatigue in female patients on hemodialysis.

• Journal of Korean Critical Care Nursing
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• v.6 no.2
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• pp.65-77
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• 2013

Purpose: The purpose of the study was to analyze the nursing activities related to continuous renal replacement therapy (CRRT) in the intensive care units (ICU). Methods: We developed a list of 31 CRRT related nursing activities based on literature review and reviewed by expert group. A total of 109 direct time measurement records by 43 ICU nurses were collected and analyzed in terms of total time per shift, frequency, standard time, difficulty and performance levels of each CRRT nursing activity. Results: The mean time for CRRT nursing activity was 85.60 minutes per 8 hour shift. Nurses have spent average $9.46{\pm}6.98$ minutes in a shift for "waste fluid bag change" activity. In addition, "check catheter location" was the most time consuming single activity. The most difficult activity was "counseling-answer" and the most competent one was "dialysis solutions change". Conclusion: The CRRT nursing activities accounted for a significant portion of total nursing workload. Practical allocation of nursing staff for CRRT patient along with development of a new nursing cost system need to be considered. Continuous nursing educational and training programs on CRRT should be developed.

• Nutrition Research and Practice
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• v.8 no.1
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• pp.103-111
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• 2014

This study aims to determine the effect of a trained dedicated dietitian on clinical outcomes among Lebanese hemodialysis (HD) patients: and thus demonstrate a viable developing country model. This paper describes the study protocol and baseline data. The study was a multicenter randomized controlled trial with parallel-group design involving 12 HD units: assigned to cluster A (n = 6) or B (n = 6). A total of 570 patients met the inclusion criteria. Patients in cluster A were randomly assigned as per dialysis shift to the following: Dedicated Dietitian (DD) (n = 133) and Existing Practice (EP) (n = 138) protocols. Cluster B patients (n = 299) received Trained Hospital Dietitian (THD) protocol. Dietitians of the DD and THD groups were trained by the research team on Kidney Disease Outcomes Quality Initiative nutrition guidelines. DD protocol included: individualized nutrition education for 2 hours/month/HD patient for 6 months focusing on renal osteodystrophy and using the Trans-theoretical theory for behavioral change. EP protocol included nutrition education given to patients by hospital dietitians who were blinded to the study. The THD protocol included nutrition education to patients given by hospital dietitian as per the training received but within hospital responsibilities, with no set educational protocol or tools. Baseline data revealed that 40% of patients were hyperphosphatemics (> 5.5 mg/dl) with low dietary adherence and knowledge of dietary P restriction in addition to inadequate daily protein intake ($58.86%{\pm}33.87%$ of needs) yet adequate dietary P intake ($795.52{\pm}366.94$ mg/day). Quality of life (QOL) ranged from 48-75% of full health. Baseline differences between the 3 groups revealed significant differences in serum P, malnutrition status, adherence to diet and P chelators and in 2 factors of the QOL: physical and social functioning. The data show room for improvement in the nutritional status of the patients. The NEMO trial may be able to demonstrate a better nutritional management of HD patients.

• Journal of muscle and joint health
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• v.30 no.3
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• pp.157-167
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• 2023

Purpose: The purpose of this study was to measure the relationship among activities of daily living, ego integrity, social support and the compliance of patient-role behavior in elderly patients receiving hemodialysis, including the effect of these variables on the compliance of patient-role behavior. Methods: A descriptive survey was conducted with 150 elderly patients over 65 years of age who were also receiving hemodialysis. Data was collected from September 28 to November 13, 2021 and analyzed using t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple regression analysis with SPSS/WIN 26.0. Results: The results show that patient compliance had significant correlations with ego integrity (r=.63, p<.001) and social support (r=.28, p=.001). The other factors influencing patient compliance were the sub-domains of ego integrity, such as the acceptance of the past and the presence (β=.46, p<.001) and attitudes toward life (β=.26 p<.001), with an explanatory power of approximately 35.0% (F=17.21, p<.001). Conclusion: This study confirms that the ego integrity of elderly patients receiving hemodialysis has an effect on the compliance of patient role behavior. Nursing intervention programs that improve the ego integrity of elderly hemodialysis patients could help improve the compliance of patient-role behavior, which is an important factor in the disease management process.