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
This study was conducted to assess need for education on the infection control by examining the knowledge on infection control in home care of the home care trainees who had completed an infection control course. Using 64 items questionnaire. home care trainees of eight home care education institutions who took classes related with infection control. The level of knowledge evaluated subjectively was 4.24point (full mark: 5 point). The correct answer rates for handwashing and gloving. cleaning patients' rooms. preventing sharp injury, preventing exposure to potential infectious agents, home care bag technique were 84.5% 86.4% 70.7% 65.3% 76.2% representatively. For the knowledge on the infection control principles to prevent catheter related infection, indwelling catheter related infection, tracheal tube related pneumonia. L-tube related infection, oxygen therapy related infection. and wound infection were 62.8% 27.8% 39.1% 87.8% 76.5% 80.5% representatively. The correct answer rates varied depending upon the educational institutes (p< = .0001), educational levels (p= .001), workplaces (p<.0001), and the experience of infection control education (p= .001). Considering these results. a standardized curriculum must be developed and implemented after analyzing the existing infection control curricula of the home care education institutes. and guide books for infection control in home care should be developed and distributed. In addition. continuous infection control education be provided to the home care nurses through reeducation so they can acquire new knowledge needed for carrying out infection control activities effectively.
Type 1 diabetes mellitus (T1 DM) develops in genetically susceptible individuals as a result of progressive autoimmune destruction of beta cells. There is larger global variation in incidence among children aged 0-14 years. The incidence of T1 DM in Korea is very low. The latest survey in Korea was conducted in 2001 by Korean Society of Pediatrics to analyse the childhood (0-14 years) national-wide incidence during 1 995-2000. The average childhood incidence (/100,000 and year) was 1.36 (95% CI: 1.23-1.48), higher than 1.06 of Korea in 1 994. This survey reported that higher mean annual incidence was observed in female (girls, 1.67 vs boy 1.07), older age group (10-14 years, 1.98; 5-9 years, 1.43; 0-4 years, 0.73), Kangwondo (2.09) and Seoul (1.99), and more new patients developed in spring (spring, 27.1%; winter, 26.6%; summer, 24.8%; autumn, 21.5%). The increase of childhood T1 DM incidence has occurred in every region (4.0% in Asia, 3.2% in Europe during 1990-1999). Also, steady increase in incidence was observed during 1985-2000 in Korea. This trends may be maintained or accelerated by environmental factors, known as triggers, modifiers and promoters of the T1 DM occurrence. The rising incidence of T1 DM suggests the need for continuous monitoring of incidence by using standardized methods in order to plan or assess prevention strategies.
Background To achieve improvements in intramuscular injection, autologous fat grafting, and gluteal artery perforator flaps in infants and children, the relationships of computed tomography (CT)-determined gluteal muscle thickness (MT) and subcutaneous tissue thickness (SCT) with age and body mass index (BMI) were analyzed. Methods Gluteal SCT and MT at ventrogluteal (VG) and dorsogluteal (DG) sites were measured in a standardized manner in 350 patients aged 0 to 6 years who had visited a tertiary hospital and had undergone abdominopelvic CT between January 2005 and December 2016. Recorded measurements were analyzed using one-way analysis of variance and stepwise multiple regression to identify the factors that were most closely related to MT and SCT. Results Subcutaneous tissue at VG sites was thinner than at DG sites, but not significantly so in any age group. Muscles tended to be thinner at VG sites in 4 to 7-year-old, but thicker at VG sites in 1 to 3-year-old, though the differences were not significant. MT in the VG and DG regions was found to be related to age, and SCT in these regions to be related to age and BMI. Conclusions The VG and DG sites should be considered as alternatives for intramuscular injection in infants and children when the anterolateral site is problematic. In addition, considering the gluteal MT and SCT of infants and children should help produce good results in autologous fat grafting and gluteal artery perforator flap harvesting.
Hong, Suk Hyun;Han, Gap Su;Jung, Sang Hun;Chun, Chung Min;Choi, Sung Hyuk;Lee, Sung Woo;Hong, Yun Sik
Journal of Trauma and Injury
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v.18
no.1
/
pp.33-40
/
2005
Background: This study compared the performance of trauma care in an urban and a suburban hospital before and after the enhancement of emergency and intensive care. Method: The medical records of patients who were admitted to the intensive care unit following trauma from 1994 to 1995 and from 2002 to 2003 were examined. The standardized W (Ws), the 95% confidence interval (CI) of the Ws, and the predicted survival rate (Ps) were calculated. During each period, each hospital's actual survival rate was compared with the 95% CI of the Ps according to the revised trauma score (RTS) and injury severity score (ISS). Spell out RTS and ISS. Result: From 1994 to 1995, 225 and 121 records from the urban and the suburban hospitals were reviewed, respectively. The 95% CI's of the Ws were -2.30 to 2.73 and -11.40 to -5.90, respectively. The actual survival rate of the suburban hospital was significantly lower than the predicted survival rate at all RTS. From 2002 to 2003, 315 and 268 records from the urban and the suburban hospitals were reviewed, respectively. The 95% CI's of the Ws was -3.56 to 0.24 and -3.73 to 0.26, respectively. There was no difference between the actual survival rate and the predicted survival rate. Conclusion: An enlargement of the capacities of emergency and intensive care may improve the performance of trauma care at a small suburban hospital.
Background: Cancer incidence rates are increasing particularly in developing countries. It is crucial for policy makers to know basic cancer epidemiology in each region to design comprehensive prevention plans. There have hitherto been no population-based data available for cancer in Khuzestan province. The present report is a first from the regional population-based cancer registry for the period of 2002-2009. Materials and Methods: Data were collected retrospectively reviewing all new cancer patients whom were registered in Khuzestan province cancer registry during an 8-year period (2002-2009). All cases were coded based on the ICD-O-3 coding system and collected data were computerized using SPSS (Chicago, IL) software, version 11.5. The age standardized incidence rates (ASRs) per 100,000 person-year for all cancers were computed using the indirect method of standardization to the world population. Results: During the 8-year study period, 16,801 new cancer cases were registered. Based on the computed ASRs, the five most frequent malignancies in females were breast (26.4 per 100,000), skin (13.6), colorectal (5.72), stomach (4.31) and bladder(4.07) and in males, the five most frequent were skin (16.0 per 100,000), bladder (10.7),prostate (7.64), stomach (7.17), and colorectal (6.32).The ASR for all malignancies in women was 92.5 per 100,000, and that for men was 87.4. Conclusions: The observed patterns from the analysis of Khuzestan cancer registry data will lead to better understanding of the epidemiology of various malignancies in this part ofthe country and consequently provide a useful guide for authorities to make efficacious decisions and policies about a cancer control program for south-west Iran.
Journal of the Korea Academia-Industrial cooperation Society
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v.16
no.3
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pp.1946-1956
/
2015
The purpose of the this study was to provide objective evidence through a systematic review and meta-analysis regarding the effects of self-management in knee osteoarthritis. Articles published between 1999 and 2013 from periodicals indexed Ovid Medline, CINAHL, PubMed, RISS, KISS and other databases were selected, using the following key words: Osteoarthriti* OR OA, self-(management OR care OR help). A selection of 11 studies(7 randomized controlled trials and 4 quasi-experimental interventions that were used were exercise, education, massage and self-help group. As a result of mera-analysis, self-management significantly effected pain, physical function, activities of daily living, and self-efficacy. In particular, self-management showed great effect on ADL, and moderate effect on pain and physical function. Based upon these result, it is necessary to develop a standardized self-management program for knee osteoarthritis patients.
Background: Gallbladder cancer (GBC) is a rare but highly invasive malignancy characterized by poor survival. In a national cancer survey, the age-standardized incidence rate of GBC was highest in Jeju Island among the 15 provinces in South Korea. The aim of this descriptive epidemiological study was to suggest the modifiable risk factors for this rare malignant disease in Jeju Island by performing an age-sex-matched case-control study. Materials and Methods: The case group included patients diagnosed with GBC at the Department of Internal Medicine of Cheju Halla General Hospital, Jeju, South Korea, within the 5-year study period. The control group consisted of age-sex-matched subjects selected from among the participants of the health promotion center at the same institute and in the same period. We compared 78 case-control pairs in terms of clinical variables such as histories of hypertension, diabetes, vascular occlusive disorders, alcohol and smoking consumption, obesity, and combined polypoid lesions of the gallbladder (PLG) or gallstone diseases (GSDs). Results: Among the relevant risk factors, alcohol consumption, parity ${\geq}2$, PLG, and GSDs were significant risk factors in the univariate analysis. PLG (p < 0.01; OR, 51.1; 95% confidence interval [CI], 2.98-875.3) and GSD (p < 0.01; OR, 54.9; 95% CI, 3.00-1001.8) were associated risk factors of GBC in the multivariate analysis with the conditional logistic regression model. However, we failed to find any correlation between obesity and GBC. We also found a negative correlation between alcohol consumption history and GBC in the multivariate analysis (p < 0.01; OR, 0.06; 95% CI, 0.01-0.31). Conclusions: These results suggest that combined PLG and GSDs are strongly associated with the GBC in Jeju Island and mild to moderate alcohol consumption may negatively correlate with GBC risk.
Objective: To study the effect of body composition on reproduction in women with unexplained infertility treated with a controlled ovarian hyperstimulation and intrauterine insemination programme. Methods: This prospective observational study was conducted on 308 unexplained infertile women who were scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme and were grouped as pregnant and non-pregnant. Anthropometric measurements were performed using TANITA-420MA before the treatment cycle. Body composition was determined using a bioelectrical impedance analysis system. Results: Body fat mass was significantly lower in pregnant women than in non-pregnant women ($15.61{\pm}3.65$ vs. $18.78{\pm}5.97$, respectively) (p=0.01). In a multiple regression analysis, body fat mass proved to have a stronger association with fecundity than the percentage of body fat, body mass index, or the waist/hip ratio (standardized regression coefficient${\geq}0.277$, t-value ${\geq}2.537$; p<0.05). The cut-off value of fat mass, which was evaluated using the receiver operating characteristics curve, was 16.65 with a sensitivity of 61.8% and a specificity of 70.2%. Below this cut-off value, the odds of the pregnancy occurrence was found to be 2.5 times more likely. Conclusion: Body fat mass can be predictive for pregnancy in patients with unexplained infertility scheduled for a controlled ovarian hyperstimulation and intrauterine insemination programme.
Kim, Yun-Hee;Kang, Seo-Young;Kim, Mi-Won;Jang, Keum-Seong;Choi, Ja-Yun
Journal of Korean Academy of Nursing Administration
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v.14
no.3
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pp.344-351
/
2008
Purpose: The aim of this study was to testify whether clinical performance examination (CPX) was useful to evaluate comprehensive performance for nursing students just prior to graduation. Method: A cross-sectional descriptive study was designed to examine the usefulness. A total of 61 nursing students whose requirement credits were completed for graduation from a C University in G-city, at December, 5, 2007. Data were analyzed by Pearson's Correlation Coefficient and Spearman's rank Correlation Coefficient. Results: This study showed that both of the finals scores with paper and pens and the clinical practicum scores were not correlated with the CPX scores (r=-.031, p=.811; r=.028, p=.831). Consistency of scores between faculties and standardized patients was moderate (r=.752, p=.000). Conclusion: CPX was considered as a different and innovative evaluation from previous testing systems to test the various aspects of performance including knowledge, skill and attitude. Therefore, CPX under high raters' consistency was useful to test nursing students's final performance. Further study would be needed to develop the standard of CPX system.
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