• Title/Summary/Keyword: Suction care

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Saving Effects Cost and Time in Nursing through Improving Sterilization Method of Inner Cannula (기관내관 소독 방법 개선에 따른 간호업무 시간단축 및 비용 절감 효과)

  • Yi, Haeng-Seon;Kim, Haerina;Kim, Eun-Suk;Kim, Bo-Ram;Seong, Seon-Suk
    • Quality Improvement in Health Care
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    • v.14 no.1
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    • pp.55-59
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    • 2008
  • Background : The purpose of inner cannula is to protect the upper air way and permit air to pass freely, in addition, to provide endotracheal suction, artificial respiration and to maintain adequate oxygen saturation. The tube needs to be sterilized for maintenance and cleanness of air way and for prevention of bronchospasm. However, it has been reported that there is no guideline for sterilization and many hospitals conduct their own sterilization methods, for example, once a day(13's general hospital), three times a day(The Catholic University of Korea ST Mary's hospital) or even no cleansing. Consequently, the QI team of our hospital suggested the SOP(standard operating procedure) of sterilization and evaluate cost and time effect in nursing. Method : 1) Benchmarking of 13's neurosurgery department of general hospital in Seoul 2) Investigation of test records of sputum culture from patients with intubation for tracheotomy 3) Check of results of O2 Sat. monitoring to confirm of maintaining opened air way Result : 1) Improvement of process: decrease of excess sterilization of inner cannula (from 3 times a day to once a day) 2) Cost effects: saving over 10 million won per one year 3) Providing better nursing: time effects (30 min a day) permit to conduct more nursing activities Conclusion : It can get Cost and time effects in nursing with improved sterilization method of inner cannula. It needs to do research on improvement of the monthly exchange protocol of outer cannula and provide supporting data for the proper exchange schedule. The result of additional microorganism detection from patients with new process needs to be evaluated further more.

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Importance-Performance Analysis about Early Mobilization after Abdominal Surgery Patients in Surgical Ward Nurses (복부수술 환자의 조기운동에 대한 외과병동 간호사의 중요도-수행도 분석)

  • Kim, Bo Eun;Choi, Hye-Ran
    • Journal of Digital Convergence
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    • v.19 no.12
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    • pp.567-575
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    • 2021
  • This study was aimed to identify surgical ward nurses' importance-performance awareness toward early mobilization after abdominal surgery patients. The date were collected from 162 nurses and the importance and performance of early mobilization were analyzed by the IPA method. The collected data were analyzed using the SPSS/WIN 25.0 by implementing descriptive statistics, independent t-test, paired t-test, and ANOVA. Early mobilization was divided into exercise of pulmonary complications and early ambulation. As a result of the study, the areas requiring concentration were 'check risk of aspiration', and areas requiring improvement were 'oral care', 'check lung sound', 'percussion/vibration', 'suction', and 'reinforcement exercise in bed'. Therefore, each item of early mobilization is recommended to reduce the gap between importance and performance in clinical care.

Performance evaluation of R22 alternative refrigerants (R22 대체냉매의 성능 평가)

  • 송용재;박봉진;정동수;김종보
    • Korean Journal of Air-Conditioning and Refrigeration Engineering
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    • v.10 no.3
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    • pp.292-302
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    • 1998
  • In this study, 14 refrigerant mixtures composed of R32, R125, R134a, R143a, R152a, and R1270(Propylene) were tested in a breadboard heat pump in an attempt to replace R22 used in most of the residential air conditioners and heat pumps. The heat pump was of 1 ton capacity and water was employed as the secondary heat transfer fluids. All tests were conducted under ARI test A condition. Ternary mixtures composed of R32, R125, and R134a were shown to have 4∼5% higher COP and capacity than R22 and hence they seem to be very promising candidates to replace R22. On the other hand, ternary mixtures containing R125, R134a, and R152a have lower COP and capacity than R22. R32/R134a binary mixtures show a 7% increase in COP and have the similar capacity to that of R22 and hence they are also good candidates to replace R22. Special care must be exercised when a suction line heat exchanger is used with these mixtures in air conditioners. Finally, the compressor discharge temperatures of all mixtures tested were lower than those of R22 by 15.g∼34.7t, which indicates that these mixtures would offer better system reliability and longer life time than R22.

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A Case of Oral Myiasis Caused by Lucilia sericata (Diptera: Calliphoridae) in Korea

  • Jang, Mun;Ryu, Seung-Min;Kwon, Sang-Chang;Ha, Jun-Ouk;Kim, Young-Hoon;Kim, Dong-Hyun;Jung, Soon-Myung;Lee, Soon-Il;Sohn, Woon-Mok;Cha, Hee-Jae;Ock, Meesun
    • Parasites, Hosts and Diseases
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    • v.51 no.1
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    • pp.119-123
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    • 2013
  • We report here a case of oral myiasis in the Republic of Korea. The patient was a 37-year-old man with a 30-year history of Becker's muscular dystrophy. He was intubated due to dyspnea 8 days prior to admission to an intensive care unit (ICU). A few hours after the ICU admission, 43 fly larvae were found during suction of the oral cavity. All maggots were identified as the third instars of Lucilia sericata (Diptera: Calliphoridae) by morphology. We discussed on the characteristics of myiasis acquired in Korea, including the infection risk and predisposing factors.

A STUDY ON KOREA ORIENTAL NURSES' ROLE (한방간호사(韓方看護師)의 역할(役割)에 대한 연구(硏究))

  • Ok, Do-Hoon;Park, Chan-Kuk;Shin, Soon-Shik
    • Korean Journal of Oriental Medicine
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    • v.5 no.1
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    • pp.27-53
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    • 1999
  • The goal of this study is to review and define the role of nurses' who are engaged in Korea Oriental medical treatments in oriental medical hospitals. We think this study can contribute to the development of 'Korea Oriental medical science & nursing science' and 'Public health care'. A large portion of nurses's role in Korea Oriental Medicine(KOM. 한방/한의학) is assistance to doctors treatment. But besides of these role, we think there are many things that are riskless for nurses to do alone. But in present situation, few nurses in KOM. have enough knowledge to treat these medical treatments alone. So we believe this study will provide a way for nurses to participate more actively in KOM. public health care. With the goal of this study, we checked all medical treatments that have been practiced in oriental medical hospitals, and classified these treatments with some groups. And we organized a inquiry. At this inquiry, we ask 'What is the adequate role of nurses in Korea Oriental medical treatment? & What kind of treatment can nurses do?' We got 58 responses from nationwide 121 hospitals. From these response, more than half of them said nurses can do following medical treatment in the oriental medical hospital: 1. starting and ending part of following treatments; External treatments by instrument, by hydrotheraphy, by herb, by suction, moxibustion, Manipulative therapies on soft structure, Living and mind-body therapies. 2. pulling out Acupuncture. 3. boiling herb, judgement on dosing temperature, assisting in dosing, 4. assisting Diet, 5. operating from Living and mind-body therapies. 6. leading Physical training However, these results are coming out from present situation. So, after well-oriented instructions for nurses, this study will be need to carry out again. From this study, we suggest a desirable curriculum for students who study 'Korea Oriental Nursing Science.' That is to say, at basic course students take 4 subject for 6 credits. And at as an expert course, it should be dividend into Clinical Nursing Specialist in KOM., Self-care Nursing Specialist, Regimen Nursing Specialist and take 17 credits per each course.

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Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling (환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서)

  • Park, Jung-Ho;Joe, Hyon;Park, Hyeoun-Ae;Han, Hye-Rah
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.132-146
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    • 1995
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

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The study of comparison of Eastern-Western Medicine on the pathological concept of the Pung(風) and the cause and therapy of Jung Pung(中風) showed the following results. (풍(風)의 병리적(病理的) 의미규명(意味糾明)과 중풍(中風)의 원인(原因) 및 치료(治療)에 대한 동서의학적(東西醫學的) 비교(比較).)

  • Kim, Sae-Gil
    • The Journal of Korean Medicine
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    • v.16 no.1 s.29
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    • pp.96-117
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    • 1995
  • 1. The Pung(風) is the necessary power for growth and maintenance of life. 2. The characteristics of the Pung(風) is the Yang evil, the features for opening and excretion, mobility and rapid change. That is the major cause of all diseases, and its mobility is the main character. 3. Jung Pung(中風) is the same concept of apoplexy in Western medicine. 4. Jung Pung(中風) is classified on the basis of pathology, anatomy, and histology in Western Medicine, but In Oriental Medicine that is classified on the basis of symptom and severity of disease. 5. In Western Medicine, Jung Pung(中風) was regarded as the local cause of disease, but in Oriental Medicine regarded as the physiological changes caused by the weakness of the whole body. 6. In the emergency care, the method of GaeKeum is compared to Levin tubing, the method of to the use of urokinase for the promotion of cerebrovascular circulatio, and the method of To(吐法) to suction for the elimination of Dam(痰), the method of Hun(熏法) to the use of solution for the improvement of circulation. 7. With the comparison of the cause and diagnosis, the hemorrhagic disease and infarction were regarded as the major agents in Western Medicine and the symptom appeared in the patient was the standard of diagnosis and therapy in Oriental Medicine. 8. In the Western therapy of cerebral hemorrhage, the method of coagulation and hemostasis was used for the elimination of hematoma and cerebral edema, but in Oriental Medicine, the method of YanghaelGiHael(凉血止血) was used for descending the PungHwa(風火) and hemostasis. 9. In the period of recovering injury, the physical therapy was underlined for the recovering of partial function in Western Medicine, the method of accupuncture and drug therapy was adapted for the normal function of the whole body.

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The Study of Critical Indicators Development for Establishing Patient Classification System in the ER (응급실의 환자분류체계 확립을 위한 결정지표 개발 연구)

  • Seong, Young-Hee;Seong, Il-Sun;Lee, Seung-Ja;Kim, Jeong-Ha;Moon, Yu-Jeong;Choe, Yeong-Mi;Lee, Jee-Hyang
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.3
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    • pp.444-453
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    • 2006
  • Purpose: The purpose of the study was to identify critical indicators for the development of efficient patient classification system in a emergency room. Method: This study involved following five steps. Step 1. Selection of the lists direct nursing services in the ER. Step 2. Measurement of the time of direct nursing services from Aug. 31st to Nov. 30th, 2005. Step 3. Classification of the patients according to the nursing care time. Step 4. The determination the critical indicators for different patient classes. Result: Determinate indicators were as follow: 3 items in the first group (vital sign checking, IV route starting, blood sampling), 3 items in the second group (vital sign checking, fluid infusion, blood sampling), 9 items in the third group (I/O checking, $O_{2}$ inhalation, suction, fluid infusion, IV bolus, Central catheter preparation & management, blood sampling, intubation preparation & management, postmortem management), 7 items in the fourth group (EKG monitoring, BP monitoring, $O_{2}$ inhalation, fluid infusion, using the specific drugs, CPR, postmortem management). Conclusion: This study can help future studies which measure nursing services standard time or assigns value to emergency nursing services.

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National-Wide Survey on Endotracheal Suctioning in High-Risk Infants (고위험신생아를 위한 기관지흡인에 대한 실태조사)

  • Ahn Youngmee
    • Child Health Nursing Research
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    • v.5 no.2
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    • pp.198-210
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    • 1999
  • The goal of respiratory management in high risk infants is to maintain proper oxygenation by supporting respiration, therefore to minimize the secondary complications and to promote the maximum growth and development. While on artificial ventilator to achieve this goal, the infants require endotracheal suctioning(ETS) to remove lung secretions. However, the negative effects of ETS in neoates have been documented and include hypoxia, bradycardia, mucosal damage, increased intracranial pressure, and death result. The purpose of the study was to investigate how ETS is currently performed in NICU, which would be beneficial to develop the standardized ETS protocol and to apply it to these population. A national-wide survey on clinical protocol of ETS was performed to 149 neonatal nurses with the average of 3 years and 6 months experience in neonatal nursing, 34.2% of whom was bachelor in nursing. The results showed that about 89% of the nurses initiate En primarily based on the need of the subjects. The aseptic regulation on ETS was used in 83.9% of the subjects. There was no regulation on the length of catheter in 32.9% and on ID/OD ratio in 17.4%. Many nurses administered hyperoygenation/hyperinflation/hyperventilation based on personal knowhow, rather than scientific rationals (77.2%, 40.9%, 75.2%, retrospectively). About 41% of the nurse regulate subjectively the suction power, while 73.8% of them rotate the sub ject's head during suctioning and the half of the nurses was favorable in adapting the closed-suctioning protocol. With the findings of the study, the current clinical application of E% in neonates appears to be based on adult care practices, or personal preference, rather than scientific validation of the safety and effectiveness of the procedure. This study support the needs for developing and applying the standardized ETS protocolin conjunction with the consideration given to the physiologic characteristics of the neonates in respiratory distress.

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A study on the Practical Education in Fundamentals of Nursing (기본 간호학 실습교육의 현황)

  • Yoo Jae-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.2 no.2
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    • pp.199-211
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    • 1995
  • This study analyzed the practical education in fundamentals of nursing, for the 36 nursing schools including 12 4-year nursing schools and 24 junior college nursing schools. This survey was done from september 5th to october 5th in 1995. The results of this study were as follows : 1. Required credit in fundamentals of nursing. 1) The highest incidence of the total required credit was 7 in 4-year nursing school and 9 in junior college. 2) For the lecture course credit, the large number of 4-year nursing school gave 5 credit lessons and 6 credits provided in junior nursing colleges. 3) For the credit of practical education the major portion of 4-year nursing school gave 2 credits instruction, however junior nursing school provided 3 credits. 2. Laboratory practice in fundamentals of nursing. In laboratory practice, the ratio of instructor and student was 1 : 20 in 83.4% of the 4-year nursing school and in 66.7% of the junior nursing school. 3. Contents and hours of fundamental nursing practice. 1) In the area of health assessment and nursing process, the large number of schools allocated following hours : 6 hours for vital signs, 4 hours for nursing process, 2 hours for recording but practice for physical examination and communication was done in few schools. 2) In the area of functional health pattern, the large number of schools allocated practice hours like followings : 2 hours for I/O, 2 hours for gavage feeding, 2 hours for elimination, 6 hours for catheterization, 6 hours for bed making, 2 hours for positioning, 6 hours for personal hygiene, 2 hours for R.O.M, 4 hours for moving turning lifting, 2 hours for inhalation and suction. But C.P.R and terminally ill patient care were taught in smaller number of schools. 3) In the area of special nursing measures, the major portion of nursing schools allocated hours like followings. It consisted of 6 hours for asepsis, 16-18 hours for medication, 2 hours for heat and cold application, 2 hours for wound care. 4) 22.2% of the nursing schools had total review practice time and 36.1% of the nursing schools had the students clinical practice. Based on above mentioned results, 4-year nursing school had faithful practical education of fundamental nursing than junior nursing school. But for the contents and allocated hours for practice education, junior nursing schools were much more contents and hours than 4 year school.

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