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Development of a simplified malnutrition screening tool for hospitalized patients and evaluation of its inter-methods reliability (입원환자의 초기영양평가를 위한 단순영양검색도구 개발 및 도구 간 신뢰도 검증)

  • Yun, Oak Hee;Lee, Gyuhwi;Park, Yoon Jung
    • Journal of Nutrition and Health
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    • v.47 no.2
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    • pp.124-133
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    • 2014
  • Purpose: The current study was designed for development of a simplified malnutrition screening tool (SMST) for hospitalized patients using readily available laboratory and patient information and for evaluation of its reliability compared to well-established tools, such as PGSGA and NRS-2002. Methods: Anthropometric and biochemical measurements, as well as a few subjective assessments, of 903 patients who were preclassified by their nutritional status according to PGSGA were analyzed. Among them, a combination of factors, including age, BMI, albumin, cholesterol, total protein, hematocrit, and changes in body weight and food intake, were statistically selected as variables for SMST. Results: According to SMST, 620 patients (68.7%) were classified as the normal group and 283 patients (31.3%) were classified as the malnutrition group. Significant differences in age, albumin, TLC, BMI, hemoglobin, hematocrit, total protein, cholesterol, and length of stay were observed between the two groups. For inter-methods reliability, the screening results by SMST were compared with those by PGSGA and NRS-2002. The comparison with PGSGA and NRS-2002 showed 'Substantial agreement' (sensitivity 94.4%, specificity 88.4%, ${\kappa}$ = 0.747) and 'Moderate agreement' (sensitivity 96.1%, specificity 79.5%, ${\kappa}$ = 0.505), respectively, indicating that SMST held high inter-methods reliability. Conclusion: In conclusion, SMST, based on readily available laboratory and patient information and simple subjective assessments on changes in food intake and body weight, may be a useful alternative tool with a simple but reliable risk index, especially in resource-limited domestic hospitals.

Development and Application of an Online Clinical Practicum Program on Emergency Nursing Care for Nursing Students (간호학생의 응급환자간호 임상실습 온라인 프로그램 개발 및 적용)

  • Kim, Weon-Gyeong;Park, Jeong-Min;Song, Chi-Eun
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.1
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    • pp.131-142
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    • 2021
  • Purpose: Clinical practicums via non-face-to-face methods were inevitable due to the COVID-19 pandemic. We developed an online program for emergency nursing care and identified the feasibility of the program and the learning achievements of students. Methods: This was a methodological study. The program was developed by three professors who taught theory and clinical practicum for adult nursing care and clinical experts. Students received four hours of video content and two task activities every week in four-week program. Real-time interactive video conferences were included. Qualitative and qualitative data were collected. Results: A total of 96 students participated in the program. The mean score for overall satisfaction with the online program was 4.72(±1.02) out of 6. Subjects that generally had high learning achievement scores were basic life support care, fall prevention, nursing documentation, infection control, and anaphylaxis care. As a result of a content analysis of 77 reflective logs on the advantages of this program, students reported that "experience in applying nursing process," "case-based learning and teaching method," and "No time and space constraints" were the program's best features. Conclusion: Collaboration between hospitals and universities for nursing is more important than ever to develop online content for effective clinical practicum.

The Validation of a Commercial Testosterone RIA Test Kits (Testosterone RIA 검사 kit 별 유효성 비교평가)

  • Ryu, Hwa-jin;Shin, Seon-yeong;Cho, Seong-uk
    • The Korean Journal of Nuclear Medicine Technology
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    • v.26 no.1
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    • pp.38-41
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    • 2022
  • Purpose Testosterone is a steroid hormone synthesized by the Leydig cells of the testes in men, and by the adrenal cortex and ovaries in women. Testosterone production is regulated by luteinzing hormone secreted by the anterior pituitary gland. In this experiment, the effectiveness of testosterone radioimmunoassay (RIA) kits produced by three companies was evaluated and compared in case the production of testosterone kits was stopped or supply problems occurred. Materials and Methods In October 2021, samples were collected from the patients (n=49) who requested the testosterone RIA test. The experiment was conducted by dividing the patient's sample into low concentration (1.0 ng/mL or less), medium concentration (2.0-4.0 ng/mL) and high concentration (6.0 ng/mL or more). The Testosterone RIA test compared and evaluated the validity of Company A kits used in this hospital and those of Company B and C used in other hospitals. The precision, sensitivity, recovery, linearity and correlation were evaluated for each kit. The testosterone RIA test was carried out in accordance with the insert kit manual for each manufacturer. Results As a result of measuring the precision of the intra assay, the Coefficient of Variation (CV) value of the company A kit was high at 11.4% only in the low concentration sample, and in the case of the company B and C kits, the CV value was less than 10% at low, medium, and high concentrations. In the inter-assay precision measurement, the CV value was less than 15% in both A and C kits, but in the case of the B kit, the CV value exceeded 15% at low and medium concentrations. Sensitivity was 0.13 ng/mL for company A, 0.01 ng/mL for company B, and 0.01 ng/mL for company C, and the linearity of all three kits showed excellent linearity. In the case of recovery rate, all of the A, B, and C company kits showed results that were out of 90-110%. In the case of correlation test, when compared with the company A kit currently use in here, the correlation coefficient (R2) value for the company B kit was 0.9508, and for the company C kit was 0.9352 Conclusion As a result, there was a slight difference in precision at the low concentration sample. The correlation test showed an excellent correlation coefficient. However, it was difficult to secure samples of various concentrations because there were not many tests of testosterone requested at this hospital. So, additional experiments should be carried out by acquiring samples of various concentrations on each laboratory later.

The effect of Type 2 diabetes management using a smartphone-based blood glucose management training program (모바일 자가혈당관리 교육프로그램을 이용한 2형 당뇨병 관리 효과 분석)

  • Lee, Jung-Hwa;Jung, Jin-Hee;Sim, Kang-Hee;Choi, Hee-Sun;Lee, Jeong-Rim;Kang, Yang-Gyo;Song, Bok-Rye
    • Journal of Industrial Convergence
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    • v.20 no.9
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    • pp.59-70
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    • 2022
  • Background: Diabetes education is an important factor in blood glucose control. Reinforced education is necessary for effective diabetes education. However, it is difficult to provide reinforced diabetes education within Korea's medical environment. Therefore, we want to analyze the effect of continuous diabetes education using mobile health care that can effectively provide repeated education without having to face the patient. Methods: This study is a multicenter, randomized, controlled, pre-post design study conducted to analyze the effect of a continuous diabetes education method. A total of 109 people were registered at five hospitals in south Korea, and they were randomly assigned to the app group (34 people) who received real-time coaching and repetitive training, the logbook group (37 people) who received face-to-face training after writing a blood glucose logbook, and the general group (38 people) who received a one-time diabetes education. The study was conducted for a total of 24 weeks. Twenty-one patients withdrew their consent and failed to perform an HbA1c. A final 88 patients were analyzed. The difference in HbA1c, Self-management behavior, and Quality of life before and after education was analyzed. Results: The study involved 51 (58%) male subjects, mean age was 55.8 years and mean duration of diabetes was 7.6 years. After 24 weeks of intervention, there was no significant difference in self-care behavior and quality of life between the three groups, but the HbA1c of the app group significantly decreased after education compared to the logbook group and the general group (F=4.62, p=.013). Conclusion: It can be seen through the app group that receiving real-time education is more effective in improving blood glucose management and continuous diabetes education is important.

Investigation on the Perception of Mandatory Clinical Practice in the Department of Radiology Following the Amendment of the Medical Technologists Act (의료기사 등에 관한 법률 개정으로 방사선(학)과 현장실습 의무화에 따른 인식 조사)

  • Jeong-Mu Lee;Yong-Ki Lee;Sung-Min Ahn
    • Journal of the Korean Society of Radiology
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    • v.18 no.3
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    • pp.293-300
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    • 2024
  • On October 31, 2023, the revision of the Medical Technologist Act made it mandatory to complete field training courses in order to obtain a license as a radiologic technologist. Therefore, we would like to survey the actual situation of field training in medical institutions to inform the revised Medical Technologist Act and propose improvement measures to increase the effectiveness of field training. A survey was conducted from March to April, 2023, among radiologic technologists working in medical institutions. The questionnaire was sent through a form on a domestic portal site, Company N, and 120 respondents completed it. Eighty-two respondents, or 68.3 percent, had experience in educating on-the-job training students. 58% of the respondents were aware of the fact that the amendment to the Act on Medical Technologist etc. made field training mandatory to obtain a radiologic technologist license. In accordance with Article 9 of the Medical Technologist Act, which prohibits unlicensed persons from practicing, 50% of the respondents were aware that those who are in training to complete an education course equivalent to the license they are seeking to obtain at a university or other institution are allowed to practice as medical Technologists. When asked what is currently taught during fieldwork, 6% of respondents said that they are required to perform radiation-generating activities in addition to observing, guiding patients, and positioning and moving patients. When asked about the future direction of education as fieldwork becomes mandatory for licensure, 77% of respondents said that they will teach more than they currently do. When asked about the appropriate total length of fieldwork, 35% said 12 weeks and 480 hours, 33% said 8 weeks and 320 hours, and 27% said 16 weeks and 640 hours. It can be seen that the current on-the-job training is inadequate according to various regulations, and students' satisfaction is low. However, with the revision of the Act on Medical Technologists, field training has become mandatory to obtain a license as a radiologist, and it is necessary to improve the educational conditions of field training. Therefore, it is necessary to comply with the Nuclear Safety Act and the Rules on the Safety Management of Diagnostic Radiation Generating Devices, introduce standardized training objectives and evaluation systems, designate training hospitals and radiologists in charge of training, and introduce extended training periods and simulation exercises to internalize field training.

Epidemiological Changes and Clinical Features of Hepatitis A in Children, Living in Kyung-gi Province, Since 1988 to 1998 (최근 10년간(1988~1998) 경기지역 소아에서 A형 간염의 역학적 변화 및 임상에 관한 연구)

  • Kim, Hyun;Kim, Jong Hyun;Kim, Dong Un;Hur, Je Kyun;Lee, Won Bae;Seo, Byung Kyeu;Kang, Jin-Han
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.230-238
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    • 1998
  • Purpose : Worldwidely, the incidence of the hepatitis A has been markedly decreased in the past years. Also in Korea, there has been only a few sporadic cases without evidence of epidemics since the mid 1980s. However, the incidence of the hepatitis A in young adults and childen has been in trends of increasing since 1996. So, we retrospectively performed the study on the epidemiolgical changes and the clinical feature of hepatitis A in childen, living in Kyung-gi province, since 1988 to 1998. Methods : The four affiliated hospitals of the Catholic University of Korea, Our lady of Mercy's hospital, Holy family hospital, Eui-Jung-bu St. Mary's hospital, and St. Vincent hospital, were enrolled in this study. We conducted statistical analysis on the incidence of hepatitis A since 1988 to 1998, concerning with the period (monthly, annually), age, sex and related epidemiological property, by reviewing the hospital records of the patients with hepatitis A. We simultaneously performed the study concerning with the clinical characteristics of hepatitis A. Results : 1) During the study period, 46 children was diagnosed as hepatitis A, and among them 28 children (60.1%) developed sporadically in the 1998. And sex ratio was 1.2(male):1(female). 2) Most of the patients developed between March and July, and hepatitits A were mainly developed in the patients above the 10 year old ages(37 patients; 80.4%). 3) The socioeconomic and educational status of the patient's parents was almostly below the middle and low class. Although, we could not find the etiological factors in most cases, but we found the evidence of interfamilial transmission in one family. 4) The patients complained the symptoms of nausea and vomiting, jaundice, poor appetite, mild fever, fatigueness, abdominal pain, URI symptom, dyspepsia, dark urine, headache and diarrhea in order, and findings of jaundice, hepatomegaly, RUQ tenderness, splenomegaly and LLQ tenderness in order were seen. 5) All patients showed abnormal findings of the liver function tests, and the pattern of cholestatic hepatitis were seen in most cases, but these findings were normalized within the 2~4 weeks. The findings of the gall bladder wall thickening, hepatomegaly, splenomegaly and ascites were seen on abodominal sonogram. 6) The prognosis of all patients were good without complications, except in one case who had the episode of transient recuurence. And the mean hospitalization dates were 11.1 days. Conclusion : We found that the incidence of hepatitis A showed the increasing trend, and peaked in the 1998 in Kyung-gi province children. And hepatitis A mainly developed in children above the 10 year old ages. The scioeconomic and educational status of patient's family was almostly below the middle class. All of them showed abnormal liver function, and clinically cholestatic hepatitis features were seen in most cases. But, the prognosis was excellent without complication in all cases.

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The Present Situation and Future Strategies of 4-Year Nursing Baccalaureate Program (한국 4년제 대학 간호교육의 현황과 발전방안)

  • Park Jeong-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.1 no.1
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    • pp.17-23
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    • 1995
  • One of the biggest problems of Nursing Education in Korea is the division among nursing education programs of the last 3 and 4 years. To solve this problem, Nursing community must do variable trials to achieve the unity of a 4-year educational program. With this, we need to observe the phenomena and reality of the present 4-year nursing educational program that we have. The object of this study is to analyse and discuss that we have. The object of this study is to analyse and discuss the problems and future strategies of 4-year Nursing Baccalaureate program. 1. Problems as nursing department in Medical School. 1) Many 4-year nursing baccalaureate programs are operating under the medical school as nursing department. So the academic development in nursing department is unprogressive and is not approved as unique discipline. 2) The operating system between nursing and medical department are different even though they are in the same school. 3) Inequality between nursing and medical department : In many case, the nursing professor can not attend administraion committees to discuss the medical school's operation because of many differences between nursing and medical organization. 4) Weakness of the leadership and the student activities in nursing student : The nursing student involvement is usually passive because of the difference of curriculum, less number than medical students and the difference between 4-year and 6-year education program. 5) There is the obscurity of the relationship between department of nursing and other departments in whole university. 2. Problems in nursing itself 1) We need to reconstruct nursing discipline. We must change from the disease centered model to health centered model and life cycle centered model so that we can be distinguished from medicine. We also must change from hospital centered nursing to all population centered nursing, 2) The improvement of curriculum ; When the independent framework of nursing discipline become established, we need to improve the curriculum. 3) The education of clinical practice ; Most nursing school programs are divided into professors who are lecturing the theory and clinical teachers who are teaching the nursing technique in the clinic. So, what is needed in nursing discipline is that the professors have a dual position. In America, The professor is required to be a clinical specialist and to have his or her clinic so that the professor become a good role model, teach the clinical practice effectively, and give the student the practice field. 4) To extend fields of nursing : At first, the school nurse must become the school health educator, a real teacher. The nurse must establish and operate a childern's wellbeing center or nursery school, a disabled people's house or senile's wellbeing center, a mental health center, and a health promotion clinic for healthy people. 5) The name 'nursing department' need to be considered. When the focus is to be changed from the disease model to health improvement model, we take into consideration change 'nursing college', 'nursing department' and 'nursing profession' to 'health science college' or 'health wellbeing college'. 6) We must have highly qualified academic students. Each Nursing educational faculties must have the high qualified students through the development of nursing educational program and the increment of scholarship. The Korean Nurses Association and The Korean Clinical Nurses Association need to make an endeavor for the improvement of work condition and payment of clinical nurses of hospitals who consist of 70% of all nursing manpower. 3. Improvement Strategy 1) All nursing educational program must be changed 4-year program gradually. 2) Nursing department need to try to become nursing college. 3) We need to study many researches for improvement of the problem in nursing discipline and nursing education. We need more interdisciplinary researches, and we need to be granted for that research. 4) We need to have many seminars and workshops thoughout the whole country to expand a sense of nursing education. 5) Drawing up a policies plan for the nursing educational improvement : The Korean Nurses Association, The Korean Academic Nursing Association, Korea Nursing College and department President's Committee, and Korea Academic Society of Nursing Education must try for the development of nursing educational improvement and ask for government frame the policy to develop nursing education.

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Reducing error rates in general nuclear medicine imaging to increase patient satisfaction (핵의학 일반영상 검사업무 오류개선 활동에 따른 환자 만족도)

  • Kim, Ho-Sung;Im, In-Chul;Park, Cheol-Woo;Lim, Jong-Duek;Kim, Sun-Geun;Lee, Jae-Seung
    • Journal of the Korean Society of Radiology
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    • v.5 no.5
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    • pp.295-302
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    • 2011
  • To n the field of nuclear medicine, with regard to checking regular patients, from the moment they register up to the doctor's diagnosis, the person in charge of the checks can find errors in the diagnosis, reexamine, reanalyze the results or save images to PACS. Through this process, the results obtained from the readings are delayed due to checks and additional tests which occur in hospitals, causing patient satisfaction and affected reliability. Accordingly, the purpose is to include visual inspection of the results to minimize error, improve efficiency and increase patient satisfaction. Nuclear medicine and imaging tests from examines at Asan Medical Center, Seoul, from March 2008 to December 2008, were analyzed for errors. The first stage, from January 2009 to December 2009, established procedures and know-how. The second stage from January 2010 until June 2010 conducted Pre-and Post-filtering assessment, and the third stage from July 2010 until October 2010 consisted of cross-checks and attaching stickers and comparing error cases. Of 92 errors, the 1st, 2nd and 3rd stage had 32 cases, and there were 46 cases after the 4th stage, with the overall errors reduced by 74.3% from 94.6%. In the field of general nuclear medicine, where various kinds of checks are performed according to the patient's needs, analysis, image composition, differing images in PACS, etc, all have the potential for mistakes to be made. In order to decrease error rates, the image can continuously Cross-Check and Confirm diagnosis.

Effect of Hot Water and Microwave Heating on the Inactivation of Enterobacter sakazakii in Reconstituted Powdered Infant formula and Sunsik (열수(熱水)와 마이크로웨이브 가열이 조제분유 및 선식 용해 중 Enterobacter sakazakii 사멸에 미치는 영향)

  • Kim, Jung-Beom;Park, Yong-Bae;Lee, Myung-Jin;Kim, Ki-Cheol;Huh, Jeong-Weon;Kim, Dae-Hwan;Lee, Jong-Bok;Kim, Jong-Chan;Choi, Jae-Ho;Oh, Deog-Hwan
    • Journal of Food Hygiene and Safety
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    • v.23 no.2
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    • pp.157-162
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    • 2008
  • Enterobacter sakazakii was initially referred to as yellow-pigmented Enterobacter cloacae and reclassified in 1980. E. sakazakii infection cause life-threatening meningitis, septicemia, and necrotizing enterocolitis in infants. Powdered infant formula (PIF) and baby foods may be the important vehicle of E. sakazakii infection. It has been reported that E. sakazakii was isolated from PIF and sunsik ingredients produced in Korea. Some infants have been fed sunsik as a weaning diet. Therefore, it is necessary that this organism should be inactivated on preparing PIF and sunsik at homes and in hospitals. The cocktail of three Korean E. sakazakii strains (human, sunsik and soil isolates) were used to investigate the inactivation of this organism with hot water at 50, 60, 65, 70 and $80^{\circ}C$ and microwave heating for 60, 75, 90, 105 and 120 sec. Reconstituted PIF and sunsikwere inoculated with cocktailed vegetative cells of E. sakazakii at 6 log CFU/mL. Thermal inactivation of vegetative cells of E. sakazakii were achieved by reconstituted PIF and sunsik with hot water at $60^{\circ}C$ or greater and with microwave heating at 2,450 MHz for 75 sec or longer. Considering that biofilm formation of E. sakazakii was adapted to survive the dry environment that is PIF and sunsik and thermal resistance increased, it is suggested that inactivation of E. sakazakii was used by hot water at $70^{\circ}C$ or greater and microwave heating for 90 sec or longer. Reconstituted PIF and sunsik were inoculated with cocktailed vegetative cells of E. sakazakii at 2 to 3 log CFU/mL to investigate the growth curve of this organism and stored at 5, 10, 15, 20, 25, 30 and $35^{\circ}C$. Viable counts slightly changed at 5, $10^{\circ}C$ during 48 h but grew at $15^{\circ}C$ or greater. Considering that E. sakazakii is able to grow in infant formula milk at refrigerator temperature, reconstituted PIF and sunsik that are not immediately consumed should be discarded or stored at refrigeration temperatures within 24 h.

A Study on the Mobile Medical Service Program -Based on the Community Diagnosis of a Remote Farm Area- (순회진료사업(巡回診療事業)의 문제점(問題点)과 개선방향(改善方向) (일부(一部) 무의지역에 대(對)한 지역사진단(地域社診斷)을 중심(中心)으로))

  • Park, Hung-Bae;Choi, Dong-Wook
    • Journal of Preventive Medicine and Public Health
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    • v.11 no.1
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    • pp.86-97
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    • 1978
  • The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

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