• Title/Summary/Keyword: Win-stay

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The Effects of Medical Staffing Level on Length of Stay (의료 인력의 확보가 환자 입원일수에 미치는 영향)

  • Lee, Han-Ju;Ko, Yu-Kyung;Kim, Mi-Won
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.3
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    • pp.327-335
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    • 2011
  • Purpose: The objective of this study was to analyze the effects of medical staffing level as bed-to-medical staff ratio on patient outcomes as length of stay (LOS) among hospitals in Korea. Methods: Two hundred and fifty one hospitals participated in the study between January and March 2008. Data for the study was requested by an electronic data interchange from the Health Insurance Review Agency in 2008. In data analysis, SPSS WIN 15.0 program was utilized for descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results: The mean score for length of stay was 13.6 days. The mean of operating bed-to-nurse ratio was 7.93:1. The predicting factors for LOS were bed-to-nurse's aide ratio, bed-to doctor's ratio, severely ill patient rate, and hospital type. These factors explained 28.9% of the variance in patient outcomes. Conclusion: This study results indicate that the relationship between medical staffing level and patient outcomes is important in the improvement of the quality of patient care. Thus, improvements in the quality of the nurse practice environment could improve patient outcomes for hospitalized patients.

Utilization Status of Emergency Medical Service for Children (아동의 응급의료서비스 이용실태)

  • Jeon, Hye-Jin;Kim, So-Sun;Bae, Hyun-A;Yoo, Il-Young
    • Child Health Nursing Research
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    • v.14 no.1
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    • pp.5-13
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    • 2008
  • Purpose: This study was done to describe utilization status of emergency medical service for children at one university affiliated hospital located in Seoul. Data were obtained from the medical records of patients under 13 years of age who visited the ER from January 1 to December 31, 2006. Method: Medical records missing the time of discharge were excluded in the analysis of waiting time, which resulted in 19,766 cases. Data were analyzed using SPSS WIN 14.0 version. Result: There were slightly more boys (58.4%), average age of the children was 3.97 years of age. More children at the aged 1 to 3 years (51.3%) visited the ER. Fever was the most frequent complaint: 5,180 cases (24.38%). The other complaints were head or facial laceration (10.55%), vomiting (9.63%), abdominal pain (8.06%), cough (7.67%), and painful limb swelling (6.34%). Average waiting time before the first medical examination was 17 minutes, and average ER stay time was 3 hours and 23 minutes. Conclusion: The results suggest the need to assign a nurse specialist for pediatric ER to provide more efficient care for the children. Also, extra staff assignment during the evening shift or extending office hours of local pediatricians should be considered.

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The Effect of Chest Meridian Massage on Post- Anesthetic Recovery of General Anesthesia Patients (흉부경락마사지가 충수돌기 절제술 환자의 마취 후 회복에 미치는 효과)

  • Lee, Byung-Yup;Shon, Kyung-Hee
    • Korean Journal of Adult Nursing
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    • v.17 no.4
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    • pp.612-621
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    • 2005
  • Purpose: This study aims at confirming the effects of the chest meridian massage on the post-anesthetic recovery of general anesthesia appendectomy patients. Method: The research was post-test designed as a nonequivalent control group among quasi-experiments tested. The data was collected from June 20, 2003 to October 14, 2003 at a hospital in P city. In the collected data, using SPSS Win 10.0 program, these general features were analyzed by real numbers and percentages; the homogeneity among variables by $X^2-test$ and t-test and the research hypothesis by the t-test. Result: Hypothesis 1; The experimental group receiving the treatment of the chest meridian massage will have a much higher post-anesthetic recovery score than that of the control group not receiving it was supported(t=2.544, p=.014). Hypothesis 2; The experimental group receiving the treatment of the chest meridian massage will have a much shorter time of stay in the recovery room than that of the control group not receiving it was supported(t=-4.919, p=.000). Conclusion: According to these results, it may be concluded that Chest Meridian Massage is effective in producing a higher level of post-anesthetic recovery score and helps appendectomy patients reduce the time of stay in the recovery room. Therefore the chest meridian massage can be considered as an intervention therapy for directly nursing general anesthesia appendectomy patients.

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Recovery Outcomes Following Laparoscopic Surgery in Overweight Rectal Cancer Patients (과체중 직장암 환자의 복강경 수술 회복성과)

  • Woo, Sang Jun;Lee, Eun Sook;Kim, Hyeong Rok
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.3
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    • pp.17-26
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    • 2009
  • Purpose: The purpose of this study was to compare the recovery outcomes between a normal weight group (BMI<25) and an overweight group ($$BMI{\geq_-}25$$), who received laparoscopic surgery for rectal cancer, to provide information for effective decision making. Methods: Data from 76 patients who received laparoscopic surgery for rectal cancer in a university hospital were reviewed retrospectively from September 2004 to March 2007. Collected data were analyzed using Win SPSS 12.0. The recovery outcomes related to the operation were the length of the operation, the amount of bleeding during the operation, the length of stay in the recovery room, first bowel movement, the length of hospital stay, and complications. Results: There was no statistical difference between the two groups with regard to the recovery outcomes. Conclusion: From the above results, nursing information can be offered to help make effective decisions before the operation for overweight patients with rectal cancer who prefer laparoscopic surgery.

The Effectiveness of Early Tracheostomy (within at least 10 Days) in Cervical Spinal Cord Injury Patients

  • Choi, Hoi Jung;Paeng, Sung Hwa;Kim, Sung Tae;Lee, Kun Su;Kim, Moo Sung;Jung, Yong Tae
    • Journal of Korean Neurosurgical Society
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    • v.54 no.3
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    • pp.220-224
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    • 2013
  • Objective : This study aimed to determine the optimal time for tracheostomy by evaluating the benefits and safety of early versus late tracheostomy in spinal cord injury (SCI) patients. Methods : We retrospectively reviewed a total of 254 patients with spinal cord injury. Of them, we selected 21 spinal cord injury patients who required tracheostomy due to long-term mechanical ventilation and analyzed their medical records. The patients were categorized into two groups. Early tracheostomy was performed day 1-10 from intubation in 10 patients and the late tracheostomy was performed after day 10 in 11 cases. We also evaluated the duration of mechanical ventilation, stay in the ICU and complications related to tracheostomy, the injury level of and clinical severity. All data was analyzed using SPSS 18.0/WIN. Results : The early tracheostomy offered clear advantages for shortening the total ICU stay (20.8 day vs. 38.0 day, p=0.010). There was also statistically significant reduction in the total length of time on mechanical ventilation (5.2 day vs. 29.2 day, p=0.009). However, the reductions in the incidence of pneumonia (40% vs. 82%) and the length of ICU stay post to tracheostomy (6 day vs. 15 day) were found to be statistically not significant. There were also no statistically significant differences in the injury level and clinical severity between the groups. Conclusion : We concluded that the early tracheostomy (at least 10 days) is beneficial for SCI patients who are likely to require prolonged mechanical ventilation.

Analysis of Direct Nursing Activity and Patient Outcomes Related to Graded Fee of Nursing Management for Inpatient (입원환자 간호관리료 차등제에 따른 직접간호활동 및 환자결과 비교)

  • 박성희
    • Journal of Korean Academy of Nursing
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    • v.33 no.1
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    • pp.122-129
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    • 2003
  • Purpose: The purpose of this study is to examine the difference of direct nursing activity and patient outcomes as mortality rate, complication rate, readmission rate and length of stay related to graded fee of nursing management for inpatient. Method: The subjects of this study were 44 general hospitals with more than 500 beds. Data totaled to 86,044 claims provided to inpatients in Jan. 2001 requested by an electronic data interchange from a Health Insurance Review Agency. The data was analyzed by SPSS win(ver.10.0) and statistical methods used were frequency, one-way ANOVA, $X^2$-Test and regression. Result: Synthetic judgment through performance index and 95% confidence interval, direct nursing activity showed to provided adequate quality of nursing care on 2nd, 3rd, 4th and 6th nursing degree. Also, patient outcomes showed difference by graded fee of nursing management for inpatient. Mortality rate of 2nd was the lowest with P.I. 67.9, 3rd, 5th, 6th, 4th in order. In case of complication rate, 2nd, 3rd and 4th were lower than other nursing degree. Readmission rate of 4th and 5th was the lowest. Length of stay of 2nd was the shortest with P.I. 88.3, 3rd, 4th, 5th, 4th, 6th in order. Conclusion: The findings from this study showed that, the higher nurse-to-patient ratio, the greater amount of direct nursing care activity for the patient. Also, the more direct nursing activities influenced a lower mortality rate, complication rate and readmission rate, shorter length of stay.

An Empirical study on the Influence of Perceived Crowding on Emotional Response and the Stay hour change (혼잡지각이 감정적 반응과 체류시간변화에 미치는 영향)

  • Shim, Wan-Seop;Hong, Sung-Do
    • Korean Business Review
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    • v.19 no.2
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    • pp.207-230
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    • 2006
  • The study which it sees probably is the tourist' from the tourist resort, a emotional response and the change of stay hour and the follows in crowding perceived degree and it examines it does. In order to achieve the purpose of this study, carried out literature study of a related field and set up a study model. We used one method. The first method was directly distributing questionnaires to tourist' by use of one researcher who has been trained in tourist site, in order to confirm hypothesis established according to a theoretical background. And as the site of study, chose Mureung Valley which are located in the East Sea region which is one of the largest domestic vacation destinations. Through these methods, we were able to obtain participation of 450 people from across the country. Using 408 responses(42 responses removed). we derived statistics by means of Win SPSS Version 10.0 statistics program package. The analysis results ara as follows: First, Perceived Crowding affects tourists' Emotional Response and the Stay hour change. Specially, perceived Crowding is from in the Emotional Response factor it is joyful with there is relationship of excitation relationship effect. Second, There is relationship of effect even to sentimental reaction and stay hour change. This also is from in the Emotional Response factor it is joyful with there is relationship of excitation relationship effect. Finally, we discuss the results of analysis and suggest research limitation and future and future study.

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Study of the non-linearity of cable damper to enhance damping performance of stay cable (사장교 케이블의 감쇠성능 향상을 위한 댐퍼의 비선형성 연구)

  • Seo, Ju-Won;Koh, Hyun-Moo
    • Proceedings of the Korean Society for Noise and Vibration Engineering Conference
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    • 2007.05a
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    • pp.147-156
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    • 2007
  • This study offers a design procedure of optimum cable damper for multi-mode vibration control with nonlinear damper and also investigate the relation between mode and amplitude dependency. The proposed multi-mode damping index, which is defined as a energy loss ratio of cable potential, is a main component of optimization problem of optimum nonlinear damper. In order to include the amplitude dependency of nonlinear damper, it is assumed to exist three kinds of multi-mode patterns such as ambient vibration, support excitation and rain-win induced vibration. The optimum damper exponent depends on amplitude patterns. In case of ambient vibration, optimum factor is less than 0.5. In case of support excitation or rain-wind induced vibration is between 0.5 and 1.0. In this study, the effects of cable sag and inclination angle are included in the asymptotic design equation of damped cable structures.

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A Survey on the Nurse Staffing Level and Patient Outcome (일부 종합병원의 간호사 확보수준과 환자결과(Patient-Outcome) 분석)

  • Park, Bo-Hyun;June, Kyung-Ja;Kim, Yun-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.4
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    • pp.559-569
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    • 2003
  • Purpose: The purpose was to investigate nurse staffing levels and patient outcomes(nosocomial infection, patient fall, pressure ulcer). Method: The subjects of this study were 305 nurses from 20 general hospitals who worked at 39 medical and surgical wards. Self-reporting questionnaire which was developed by the writer through preceding study was used. In data analysis, SPSS WIN 10.0. program was utilized for descriptive statistics, ANOVA. Result: The mean of patient-to-nurse ration was 5.2:1. 65% among 20 hospitals was over 300 beds, 90 was located in urban area and 55 was private hospitals. Patient-to-nurse ration of hospitals in under 300 beds or rural area or private ownership was lower than hospitals in 300 beds or urban area or public ownership. 89.9 among 39 wards was medical or surgical wards. The mean of length of stay, 8-14 days got a majority and showed higher patient-to-nurse ration. Of the general characteristics, rural was significantly hight to patient fall(F=3.205, p<.05), medical unit was significantly high to patient fall, pressure ulcer(patient fall: F=8.890, p<.001, pressure ulcer: F=3.399, p<.05) and over 15 days was significantly higher than under 14 days of the mean of length of stay. And there was significant relationship between over 6.0:1 and over 4.0:1 to less than 5.0:1(F=4.817,p<.01). Conclusion: This study has shown a relationship between patient-to-nurse ration and patient fall using not objective research tool but self-reporting questionnaire. Therefore further research is needed to study using objective research tool. Based on this study, the effect of nurse staffing levels on patient outcome also has to be studied.

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Risk Factors and Clinical Outcomes of Unplanned Reintubation after Planned Extubation in Adult Patients admitted to the Intensive Care Unit after Cardiac Surgery (성인 심장수술 후 중환자실에 입실한 환자의 계획된 발관 후 비계획적 기관 재삽관 위험요인과 임상결과)

  • Lee, Ju-Hee;Choi, Hye-Ran
    • Journal of Korean Critical Care Nursing
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    • v.15 no.3
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    • pp.88-100
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    • 2022
  • Purpose : This study aimed to identify risk factors for unplanned reintubation after planned extubation and to analyze the clinical outcomes in patients admitted to the intensive care unit after cardiac surgery. Methods : The study examined patients who underwent intubation and planned extubation admitted to the intensive care unit after cardiac surgery between January 1, 2017, and December 31, 2021. The reintubation group comprised 58 patients underwent unplanned reintubation within 7 days of planned extubation. The maintenance group comprised 116 patients who did not undergo reintubation and were matched with the reintubation group using the rational for matching criteria. Data were collected retrospectively from electronic medical records. We used the independent t-test, Mann-Whitney U test, 𝑥2-test, Fisher's exact test, and logistic regression analysis with SPSS/WIN 27.0. Results : The multivariate logistic regression analysis demonstrated that albumin (odds ratio [OR]=0.38, 95% confidence interval [CI]=0.20-0.72), surgery time (OR=1.54, 95% CI=1.20-1.97), PaO2 before extubation (OR=0.85 per 10 mmHg, 95% CI=0.75-0.97), postoperative arrhythmia (OR=2.82, 95% CI=1.22-6.51), reoperation due to bleeding (OR=4.65, 95% CI=1.27-17.07), and postoperative acute renal failure (OR=2.97, 95% CI=1.09-8.04) were risk factors for unplanned reintubation. The reintubation group had a higher in-hospital mortality rate (𝑥2=33.74, p<.001), longer intensive care unit stay (Z=-7.81, p<.001), and longer hospital stay than the maintenance group (Z=-8.29, p<.001). Conclusion : These results identified risk factors and clinical outcomes of unplanned reintubation after planned extubation after cardiac surgery. These findings should be considered when developing and managing an intervention program to prevent and reduce the incidence of unplanned reintubation.