Min, Kyoung A;Sohn, Ki Ho;Suh, Ok Kyung;Choi, Kyung Eob
Korean Journal of Clinical Pharmacy
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v.8
no.1
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pp.35-46
/
1998
A retrospective study was conducted to evaluate the appropriateness of total parenteral nutrition (TPN) for 200 hospitalized adult patients in Samsung Medical Center from January 1st in 1995 to June 31st in 1997. Standard criteria were modified and determined from those stated by AJHP (American Journal of Health System Pharmacy) and ASPEN (American Society of Parenteral and Enteral Nutrition). The justification for indications was appropriate in $35\%,\;44\%,\;and\;32\%$ of the patient's in 1995, 1996, and 1997, respectively, without significant improvement over the last two and half years. Before and during the administration of TPN, several monitoring indicators were well documented, and monitoring frequencies were increased over two and half years period. However, the majority of the monitoring indicators were not found in the standard criteria range of $90\%$. The monitoring indicators for electrolyte balance, $PO_4$ and Mg, were not measured appropriately and resulted in the complications which could have been prevented. The indicator for lipid tolerance, triglyceride and the indicator for hemorrhagic incidence, prothrombin time (PT), were not well documented in comparison with other indicators. The indicators for the improvement in nutritional status, albumin and total protein, were appropriate in $90\%$ of the patients. Determination of TPN formula was based on the laboratory data and chart reviews, and it was appropriate in $98\%$. But the administration of lipid and vitamin K for the prevention of essential fatty acid deficiency and hemorrhage, respectively, was not carried out appropriately when the administration of TPN was prolonged, lasting more than 7 days. When a patient returned to oral or enteral feeding, TPN was terminated. However, increase in albumin level or weight was rarely observed. In conclusion, healthcare professionals should all work as a team and active participation to provide optimized nutrition support for partners.
Journal of Korean Academy of Nursing Administration
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v.3
no.1
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pp.107-118
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1997
This study was designed to obtain basic data for development of evaluation tool which would be needed to measure the outcome of general quality nursing care of individual patient. The purpose of this study was to analyze and classify the outcome indicators of quality nursing care. The 29 articles of quality nursing care and outcome measures were selected coveniently, and analyzed to classify the outcome indicators of quality nursing care using open coding method. The results of this study were as follows: 1. Quality nursing care was defined as level of excellence of nursing care to achieve good patient outcome. 2. The 6 domains of which were health status, satisfaction, self care, patient progress and prognosis, and compliance were identified in outcome indicators of quality nursing care 3. Seven indicators of health status domain which were perceived health status, quality of life, well-being, daily activities, physical-physiological status, psychoemotional status, and social role functioning were identified. 4. Two indicators of satifaction domain which were patient satisfaction and family satisfaction were identified. 5. Three indicators of self care domain which were skill, knowledge, and home management were identified. 6. Seven indicators of patient progress and prognosis domain which were change of clinical status, resolution of nursing diagnosis and problem, days of stay, dicahrge state, recovery state, survival were identified. 7. compliance with therapeutic direction compliance was identified as an indicator of compliance domain. 8. It was sugested that studies for development of evaluation tools for outcomes of quality nursing the results of this study could be executed
Mobile phones used by healthcare workers are not only an indicator of the contamination of healthcare associated bacteria, but can also be another source of infection. The number and time of handwashing, mobile phone operation time and disinfection were highly relation with the bacterial contamination on the surface of mobile phone. Healthcare associated bacteria isolated from the mobile phone surface were 28 MRCoNS (48.3%), 14 S. aureus (24.2%), 3 MRSA (5.2%), 5 A. baumannii (8.6%), 3 MRAB (5.2%), 3 Entrococcus spp. (5.1%), 2 Pantoea spp. (3.4%), 2 A. lowffii (3.4%), 1 E. cloacae (1.7%), 1 P. stutzeri (1.7%), and P. mirabillis (1.7%). For isolation according to department, 2 MRAB from the emergency room and 1 MRSA from intensive unit, the radiology team and the rehabilitation medical team, respectively were isolated. As a result of the relation of isolates from the department of patient contact (ER, RT, GW, CP, ICU, RMT), the bacterial isolation rate was 75% and the department of patient non-contact (MRT) was 10%.
As the importance of cardiovascular health is highlighted, research on its correlation with blood pressure, the most important indicator, is being actively conducted. Therefore, extensive clinical data is essential, but the measurement of the central arterial blood pressure waveform must be performed invasively within the artery, so the quantity and quality are limited. This study suggested a mock circulatory robot and artificial aorta to reproduce the blood pressure waveform generated by the overlap of forward and reflected waves. The artificial aorta was fabricated with biomimetic silicone to mimic the physiological structure and vascular stiffness of the human. A pressurizing chamber was implemented to prevent distortion of the blood pressure waveform due to the strain-softening of biomimetic silicone. The reproduced central arterial blood pressure waveforms have similar magnitude, shape, and propagation characteristics to humans. In addition, changes in blood pressure waveform due to aging were also reproduced by replacing an artificial aorta with various stiffness. It can be expanded to construct a biosignal database and health sensor testing platform, a core technology for cardiovascular health-related research.
Apgar score is most widely used evaluating indicator of newborn health, but it is very Subjective. Umbilical cord blood gas analysis is more objective and effective than Apgar score in evaluation of newborn status. Cord blood gas was changed slightly by processing of time after fetal birth. This study was undertaken to observe objectiveness and effectiveness of umbilical arterial blood gas analysis and effects of time interval of cord clamping to newborn health with 122 pregnant women and their babies. We observed following results : 1. There were poor correlation between Apgar score and umbilical cord arterial blood analysis in evaluating of newborn health (P>0.05). 2. There was no clinical significance of Apgar score or umbilical arterial blood gas analysis as single indicator in evaluating of newborn health (P>0.05). 3. Gas analysis and pH of umbilical arterial blood was more helpful in evaluating of newborn health than Apgasr score. 4. There were no significant effects of time interval of umbilical cord clamping to newborn health. 5. If there were no indications of early umbilical cord clamping, cord blood sampling at immediately after birth without cord clamping was more effective to evaluate newborn status.
Background: Increasing evidence from animal, epidemiological and clinical investigations suggest that dietary anthocyanins have potential to prevent chronic diseases, including cancers. It is also noteworthy that human epidermal growth factor receptor 2 (ErbB2) protein overexpression or ErbB2 gene amplification has been included as an indicator for metastasis and higher risk of recurrence for breast cancer. Materials and Methods: The present experiments investigated the anti-metastasis effects of black rice anthocyanins (BRACs) on ErbB2 positive breast cancer cells in vivo and in vitro. Results: Oral administration of BRACs (150 mg/kg/day) reduced transplanted tumor growth, inhibited pulmonary metastasis, and decreased lung tumor nodules in BALB/c nude mice bearing ErbB2 positive breast cancer cell MDA-MB-453 xenografts. The capacity for migration, adhesion, motility and invasion was also inhibited by BRACs in MDA-MB-453 cells in a concentration dependent manner, accompanied by decreased activity of a transfer promoting factor, urokinase-type plasminogen activator (u-PA). Conclusions: Together, our results indicated that BRACs possess anti-metastasis potential against ErbB2 positive human breast cancer cells in vivo and in vitro through inhibition of metastasis promoting molecules.
Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.
Background: The purpose of this study was to propose a method for developing a measure of hospital-wide all-cause risk-standardized readmissions using administrative claims data in Korea and to discuss further considerations in the refinement and implementation of the readmission measure. Methods: By adapting the methodology of the United States Center for Medicare & Medicaid Services for creating a 30-day readmission measure, we developed a 6-step approach for generating a comparable measure using Korean datasets. Using the 2010 Korean National Health Insurance (NHI) claims data as the development dataset, hierarchical regression models were fitted to calculate a hospital-wide all-cause risk-standardized readmission measure. Six regression models were fitted to calculate the readmission rates of six clinical condition groups, respectively and a single, weighted, overall readmission rate was calculated from the readmission rates of these subgroups. Lastly, the case mix differences among hospitals were risk-adjusted using patient-level comorbidity variables. The model was validated using the 2009 NHI claims data as the validation dataset. Results: The unadjusted, hospital-wide all-cause readmission rate was 13.37%, and the adjusted risk-standardized rate was 10.90%, varying by hospital type. The highest risk-standardized readmission rate was in hospitals (11.43%), followed by general hospitals (9.40%) and tertiary hospitals (7.04%). Conclusion: The newly developed, hospital-wide all-cause readmission measure can be used in quality and performance evaluations of hospitals in Korea. Needed are further methodological refinements of the readmission measures and also strategies to implement the measure as a hospital performance indicator.
Purpose: Mid-upper-arm circumference (MUAC) is considered an alternative screening method for obesity. The aims of this investigation were to examine the ability of MUAC to correctly identify children with elevated body mass index (BMI) and to determine the best MUAC cutoff point for identification of children with high BMI. Methods: Anthropometric measurements (height, weight, and MUAC) from a cross-sectional sample of 7,921 Pakistani children aged 5-14 years were analyzed. Pearson correlation coefficients between MUAC and other anthropometric measurements were calculated. Receiver operating characteristic curve analysis was used to determine the optimal MUAC cutoff point for identifying children with high BMI. Results: Among 7,921 children, the mean (${\pm}$standard deviation) age, BMI, and MUAC were 10.00 (${\pm}2.86years$), 16.16 (${\pm}2.66kg/m^2$), and 17.73 (${\pm}2.59cm$), respectively. The MUAC had a strong positive correlation with BMI. The optimal MUAC cutoff points indicating elevated BMI in boys ranged from 16.76 to 22.73, while the corresponding values in girls ranged from 16.38 to 20.57. Conclusion: MUAC may be used as a simple indicator of overweight/obesity in children, with reasonable accuracy in clinical settings.
Journal of the Korea Society of Computer and Information
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v.22
no.2
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pp.105-110
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2017
We propose a effectiveness of the assistant pad during cardiopulmonary resuscitation and provide basic data for high quality cardiopulmonary resuscitation. The subjects of the study were 28 students in the emergency department who completed the BLS Health Care-Provider under the experimental study by the randomized crossover design. Data were analyzed by using SPSS 20.0 Version. The results of this study showed that chest compressions using assistant pads decreased pain and fatigue than normal chest compressions, and the depth of chest compressions was deeper than normal depth. The results of this study shows that the use of assistant pads between the one hand and the other hand during cardiopulmonary resuscitation may increase accuracy and depth were improved. Therefore intensive indicator also improved. However, with regard to the use of assistant pads, further studies will be needed to identify the potential for clinical use.
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