• Title/Summary/Keyword: clinical indicator

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Analysis of Clinical Indicators related to Pattern-Identification in Acute Cerebral Infarction Patient (급성기 뇌경색 환자에 있어 변증형별 유의한 임상지표의 분석)

  • Lee, Eun-chan;Hyun, Sang-ho;Kwak, Seung-hyuk;Woo, Su-kyung;Park, Ju-young;Jung, Woo-sang;Moon, Sang-kwan;Cho, Ki-ho;Park, Sung-wook;Ko, Chang-nam
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.13 no.1
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    • pp.33-42
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    • 2012
  • Object : The aim of this study was to assess the clinical indicators related to Pattern-Identification(PI) in acute cerebral infarction patients. Methods : We studied hospitalized patients within 30days after ictus, who admitted at Korean Medicine Center of Kyung-Hee University from January 2010 to October 2012.(n=290) Two Traditional Korean Medicine(TKM) physicians evaluated the patients independently and diagnosed PI. Inter-rater reliability was measured using simple percentage agreement and the Cohen's kappa(κ) coefficient. To assess the clinical indicators closely related to each PI, we analysed average score of each indicator in each group. Results : Simple percentage agreement of PI between raters was 64.83% and Cohen's kappa(κ) coefficient was 0.526(95% CI: 0.451-0.600). Inter-rater reliability level was fair to good. We analysed the clinical indicators in each group. Significant indicators for Fire-Heat Pattern(FHP) were reddened complexion and strong pulse power, and meaningful indicators for FHP were halitosis and thick tongue fur. Significant indicator for Dampness-Phlegm Pattern(DPP) was overweight and there was no meaningful indicator. Significant indicator for Yin-Deficiency Pattern(YDP) was dry tongue fur and meaningful indicator for YDP was thirst. There was no significant indicator for Qi-Deficiency Pattern(QDP) and pale complexion and faint low voice were meaningful indicators for QDP. Conclusions : This study reveals the significant and meaningful clinical indicators related to each Pattern-Identification in acute cerebral infarction patients. It will contribute to standardization of Korean Medical Diagnosis and Treatment in acute cerebral infarction patients.

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Nursing Competency And Indicator Development By Emergency Nurse's Clinical Ladder (응급실 간호사의 임상 등급(clinical ladder)에 따른 간호역량 및 행동지표 개발)

  • Youk, Shin-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.3
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    • pp.481-494
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    • 2003
  • Purpose: This study was to develop nursing competencies, sub-competencies and behavior indicators according to the clinical ladder of emergency nurses. Method: index of content validation was used by 21 clinical experts. Results: This study had three phases to develop nursing competencies, sub-competencies and behavior indicators. In first phase: 12 nursing competencies and 33 sub-competencies were developed through the literature review on nursing competency and emergency nurses' job description. The content of 12 competencies and 33 sub-competencies were reviewed by 3 nursing professors. The 12 competencies and 33 sub-competencies were followed: clinical judgement and measures(6 sub-competencies), processing ability of ward works(2 sub-competencies), flexibility(2 sub-competencies), resources management(2 sub-competencies), confidence(3 sub-competencies), cooperation(2 sub-competencies), professional development power(2 sub-competencies), patient service orientation(3 sub-competencies), inclination toward ethical value(5 sub-competencies), influence power(2 sub-competencies), developing others(2 sub-competencies), self control(2 sub-competencies). In second phase, 132 behavior indicators were developed according to nurse clinical ladder: novice, advanced novice, competent, proficient. In Third phase, content validity was examined on 132 behavior indicators by 21 clinical experts. 126 among 132 indicators had over 70% agreement among experts and 6 indicators under 70% were revised. Conclusion: nursing competencies, sub competencies and behavior indicators can be used nurses' clinical performance as well as establishing proper directions for professional growth related to reward system.

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Readmission Rate: Experience in USA, Canada and UK (미국, 캐나다, 영국의 재입원율 활용 현황)

  • Lee, Sang-Ah;Ju, Yeong-Jun;Shin, Jae-Yong;Park, Eun-Cheol;Lee, Hoo-Yeon
    • Quality Improvement in Health Care
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    • v.22 no.1
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    • pp.29-37
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    • 2016
  • Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.

A Study on the Development of Diagnosis and Assessment Index by Soeumin's Ordinary Symptoms (소음인 소증 진단평가지표 개발 연구)

  • Hwang, Sabi;Lee, Junhee
    • Journal of Sasang Constitutional Medicine
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    • v.33 no.1
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    • pp.38-56
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    • 2021
  • Objective This study was devised to create a new diagnosis and an assessment index by Soeumin's Ordinary Symptoms. Method First, a Working Committee and an Advisory Committee were formed for development, and the development goals were set. Then, the Soeumin's disease diagnosis indicators were extracted from the previous Clinical Practice Guidelines for Sasang Constitutional Medicine. To increase the clinical applicability, the extracted diagnosis indicators were focused on ordinary symptoms, and translated into Korean. The translated diagnosis and assessment indicators for Soeumin were surveyed to the Advisory Committee using the Delphi technique, and the inclusion, importance, and validity of each indicator were investigated accordingly. Result The translated diagnosis and assessment indicators were finally revised based on the surveyed inclusion and translation validity opinions, and the weight of each indicator was set based on the investigated importance, and a draft of the diagnosis and assessment index was developed. Conclusion This developed index can help to make effective diagnose about Soeumin's diseases by clinical doctor. In the future, a clinical study of this index can be conducted to consider the reliability, validity, and cut-point, and through this process, the actual clinical applicability will be improved.

Clinical Usefulness of Gastric Residual Volume as An Indicator to Provide Approximately Enteral Nutrition for Patients in Intensive Care Units: A Systematic Literature Review (중환자의 경관영양 공급 지표로서 위 잔여량의 임상적 효용성: 체계적 문헌고찰)

  • Kim, Hyunjung;Chang, Sun Ju
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.267-275
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    • 2014
  • Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.

Factors related to Family Caregiver Satisfaction with Elderly in Nursing Facilities (시설입소 노인환자 부양가족의 만족도 영향요인)

  • Kim, Young ae;Kim, Soon Ae;Lee, Joo Young;Hwang, Moon Sook;Yoon, Hee Sang
    • 한국노년학
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    • v.29 no.2
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    • pp.395-405
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    • 2009
  • This study aims at providing an upgraded suggestion to improve satisfaction for the family caregiver. This study was conducted to find the relationship between satisfaction and family support and outcome indicator to investigate the factors that have influence on the satisfaction. The study population was 126 families of 5 elderly residing in institutionalized elderly homes in seoul and kyunggi. The data collection was measured satisfaction, family support, and outcome indicator instrument. The satisfaction showed meaning relationship with outcome indicator and family support. Explainary power of independent variables of product index was 23%. Factors influencing satisfaction for the family was economic level, family support and outcome indicator. This study was done to give suggestions to improve family caregiver satisfaction and to serve as a basis for policy strategies by examining the current conditions of the nursing facilities.

Effect Analysis of Electronic Clinical Trial Systems (효율성 측정지표를 활용한 전자적 임상시험프로세스 효과분석)

  • Lee, Hyun-Ju;Choi, In-Young
    • The Journal of the Korea Contents Association
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    • v.11 no.1
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    • pp.350-356
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    • 2011
  • The purpose of this study is to empirically examine how much the electronic clinical trial data management system actually enhances its efficiency. While the development of clinical trial markets highlights the significance of data management with increasing rate of adoption of electronic systems, its effects have not been fully supported with rigorous evidences. Particularly, the adoption rate of electronic clinical trial systems is low in domestic clinical trials markets. This study attempts to analyze the effect of the systems for reminding the importance of e-data management in clinical trials. The measurement indicator is experimented with the time related data collected from a multi-center clinical trial case. The result showed that the speed of the electronic clinical trial processes can be improved. The implication of this study lies in its first attempt to empirically analyze the effect of electronic clinical data management systems. Furthermore, application of the indicator in conjunction with electronic clinical trial processes is expected to facilitate strategic data management.