• 제목/요약/키워드: clinical nutrition support

검색결과 108건 처리시간 0.019초

우리나라 병원에서의 영양지원팀 운영과 관련된 문제점에 관한 연구: 한 대학병원의 경우 (Problems Associated with the Management of Nutrition Support Team in Hospitals in Korea)

  • 강혜진;스리니바산샨무감;용철순;김정애;이종달;유봉규
    • 한국임상약학회지
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    • 제18권1호
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    • pp.45-49
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    • 2008
  • The goal of this research was to identify problems associated with the management of nutrition support team (NST) in hospitals in Korea. Management status of NST in the hospitals was surveyed over the phone or interviewed by visit during August 2007. NST in foreign countries was collected by reference search and websites in the internet. Survey analysis also was performed during March, 2007 with forty-one medical staff in a university hospital located in Jinju, Kyungsangnamdo. Korean Society for Parenteral and Enteral Nutrition (KSPEN) was organized in 2001 and currently has thirty-three member hospitals with on-site NST as of August, 2007. Most of the member hospitals were big hospitals with more than 500 beds and were organized within five years. The most significant problem identified was the shortage of nutrition specialists exclusively involved in the NST. Survey analysis revealed that more than half of medical staff prescribed parenteral nutrition based on their own nutrition requirement calculation rather than consultation with NST. It appears that status of NST management of hospitals in Korea are considered to be at beginner stage and therefore, needs more aggressive advertising activity to increase consultation usage by medical staff.

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[ $\b{S}afety\;\b{A}nd\;\b{E}fficacy$ ] of $\b{K}orean$ red ginseng Intervention (SAEKI) Trial: Rationale, Design, and Expected Findings

  • Sievenpiper John L;Buono Marco Di;Stavro P. Mark;Jenkins Alexandra L;Nam Ki Yeul;Choi Melody;Naeem Asima;Leiter Lawrence A;Sung Mi-Kyung;Vuksan Vladimir
    • 고려인삼학회:학술대회논문집
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    • 고려인삼학회 2002년도 학술대회지
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    • pp.424-455
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    • 2002
  • Diabetes mellitus is reaching epidemic proportions worldwide. The insufficiency of medication to cope with this burden has coincided with a dramatic rise in the prevalence of use of complementary and alternative therapies, especially herbal treatments. This surge in demand presents a challenge to prove the safety and efficacy of these treatments in diabetes. Korean red ginseng (steam treated Panax ginseng C.A. Meyer) is a strong candidate to succeed. It has been shown to possess a multitude of hypoglycemic effects and improve metabolic disturbances related to diabetes in in vitro and animal models. Data in humans is also emerging to support these benefits. Whether these results can be replicated in a rigorous clinical testing program is unclear. We therefore investigated the antidiabetic effects of Korean red ginseng in a series of 2 acute and 1 longterm randomized, double-blinded, placebo-controlled clinical trials. This paper provides the rationale for this program of study, expanding on the problem of diabetes, its management, and the possible role for Korean red ginseng. It then describes the design and expected findings.

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Exploring the Use of Information Technology in Dietetics Practice among Clinical Dietitians

  • Wong Karine;Ham Sunny;Forsythe Hazel W.
    • Journal of Community Nutrition
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    • 제7권3호
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    • pp.149-155
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    • 2005
  • This exploratory study investigated the software programs utilized by clinical dietitians and their perceptions on the use of information technology. The study focused on the use of specialized software for dietetics, general software for any office use and the Internet. A self-administered survey was used to collect data from clinical dietitians identified in the Kentucky Dietetic Association Directory 2003-2004. The survey was conducted in March through April, 2004. A total of 22 responses were collected, which yielded a response rate of $68\%$. Findings suggest that computer use has become a routine for optimal clinical practice ; major specialized software programs are used for nutrition assessment, nutrition analysis and menu development. Use of specialized software appears to be unassociated with dietitians' age and years of experience ; however, the associations are indicated between use of specialized software and education level as well as their specialty ; word processing and spreadsheet are the major general software used. Internet is used mainly for information search and communication. Respondents perceived that overall work efficiency and productivity significantly increased with computer use. The complexity of software is the major barrier encountered so training is the most needed support by the department. Strategic promotion on the use of specialized software should be targeted to the management team of the hospitals/facilities.

아트로핀으로 치료하는 유기인계와 카바메이트 중독 환자의 영양지원 평가와 방법 (Assessment and Methods of Nutritional Support during Atropinization in Organophosphate and Carbamate Poisoning Cases)

  • 박종욱;민영기;최상천;고동완;박은정
    • 대한임상독성학회지
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    • 제18권2호
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    • pp.123-129
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    • 2020
  • Purpose: Atropine is an antidote used to relieve muscarinic symptoms in patients with organophosphate and carbamate poisoning. Nutritional support via the enteral nutrition (EN) route might be associated with improved clinical outcomes in critically ill patients. This study examined the administration of nutritional support in patients undergoing atropinization, including methods of supply, outcomes, and complications. Methods: A retrospective observational study was conducted in a tertiary care teaching hospital from 2010 to 2018. Forty-five patients, who were administered with atropine and on mechanical ventilation (MV) due to organophosphate or carbamate poisoning, were enrolled. Results: Nutritional support was initiated on the third day of hospitalization. Thirty-three patients (73.3%) were initially supported using parenteral nutrition (PN). During atropinization, 32 patients (71.1%) received nutritional support via EN (9) or PN (23). There was no obvious reason for not starting EN during atropinization (61.1%). Pneumonia was observed in both patient groups on EN and PN (p=0.049). Patients without nutritional support had a shorter MV duration (p=0.034) than patients with nutritional support. The methods of nutritional support during atropinization did not show differences in the number of hospital days (p=0.711), MV duration (p=0.933), duration of ICU stay (p=0.850), or recovery at discharge (p=0.197). Conclusion: Most patients undergoing atropinization were administered PN without obvious reasons to preclude EN. Nutritional support was not correlated with the treatment outcomes or pneumonia. From these results, it might be possible to choose EN in patients undergoing atropinization, but further studies will be necessary.

초기 경장영양 공급 수준과 다발성 외상 중환자의 임상 경과와의 상관성 연구 (Association of the initial level of enteral nutrition with clinical outcomes in severe and multiple trauma patients)

  • 양수영;정승연;이지현;권준식;김유리
    • Journal of Nutrition and Health
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    • 제55권1호
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    • pp.85-100
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    • 2022
  • 본 연구에서는 다발성 외상 중환자에게 있어 급성 단계에서의 이화학적 상태 및 경장영양 공급 수준이 임상적 예후에 미치는 영향을 알아보고자 하였다. 먼저 조사 대상자 302명의 특성을 분석한 결과, 남성의 비율이 높으며 다른 중환자실에 비해 연령이 낮게 나타났으며 과체중의 체격을 가지고 있었다. 입원 후 7일간의 경장영양 공급 수준에 따라 일반적 결과와 합병증 발생률, 영양 관련 생화학적 지표를 비교한 결과, 초기 경장영양이 가장 적극적으로 공급되었던 High EN 그룹에서 사망률, CRP에서 유의적으로 감소하였다. 질소 평형을 기준으로 이화상태가 양호한 그룹에서는 경장영양 공급 기간이 길수록 HAIs 발생률이 높았으나, 이화상태가 불량한 그룹에서는 적극적인 경장영양 공급에도 여러 합병증 발생이 증가하지 않았다. 생화학적 검사 결과에서는 그룹 간 유의적인 차이가 없었으며, 경장영양 공급 수준에 따른 사망률 감소 추세는 두 그룹 모두에서 유지되었다. 결론적으로, 본 연구에서는 사망률 감소, 염증 수치의 감소 등에서 초기 경장영양 공급 일수가 증가할수록 긍정적인 효과를 확인하였다. 단, 후향적 관찰연구라는 제한점을 미루어 보아 향후 연속적으로 이화상태를 모니터링 및 평가하며 기본 특성의 차이가 없는 그룹 간에서 경장영양 공급 수준을 차별화한 전향적 코호트 연구가 필요하겠다.

의료기관 평가제도 영양부문 기준 및 결과의 시계열 변화 분석 (The Time Series Analysis of Standards and Results of Nutritional Domain in Hospital Evaluation Program)

  • 이주은
    • 대한영양사협회학술지
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    • 제19권4호
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    • pp.317-342
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    • 2013
  • The purpose of this study was to evaluate the current state of foodservice and clinical nutrition management in a hospital-based nutrition department. Nutritional guidelines and survey reports of hospital evaluation programs from 2004 to 2009 were analyzed. In total, 275 hospitals in the first period and 288 hospitals in the second period were evaluated. The division of knife and chopping board use decreased from 97.2% in 2005 to 89.7% in 2008, the maintenance of a proper freezer temperature (below $-18^{\circ}C$) increased from 82.1% in 2004 to 97.7% in 2007 (88.9% to 97.4% from large hospitals and 69.8% to 86.5% from small/medium hospitals in 2005 and 2008, respectively). In tube-feeding management, the performance rate of material cold storage and the offer rate of tube-feeding were 65.9% and 94.2% in 2007, respectively. The cold storage of material, proper use within 24 hours after opening or production, and the use of an appropriate label were 47.3%, 71.2% and 67.2% in 2009, respectively. The rate of a management system for undernourished patients was 86.0% in 2007 (56.4% for large hospitals, 18.9% for small/medium hospitals) and 14.3% in 2009. In standards of nutrition support management, the performance rates of constructing a nutrition support team, the nutrition support team activity, and organizing multidisciplinary team were 66.7%, 43.6%, and 64.1% respectively, in 2004. For large hospitals, those rates were 61.1%, 36.1%, and 58.3%, in 2005, 93.0%, 62.8%, and 91.9% in 2007, and 69.2%, 43.6%, and 69.2% in 2008, respectively. The results of this study suggest standards on sanitary foodservice preparation, production, and tube-feeding production need to correspond with HACCP regulations for small/meidium hospitals in standards of a healthcare accreditation system. It will be necessary to understand the operating conditions of nutrition departments in convalescent hospitals, psychiatric hospitals, and geriatrics hospitals. As the application of accreditation is required from 2013, standards will need to be improved and continuously updated for healthcare accreditation.

유치원 학부모들의 급식 중요도 인식에 따른 급식지원 요구도 분석 (Analysis for the Need to Support Kindergartens based on Perception of Parent regarding Important Factors for Foodservice)

  • 정지영;김유리;김건희;오지은
    • 한국식생활문화학회지
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    • 제35권1호
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    • pp.79-85
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    • 2020
  • This study aims to classify parents by considering important factors in the management of foodservice for children. An offline survey was conducted by enrolling 583 Korean parents whose children attended public or private kindergartens in Seoul. The important factors required for managing foodservice for children are meal service resources, menu management, and food allergy. Considering these factors, parents were grouped into 3 clusters: the allergy important group, environment important group, and high concern group. Evaluation of the demographic characteristics revealed a significant difference between clusters with respect to type of kindergarten. Parents perceived that a private kitchen is more required than a private dining room, and perceptions about the need for a private kitchen and dining room were significantly different among the clusters. Furthermore, the results reveal significant differences between clusters, when considering the need to support meal service. Therefore, the government needs to consider characteristics of the parent cluster if they plan to support the kindergarten foodservice. We believe that this study can be used as supportive data to establish a working policy.

웹기반 진단 보조 시스템의 진단 일치도 연구 (A Study for Diagnostic Agreement between Web-based Diagnosis Support System and Korean Medical Doctors' Diagnosis)

  • 이승엽;강민지;임현정;양웅모
    • 대한융합한의학회지
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    • 제6권1호
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    • pp.37-42
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    • 2024
  • Objectives: This study aims to evaluate the clinical validity of the system by conducting a clinical study to assess the diagnostic agreement between the system and Korean medical doctors. Methods: This study was conducted from September 7, 2023, to December 7, 2023, across five Korean medicine institutions, involving 100 adult participants aged 20-64 who consented to participate. Participants first entered their symptoms into a web-based program, which utilized an AI-based algorithm to diagnose 36 types of pattern differentiation. Subsequently, Korean medical doctors conducted face-to-face diagnoses using the same 36 types. The diagnostic agreement between the system and the doctors' diagnoses was analyzed using descriptive statistical analysis, and the results were expressed as a percentage agreement. Results: Analysis of the diagnostic data from 100 participants revealed that the web-based diagnosis support system identified an average of 7.76±0.79 patterns per patient, while Korean medical doctors identified an average of 7.99±0.10 patterns per patient. The diagnostic agreement between the system and the doctors showed an average of 7.08±1.08 patterns per patient, with an overall diagnostic agreement rate of 88.57±13.31%. Conclusion: This study developed a web-based diagnosis support system for traditional Korean medicine and evaluated its clinical validity by assessing diagnostic agreement. Comparing the diagnoses of the system with those of Korean medical doctors for 100 patients, the system showed an approximately 89% agreement rate with the clinical diagnoses. The system holds potential for aiding Korean medical doctors in pattern differentiation diagnosis in clinical practice.

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Analysis of the Prevalence and Risk Factors of Malnutrition among Hospitalized Patients in Busan

  • Lee, Ha-Kyung;Choi, Hee-Sun;Son, Eun-Joo;Lyu, Eun-Soon
    • Preventive Nutrition and Food Science
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    • 제18권2호
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    • pp.117-123
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    • 2013
  • This study investigated the prevalence of and risk factors for malnutrition in hospitalized patients in Busan, Republic of Korea. 944 patients (440 men and 504 women) were hospitalized in four Busan general hospitals from March through April, 2011. Nutritional status was assessed on admission by the Nutritional Risk Screening 2002. Data were collected from the electronic medical records system for the characteristics of the subjects, clinical outcomes, biochemical laboratory data, and nutrition support states. Clinical dietitians interviewed the patients using structured questionnaires involving data on weight loss and problems related to oral intakes. Malnourished patients were significantly older (P<0.001) than well-nourished patients, but the values for BMI, serum albumin, total cholesterol, TLC, hemoglobin, and hematocrit were significantly lower (P<0.001) for malnourished than for well-nourished patients. Logistic regression indicated that the main determinant factors for nutritional status were the age, length of stay, BMI, serum albumin, and total cholesterol. In order to increase therapeutic effects of hospitalized patients, clinical dietitians need to offer proper nutritional intervention based on the results of nutrition assessment and identification of malnutrition.

의료진의 병원영양관리에 대한 인식조사 (The Medical Staffs' Perception about Nutrition Care)

  • 류은순;이송미;엄영람
    • 대한영양사협회학술지
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    • 제4권1호
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    • pp.40-52
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    • 1998
  • This study was undertaken to identify medical staffs’ perception about nutrition care and dietitian's role in hospitals. Questionnaires were sent to 874 medical staffs at 50 general hospials size over 100 beds, located in Seoul and Pusan, A total of 649(74.3%) of medical staffs returned questionnaries from 47 general hospitals. The results of this study can be summarized as follows. 1. 89.6% of medical staffs responded that they required the help of the dietitian when the patients needed the nutrition acre and also most of them(87.0%) held positive perceptions about the necessity of the nutrition support team. 2. When the medical staffs prescribed the special diet of the patients' nutrition care, 90.0% of them preferred that diet would be order after consulting with dietitian. 3. Half of the medical staffs(52.1%) responded that they were scarced of the knowledge about the clinical nutrition and then 66.4% of them recognized the need of nutrition education at the medical school. 4. The medical staffs responded that dietitian must have the knowledge about food, nutrition and medical science(52.5%) and the competence of discussion with medical staffs about nutrition the patients(30.8%).

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