• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.2
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• pp.92-96
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• 2014

Dabigatran is the first oral direct thrombin inhibitor approved by the US Food and Drug Administration (FDA) for prevention of stroke and systemic embolism in patients with nonvalvular atrial fibrillation. Because dabigatran is excreted mainly by the kidneys, serum levels of dabigatran can be elevated to a supratherapeutic range in patients with renal failure, predisposing to emergent bleeding. We describe the case of a 66-year-old man taking dabigatran 150 mg twice daily for atrial fibrillation and cerebral infarction who presented with hematochezia and disseminated intravascular coagulation. Laboratory evaluation showed a hemoglobin level of 6.3 g/dL, platelets of $138,000/mm^3$, activated partial thromboplastin time (aPTT) of 10 s, and an international normalized ratio (INR) of 8.17. Colonoscopy showed a bleeding anal fissure. Hemostasis was provided by hemoclips and packed red blood cells and fresh frozen plasma were transfused. Since then, there was no further hematochezia, however, bleeding including oral mucosal bleeding, hematuria, and intravenous site bleeding persisted. At presentation, his serum creatinine was 4.96 mg/dL (baseline creatinine, 0.9 mg/dL). Dabigatran toxicity secondary to acute kidney injury was presumed. Because acute kidney injury of unknown cause was progressing after admission, he was treated with hemodialysis. Fresh frozen plasma transfusion was provided with hemodialysis. At 15 days from admission, there was no further bleeding, and laboratory values, including hemoglobin, partial thromboplastin time, and prothrombin time were normalized. He was discharged without bleeding. After 2 months, he undergoes dialysis three times per week and no recurrence of bleeding has been observed.

• Journal of Korean Public Health Nursing
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• v.28 no.3
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• pp.644-657
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• 2014

Purpose: The purpose of this study was to try to understand the essence of the experience early turnover of the new nurse by applying the phenomenological method and to provide basic data for a community-based management program. Method: Phenomenological approach was used to identify subjects experience. Subjects were five new nurses, with less than one year of clinical experience in clinical practice. This study used in-depth interview. Results: there were 104 meaningful sentences or phrases, with 41 generally comprehensive thema. Finally, thema were classified into 12 thema clusters. Conclusion: Finally, based on the results, some suggestions regarding management of early turnover of new nurses are needed. First, we proposed a new characterized of hospital selection method for each hospital. Second, practical training in clinical practice in the school and the community is necessary in order to reduce the real impact of new nurses. New nurses require various support elements in order to mitigate the real shock the first time they encounter clinical practice. Third, addition of work-related training and promotion of a self-esteem program will be needed. Fourth, interview opportunities with seniors who adapted successfully in clinical should be provided for new nurses. In addition, continuous communication should be provided for new nurses.

• Women's Health Nursing
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• v.21 no.4
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• pp.321-331
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• 2015

Purpose: Purpose of this study was to identify the effect of structured information on immediate preoperative anxiety and uncertainty for women undergoing total laparoscopic hysterectomy. Methods: Sixty women who were admitted for total laparoscopic hysterectomy were recruited at a university hospital in Gyeonggi-do from June to October 2014. Thirty women were assigned to either the experimental or the control group. Women in the experimental group were provided structured information, which consisted of visual and auditory materials about surgical preparation and process, practical experience on devices such as IV-PCA pump and Inspiro-meter and actual experience on route to go to the operating room. State-anxiety, uncertainty, and blood pressure and pulse rate as biological indicators were measured before and after the intervention to examine the effect. Results: Significant group differences were found on state anxiety, uncertainty, including ambiguity, inconsistency, and unpredictability at the holding area. There was a significant difference on pulse rate in the operating room between the two groups. Conclusion: Findings demonstrated that the structured information provided for women undergoing laparoscopic hysterectomy preoperatively was effective on immediate preoperative anxiety and uncertainty. Nurses may contribute to decreasing patients' anxiety and uncertainty by utilizing this structured information preoperatively.

• Journal of Korean Academy of Nursing
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• v.40 no.5
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• pp.714-723
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• 2010

Purpose: The purpose of this study was to examine the effects of using gauze frozen with normal saline or ice on thirstrelief and oral condition of laparoscopic cholecystectomy patients. Methods: A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants (n=53) received either gauze frozen with normal saline (n=17), ice (n=18) or wet gauze (n=18) for thirst-relief. The subjective thirst level and oral condition of the participants were assessed before the intervention, 15 min after the first intervention and 15 min after the second intervention. Results: After oral care was provided twice, there were significant differences in thirst level among the groups. When oral care was provided twice, the oral condition of tongue, saliva, mucosal membrane, and gingiva was improved in patients receiving gauze frozen with normal saline or ice. Conclusion: Gauze frozen with normal saline and ice can be effective for oral care in reducing the thirst level and improving the condition of the oral cavity.

• The Journal of Korean Physical Therapy
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• v.27 no.2
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• pp.118-123
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• 2015

Purpose: This study was conducted in order to present basic policy data for introduction of a home-based physical therapy (HBPT) policy. Methods: The study surveyed physical therapists and patients for six weeks, in order to identify satisfaction with physical therapy. The statistical significance of the management plan with regard to costs and cost estimation and payment methods was determined and managed according to the operating principals of HBPT, eligibility criteria, number of visits, treatment time, and team approach. Results: Through the survey all groups of patients and physical therapists recognized the need for HBPT. They felt that the most desirable methods for activation of physical therapy visits involve precise diagnosis and evaluation through a team approach. While making regular visits to the patient three times a week, an expert visiting physical therapist with 3 to 5 years of experience in the clinical field could provide central nerve developmental treatment in less than 60 minutes; this service could be provided at a reasonable cost, minimizing unnecessary hospital visits, reducing time, medical expenses and facilitating a quick recovery due to psychological satisfaction resulting from a decrease in the psychological anxiety patients often experience in medical institutions. Conclusion: Based on the study results provided above, if HBPT is to be introduced, appropriate pricing and programs should be based on the results of pilot projects.

• Proceedings of the KSCN Conference
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• 1998.08a
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• pp.21-30
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• 1998

Sound nutrition is the basic foundation for the health of a population. Proper nutrition education through the school system can actualize the building of sound nutrition being provided at school lunch programs along with nutrition education can have far reaching impact to the health of the whole nation. In Hong Kong, the recent change over from a half day to full day school program signaled the need for a school lunch program. However, there has been no organized effort so far in Hong Kong to provide such service. School lunches are being provided by caterers who are more concerned about profits than food safetly. Alarming rates of food poisoning occurring recently in Taiwan school has further accentuated the importance of fool safety. With the advent of centralized food production technologies, Dietirians can apply their nutrition knowledge and integrate with food production processes such that safe, healthy and nutritious mcals can be produced in large quantities in a cost-effective manner serving he needs of the school children. This paper introduces the centralized food production concept, using some of the cool chill production centers for school lunch programs in the United States as examples to discuss how new technologies and management system can be integrated to yield the best outcome in food quality and safety.

• The Korean Journal of Health Service Management
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• v.9 no.4
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• pp.51-62
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• 2015

Objectives : Identify the factors that affect organizational citizenship behavior of hospital nurses, and to provide a basis for developing an effective nursing workforce management system. Methods : Participants of this study were 214 nurses serving at general hospitals located in B Metropolitan City. Data collection was performed from Oct.15th to 25th, 2014. The methods of analyzing data were ANOVA, Scheffe's-Test, Pearson's Correlation Coefficient Analysis and the Stepwise Multiple Regression Analysis according to the SPSS WIN 18.0 Program. Results : Emotional intelligence explained 42.1% of the subjects' organizational citizenship behaviors. This figure increased to 48.7, 51.3 and 52.3%, respectively when other three factors of job satisfaction, age and educational background were added on a one-by-one basis. Conclusions : Considering that emotional intelligence is a critical factor in organizational citizenship behaviors, general hospitals should develop and implement education and training programs that can raise their nurses' emotional intelligence and job satisfaction and, concomitantly, promote their organizational citizenship behaviors provided that feedbacks is provided later.

• The Journal of Korean Physical Therapy
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• v.33 no.2
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• pp.91-96
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• 2021

Purpose: This study investigated the effects of cryotherapy on the ankle joint muscle strength and balance ability in stroke patients with ankle joint muscles. Methods: In this study, 20 patients with chronic stroke were recruited from a rehabilitation hospital. The patients were divided into two groups: a cryotherapy group (10 patients) and a control group (10 patients). The cryotherapy group performed sit-to-stand training for 15 minutes and then cryotherapy for the minutes. In the control group, after sit-to-stand training for 15 minutes, blocked cryotherapy was provided for three minutes. In both groups, the interventions were provided five times a week for three weeks. The strength of the ankle joint muscles was measured before and after the training using the Biodex systems 3. The static balance ability was measured using balancia software, and the dynamic balance ability was measured by performing the sit-to-stand test (FTSST) five times. Results: After the training periods, the cryotherapy group showed significant improvement in the ankle dorsiflexor strength, ankle plantarflexor strength, weight distribution of the affected side, and FTSST compared to the control group (p<0.05). Conclusion: Based on these results, cryotherapy could be considered an effective method to improve the strength of ankle joint muscles. Cryotherapy improves muscle strength as it increases the motor neuron excitability. Therefore, cryotherapy may be considered to improve the strength of the ankle joint muscles of stroke patients.

• Journal of East-West Nursing Research
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• v.15 no.2
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• pp.157-167
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• 2009

Purpose: This study examines the patient problems and nursing interventions during telephone consultations by nurses in an ophthalmology nursing unit. Methods: The data were collected during telephone consultations. A total of 13 nurses consulted 170 patients between September 29 and November 30, 2008 at a tertiary teaching hospital. Problems were raised by the patients and nursing interventions were provided to the patients by the nurses. The SPSS program was used to analyze the data. Results: There were 228 telephone inquiries by 170 patients. The problems were categorized into four groups based on a literature review and validated by 14 nurses: physical symptoms, medications, administrative matters, and follow-up care. Interventions provided by the nurses were categorized into six groups: instructing patients; providing information; providing background knowledge; assuring the patients; referring to the patients to other ancillary departments; and delivering doctor's orders. Conclusions: Nurse interventions for a specific patient problem varied depending on the nurse providing the consultation. The participating nurses expressed the need for a common protocol for telephone consultations. Thus, it would be beneficial to develop a guideline for telephone consultations to minimize practice variations among nurses.

• Journal of Korean Clinical Health Science
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• v.3 no.1
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• pp.276-289
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• 2015

Purpose. To efficiently manage hospitals, this study aims to analyze the general characteristics, common-type balance sheet, common-type profit and loss statement and financial ratio of a tertiary general hospital and use the results as basic data for future hospital development by comprehending causes for problems and analyzing hospital management. Methods. By using information about a tertiary general hospital, located in A Metropolitan City, provided through Alio (www.alio.go.kr), a public organization information provider, Health Insurance Review & Assessment Service, and Ministry of Health and Welfare, this study used data during 3 years(2011 to 2013) by analyzing the general characteristics, common-type balance sheet, common-type profit and loss statement, industrial mean ratio and financial ratio of hospitals. Results. This study came to the following conclusions through the general characteristics, common-type balance sheet, common-type profit and loss statement, industrial mean ratio, financial ratio, circular chart and ROI by analyzing the data from 2011 to 2013. Conclusions. Overall, A Tertiary General Hospital showed an increase in fixed cost due to the construction of J Hospital and even in the size of capital and assets. It also showed an increase in medical profit, but the increase of its medical cost was higher, resulting in a financial loss. Especially, this hospital showed a slight decrease in net profit, featuring a reduction in inventory turnover. When the management of A Tertiary General Hospital was predicted based on such features, this hospital is expected to improve its profit structure through the opening of J Hospital, and it is necessary for this hospital to increase and sustain the turnover rate of inventories accumulated by managing them better.