Hyun, Sookyung;Moffatt-Bruce, Susan;Newton, Cheryl;Hixon, Brenda
International Journal of Advanced Culture Technology
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v.7
no.2
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pp.28-33
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2019
Electronic health records (EHRs) enable us to use and re-use electronic data for various multiple purposes, such as public reporting, quality improvement, and patient outcomes research. Current hospital-acquired pressure injury (HAPI) risk assessment instruments have not been specifically developed for intensive care unit (ICU) patients and showed false positive rates in this specific populations. Previous research studies report a number of risk factors; however, it is still not clear what factors influence ICU HAPI in this population. As part of a larger research study, we performed an exploratory analysis by using a large electronic health record data. The aims of this study were to compare characteristics of patients who developed HAPIs during their ICU stay with those who did not, and to determine whether the two groups were different in the aspects of length of ICU stay, discharge disposition, and discharge destinations. We conducted chi-square test and t-test for group comparison. Association was examined by using bivariate analyses. Pearson correlation coefficients were used to examine correlation between LOS and number of medications. Our findings suggest a number of consistent and potentially modifiable risk factors, such as sedation, feeding tubes, and the number of medications administered. The mortality of the HAPI group was significantly higher than the non-HAPI group in our data. Discharge disposition was significantly different between the groups. 67% of the HAPI group transferred to intermediate or long-term care hospitals whereas 57.7% of the non-HAPI group went home after discharge. Awareness of these risk factors can lead to clinical interventions that can be preventative in the ICU setting.
Purpose: The purpose of this study was to explore and describe the essence of hospital life concerning discharge from rehabilitation facility as defined by clients with complete quadriplegia. Method: This was a qualitative research using Giorgi's descriptive phenomenology. Four participants with complete quadriplegia were participated. Results: The lived experience of discharge from rehabilitation facility among clients with complete quadriplegia was structured by 10 components and was defined as a life event which those patients felt fears and worries to leave the therapeutic environment and to return to their community with various changes due to their disability. During their hospital stay, the patients with quadriplegia were concerning to prepare proper living conditions and their health conditions so that they could keep their life independent and worthy. They also cherished a hope for cure for their cervical injury even at the moment of discharge. Conclusion: This study suggests developing a discharge program which relieves the clients' emotional burden for discharge from inpatient rehabilitation facility and helps them to take an active role in preparing for returning to their daily life.
Purpose: The aim of this study was to investigate the risk factors for brain reperfusion injury in ischemic stroke patients and to analyze the clinical outcomes. Methods: A retrospective study was conducted in 168 patients who underwent mechanical thrombectomy. The data were analyzed using descriptive statistics, t-test, Mann-Whitney U test, Chi-Square test, Fisher's exact test, and logistic regression with IBM SPSS/WIN 24.0. Results: Brain reperfusion injury occurred in 67 patients (39.9%) with a low favored outcome (𝛘2=6.01, p=.014). On multivariable analysis, blood urea nitrogen (Odds ratio [OR]=1.14, 95% Confidence interval [CI]=1.06-1.23), aphasia (OR=6.16, CI=1.62-23.40), anosognosia (OR=4.84, CI=1.13-20.79), presence of both aphasia and anosognosia (OR=7.33, CI=1.20-44.60), and time required to achieve targeted blood pressure (OR=1.00, CI=1.00-1.00) were identified as risk factors for brain reperfusion injury. A statistically significant difference was detected in clinical outcomes, including hemorrhagic transformation (𝛘2=6.32, p=.012), intensive care unit length of stay (Z=-2.08, p=.038), National Institute of Health Stroke scale score at discharge (Z=-3.14, p=.002), and modified Rankin Scale score at discharge (Z=-2.93, p=.003). Conclusion: This study identified the risk factors and presented the clinical outcomes of brain reperfusion injury. It is necessary to consider these risk factors for evaluating the patients and to establish nursing interventions and strategies.
Ahmad Hammad Hassan;Aref-Ali Gharooni;Harry Mee;James Geffner;Fahim Anwar
Journal of Trauma and Injury
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v.36
no.1
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pp.39-48
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2023
Purpose: Sports offer several health benefits but are not free of injury risk. Activity dynamics vary across sports, impacting the injury profile and thereby influencing healthcare resource utilization and health outcomes. The purpose of this study was to investigate sports-related major trauma cases and compare differences across sports and activity groups. Methods: A retrospective case notes review of sports-related major traumas over a 5-year period was conducted. Demographic, hospital episode-related, and health outcome-related data were analyzed, and differences were compared across sports and activity groups. The Glasgow Outcome Scale (GOS) at discharge was used as the primary outcome measure and the length of hospital stay as the secondary outcome measure. Results: In total, 76% of cases had good recovery at discharge (GOS, 5), 19% had moderate disability (GOS, 4), and 5% had severe disability (GOS, 3). The mean length of hospital stay was 11.2 days (range, 1-121 days). The most severely injured body region was the limbs (29.1%) and vertebral/spinal injuries were most common (33%) in terms of location. A significant difference (P<0.05) existed in GOS across sports groups, with motor sports having the lowest GOS. However, no significant differences (P>0.05) were found in other health-outcome variables or injury patterns across sports or activity groups, although more competitive sports cases (67%) required admission than recreational sports cases (33%). Conclusions: Spinal injuries are the most frequent sports injuries, bear the worst health outcomes, and warrant better preventive measures. Head injuries previously dominated the worst outcomes; this change is likely due to better preventive and management modalities. Competitive sports had a higher injury frequency than recreational sports, but no difference in health outcomes or injury patterns.
This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.
International journal of advanced smart convergence
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v.11
no.1
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pp.127-133
/
2022
This study aims to find out the associative relationship between dementia and comorbidities. To conduct this study, we used KNHDIS(Korea National Hospital Discharge In-depth Injury Survey) data from 2009 to 2018 provided by the KDCA(Korean Disease Control and Prevention Agency) annually. We used MySQL for data preprocessing and R for data analysis. As a result of applying the Apriori algorithm criteria of support(≥0.01), confidence(≥ 0.6), and lift(>1), seventeen rules related to dementia were discovered. The diseases associated with dementia were diabetes mellitus, hypertension, disorders of lipoprotein metabolism, glomerular disorders in diabetes mellitus, renal diseases, cardiovascular disease, cerebrovascular disease, and other urinary system disorders. This study can be utilized as primary data for the care of patients with dementia and provides implications for improving effective dementia prevention policies.
Journal of Korean Academy of Nursing Administration
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v.2
no.2
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pp.43-57
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1996
The purpose of this research conducted has been an the development of a computer program to be used for nursing of spinal cord injury patients. The research is also intended to contribute by supplying the basic data, to the development of other programs in relevant areas where similar nursing information system is required. This research used System Development Life Cycle method. Results from the study were as follows : The scope of Information System in nursing practice were based on a wide range of mateials as charts at four hospitals in Pusan that cover the nursing period of spinal cord injury patients from admission to discharge and other sources of reference, the research is done for nursing diagnosis, nursing history, admission and discharge education, and the performing of doctor's order, which were divided into a subsystem that consisted of help, Patient Management, Performing of Docter's Order, and Basic Data Management and then these was analysed systematically using Hierachy Plus Input Process Output, necessary information, data flow diagram, and conceptual designs were developed for chosem system. Furthemore, the system has been programed by a conceptual design that includes the objects of the program and the origins of the sources. The oder to make sure of the proper function, the computer program was actually applied to a nursing practice that had been developed for a hypothetical situation through the two nurses who were in charge of spinal cord injury patients after they were trained to understand the structure and the contents of computer program about the nursing practice from using the computer program developed. Also, the compensatory strategy has been worked out against any problems to arise. It is expected that this kind of nursing practice information system to be used for the spinal cord injury patients that has been developed through the processes shown above will increase the satisfaction for both patients and nurses by enabling them to give more professional advice and service to the development of more information systems for many hospitals.
This study selected in-depth discharge damage survey data and analyzed 92,364 patients whose main diagnosis was S00-T98 (damage, addiction, and specific other results due to external factors) based on the Korean Standard Classification of Diseases and Deaths (KCD-7th) among patients discharged from the hospital after inpatient treatment from January 2016 to December 2018. As a result of analyzing the general characteristics of injured and traumatic patients, the incidence rate of men was higher in gender, and the incidence rate of women increased as the year increased. As a result of analyzing the characteristics of injury and trauma patients other than injury, the injury intention had a high rate of unintentional damage, the damage place was the highest on the road/road, and it showed a decreasing trend as the year increased, and it showed an increasing trend in the residential area. It can be used as basic data for the establishment of a related system to prevent damage as a result of subsang.
The purpose of this study was to analyze the relationship between maternal attachment and discharge against advice in high risk infants and determine the factors which affect discharge against advice. Data of this study were collected by means of reviewing the medical records of 127 in-patients who were diagnosed as high risk infants in admission and interviewing of the mothers of these patients was done by telephone. The high risk categories were neonatal hyperbilirubinemia, congenital anomaly, congenital heart disease, blood disorder, neonatal infection and birth injury. Maternal attachment was measured by deviding the subjects into 2 groups, the one the continuing treatment group and the other the discharge against advice group. Maternal attachment is determined by an interplay of maternal attitude and specific infant behaviors. Maternal attachment developes through continuous physical and psychological contact between mother and infants. Later it developes into maternal love. The results were as follows: 1. There was a significant association between maternal attachment and discharge against advice, that is, the attachment score was higher in the continuing treatment group. 2. Inspite of controlling medical insurance, severity of disease and the length of stay, it was found that there continued to be either a partially significant or fully significant relationship between maternal attachment and discharge against advice. Stepwise multiple regression revealed that maternal attachment was second in importance as a predictor of discharge against advice, which indicates that maternal attachment was a significant predictor of discharge against advice. 3. Stepwise multiple regression revealed that in 32.3% of these cases the significant predictors of discharge against advice were length of stay, maternal attachment, delivery type, feeding type and income.
Journal of the Korea Academia-Industrial cooperation Society
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v.13
no.2
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pp.747-754
/
2012
The purpose of this study was to compare inter-regional accident modes using the National Hospital Discharge Patient Injury Survey. In order to determine economic status of each region, 234 cities and counties were categorized as 5 groups according to their financial self-reliance ratio. The main results are as follows. First, transport accidents had increased by the age group of 25 to 44 but decreased thereafter. Second, the frequency of car accidents was the highest among several types of transport accidents. Most common site of transport accidents was roads and highways. Third, there was significant difference in the modes of transport accident among regions. Fourth, emergency admission rate was quite different according to regional groups but it was no significant difference by economic status. Lastly, there was significant difference in injury patterns by region groups. In regions which were high economic status, there were relatively less serious injury patterns such as sprain, strain, dislocation while regions which were in low economic status had experienced serious injury including fracture, stab wound, and open fracture. We could find the difference in accident modes by regional economic status. Therefore, health authority should consider different accident prevention strategies by regional groups.
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