• Asian Pacific Journal of Cancer Prevention
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• 제17권9호
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• pp.4341-4347
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• 2016

Background: Patient safety is one of the key components of nursing care for cancer cases. Valid and reliable context-based instruments are necessary for accurate evaluation of patient safety in oncology units. The aim of the present study was to develop and evaluate the psychometric properties of the Patient Safety Violation Scale in medical oncology units in Iran. Materials and Methods: In this methodological study, a pool of 58 items was generated through reviewing the existing literature. The validity of the 58-item scale was assessed through calculating impact score, content validity ratio, and content validity index for its items as well as conducting exploratory factor analysis. The reliability of the scale was evaluated by assessing its internal consistency and testretest stability. Study sample consisted of 300 oncology nurses who were recruited from thirteen teaching hospitals affiliated to Tehran University of Medical Sciences, Tehran, Iran. Results: Sixteen items were excluded from the scale due to having low impact scores, content validity ratios, or content validity indices. In exploratory factor analysis, the remaining 42 items were loaded on five factors including patient fall, verification of patientidentity, harm during care delivery, delay in care delivery, and medication errors. These five factors explained 62% of the total variance. The Cronbach's alpha of the scale and the test-retest interclass correlation coefficient were equal to 0.933 and 0.92, respectively. Conclusions: The 42-item Patient Safety Violation Scale is a simple and short scale which has acceptable validity and reliability. Consequently, it can be used for assessing patient safety in clinical settings such as medical oncology units and for research projects.

• 수산해양교육연구
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• 제25권5호
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• pp.1179-1191
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• 2013

Many sanitation control problems due to aging facilities and equipment were identified when applying an HACCP system to a flatfish (Paralichthys olivaceus) aquaculture farm. Specifically, the major problems included a lack of awareness about worker hygiene, lack of management of the use of fish medicines, and vulnerability to secondary contamination by cross-contamination owing to a failure to separate breeding tools used for healthy and unhealthy fish. Therefore, the management standards on the farm regarding the surrounding environment, facilities and equipment, breeding tools, feed and medication, and the hygiene of practitioners must be improved. The hygiene management standards were divided into different procedures such as the management of farm hygiene and environmental sanitation, facilities and equipment, fish hygiene, feed, medications, water, and the stocking and shipping of fish. For each procedure, we established the management standards, inspection period, inspection procedures, and how to deal with errors that occur, to enable hygiene management by a small number of managers. Additionally, an inspection system and record form to implement an HACCP system were developed to maintain systematic management. The management and inspection of all aspects of the farm were designed to be easily managed by the supervisor.

• Asian Pacific Journal of Cancer Prevention
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• 제17권4호
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• pp.2329-2336
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• 2016

Background: Despite the existence of established guidelines advocating the use and value of chemotherapy order templates, chemotherapy orders are still handwritten in many hospitals in Lebanon. This manuscript describes the implementation of standardized chemotherapy order templates (COT) in a Lebanese tertiary teaching hospital through multiple steps. Initial Assessment: An initial assessment was conducted through a retrospective appraisal of completeness of handwritten chemotherapy orders for 100 adult patients to serve as a baseline for the project and identify parameters that might afford improvement. Choice of solution: Development of over 300 standardized pre-printed COTs based on the National Comprehensive Cancer Network templates and adapted to the practice culture and patient population. Implementation: The COTs were implemented, using Kotter's 8-step model for leading change, by engaging health care providers, and identifying and removing barriers. Evaluation: Assessment of physicians' compliance with the new practice (122 orders assessed) was completed through two phases and allowed for the identification of areas of improvement. Lessons Learned: Overall, COT implementation showed an average improvement in order completion from 49.5% (handwritten orders) to 77.6% (phase 1-COT) to 87.6% (phase 2-COT) reflecting an increase of 38.1% between baseline and phase 2 and demonstrating that chemotherapy orders completeness was improved by pre-printed COT. As many of the hospitals in Lebanon are moving towards standardized COTs and computerized physician order entry (CPOE) in the next few years, this study provides a prototype for the successful implementation of COT and demonstrates their role in promoting quality improvement of cancer care.

• 한국의료질향상학회지
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• 제21권1호
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• pp.66-76
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• 2015

Objectives: The purpose of this study is to develop a case review form for detecting adverse events through a medical records review in hospitalized patients in South Korea. Methods: To develop the case review form, several literatures were reviewed, first. Through the clinical expert meeting, screening criteria were selected and case review form was developed. Result: The Korean version of case review form consisted of the review form-1 for adverse event screening and form-2 for adverse event identification. The applied methodology for the case review form is determined according to the previous studies. For example, the method used in the first stage review is nurse review. Furthermore, the National Coordinating Council for Medication Errors Reporting and Prevention index is used to categorize disability, and a scale of 1 to 6 was used in the causation scores and preventability scores, respectively. Through the clinical expert meeting, a total of 41 screening criteria were selected. Conclusion: The Korean specific case review form was developed for detecting adverse events in hospitalized patients. The results from this study can be used in a large-scale study regarding the nationwide incidence of adverse events.

• 임상간호연구
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• 제26권1호
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• pp.10-25
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• 2020

Purpose: The purpose of this study was to update the previously developed nursing practice guideline for enteral nutrition (EN). Methods: The guideline update was done in 22 steps using standardized methodology for nursing practice guidelines. Results: The updated EN guideline consisted of 16 domains and 228 recommendations. The domains and number of recommendations in each domain were for IDSA (Infectious Diseases Society of America): 8 on general instruction, 9 on general instruction for special nutrition, 9 on general instruction for EN, 3 on assessment of EN, 10 on access to EN, 18 on EN device insertion, 16 on selection and preparation of nutritional supplements, 46 on administration and stopping EN, 22 on maintenance and management of EN, 9 on monitoring EN, 16 on prevention and management of complications of EN, 18 on medication administration, 20 on EN in various situations, 20 on prevention of errors, 1 on nursing education, and 3 on nursing documentation. For the levels of evidence, there were 9.7% for level I, 13.1% for level II, 62.5% for level III and 1.1% for GRADE (Grading of Recommendations Assessment, Development and Evaluation): 3.3% for low, 0.8% for moderate, 9.3% for very low. A total of 133 recommendations were newly developed and 10 previous recommendations were modified. Conclusion: This updated EN nursing practice guideline can be used to enhance evidence-based practice in fundamentals of nursing practice and it should be disseminated to nurses nationwide in order to improve the efficiency of EN practice.

• 대한임상독성학회지
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• 제20권2호
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• pp.39-44
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• 2022

N-Acetylcysteine (NAC) is the standard antidote treatment for preventing hepatotoxicity caused by acetaminophen (AAP) poisoning. This review summarizes the recent evidence for the treatment of AAP poisoning. Several alternative intravenous regimens of NAC have been suggested to improve patient safety by reducing adverse drug reactions and medication errors. A two-bag NAC infusion regimen (200 mg/kg over 4 h, followed by 100 mg/kg over 16 h) is reported to have similar efficacy with significantly reduced adverse reactions compared to the traditional 3-bag regimen. Massive AAP poisoning due to high concentrations (more than 300-lines in the nomogram) needs to be managed with an increased maintenance dose of NAC. In addition to NAC, the combination therapy of hemodialysis and fomepizole is advocated for severe AAP poisoning cases. In the case of a patient presenting with an altered mental status, metabolic acidosis, elevated lactate, and an AAP concentration greater than 900 mg/L, hemodialysis is recommended even if NAC is used. Fomepizole decreases the generation of toxic metabolites by inhibiting CYP2E1 and may be considered an off-label use by experienced clinicians. Since the nomogram cannot be applied to sustained-release AAP formulations, all potentially toxic sustained-release AAP overdoses should receive a full course of NAC regimen. In case of ingesting less than the toxic dose, the AAP concentration is tested twice at an interval of 4 h or more; NAC should be administered if either value is above the 150-line of the nomogram.

• Journal of Acupuncture Research
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• 제21권2호
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• pp.1-20
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• 2004

Objective : The aim of this study was to investigate effects of Angelica gigas Nakai(AGN) on the ischemic injury by intraluminal filament insertion in the rats. Methods : The ischemia was induced by intraluminal filament insertion into middle cerebral artery. AGN herbal acupuncture into SP10 was carried out during 3 weeks after ischemic injury. Eight-arm radial maze was designed for the behavioral task. AGN herbal acupuncture showed neuroprotective agents in cresyl violet, acetylcholinesterase(AchE), choline acetyltransferase(ChAT) and nerve growth factor(NGF)-stain. Then check the effect of regional cerebral blood flow(rCBF) according to AGN herbal acupuncture in rats. Results : The errors in the eight-arm radial maze task were significantly decreased in normal group compared with control group on 1~6days, AGN2(0.02g/kg) herbal acupuncture group on 1~5days, AGN3(0.1g/kg) on 1~3days, AGN4(0.5g/kg) on 1, 3~6days. The rate of correct choice was significantly increased in AGN1(0.01g/kg) and AGN4 herbal acupuncture groups. The density of neurons in the hippocampal CA1 was the most increased in normal group and AGN1, AGN3, AGN4 herbal acupuncture groups compared with control group. The density of AchE in the hippocampal CA1 had a tendency to increase in all the groups when they were compared with control group, but not significant. The density of ChAT in the hippocampal CA1 was significantly increased in normal group and AGN1, AGN4 herbal acupuncture groups compared with control group. The density of NGF in the hippocampal CA1 was significantly increased AGN4 herbal acupuncture group compared with control group. The rCBF was significantly increased in AGN1, AGN3 and AGN4 herbal acupuncture groups without the change of blood pressure. Conclusions : These results suggest that AGN herbal acupuncture can be used for controlling stroke in early stage as herbal medication.

• 한국의사학회지
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• 제15권1호
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• pp.63-146
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• 2002

Huh-Im(許任, 1570~1647) was an acupuncture doctor of Chosun(朝鮮) era through the late 16th century and early 17th century. Even though he was a person of low birth, he participated in the loyal medication through three loyal generations, Sunjo(宣祖), Kwanghaegun(光海君) and Injo(仁祖). He was recognized of his services and became an official, 'Dangsanggwan'(堂上官) and Kyunggi(京畿) district official several times. In the early Chosun era, acupuncture medicine was focused. During the late 16th century, Imjin(壬辰) war aroused more needs about acupuncture medicine, and acupuncture doctors showed remarkable work. Under these circumstances, Huh-Im(許任)'s fame spread throughout the country. Huh-Im(許任) wrote ChimGuKyungHumBang("鍼灸經驗方") in 1644 based on his lifetime clinical acupuncture & moxibustion experience. It was the first specialized book of acupuncture in Chosun era. This event took place 30 years after DongEuiBoGam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") was published. But it was not influenced much by DongEuiBoGam - Acupuncture Chapter("東醫寶 鑑-鍼灸篇") in the form or contents. ChimGuKyungHumBang("鍼灸經驗方") and Huh-Jun(許浚)'s DongEuiBo- Gam - Acupuncture Chapter("東醫寶鑑-鍼灸篇") were the fruits of the middle Chosun, and they are complementary to each other in theory and practice. The chief distinctions of ChimGuKyungHumBang("鍼灸經驗方") are in it's compact and practical edition and a lot of his clinical acupuncture prescriptions mentioned in the book. Huh-Im(許任) not only accepted the existing books such as NaeKyung("內經"), DongInSuHyulChimGuDoKyung and Shin- Eung Kyung("神應經") with his point of view and clinical experience, but also showed creative operation of studies. Indicating incorrect acupuncture points(訛穴), acupuncture remedy based on the visceral pathogenesis(臟腑病機) and the channel pathogenesis, research on new acupuncture points, sorting out plenty of outer meridian acupuncture points(經外奇穴), creating supplementary and purging acupuncture method(鍼補瀉法) which is a change of hand treatment of KiHyoYangBang("奇效良方"), operating variety of acupuncture and moxibustion treatments, and application of acupuncture treatments on surgery field such as intumescences and emergency cases are the examples. Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") influenced on the folk remedy books(民間經驗方書) in the late Chosun era. Compact and practical characteristics of the book let acupuncture treatment be freindly to the people. It can be confirmed in JeungBoSanRimKyungJe-Emergency Chapter("增補山林經濟-救急篇") or the formation of SaAmChimBob(舍巖鍼法). ChimGuKyungHumBang("鍼灸經驗方") was introduced to Japan in 18th century and published twice. ChimGuJibSung("鍼灸集成"), known as an acupuncture medical book of late Qing dynasty(淸末, 1874), is confirmed to be an plagiarization of DongEuiBoGam-Acupuncture Chapter("東醫寶鑑-鍼灸篇") and ChimGuKyungHum- Bang("鍼灸經驗方") of 17th century Chosun. Confusions and errors arouse from mistaken editional trend of ChimGuJIbSung("鍼灸集成") which had not disclosed it's original author and the title of the book must be reformed. In this way, fruits of acupuncture of the middle Chosun era including Huh-Im(許任)'s ChimGuKyungHumBang("鍼灸經驗方") will take a right place in acupuncture medicine history.