• Title/Summary/Keyword: multiple admissions

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Appropriateness of Admissions in the Emergency Room of a Tertiary Hospital (응급실 방문 환자의 입원의 적절성에 영향을 미치는 요인)

  • Cho, Hong-Jun;Lee, Sang-Il
    • Quality Improvement in Health Care
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    • v.2 no.1
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    • pp.58-67
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    • 1995
  • Background: This paper describes an effort to provide baseline informations for appropriate utilization of emergency room in a tertiary hospital. Methods: Authors have evaluated that the admissions in the emergency room were medically necessary by objective criteria, Appropriateness Evaluation Protocol(AEP), for one month in a tertiary hospital. Data were analysed by chi-square test and multiple logistic regression to exmaine statistical significances at the level of 0.05. Results: The prevalence of inappropriate decisions for admission was found to be 47.8%(154/322). Whether the physician decided the patient to admit or not was affected by type of services, number of departments involved, patients' medical condition, route of visit, and a day of the week visited. Level of appropriateness of admission is significantly related to patients' age, type of services, and a day of the week visited. Conclusion: We found that substantial proportion of admissions through emergency room are medically unnecessary and that non-medical factors are related to physician's for admission decisions and level of appropriateness of admission. This suggests that policy measures be required to relieve the overcrowding problem and to reduce non-emergent utilization of emergency room in a tertiary hospital.

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A Case of Liver Abscess in A Child (소아에서 발병한 간농양 1예)

  • Oh, Seung-Taek;Choi, Kwang-Hae
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.72-77
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    • 2008
  • Liver abscess in children is rare in developed countries; the incidence is 25 per 100,000 admissions in USA. Common complications are pleural effusion, empyema, pneumonitis, hepatopleural or hepatobronchial fistula, intraperitoneal or intrapericardiac rupture, septic shock, cerebral amebiasis, etc. These complications may lead to death if the management is delayed. However, recent management results in a mortality of less than 15%. We report a case of liver abscess in a child. He manifested with fever and abdominal pain in the right upper quadrant. On computerized tomography scans, multiple cystic lesions were seen in both lobes of the liver and were 5 to 55 mm in size. In laboratory findings, neutrophilic leukocytosis, peripheral eosinophila, elevated values of ESR, C-reactive protein, and elevated serum AST, ALT, ALP and GGT were detected. Furthermore, we determined the organisms in the blood culture and serum. Blood culture was positive for Streptococcus spp., and amebic indirect hemagglutination antibody titer was increased to 1:512.

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Recurrent Bacterial Meningitis Secondary to Cochlear Aplasia, Right and Acquired Cribriform Plate Defect due to Trauma (두개골의 결손과 동반된 재발성 세균성 뇌막염 2례)

  • Chang, Soo Hee;Kim, Sun Jun;Kim, Jung Soo
    • Pediatric Infection and Vaccine
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    • v.5 no.2
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    • pp.283-288
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    • 1998
  • Recurrent meningitis in children is not only a potentially life threatening condition, but often involves the child in the trauma though repeated hospital admissions and multiple invasive investigations to find the underlying causes. Symptoms and signs of CSF rhinorrhea or otorrhea are infrequent in these patients and difficult to diagnose in young children. All young children treated for meningitis should then be administered an evoked potential audiometry as a post-treatment test. If sensorineural hearing loss is identified, the clinician should be alerted to the possibility of CSF leakage as the cause of the meningitis. Radiologic studies should be performed to rule out preexisting congenital, or acquired, abnormalities requiring surgical exploration. Two young children with recurrent meningitis due to a right cochlear aplasia and a cribriform plate defect caused by trauma are presented to illustrate the problems of diagnosis and management. A review of literatures will also be presented briefly.

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Single Center Experience on Causes of Cancer Patients Visiting the Emergency Department in Southwest Turkey

  • Tanriverdi, Ozgur;Beydilli, Halil;Yildirim, Birdal;Karagoz, Ulku
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.687-690
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    • 2014
  • Background: Emergency departments are visited by cancer patients for palliation of cancer-related symptoms, management of treatment-related side effects, oncologic emergencies, co-morbidities, and/or end of life care. In this study, we aimed to identify the characteristics of cancer patients admitted to an emergency medicine department in Southwest Turkey. Materials and Methods: In this retrospective descriptive study, a total of 304 emergency department admissions of 102 patients with cancer due to medical conditions were evaluated. Descriptive statistical methods, statistical analysis for correlation, Student's t-test, chi-square tests and logistic regression test were used. Results: The majority of patients visiting to emergency departments were male (n=66, 65%) and over 65 years of age (53, 52%). Some 30% (n=31) had a lung cancer diagnosis, 32% (n=33) presentation with dyspnea, 53% (n=55) with metastasis, 30% (n=16) with multiple metastatic lesions in lung, and 68% (n=70) had a poor ECOG performance status (score 3 to 4). Conclusions: Emergency departments have valuable roles in managing and caring for patients with malignancies.

Length of hospital stay among oral and maxillofacial patients: a retrospective study

  • Tan, Fo Yew;Selvaraju, Kalpana;Audimulam, Harshinie;Yong, Zhi Chuan;Adnan, Tassha Hilda;Balasundram, Sathesh
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.47 no.1
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    • pp.25-33
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    • 2021
  • Objectives: Many conditions of the oral and maxillofacial region require hospitalization and in-patient care. The average length of stay (LOS) of these patients varies and is usually affected by multiple confounding variables. However, even with an increasing number of hospital admissions, published evidence on the factors that affect the LOS of oral and maxillofacial patients is lacking. Therefore, this study assessed the LOS of in-patients at the oral and maxillofacial surgery department of a government-funded, multi-specialty hospital in Malaysia, based on their reasons for admission and other factors. Materials and Methods: Our samples were collected retrospectively over a 5-year period and included patients with maxillofacial infections, post-trauma stabilization, facial bone fracture surgery, benign and malignant lesion surgery, dentoalveolar surgery, and other maxillofacial surgeries as reasons for admission. Factors potentially affecting LOS were also recorded, and their significance was determined using multiple logistic regression analyses. A P-value of less than 0.05 was considered to be statistically significant. Results: A total of 1,380 patients were included in this study. Most (84.5%) of our in-patients were of Malay ethnicity, and males outnumbered females in our sample by 502 subjects. The median LOS of our in-patients was 3 days. Sex, ethnicity, age, reason for admission, and American Society of Anesthesiology (ASA) classification were factors that significantly affected LOS. Conclusion: The median LOS reported in this study was 3 days. LOS was significantly affected by sex, ethnicity, age, reason of admission and ASA classification.

The Influence of Interpersonal Relationship and Communication Competence of Nursing Students who took Blended Learning on the Adjustment to College Life (블렌디드 러닝 수업을 받은 간호대학생의 대인관계와 의사소통능력이 대학생활적응에 미치는 영향)

  • Shin, Eun Sun
    • The Journal of the Korea Contents Association
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    • v.22 no.10
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    • pp.392-403
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    • 2022
  • The purpose of this study is to investigate the effect of interpersonal relationships and communication skills of nursing students who received blended learning classes on adjustment to college Life. The subjects of this study were 133 first and second year nursing students. The survey was conducted from november 22th to december 3th. 2021. The data was analyzed with the SPSS/WIN 26.0 program. Descriptive statistics and meen differences were analyzed using an t-test, ANOVA, Pearson's correlation coefficient, Multiple regression. The result adjustment to college life of interpersonal relationship, communication competence it was found that there was a significant positive correlation between. The factors of communication competence, interpersonal relationship, Nursing and admissions motivation were impact on the adjustment to college life level of nursing students. The explanatory power of this was 44.3%. In conclusion, a strategy for improving communication skills and smooth interpersonal relationships is needed so that nursing students who have received blended learning can adjustment to college life.

Nosocomial Infection in Neonatal Intensive Care Unit (신생아 중환자실의 원내 감염 추이)

  • Kwon, Hye Jung;Kim, So Youn;Cho, Chang Yee;Choi, Young Youn;Shin, Jong Hee;Suh, Soon Pal
    • Clinical and Experimental Pediatrics
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    • v.45 no.6
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    • pp.719-726
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    • 2002
  • Purpose : Neonates in neonatal intensive care units(NICU) have a high risk of acquiring nosocomial infection because of their impaired host defence mechanism and invasive procedures. Nosocomial infection result in considerable morbidity and mortality among neonates. This study was carried out to survey both the epidemiology of nosocomial infection in our NICU and the annual trends of pathogens. Methods : We retrospectively reviewed culture proven nosocomial infection which occurred in our NICU from January 1995 to December 1999. The data included clinical characteristics, site of infection, pathogens, and mortality. Results : Nosocomial infection rates was 9.0 per 100 NICU admissions during the five-year period. Major sites of infection were bloodstream(32.3%), skin(18.4%), endotracheal tube(17.2%), and catheter(10.6%). The most common pathogen was S. aureus(29.9%). and the others were coagulase- negative staphylococci(CONS)(14.8%), Enterobacter(12.4%), and Candida(9.0%). During the five-year period, nosocomial infection rates increased from 9.5 to 11.6 per 100 admissions with the increase of CONS, Candida, Klebsiella, and Acinetobacter baumannii. The infection rate of S. aureus decreased. Multiple episodes of nosocomial infection occurred in 26.1% of all nosocomial infections. Overall bloodstream infection rates were 3.6 per 100 NICU admissions during five years. CONS(29.1%) and S. aureus(27.1%) were the two most common pathogens. Increasing rates of bloodstream infection by CONS, Candida, Klebsiella, and Acinetobacter baumannii were observed. Bloodstream infection related mortality was 11.9%. Conclusion : The predominant pathogens of nosocomial infection in NICU were S. aureus and CONS. Bloodstream infection, the most frequent nosocomial infection, should be a major focus of surveillance and prevention efforts in NICU.

Medication Status and Adherence of the Elderly under Home Care Nursing (가정간호 노인대상자의 처방약물복용 실태 및 복용 이행도 영향요인)

  • Kim, Young-Hee;Lee, Mi-Kyoung;Lee, Sung-Ja;Cho, Myung-Sook;Hwang, Moon-Sook
    • Research in Community and Public Health Nursing
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    • v.22 no.3
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    • pp.290-301
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    • 2011
  • Purpose: This study is a descriptive research intended to clarify the medication status of community-dwelling elders and to identify factors affecting their medication adherence. Methods: Data were collected using questionnaires and interviews from 101 subjects who had taken prescribed drugs for at least 7 days sampled among elderly people using home care nursing at a general hospital in Seoul. Results: According to the results of this study, medication adherence measured by pill counting was 88.3% and that measured by self-reporting was 94.6%. There were statistically significant differences in medication adherence according to major disease (p=.006), the number of admissions (p=.032), the number of drugs (p=.051), the frequency of medication (p=.026), and depression (r=-.205). In addition, depression was found to be a significant variable explaining the medication adherence with explanatory power 3.8% (p=.035). Conclusion: The presence of depression affected the elderly subjects' the medication adherence. Therefore, more concern and educational approaches are required to encourage elderly people to comply correctly with medication regimens particularly for elderly patients who have a malignant or long-lasting disease or who have to take multiple drugs or maintain a daily dosing frequency.

Statistical Analysis of Private Education Expenses in Korea (초·중·고생의 사교육비 지출에 대한 통계 분석)

  • Oh, Man-Suk;Kim, Jin-Hee
    • The Korean Journal of Applied Statistics
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    • v.24 no.1
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    • pp.193-206
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    • 2011
  • Due to the great impact of private education expenses on many areas including economics and politics, reducing private education expenses is one of the key issues in Korea. In this paper, we analyze the data from a survey on private education expenses, conducted by Statistics, Korea, in 2008. We study the effect of some demographic variables on two dependent variables, the expenses for out-of-school private education (Private) and the expenses for after-school programs (Afterschool), by using a multiple linear regression model. The analysis results show that 'residential area' and 'school level' variables have a significant effect on the two dependent variables. 'Private' increases in the order of small town, middle town, or metropolitan city, and Seoul, by about 7%. On the other hand, 'Afterschool' are about the same for all areas except for the small town. In terms of the effect of 'school level', 'Private' for high school students is about 17% larger than all other students including professional high school students. This shows a strong correlation between university admission and private education, in Korea. 'Afterschool' is larger for high school and elementary school students and decreases in the order of professional school students and middle school students. It seems that after-school programs are alternatives to expensive private education programs for elementary school students, and that high school students are attracted to after-school programs to get a good GPA, which is important for university admissions.

A Study of the Anxiety Levels of Hospitalized Psychiatric Patients in Terms of Length of Hospitalization (정신과 입원환자의 입원기간에 따른 불안정도에 관한 연구)

  • 김윤희
    • Journal of Korean Academy of Nursing
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    • v.11 no.1
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    • pp.45-63
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    • 1981
  • This study was done to determine the relationship between the anxiety levels of hospitalized psychiatric patients and various influencing variables. The purpose of this study was to determine factors that may help hospitalized psychiatric patients to experience lower levels of anxiety in relation to changing situations and provide the basic data for a dynamic approach which is important in the field of modern psychiatric nursing that understands and analyses the meaning of patients behavior. The anxiety may produce stress, which is a common experience among all human beings. Patients may merely feel uncomfortable in the state of mild anxiety, however, the severe state could be an obstacle to treatment and recovery from disease. The anxiety of the psychiatric patient is a factor which greatly influencing the patient's behavior, so his disorderd behavior is an expression of defence or pathologically fixed behavior. According the psychiatric patient's anxiety at the time of admission is the concern of the health team. The nurse's special concern has to do with understanding and supporting the patient and meeting his individual needs by frequent close contact during the entire hospitalization period, compared to other teamembers the nurse's responsibility in this regard is greated. So this study emphasizes the necessity of creating conditions these, but above all the psychiatric nurse should create a therapeutic environment by not only regarding the patient's behavior or symptoms but understanding the meaning of them. The subjects of this study were 57 psychiatric patients selected from the K neuropsychiatric hospital located in Kunsan city. Data were collected twice from the same patients within a 24 hour period after admission and 10 days after admission. (September 18th to November 8th, 1980). The data collected method was through direct interview, and the interview time was 20 minutes for each patient. Data analysis included Item Analysis & Internal Consistency Reliability Tests, Percentages, t-test, analysis of variance and stepwise multiple regression analysis. The findings of this study were as follows. A. Test of Hypothesis a. Hypothesis 1 :“The anxiety level of psychiatric patients within 24 hours after admission will be higher than those of the same patients 10 days after admission,”was accepted. (t = 3. 15 ; p < 0.005) b. Hypothesi 2:“The more the number of admissions the higher the level of anxiety related to two categories”, was accepted. (affective anxiety: F = 5.50, p < 0.005, Somatic anxiety: F = 9.12, p <.

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