• Title/Summary/Keyword: patient assessment

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Clinical Assessment of Pain and Sensory Function in Peripheral Nerve Injury and Recovery: A Systematic Review of Literature

  • John, Albin A.;Rossettie, Stephen;Rafael, John;Cox, Cameron T.;Ducic, Ivica;Mackay, Brendan J.
    • Archives of Plastic Surgery
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    • v.49 no.3
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    • pp.427-439
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    • 2022
  • Peripheral nerve injuries (PNIs) often present with variable symptoms, making them difficult to diagnose, treat, and monitor. When neurologic compromise is inadequately assessed, suboptimal treatment decisions can result in lasting functional deficits. There are many available tools for evaluating pain and functional status of peripheral nerves. However, the literature lacks a detailed, comprehensive view of the data comparing the clinical utility of these modalities, and there is no consensus on the optimal algorithm for sensory and pain assessment in PNIs. We performed a systematic review of the literature focused on clinical data, evaluating pain and sensory assessment methods in peripheral nerves. We searched through multiple databases, including PubMed/Medline, Embase, and Google Scholar, to identify studies that assessed assessment tools and explored their advantages and disadvantages. A total of 66 studies were selected that assessed various tools used to assess patient's pain and sensory recovery after a PNI. This review may serve as a guide to select the most appropriate assessment tools for monitoring nerve pain and/or sensory function both pre- and postoperatively. As the surgeons work to improve treatments for PNI and dysfunction, identifying the most appropriate existing measures of success and future directions for improved algorithms could lead to improved patient outcomes.

Right Pneumonectomy in a Patient with Poor Pulmonary Function (폐 기능이 불량한 환자에서의 우측 전폐절제수술)

  • 주석중
    • Journal of Chest Surgery
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    • v.25 no.11
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    • pp.1218-1220
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    • 1992
  • Pneumonectomy on a patient with documented poor pulmonary function indicating a contraindication to surgery can be associated with a high risk of serious postoperative morbidity or mortality. However the usual criterias, on the performance of a pneumonectomy on a high risk patient based on the preoperative assessment of the pulmonary function may not sometimes predict with accuracy the operative outcome in the postoperative period. We recently performed pneumonectomy with good results on a patient with poor pulmonary function that would otherwise have been an absolute contraindication to surgery by usual criteria.

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Impact of Nurse Staffing Level and Oral Care on Hospital Acquired Pneumonia in Long-term Care Hospitals (요양병원의 간호인력 확보수준과 구강간호 실시여부가 노인 환자의 폐렴발생에 미치는 영향)

  • Chae, Jung Mi;Song, Hyunjong;Kang, Gunseog;Lee, Ji Yun
    • Journal of Korean Academy of Nursing Administration
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    • v.21 no.2
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    • pp.174-183
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    • 2015
  • Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.

A Clinical case study for the diagnosis and assessment of abdominal cold hypersensitivity treatment by DITI (적외선 체열검사(DITI)로 복부냉증의 진단과 치료 경과를 평가한 단일 임상례)

  • Kim, Eun-Gyung;Hwang, Deok-Sang;Lee, Chang-Hoon;Lee, Kyung-Sub
    • Journal of Oriental Medical Thermology
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    • v.7 no.1
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    • pp.55-65
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    • 2009
  • Purpose: This study was performed to evaluate DITI (Digital Infrared Thermographic Imaging)'s potential for diagnosis and indicator of abdominal cold hypersensitivity treatment from the clinical case study. Methods: The patient was a 35-year-old woman who was suffered by general coldness, sweating and general pain. The patient was treated by Herb medicine, Acupuncture treatment, Moxa treatment and Physical Treatment. The progress of symptoms was evaluated by checking the change of VAS, and inspecting the DITI. We studied the statistical significance from the difference of DITI results before and after treatment by paired T-test using SPSS windows (version 12.0). Results: The general coldness, sweating and general pain of this patient have declined, especially the abdominal coldness improvement showing. As a results, the temperature of four abdominal sites(GV4,6,12,17) after treatment were statistically higher than those before treatment. With comparison of Indang, DITI difference of abdominal sites before and after treatment were statistically significant from paired T-tests. Conclusion: The results suggest that DITI can be used for the diagnosis and assessment of abdominal cold hypersensitivity treatment.

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The Opinion of Experts and Stakeholder on Introduction of Orphan or Anticancer Drugs Funding Program (희귀질환 약제, 항암제 별도 기금 도입에 대한 약제급여 결정 전문가와 이해관계자 시각)

  • Kim, Sujin;Jung, Seungyeon;Kim, Dong-Sook
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.3
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    • pp.177-184
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    • 2020
  • Background & objective: The Korean government has expanded its benefit coverage to enhance patients' access to orphan drugs and cancer medicines. However, the number of new drugs whose indications were not applied to reimbursement in health insurance was increased. This study aimed to understand the perspectives of experts and various stakeholders on the introduction of a new funding program for cancer treatment and orphan drugs. Methods: We conducted email surveys comprising 19 questions, from September 9 to 26, 2016. We distributed questionnaires to members of the Pharmaceutical Benefit Appraisal Committee and Cancer Assessment Committee. We also conducted a qualitative study through group interviews with stakeholders, including pharmaceutical companies and some patient groups for diseases. Results: A total of 35 survey respondents recommended the introduction of a funding program for orphan drugs, whereas 66% recommended the launch of funding for anticancer drugs. In addition, most pharmaceutical companies and patient groups recommended the introduction of new funding programs targeting patients with cancer and rare diseases. However, some participants asserted that it would be more appropriate to modify the existing reimbursement scheme than launch new funding. Conclusion: This study concluded that introducing new funding needs a social consensus to relieve financial hardships at the patient level.

Development and Application of Simulation Learning Scenario using Standardized Patients: Caring for Neurological Patients in Particular (표준화 환자를 활용한 시뮬레이션 학습시나리오 개발 및 적용 : 신경계 환자 간호를 중심으로)

  • Kim, Ye-Eun;Kang, Hee-Young
    • The Journal of the Korea Contents Association
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    • v.13 no.11
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    • pp.236-248
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    • 2013
  • This study was to develop the simulation learning scenario using standardized patients, and to evaluate the effect of it. This study was a pre-post test design with a single group and participants were recruited from fourth-year nursing students at a university. This study has developed the case scenario for a patient with spontaneous intracerebral hemorrhage and the simulation learning using standardized patients, which was applied in this study, had improved problem solving ability and clinical performance ability on nursing students. Through this study, the nursing student will grow up to be a professional nurse by learning the nursing assessment including consciousness assessment. Also, the simulation learning scenario using standardized patient should be developed in the various fields.

Experience of ReCell in Skin Cancer Reconstruction

  • Gilleard, Onur;Segaren, Nicholas;Healy, Ciaran
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.627-629
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    • 2013
  • The ReCell system (Avita Medical) is a cell culture product that allows the immediate processing of a small split-thickness skin biopsy to produce a complete population of cells including keratinocytes, melanocytes, Langerhans cells and fibroblasts. This series is the first to highlight the reconstructive applications of ReCell following ablative skin cancer surgery. The ReCell system was utilized for three patients following skin cancer excision. In two cases, the cells were applied to forehead flap donor sites following nasal reconstruction. In one case, the cells were applied to the calvarial periosteum following wide local excision of a melanoma scar. Assessment of the treated area was performed using the patient and observer scar assessment scale after 1 year. The Patient and Observer Scar Assessment Scale (POSAS) scores for the 2 patients treated with ReCell following forehead flap surgery were 22 and 32. The score for the patient that underwent wide local excision of a melanoma scar was 45. The absence of a donor site, accelerated healing and the satisfactory aesthetic appearance of the mature scars in this series suggest that ReCell may play a useful role in reconstruction following skin cancer excision.

Development of a Tele-Rehabilitation System for Outcome Evaluation of Physical Therapy

  • Park, Hyung-Soon;Lee, Jeong-Wan
    • Journal of Biomedical Engineering Research
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    • v.29 no.3
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    • pp.179-186
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    • 2008
  • This paper presents a portable tele-assessment system designed for remote evaluation of the hypertonic elbow joint of neurologically impaired patients. A patient's upper limb was securely strapped to a portable limb-stretching device which is connected through Internet to a portable haptic device by which a clinician remotely moved the patient's elbow joint and felt the resistance from the patient. Elbow flexion angle and joint torques were measured from both master and slave devices and bilaterally fed back to their counterparts. In order to overcome problems associated with the network latency, two different tele-operation schemes were proposed depending on relative speed of tasks compared to the amount of time delay. For slow movement tasks, the bilateral tele-operation was achieved in real-time by designing control architectures after causality analysis. For fast movement tasks, we used a semi-real-time tele-operation scheme which provided the clinicians with stable and transparent feeling. The tele-assessment system was verified experimentally on patients with stroke. The devices were made portable and low cost, which makes it potentially more accessible to patients in remote areas.

Nutrition Evaluation Screening Tool: An Easy to Use Screening Tool for Hospitalised Children

  • Dokal, Kitt;Asmar, Nadia;Shergill-Bonner, Rita;Mutalib, Mohamed
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.24 no.1
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    • pp.90-99
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    • 2021
  • Purpose: Nutrition screening is vital to ensure patients are appropriately managed in hospital. In paediatrics there is currently no universally accepted nutrition screening tool. The Nutrition Evaluation Screening Tool (NEST) was developed as an easy to use and practical screening tool for hospitalised children. We aim to evaluate compliance of the NEST and assess agreement of the NEST with the already validated nutrition screening tools, Screening Tool for Risk on Nutritional Status and Growth (STRONGkids), Screening Tool for the Assessment of Malnutrition in Paediatrics (STAMP) and the Subjective Global Nutritional Assessment (SGNA) tool. Methods: Retrospective review of 102 patient episodes at the Evelina London Children's Hospital. Electronic records were used to assess NEST compliance and to complete the nutrition tools for each patient episode. Cohen's kappa was used to determine the level of agreement between each nutrition tool. Results: There was moderate agreement between the NEST and the two screening tools, STRONGkids (κ=0.472) and STAMP (κ=0.416) for patients on initial screening at admission. 87.2% of patient episodes were NEST compliant within 24 hours of admission to hospital. Conclusion: The moderate agreement between these two already validated screening tools enhances the NEST's validity as a paediatric screening tool. The NEST had the strongest correlation with the SGNA tool compared to other screening tools. The NEST is user friendly screening tool for hospitalised children.

Reliability and Validity of the Assessment Tool for Measuring Communication Skills in Nursing Simulation Education (시뮬레이션 교육에서 간호학생의 의사소통능력 측정도구의 신뢰도와 타당도 검증)

  • Yang, Hee Mo;Hwang, Seon Young
    • Korean Journal of Adult Nursing
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    • v.28 no.1
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    • pp.95-105
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    • 2016
  • Purpose: This study was conducted to test whether Health Communication Assessment Tool (HCAT) developed by Campbell et al. in 2013 can be applied to assess Korean nursing students' communication skills in simulation education. Methods: The content validity of the Korean version of HCAT (K-HCAT) was evaluated through expert's assessment and a principal component analysis was conducted for testing construct validity. The convergent validity was tested by measuring relationship between the K-HCAT and those of existing communication assessment tool for standardized patient instruction. The evaluation was done by surveying 154 senior students from four different nursing colleges. Results: The K-HCAT was condensed into 15 items from the original 22 HCAT items. Four factors were extracted from the principal component analysis; factor loadings ranged from .50 to .83; cumulative explained variance was 62.65%. Four factors were entitled as 'relationship building', 'empowering', 'empathy/response', and 'education/feedback'. Cronbach's ${\alpha}$ for sub-dimensions ranged from .73 to .84. An evaluation of convergent validity showed that the scores of the K-HCAT were moderately correlated with those of an assessment tool for standardized patient instruction. Conclusion: The K-HCAT can be used as an effective tool for assessing nursing students' communication skills in various kinds of simulation educations Further research is needed to test the consistency of the K-HCAT.