• Title/Summary/Keyword: standard hospital

Search Result 2,939, Processing Time 0.026 seconds

Factors Influencing Geriatric Nursing Performance among Clinical Nurses (임상간호사의 노인간호수행에 영향을 미치는 요인)

  • Hong, Ye Ji;Lee, Youngjin;Bae, Sun Hyoung;Kang, Minkyung
    • Journal of Home Health Care Nursing
    • /
    • v.31 no.1
    • /
    • pp.89-98
    • /
    • 2024
  • Purpose: This descriptive research study is intended to develop practical strategies for enhancing the quality of elderly care by evaluating the levels of ageism and compassion competence among clinical nurses and their impact on geriatric nursing performance. Methods: This study involved 162 nurses who provided direct care to elderly patients in a department with many such patients. Of the 161 returned questionnaires, 150 were analyzed, excluding 11 that had insincere or missing responses. To analyze the data, a comprehensive approach was employed using the IBM SPSS 27.0 program that included calculations of frequency and percentage, mean, and standard deviation, as well as more complex statistical tests such as the independent t-test, one-way ANOVA, Pearson's correlation coefficients, and hierarchical linear regression analysis. Results: Compassion competence was significantly positively correlated with elderly care and negatively correlated with ageism. This study conclusively demonstrates that compassion competence among nurses in geriatric nursing situations plays a crucial role in provision of quality nursing grounded in understanding and respect for the elderly. Consequently, it is imperative to develop educational strategies tailored to each career stage of nursing practice to further enhance effective elderly care. Conclusion: This study conclusively demonstrates that compassion competence in geriatric nursing situations plays a crucial role in provision of quality nursing grounded in understanding and respect for the elderly. Consequently, it is imperative to develop educational strategies tailored to each career stage of nursing practice to further enhance effective elderly care.

Clinical Application of the 2021 Korean Thyroid Imaging Reporting and Data System (K-TIRADS) (2021 한국 갑상선영상 판독과 자료체계의 임상적용)

  • Dong Gyu Na
    • Journal of the Korean Society of Radiology
    • /
    • v.84 no.1
    • /
    • pp.92-109
    • /
    • 2023
  • In patients with thyroid nodules, ultrasonography (US) has been established as a primary diagnostic imaging method and is essential for treatment decision. The Korean Thyroid Imaging Reporting and Data System (K-TIRADS) is a pattern-based, US malignancy risk stratification system that can easily diagnose nodules during real-time ultrasound examinations. The 2021 K-TIRADS clarified the US criteria for nodule classification and revised the size thresholds for nodule biopsy, thereby reducing unnecessary biopsies for benign nodules while maintaining the appropriate sensitivity to detect malignant tumors in patients without feature of high risk thyroid cancer. Thyroid radiology practice has an important clinical role in the diagnosis and non-surgical treatment of patients with thyroid nodules, and should be performed according to standard practice guidelines for proper and effective clinical care.

Is conventional radiofrequency ablation of the superolateral branch, one of the three genicular nerves targeted as standard, necessary or not? A non-inferiority randomized controlled trial

  • Osman Albayrak;Canan Sanal Toprak;Osman Hakan Gunduz;Savas Sencan
    • The Korean Journal of Pain
    • /
    • v.37 no.3
    • /
    • pp.264-274
    • /
    • 2024
  • Background: Radiofrequency ablation is an effective treatment modality in the symptomatic treatment of knee osteoarthritis. Our aim was to compare the efficacy of radiofrequency ablation of the superomedial and inferomedial genicular nerves (2 branches) with the superolateral, superomedial, and inferomedial genicular nerves (3 branches) and to show whether the 2-branch procedure is inferior to the 3-branch procedure. Methods: This study is a prospective, randomized, single-blind clinical study. Eligible participants were randomized into 2 groups: group A, which applied the procedure to the superomedial and inferomedial genicular nerves, and group B, which applied it to the superomedial, superolateral and inferomedial genicular nerves. Pain was evaluated with the numerical rating scale, quality of life with the Short Form-36 (SF-36), and disability with the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index before, and at 1 and 3 months after the procedure. Results: A total of 41 patients were included. There were no differences between the groups except for the SF-36 physical health sub-score at baseline. A significant improvement was seen in the numeric rating scale (NRS) score, SF-36 sub-scores, WOMAC Index total, as well as pain and physical function scores in both groups, though no significant difference was detected between the groups during follow-up. Conclusions: Although we were unable to establish the noninferiority of conventional radiofrequency ablation (CRFA) applied to 2 branches to CRFA applied to 3 branches, in this trial, significant and similar improvement was observed in NRS, WOMAC total, pain, and physical function and SF-36 scores in both groups.

The Reliability and Validity of a Portable Hand-held Spirometer for the Measurement of Various Lung Functions in Healthy Adults

  • Merve Nur Uygun;Jun-Min Ann;Byeong-Hyeon Woo;Hyeon-Myeong Park;Ha-Im Kim;Dae-Sung Park;In-Beom Jeong
    • Physical Therapy Rehabilitation Science
    • /
    • v.13 no.2
    • /
    • pp.179-186
    • /
    • 2024
  • Objective: This study aims to assess the reliability and validity of the new hand-held spirometer as a potential substitute for traditional pulmonary function testing (PFT) devices. Design: Cross-sectional study. Methods: In this study, thirty healthy adults underwent spirometry using both the new hand-held spirometer and the MIR spirometer, which is a standard PFT device. Parameters including peak expiratory flow (PEF), forced expiratory volume in one second (FEV1), and forced vital capacity (FVC) were measured and analyzed for validity and reliability. Inter-rater reliability and validity were evaluated through 95% limits of agreement (LOA) and intraclass correlation coefficients (ICC). Statistical analyses, including the Bland-Altman plots and the ICC, were utilized to assess agreement between the two devices. Results: The new hand-held spirometer exhibited a good agreement with intra-class coefficient (ICC [2,1]) ranging 0.762 to 0.956 and 95% LOA of -1.94 to 1.80 when compared with MIR. The test-retest reliability of the hand-held spirometer analyzed using - ICC [2,1] demonstrated a good level of consistency (ICC [2,1] =0.849-0.934). Conclusions: In conclusion, the study aimed to assess the potential of the new hand-held spirometer as a viable alternative to traditional PFT devices, with a specific focus on its reliability and validity in spirometric measurements. The new hand-held spirometer exhibited good test-retest reliability across all measured variables, suggesting its potential as a valid and reliable tool for simultaneous PFT measurements.

A Comparison of Item Characteristics and Test Information Between the K-MMSE~2:SV and K-MMSE

  • Jihyang Kim;Seungmin Jahng;SangYun Kim;Yeonwook Kang
    • Dementia and Neurocognitive Disorders
    • /
    • v.23 no.3
    • /
    • pp.117-126
    • /
    • 2024
  • Background and Purpose: The Korean-Mini Mental State Examination, 2nd edition (K-MMSE~2) was recently released. This study aimed to determine whether the K-MMSE~2: Standard Version (K-MMSE~2:SV) had the same test characteristics as the K-MMSE. Methods: A total of 1,514 healthy community-based participants aged 19 to 90 years were administered the K-MMSE~2:SV Blue Form along with the language items from the K-MMSE. The item and test characteristics and test information for the K-MMSE~2:SV and K-MMSE were compared using Item Response Theory analysis. Results: Item discriminations for the K-MMSE~2:SV and K-MMSE were above the moderate range for all items except Recall. Most of the items on the K-MMSE~2:SV and K-MMSE had item category difficulty in the very easy or easy range. The test information curve (TIC) showed that the K-MMSE~2:SV and K-MMSE provide almost the same amount of information (27.86 vs. 28.44), with both tests providing the most information at an ability level of -1.57. The generalizability (G) coefficient for the K-MMSE~2:SV and K-MMSE was 0.99. Conclusions: These results indicate that the K-MMSE~2:SV and K-MMSE are equally optimal tests for screening for mild cognitive impairment and early dementia. Given that the amount of test information provided by the two tests was almost identical, the shapes of the TICs were very similar, and the G coefficient was close to 1, we can conclude that the K-MMSE and K-MMSE~2:SV are equivalent tests.

The effects of remdesivir on mortality and the requirement for mechanical ventilation in patients with COVID-19: a systematic review stratified by disease severity

  • Seungeun Ryoo;Miyoung Choi;Su-Yeon Yu;Young Kyung Yoon;Kyungmin Huh;Eun-Jeong Joo
    • The Korean journal of internal medicine
    • /
    • v.39 no.1
    • /
    • pp.160-171
    • /
    • 2024
  • Background/Aims: The effectiveness of remdesivir treatment in reducing mortality and the requirement for mechanical ventilation (MV) remains uncertain, as randomized controlled trials (RCTs) have produced conflicting results. Methods: We searched MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and other data resources to find RCTs published prior to April 10, 2023. The selection of studies, assessment of risk of bias, and meta-analysis were conducted according to PRISMA guidelines. The primary outcomes were all-cause mortality and the need to initiate MV. Results: A total of 5,068 articles were screened, from eight RCTs comprising 11,945 patients. The meta-analysis found that, compared to standard care or placebo, remdesivir treatment provided no significant all-cause mortality benefit (pooled risk ratio [RR], 0.93; 95% confidence interval [CI], 0.85-1.02; 8 studies; high certainty evidence), while subgroup analyses revealed a trend towards reduced mortality among patients requiring oxygen but not MV (pooled RR, 0.88; 95% CI, 0.77-1.00; 6 studies; I2 = 4%). The need to initiate MV (pooled RR, 0.74; 95% CI, 0.59-0.94; 7 studies; moderate certainty evidence) in remdesivir-treated patients was also reduced compared to controls. Remdesivir significantly increased clinical improvement and discharge and significantly reduced serious adverse events. Conclusions: In this systematic review and meta-analysis of RCTs, it was found that remdesivir treatment did not show a substantial decrease in the risk of mortality. However, it was linked to a reduction in the necessity for additional ventilator support, suggesting remdesivir could be beneficial for COVID-19 patients, particularly those who are not on MV.

Effectiveness of the Eye Care Protocol in the Intensive Care Unit Patients: A Randomized Controlled Trial (중환자실 입원환자의 눈 간호 프로토콜 적용 효과: 무작위 대조군 전후 실험연구)

  • Lim, Kyu Won;Ha, Shin Young;Kang, In Soon
    • Journal of Korean Academy of Nursing
    • /
    • v.54 no.3
    • /
    • pp.432-445
    • /
    • 2024
  • Purpose: This study investigated the effects of an eye care protocol (ECP) on patients in the intensive care unit (ICU). Methods: This study utilized a randomized controlled design. Participants were patients who met the inclusion criteria and were admitted to the ICU (36 in the experimental group and 38 in the control group). The experimental group received an ECP, while the control group received standard eye care, starting the day after admission, for a duration of 10 days. The ECP classifies the degree of eyelid obstruction into three stages based on the degree of exposure to the lower eyelid conjunctiva and cornea. The protocol included cleansing with normal saline gauze, administering eye drops, applying silicone and polyurethane films, and recommending consultation with an ophthalmologist if necessary. The effectiveness of ECP was assessed by analyzing tear volume, hyperemia, chemosis, and eye discharge. Data analysis was conducted using SPSS 27.0, employing the Mann-Whitney U-test and generalized estimating equations. Results: On day 5, the experimental group demonstrated a significant increase in tear volume in both eyes compared with the control group. However, no statistically significant differences were observed in the incidence of hyperemia, chemosis, and eye discharge on days 5 and 10 of the intervention. Conclusion: The application of the ECP in this study increased tear volume in ICU patients, thereby reducing discomfort caused by dry eyes. It has the potential to prevent complications such as damage to the surface of the eyeball resulting from decreased tear volume.

An Evaluation of the Rapid Antimicrobial Susceptibility Test by VITEK MS and VITEK 2 Systems in Blood Culture (혈액배양에서 VITEK MS와 VITEK 2 System을 이용한 신속 항생제 감수성 시험의 유용성 평가)

  • Park, Kang-Gyun;Yu, Young-Bin;Yook, Keundol;Kim, Sang-Ha;Kim, Sunghyun;Kim, Young Kwon
    • Korean Journal of Clinical Laboratory Science
    • /
    • v.49 no.3
    • /
    • pp.279-284
    • /
    • 2017
  • The results of rapid antimicrobial susceptibility test (AST) in blood cultures were obtained by inoculating the bacteria directly into the VITEK MS and the VITEK 2 systems without subculturing in the blood culture positive medium. The obtained results were compared with the results using a standard method to evaluate their reliability and accuracy. The direct AST results in blood culture positive specimens were 97.9% (1,936/1,978), consistent with the standard AST results. Gram-positive bacteria showed a concordance rate of 97.2% (1,051/1,081), a very major error rate of 0.5% (5/1,081), a major error rate of 0.1% (1/1,081), and a minor error rate of 2.2% (24/1,081). Staphylococcus epidermidis was the main cause of discordance, and gentamicin (N=9) and fusidic acid (N=8) showed high errors. The overall concordance rate and minor error among the Gram-negative bacteria were 98.6% (885/897) and 1.4% (12/897), respectively. Escherichia coli and Pseudomonas aeruginosa were the major causative bacteria of Gram-negative bacteria. Among them, amoxicillin/clavulanic acid (N=3) showed high error. Direct AST met the CLSI criteria and shortened the reporting time by 24 hours; however, we found that there was a need to perform an addition test via disk diffusion for antimicrobials with very large errors. These results suggest that the method of direct AST in blood culture positive medium may be very useful in efficiently treating patients.

Incidence and Risk Factors for Extended-Spectrum ${\beta}-Lactamase-Producing$ Escherichia coli in Community-acquired Childhood Urinary Tract Infection (지역사회 획득 소아 요로 감염에서 Extended-Spectrum ${\beta}-Lactamase$ 생성)

  • Lee Jung-Won;Shin Jee-Sun;Seo Jeong-Wan;Lee Mi-Ae;Lee Seung-Joo
    • Childhood Kidney Diseases
    • /
    • v.8 no.2
    • /
    • pp.214-222
    • /
    • 2004
  • Purpose: Appropriate antibiotic therapy is important in childhood urinary tract infection and the selection of anibiotics is based on antimicrobial sensitivity of Escherichia coli. Extended-Spectrum ${\beta}-Lactamase(ESBL)$ is an enzyme produced by gram-negative bacilli that has the ability to hydrolyse penicillins, broad-spectrum cephalosporin and monobactam. There have been many reports of outbreaks of hospital infection by ESBL-producing organism. However, community-acquired infection with ESBL-producing organism are rare. This study was performed to retrospectively identify the incidence, characteristics and risk factors of ESBL (+) E. coli in community-acquired childhood UTI. Methods: In 288 children admitted in Ewha Womans University Hospital with E. coli UTI from Mar 2001 to February 2003, ESBL was isolated. ESBL was confirmed by the utilization of an automatized machine(Vitek GNS 433 card) using liquid medium dilution method according to National Committee for Clinical Laboratory Standard. The clinical characteristics, risk factors, antimicrobial resistance and treatment effectiveness were compared with ESBL(-) E. coli UTI. Results: Of 288 E. coli isolates, 31(10.8%) produced ESBL and 93.5%(29/31) occurred in infants younger than 6 month of age(P<0.01). No significant differences were noted in prior antibiotic use, prior admission history and underlying urogenital anomaly. Antimicrobial resistance was significantly higher in ESBL(+) E. coli compared with control patients (P<0.05). Although ceftriaxone showed 100% resistance in ESBL(+) E. coli, bacteriologic sterilization rate after ceftriaxone therapy was higher(96.8%). However, the recurrence rate of febrile UTI within 6 months was higher(25.8%) than control patients(6.6%). Conclusion: Epidemiologic study is required to find out any new risk factors of community-acquired ESBL(+) E. coli UTI and changes in selection of empirical antibiotics should be considered.

  • PDF

Determination of Appropriate Exposure Angles for the Reverse Water's View using a Head Phantom (두부 팬텀을 이용한 Reverse Water's View에 관한 적절한 촬영 각도 분석)

  • Lee, Min-Su;Lee, Keun-Ohk;Choi, Jae-Ho;Jung, Jae-Hong
    • Journal of radiological science and technology
    • /
    • v.40 no.2
    • /
    • pp.187-195
    • /
    • 2017
  • Early diagnosis for upper facial trauma is difficult by using the standard Water's view (S-Water's) in general radiograph due to overlapping of anatomical structures, the uncertainty of patient positioning, and specific patients with obese, pediatric, old, or high-risk. The purpose of this study was to analyze appropriate exposure angles through a comparison of two different protocols (S-Water's vs. reverse Water's view (R-Water's)) by using a head phantom. A head phantom and general radiograph with 75 kVp, 400 mA, 45 ms 18 mAs, and SID 100 cm. Images of R-Water's were obtained by different angles in the range of $0^{\circ}$ to $50^{\circ}$, which adjusted an angle at 1 degree interval in supine position. Survey elements were developed and three observers were evaluated with four elements including the maxillary sinus, zygomatic arch, petrous ridge, and image distortion. Statistical significant analysis were used the Krippendorff's alpha and Fleiss' kappa. The intra-class correlation (ICC) coefficient for three observers were high with maxillary, 0.957 (0.903, 0.995); zygomatic arch, 0.939 (0.866, 0.987); petrous ridge, 0.972 (0.897, 1.000); and image distortion, 0.949 (0.830, 1.000). The high-quality image (HI) and perfect agreement (PA) for acquired exposure angles were high in range of the maxillary sinus ($36^{\circ}-44^{\circ}C$), zygomatic arch ($33^{\circ}-40^{\circ}$), petrous ridge ($32^{\circ}-50^{\circ}$), and image distortion ($44^{\circ}-50^{\circ}$). Consequently, an appropriate exposure angles for the R-Water's view in the supine position for patients with facial trauma are in the from $36^{\circ}$ to $40^{\circ}$ in this phantom study. The results of this study will be helpful for the rapid diagnosis of facial fractures by simple radiography.