• Title/Summary/Keyword: the medical staff

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Clinical Factors Associated with Specimen Adequacy for Conventional Cervical Cytology in Thammasat University Hospital, Thailand

  • Anantaworapot, Akegapot;Manusook, Sakol;Tanprasertkul, Chamnan;Lertvutivivat, Supapen;Chanthasenanont, Athita;Bhamarapravatana, Kornkarn;Suwannarurk, Komsun
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.9
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    • pp.4209-4212
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    • 2016
  • Purpose: To study clinical factors related to adequacy of transformation zone (TZ) components in cervical smears. Materials and Methods: Medical and Papanicolaou (Pap) smear reports from Thammasat University Hospital, Thailand during January to December 2015 were collected. Demographic data was reviewed by attending physicians and impact of clinical factors onTZ adequacy was primary outcome. A total of 3,251 smears were reviewed. Finally, 2,098 smears met The inclusion criteria and enrolled into this study. Results: Average age and bodyweight of participants in this study were 43.0 years and 60.0 kg, respectively. Ninety seven percent of smears were classified as satisfactory for evaluation according to the Bethesda system 2001. Adequacy (group A) and inadequacy (group B) of TZ were equal in percentage (50.9/46.0). Prevalence of abnormal cervical cytology was 4.4%. Percentages of abnormal Pap smears in group A and B were 7.3 and 1.4, respectively (p<0.001). Factors associated with increased adequacy of TZ were old-age (${\geq}50yr$), nulliparity, within 3-months postpartum, history of TZ inadequacy and abnormal smears. Sexually transmitted disease (STD), hormonal usage, previous cryotherapy and smears collected by staff were associated with inadequacy of TZ. Conclusions: Collection of cervical specimens should be carefully performed. STD history, hormonal usage and previous cryotherapy are risk factors for TZ inadequate specimens.

Evaluation of Radiation Exposure to Medical Staff except Nuclear Medicine Department (핵의학 검사 시행하는 환자에 의한 병원 종사자 피폭선량 평가)

  • Lim, Jung Jin;Kim, Ha Kyoon;Kim, Jong Pil;Jo, Sung Wook;Kim, Jin Eui
    • The Korean Journal of Nuclear Medicine Technology
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    • v.20 no.2
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    • pp.32-35
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    • 2016
  • Purpose The goal for this study is to figure out that medical staff except Nuclear Medicine Department could be exposed to radiation from the patients who take Nuclear Medicine examination. Materials and Methods Total 250 patients (Bone scan 100, Myocardial SPECT 100, PET/CT 50) were involved from July to October in 2015, and we measured patient dose rate two times for every patients. First, we checked radiation dose rate right after injecting an isotope (radiopharmaceutical). Secondly, we measured radiation dose rate after each examination. Results In the case of Bone scan, dose rate were $0.0278{\pm}0.0036mSv/h$ after injection and $0.0060{\pm}0.0018mSv/h$ after examination (3 hrs 52 minutes after injection on average). For Myocardial SPECT, dose rate were $0.0245{\pm}0.0027mSv/h$ after injection and $0.0123{\pm}0.0041mSv/h$ after examination (2 hrs 09 minutes after injection on average). Lastly, for PET/CT, dose rate were $0.0439{\pm}0.0087mSv/h$ after examination (68 minutes after injection on average). Conclusion Compared to Nuclear Safety Commission Act, there was no significant harmful effect of the exposure from patients who have been administered radiopharmaceuticals. However, we should strive to keep ALARA(as low as reasonably achievable) principle for radiation protection.

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The Change of Health Service before and after the Unification of two Health Subcenters in a Rural Area (한 농촌지역 2개면 보건지소 통합전후 보건의료사업 변화 연구)

  • Sul, Sue-Jeong;Park, Hyang;Sohn, Seok-Joon;Park, Jong;Kim, Ki-Soon
    • Journal of agricultural medicine and community health
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    • v.25 no.2
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    • pp.427-440
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    • 2000
  • A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

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The Validation of Standardized Nursing Care Plans Developed for Computerized Use in Clinical Practice (간호업무 전산화를 위해 개발된 표준화된 간호계획서의 타당성 검정)

  • 김용순
    • Journal of Korean Academy of Nursing
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    • v.21 no.3
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    • pp.349-364
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    • 1991
  • Recognition of the usefulness and the importance of the nursing diagnosis is increasing. There is a prevailing opinion that nursing diagnosis should be used to improve the quality of nursing care. Developing standardized nursing care palns based on nursing diagnoses is therefore considered one of the most essential projects for professional growth and improvement in the nursing world of Korea. Consequently, in the first stage of this research project, the ten nursing diagnses used most frequently with patients on medical and surgical wards were determined and related nursing care plans were developed, implemented and evaluated. The application of the standardized nursing care plans raised the nurses' confidence and proved to be effective in enhancing the quality of nursing care. This study was initiated as the next stage, to develop, test, and determine the validity of nursing care plans for the remaining nursing diagnoses. Nineteen medical and surgical wards were selected for the study ; the 176 staff nurses working on those wards and 1211 patients hospitalized there (603 patients during the nursing care plan use) took part in the project. The following summarizes the results of the study : 1. After listing all the nursing diagnoses up to the 20th in frequency from each ward except the ten used in the first study, 22 nursing diagnoses were selected. Two related to ‘self care deficit’, were combined into one. Standardized nursing care plans were established for these 21 nursing diagnoses. 2. The first page of each nursing care plan lists the related factors and defining characteristics as supporting data. The application rate distribution revealed that the majority were recorded less than 50% of the time. For each nursing diagnosis, only one to three related factors were recorded more than 50% of the time regardless of the number of suggested related factors, and similarly, only one to five defining characteristics were recorded more than 50% of the time regardless of the number of suggested defining characteristics. Therefore, these factors and defining characteristics were proposed as the common related factors and the typical signs and symptoms for each nursing diagnosis. 3. The application rate distribution for the expected outcomes, and the nursing orders that were the main data of each nursing care plan occurred more than 50% of the time, unlike the related factors and the characteristics that occurred less frequently. These findings supported the clinical validity. 4. In an effort to evaluate indirectly the effect of the use of the standardized nursing care plans, nurses' job satisfaction and perceptions of their ability in the use of the nursing process were measured and compared. Scores after the use of the plans were significantly higher than those before. The experience in actually using the standardized nursing care plans with patients increased the nurses' professional and emotional satisfaction and their confidence in using the nursing process. Also when the nurses who actually used the nursing care plans were asked to rate their effectiveness, the highest score was given to ‘the ease of establishing the nursing goal’, followed by ‘improved professional advice and care for patients’, ‘the efficiency and systemization of charting’, ‘the definite recognition of the nursing problem’, and ‘the selection of effective and appropriate nursing interventions’ in descending order. The results indicate the nurses were very positive about the effect of the real clinical application of standardized nursing care plans, and that the objective of this study to utilize the nursing diagnosis to strengthen the nursing process was attained.

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A Study of Ethical Sense of Value and Discord of the Clinical Nurse (임상간호사(臨床看護師)의 윤리적(倫理的) 가치관(價値觀)과 윤리적(倫理的) 갈등(葛藤)에 관한 연구(硏究))

  • Jong, Heui-Ja;Moon, Heui-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.2
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    • pp.349-371
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    • 1995
  • Professional nurse shall possess the firm nursing idea and ethical nursing philosophy based on the professional knowledge and technology but due to the rapid social situations has changed the value to man thus the nurse's sense of value in the nursing secenes has been confused and changed bringing the new ethical problems and discord due to the ethically difficult problems. This study is aimed to know about the discord between the ruling ethical sense of value and the ethical discord exeriencing in the clinical scenes of the nurse and to help them establish affirmative ethical sense of value and provide them with the materials which can effectively meet the ethical discord. The study research has been conducted by selecting 515 clinical nurses in 8 general hospitals as the subject from Mar. 13, 1995 to Apr. 3. The tool measuring the ethical sense of value disigned by Lee, Young Sook has been used and supplemented and the tool measuring the ethical discord was the question papers about the ethical dillemma of Han, Sung Sook. The collected materials have been analyzed by the statistical methods of arithmetical everage, t-test, ANOVA, Pearson's Correlation Coefficient and etc. The result of the study is as the below ; 1) The average point of the ethical sense of value of the nurse was 3.62(maximum point : 5) which showed that the ethical level was so high and the highest question item in the ethical level of the whole items of the ethical sense of value was "They conduct as directed by the doctor in case the disposition of the doctor looks mistaken"(4.56 point), "They keep the secret of the patients while serving them."(4.56) and the lowest item was "using placobo for the patients is not allowed" : (1.85 point). 2) Statistical variation which showed the significant difference in the relation with the ethical sense of value according to the general characters of the nurse has shown as scholarly years(F=3.47, p=.016), religion(F=1.66, p=.004), interest degree of ethical education(F=4.18, p=.006),attitude to the job of nursing(F=6.76, p=.006), ethical standard(F=3.28, p=.021), and recognition degree on ethical principles(F=4.53, p=.001). 3) The average point of the ethical discord of the nurse was 0.54(The maximum-1 point) point and the ethical discord in the clinical scenes : "the problems arising from the lack of manpower of the nurse"(0.86), "the discord from the uncooperative relation between them and the medical staff and"(0.75) and indifference of the doctor about the report of the nurse(0.73). 4) The variation which showed the significant difference statistically in the ethical discord according to the general characters of the nurse was that Age(F=19.88, p=.000), schooling(F=5.32, p=.001), Experience(F=15.77, p=.000), position(F=13.58, p=.000) and ethical standard(F=2.63, p=.049). 5) The results of the analysis of correlation between ethical sense of value and discord(r=0.519, p=.239) showed no significant correlation statistically.

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A Study on Service Satisfaction of Users' Family in Charged Recuperation Facilities Specializing in the Old (유료노인전문요양시설 이용자 가족의 서비스 만족도 및 요구조사)

  • Chung, Yeon-Kang;Han, Seung-Eui;Lee, Young-Mi
    • Research in Community and Public Health Nursing
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    • v.14 no.3
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    • pp.397-406
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    • 2003
  • The purpose of this study is to provide the basic data in order to improve the quality of charged recuperation facilities which are specialized in the old. after finding out the satisfaction degree for the services which are provided in the current charged recuperation facilities specialized in the old and surveying the services which are demanded by users. As for the research method. the subjects were 88 family members of the users in the five charged recuperation facilities, which are specialized in the old and located in Seoul and Incheon. The survey research was executed from 27th July to 15th September, 2002. Then the collected data were analyzed by using the SPSS 10.0 for windows program. The research results are as follows. Firstly, in the satisfaction degree of the user's family about the daily service showed the highest satisfaction degree for the kind service of the staff to the users. In the satisfaction degree about the specialized service of the user's family, the satisfaction degree was high in bedsore prevention, periodical health care, proper medical treatment, family counsel, and adequate disease management. In the satisfaction degree about the facility and environmental service, the satisfaction degree about the surrounding environment of the facility or safety facility, and the comfort condition was high. In the satisfaction degree about the services related to the local society, it was high in the hospital and medical-related field. Secondly, in the demanded services, the demanding degree for worship, mental and spiritual nursing, hospice, funeral service, family meeting, and support for the special vehicle were not so high, but it was shown that they were generally demanded. Thirdly, it was shown that the provided services had an overall high satisfaction degree. In the service satisfaction degree according to the general characteristics of the user's family, it was recognized that there was a significant difference between the distinction of sex and local society related services. Also, there was a significant difference in the satisfaction degree between age and specialized service. Through the above research results, detailed rehabilitation programs such as linguistic treatment and working treatment should be more and more compensated in order to supplement the insufficient points of the services provided by the charged recuperation facility specialized in the old. Additionally, the correlation with the local society such as education and training for specialized human labor, close cooperation among the facilities, and positive participation in local society events are thought to be reinforced.

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Analysis of the Sports Injury in the Taekwondo Matches (태권도 경기 중 스포츠 손상에 대한 분석)

  • Her, Jin-Gang;Kim, Kwang-Soo
    • The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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    • v.5 no.1
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    • pp.75-80
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    • 1999
  • The Taekwondo being a martial sports, there are higher chances for the injury to occur than the non martial sports. Therefore, this study analyze the frequency, the area, the type, and the condition of the injury which are prone to occur in the Taekwondo matches; it is to help the Taekwondo players in prevention of the injury and in treatment. The subjects of this study were the 48 players (male 24, female 24) who participated in the final selection contest of the national team player on March 9 to 12, 1993. The data of the injury were obtained from the medical recoder staff and were analyzed to the frequency of the injury per match, the vulnerable area of the injury, the type of injury, and the condition of the injury with a gender difference. There were 24 matches for the male and 24 matches for the female, total 48 matches. Therefore, the total participation number of the players are the double of the match number. 1. The frequency of the injury per match was 18.3%(11/60) for male and 23.1%(12/52) for women. 2. The areas of the injury were ankle 36.4%(4), foot 18.2%(2), knee 18.2%(2), lower leg 18.2%(2), wrist 9.1%(1) in male; foot 33.4%(4), ankle 16.7%(2), knee 16.7%(2), lower back 16.7%(2), lower leg 8.3%(1), face 8.3%(1) in female. 3. The types of the injury were contusion 45.5%(5), sprain 27.3%(3), abrasion 9.1%(1), laceration 9.1%(1), tendon rupture 9.1%(1) in male; contusion 33.3%(4), sprain 33.3%(4), abrasion 16.7%(2), subcutaneous hemorrhage 8.3%(1), dislocation 8.3%(1) in female. 4. The condition of the injury were the unblocked attack 36.4%(4), attacking kick 27.3%(3), blocking a kick 18.2%(2), attacking punch 9.1%, impact with surface 9.1%(1) in male; attacking kick 33.3%(4), unblocked attack 25%(3), blocking a kick 25%(3), attacking punch 8.3%(1), impact with surface 8.3%(1) in female. This study shows that the injury from the Taekwondo matches occurred most in the lower extremity joints and the foot, and shows that the most of the injury types were contusion and sprain. Therefore, it is believed to be helpful to wear the proper fitting ankle or the knee protector and using other protective equipment to prevent the sports injury in the Taekwondo matches.

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A Study on the Intradermal Skin Test of Antibiotics (항생물질 주사제의 피내반응검사에 대한 조사연구)

  • Yoo Jae-Hee;Shon Young-Hee;Kim Won-Ock
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.4 no.2
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    • pp.319-336
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    • 1997
  • This study was done to identify the reality in doing the intradermal skin test of injectional antibiotics and to serve a basis to the clinical and educational situations. For the study, the survey was done to the staff nurses who are working at one of the selected 39 hospitals in the capital area, from January 6 to Feburary 8 in 1997. The data analysis was done by mean, standard deviation, Fisher's exact test, t-test, ANOVA through running SAS computer program. The results of the study were as follows : 1. The dilution ratio of the antibiotics was mostly 1 : 10 regardless of what kind of antibitics. Making the contrast was done only for the suspended to the antibiotics. Mostly the reaction was detected after 15 to 20 minutes from its diameter of redness and wheals. Most of the respondents answered they do the intradermal skin test only once for the same antibiotics. 2. In the education on the skin test the 66.7% from the respondents had exposed to the education mostly through the new nurses orientation. The 85,4% from them answered the need of the continuous education which had a significant difference in the number of beds(p=.046). The had experiences of detecting positive reactions(98.3%), and of anaphylaxis(49.5%) which had a significant difference in experience(p=.002) and in their age groups(p=.000). 3. The averge score of the confidence on the intradermal skin test was 3.32 form 4-point scale. Also it had a significant difference from the number of beds(p=.010), the year of experiences(p=.016), and their age groups(p=.046). 4. From the general characteristics of respondents, the injection methods had a significant difference in the amounts of injection, whether adopting the contrast pairing, and the repeatable skin tests for the same antibiotics. 5. Only 15 from 39 hospitals had their protocol about the intradermal skin test provided by nursing department which differs in its contents from that provided by the medical information center. From the results of the study, it is suggested that the continuous education on the intradermal skin test and its unified protocol should be provided. Also it is recomended that the drug manufacturer should notice about its anaphylactic cautions and pack its extra skin test use.

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The Experiences of Trial Alternative Therapies for Cancer Patients (암환자의 대체요법 시행경험)

  • Go, Dock-Soon;Chung, Yeon-Kang
    • Journal of Home Health Care Nursing
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    • v.8 no.2
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    • pp.109-120
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    • 2001
  • This study has been done in order to help the people understand the cancer patients and provide the basic materials for the care of cancer patients by deeply understanding the living experience of the practice of alternative therapy for cancer patients. Data were collected with several in depth interviews and observations. Collected datas were analyzed by using phenomenological method of study by Giorgi (1970). The trial experience of alternative therapy for cancer patients has been classified into the one of having concerns, following, being infatuated, and coming out by pushing, and the experience of having concerns appeared as the meaning of the limit of modern medicine, despair, loneliness. hope, emotional support. dissolution of the feeling of uneasiness. the feeling of burden of the medical expense, self-treating, the subject of treatment. and indifference while the experience of following appeared as the meaning of blind following, temptation, going outside to look for something, wandering. following unconditionally, advise of the professionals, mistaken belief. self-abandonment, powerlessness. disconnection of dialogue with the medical staff. elevation of immunity, strengthening the physical power, absence of the source of examined information, clinging, self-responsibility. the experience of being infatuated appeared as the meaning of thorough trial. affirmative experience. devotion. diverse efforts, faithful trial. affirmative self-suggestion. change of the style of life. the feeling of burden of expense, being envious, bitter feeling toward the family, considering family, family discords, and difficulty of enforcement. The experience of coming out by pushing appeared as the meaning of waiting. self-reflection. maintaining the distance. cutting attachment, throwing the greed away, coming out by pushing. being thoughtful. accepting disease. individual difference of physical quality, and ambivalence. But they return to the experience of being concerned all over again in case of recurrence or metastasis of the disease even though they come out of such stage, and they always have ambivalence even in the condition with no recurrence and metastasis. In conclusion, the trial of alternative therapy for cancer patients could be explained as the adaptive behavior to the disease which is difficult to be cured. the cancer. The cancer patients are exposed to the side effects and harm without the examined information resources. Therefore the nurse should well aware of the alternative therapy and be able to do the appropriative management through the open communication with the patients who are under the trial of alternative therapy.

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The Relationship between Noise and Sleep Patterns in Intensive Care Units (소음과 수면양상에 관한 연구 - 중환자실을 중심으로 -)

  • Son, Youn-Jung
    • Korean Journal of Adult Nursing
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    • v.13 no.2
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    • pp.209-222
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    • 2001
  • The environment in the ICU leads to negative changes in a patient's usual sleep pattern and so contributes negatively to the patient's health condition as compared to patients in general wards. Therefore, it is thought that an important nursing intervention would be to identify the relation between noise and sleep patterns which play an important role in illness recovery. The purpose of the present study was to explore the relationship between noise in the ICU and the sleep pattern of patients admitted to the ICU. A descriptive correlation design was used to examine the relationship. Thirty-four subjects were recruited from a Medical ICU (MICU), Surgical ICU (SICU) and Coronary Care Unit (CCU) at a large university hospital in Suwon. Data were collected from September 28 to October 31 in 1999. In the present study, noise was categorized into noise level and patients' perception of noise. The objective noise level was measured using the A-Weighted Sound Level Meter. The patients' preception of noise was measured using a self-reported questionnaire developed by the researcher. Sleep patterns in this study includes both quantity and quality of sleep. These were measured using open ended questionnaires and the 'Korean Sleep Scale A' developed by Oh, Song, Kim(1998). The data was analyzed using the SPSS-WIN to test the research question, Pearson product moment correlation coefficient was run. Ancillary analysis were conducted with demographic variables to determine their relation to the main study variables. For the ancillary analysis, t-test and one-way ANOVAs were performed. The results of the present study are summerized as follows : 1. The total mean of objective noise level (10pm-6am) was 56.2dB. The means for night time noise level in individual ICUs for the SICU, MICU and CCU, were 58.7dB, 58.6dB and 48.3dB, respectively. The total mean for patients' noise perception was 42.8 out of a maximum possible score of 76. For item means of noise perception, the one ranked highest was "conversations between doctors and nurses" (3.2). The one ranked lowest was "noise from the radio" (1.2). Regarding the degree of perception for each type of noise source, the one ranked highest was "equipment noise" (2.6), the second was "conversation between medical staff" (2.4), the third was "conversation between patients, caregivers and visitors" (2.3), and the one ranked lowest was "environment noise" (1.8). 2. Looking at quantity of sleep of ICU patients, the mean nocturnal sleep time was found to be 4.9 hours. The total mean of sleep quality for ICU patients was 21.0 out of a maximum possible score of 40. 3. The relationship between perception of noise and quantity of sleep was statistically significant(r= - .41, p<.05). The relationship between perception of noise and quality of sleep was also statistically significant(r= - .47, p<.01). The results of the study indicate that personal perception of noise is related to sleep patterns. Therefore, it is suggested that nursing interventions be developed to reduce the degree of personal perception of noise and, thus, decrease sleep pattern disturbances in patients in the ICU.

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