• 제목/요약/키워드: waste medicine

검색결과 174건 처리시간 0.028초

입원환자의 투약체계와 방법의 개선을 위한 현장연구 (Field Study For The Improvement of Medication System and Method for Inpatients at General Hospital)

  • 유형숙;권영미;송미숙;김형애;박경숙
    • 간호행정학회지
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    • 제1권1호
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    • pp.147-211
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    • 1995
  • Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.

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대한치과보철학회지에서 볼 수 있는 통계적 오류의 고찰(2006 - 2010) (Assessment of statistical errors of articles published in the Journal of the Korean Academy of Prosthodontics: 2006 - 2010)

  • 강동완;서윤암;오남식;임회정
    • 대한치과보철학회지
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    • 제50권4호
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    • pp.258-270
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    • 2012
  • 연구 목적: 대한치과보철학회지의 최근 5년간 게재된 논문 중에서 통계 방법이 사용된 논문의 빈도를 조사하고 통계 방법의 종류 및 오류의 유형과 빈도를 살펴 보고 오류별 적절한 통계 방법을 제시하고 통계분석 가이드라인을 개발하여 대한치과보철학회지의 학술적 발전에 기여하고자 한다. 연구 재료 및 방법: 2006년부터 2010년까지 게재된 논문 336편 중 통계방법이 사용된 255편을 연구대상으로 하여 연도별로 통계 방법 사용 여부, 주로 사용된 통계방법과 소프트웨어의 유형과 빈도를 조사하였다. 통계방법 별로 고안된 가이드라인에 따라 오류를 조사하였는데 주로 실험설계의 적절성, 분석법에 대한 가정검토, 표본의 독립성 및 변수의 적합성, 적절한 표본 수와 적절한 통계방법이 사용되었는지에 대한 평가를 하였고 이를 토대로 고안된 가이드라인을 제시하였다. 결과: 본 연구에서 조사된 논문 중 추론통계를 사용한 논문이 193편(75.9%)으로 대다수를 차지하였고 사용된 소프트웨어는 SPSS가 153편(59.77%)으로 가장 많았다. 추론통계를 사용한 논문들을 대상으로 통계방법을 분류한 결과 ANOVA (41.5%), t-test (20.0%), 비모수 방법(16.9%)순으로 많았고 최근에 가까울수록 다양한 분석법을 시도하였으나 유의한 변화는 관찰되지 않았다. 대부분의 논문들은 표본수의 산출근거를 제시하지 않았고, 분석법에 대한 가정(독립성, 정규성, 등분산성 등) 검토를 하지 않은 공통적인 오류를 범했다. 전체적으로는 61.2%의 통계적 오류를 범하였다. 결론: 대부분의 오류는 전체적인 분석 후 세부적인 분석으로 들어가야 하는데 두 요인에 대한 상호작용을 무시하고 단변수 분석을 여러 번 한 경우와 연구 계획 단계에서 적절한 표본 수를 산출하지 않아 나타난 경우 등이었다. 이러한 통계 오류를 최소화하기 위하여 분석 방법 별 검정 절차에 대한 통계분석 가이드라인을 제시하였다.

가정간호실무에 적용가능한 이론적틀 (Appling Nursing Theory to Clinical Practice of Home Health Care)

  • 우선혜
    • 가정간호학회지
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    • 제11권1호
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    • pp.5-13
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    • 2004
  • The home health care industry has grown rapidly and can be expected to continue to grow in the foreseeable future. Home health care refers to the practice of nursing applied to clients with a health condition in the clients place of residence. clients and their designated care givers are the focus at home health nursing practice. The goal of care is to initiate. manage and evaluate the resources needed to promote the clients optimal level of well-being and function. Nursing activities necessary to achieve this goal may warrant preventive maintenance and restorative emphases to prevent potential problems from developing. Many project program were suggested home health care model for Korea's health care system and policy direction for expansion and establishment of home health care .But the aim of this paper is to provide on overview for theoretical frame work in home health care. Theories and conceptual frameworks or models are important nursing because they define and guide the boundaries of professional practice and identify key nurse-patient-caregiver relationships that emerge with caring. Following is the research with an investigation of the literature review in the University of Arizona international medline database, In conclusion, are as followers: First, many nursing theorists have had a tremendous impact on nursing practice. the following highlights those nursing theorists that are particularly helpful in understanding home health care. 1. Florence Nightingale : Our earliest theoretical legacy. Nightingale's believes are reflected in basic infection control practice such as hand washing and infectious waste disposal and are key nursing interventions in home care. 2. Martha Roger's :Science of unitary human beings theory. Rorger's believed that the focus of shared. non invasive healing modelities is the human environmental field rather than direct physical care. These modelities continue to evolve as our awareness (reflecting greater diversity, faster rhythms, motions, and ways of knowing) transcends time and space, allowing individuals to get in touch with their integral nature of unbroken wholeness. On people as ever changing energy fields have special relevance in home care especially with hospice and palliative care applications. 3. Madeline Leininger's; Transcultural nursing theory. Home care nurses move through a variety of communities and often care for patients from different cultural back grounds. Therefore Leininger's work has a good that with home care because home care nursing practice is very culturally focused. 4. Dorothea Orem's : Self care deficit theory. Orem's theory views care as something to be performed by both nurses and patients. The role of the nurse is to provide education and support that help patients acquire the necessary activities to perform self-care. Orem's theory is foundational to have care because it begins to truly acknowledge the role of the patient in managing his or her own health. which is referred to as self-care. 5. Margaret Neuman's; Health as expending consciousness theory. Neuman believes that health compasses disease and reflects an underlying pattern of person-environment interaction. A key application of 'Neuman's work to home care is for nurses to understand that health and illness do not necessarily exist at opposite ends of a continuum. 6. Jean Watson's: Theory of human caring. Watson's theory of human caring in nursing proposes human caring as the moral ideal of nursing. Nurses participate human caring to protect, enhance and preserve humanity by assisting individuals to fing meaning in illness. pain and existence and to help others gain self knowledge. self control. and self healing such thinking lends richness to theory development. as well as clinical practice in home care. Second, Robin Rice : Dynamic self determination for self care. (A theoretical framework for home care) Dynamical self determination for self care can be useful to home care nurses in a variety of ways. As research tool it can be reflected in the interview process when the home visit. The home care nurse's role is that of facilitator of patient self-determination for self care through numerous strategies. including patient education and case management.

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솔장다리 추출물의 항산화 활성 및 세포주기조절에 의한 항암 활성 분석 (Anti-oxidative and Anti-cancer Activities by Cell Cycle Regulation of Salsola collina Extract)

  • 오유나;진수정;박현진;권현주;김병우
    • 한국미생물·생명공학회지
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    • 제42권1호
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    • pp.73-81
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    • 2014
  • 본 연구에서는 명아주과 수송나물속 솔장다리(Salsola collina Pall.) 추출물의 항산화 및 항암 활성을 분석하였다. 먼저 솔장다리의 에탄올 추출물의 DPPH radical scavenging activity를 분석한 결과, $IC_{50}$$4.82{\mu}g/ml$로 나타나 강한 항산화능을 보유하였음을 확인하였다. 또한 대장암 세포주(HT29), 폐암 세포주(A549), 간암 세포주(HepG2)를 사용하여 솔장다리 추출물의 암세포 사멸효과를 분석한 결과, $IC_{50}$가 각각 43.8, 64.1, $92.5{\mu}g/ml$로 강력한 세포사멸효과를 나타냈으며 특히 HT29에 대한 강한 사멸효과를 보였다. 솔장다리 추출물의 항암 활성 기전 분석을 위해 세포주기를 분석한 결과, 대장암세포인 HT29의 G2/M arrest를 유도하였으며 최고 농도인 $60{\mu}g/ml$까지 S기 세포수가 증가하였다. 세포주기관련 단백질의 발현 분석 결과, 솔장다리 추출물을 처리한 경우, G2기에서 M기로의 전이에 필수적인 단백질인 Cdc25C와 cyclin A의 발현이 감소되었고, 반면 Cdc25C와 Cdc2의 불활성화 형태인 p-Cdc25C, p-Cdc2는 증가하였다. 또한 p21과 Wee1의 발현도 증가되었다. 하지만 p53의 발현량은 변화가 없었다. 이러한 결과는 솔장다리 추출물을 처리한 경우, p53 비의존적으로 p21의 발현이 증가되어 cyclin A/Cdc2 complex의 활성이 조절되고, 이어서 G2/M phase의 check point에 작용하는 Wee1의 발현증가 및 Cdc25C, Cdc2의 인산화에 의한 불활성화를 통하여 G2/M arrest가 유도되는 것을 시사한다. 또한 솔장다리 추출물 처리에 의해 S기 진행을 조절하는 Cdk2의 발현량도 감소하여, cyclin A/Cdk2 complex가 감소되어 S기의 세포수가 증가한 것으로 보인다. 따라서 본 연구 결과를 통해 솔장다리 추출물이 높은 항산화 활성을 지니며 암세포의 세포주기를 조절하여 높은 항암 활성을 보유함을 확인하였다.