• 제목/요약/키워드: wound care

검색결과 261건 처리시간 0.023초

재가 취약계층을 위한 지역사회 중심 가정간호서비스의 경제적 효과 (Economic Effect of Home Health Care Services for Community-dwelling Vulnerable Populations)

  • 이은희;김진현
    • 대한간호학회지
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    • 제46권4호
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    • pp.562-571
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    • 2016
  • Purpose: In this study the costs and benefits of a home health care program were examined to evaluate the economic feasibility of the program. Methods: The study participants included 349 patients in the community who had been registered at a home health care center for 5 years. The costs and benefits of the program were analyzed using performance data and health data. The benefits were classified as the effects of pressure ulcer care, skin wound care and catheters management. The program effect was evaluated on the change of progress using transition probability. Benefits were divided into direct benefit such as the savings in medical costs and transportation costs, and indirect benefits which included saving in productivity loss and lost future income. Results: Participants had an average of 1.82 health problems. The input cost was KRW 36.8~153.3 million, the benefit was KRW 95.4~279.7 million. Direct benefits accounted for 53.4%~81.2%, and was higher than indirect benefits. The net benefit was greater than 0 from 2006 to 2009, and then dropped below 0 in 2010. Conclusion: The average net benefit during 5 years was over 0 and the benefit cost ratoi was over 1.00, indicating that the home health care program si economical.

입원 환자의 욕창예방과 중재를 위한 알고리즘 개발 (Development of an Algorithm for the Prevention and Management of Pressure Ulcers)

  • 김진미;박정숙
    • 성인간호학회지
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    • 제22권4호
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    • pp.353-364
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    • 2010
  • Purpose: The purpose of this study was to develop an algorithm for preventing and managing of pressure ulcer and to verify the its appropriateness. Methods: The first step was development of a pre-algorithm through a literature review and expert opinion. The second step was to establish content validity by submitting the algorithm questionnaires about the content to 12 experts. The third step was the revision of the algorithm. The fourth and last step was to establish the clinical validity of the algorithm with 25 experienced nurses. Results: For the ease of the practitioner the algorithm for prevention and the management of pressure ulcers was confined to one page depicting the main algorithm pathway and seven stepwise guidelines. The guidelines included skin care of pressure ulcer prevention, mechanical loading care, support surface care, reposition care of pressure ulcer, and Stages II, III and IV explanations along with debridement/wound irrigation and infection control. Most of all algorithm courses chosen more than 80% of agreement by expert index of content validity. The usefulness, appropriateness, and convenience of the algorithm were demonstrated through clinical validity with intensive care unit and ward nurses. Conclusion: The algorithm will improve the quality of pressure ulcer nursing care as it provides a model for decision making for clinical nurses as well as providing consistent and integrated nursing care for patients with pressure ulcer throughout an institution.

The Effect of Application Parameter of Pulsed Direct Current on Wound Healing of Patients with Pressure Ulcer

  • Kim, Ga Yeong;Lee, Sang Bin;Moon, Ok Kon;Kim, Ji Sung;Choi, Jung Hyun;Wang, Jung San;Park, Joo Hyun;Kim, Hong Rae;Lee, Ju Hwan;Min, Kyung Ok
    • 국제물리치료학회지
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    • 제5권2호
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    • pp.752-756
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    • 2014
  • This study investigated the effects of changes to the pulsation factor of pulsed direct currents on wound healing. Patients with a pressure ulcer at a care hospital for the elderly were randomly divided into three groups: Group 1 involved the application of $100{\mu}s$ in pulse duration, 10 ms in pulse period, 100 pps in a pulsation factor, 15 mA in pulse amplitude, and polarity red+ by using pulsed direct currents; Group 2 involved a change of pulse period to 8 ms; and Group 3 received general wound management. Although there were no statistically significant differences in the changing stages of pressure ulcers among the groups, all the groups dropped in numerical stages. In the two groups to which pulsed direct currents were applied, there was a statistically significant reduction in the stages of pressure ulcers from the initial assessment to the 12-week assessment (p<.05). Even though there were no statistically significant differences in changes to the area of pressure ulcers among the groups, a statistically significant decrease was found in pulsed direct current group 2 whose pulse period was shortened (p<.05). There was no difference in the healing rate of pressure ulcers among the groups, but it made a numerical increase in pulsed direct current group 1 and group 2 and a numerical decrease in group 3. There were no significant differences in the characteristics of those who had a full recovery among the groups. Those findings indicate that pulsed direct currents have positive effects on the wound healing of patients with a pressure ulcer and that a treatment with pulsed direct currents whose pulsation factor is raised by reducing the pulse duration is especially effective.

초기 산욕부의 간호요구도와 만족도에 관한 연구 (A Study on the Nursing Needs and Satisfactions of Early Postpartum Women)

  • 유연자;이은주
    • 여성건강간호학회지
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    • 제5권3호
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    • pp.389-409
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    • 1999
  • This study was carried out to identify the differences between nursing needs and levels of satisfaction of postpartum women during the early postpartum period. The goal of this study was to obtain needed to develope the nursing quality for postpartum women. The subjects were 87 postpartum women who had vaginal delivery at 2 general hospital and 2 maternity hospital in the Ulsan City. The period for the data collection was from June 1 to 29, 1999. The data was gathered using an 98 items questionnaire which was a modified version of a questionnaire the developed by Y. J. Chun. Results found are as follows : 1. The general characteristics of the subjects : The majority of subjects were 25-29 yrs. (57.5%), high school and college graduates(96.5%), unemployed(75.9%), middle ranged economics(93.1%), had no religion(43.7%), male baby(52.9%), birth weight 3-3.5Kg(49.4%), wanted pregnancy(96.6%), no abortion history(50.6%), had antenatal care(89.7%), had prenatal education(32.2%), postnatal education(42.5%), intended breast feeding (46.0%), had resonable self confidence about self(20.7%), infant care(36.8%) and nuclear family pattern(82.3%). 2. The level of nursing needs of overall nursing care(3.93) and the levels of satisfaction(3.86) was relatively high. The nursing needs by category of nursing care, the highest need was in the emotional and psychological care(4.09), and the lowest need was in physical need(3.73). The satisfactions by category of nursing care, the highest satisfaction was in emotional and psychological care(4.11) and the lowest satisfaction was in education in self care(3.64). The significant differences between nursing needs and satisfactions were found on education in infant care(p=.005), and education in self care(p=.020). 3. Among items of physical care, 'accurate medication and treatment(4.21)', 'control of postpartum hemorrhage(4.13)', 'pain control and care of episiotomy wound (4.12)' and 'regular observation of postpartum conditions(4.09)' showed high nursing needs. 'Accurate medication and treatment(4.31)', 'regular observation of postpartum condition(4.24)', 'control of postpartum hemorrhage(4.22)' and 'pain control and care of episiotomy wound(4.12)' showed high satisfaction levels. 4. Among items of emotional and psychological care, 'personal treatment(4.32)', kind and faithful care(4.30)', 'detailed explanation on the treatment or nursing care(4.25)', 'adequate draping during the care and treatment(4.23)' and detailed explanation on a doubt(4.13)', showed high nursing needs, 'personal treatment(4.52)', 'kind and faithful care(4.45)', 'detailed explanation on a doubt(4.24)', 'detailed explanation on the treatment or nursing care(4.21)' and 'adequate draping during the care and treatment(4.18)' showed high satisfaction of nursing care. Difference between the level of nursing needs and satisfaction was significant except item of 'early contacts with their baby and breast feeding'. 5. Among items of environmental care, the highest level of need and satisfaction were on the items of 'neat bedding and clothes(4.05, 4.21)' and 'room cleansing or care of room(4.01, 4.28)'. Differences between the level of nursing care and satisfaction were 'room cleansing of care of room'. 6. Among items of educational needs on self care, 'sitz bath method(4.22)', 'high risk symptoms to immediate clinic visits(4.13)', 'the timing of tub bath(4.05)' and 'good secretion of breast milk(4.03)', showed high nursing needs, 'sitz bath method(4.22)' showed high satisfaction of nursing care. Differences between the level of nursing care and satisfaction were 'the timing of hair shampoo', 'the timing of tub bath', ' the method of pad change', 'postpartum exercise', 'good secretion of breast milk', 'maintenance of breast figure', 'contraindicated drugs in postpartum women', 'kegel exercise' and 'breast self examination'. 7. Among items of educational needs on infant care, 'immunization of infants(4.36)', 'symptoms of sickness to immediate clinic visits(4.28)'. 'safety and emergency care(4.28)', 'umbilical care(4.26)', 'feeding times and intervals(4.24)', 'normal growth and development of infant(4.24)' and 'infection control(4.22)', showed high level of nursing care, 'immunization of infants(4.21)', 'feeding times and intervals(4.17)', were high satisfaction items showed significant differences between the level of nursing care and satisfaction. 8. Relationship between nursing needs and levels of satisfaction among postpartum women were as follows : 1) Physical area : There were no significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'working mothers', 'baby's weights', 'baby's sex', 'planning of feeding' and 'routes of receiving postpartum informations'. 2) Emotional and psychological area : The level of nursing needs were significantly different in the area of 'confidence in self care'. Satisfaction levels were significantly different among 'baby's sex', 'baby's weights', 'the confidence of infant care' and 'working mother'. 3) Environment area : There were on significant differences in the level of nursing needs, but satisfaction levels were significantly different among 'maternal age' and 'baby's weights'. 4) Education in self care : The level of nursing needs were significantly different among 'parity history' and 'type of family formation'. Satisfaction levels were significantly different among 'working mother', 'baby's sex', 'antenatal care', 'postpartum education', 'planning of feeding', 'routes of receiving postpartum informations'. 5) Education in infant care area : The level of nursing needs were significantly different among 'parity history'. Satisfaction levels were significantly different among 'baby's sex', 'receiving postpartum education or not' and 'working mother'.

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Factors affecting complications after treatment of epidermal cyst

  • Choi, Man Ki;Chung, Kyu Jin
    • Journal of Yeungnam Medical Science
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    • 제36권2호
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    • pp.136-140
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    • 2019
  • Background: Epidermal cysts are the most common benign epithelial tumors in humans. The curative treatment of epidermal cyst is surgical excision. However, only few studies have investigated the cause and mechanism of postoperative complications of epidermal cysts. Therefore, this study aimed to evaluate the factors affecting complications of epidermal cyst after surgical treatment. Methods: Patients with histologically diagnosed epidermal cysts were selected from among 98 consecutive patients with excised benign cystic tumors from March 2014 to August 2017. Sex, age, size, mobility, site of occurrence, history of infection, history of incision and drainage, complications, history of reoperation, and method of overcoming complications was obtained by analyzing medical records retrospectively. Results: Five of the 98 patients had wound dehiscence due to surgical infection. Three of them underwent wound healing with conservative treatment without a second operation. The other two patients underwent a second operation and showed signs of preoperative infection. None of the factors showed statistical significance in relation to the occurrence of complications. Conclusion: Postoperative complications occurred when the excision of the epidermal cyst was performed at preoperative infection sites or at sites with high tension, so attention should be paid to postoperative care.

줄기세포배양액이 열 안정성에 미치는 영향 (Effect of stem cell culture on thermal stability)

  • 문지선
    • 한국응용과학기술학회지
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    • 제38권1호
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    • pp.186-195
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    • 2021
  • In this study, when stem cell culture solution is used as a cosmetic ingredient, one of the most prominent problems is that the ingredients generally have low thermal stability. Therefore, in this study, in order to find out how the stem cell culture medium is heated or preserved at high temperature, the effect of various effects of stem cells on the various effects of the stem cells was investigated. Investigated. As a result of the experiment, the wound healing assay confirmed that the cell migration increased after 6 hours, and after 24 hours, it was confirmed that the cell mobility was increased and cell division was promoted, thereby being concentrated. As a result of investigating the amount of transdermal water loss by preparing a cosmetic product containing stem cell culture solution, it was confirmed that the culture solution addition group showed an improvement rate of 31% compared to the non-added group, thereby helping in skin wound recovery. As a result of this, it is considered that this point should be considered when the stem cell culture medium is used as an active ingredient in cosmetics in the future.

119구급차로 이송된 환자의 병원 전 전문응급처치에 관한 조사 (A Analysis of Prehospital care on the patients Transported via 119System)

  • 박진옥;이경희;노상균;최청숙
    • 한국응급구조학회지
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    • 제7권1호
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    • pp.127-134
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    • 2003
  • An analysis was performed to evaluate the prehospital advanced emergency care in Emergency Medical Service system(EMS) through the review of the 119 transfort chart of 190 patients who visited to Jecheon Seoul hospital emergency center at Chungbuk Jecheon via 119 system during the period from October 2002 to September 2003. The results were obtained as follows: 1. Among 190 patients, male were 127(66.8%) and female were 63(33.2%) and nontraumatic patients were 81(42.6%) and traumatic patients were 109(57.4%). 2. The analysis of prehospital care by Emergency Medical Technician(EMT) revealed that Airway maintenance and keeping oral airway(37.7%), oxygen supply(75.9%), Tourniquett or MAST(18.9%), Immobilization of neck or spine(94.7%), Immobilization of extremities (51.4%), wound bandage and dressing(25.0%), BCLS(12.1%) and Application of AED(2 patients). 3. The analysis of prehospital care by EMT revealed prehospital care was limited to keep of intubation or LMA, medication and IV insertion, insertion of gastric tube and ACLS. 4. There was no case of the notification to medical institute or consultation to doctor.

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지역사회중심 가정간호사업 개발 및 평가 (Development & Evaluation of Community-Based Home Care Nursing Service Program)

  • 이원희;김조자;강규숙;오의금;박희옥;조원정
    • 지역사회간호학회지
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    • 제15권2호
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    • pp.209-217
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    • 2004
  • Purpose: The purpose of this study was to construct the structure, process and outcome of community-based home care nursing service and to examine their validity. Method: There were two steps. The first step was developing the structure and process of community-based home care and the second was evaluating the outcome of community-based home care. Home care services were provided to 25 clients who had health problems. Data on these clients were analyzed. Result: According to Albrecht Model, in the developed structure and process of community-based home care, structure contained facility's philosophy, organization, delivery system, steering committee, office, equipments, medical instruments, the home care nurse and client of home care nursing. Process contained classification of client. nursing diagnosis and nursing intervention. The majority of clients were men (56%). The service was used mostly by people aged over 50 (82%). The most frequent nursing diagnoses were altered urinary elimination (23.2%). impaired skin integrity (21.8%) and risk for infection (17.6%). Nursing interventions included wound care (16.7%), tube care (15.1%) and catheter care (14.5%). Conclusion: Several strategies are suggested from this study: first, activate a referral system within the national health care system: second, increase public information on home care nursing: third, develop home care nursing services for elderly people: and fourth, construct a cooperation system between home care services and social welfare services.

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산욕기 산모의 가정간호 요구도 조사 (A Study on the Home Health Care Need of Postpartum Mothers)

  • 양영옥;최소영
    • 가정간호학회지
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    • 제10권2호
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    • pp.148-157
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    • 2003
  • The purpose of this study was to provide the basic data for developing a program for effective intervention for home health care need of postpartum mothers and newborn babies. The subjects were 104 women. The data were collected from march, 2003 to June, using a 81 item questionnaire and analyzed by SPSS program for frequency, Mean, ANOVA. The results were as follow. 1. The mean of care needs of newborn babies was higher than that of physical demand of Postpartum mothers. The mean of physical demand of Postpartum mothers was $3.99\pm.42$. The mean of care needs of newborn babies was $4.11\pm.50$. 2. The most highest mean of physical demand of Postpartum mothers was wound care for caesarean section and episiotomy($4.53\pm.66$), and then breast engorgement care($4.38\pm.71$). The most highest mean of care needs of newborn babies was emergency care methods($4.58\pm.52$), and then infection control $4.51\pm.56$). 3. 66.3% of postpartum mothers positively desired consultation hospitals centered home care need during postpartial periods. 4. Influential variables of home health care need was postpartial periods. they wanted the first week after delivery, more freqently visiting of home care nurse. 37.5% of postpatial mothers wanted visiting within 1 weeks after delivery. 31.7% wanted 2 times/week. In conclusion, it is necessary to study to make a program in nursing of home health care for postpartum mothers, and to keep on studying repeatedly in order to raise the number of objects and to find related variables.

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뇌혈관질환자의 가정간호 서비스 및 진료비 분석 (Analysis on Home Care Services and Home Health Care Cost of CVA Patients in Korea)

  • 김은경;신숙연;황정해
    • 간호행정학회지
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    • 제12권2호
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    • pp.225-232
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    • 2006
  • Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

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