Brain Injuries, Traumatic ; therapy ; Clinical Protocols ; Enteral Nutrition ; methods ; statistics & numerical data ; Female ; Humans ; Intensive Care Units ; standards ; Male ; Middle Aged ; Nutrition Policy ; Nutrition Therapy ; methods ; standards ; Respiration, Artificial ; Retrospective Studies ; Treatment Outcome

PURPOSE: The purpose of this study was to evaluate the effect of a self-evaluation method using video recording on competency in nursing skills, self-directed learning ability, and academic self-efficacy in nursing students. METHODS: The study design was a non-equivalent pre-post quasi-experimental design. The experimental and control groups were randomly assigned with 35 participants in each group. Interventions for the experimental group were video recording and students\' self-evaluation of what they did. Nursing skills included in the study were tube feeding, intradermal injection, subcutaneous injection, and intramuscular injection. Competency in nursing skills was measured one time at the end of the study using a checklist. Self-directed learning ability and academic self-efficacy were measured 3 times (pre-, mid-, and post-intervention) over the 8 weeks. Independent t-test, chi-square test, and repeated measures ANOVA were used for data analyses. RESULTS: There was no statistically significant difference for competency in nursing skills and self-directed learning ability over the 8 weeks of the practice session. There was a significant difference in academic self-efficacy by groups over time. CONCLUSION: Results indicate that self-evaluation method using video recording is an effective learning way to improve academic achievement in nursing students.
Checklist ; Diagnostic Self Evaluation* ; Enteral Nutrition ; Humans ; Injections, Intradermal ; Injections, Intramuscular ; Injections, Subcutaneous ; Learning* ; Nursing* ; Self Efficacy ; Self-Assessment ; Statistics as Topic ; Students, Nursing ; Video Recording*

OBJECTIVETo study the effect of breastfeeding quality improvement on the breastfeeding rate in very low birth weight (VLBW) and extremely low birth weight (ELBW) infants in the neonatal intensive care unit (NICU).

METHODSA retrospective analysis was performed for the clinical data of VLBW and ELBW infants who were admitted from July 2014 to July 2015 (pre-improvement group) and those who were admitted from August 2015 to June 2016 after the implementation of breastfeeding quality improvement measures (post-improvement group). The parameters including condition of breastfeeding (breastfeeding rate, breastfeeding amount, and breastfeeding time), duration of parenteral nutrition, time to enteral feeding, and incidence of feeding intolerance were compared between the two groups.

RESULTSThe implementation of breastfeeding quality improvement measures significantly increased breastfeeding rate and amount, significantly shortened time to addition of human milk fortifier, duration of parenteral nutrition, and time to enteral feeding, and significantly decreased the incidence of feeding intolerance.

CONCLUSIONSBreastfeeding quality improvement measures can increase breastfeeding rate in the NICU and decrease gastrointestinal complications in preterm infants.

Breast Feeding ; statistics & numerical data ; Enteral Nutrition ; Female ; Humans ; Infant, Extremely Low Birth Weight ; growth & development ; Infant, Newborn ; Infant, Very Low Birth Weight ; growth & development ; Intensive Care Units, Neonatal ; Male ; Parenteral Nutrition ; Quality Improvement ; Retrospective Studies ; Weight Gain

PURPOSE: Parenteral nutrition (PN) is known to provide therapeutic beneficial improvements in malnourished patients for whom enteral nutrition is not feasible. The objective of this study was to investigate the current clinical characteristics and utilization of PN in Korea. METHODS: We analyzed the Health Insurance Review Agency National Inpatients Sample database from 2014 to 2016, which included 13% of all hospitalized patients in Korea. Adult patients aged 20 years or older and receiving premixed multi-chamber bag containing PN were included for this study. Patient characteristics, admission type, primary diagnosis, and hospital demographics were evaluated. SAS version 9.4 was used for data analysis. RESULTS: From 2014 to 2016, 149,504 patients received premixed PN, with 226,281 PN prescriptions being written. The mean patient age was 65.0 years, and 81,876 patients (54.8%) were male. Premixed 3-chamber bag and 2-chamber bag PN solutions were utilized in 131,808 (88.2%) and 32,033 (21.4%) patients, respectively. The number of patients hospitalized through the emergency department were 70,693 (47.3%), whereas 43,125 patients (28.8%) were administered PN in intensive care units. In the adult PN patients, the highest primary diagnosis was malignant neoplasm of the stomach (8,911, 6.0%), followed by organism unspecified pneumonia (7,008, 4.7%), and gastroenteritis and colitis of unspecified origin (6,381, 4.3%). Overall, 34% of adult PN patients were diagnosed with malignancies, the most common being neoplasm of the stomach (17.7%), neoplasm of bronchus/lung (11.2%), neoplasm of colon (11.1%), and neoplasm of liver/intrahepatic bile ducts (10.0%). PN solutions were most frequently administered in the metropolitan area (55.0%) and in hospitals with more than 1,000 beds (23.6%). CONCLUSION: PN was commonly administered in older patients, with primary diagnosis of malignancy in a significant number of cases. This study is the first large-scale description of PN-prescribing patterns in real-world clinical practice in South Korea.
Adult* ; Bile Ducts ; Colitis ; Colon ; Demography ; Diagnosis ; Emergency Service, Hospital ; Enteral Nutrition ; Gastroenteritis ; Humans ; Inpatients ; Insurance, Health ; Intensive Care Units ; Korea* ; Male ; Nutritional Support ; Parenteral Nutrition* ; Pneumonia ; Prescriptions ; Statistics as Topic ; Stomach

To evaluate the incidence of delayed enteral nutrition (EN) and identify avoidable causes of delay, we retrospectively reviewed medical records of 200 children (median age [range]; 37.5 [1-216] months) who stayed in the intensive care unit (ICU) for a minimum of 3 days. Among 200 children, 115 received EN following ICU admission with a median time of EN initiation of 5 days after admission. Of these, only 22 patients achieved the estimated energy requirement. A significant decrease in the final z score of weight for age from the initial assessment was observed in the non-EN group only (-1.3+/-2.17 to -1.57+/-2.35, P<0.001). More survivors than non-survivors received EN during their ICU stay (61.2% vs 30.0%, P=0.001) and received EN within 72 hr of ICU admission (19.8% vs 3.3%, P=0.033). The most common reason for delayed EN was gastrointestinal (GI) bleeding, followed by altered GI motility and hemodynamic instability. Only eight cases of GI bleeding and one case of altered GI motility were diagnosed as active GI bleeding and ileus, respectively. This study showed that the strategies to reduce avoidable withholding EN are necessary to improve the nutrition status of critically ill children.
Adolescent ; Child ; Child, Preschool ; Critical Illness ; Energy Intake ; Enteral Nutrition/*statistics & numerical data ; Female ; Gastrointestinal Hemorrhage/*diagnosis ; Gastrointestinal Motility ; Humans ; Ileus/*diagnosis ; Infant ; Intensive Care Units ; Male ; Nutritional Status ; Retrospective Studies ; Treatment Outcome ; Withholding Treatment/*statistics & numerical data

OBJECTIVETo compared the clinical efficacy of laparoscopic repair (LR) versus open repair (OR) for perforated peptic ulcers.

METHODSFrom January 2010 to June 2014, in Shanghai Tongji Hospital, 119 patients who were diagnosed as perforated peptic ulcers and planned to receive operation were prospectively enrolled. Patients were randomly divided into LR (58 patients) and OR(61 patients) group by computer. Intra-operative and postoperative parameters were compared between two groups. This study was registered as a randomized controlled trial by the China Clinical Trials Registry (registration No.ChiCTR-TRC-11001607).

RESULTSThere was no significant difference in baseline data between two groups (all P>0.05). No significant differences of operation time, morbidity of postoperative complication, mortality, reoperation probability, decompression time, fluid diet recovery time and hospitalization cost were found between two groups (all P>0.05). As compared to OR group, LR group required less postoperative fentanyl [(0.74±0.33) mg vs. (1.04±0.39) mg, t=-4.519, P=0.000] and had shorter hospital stay [median 7(5 to 9) days vs. 8(7 to 10) days, U=-2.090, P=0.001]. In LR group, 3 patients(5.2%) had leakage in perforation site after surgery. One case received laparotomy on the second day after surgery for diffuse peritonitis. The other two received conservative treatment (total parenteral nutrition and enteral nutrition). There was no recurrence of perforation in OR group. One patient of each group died of multiple organ dysfunction syndrome (MODS) 22 days after surgery.

CONCLUSIONLR may be preferable for treating perforated peptic ulcers than OR, however preventive measures during LR should be taken to avoid postopertive leak in perforation site.

China ; Comparative Effectiveness Research ; Digestive System Surgical Procedures ; adverse effects ; methods ; Enteral Nutrition ; Female ; Fentanyl ; Humans ; Laparoscopy ; adverse effects ; rehabilitation ; Laparotomy ; Length of Stay ; statistics & numerical data ; Male ; Multiple Organ Failure ; epidemiology ; Operative Time ; Pain, Postoperative ; drug therapy ; epidemiology ; Parenteral Nutrition, Total ; Peptic Ulcer Perforation ; rehabilitation ; surgery ; Peritonitis ; therapy ; Postoperative Complications ; epidemiology ; therapy ; Postoperative Period ; Prospective Studies ; Recurrence ; Reoperation ; Treatment Outcome