Background: This study examined the impact of the performance improvement and patient safety (PIPS) program implemented in 2015 on outcomes for trauma patients in a regional trauma center established by a government-led project for a national trauma system in Korea. Methods: The PIPS program was based on guidelines by the World Health Organization and American College of Surgeons. The corrective strategies were proceeded according to the loop closure principle: data-gathering and monitoring, identification of preventable trauma deaths (PTDs), evaluation of preventable factors, analysis of findings, and corrective action plans. We established guidelines and protocols for trauma care, conducted targeted education and peer review presentations for problematic cases, and enhanced resources for improvement accordingly. A comparative analysis was performed on trauma outcomes over a four-year period (2015–2018) since implementing the PIPS program, including the number of trauma team activation and admissions, time factors related to resuscitation, ventilator duration, and the rate of PTDs. Results: Human resources in the center significantly increased during the period; attending surgeons responsible for trauma resuscitation from 6 to 11 and trauma nurses from 85 to 218. Trauma admissions (from 2,166 to 2,786), trauma team activations (from 373 to 1,688), and severe cases (from 22.6 to 33.8%) significantly increased (all P < 0.001). Time to initial resuscitation and transfusion significantly decreased from 120 to 36 minutes (P < 0.001) and from 39 to 16 minutes (P < 0.001). Time to surgery for hemorrhage control and decompressive craniotomy improved from 99 to 54 minutes (P < 0.001) and 181 to 135 minutes (P = 0.042). Ventilator duration and rate of PTDs significantly decreased from 6 to 4 days (P = 0.001) and 22.2% to 8.4% (P = 0.008). Conclusion Implementation of the PIPS program resulted in improvements in outcomes at a regional trauma center that has just been opened in Korea. Further establishment of the PIPS program is required for optimal care of trauma patients.

Background: This study examined the impact of the performance improvement and patient safety (PIPS) program implemented in 2015 on outcomes for trauma patients in a regional trauma center established by a government-led project for a national trauma system in Korea. Methods: The PIPS program was based on guidelines by the World Health Organization and American College of Surgeons. The corrective strategies were proceeded according to the loop closure principle: data-gathering and monitoring, identification of preventable trauma deaths (PTDs), evaluation of preventable factors, analysis of findings, and corrective action plans. We established guidelines and protocols for trauma care, conducted targeted education and peer review presentations for problematic cases, and enhanced resources for improvement accordingly. A comparative analysis was performed on trauma outcomes over a four-year period (2015–2018) since implementing the PIPS program, including the number of trauma team activation and admissions, time factors related to resuscitation, ventilator duration, and the rate of PTDs. Results: Human resources in the center significantly increased during the period; attending surgeons responsible for trauma resuscitation from 6 to 11 and trauma nurses from 85 to 218. Trauma admissions (from 2,166 to 2,786), trauma team activations (from 373 to 1,688), and severe cases (from 22.6 to 33.8%) significantly increased (all P < 0.001). Time to initial resuscitation and transfusion significantly decreased from 120 to 36 minutes (P < 0.001) and from 39 to 16 minutes (P < 0.001). Time to surgery for hemorrhage control and decompressive craniotomy improved from 99 to 54 minutes (P < 0.001) and 181 to 135 minutes (P = 0.042). Ventilator duration and rate of PTDs significantly decreased from 6 to 4 days (P = 0.001) and 22.2% to 8.4% (P = 0.008). Conclusion Implementation of the PIPS program resulted in improvements in outcomes at a regional trauma center that has just been opened in Korea. Further establishment of the PIPS program is required for optimal care of trauma patients.

PURPOSE: To report a case of anterior segment ischemia after superior and inferior rectus muscle surgery in a patient with superior rectus muscle enlargement. This is the first report in the Republic of Korea of anterior segment ischemia after two rectus muscles surgery. CASE SUMMARY: An 80-year-old male was referred to our clinic with a 3 years history of diplopia. The patient had 30 prism diopters right eye hypertropia in the primary position and downgaze limitation. The orbital computed tomography scan revealed enlargement of the right superior rectus muscle. He underwent right superior rectus recession and inferior rectus resection. On postoperative day 2, slit lamp examination revealed diffuse corneal edema, Descemet's membrane folding, an aqueous flare and a dilated pupil. Treatment with 45 mg oral steroid was initiated, and 1% prednisolone acetate and 0.5% Levofloxacin eye drops were administered. At postoperative 1 month, the patient was orthophoric in the primary position, and there was no corneal edema, pupil abnormality or aqueous flare. CONCLUSIONS: Base on the present case, the possibility of anterior segment ischemia should be considered after even two muscles surgery, and older patients with vertical muscle surgery should be considered more carefully.
Aged, 80 and over ; Aqueous Humor ; Corneal Edema ; Descemet Membrane ; Diplopia ; Humans ; Ischemia ; Levofloxacin ; Male ; Muscles ; Oculomotor Muscles ; Ophthalmic Solutions ; Orbit ; Prednisolone ; Pupil ; Republic of Korea ; Slit Lamp ; Strabismus

PURPOSE: We report our experience with a case of orbital lymph node which has not been previously reported in the Republic of Korea. CASE SUMMARY: A 24-year-old female patient with no underlying disease visited our hospital with a 2-month history of a mass at the lateral side of the left upper eyelid. On physical examination, a round, well-defined subcutaneous mass was palpable, and pain, swelling or a skin change were not reported or seen. The appearance, location, and imaging findings of the mass were suspected to be dermoid, and excisional biopsy was performed for accurate diagnosis and treatment. The 1.0 × 0.7 cm-sized, round-shaped and brown-colored mass was excised. The mass was well-defined but in the posterior part; it was attached to the periosteum. The mass was finally diagnosed as a lymph node with lymphadenitis by histopathological examination. No recurrence or new lesion was observed after surgery, and the patient did not complain of abnormal symptoms. CONCLUSIONS: A Complete orbital lymphoid tissue has not yet been found in the orbit, and lymph nodes are known to be absent. However, as in this case, when an orbital mass is observed, the possibility of lymph node should be considered and histopathological examination should be performed to confirm it.
Biopsy ; Dermoid Cyst ; Diagnosis ; Eyelids ; Female ; Humans ; Lymph Nodes ; Lymphadenitis ; Lymphoid Tissue ; Orbit ; Periosteum ; Physical Examination ; Recurrence ; Republic of Korea ; Skin ; Young Adult

PURPOSE: This study was conducted in order to analyze themes, concepts, research methods and results of previous domestic research on the nursing of hematologic patients conducted through the last 10 yr, to find trends in the research, and to provide basic materials for setting the direction of future research on the nursing of hematologic patients. METHODS: This study analyzed a total of 72 nursing theses related to hematology sampled from domestic theses for a master's or doctoral degree and papers published in six nursing journals registered in Korea Research Foundation from January 2000 to July 2009. RESULTS: Of the 72 theses, 51 were for a master's degree, 7 for a doctoral degree, and 14 not for an academic degree. The concept covered most frequently in correlation research was 'quality of life' and concepts found in comparative research were stress and quality of life. In experimental research, the most common nursing intervention was oral care. The scale used most frequently was Spielberger's Anxiety Scale. CONCLUSION: It is necessary to expand experimental research applying nursing interventions, and to use objective physiological indexes for more effective assessment in experimental research. Furthermore, interdisciplinary research is required for enhancing the quality of clinical nursing research.
Anxiety ; Clinical Nursing Research ; Hematology ; Hematopoietic Stem Cell Transplantation ; Humans ; Korea ; Nursing Research ; Quality of Life

The Second Meeting of the National Control Laboratories for Vaccines and Biologicals in the Western Pacific, was jointly organized by the National Institute of Food and Drug Safety Evaluation of the Ministry of Food and Drug Safety in the Republic of Korea, and by the World Health Organization Regional Office for the Western Pacific. In the National Lot Release Systems session countries including Canada, China, Japan, Malaysia, Vietnam, and the Republic of Korea, all shared information on their current Lot Release Systems, including current practices and developments in risk-based official lot release of vaccines. In the session on Quality Control of Blood Products, experts from the National Institute for Biological Standards and Control shared quality control and research results for; blood coagulation factor VIII products, and the measurement of procoagulant activity in immunoglobulin products. Representatives from Japan proposed a regional collaborative study to test aggregated immunoglobulin free from complement activity. A cell-based Japanese encephalitis vaccine potency assay was proposed by representatives from Korea and they also called for voluntary participation of other National Control Laboratories in a collaborative study, on the first Korean Gloydius anti-venom standard. Participants agreed in general to continue communicating, and coordinate presentation of the study results.
Blood Coagulation Factors ; Canada ; China ; Complement System Proteins ; Encephalitis, Japanese ; Factor VIII ; Immunoglobulins ; Japan ; Korea ; Malaysia ; Quality Control ; Republic of Korea ; Vaccine Potency ; Vaccines* ; Vietnam ; World Health Organization