No abstract available.
Humans ; Infant, Newborn* ; Microbubbles*

OBJECTIVES: The objective of this study is to find out what nurses wrote in narrative nursing notes. METHODS: Forty-six patients' nursing notes were analyzed based on the nursing process. Eight patterns were extracted depending on the different combinations of the nursing process components. RESULTS: Of the 8 patterns, assessment only pattern was the most frequent comprising 45.8% and assessment or diagnosis-intervention-outcome patterns accounted for 25.9% of the total nursing phrases. The content of nursing notes was also classified into 15 categories. Out of these 15 categories, nursing outcomes were recorded more frequently in nursing care mainly driven by doctor's order such as diseases related symptom management, insomnia care, respiratory care and pain control than in independent nursing care such as education and emotional care. According to the survey on nurses' attitude toward nursing record, nurses did not document nursing outcome as much as they reported they did. The main reasons for this discrepancy were insufficient time for recording and lack of knowledge about why, how and what to evaluate. CONCLUSION: Even though there is room for improvement, nursing notes can be used a source for nursing contribution to patient outcomes.
Education ; Humans ; Nursing Care ; Nursing Process* ; Nursing Records* ; Nursing* ; Outcome Assessment (Health Care) ; Sleep Initiation and Maintenance Disorders ; Thoracic Surgery*

BACKGROUND: The purpose of this study is to evaluate the evidence for the effectiveness of different isolation policies in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in hospital in-patients. METHODS: We prospectively evaluated the effectiveness of an isolation policy on transmission of MRSA in the 745-beds hospital. First period, all patients with MRSA (March - July 2000) were not isolated Second period, strict isolation policies were performed (August 2000 - January 2002). All patients with MRSA were isolated in separated room, hand hygiene using alcohol handrub, gowning and g1oving, apply of MRSA notice sticker, criteria in isolation remove, separated disinfection and wastement. Third period, semi strict isolation policies were performed (February 2002 - August 2005). Some patients with MRSA were isolated in separated room and others were admitted in general ward for bed shortage. Only some practices were performed in hand washing and separated disinfection in general ward. RESULTS: The rates of MRSA nosocomial infection per patients during 1st, 2nd, and 3rd surveillance were reported 0.56, 0.23, and 0.42 (P<0.05). Patient-days rate of MRSA nosocomial infection during 1st, 2nd, and 3rd surveillance were reported 0.62, 0.27, and 0.38 (P<0.05). CONCLUSION: With many different isolation policies, it was possible to reduce nosocomial infection of MRSA. In this study, strict isolation policies (2nd period) were the most effective practices in reducing MRSA infection.
Cross Infection ; Disinfection ; Hand Disinfection ; Hand Hygiene ; Humans ; Incidence ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Patients' Rooms ; Prospective Studies

PURPOSE: Alterations in cerebral blood flow are very important for understanding the neurological consequences of all varieties of perinatal asphyxia. The purpose of this study is to measure the change of cerebral blood flow velocity and resistance index (RI) of middle cerebral artery (MCA) according to the time in asphyxiated infants. METHODS: We studied 7 asphyxiated term infant and 27 normal term infant who were born at Ewha Womans University Hospital from January 1996 to August 1997. Using the Doppler ultrasound, we examined blood flow velocity and RI of the middle cerebral artery. RESULTS: Clinical characteristics were not significantly different in both groups. Peak systolic flow velocity (PSFV) in asphyxiated infants significantly decreased than control (P<0.05). End diastolic flow velocity (EDFV) was not significantly different in both groups. RI in asphyxiated infants significantly decreased for 24 hours (P<0.05). No control infant ever had a RI value of 0.55 or below, three (42.9%) asphyxiated infants had a RI value of 0.55 or below. The changes of the systemic BP and heart rate were not significant. Two (28.6%) asphyxiated infants were proven periventricular white matter ischemia by ultrasonography. CONCLUSION: It is therefore very important to monitor RI in asphyxiated infants even if the degree of asphyxia is mild.
Asphyxia ; Blood Flow Velocity* ; Female ; Heart Rate ; Humans ; Infant* ; Ischemia ; Middle Cerebral Artery ; Ultrasonography

PURPOSE: Alterations in cerebral blood flow are very important for understanding the neurological consequences of all varieties of perinatal asphyxia. The purpose of this study is to measure the change of cerebral blood flow velocity and resistance index (RI) of middle cerebral artery (MCA) according to the time in asphyxiated infants. METHODS: We studied 7 asphyxiated term infant and 27 normal term infant who were born at Ewha Womans University Hospital from January 1996 to August 1997. Using the Doppler ultrasound, we examined blood flow velocity and RI of the middle cerebral artery. RESULTS: Clinical characteristics were not significantly different in both groups. Peak systolic flow velocity (PSFV) in asphyxiated infants significantly decreased than control (P<0.05). End diastolic flow velocity (EDFV) was not significantly different in both groups. RI in asphyxiated infants significantly decreased for 24 hours (P<0.05). No control infant ever had a RI value of 0.55 or below, three (42.9%) asphyxiated infants had a RI value of 0.55 or below. The changes of the systemic BP and heart rate were not significant. Two (28.6%) asphyxiated infants were proven periventricular white matter ischemia by ultrasonography. CONCLUSION: It is therefore very important to monitor RI in asphyxiated infants even if the degree of asphyxia is mild.
Asphyxia ; Blood Flow Velocity* ; Female ; Heart Rate ; Humans ; Infant* ; Ischemia ; Middle Cerebral Artery ; Ultrasonography

We studied 49 patients who showed partially accommodative esotropia retrospectively. They were glasses for accommodative component and underwent surgery for nonaccommodative one. The mean value of refractive error was +4.41 +/- 2.04 D. The mean deviation angle of accommodative component was 20.78 +/- 12.59 PD (prism diopter), and the one of non-accommodative component was 30.45 +/- 15.12 PD. Mild amblyopia was shown in 58% of these patients. The DVD or IOOA was infrequently accompanied in these patients. Stereopsis was much improved after straightening eyes. Deterioration was noticed in 14% of the patients. The longer the duration between onset and the time at straightening eyes, and the earlier the onset of deviation, the more deterioration was noticed. This study revealed that the characteristics of partially accommodative esotropia was similar to the accommodative esotropia.
Amblyopia ; Depth Perception ; Esotropia* ; Eyeglasses ; Glass ; Humans ; Refractive Errors ; Retrospective Studies

We studied 49 patients who showed partially accommodative esotropia retrospectively. They were glasses for accommodative component and underwent surgery for nonaccommodative one. The mean value of refractive error was +4.41 +/- 2.04 D. The mean deviation angle of accommodative component was 20.78 +/- 12.59 PD (prism diopter), and the one of non-accommodative component was 30.45 +/- 15.12 PD. Mild amblyopia was shown in 58% of these patients. The DVD or IOOA was infrequently accompanied in these patients. Stereopsis was much improved after straightening eyes. Deterioration was noticed in 14% of the patients. The longer the duration between onset and the time at straightening eyes, and the earlier the onset of deviation, the more deterioration was noticed. This study revealed that the characteristics of partially accommodative esotropia was similar to the accommodative esotropia.
Amblyopia ; Depth Perception ; Esotropia* ; Eyeglasses ; Glass ; Humans ; Refractive Errors ; Retrospective Studies

Background: Post-dural puncture headache (PDPH) is one of the well-known complication of spinal anesthesia. Epidural blood patch is the treatment of choice for PDPH but is rarely used for the prevention of PDPH after spinal anesthesia. The purpose of this study is to observe the effectiveness of epidural blood patch for prevention of PDPH and to evaluate the complications after epidural blood injection. Methods: Three hundred patients (ASA I or II) receiving spinal anesthesia were studied. They were randomly devided into two groups. Patients in Group I, the control group, were maintained in a supine position for 24 hour after spinal anesthesia. Patients in Group II, the study group, received 3 ml of autologous blood in the epidural space after spinal anesthesia. PDPH was evaluated for 5 days. The incidence, location, onset, and duration of headache in the patients presenting with PDPH were measured for 5 days, and the complications following epidural blood patch in Group II were observed for 2 weeks. Results: The incidence of PDPH in group I was 11%, but 0% in group II. There were no specific complications following epidural blood patch in Group II. Conclusions: This study suggest that the 3 ml epidural autologous blood patch is an useful method for the prevention of PDPH in patients with spinal anesthesia.
Anesthesia, Spinal* ; Blood Patch, Epidural ; Epidural Space ; Headache ; Humans ; Incidence ; Post-Dural Puncture Headache ; Punctures* ; Supine Position

No abstract available.
Infection Control* ; National Health Programs*

Most of health care professional obtain and update their new knowledge and skills through continuing education. Nurses who works three shifts per day are not easy to attend continuing education session usually offered during their working hours. One of solutions to this problem would be to develop a education program which does not limit time and place. The aim of this study is to develop and evaluate a web-based continuing education program, to help nurse improve their knowledge of transfusion therapy and medical law, and to enhance their ability to contribute to the quality of patient care. A wide range of contents regarding transfusion therapy are covered extensively, concentration on principles of transfusion therapy and administration of whole blood and blood components, transfusion reactions. In the medical law, contents on Korean law in general, medical law, history of revision of medical law, nursing related medical laws are covered, Many color illustrations have been included to help nurses learning process. Each unit has a set of multiple choice questions to provide feedback to nurses. Two sets of questionnaires were used for this study. First, a questionnaire was administered to 21 nurses to collect information on their general characteristics, opinions of inservice and continuing education, and experiences of using computer and internet before they were exposed to the program. Second, another questionnaire was administered to 21 nurses after they were exposed to the program. They were asked to evaluate program in terms of its easiness of use, contents and ways of presenting contents, and usefulness of program for learning. The program generally was well received by the nurses. The program is a useful adjunct to the existing continuing education program. It also could be used in nursing student education and other health sciences.
Blood Group Incompatibility ; Delivery of Health Care ; Education* ; Education, Continuing ; Humans ; Internet* ; Jurisprudence ; Learning ; Multimedia* ; Nursing ; Patient Care ; Surveys and Questionnaires ; Students, Nursing ; Teaching Materials*