PURPOSE: The purpose of this study was to assess the clinical application of a bar code medication administration and blood transfusion system and to identify its effects from the aspect of patient safety and nurse satisfaction in a tertiary hospital. METHODS: The system in this study was PDA with bar code reading capability and wireless networking function. The logs created during application of the system and administration error reports were analyzed. For nurses' satisfaction with the system, data were collected from 337 nurses using the instrument developed by Otieno et al. and analyzed using descriptive statistics. RESULTS: The system application rate was 98.8%, and the main failure cases in the system application included bar code or network related factors. When the system was applied, 0.02% of errors were prevented. The nurses were satisfied with the system from the aspect of patient safety, however relatively less satisfied with the system from the aspect of work efficiency. CONCLUSION: The results of the study indicate the usefulness for patient safety of applying the bar code medication administration and blood transfusion system to clinical practice. However technological improvements including bar code and network communication are necessary to ensure higher work efficiency in nursing practice.
Automatic Data Processing ; Blood Transfusion ; Dietary Sucrose ; Information Systems ; Patient Safety ; Tertiary Care Centers

This study has been focused on understandings for the problems of dietitian who perform nutrition service in the field of industry foodservice and then focused on using of its findings as basic material for smooth nutrition service performance through analyzing job satisfaction, job characteristic and its importance of dietitians' task in industry foodservice. A questionnaire survey of 120 nutritionists who have engaged themselves in industry foodservice-60 are under direct management and 60, held in trust-has been performed, and 95 responses (79%) have been collected and categorized, except some unfinished responses. The examined data have been classified statistically by using of SPSS, and then analyzed into frequency, percentage, mean value, standard deviation, and correlation among factors, according to questionnaires. The findings of the research can be summarized as following: The details of the surveyed dietitians were: 20~25 years old on an average; working less than two years; college graduates; mere employees; receiving monthly pay of 70~100 won on an average; working more than 52 hours weekly; and providing with four meals a day in a single menu. For job satisfaction and job characteristic, the service itself and the understanding of the service appear as main features. For the relative importance of the service, the findings show that the menu making, sanitation and cost control occupy an important position, while nutrition counseling, nutrition education and dietary control by ailments make up very low portion. For the cause of not enacting the nutrition service, the lack of counseling ability and the overburden of food service are at the top. The findings of this research, therefore, present the needs of the service capacity education and the reduction of excessive foodservice hours of dietitians in order to secure the efficient nutrition service in industry foodservice. To achieve this goal, first of all, there should be an intensive education course in school by using of practice hours. for enhancing practical service adaptability, and then the computerization of foodservice should be executed perfectly to reduce the excessive foodservice hours.
Cost Control ; Counseling ; Education ; Food Services ; Humans ; Job Satisfaction* ; Meals ; Nutritionists* ; Surveys and Questionnaires ; Sanitation

PURPOSE: The purpose of this study was to explore emotional labor experienced by nurses in ambulatory care setting. METHOD: The phenomenological method developed by Giorgi was used for this study. The participants were 9 nurses who had experienced emotional labor. Data were collected between May and August 2010 by face-to-face interviews. The interview was recorded and then transcribed. RESULTS: The constituents associated with the meaning of the nurses' experiences of emotional labor in ambulatory care setting were as followings: bearing down of suffering emotions coming up from the bottom, feeling loneliness when having to undertake care alone by oneself, having conflict between nursing professional and services, managing mind by means of both internal and external resources, getting ridding oneself of conflict with forced emotions over time. CONCLUSIONS: The results of this study should contribute to a deeper understanding of the meaning of emotional labor experienced by nurses in ambulatory care. The results also highlight the need to develop programs for nurses in ambulatory care setting to help them express their real action.
Ambulatory Care ; Loneliness ; Stress, Psychological ; Ursidae

PURPOSE: The purpose of this study was to identify risk factors for pediatric inpatients falls. METHODS: The study was a matched case-control design. The participants were 279 patients under the age of 6 who were admitted between January 1, 2004 and December 31, 2009. Through chart reviews, 93 pediatric patients who fell and 186 ones who did not fall were paired by gender, age, diagnosis, and length of stay. Five experts evaluated the 38 fall risk factors selected by the researchers. RESULTS: In a general hospital, pediatric patients with secondary diagnosis, tests that need the patient to be moved, intravenous lines, hyperactivity, anxiolytics, sedatives and hypnotics, and general anesthetics showed significance for falls on adjusted-odds ratios. Conditional logistic regression analysis was performed to elucidate the factors that influence pediatric inpatient falls. The probability of falls increased with hyperactivity and general weakness. Patients who didn't have tests that required them to be moved and intravenous line had a higher risk of falls. CONCLUSION: These findings provide information that is relevant in developing fall risk assessment tools and prevention programs for pediatric inpatient falls.
Accidental Falls/*prevention & control ; Age Factors ; Analgesics ; Case-Control Studies ; Child ; Child, Preschool ; Female ; Hematologic Diseases/pathology ; Hospitalization ; Hospitals, General ; Humans ; Infant ; Length of Stay ; Logistic Models ; Male ; Neoplasms/pathology ; Odds Ratio ; Retrospective Studies ; Risk Factors ; Sex Factors

PURPOSE: To evaluate the CT findings of tuberculous pericardial effusion. MATERIALS AND METHODS: In 12patients with tuberculous pericardial effusion. CT scans were obtained. The condition was diagnosed by thepresence of chronic granulomatous inflammation with caseous granuloma or acid fast bacilli in a biopsy specimen orpericardial fluid. CT findings were evaluated with regard to the appearance and the location of pericardialthickening, location of pericardial effusion, loculation of the pericardial effusion by adhesion of pericardiumand associated findings such as pulmonary tuberculosis or pleural effusion. RESULTS: In all cases, pericardialeffusion and thickening were seen. This thickening was usually even(10 of 12 cases), and occurred mainly in theanterior portion(7 of 12 cases). Thickened pericardium was enhanced and showed higher attenuation than adjacentchest wall muscle. Effusion was usually found in the anterior portion(10 of 12 cases), though the right and leftside were also involved(5/12 and 6/12 cases, respectively). Loculation of pericardial effusion was noted in tencases. Pleural effusion occurred in eight cases and associated active pulmonary tuberculosis in five. CONCLUSION: The CT findings of tuberculous pericardial effusion are enhanced evenly-thickened pericardium and anteriorloculated pericardial effusion, and are helpful for the diagnosis of tuberculous pericardial effusion.
Biopsy ; Diagnosis ; Granuloma ; Inflammation ; Pericardial Effusion* ; Pericardium ; Pleural Effusion ; Tomography, X-Ray Computed ; Tuberculosis ; Tuberculosis, Pulmonary

Recently, we have experienced with various changes in the health insurance. Korean government is implementing the prospective payment system(PPS) as a pilot project to reduce medical expenditure. Case management is an effective way to reduce costs, while not sacrificing quality of service, under the PPS. In this study, the integrated decision support system(DSS) for case management was presented to support two case management activities ; utilization management and discharge planning. This system can be used in three ways ; prospective, concurrent, and retrospective management. By monitoring cases from medical record database, the DSS provides basic patient information, payment information, medical service information to the case manager. In the future, data warehouse should be introduced to integrate various databases related to case management and to improve quality of information produced by the DSS.
Case Management* ; Cesarean Section* ; Critical Pathways ; Diagnosis-Related Groups* ; Female ; Health Expenditures ; Humans ; Insurance, Health ; Medical Records ; Patient Discharge ; Pilot Projects ; Pregnancy

PURPOSE: To describe the chest radiographic and CT findings of diffuse pulmonary hemorrhage. MATERIALS AND METHODS: Two radiologists retrospectively analysed the chest radiographic and CT findings of six patients withdiffuse pulmonary hemorrhage. Using open lung biopsy (n=2) and transbronchial lung biopsy or bronchoalveolarlavage (n=4), diagnosis was based on the presence of hemosiderin-laden macrophage or intra-alveolar hemorrhage.Underlying diseases were Wegener's granulomatosis (n=2), antiphospholipid antibody syndrome (n=2),Henoch-Schonlein purpura (n=1), and idopathic pulmonary hemosiderosis (n=1). In all patients, sequential chestradiographs, obtained during a one to six-month period, were available. HRCT scans were obtained in five patients,and conventional CT scans in one. Follow-up HRCT scans were obtained in two. We also analyzed the patterns ofinvolvement, distribution and sequential changes in the pulmonary abnormalities seen on chest radiographs and CTscans. RESULTS: Chest radiographs showed multifocal patchy consolidation (n=6), ground-glass opacity (n=3), andmultiple granular or nodular opacity (n=3). These lesions were intermingled in five patients, while in one therewas consolidation only. Sequential chest radiographs demonstrated the improvement of initial pulmonaryabnormalities and appearance of new lesions elsewhere within 5-6 days, though within 7-25 (average, 13) days,these had almost normalized. HRCT scans showed patchy consolidation (n=5), multiple patchy ground-glass opacity(n=5), or ill-defined air space nodules (n=4). These lesions were intermingled in five patients, and in one,ground-glass opacity only was noted. In two patients there were interlobular septal thickening and intralobularreticular opacity. The distribution of these abnormalities was almost always bilateral, diffuse with no zonalpredominancy , and spared the apex of the lung and subpleural region were less affected. CONCLUSION: Althoughchest radiographic and CT findings of diffuse pulmonary hemorrhage are nonspecific, sequential changes inbilateral multifocal patchy consolidation and ground-glass opacity, accompanied by clinical symptoms such ashemoptysis or anemia, may be helpful in the diagnosis of diffuse pulmonary hemorrhage.
Anemia ; Antiphospholipid Syndrome ; Biopsy ; Diagnosis ; Follow-Up Studies ; Hemorrhage* ; Hemosiderosis ; Humans ; Lung ; Macrophages ; Purpura ; Radiography, Thoracic ; Retrospective Studies ; Tomography, X-Ray Computed ; Wegener Granulomatosis

Purpose: To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. Methods: A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. Results: 65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. Conclusion It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

OBJECTIVE: It is well known that fresh blastocyst transfer results in better pregnancy outcomes with a smaller number of transferred embryos compared with cleavage stage embryo transfer. However, in terms of frozen-thawed blastocyst transfer, only a few studies are available. We aimed to evaluate clinical outcomes of frozen-thawed embryo transfer (FET) with blastocysts. METHODS: Retrospective analysis of FET cycles with blastocysts (B-FET) between Jan 2007 and June 2009 was performed. Age-matched FET cycles with cleavage stage embryos (C-FET) during the same period were collected as controls. A total of 58 B-FET cycles were compared with 172 C-FET cycles and also compared with those of post-thaw extended culture blastocysts from frozen pronuclear stage embryos (22 cycles). RESULTS: There was no difference in the patient characteristics of each group. The embryos' survival rates after thawing were comparable (>90%) and there was no difference in the implantation rate or clinical and ongoing pregnancy rate among the three groups. CONCLUSION: In FET, blastocyst transfers may not present better pregnancy outcomes than cleavage stage embryo transfers. A further large-scale prospective study is needed.
Blastocyst ; Embryo Transfer ; Embryonic Structures ; Female ; Humans ; Pregnancy ; Pregnancy Outcome ; Pregnancy Rate ; Retrospective Studies ; Survival Rate

The objectives of this study was to discover knowledge in predicting lengths of stay of Cesarean Section by patients characteristics and treatment method using data mining technique and to suggest the approach to the development of critical pathway. The findings suggest that data mining technique from the large pool of accumulated patients data can be utilized to systematize newly observed correlations, patterns and trends and to develop critical pathway for the treatment and management. The results of the study can be contributed to aid developing the clinical pathway for cesarean section suitable to Korean patients. And the application of the developed critical pathway in clinical practice will produce the actual effect and value.
Cesarean Section* ; Critical Pathways* ; Data Mining* ; Female ; Humans ; Pregnancy