BACKGROUND: One of the problem in emergency room(ER) of university hospital is over-crowdedness that causes exhaustion of medical resources (personnel, device, space) and disturbes optimal treatment. METHODS: This is an evaluative research for the purpose of promoting efficient operation system in ER of university hospital. RESULTS: 1) In 387 visitors, mean age was 47.5 years, and male to female ratio 1.21:1. As the specialty in charge, 28.9%f them were internal medicine, 26.6%mergency medicine, 9.9%eurology, and 8.5%eurosurgery. 24%f visitors have come by ambulances. The patients stayed for average 16.1 hours. The admission rate of ER visitors was 33.4 %60.3 %returned home after some management. 2) The visitors had various causes without correlation between the severity of conditions and the choice of high level hospital ER. They perceived their situations emergent in 78.4% but after triage only 25.6%were classified emergent. 48.6%of the visitors were the patients of out-patient department of this hospital due to chronic diseases. 3) The patients were assessed within 9.5 minutes after arrival at ER by nurse and within 34 minutes by doctor. If they were in need of consultation to second/third department, they waited for 141.5/460 minutes respectively to see the doctor. They waited for 59.9/52.7 minutes to get routine laboratory sampling/radiologic examination respectively. 4) Every 2.3 new patients visited this ER per hour. Average 63.2 patients were taken over to next shirt of nurse duty, and 60%of them had chronic degenerative diseases. CONCLUSION: The causes of overcrowding in ER of the university hospital were (1) huge number of patients at out-patient department of the hospital, (2) shortage of beds compared to the number of patients waiting admission, (3) too many kinds of procedures performed in ER, (4) cooperation failure among doctors of different specialty, and (5) no definite criteria of admission/discharge into/from ER. To solve these problems, conversion of ER management policy from complete examination and treatment to more simple and rapid one is necessary.
Ambulances ; Chronic Disease ; Emergencies* ; Emergency Service, Hospital* ; Female ; Hospitals ; Humans ; Internal Medicine ; Male ; Outpatients ; Triage

No abstract available.
Family Practice* ; Humans

No abstract available.
Humans ; Male ; Nursing* ; Urinary Incontinence*

PURPOSE: This study was aimed at exploring the current status of graduate programs for an advanced practice nurse(APN) to recommend future directions of APN education. METHODS: A total of 142 students enrolled in seven APN specialty programs, 67 professors who were involved in APN education, and nine nurse administrators participated in the study. Data was collected by questionnaires and focus group interviews. RESULTS: The current definition of APN was found not to be specific enough to represent expected roles of APN in regards to knowledge, attitudes, roles, and skills. Standard curricula employed regardless of the area of APN specialty, lack of qualified clinical practice settings, as well as prepared instructors were found to be problematic. CONCLUSION: The following needs to be addressed: 1. redefining of APN roles, 2. tailoring specialty areas of APN, 3. consolidating educational programs, and 4. ensuring APN role models and faculty. Suggesting a CNS role in Korean APN, areas of APN should be rearranged toclarify their roles and educational programs need to be further developed to meet the expectations and quality of APNs. It is necessary to ensure APN's employment in the health care system by laws and policies to perform advanced nursing roles.
Adult ; Curriculum ; Education, Nursing, Continuing ; Education, Nursing, Graduate ; Educational Measurement ; Focus Groups ; Humans ; Interviews as Topic ; Middle Aged ; Nurse Clinicians/*education ; Nurse Practitioners/*education ; Nursing Evaluation Research ; Questionnaires ; Societies, Nursing ; Specialties, Nursing/*education

Renal artery stenosis is a rare cause of acute pulmonary edema. So-called flash pulmonary edema is associated with bilateral renal artery stenosis or stenosis in a single functioning kidney. Flash pulmonary edema has been recognized as an absolute indication for vascular intervention. A 33-year old man was admitted with acute shortness of breath. Renal angiography showed occlusion of the right renal artery. He underwent a right renal artery bypass graft. However, after the renal artery bypass graft, episodes of pulmonary edema recurred. A renal angiography showed complete obstruction of the right renal artery and bypass graft. The left renal angiography showed an intact renal artery and decreased kidney size.
Adult ; Angiography ; Constriction, Pathologic ; Dyspnea ; Humans ; Kidney ; Pulmonary Edema* ; Renal Artery Obstruction* ; Renal Artery* ; Transplants*

PURPOSE: This study was to analyze the trend of research on intervention for patients with metabolic syndrome. METHOD: Using Pubmed, Medline, and CINAHL search engines, a randomized controlled trial(RCT) researching titles such as "metabolic syndrome", "intervention", "lifestyle modification", or "community-based" were collected. A total of 16 researches were analyzed based on the guidelines of the National Cholesterol Education Program-Adult Treatment Panel(NCEP-ATP III). RESULTS: 1) The total period of the intervention was from 12 to 24 weeks, the frequency was 3 to 5 times per week, and the duration of each session was from 45 to 60 minutes. The types of intervention included exercise, diet, and medication. Among these types, diet was performed most frequently. 2) The outcomes of the intervention was measured with physical aspects such as anthropometric measures, body composition, or biological markers. No studies have evaluated psychosocial outcomes such as quality of life. 3) In terms of effectiveness of the intervention, anthropometric indicators, body composition, or serological markers showed positive effects, whereas results on endothelial or urine indicators were inconsistent. CONCLUSION: Methodological research developing comprehensive therapeutic lifestyle modification programs and intervention studies are needed for patients with metabolic syndrome. In addition, effects should be evaluated with multidimensional perspectives.
Humans ; Life Style ; Metabolic Syndrome X/*nursing ; *Nursing Methodology Research ; Randomized Controlled Trials as Topic ; Statistics, Nonparametric

Purpose: This study aims to describe and identify in-depth the breastfeeding experience of primiparas for more than one year using a phenomenological research method and to raise the understanding of the primiparas’ subjective experiences during the breastfeeding process to contribute to the improving and maintaining maternal and child health. Methods: This research was a phenomenological and qualitative study conducted on 5 primiparas who continued breastfeeding for more than 12 months. Data was collected through individual in-depth interviews from November 1, 2021 to March 20, 2022, and it was analyzed through the sixth stage of phenomenological research analysis presented by Colaizzi. Results: The study consisted of 10 theme clusters and 26 themes from meaningful statements about the breastfeeding success experiences of primiparas for more than one year. The 10 theme collections were "Planning breastfeeding during pregnancy," "Commitment to breastfeeding through information and education," "Challenges faced during breastfeeding," "Continuous hard work," "Continued conflict over breastfeeding amid confusion," "Connects with experts who lead the way," "Establishes one's own standards and direction," "Peace after hard work," "Solid and firm confidence," and "Deep-rooted beliefs brestfeeding serve as reminders." Conclusion It is expected that this study will help to understand the individual difficulties and problems experienced by primiparas during breastfeeding, the importance of breastfeeding education, the role of medical personnel in the early stage of childbirth, social and environmental support, and the importance of an active window for information exchange. By identifying these factors, this study can serve as basic data for nursing practice to promote successful breastfeeding.

BACKGROUND: The aim of this study was to evaluate antibiotic consumption by adult patients at a single university hospital in Korea between 2001 and 2012. METHODS: We used the 2004 World Health Organization Anatomical Therapeutic Chemical Classification System definition of defined daily doses (DDD) per 1,000 patient-days to calculate the annual antibiotic consumption for 18 antibiotic groups. Chi-square linear-by-linear analysis was performed to evaluate antibiotic consumption trends for each group. RESULTS: Average annual antibiotic consumption during 2001-2012 was 644.6 DDD/1,000 patient-days (standard deviation, 33.3 DDD/1,000 patient-days). Although no statistically significant change was observed during the study period, consumption of first- and second-generation cephalosporins, and aminoglycosides was significantly decreased, while that of beta-lactam/beta-lactamase inhibitors, fourth-generation cephalosporins, carbapenem, glycopeptide, linezolid, colistin, and quinolone increased significantly. CONCLUSION: The total amount of prescribed antibiotics did not change, but the use of broad-spectrum antibiotics increased during the study period.
Adult ; Aminoglycosides ; Anti-Bacterial Agents ; Cephalosporins ; Classification ; Colistin ; Hospitals, University ; Humans ; Korea ; World Health Organization ; Linezolid

PURPOSE: This study was to identify knowledge, perception and health behavior about metabolic syndrome for an at risk group in a rural community area. METHODS: A descriptive cross-sectional survey design was used. A total of 575 adults with hypertension, diabetes mellitus, dyslipidemia, and/or abdominal obesity were recruited from 11 rural community health care centers. A questionnaire was developed for this study. Anthropometric measures were measured and blood data was reviewed from the health record. RESULTS: Knowledge about the metabolic syndrome was low as evidenced by only a 47% correct answer rate. Only 9% of the subjects ever heard about the disease, and 87% answered they do not know the disease at all. 87% of the subjects were not performing regular exercise, 31% drank alcohol more than once a month, 12.5% were current smokers, and 33.6% are did not have a regular health check-up. CONCLUSION: Development of systematic public health care programs are needed to prevent future increases in cardiovascular complications and to decrease health care costs. These might include educational programs for the primary health care provider and an at risk group, a therapeutic lifestyle modification program, and a health screening program to identify potential groups.
Aged ; Anthropometry ; Awareness ; Blood Chemical Analysis ; Cross-Sectional Studies ; Female ; *Health Behavior ; Health Care Surveys ; Health Knowledge, Attitudes, Practice ; Humans ; Life Style ; Male ; Metabolic Syndrome X/etiology/*psychology ; Middle Aged ; *Perception ; Risk Factors ; *Rural Health ; Rural Health Services/organization & administration

PURPOSE: In recent years, many psychological problems in patients with stomas have been addressed in a number of studies. But there are only a few studies that use objective measures to take into account self-appraisal by patients with permanent or temporary stomas. The aim of this study is to compare the psychological attitude of patients with permanent and temporary stomas and to determine the most appropriate psychological supportive care. METHODS: Sixty-five patients, who received a stoma between January 2009 and March 2012, were classified into two groups with either permanent or temporary stomas and were observed prospectively. We developed a questionnaire with the aid of a psychiatrist to analyze the grade of psychological attitude of self-appraisal of patients. The questionnaire was categorized into three parts; body image scale, self-esteem scale, and depression scale. Patients responded to the questionnaire 4 weeks after the operation and the answers of each group were compared. RESULTS: Out of 65 patients, 42 received temporary stomas and 23 received permanent stomas. There was no significant mean difference between permanent and temporary stoma patients in the body image scale, the self-esteem scale, and the depression scale. However, patients with a permanent stoma tended to have a worse body image and lower self-esteem on some specific items within the questionnaires. CONCLUSION: Patients with stomas have negative attitudes toward themselves and some meaningful differences were found between different types of stoma applied. Surgeons should be concerned about postoperative psychological support for patients with stomas.
Body Image ; Depression ; Diagnostic Self Evaluation* ; Humans ; Ostomy ; Prospective Studies* ; Psychiatry ; Self Concept ; Surveys and Questionnaires