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      • KCI등재후보

        신체적 억제대 지침 개발 및 사용 효과

        정윤중,김혜현,김은한,김지연,차세정,김유진,강정은,정연화,정영선,김영환,경규혁,홍석경,Jung, Yooun-Joong,Kim, Hea-Hyun,Kim, Eun-Han,Kim, Ji-Yeoun,Cha, Se-Jung,Kim, You-Jin,Kang, Jung-Eun,Chung, Yeon-Hwa,Jung, Young-Sun,Kim, Young-Hwan,Kyou 한국의료질향상학회 2014 한국의료질향상학회지 Vol.20 No.1

        Objective: The objective of this research was to develop a guideline for more effective use of physical restraint on patients in the intensive care unit and training the nurses on it and applying it on clinical practice to assess its effectiveness. Method: This research analyzed the before and after effect of the development of a guideline for physical restraint by dividing the category into nurse and patient. In the case of nurse, a comparison of knowledge and nursing service regarding the use of physical restraint from before the training on physical restraint guideline(Jan. 2011) and after the training on physical restraint guideline(Dec. 2011) was made. In the case of patient, a comparison of physical restraint usage rate and average usage time, the number of unplanned extubation cases were compared from before the use of physical restraint (Jan.~Apr. 2011) and after the use of physical restraint (Sep.~Dec. 2011) were made. Result: After the training on the physical restraint guideline, the knowledge of the nurse and the nursing practice showed notable improvement by (p<0.000) and (p<0.048) respectively and in patient, physical restraint usage rate and average time of usage decreased by (p<0.001) and (p<0.001) respectively. And despite the decrease in the number of cases in which the physical restraint was used, the number of unplanned extubation cases remained the same. Conclusion: Physical restraint guideline training and guideline usage can be stated to have brought out positive effect in both the nurse and patient. In order to maintain such positive effects, continuous training is necessary and continuous revaluation is necessary, regarding knowledge and nursing practices.

      • KCI등재후보

        외상환자의 치료에서 외상 전문간호사 도입 결과

        정윤중 ( Yooun Joong Jung ),김영환 ( Young Hwan Kim ),김태현 ( Tae Hyun Kim ),금민애 ( Min Ae Keum ),마대성 ( Dae Sung Ma ),경규혁 ( Kyu Hyouck Kyoung ),김정재 ( Jung Jae Kim ),홍석경 ( Suk Kyung Hong ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4

        Purpose: Ongoing treatment and care, as well as initial stabilization, are required for trauma patients. With increasing number of sickest trauma patients and shortage of surgeons, the need for advanced practice nurse to provide and coordinate trauma care has been greater. The purpose of this study is to analyze the effect of hiring a trauma clinical nurse specialist and its influence on the treatment of trauma patients. Methods: Based on the employment of the clinical nurse specialist in December 2010, the patients were divided into two groups: patients admitted from January 1, 2010 to November 30, 2010 and patients admitted from December 1, 2010 to December 31, 2011. Retrospectively, data were collected using electronic medical records. The general characteristics, clinical courses, and ICU re-admission rates, collaboration (transfers to other departments and collaborative surgery) were compared. Results: To have a clinical nurse specialist on the trauma team resulted in a statistically significant reductions in the length of general ward hospital stay (p<0.05), the ICU re-admission rate, (p<0.03), the lead-time before transfer to other departments (p<0.05). Conclusion: The clinical nurse specialist, as a professional practitioner, improved the quality of treatment through early detection and management of problems. In addition, as a coordinator, the clinical nurse specialist maintained a cooperative relationship with multi-disciplinary medical personnel. The trauma clinical nurse spe-cialist contributed to the treatment of trauma patients positively through a decrease in ICU re-admission rate and length of hospital stay. (J Trauma Inj 2012;25:254-260)

      • KCI등재후보

        외상환자의 보험체계에 따른 진료비 분석

        박희성 ( Hee Seung Park ),정윤중 ( Yooun Joong Jung ),김영환 ( Young Hwan Kim ),김태현 ( Tae Hyun Kim ),금민애 ( Min Ae Km ),경규혁 ( Kyu Hyouck Kyoung ),김정재 ( Jung Jae Kim ),홍석경 ( Suk Kyung Hong ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.4

        Purpose: In Korea, the nation`s medical expenses were 12 billion won in 2010. The medical costs for individuals can also be overwhelming. If a patient has sustained severe trauma, his/her insurance company responsible may pay only part of the medical bills. In Korean, there are diverse types of medical insurance, such as health insurance, automobile insurance, and industrial accident compensation insurance. And each insurance system has a different type of payment system. Our study will be essential for establishing the optimal medical expense payment system. Methods: From January to December 2011, we retrospectively reviewed the medical charts of 161 patients who were admitted to our hospital`s emergency room after having undergone severe trauma. Of those 161 patients, 125 were retrospectively reviewed. Written permission was obtained from all of the patients. We analysed the demographic characteristics, clinical outcomes, data of the trauma, type of the patient`s insurance, and the entire bill when the patient was discharged. Results: Seventy-one patients had health insurance, 48 automobile insurance, and six industrial accident compensation insurance. High-deductible insurance included health insurance and industrial accident compensation insurance, with the deductibles up to 20.6% and 19.1%, respectively. We attempted to analyze the cause of the high deductible rate. In patients with health insurance, medicines, primarily sedatives, pain killers, antibiotics, and fluids. comprised a large proportion. On the other hand, industrial accident compensation insurance deducted for a high-grade hospital room charge. Conclusion: We found that medical expenses were diverse according to the type of insurance. In particular, health insurance forced patients to pay too much of the medical expenses. Therefore, in Korea we should try to identify the insurance problems and improve the wage system. (J Trauma Inj 2012;25:178-187)

      • KCI등재

        유미복막증이 동반된 복부장기 손상

        김영환 ( Young Hwan Kim ),정윤중 ( Yooun Joong Jung ),홍석경 ( Suk Kyung Hong ) 대한외상학회 2012 大韓外傷學會誌 Vol.25 No.3

        Chyloperitoneum or chylous ascite after trauma is a rare condition. It can develop after direct injuries of lymphatic vessels or cisterna chyli. Though isolated chyle duct injury has sometimes been reported, chyloperitoneum is generally accompanied by various kinds of damage to other intraabdominal organs. There``s still no established therapeutic protocol regarding the treatment of chyloperitoneum when it is accompanied by the serious injuries of intraabdominal organs. We describe a 66-year-old male with serious intraabdominal organ injuries after blunt trauma. In our case, chyloperitoneum developed due to the injuries to the mesenteric lymph vessels and compression of cisterna chyli by hematoma around aorta. (J Korean Soc Traumatol 2012;25:105-108)

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