Development of Job Standards for Nurse-Led Rapid Response Teams

Ju-Ry Lee,JuHee Lee,Yon Soo Jang,Yeon-Hee Kim,Sang-Bum Hong,Eui Geum Oh 한국간호과학회 2019 한국간호과학회 학술대회 Vol.2019 No.10

Nurses’ experience with deteriorating ward patients at the underserved emergency medical service areas hospital: a qualitative study

Ju-Ry Lee,A-Reum Hwang 한국간호과학회 2023 한국간호과학회 학술대회 Vol.2023 No.11

국내 간호사 주도 신속대응팀 간호사의 업무활동 분석

이주리(Lee, Ju-Ry),오의금(Oh, Eui Geum),유은영(Yoo, Eun-Young) 한국간호행정학회 2021 간호행정학회지 Vol.27 No.1

Purpose: The purpose of this study was to identify the work activities of nurse-led rapid response teams (RRT). Methods: For this study a methodological approach was used to identify work activities for nurse-led RRT. The study was conducted in two stages. The first step was to analyze the work activities of domestic nurse-led RRTs using the interview method, and then develop a questionnaire based on the results of the interviews. As a second step, field surveys were conducted by nurse-led RRT nurses to investigate importance and performance based on the developed questionnaire. Results: Fifty-eight work activities were identified for nurse-led RRTs in the following nine core areas: advanced nursing practice, education, counseling, consultation, collaboration, ethical decision-making, research, evidence-based practice, and leadership. Conclusion: The identified work activities for nurse-led RRTs will be used as basic data in nurse-led RRTs job description, developing job standards and can also serve as basic data for developing a nurse-led RRT educational curriculum. The results of this study suggest that follow-up research is needed to develop job standards based on the identified nurse-led RRT"s work activities.

일반병동 내 중증 패혈증 또는 패혈성 쇼크 환자의 중환자실 전동 예측에 대한 수정조기경고점수(Modified Early Warning Score)의 타당성

이주리(Lee, Ju Ry),최혜란(Choi, Hye Ran) 한국간호과학회 2014 Journal of Korean Academy of Nursing Vol.44 No.2

Purpose: To assess whether the Modified Early Warning Score (MEWS) predicts the need for intensive care unit (ICU) transfer for patients with severe sepsis or septic shock admitted to general wards. Methods: A retrospective chart review of 100 general ward patients with severe sepsis or septic shock was implemented. Clinical information and MEWS according to point of time between ICU group and general ward group were reviewed. Data were analyzed using multivariate logistic regression and the area under the receiver operating characteristic curves with SPSS/WIN 18.0 program. Results: Thirty-eight ICU patients and sixty-two general ward patients were included. In multivariate logistic regression, MEWS (odds ratio [OR] 2.02, 95% confidence interval [CI] 1.43-2.85), lactic acid (OR 1.83, 95% CI 1.22- 2.73) and diastolic blood pressure (OR 0.89, 95% CI 0.80-1.00) were predictive of ICU transfer. The sensitivity and the specificity of MEWS used with cut-off value of six were 89.5% and 67.7% for ICU transfer. Conclusion: MEWS is an effective predictor of ICU transfer. A clinical algorithm could be created to respond to high MEWS and intervene with appropriate changes in clinical management.

Antifibrotic Activity of Diterpenes from Biota orientalis Leaves on Hepatic Stellate Cells

Lee, Mi-Kyeong,Yang, Hye-Kyung,Yoon, Jeong-Seon,Jeong, Eun-Ju,Kim, Do-Yoon,Ha, Na-Ry,Sung, Sang-Hyun,Kim, Young-Choong 대한약학회 2008 Archives of Pharmacal Research Vol.31 No.7

Antifibrotic effect of twelve diterpenes (1-12) from the 90% methanolic fraction of Biota orientalis leaves was evaluated employing HSC-T6 cells by assessing cell proliferation and morphological change. Among these diterpenes, totarol (8) and isopimara-8(14),15-dien-19-oic acid (9) dramatically reduced cell proliferation in dose- and time-dependent manner. Furthermore, treatment with these compounds resulted in the different pattern of morphological changes of HSC-T6 cells. Taken together, antiproliferative activity of diterpenes from B. orientalis might suggest therapeutic potentials against liver fibrosis.

정신분열병 환자에 대한 통합심리치료의 효과

이만홍,이희상,조현상,현명호,안석균,유상우,박지환,한승진,현용호,구민성,손석한,김세주,이현주,박소라,송선미,안혜리,최정아,남궁기,유계준 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.6

목 적: 본 연구는 인지재활이 강화된 통합심리치료를 정 신분열병 환자에게 시행하여 그 결과를 평가하고 행상의 문제점을 분석하여 정신분열병 환자의 재활을 위한 한국형 통합심치료를 개발하기 위한 목적으로 실시되었다 . 방 법. 정신분열병으로 입원한 환자에게 인지분화,사회지각, 언어소통,사회기술, 문제해결기술의 5단계 구성된 통합심리치료를 12주간 주3회 실시하였고 치료 전후에 저자들이 개발한 인지분화평가척도, 사회기술평가척로,문제해결기술척도와Positive And Negative Syndrome Scale로 치료효과를 평가하였다. 집단내의 상호작용과 사회적 관심과 같은 비특이적인 간섭변인을 배제하기 위하여 정신건강교육에 의한 관심 -위약 대조군을 설정하여 비교하였다. 결 과: 통합심리치료를 시행한 군은 대조군에 비해 일반정신병리점수와 임상중상 총점수의 유의미한 호전이 있었고 인지기능의 호전은 인지분화 소프로그램후에서만 관찰되었으며 사회기술 소프로그램후의 사회기술기능은 제한적 효과만 있었다. 그러나 통합심리치료 시행군내에서는 12주후 양성증상. 음성증상. 일반 정신병리 모두에서 호전되었다. 결 론: 본 결과는 통할심리치료가 정신분열병 환자에게 임상 중상 영역의 치료효과가 있음을 지지하지만 인지 영역 훈련이 갖는 특정 효과는 보여주지 않았다 한편으로는 치료 프로그램의 사회문화적이고도 언어적인 배경의 차이. 치료기간, 집단구성원의 기능 동질화, 정서 처리, 인지영역 훈련에 대한 치료자의 숙련도 등의 시행상의 문제가 있어 우리나라 환자에의 적용을 위해서는 통합심리치료 원저의 수정이 요구된다. 0bjectives : This study, as a preliminary one attempting to develop the Korean version of Integrated Therapy for the rehabilitation of schizophrenic patients, was designed to investigate the results of Integrated Psychological Therapy(IPT) and review the problems during the program application. Methods : Cognitive Differentiation Scale, problem-Solving Scale, and PANSS(Positive And Negative Syndrome ScalE) were administered to schizophrenic inpatients before and after IPT incorporating cognitive diffirentiation, social perception, verbal communication, social skill and interpersonal Problem-solving skill subprograms. The therapy groups were offered activities three times per week during the 12-week program. The control groups were attention-placebo groups for control ling factors such as group interaction and social attention, and were offered psychoeducation. Results : The 12-week IPT groups, compared with the control groups, demonstrated sign-nificant improvements in the general psychopathology and the total symptoms of PANSS, but did not in cognitive functions and problem-solving skill. Significant improvements in cognitive functions were found only artier cognitive differentiation subprogram and social skill subprogram had limited effects on social skills. But within 12-week IPT groups significant improvements in the positive symptoms, negative symptoms and general psychopathology werc found. Conclusion : These findings support some effectiveness of IPT, but do not address the unique contribution by cognitive components. Applied to schizophrenic patients in this country, this modality had the problems such as differences in sociocultural and lingual background, duration of treatment, homogeneity in the level of the functioning among group members, management of emotions in activities, and the therapists'skill in the training of cognitive components. So the modification of this modality will be required.

Targeted busulfan and fludarabine-based conditioning for bone marrow transplantation in chronic granulomatous disease

Ju, Hee Young,Kang, Hyoung Jin,Hong, Che Ry,Lee, Ji Won,Kim, Hyery,Song, Sang Hoon,Yu, Kyung-Sang,Jang, In-Jin,Park, June Dong,Park, Kyung Duk,Shin, Hee Young,Kim, Joong-Gon,Ahn, Hyo Seop The Korean Pediatric Society 2016 Clinical and Experimental Pediatrics (CEP) Vol.59 No.no.sup1

Chronic granulomatous disease (CGD) is a primary immunodeficiency disease caused by impaired phagocytic function. Hematopoietic stem cell transplantation (HSCT) is a definitive cure for CGD; however, the use of HSCT is limited because of associated problems, including transplantation-related mortality and engraftment failure. We report a case of a patient with CGD who underwent successful HSCT following a targeted busulfan and fludarabine reduced-toxicity myeloablative conditioning. Intravenous busulfan was administered once daily for 4 consecutive days (days -8 to -5), and the target area under the curve was $75,000{\mu}g{\cdot}hr/L$. Fludarabine ($40mg/m^2$) was administered once daily for 6 consecutive days from days -8 to -3. Antithymocyte globulin (2.5 mg/kg/day) was administered from days -4 to -2. The patient underwent successful engraftment and did not have any severe toxicity related to the transplantation. Conditioning with a targeted busulfan and fludarabine regimen could provide a better outcome for HSCT in CGD, with close regulation of the busulfan dose.

Hemophagocytic lymphohistiocytosis diagnosed by brain biopsy

Ju, Hee Young,Hong, Che Ry,Kim, Sung Jin,Lee, Ji Won,Kim, Hyery,Kang, Hyoung Jin,Park, Kyung Duk,Shin, Hee Young,Chae, Jong-Hee,Phi, Ji Hoon,Cheon, Jung-Eun,Park, Sung-Hye,Ahn, Hyo Seop The Korean Pediatric Society 2015 Clinical and Experimental Pediatrics (CEP) Vol.58 No.9

Hemophagocytic lymphohistiocytosis (HLH) is characterized by fever, splenomegaly, jaundice, and pathologic findings of hemophagocytosis in bone marrow or other tissues such as the lymph nodes and liver. Pleocytosis, or the presence of elevated protein levels in cerebrospinal fluid, could be helpful in diagnosing HLH. However, the pathologic diagnosis of the brain is not included in the diagnostic criteria for this condition. In the present report, we describe the case of a patient diagnosed with HLH, in whom the brain pathology, but not the bone marrow pathology, showed hemophagocytosis. As the diagnosis of HLH is difficult in many cases, a high level of suspicion is required. Moreover, the pathologic diagnosis of organs other than the bone marrow, liver, and lymph nodes may be a useful alternative.

병동 급성악화 환자의 중환자실 전동 위험요인 분석

이주리,Lee, Ju-Ry 한국디지털정책학회 2021 디지털융복합연구 Vol.19 No.4

목적: 병동에서 급성악화 환자가 발생할 때 환자에게 집중치료가 필요한지 여부에 대한 결정은 환자의 예후를 향상시키기 위해서는 매우 중요하나, 특히 사용 가능한 ICU 자원이 제한적일 때는 ICU 전동 여부를 결정하기에는 어려움이 있다. 따라서 본 연구는 일반병동 급성 악화 환자를 대상으로 중환자실 전동 위험요인을 확인하고자 한다. 연구방법: 후향적 조사연구로서 대상자는 일 상급종합병원 일반병동에 입원한 18세 이상의 성인 환자 중 악화상태를 보여 신속대응팀에 의뢰된 환자 2,945명을 대상으로 하였다. 중환자실 전동 위험요인을 파악하기 위해 다변량 로지스틱 회귀분석을 시행하였다. 연구결과: 다변량 로지스틱 회귀분석 결과 입원시 고형암을 진단받은 경우 (odds ratio [OR] 0.39, 95% CI 0.32-0.47), 악화원인이 호흡문제인 경우 (OR 1.51, 95% CI 1.17-1.95), MEWS (OR 1.22, 95% CI 1.17-1.28)와 SpO2/FiO2 score (OR 2.41, 95% CI 2.23-2.60)가 중환자실 전동 위험요인으로 나타났다. 결론: 본 연구 결과는 중환자실 전동 위험이 높은 환자의 조기 예측을 가능하게 하여 환자의 예후를 향상시키는데 도움이 될 것으로 사료된다. Purpose: When a patient with acute deterioration occurs in a ward, the decision to transfer to intensive care unit (ICU) is critical to improve the patient's outcomes. However, when available ICU resources limited, it is difficult to determine which of the deteriorating ward patients to transfer to the ICU. Therefore the purpose of this study was to identify risk factors in predicting deteriorating ward patients transferred to intensive care unit (ICU). Methods: We reviewed retrospectively clinical data of 2,945 deteriorating ward patients who referred medical emergency team. Data were analyzed with multivariate logistic regression. Results: The solid cancer that diagnosed at hospitalization (odds ratio[OR] 0.39; 95% confidence interval [CI] 0.32-0.47), when the cause of deterioration was respiratory problem (1.51; 95% CI 1.17-1.95), high MEWS (1.22; 1.17-1.28) and SpO2/FiO2 score (2.41; 2.23-2.60) were predictive of ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.

원예치료가 성인 뇌병변 장애인의 자발성에 미치는 영향

임주리(Ju-Ry Lim),장소현(Soh-Hyun Jang),이아영(A-Young Lee),조원근(Weon-Keun Cho) 한국산림휴양학회 2010 한국산림휴양학회 학술발표회 자료집 Vol.2010 No.6월