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단일 기관에서 지방유제 단독 제형 투여 처방의 적절성 평가
정혜련 ( Hye Ryun Jung ),은명온 ( Myoung On Eun ),방은숙 ( Eun Sook Bang ),이지현 ( Ji Hyun Lee ),김미향 ( Mi Hyang Kim ),홍정 ( Jeong Hong ),박은정 ( Eun Jung Park ),이재명 ( Jae Myeong Lee ) 한국정맥경장영양학회 2014 한국정맥경장영양학회지 Vol.6 No.3
Purpose: IV-lipid emulsion can be a nutritional supplement to provide essential fatty acids and energy for patients who need total parenteral nutrition support. The recommended administration dose of lipid emulsion is less than 2.5 g/kg/d and the rate should not exceed 0.15 g/kg/h for adult patients. The purpose of this study is to evaluate the adequacy of the currently prescribed administration rate of IV-lipid emulsion in a single center. Methods: We analyzed 1,739 lipid emulsion administration prescriptions in 1,095 patients over 18 years old at Ajou University Hospital from January 1, 2014 to March 31. Results: The median prescription rate of total lipid emulsion was 0.134 (0.012∼1.125) g/kg/h, and the exceeding portion of maximum recommended infusion rate was 36.9%. The median administration prescription rate of lipid emulsion was faster in 500 mL emulsions, compared to 250 mL emulsion (0.146 g/kg/h vs. 0.075 g/kg/h; P<0.001) and at emergency room (ER), compared to general ward (0.154 g/kg/h vs. 0.123; P<0.001). The exceeding portion of maximum recommended infusion rate of lipid emulsion was also higher in 500 mL emulsion, compared to 250 mL emulsion (52.2% vs. 30.4%; P<0.001) and at ER, compared to general ward (52.1% vs. 30.4%; P<0.001). Triglyceride level was higher in exceeding recommended infusion rate compared to less, but not statistically significant (119 mg/dL vs. 261 mg/dL; P=0.202). Conclusion: Administration prescription rate of lipid emulsion exceeded the recommended rate and this feature was dominant in 500 mL emulsion and at ER. Education and monitoring of lipid emulsion prescription is needed for appropriate lipid administration and prevention of fat overload syndrome.
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중앙 집중형 망에서 인공면역체계 기반의 적응적 망 이상 상태 탐지 모델 설계
유경민(Kyoung-Min Yoo),양원혁(Won-Hyuk Yang),이상열(Sang-Yeol Lee),정혜련(Hye-Ryun Jeong),소원호(Won-ho So),김영천(Young-Chon Kim) 한국통신학회 2009 韓國通信學會論文誌 Vol.34 No.3
기존의 망 이상 상태 탐지 시스템들은 주로 정상 상태의 시스템 사용률 등과 같은 통계 값으로 결정된 임계값을 기반으로 탐지하기 때문에 이상 상태임에도 불구하고 정상 상태와 비슷한 시스템 통계 값을 가지면 탐지하지 못하는 문제점이 있다. 이러한 단점들을 해결하기 위하여 본 논문에서는 인간면역체계의 학습, 적응, 기억 능력등의 특성을 이용하는 인공면역체계 기반의 적응적 망 이상 상태 탐지 모델을 제안한다. 이를 위하여 인간면역 시스템의 수지상 세포 (Dendritic Cell)와 T 세포 사이의 상호 작용을 이용한 탐지 모델을 설계하고 각 구성 요소 및 기능을 정의한다. 중앙 집중 제어 노드는 각 라우터 노드로부터 전달받은 정보를 분석하여 대응 방법을 해당 라우터들에게 전달한다. 또한 라우터 노드는 학습을 통해 얻어진 데이터를 기반으로 이상 상태를 탐지할 뿐만 아니라 중앙 집중 제어 노드로부터 전달받은 정보를 이용하여 이상 상태를 처리한다. 최종적으로 제안된 이상 상태 탐지 모델의 타당성을 검증하기 위하여 구성 모듈을 설계하고 flooding 공격에 대한 시뮬레이션을 수행한다. The traditional network anomaly detection systems execute the threshold-based detection without considering d ynamic network environments, which causes false positive and limits an effective resource utilization. To overco me the drawbacks, we present the adaptive network anomaly detection model based on artificial immune system (AIS) in centralized network. AIS is inspired from human immune system that has learning, adaptation and mem ory. In our proposed model, the interaction between dendritic cell and T-cell of human immune system is adopte d. We design the main components, such as central node and router node, and define functions of them. The ce ntral node analyzes the anomaly information received from the related router nodes, decides response policy and sends the policy to corresponding nodes. The router node consists of detector module and responder module. The detector module perceives the anomaly depending on learning data and the responder module settles the anomaly according to the policy received from central node. Finally we evaluate the possibility of the proposed detection model through simulation.
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종양내과병동 간호단위 핵심간호실무 학습프로그램 개발 및 평가
김연희(Kim, Yeon Hee),정영선(Jung, Young Sun),이순행(Lee, Soon Haeng),김경옥(Kim, Kyoung Ok),정영남(Jeong, Young Nam),정혜련(Jung, Hye Ryun),김경희(Kim, Kyunghee) 대한종양간호학회 2013 Asian Oncology Nursing Vol.13 No.4
Purpose: This study was conducted to develop a nurse-learning program for the pain management of cancer patients. Methods: In this methodological study, a learning program was developed between January and June 2011, following the methodological procedure based on the ADDIE Instructional System Design. Results: The learning program consists of 4 parts: learning goal, learning outcomes, learning method, and evaluation method. Learner-centered learning goal and learning outcomes were established, and lecturebased group learning and self-directed study were combined as the learning method. For the evaluation, we developed a written test, a nursing skill checklist, and a case report evaluation tool. After a pilot test, the learning program was assessed by an expert group for its construct validity and content-related conformance. Moreover, the effectiveness of the program was validated by the results of the learning outcomes evaluation and the achievement levels of 40 trainees who participated in the program. Conclusion: On the basis of the results of this study, we suggest that this unit-based core nursing practice learning program, comprising 202 nursing units developed by a research institute nursing department since 2010, be shared by all nurses in clinical nursing care settings to improve their practical performance and ensure necessary specialization.
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