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Characteristics and Risk Factors for Delirium in The Surgical Step-Down Unit
Yooun-joong Jung,Soyeon Yoon,Jinjoo Kim,Yoon Jung An,Jeonghui Ok 대한외상중환자외과학회 2023 Journal of Acute Care Surgery Vol.13 No.3
Purpose: This study aimed to investigate the incidence rate, types and risk factors for delirium in patients admitted to the surgical Step-Down Unit (SDU). Methods: This study was a retrospective study of the electronic medical records of patients admitted to a surgical SDU from February 2020 to July 2020. The delirium assessment was conducted using the short Confusion Assessment Method (a tool that allows quick and easy screening of delirium) and the incidence and risk factors for delirium were determined. Results: Among a total of 227 patients in the study, the incidence rate of delirium was 35 cases (16.7%). It predominantly occurred on the first day (n = 16, 45.7%) and the second day of admission (n = 15, 42.8%). The peak occurrence of delirium was between 14:00 and 22:00 (n = 30, 85.7%). The most common type of delirium was hypoactive (n = 19, 54.3%). The results of multiple logistic regression analysis indicated that the factors influencing the occurrence of delirium in the surgical step down unit (SDU) were age, hypertension, stroke, white blood cell count, and the use of restraints. Conclusion: Considering the characteristics of high-risk groups for delirium in the surgical SDU, it is necessary to establish nursing practice guidelines to minimize delirium.
Status and Needs of Continuing Education for Trauma Nursing
( Yooun-joong Jung ),( Suhyun Kim ),( Sangmi Noh ),( Eunkyoung Seo ),( Soyoung Jung ),( Jiyoung Kim ) 대한외상학회 2019 大韓外傷學會誌 Vol.32 No.3
Purpose: This study was conducted to status and needs for continuing education for trauma hospital nurses in Korea. Methods: Thirty nurses from the seven level I trauma center hospitals or trauma treatment systems were randomly selected and surveyed. The survey was conducted from March 1 to May 31, 2017. Categorical data were analyzed with Pearson chi-square tests and Continuous variables were analyzed with ANOVA. Results: Only 86 out of 204 nurses had received continuing education (42.1%). The current status of continuing education programs, delivering institution (p<0.001), education method (p<0.001), education period (p=0.003), number of participants (p=0.007), and instructors (p=0.014) were also significantly different from trauma center to trauma center. There were 108 (52.9%) nurses who responded that continuing education programs were “needed” 92 (45.1%) and “very much needed 16 (7.8%). According to each trauma center’s characteristics were significantly differences in the need for continuing education (p=0.089), subject selection method (p<0.001) and the number of continuing education sessions (p=0.043) depending on the hospital. Conclusions: It is necessary to consider differences between the hospitals to develop continuing education programs that reflect the needs of nurses, in order to improve the efficiency of and satisfaction with the educational programs.
Yooun-joong Jung,Younghwan Kim,Kyuhyouck Kyoung,Min Ae Keum,Taehyun Kim,Dae seong Ma,Suk-Kyung Hong 대한중환자의학회 2018 Acute and Critical Care Vol.33 No.4
Background: The aim of this study was to investigate the effects of using a systematic approachto tracheostomy care by a clinical nurse specialist and surgical intensivists for patientswith a tracheostomy who were transferred from the surgical intensive care unit (SICU) to thegeneral ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomywho were transferred to the general ward. The study period was divided into a preinterventionperiod (January 1, 2007 to December 31, 2010) and a postintervention period (January1, 2011 to December 31, 2014), and electronic medical records were used to analyze andcompare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in thepostintervention group. Decannulation time (26.7±25.1 vs. 12.1±16.0 days, P=0.003),length of stay in the general ward (70.6±89.1 vs. 40.5±42.2 days, P=0.008), length of totalhospital stay (107.5±95.6 vs. 74.7±51.2 days, P=0.009), and readmission rate of SICU decreaseddue to T-cannula occlusion (58.8% vs. 5.9%, P=0.010). Conclusions: Using a systematic approach to tracheostomy care in the general ward led toreduction in decannulation time through professional management, which resulted in ashorter hospital stay. It also lowered SICU readmission by solving problems related to direct Tcannula.
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)
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)