Predication of Falls in Hospitalized Cancer Patients

Purpose@#/Objectives: To determine predictors of fall events in hospitalized patients with cancer, and identification of fall risk. @*Methods@#An analysis of medical records was conducted together with a review of standardized fall reports of 565 patients admitted between January 1 and December 31, 2020. The collected data were analyzed with the chi-squared test, Fisher exact test, independent t-test, and logistic regression analysis using STATA 17 program. @*Results@#There was a statistically significant increased fall risk; accompanied by a guardian (OR=10.30 CI=2.66~39.94), number of attachment devices (OR=1.30, CI=0.46~0.64), medication (OR=0.17, CI=0.04~0.84), pain (OR=4.73, CI=1.59~14.0), walking problem (OR=29.85, CI=9.31~95.74), chemotherapy (OR=5.20, CI=1.81~14.89), and fall risk score (OR=1.83, CI=1.50~2.24). @*Conclusion@#These findings can serve as academic evidence to support the role of nurses in assessing the risk of fall events/accidents with regard to cancer patients and the development of individually adjusted fall assessment tools.

Epidemiology and Clinical Characteristics of Rapid Response Team Activations / 대한구급학회지

BACKGROUND: To ensure patient safety and improvements in the quality of hospital care, rapid response teams (RRTs) have been implemented in many countries, including Korea. The goal of an RRT is early identification and response to clinical deterioration in patients. However, there are differences in RRT systems among hospitals and limited data are available. METHODS: In Seoul St. Mary's Hospital, the St. Mary's Advanced Life Support Team was implemented in June 2013. We retrospectively reviewed the RRT activation records of 287 cases from June 2013 to December 2016. RESULTS: The median response time and median modified early warning score were 8.6 minutes (interquartile range, 5.6 to 11.6 minutes) and 5.0 points (interquartile range, 4.0 to 7.0 points), respectively. Residents (35.8%) and nurses (59.1%) were the main activators of the RRT. Interestingly, postoperative patients account for a large percentage of the RRT activation cases (69.3%). The survival rate was 83.6% and survival was mainly associated with malignancy, Acute Physiology and Chronic Health Evaluation-II score, and the time from admission to RRT activation. RRT activation with screening showed a better outcome compared to activation via a phone call in terms of the intensive care unit admission rate and length of hospital stay after RRT activation. CONCLUSIONS: Malignancy was the most important factor related to survival. In addition, RRT activation with patient screening showed a better outcome compared to activation via a phone call. Further studies are needed to determine the effective screening criteria and improve the quality of the RRT system.

Epidemiology and Clinical Characteristics of Rapid Response Team Activations / 대한중환자의학회지

BACKGROUND: To ensure patient safety and improvements in the quality of hospital care, rapid response teams (RRTs) have been implemented in many countries, including Korea. The goal of an RRT is early identification and response to clinical deterioration in patients. However, there are differences in RRT systems among hospitals and limited data are available. METHODS: In Seoul St. Mary's Hospital, the St. Mary's Advanced Life Support Team was implemented in June 2013. We retrospectively reviewed the RRT activation records of 287 cases from June 2013 to December 2016. RESULTS: The median response time and median modified early warning score were 8.6 minutes (interquartile range, 5.6 to 11.6 minutes) and 5.0 points (interquartile range, 4.0 to 7.0 points), respectively. Residents (35.8%) and nurses (59.1%) were the main activators of the RRT. Interestingly, postoperative patients account for a large percentage of the RRT activation cases (69.3%). The survival rate was 83.6% and survival was mainly associated with malignancy, Acute Physiology and Chronic Health Evaluation-II score, and the time from admission to RRT activation. RRT activation with screening showed a better outcome compared to activation via a phone call in terms of the intensive care unit admission rate and length of hospital stay after RRT activation. CONCLUSIONS: Malignancy was the most important factor related to survival. In addition, RRT activation with patient screening showed a better outcome compared to activation via a phone call. Further studies are needed to determine the effective screening criteria and improve the quality of the RRT system.

Influence of Workplace Bullying and Leader-Member Exchange on Turnover Intention among Nurses / 간호행정학회지

PURPOSE: The purpose of this descriptive study was to identify the impact of workplace bullying and LMX (Leader-Member Exchange) on turnover intention among nurses. METHODS: The participants were 364 nurses from the Seoul metropolitan area who were attending a continuing education program. A structured questionnaire was used for data collection and data were analyzed using the SPSS/Window program. Hierarchical multiple regression analysis was performed to verify the effect of variables on turnover intention. RESULTS: Higher workplace bullying was associated with higher turnover intention. Workplace bullying was negatively correlated with leader-member exchange. The most influential factors for turnover intention were LMX (beta=-7.22, p<.001), work load (beta=2.96, p=.003), and workplace bullying (beta=2.64, p=.009). These factors accounted for 28% of the variance in turnover intention. CONCLUSION: The study results indicate that there is need to develop strategies to prevent workplace bullying and cultivate a good relationship between nursing managers and nurses to lower nurses' turnover intention.

Effects of a Refresher Program for Inactive Nurses on Nursing Professionalism and Nursing Clinical Self-Efficacy / 간호행정학회지

PURPOSE: The purpose of this study was to identify effects of a refresher program for inactive nurses on nursing professionalism and nursing clinical self-efficacy. METHODS: A pre-experimental design with one group pretest-posttest was used. The refresher program consisted of 150 hours and was provided to inactive nurses who were recruited from a refresher program at S institute. Eighty inactive nurses participated in the study. Data were collected between June and November 2009. To evaluate the effectiveness of the refresher program, researchers explored participants' nursing professionalism and nursing clinical self-efficacy through self-evaluation questionnaire before and after the refresher program. RESULTS: The refresher program was effective in increasing nursing clinical self-efficacy for inactive nurses (p<.001). However, no significant increase was found in nursing professionalism after completing the program. CONCLUSION: The refresher program had a positive impact on increasing the nursing clinical self-efficacy for inactive nurses.

Reference dose levels for dental periapical radiography in Chonnam Province / 대한구강악안면방사선학회지

PURPOSE: To establish reference doses of periapical radiography in Chonnam Province, Korea. MATERIALS AND METHODS: The target-skin distances were measured for dental patient's 1235 exposures including 345 mandibular molar areas. Each periapical radiation exposure was simulated with exactly the same patients exposure parameters and the simulated radiation doses were measured utilizing Mult-O-Meter (Unfors Instruments, Billadal, Sweden). The measurements were done in 44 dental clinics with 49 dental x-ray sets in Chonnam Province for one or two weeks at each dental clinic during year 2006. RESULTS: The third quartile patient surface doses were 2.8 mGy for overall periapical exposures and 3.2 mGy for periapical mandibular molar exposures. CONCLUSION: The third quartile patient surface doses in Chonnam Province can be used as a guide to accepted clinical practice to reduce patient radiation exposure for the surveyed reference doses were below the recommended dental periapical radiography dose of 7 mGy by IAEA.

Quality Assessment of Film Processing Chemicals in Dentistry / 대한구강악안면방사선학회지

PURPOSE: The purpose of this study was to compare the qualities of the four different processing chemicals(solutions). MATERIALS AND METHODS: With EP 21 films(Ektaspeed plus film, Kodak Co., USA), nine unexposed and nine exposed films of a step wedge were processed utilizing automatic film processor(XR 24, Durr Co., Germany) for 5 days. During 5 days, the total number of processed films including out-patient's intraoral films were about 400-500 for each brand. Base plus fog density, film density, contrast of processed films were measured with densitometer(model 07-443 digital densitometer, Victoreen Co., USA). These measurements were analyzed for comparison. RESULTS: The results were as follows, 1. For the base plus fog density, there was significant difference among the four chemicals (p<0.05). The sequence of the base plus fog densities was in ascending order by Kodak, X-dol 90, Agfa and Konica. 2. For the film density, all chemicals showed useful range of photographic densities(0.25-2.5). The sequence of the film densities was in ascending order by Kodak, X-dol 90, Konica and Agfa. But there was no statistically significant difference of film density between X-dol and Kodak (p<0.05). 3. The sequence of the contrasts was in ascending order by Konica, X-dol 90, Kodak and Agfa. But there was no statistically significant difference of contrast between X-dol and Konica (p<0.05). CONCLUSION: These results indicated that the four processing chemicals had the clinically useful film density and contrast, but only Kodak processing chemical had useful base plus fog density.

The Diagnistic importance of clinical and radiologic features of the Multiple Cemento-osseous dysplasia / 대한구강악안면방사선학회지

This case was diagnosed as multiple cementoosseous dysplasia on the basis of clinical & radiological features but was diagnosed as ossifying fibroma on the basis of histopathological feature. The histopathologic features of the multiple cementoosseous dysplasia and cementoossifying fibroma have common features of cementum, fibrous network and bone. Multiple cementoosseous dysplasia is reactive lesion and shows restricted lesion size, occurred on anterior and posterior tooth of the mandible and needs no treatment except periodic follow up. But Cementoossifying fibroma is the true neoplasm and grows continuously and needs surgical removal. The final diagnosis of the multiple cementoosseous dysplasia requires good correlation of the clinical histopathological, and radiological features.