ABSTRACT
PURPOSE: The aim of this study was to identify the effect of an observation window (OW) at peripheral intravenous (IV) catheter sites on early detection of IV infiltration among hospitalized children. METHODS: This was a retrospective observational study with history control group design. Participants were children who had IV infiltration after peripheral catheterization when hospitalized from January to May, 2014 and January to May, 2015 at a children's hospital located in Yangsan city, Korea. The 193 patients, who were hospitalized from January to May, 2014 formed the control group and did not have OW, and the 167 patients, who were hospitalized from January to May, 2015 formed the window group and had OW. Data were analyzed using χ²-test, independent samples t-test and multiple logistic regression. RESULTS: First stage IV infiltration was 39.5% for the window group and 25.9% for the control group, which was significantly different (p=.007). The likelihood of 2nd stage and above IV infiltration decreased by 44% in the window group, which was significantly different (p=.014). CONCLUSION: OW at the peripheral IV catheter site was found to be an effective measure in early recognition of IV infiltration. Considering the effect of OW, we recommend that nurses should make an OW with transparent dressing during stabilization of the IV catheter site in hospitalized children in clinical settings.
Subject(s)
Child , Humans , Bandages , Catheterization, Peripheral , Catheters , Child, Hospitalized , Infusions, Intravenous , Korea , Logistic Models , Observational Study , Retrospective StudiesABSTRACT
PURPOSE: The present survey was conducted to investigate the perceptions among nurses of neonatal pain and the associated use of pharmacologic measures (PMs) and nonpharmacologic comfort measures (CMs) in neonatal intensive care units (NICUs). Pain perception, the necessity and actual use of PMs and CMs, and their relationships were investigated and compared according to nurses' positions, educational levels, the existence of guidelines, and prior education on neonatal pain management. METHODS: Participants were 141 nurses from five NICUs at university hospitals. A questionnaire was developed by researchers based on previous studies of neonatal pain management and current practices in surveyed NICUs. Five-point Likert scales were used to assess nurses' perceptions of pain, the necessity of PMs and CMs, and their actual use in 29 painful procedures. RESULTS: The mean scores of perceived pain and the necessity of PMs and CMs were 3.68, 2.96, and 3.79 points, respectively. The actual use of PMs and CMs was 1.67 and 2.63 points, respectively. The perceived necessity of PMs correlated with the actual use of PMs (r = .316, p < .001), and CMs were performed (r = .390, p < .001). Keeping or reading guidelines, or receiving education on pain management resulted in a higher perception of the necessity of PMs. CONCLUSION: Korean nurses in NICUs often underestimate the necessity of pain relief measures and use few PMs or CMs. Therefore, systematic approaches to implement guidelines, such as adaptation of guidelines for each NICU, dissemination of guideline content to all NICU staff, and regular measurements of compliance with the guidelines, are recommended.
Subject(s)
Adult , Female , Humans , Infant, Newborn , Young Adult , Attitude of Health Personnel , Cross-Sectional Studies , Intensive Care Units, Neonatal , Intensive Care, Neonatal/methods , Nursing Staff, Hospital/psychology , Pain/nursing , Pain Management/methods , Surveys and Questionnaires , Republic of KoreaABSTRACT
PURPOSE: The purpose of this study was to determine the meaning of the adaptation experiences of new ICU nurses who were working in a newly established university hospital. The study was based on phenomenological research methodology. METHODS: Data were collected over 3 months through in depth interview with 6 new nurses who had worked less than 1 year in a newly established ICU of university hospital of less than 1 year located in Y city. The Colaizzi analysis method was used for data analysis. RESULTS: The themes were classified into 13 themes clusters. The 13 themes clusters were finally grouped into 6 categories, 'The endlessness of a new beginning', 'Pressure of work due to lack of senior nurses', 'Wanting to quit', 'Attachment for the complete hospital and ICU', 'Preciousness of colleagues', 'Pride in self-growth'. CONCLUSION: New ICU nurses have a difficult time due to pressures of work and lack of expert knowledge, and anxiety adds to these problems making the situation more difficult. The study results indicate that professional knowledge and skills learned through repetition of difficult work, pride through self growth, recognition from others and good-fellowship are driving forces to overcome obstacles and with stand difficult daily work.
Subject(s)
Anxiety , Intensive Care Units , Qualitative ResearchABSTRACT
BACKGROUND: The prevalence of HIV drug resistance mutations in drug-naive patients has been shown to differ with geographic origin. The purpose of this study is to assess the prevalence of transmitted antiretroviral drug resistance mutations in drug-naive patients in Korea. METHODS: Genotypic resistance was determined by the use of the Viroseq Genotyping System in 42 antiretroviral treatment naive HIV-infected patients between March 2005 and July 2006. Transmitted drug resistance was estimated according to the IAS-USA 2005 definition, taking into account only major mutations in the protease and all mutations in the reverse transcriptase, including revertant mutations at codon 215. RESULTS: The median age of the patients was 42 years and 37 (88%) were male. The median CD4+T cell count was 136/mm3 and the mean plasma RNA level was 4.98 log copies/mL. Among 42 patients studied, 37 (88%) were newly diagnosed patients. None of the patients were recent seroconverters; 38 patients (90%) were infected with subtype B and 4 patients were infected (10%) with the non-B subtype strains (2 patients with CRF01-AE 1 as CRF02-AG; 1 patient with subtype A). Of the 42 subjects tested, we found 2 (4.8%) mutations in NRTI (V118I), but did not find a mutation in NNRTI as well as in the PI region. CONCLUSIONS: The prevalence of transmitted antiretroviral drug resistance in drug-naive patients is still low in Korean patients.
Subject(s)
Humans , Male , Cell Count , Codon , Drug Resistance , HIV , HIV-1 , Korea , Plasma , Prevalence , RNA , RNA-Directed DNA PolymeraseABSTRACT
PURPOSE: To observe the changes in periosteum-derived mesenchymal stem cells and different scaffold materials transplanted into rabbit long-bone defects. MATERIALS AND METHODS: Thirty-five white rabbits were grouped according to the material transplanted into their tibial bone defects: Group 1 (control group); Group 2-A (agar plus mesenchymal stem cells); Group 2-B (agar only); Group 3-A (Biocompatible Osteoconductive Polymer plus mesenchymal stem cells); Group 3-B (BOP(R) only); Group 4-A (xenograft plus mesenchymal stem cells); Group 4-B (xenograft only). After surgery, radiologic and microscopic observation were performed weekly for 8 weeks. RESULTS: Rabbits transplanted with mesenchymal stem cells showed better bone formation than those without. Mesenchymal stem cells transplanted with agar had better results than mesenchymal stem cells plus BOP(R). Rabbits receiving xenografts showed severe inflammatory reactions. CONCLUSION: Further research is needed on rigid scaffold materials which minimize immune reaction, and on how to ensure uniform distribution of mesenchymal stem cells within such materials.
Subject(s)
Rabbits , Agar , Heterografts , Mesenchymal Stem Cells , Osteogenesis , PolymersABSTRACT
PURPOSE: To evaluate changes in the sciatic nerve of rabbits according to the degree of femoral lengthening. MATERIALS AND METHODS: Acute and gradual bone lengthening of the femur were performed after osteotomy, using external fixators in 36 rabbits of both sexes weighing 2, 500 gm. According to the lengthening amount and the percent increase (PI), 21 rabbits (acute lengthening) were divided into seven subgroups and 15 rabbits (gradual lengthening) into five subgroups. A nerve conduction study, light microscopic and electromicroscopic analysis of the sciatic nerve were performed. RESULTS: Acute femoral lengthening between 0.5-0.75 cm (PI= 6-9%) caused remarkable electrophysiologic and microscopic changes in the sciatic nerve, gradual lengthening between 0.75-1.0 cm (PI= 9-13%) induced significant electrophysiologic changes, and gradual lengthening between 1.0-1.5 cm (PI=13-19%) caused significant pathologic change. CONCLUSION: Gradual bone lengthening is safer for nerves than acute bone lengthing because of its safety margin, in terms of PI, is double that of acute bone lengthening. The results in this study provide helpful data to those in human nerve research upon the effects of acute and gradual bone lengthening.