Improving order-to-antibiotic time by operating an automated dispensing cabinet system in the emergency medical center

Objective@#If empirical antibiotics must be administered, the pharmacy needs to deliver the drug to emergency patients as soon as possible. The purpose of this study was to investigate the impact of the installation of an automated dispensing cabinet system in an emergency center. @*Methods@#A retrospective study was conducted through the analysis of medical records in an emergency medical center for 12 months before and after the installation of the system. The order-to-antibiotic time and door-to-antibiotic time were collected retrospectively through a system log analysis. For the satisfaction survey, nursing providers who use the dispensing system were administered a survey questionnaire related to the system. @*Results@#This study covered 1,292 prescriptions before and 1,377 after the introduction of the system in the emergency center. It was observed that the average time from the order-to-drug administration decreased (48.7±57.9 vs. 41.1±52.3, P=0.001) after the introduction of the system. The door-to-drug administration time also showed a decrease (293.6±260.2 vs. 267.4±221.1, P=0.006). A satisfaction survey was conducted on 38 users of the system who agreed to participate and respond. The score of the satisfaction survey was 3.63±0.44. The user response showed that they were most satisfied with the prevention of medication errors (4.00±0.62) and system control (4.00±0.57). @*Conclusion@#The automated dispensing cabinet system in an emergency center can shorten the order-to-drug time and door-to-drug time. In addition, it helps to improve the satisfaction and work efficiency of emergency medical workers related to medication dispensation.

Effects of Trauma Center Establishment on the Clinical Characteristics and Outcomes of Patients with Traumatic Brain Injury : A Retrospective Analysis from a Single Trauma Center in Korea

OBJECTIVE: To investigate the effects of trauma center establishment on the clinical characteristics and outcomes of trauma patients with traumatic brain injury (TBI). METHODS: We enrolled 322 patients with severe trauma and TBI from January 2015 to December 2016. Clinical factors, indexes, and outcomes were compared before and after trauma center establishment (September 2015). The outcome was the Glasgow outcome scale classification at 3 months post-trauma. RESULTS: Of the 322 patients, 120 (37.3%) and 202 (62.7%) were admitted before and after trauma center establishment, respectively. The two groups were significantly different in age (p=0.038), the trauma location within the city (p=0.010), the proportion of intensive care unit (ICU) admissions (p=0.001), and the emergency room stay time (p < ;0.001). Mortality occurred in 37 patients (11.5%). Although the preventable death rate decreased from before to after center establishment (23.1% vs. 12.5%), the difference was not significant. None of the clinical factors, indexes, or outcomes were different from before to after center establishment for patients with severe TBI (Glasgow coma scale score ≤8). However, the proportion of inter-hospital transfers increased and the time to emergency room arrival was longer in both the entire cohort and patients with severe TBI after versus before trauma center establishment. CONCLUSION: We confirmed that for patients with severe trauma and TBI, establishing a trauma center increased the proportion of ICU admissions and decreased the emergency room stay time and preventable death rate. However, management strategies for handling the high proportion of inter-hospital transfers and long times to emergency room arrival will be necessary.

Effects of Trauma Center Establishment on the Clinical Characteristics and Outcomes of Patients with Traumatic Brain Injury : A Retrospective Analysis from a Single Trauma Center in Korea

OBJECTIVE: To investigate the effects of trauma center establishment on the clinical characteristics and outcomes of trauma patients with traumatic brain injury (TBI).METHODS: We enrolled 322 patients with severe trauma and TBI from January 2015 to December 2016. Clinical factors, indexes, and outcomes were compared before and after trauma center establishment (September 2015). The outcome was the Glasgow outcome scale classification at 3 months post-trauma.RESULTS: Of the 322 patients, 120 (37.3%) and 202 (62.7%) were admitted before and after trauma center establishment, respectively. The two groups were significantly different in age (p=0.038), the trauma location within the city (p=0.010), the proportion of intensive care unit (ICU) admissions (p=0.001), and the emergency room stay time (p < ;0.001). Mortality occurred in 37 patients (11.5%). Although the preventable death rate decreased from before to after center establishment (23.1% vs. 12.5%), the difference was not significant. None of the clinical factors, indexes, or outcomes were different from before to after center establishment for patients with severe TBI (Glasgow coma scale score ≤8). However, the proportion of inter-hospital transfers increased and the time to emergency room arrival was longer in both the entire cohort and patients with severe TBI after versus before trauma center establishment.CONCLUSION: We confirmed that for patients with severe trauma and TBI, establishing a trauma center increased the proportion of ICU admissions and decreased the emergency room stay time and preventable death rate. However, management strategies for handling the high proportion of inter-hospital transfers and long times to emergency room arrival will be necessary.

Factors Influencing Human Papillomavirus Vaccination Adoption Stages Based on the Precaution Adoption Process Model

PURPOSE: This study aimed to identify the factors influencing human papillomavirus (HPV) vaccination adoption stages using the Precaution Adoption Process model. METHODS: A total of 173 female university students from B metropolitan city participated. Demographics, factors contributing to action, knowledge, health beliefs, and self-efficacy related to the HPV vaccination were measured. The collected data were analyzed using descriptive statistics and multiple logistic regression analysis using SPSS for Windows version 21.0. RESULTS: Factors that contributed to the transition from the unaware and unengaged stages to the undecided about action stage included age, economic status, experience of recommendation from doctors, perceived severity of cervical cancer, and perceived barriers. Factors that contributed to the transition from the undecided about action stage to the deciding to act stage were perceived benefit and self-efficacy of the HPV vaccination. Factors that contributed to the transition from the deciding to act stage to the acting and maintenance stages were experience of recommendation from doctors and perceived severity of cervical cancer. CONCLUSION: These results suggest that aggressive HPV vaccination campaigns increase awareness. Further studies should develop tailored strategies for promoting HPV vaccination that emphasize health beliefs and self-efficacy.

Three cases of primary non-Hodgkin's lymphoma of the pelvis / 대한산부인과학회지

Primary pelvic non-Hodgkin's lymphoma is a rare malignancy that has been reported in the retroperitoneum, ovary, uterine corpus, uterine cervix, vagina and vulva. Although primary pelvic lymphoma is rare, this may be encountered more frequently as the incidence of extranodal non-Hodgkin's lymphoma increases. We experienced three cases of primary non-Hodgkin's lymphoma of the pelvis. Two cases are primary non-Hodgkin's lymphoma of the ovary and one is primary non-Hodgkin's lymphoma of the retroperitoneum. We report these cases with a brief review of literature.

Synchronous primary endometrial and ovarian cancers / 대한산부인과학회지

The coexistence of carcinoma of the endometrium and ovary of female genital tract are an uncommon event, and it occurred in 5% of the patients with endometrial cancer and 10% of the patients with ovarian cancer. However, most of them are metastatic lesion from one organ and synchronous primary cancers from both organs are rare. In the present case, we experienced a case with simultaneous primary cancers from endometrium and ovary, occurring in 37-year-old woman presented with abnormal vaginal bleeding. Preoperative endometrial biopsy revealed endometrial carcinoma, and magnetic resonance imaging showed both ovarian lesion, which is suspicious of malignancy. Intraoperative and histological finding showed stage Ib endometrioid endometrial carcinoma and stage IIIc mucinous adenocarcinoma of both ovary, and we present this case with a brief review of reference.

Two cases of arachnoid cyst of prenatal diagnosis / 대한산부인과학회지

Intracranial arachnoid cysts are collections of clear fluid within the arachnoid membrane because of nondisjunction or duplication of the structure. They are rare, represent only 1% of intracranial masses in newborns. Etiologically, they are thought to be due to maldevelopment of the arachnoid or secondary to trauma or infection. The arachnoid cyst by ultrasonogram shows characteristic well capsulated homogeneous hypoechoic cyst. Many arachnoid cysts remain asymptomatic, however, and become symptomatic later in life to cyst growth-resulting in a compression, displacement and irritation of the surrounding structures. So, early diagnosis and treatment of these cysts are important. We present two cases of arachnoid cysts diagnosed in utero by ultrasonogram. In one case, postnatal MRI was checked and confirmed arachnoid cyst with choroid plexus cyst. And other case, postnatal brain USG was checked and diagnosed arachnoid cyst. Both children are asymptomatic, and presents normal development until now. But latter children underwent surgical treatment due to persistent huge cyst and hydrocephalus.