Clinical Practice Guidelines for Oropharyngeal Dysphagia.

OBJECTIVE: Dysphagia is a common clinical condition characterized by difficulty in swallowing. It is sub-classified into oropharyngeal dysphagia, which refers to problems in the mouth and pharynx, and esophageal dysphagia, which refers to problems in the esophageal body and esophagogastric junction. Dysphagia can have a significant negative impact one's physical health and quality of life as its severity increases. Therefore, proper assessment and management of dysphagia are critical for improving swallowing function and preventing complications. Thus a guideline was developed to provide evidence-based recommendations for assessment and management in patients with dysphagia. METHODS: Nineteen key questions on dysphagia were developed. These questions dealt with various aspects of problems related to dysphagia, including assessment, management, and complications. A literature search for relevant articles was conducted using Pubmed, Embase, the Cochrane Library, and one domestic database of KoreaMed, until April 2021. The level of evidence and recommendation grade were established according to the Grading of Recommendation Assessment, Development and Evaluation methodology. RESULTS: Early screening and assessment of videofluoroscopic swallowing were recommended for assessing the presence of dysphagia. Therapeutic methods, such as tongue and pharyngeal muscle strengthening exercises and neuromuscular electrical stimulation with swallowing therapy, were effective in improving swallowing function and quality of life in patients with dysphagia. Nutritional intervention and an oral care program were also recommended. CONCLUSION: This guideline presents recommendations for the assessment and management of patients with oropharyngeal dysphagia, including rehabilitative strategies.

Design of an Automatic Jackson-Pratt Drain Auxiliary System for Postoperative Management Applications.

Background: After surgery, the exudation at a surgical site can cause complications and infections. The exudation is periodically removed through a Jackson-Pratt (JP) drain while maintaining a negative pressure in the JP bulb. However, the JP drainage tube may be clogged due to blood clotting. Thus, the periodic management of the JP drain is essential. In particular, the postoperative management of the JP drain includes squeezing and stripping it. In this study, we proposed a JP drain auxiliary system that can perform automatic stripping to assist specialists and nurses. Methodology: The proposed system was designed based on pre-experimental measurements and operated as a gripping and rolling device. Experimental Results: Twenty experiments were performed, and an average stripping efficiency of 93.8% was obtained. Conclusions: Consequently, we think that the proposed auxiliary system can automatically contribute to increase working efficiency for specialists and nurses.

Evaluation of users' level of satisfaction for an artificial intelligence-based diagnostic program in pediatric rare genetic diseases.

The artificial intelligence (AI)-based genetic diagnostic program has been applied to genome sequencing to facilitate the diagnostic process. The objective of the current study was to evaluate the experience and level of satisfaction of participants using an AI-based diagnostic program for rare pediatric genetic diseases. The patients with neurodevelopmental disorders or hearing impairments, their guardians, and their physicians from 16 tertiary general hospitals were enrolled. The study period was from April 2020 to March 2021. A survey was designed to assess their experience and level of satisfaction. A total of 30 physicians and 243 patients and guardians (199 neurodevelopmental disorders and 44 hearing impairments) completed the survey. DNA samples of the subjects were collected through buccal swabs or blood collection: 211 subjects (86.8%) through buccal swab and 29 subjects (11.9%) through blood collection. Average turnaround time for result receipt was 57.54 ± 32.42 days. For the sampling method, 193 patients and guardians (81.1%) and 28 physicians (93.3%) preferred buccal swab. The level of satisfaction of the 2 groups participating in the AI-based diagnostic program was 8.31 ± 1.71 out of 10 in the patient and guardian group and 8.42 ± 1.23 in the physician group. Clinicians, patients, and guardians are satisfied with the AI-based diagnostic program in general. With an increase in AI-based precision medicine solutions, the evaluation of the user's satisfaction with appropriate provision will help improve personal health care.

Web-Based Intravenous Fluid Treatment Monitoring Platform in Nursing Station.

BACKGROUND: Intravenous fluid treatment is the most common way to take care of inpatients. Because of the global pandemic, the number of inpatients is increasing rapidly, leading to constant demand in the contactless system. PURPOSE: In this article, we suggest a web-based intravenous fluid treatment monitoring platform in the nursing station to unburden the medical staff's workload.

Design of Automatic Isolated Medical Waste Bin Cover for Drying Waste.

Background. The recent outbreak of COVID-19 has led to an increase in isolated medical waste, making the disposal of isolated medical waste a significant problem. There is the dedicated waste bin with four-sided locking-type at the top, causing contact during waste disposal. And it has infection possibility with high humidity. Purpose. In this article, we suggest automatic isolated medical waste bin cover for drying waste.

Unmet informatics needs of nurses regarding the use of personal smartphones in the workplace.

AIMS: This study aimed to investigate the differences in practices, policies, and perceptions of nurses regarding work-related utilization of smartphones in acute-care settings. BACKGROUND: Mobile devices utilizing emerging technology are widely used in acute-care settings; however, concerns such as potential distraction, improper use, and negative impact on the nursing image in clinical practice remain valid. METHODS: Nurse managers (n = 8) and nurses (n = 181) were enrolled from eight academic tertiary hospitals that have comprehensive electronic medical record systems and mobile versions. Between October 2018 and February 2019, participants completed a questionnaire designed to explore their use of smartphones. The reporting guide for self-administered surveys of clinicians was applied. RESULTS: Approximately 80% of nurses carried personal smartphones while working, with 70% using their devices for work. The prevalence of work-related smartphone use ranged from 3% to 43% by functionality, which was lower than that estimated by managers. Frequent uses included taking pictures/videos and internet browsing. Nurses were more positive than managers about the benefits of smartphone use and less burdened by related concerns. Novice and junior nurses were more optimistic than senior nurses. Only one hospital had a policy on nurses' use of personal devices at work. CONCLUSION: Two unmet needs in the current clinical information system were identified: information supporting task-related knowledge at the bedside and security of data capture and communication. IMPLICATION FOR NURSING POLICY: The unintended perception gaps between nurses and managers regarding work-related smartphone use can be closed by nursing leadership. Unmet nursing informatics, particularly for information-seeking purposes, can be addressed in the context of quality assurance. Nurse leaders can advocate secure and proper use of smartphones in clinical practice.

Effectiveness of Integrated Education to Reduce Postoperative Nausea, Vomiting, and Dizziness after Abdominal Surgery under General Anesthesia.

This study presents an anticipatory integrated education program for nausea, vomiting, and dizziness prevention (anti-NVD education program) for patients undergoing abdominal surgery under general anesthesia. The anti-NVD education program for nephrectomy patients consisted of the following: the causes of postoperative nausea, vomiting, and dizziness; effective deep breathing and how to use an inspirometer; postoperative nausea and vomiting; effective methods of patient-controlled analgesia; and the stepwise standing up method to prevent dizziness. A study was conducted among 79 adults (experimental group: n = 40, control group: n = 39). The degree of nausea and dizziness was measured using a numerical rating scale (NRS), and vomiting and the frequency of antiemetic use were measured in terms of the number of patients. The experimental group, which received the anti-NVD education, showed remarkably lower levels of nausea (p = 0.013) and dizziness (p < 0.001) than the control group. The frequency of antiemetic use 48 hours after surgery was significantly lower in the experimental group (p = 0.03). This study proved the efficacy of the anti-NVD education program for reducing postoperative nausea and dizziness. This program can be used as a noninvasive nursing intervention to prevent nausea, vomiting, and dizziness among patients undergoing abdominal surgery.

Changes in Nurse Staffing Grades of Korean Hospitals during COVID-19 Pandemic.

The global COVID-19 pandemic is creating challenges to manage staff ratios in clinical units. Nurse staffing level is an important indicator of the quality of care. This study aimed to identify any changes in the nurse staffing levels in the general wards of hospitals in Korea during the COVID-19 pandemic. The unit of analysis was the hospitals. This longitudinal study observed the quarterly change of the nurse staffing grades in 969 hospitals in 2020. The nurse staffing grades ranged from 1 to 7 according to the nurse-patient ratio measured by the number of patients (or beds) per nurse. The major dependent and independent variables were the change of nurse staffing grades and three quarterly observation points being compared with those during the 1st quarter (1Q) of 2020, respectively. A generalized linear model was used. Unexpectedly, the nurse staffing grades significantly improved (2Q: RR, 27.2%; 95% confidence interval (CI), 15.1-27.6; p < 0.001; 3Q: RR, 95% CI, 20.2%; 16.9-21.6; p < 0.001; 4Q: RR, 26.6%; 95% CI, 17.8-39.6; p < 0.001) quarterly, indicating that the nurse staffing levels increased. In the comparison of grades at 2Q, 3Q, and 4Q with those at 1Q, most figures improved in tertiary, general, and small hospitals (p < 0.05), except at 3Q and 4Q of general hospitals. In conclusion, the nurse staffing levels did not decrease, but nursing shortage might occur.

Factors influencing changing bowel habits in patients undergoing sphincter-saving surgery for rectal cancer.

A research survey research was conducted to identify factors affecting changes in bowel habits of rectal cancer patients undergoing sphincter-saving surgery and to provide basic information useful in nursing interventions supporting treatment for rectal cancer patients. The subjects were rectal cancer patients who had undergone sphincter-saving surgery over 2 years ago. The final analysis included 107 patients who had made outpatient visits to the colorectal surgery from 12th to 31st May, 2014. Collected data were processed with SPSS Version 21.0. Changes in bowel habits in the subjects were observed: frequent bowel movement in 74 patients (69.2%) and faecal incontinence in 48 (44.9%). Most of the patients used self-care to improve their bowel function including dietary modification (78.5%), regular exercise (72.0%) and pelvic floor exercise (34.6%). Frequent defecation was associated with adjuvant chemoradiation therapy (P < 0.001) and faecal incontinence was associated with age of ≥65 years (P = 0.019) and a group who underwent adjuvant radiation therapy (P < 0.001). It is necessary to give sufficient information about possible postoperative changes in bowel habits to patients with the risk factors before surgery.

Application of stereo-imaging technology to medical field.

OBJECTIVES: There has been continuous development in the area of stereoscopic medical imaging devices, and many stereoscopic imaging devices have been realized and applied in the medical field. In this article, we review past and current trends pertaining to the application stereo-imaging technologies in the medical field. METHODS: We describe the basic principles of stereo vision and visual issues related to it, including visual discomfort, binocular disparities, vergence-accommodation mismatch, and visual fatigue. We also present a brief history of medical applications of stereo-imaging techniques, examples of recently developed stereoscopic medical devices, and patent application trends as they pertain to stereo-imaging medical devices. RESULTS: Three-dimensional (3D) stereo-imaging technology can provide more realistic depth perception to the viewer than conventional two-dimensional imaging technology. Therefore, it allows for a more accurate understanding and analysis of the morphology of an object. Based on these advantages, the significance of stereoscopic imaging in the medical field increases in accordance with the increase in the number of laparoscopic surgeries, and stereo-imaging technology plays a key role in the diagnoses of the detailed morphologies of small biological specimens. CONCLUSIONS: The application of 3D stereo-imaging technology to the medical field will help improve surgical accuracy, reduce operation times, and enhance patient safety. Therefore, it is important to develop more enhanced stereoscopic medical devices.