http://chineseinput.net/에서 pinyin(병음)방식으로 중국어를 변환할 수 있습니다.
변환된 중국어를 복사하여 사용하시면 됩니다.
신생아 집중치료를 받았던 극소 저출생체중아의 입원중 성장에 관한 연구
김승란,이재연,노서영,조영환,노환성,김애란,김기수,피수영,강위창 한국병원약사회 2002 병원약사회지 Vol.19 No.3
Pharmacists of neonatal intensive care unit(NICU) at Asan Medical Center monitored appropriateness of TPN orders from January 1999. The objective of this study was to generate growth curves and to quantify the factors associated with the growth of very small premature infants during initial hospitalization. We reviewed patient charts and daily collection forms retrospectively. Study patients included 67infants who were surviving singleton, appropriated for gestational age, weighted <1,651g at birth, born January 1st in 1999, to May 31th in 2000, who did not develop necrotizing enterocolitis. They were grouped four birth weight; <875g, 875~1,124g, 1,125~1,374g, 1,375~1,624g, respective A, B, C, D groups. The each patients'amount of macronutrient intakes, and body weight were recorded daily up to 105days of age or hospital discharge, whichever occurred first. Monitored parameters were; gestational age, sex, Apgar score, respiratory support and parenteral nutrition support duration, started day of feeding, presence of patent ductus arteriosus, infection and treatment of dexamethasone. Growth was determined as change in weight during the period. Four growth curves were generated. Postnatal ages of recovery to birth weight were 21, 20.2, 18, 12.2 days respective groups. There was positive association with respiratory support duration. Mean changes of weight were 14.4, 15.9, 16.4, 16.3g/day. There were negative associations with respiratory support and parenteral nutrition support duration, presence of the treatment of dexamethasone and positive associations with the amount of macronutrient intake. Stepwise regression explained that the growth was correlated with positive calories intake and negative parenteral nutrition support duration. The new weight curves are the reflection of current in-hospital growth trends in korean preterm babies. It is important that the pharmacist fulfills their appropriate nutrition support.
소아 약물처방 스크린프로그램과 임상약사 활동이 drug safety 향상에 미치는 효과
김승란,김재연,강민경,안숙희,신혜영,오주연,이순교,박성종,송영천 한국병원약사회 2007 병원약사회지 Vol.24 No.3
Computerized physician order entry(CPOE) system requires an adequate clinical decision support system(CDSS). Pediatric drug ordering calls for an informational backup at the drug ordering stage for several reasons such as a dosage adjustment due to children's weight, maximum dose changes due to their growth, and the risk of ten fold dosage mistakes. Noticing the needs of CDSS on maximum dose limits in the pediatric drug ordering system, clinical pediatric pharmacists developed a new screening system and monitored it. In this study, we evaluate the effects on drug safety improvement. The study was conducted in Asan Medical Center. We developed and monitored CDSS after the consultation with the department of pediatrics, drug information center, and Performance Improvement. Using the screening program, the warning massages pops up on the computer screen when high risk orders(overdose, underdose) are given and the program informs clinicians with the drug information. Then, the pediatric clinical pharmacists monitor the ultimate drug adjustment of the high risk orders and give feedbacks to the clinician if necessary. This monitoring was analyzed and evaluated. The inclusion criteria was patients under 16 years old, weighed less than 40kg who were hospitalized or visited the following departments of Asan medical Center.: Pediatrics, Pediatric Surgery, Pediatric thoracic Surgery, and Neonatal (outpatients only). Data were collected from August 1, 2005 to September 15, 2005. Total screened drugs were 181 ingredients, 324 products. 1491 high risk orders with warning signs were collected during 46 days and 352 orders were changed. Improvement of drug safety was achieved through Changed Order and adequately monitored by the clinical pharmacist's monitoring of ultimate drug dosage adjustment. The feedback of pharmacists' activities to physicians by the warning message increased the ordering compliance. Changed Order has increased from 6.53(3.33) cases per day during early 15days to 9.47(3.93) later 15 days(p<0.05). Stored Set Orders has decreased from 21.53(11.17) to 9.60(2.44)(p<0.05) per day. In conclusion, the screening program effectively informed the appropriate drug dosage information and the clinical pharmacist activities contributed to increasing the ordering compliances and supporting the drug safety in pediatric drug order.