• Title/Summary/Keyword: 상급종합병원

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Evaluation of Nivolumab Use and Factors related to Treatment Outcomes in a Cancer Center of a Top Tier General Hospital (상급종합병원 암센터에서 Nivolumab 사용평가와 치료성과에 미치는 영향인자)

  • Eoum, Gohye;Cho, Yoonsook;Rhie, Sandy Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.28 no.2
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    • pp.88-94
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    • 2018
  • Background: We strived to evaluate the status of nivolumab use and associated factors on the clinical efficacy of the drug. Methods: The study was retrospectively conducted in patients who had been administered nivolumab at least once at the cancer center of Seoul National University Hospital from June 2015 to April 2017. Data were collected from electronic medical records. A medication-use evaluation was performed based on the American Society of Health-System Pharmacists mediation-use guidelines. Results: Sixty-six of the 74 patients (89.2%) showed indications approved for nivolumab use by the Korean Ministry of Food and Drug Safety (MFDS; n=55) or the US Food and Drug Administration (FDA; n=11). Approximately 73.0% of the patients were administered the approved dose of 3 mg/kg but 25.7% were administered an unapproved fixed dose of 100 mg. The overall response rate was 21.7%, and the response rate of non-small cell lung cancer patients, who accounted for the largest number of indications, was 18.8%. Adverse reactions were found in 90.1% of the patients and were mostly mild (86%). The expression of programmed death-ligand 1 (PD-L1) was analyzed as a factor affecting treatment response (p=0.028, odds ratio [OR]=11.331). Conclusion: PD-L1 expression was found to affect treatment response. However, caution is required while using an unapproved dosage and in the absence of monitoring for effectiveness and safety. Therefore, an effective protocol or instruction manual for the proper use of nivolumab should be considered.

Knowledge, Confidence, and Learning Needs Regarding Advance Directives among Hospital Nurses (상급종합병원 간호사의 사전연명의료의향서에 대한 지식, 자신감 및 교육요구도)

  • Jang, Nan-Soon;Park, Hae-Sook;Kim, Mi-Ra;Lee, Joo-Yeon;Cho, Yeo-Won;Kim, Kyoung-Mi;Son, Youn-Jung
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.35-45
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    • 2018
  • Purpose : Nurses' knowledge regarding advance directives may affect their administration of and confidence towards end of life care. This study aimed to describe the relationships of knowledge, confidence, and learning needs with advance directives among hospital nurses. Method : This cross-sectional study was performed at a tertiary university hospital in Seoul between September 25 and October 14, 2017. Convenience sampling was used to recruit nurses who provided bedside care and had at least 1 year of clinical experience. We used a validated self-report questionnaire. Results : The mean score of knowledge, confidence and learning needs were $5.00{\pm}1.73$, $29.81{\pm}7.52$, and $64.54{\pm}8.48$ respectively. Hospital nurses' knowledge, confidence and learning needs were significantly different according to age, job position, educational level and perceived advance directives. Knowledge regarding advance directives was significantly associated with confidence (r = .27, p < .001) and learning needs (r = .16, p = .005). Conclusion : Knowledge regarding advance directives was relatively low compared to the findings of previous studies. Therefore, nurses should be knowledgeable and encouraged to initiate advance directives. It is necessary to develop a standardized educational program regarding advance directives based on Korean cultures.

A Comparison of Nursing Work Environment, Role Conflict, and Job Embeddedness of Nurses Working in Comprehensive Nursing Care Service Wards and General Wards in a Tertiary Hospital (상급종합병원에서의 간호·간병통합서비스 병동과 일반병동 간호사의 근무환경, 역할갈등, 직무 배태성 비교)

  • So, Hye-Eun;Hwang, Jee-In
    • Quality Improvement in Health Care
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    • v.26 no.1
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    • pp.11-22
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    • 2020
  • Purpose: The objective of this study was to compare and analyze the work environment, role conflict, and job embeddedness between comprehensive nursing care service (CNCS) ward nurses and general ward nurses. Methods: This descriptive research study involved 70 CNCS ward nurses and 69 general ward nurses working at an advanced general hospital in Seoul. Data were collected using the structured questionnaire from March 27 to April 14, 2019 and analyzed with the SPSS 24.0 program. Results: The work environment of the CNCS ward nurse was higher than that of the general ward nurse (t=4.38, p<.001), and the role conflict of the CNCS ward nurse was lower than that of the general ward nurse (t=-2.09, p=.038). However, job embeddedness did not show any statistically significant difference (t=0.22, p=.824). Conclusion: The results of this study show that the introduction of CNCS ward has shown improvement in the work environment and strengthened the establishment of the roles in their team, while maintaining the job embeddedness of nurses. These results indicate that improvements in the work environment, such as nurse staffing and material support, would contribute to the qualitative enhancement of nursing and that it would need to extend the introduction of CNCS wards.

An Analysis of the Disagreement in Disease Coding in South Korean Medical Institutions: Focusing on the Health Insurance Claim Data of Outpatients (우리나라 의료기관의 질병 코딩 불일치성 분석 : 외래환자 건강보험 청구 자료를 중심으로)

  • Jeon, Yun-Hee;Kang, Gil-Won
    • Journal of Digital Convergence
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    • v.16 no.12
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    • pp.533-540
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    • 2018
  • The purpose of this study was to use the data from the Health Insurance Review and Assessment Service to analyze the disagreement in disease coding given by different medical institutions on the same disease of the same patient and provide basic data that could help improve the quality of national public health statistics. 9,976,826 patients' data records from the Health Insurance Review and Assessment Service-National Patient Sample (HIRA-NPS) of 2014 were analyzed. The disagreement in disease coding differed by movement paths for medical institutions; the disagreement rate tended to increase when moving from a medical institution other than public health centers to a public health center and decrease remarkably when moving from a specialized general hospital to another. Therefore, this analysis of disagreement in disease coding among medical institutions suggests the need to supplement the system so that domestic medical institutions can realize consistent disease coding.

A Predictive Model on Patient-Centered Care of Hospital Nurses in Korea (상급종합병원 간호사의 환자중심간호 예측모형)

  • Jeong, Hyun;Park, Myonghwa
    • Journal of Korean Academy of Nursing
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    • v.49 no.2
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    • pp.191-202
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    • 2019
  • Purpose: Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required. Methods: The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables. Results: The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care. Conclusion: These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.

Newly graduated Nurse's Resilience Experience (신규간호사의 극복력 경험)

  • Hwang, Hyenam;Lee, Yoonshin
    • The Journal of the Korea Contents Association
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    • v.21 no.10
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    • pp.656-667
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    • 2021
  • Purpose: The purpose of this study was to explore the resilience experience and to identify in-depth the meaning of the resilience of newly graduated nurses. Methods: This study was a qualitative study using phenomenological research method and used data obtained from semi-structured in-depth interviews with 9 newly graduated nurses under 12 months of employment in tertiary general hospitals. The data were analyzed using Colaizzi's method. Results: As a result of analyzing the experiences of newly graduated nurses' resilience, there were totally 86 meaningful statements, 13 themes were derived from them, and they were integrated into 4 theme clusters. The four theme clusters were 'Acknowledging shortcomings and developing oneself', 'Enduring and tolerating', 'Support from people around oneself', and 'Freshening and sublimating oneself'. Conclusion: Understanding and enhancing the resilience of new nurses will help them improve nursing professionalism and reduce turnover due to reduced work stress.

A Study on the Development of Physical Examination with VR Content and User Satisfaction (VR 콘텐츠를 이용한 신체검사 개발 및 사용자 만족도 연구)

  • An, Ho-Won;Kim, Jun-Min
    • The Journal of the Korea Contents Association
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    • v.21 no.6
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    • pp.318-326
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    • 2021
  • This study aims to the effectiveness of physical examination using VR contents to solve problems such as the increase in chronic diseases and shortage of professional manpower in the health care field according to the aging and low birth rate, and to provide efficient healthcare. Therefore, this study implemented a one-stop VR content physical examination system by wearing HTC VIVE Pro VR and a stick controller. The system is from step 1 to step 5, and the final body age is determined and a simple solution is provided through five steps sequentially: color blind test, memory test, audiogram test, reaction speed test, and instantaneous cognitive ability test. In addition, for the one-stop VR content physical examination system developed by this study, as a result of verifying the user satisfaction for normal people who visited the health examination center and VR/AR clinical trial center of certified tertiary hospital in Daejeon, the overall satisfaction and the intention to reuse Was high, and according to gender, there was a significant difference in the 5-step test, and according to the age, there were significant differences in the 4-step test and the 5-step test.

Influence of Problem-solving Ability and Self-efficacy on Medication Safety Competence among Clinical Nurses (간호사의 문제해결능력, 자기효능감이 투약안전역량에 미치는 영향)

  • Jeong, Da Eun;Lee, Young Whee;Ryu, Kyung Min;Woo, Han Sol;Kim, Jan Dee
    • Journal of Convergence for Information Technology
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    • v.12 no.5
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    • pp.21-31
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    • 2022
  • This study attempted to identify factors affecting the clinical nurse's medication safety competence. Data collection was conducted with 154 nurses working in two tertiary general hospitals. Data were analyzed using by t-test, ANOVA, Pearson correlation coefficient, and stepwise multiple regression analysis with SPSS 26.0 program. As a result of the study, medication safety competence had a statistically significant correlation with problem-solving ability and self-efficacy. The factors influencing medication safety competences were in order of self-efficacy, problem-solving ability, work pattern, and current site work experience, which together accounted for 64.7% of the total variance. Therefore, in order to improve the clinical nurse's medication safety competences, prioritizing the development of a program to enhance self-efficacy and problem-solving ability is required.

Nurses' Perceptions toward Parent Participation in Pediatric Intensive Care Unit: A Content Analysis (소아중환자실 부모의 돌봄참여에 대한 간호사의 인식: 내용 분석 연구)

  • Kim, Cho Hee;Chae, Sun Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.12
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    • pp.493-501
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    • 2019
  • This paper describes nurses' perceptions toward parental participation in pediatric intensive care units (PICU). Qualitative data were collected from five nurses working at two PICUs in Seoul through individual in-depth interviews. The interviews were conducted from January to February 2016 and analyzed using traditional content analysis. Five categories were found for the parent participation in PICU: needs, attributes, benefits, barriers, and facilitating strategies for parent participation in PICU. Nurses acknowledged the necessities and benefits of parent participation, particularly in PICU, considering the parents' emotional burdens due to the critical health condition of their child as well as the limited visiting policy. The major barriers were a lack of knowledge and the skills of nurses to facilitate parent participation, nurses' heavy workloads, and lack of policies and guidelines supporting parent participation within the PICUs and hospitals. The participants indicated that organizational facilitating-strategies, such as education for nurses about meaning and skills of parent participation in PICU, raising awareness for nurses as well as parents, and ensuring professional staff dedicated to promoting parent participation, to be significant factors. Further study will be needed to develop nursing interventions to integrate parent participation in PICU care.

A Consideration of Perception on Enforcement of Serious Accident Punishment Act(SAPA) among the Workers in the Nuclear Medicine Department (중대재해처벌법 시행에 따른 핵의학 종사자의 인식 고찰)

  • Lee, Joo-Young
    • Journal of the Korean Society of Radiology
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    • v.16 no.4
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    • pp.477-490
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    • 2022
  • Serious Accident Punishment Act(SAPA) went into effect as of Jan. 27, 2022. The subject of study was the worker of the nuclear medicine department and the investigation was aimed at identifying the present situation of their understanding on the issue in the here and now, which can be utilized as basic research for further study. The survey was conducted on 51 people of the worker in the nuclear medicine department. The general factors were classified by their gender, the scale of the hospitals, the period of career, and the detailed occupational categories. The conclusion was drawn, including 1 missing data in gender and 2 in the type of occupation. The targeted hospitals were tertiary hospital, university hospital, and general hospital which have nuclear medicine department in. The period of subjects' career was categorized by less than 3 years, 3 to 5 years, 5 to 10 years, and more than 10 years. The specific occupation was classified by in-vivo radiological technologist, radiation safety manager and others. The amount of pressure that the job entails was highest in the category of general hospital, the period of 3 to 5 years of job experience, and radiation safety manager each. The system of the code was well constructed in the category of general hospital, the period of less than 3-year career, and radiation safety manager, as they responded. The blood transmissible disease had the largest number of outbreak of accidents related to the serious industrial accident. In addition, the radiopharmaceutical dosing error had the highest number of outbreak of accidents related to the serious civil accident. Therefore, we need to improve SAPA, facility inspection, security of budget, security of professional manpower. It will help the stable use of radiation and ensure patient safety.