• 대한간호학회지
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• 제50권4호
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• pp.621-630
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• 2020

Purpose: This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital. Methods: This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness. Results: The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those of CREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: - 0.16~0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63~.78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors' cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively. Conclusion: The CREP-model's discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2017년도 춘계학술대회
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• pp.350-352
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• 2017

최근 가상현실(VR)이 IT기술의 화두로 떠오르고 있다. 가상현실 기술은 처음엔 게임, 영화, 스포츠, 테마파크와 같이 엔터테인먼트 목적으로 개발되는 경우가 많았으나 점차 교육, e-커머스, 헬스케어 등 다수의 산업으로 확대되어 관련 시장의 확산에 따른 파급효과는 매우 클 것으로 예상된다. 따라서 VR을 접목한 안전교육 콘텐츠도 급부상 하고 있다. 하지만 아직까지도 우리나라의 안전 교육에 대한 프로그램 활성도는 미미한 수준이다. 제세동기를 이용한 급성 심정지 환자 구출은 가장 대표적인 안전 교육중 하나이지만 2014년 기준 국내에서 자동 제세동기를 사용하여 환자의 생명을 구한 공식적인 사례는 단 한건으로 자동 제세동기의 사용 실적이 매우 저조함을 알 수 있다. 자동제세동기 사용성과 접근성 확장을 위한 사용법 및 중요성 숙지 교육이 필요한 현황이지만 이러한 안전 교육을 단순한 이론 교육에서 끝마칠 뿐 체험 교육 마련이 쉬운 일이 아니다. 본 논문에서는 언제든지 자유롭게 효과적으로 훈련을 받을 수 있는 가상현실을 이용한 자동 제세동기 훈련 시뮬레이션을 제안한다.

• Child Health Nursing Research
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• 제5권3호
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• pp.241-249
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• 1999

Diaper dermatitis, or commonly called 'diaper rash', is among the most prevalent cutaneous disorders of infancy and early childhood and important issue in nursing. The term itself is not diagnostic since it encompasses a variety of acute inflammatory reactions which are best regarded as a family of disorders arising from a combination of factors specifically attributable to the use of diapers Intensive study of the rash Process has shown that skin wetness and fecal enzyme activity are damaging to skin and lead to the development of diaper rash. This suggests that it is important to keep urine away from babies' skin, so that the skin remains as dry as Possible and maintains its barrier function abilities. Controlling the urine will also minimize the mixing of urine and feces within the diaper. which helps prevent the increased activity of enzymes that attack the skin and cause irritation. Therefore, a diaper that keeps the skin drier and limits the mixing of urine and feces will help Prevent the conditions that lead to diaper rash. Since their introduction about 35 years ago, disposable baby diapers have undergone many design and performance changes. In Particular. the Performance of diapers was advanced by the introduction of absorbent gel materials (AGMs) to Provide advantages in skin care. dryness, and leakage Protection Especially, important was the introduction of AGM which increased the absorbent capacity of the diaper several fold and Yielded marked reductions in the degree of skin hydration occurring under the diaper Studies show not only drier skin but more stable skin pH and less dermatitis with AGM diapers than with home-laundered cloth diapers or single-use diapers without AGM Minimizing diaper area skin wetness is important for managing and Preventing diaper rash. To minimize wetness, parents should use super absorbent diapers.

• 한국병원경영학회지
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• 제22권4호
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• pp.74-86
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• 2017

Purposes: This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are related to hospital management performances, so that the study can suggest plans for activation and development of the accreditation program. Methodology: This study was performed targeting 98 hospitals answered th the survey among 189 acute care hospitals that acquired accreditation from December 2010 to February 2014. For data analysis, frequency analysis, ${\chi}^2$-test, reliability analysis, ANOVA, Kruskal-Wallis H test and multiple regression analysis with SPSS 21.0 were used. Findings: The hospitals that had staff in charge of patient safety had bigger hospital culture change than those that didn't have(p<.05). In addition, the hospital culture change was bigger as internal motives were bigger, and as CEO's will was bigger(p<.05). Meanwhile, as maintenance rate of internal management after accreditation was higher, and as CEO's will was bigger, process improvement level was higher(p<.05). The quality improvement and patient satisfaction level were higher as CEO's will was bigger, and as suitability of survey process was recognized to be high(p<.05). As a result of analyzing the factors that affect hospital management performances with hospital culture change, process improvement and quality improvement combined, as internal management maintenance rate was higher, as CEO's will was bigger, and as suitability of survey process was higher, performances were higher(p<.05). Practical Implications: Hospitals need to reinforce internal motives to improve internal competences such as the whole system maintenance opportunity and staff training. In addition, the will of hospital director is most important, and if there is hospital director's interest in quality improvement and improvement intention definitely, employees voluntarily participate in and cooperate with the accreditation program, so that prompt medical service provision and high quality of medical services can be guaranteed, leading to hospitals' management performances.

• Tuberculosis and Respiratory Diseases
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• 제83권4호
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• pp.295-302
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• 2020

Background: Weaning failure is common in mechanically ventilated patients, and if ultrasound can predict weaning outcome remains controversial. The purpose of this study was to evaluate the diaphragmatic function (thickness and excursion) measured by ultrasound as a predictor of the extubation outcome. Methods: We included 62 mechanically ventilated patients from the chest intensive care unit in this study. Sixty-two patients who successfully passed the spontaneous breathing trial (SBT) were enrolled. The transthoracic ultrasound of the diaphragm was performed during an SBT to the assess diaphragmatic function (excursion and thickness), and they were classified into the successful extubation group and the failed extubation group. Results: There was a statistically significant increase in the successful extubation group in the diaphragmatic excursion and thickness fraction (p<0.001), a statistically significant negative correlation between the diaphragmatic function and the duration of the mechanical ventilation, and a statistically significant negative correlation between the diaphragmatic excursion and the Acute Physiology and Chronic Health Evaluation II. The diaphragmatic excursion cut-off value predictive of weaning was 1.25 cm, with a specificity of 82.1% and a sensitivity of 97.1% respectively, and the diaphragmatic thickness cut-off value predictive of weaning was 21.5%, with a specificity of 60.7% and a sensitivity of 91.2%, respectively. Conclusion: The diaphragmatic ultrasonography was found to be a promising tool for predicting the extubation outcome for mechanically ventilated patients.

• 한국산학기술학회논문지
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• 제16권9호
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• pp.6071-6079
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• 2015

본 연구는 종합병원 간호사와 중등 교사들을 대상으로 감성지능에 따른 직업 정서적 만족과 직무만족, 조직몰입을 파악하고 각각의 변인들 간의 연관성을 확인하여 직업군별로 비교 분석하는 것에 목적을 두고 있다. 연구대상은 K시 소재 종합병원 간호사 58명과 동 소재 중등교사 48명을 대상으로 하였으며 자료 수집은 2014년 6월 15일부터 6월 30일까지 이루어졌다. 자료 분석은 SPSS Window 17.0, t-test, ANOVA 및 $Scheff{\acute{e}}$ test를 하였고, 연관성은 피어슨 상관계수와 다중회귀분석을 실시하였다. 연구결과 감정노동자의 감성지능은 전반적으로 직업 정서적 만족, 직무만족, 조직몰입에 정적으로 유의한 상관관계를 나타냈다. 이것은 감정노동자의 근무여건과 효율적인 제도를 마련할 수 있는 방안 모색에 기초자료가 될 것이다.

• Pediatric Infection and Vaccine
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• 제24권2호
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• pp.117-122
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• 2017

흑수열은 급성 혈관 내 용혈, 발열과 검붉은색 소변 등의 증상을 보이는 증후군으로, 말라리아 및 불규칙적인 키닌의 투약과 관련 있는 것으로 알려져 있다. 국내에서는 삼일열 말라리아만 발생하고 있으나, 최근 말라리아 유행지역을 여행한 해외여행객들로부터 열대열 말라리아의 해외 유입 보고가 증가하고 있다. 따라서 의료진들은 열대열 말라리아와 그 합병증에 대해 알 필요가 있다. 본 증례는 쇼크를 동반한 중증 열대열 말라리아 이후에 흑수열이 합병한 14세 여자에 대해 보고하는 바이다.

• 임상간호연구
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• 제26권1호
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• pp.26-46
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• 2020

Purpose: This study aimed to establish the role of and to analyze the job of nurses in a regional emergency center using the Developing a Curriculum(DACUM) process, a job analysis technique. Methods: The DACUM committee was organized, and three workshops were held from June 1st to July 4th, 2016. One hundred two nurses in a regional emergency center participated in a survey from October 3rd to 10th, 2016. The frequency, importance and difficulty of each tasks and task elements in the DACUM were investigated on a Likert scale. Results: The roles of nurses in a regional emergency center were identified and the DACUM chart was developed with 6 duties, 29 tasks and 153 task elements. According to the survey, some tasks such as 'CPR,' 'acute respiratory distress care,' and 'drug administration' showed high frequency and importance or difficulty in all nursing units in common, and different results reflected the characteristics of each nursing unit were also found. Conclusion: The results showed the feature of the regional emergency center. Based on these results, it is necessary to develop educational programs for practice.

• 대한간호학회지
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• 제49권5호
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• pp.526-537
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• 2019

Purpose: The aim of this study was to evaluate the validity and reliability of the Korean version of the Clinical Teaching Behavior Inventory (CTBI). Methods: The English CTBI-23 was translated into Korean with forward and backward translation. Survey data were collected from 280 nurses' preceptors at five acute-care hospitals in Korea. Content validity, construct validity, and criterion-related validity were evaluated. Cronbach's ${\alpha}$ was used to assess reliability. SPSS 24.0 and AMOS 22.0 software was used for data analysis. Results: The CTBI Korean version consists of 22 items in six domains, including being committed to teaching, building a learning atmosphere, using appropriate teaching strategies, guiding inter-professional communication, providing feedback and evaluation, and showing concern and support. One of the items in the CTBI was excluded with a standardized factor loading of less than .05. The confirmatory factor analysis supported good fit and reliable scores for the Korean version of the CTBI model. A six-factor structure was validated ($x^2=366.30$, p<.001, CMIN/df=2.0, RMSEA=.06, RMR=.03, SRMR=.05, GFI=.90, IFI=.94, TLI=.92, CFI=.94). The criterion validity of the core competency evaluation tool for preceptors was .77 (p<.001). The Cronbach's ${\alpha}$ for the overall scale was .93, and the six subscales ranged from .72 to .85. Conclusion: The Korean version CTBI-22 is a valid and reliable instrument for identifying the clinical teaching behaviors of preceptors in Korea. The CTBI-22 also could be used as a guide for the effective teaching behavior of preceptors, which can help new nurses adapt to the practicalities of nursing.

• 한국컴퓨터정보학회논문지
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• 제19권11호
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• pp.149-157
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• 2014

당뇨병은 급성합병증을 예방하고 장기간의 합병증의 위험도를 감소하기 위하여 지속적인 치료와 환자 자가 관리 교육이 필요한 만성질환이다. 또한 전 세계적으로 당뇨병에 대한 유병률과 사망률이 대부분의 인구집단에서 역학적 비율에 도달하였다. 많은 연구에서 당뇨병에 대한 조기진단은 적절한 치료와 생활습관을 지키는 관리를 통하여 발병을 예방하는데 도움을 줄 수 있으며, 이를 통하여 당뇨병의 합병증을 감소시키고 생존률을 향상시킬 수 있다고 보고하고 있다. 본 연구는 PIMA Indians 당뇨 데이터에 대하여 mixture of expert 모형을 적용하여 당뇨유병환자의 여부를 분류하고, 이를 로지스틱 회귀분석, 신경망분석의 성능과 비교함으로서 그 유용성을 주장하고자 하였다. 연구결과 정확도 및 ROC 곡선, c-통계량에서 ME 모형이 다른 분류도구들에 비해서 높게 나타남을 확인할 수 있었다.