• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권1호
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• pp.53-63
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• 2021

Purpose: Intensive Care Unit (ICU) is an important field of inpatient treatment, in which critically ill patients have been treated intensively with advanced medical technology. The level of treatment in the intensive care unit and the modernization of related facilities are important indicators of the quality of medical care. At present, when regional public hospitals are expanding frequently, reasonable planning of ICU has become an important part of medical institutions that treat ICU. The purpose of this study is to provide basic data on the net area of each unit, which can be used in ICU building planning. Methods: The investigation and analysis of the ICU were conducted in 12 medical institutions, based on theoretical analysis based on relevant guidelines and literature, and analysis of actual space composition and net area through architectural drawings. Results: This research provides basic data, such as the location relationship with other important departments, regional division, spatial composition, the relationship between main activities and regions, the composition of facilities in the region, and the area and proportions of each region. Implications: It is expected that the results of this article will provide effective reference materials for the reasonable spatial organization and effective operation of the intensive care units of ordinary public hospitals of different sizes in the future.

• 중환자간호학회지
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• 제15권3호
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• pp.62-74
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• 2022

Purpose : This study aimed to identify the factors influencing physical restraint-related practice among nurses working in the intensive care unit (ICU). Methods : The participants consisted of 169 ICU nurses in three general hospitals in B and U cities. Data were collected from December 2021 to January 2022 through a structured self-administered questionnaire. Demographic characteristics, physical restraint-related practice, Person-centered Critical Care Nursing (PCCN), work environment, and attitudes toward physical restraint use were measured. For data analyses, hierarchical multiple regressions were conducted using SPSS/WIN 25.0. Results : Clinical careers in the ICU, better work environments, higher PCCN levels, and more positive attitudes toward physical restraint use were associated with a better practice of physical restraints, which together explained 35.5% of the total variance of the outcome. Conclusion : Our findings suggest that to promote a safe physical restraint-related practice among ICU nurses, it is important to improve the nursing environment, prepare guidelines for applying PCCN, and provide education for endorsing positive attitudes toward the use of physical restraints.

• 한국농촌간호학회지
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• 제18권1호
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• pp.40-48
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• 2023

Purpose: This study is a descriptive research that analyzes the current status of education for COVID-19 response tasks and factors affecting work fatigue of primary health care practitioners who have experience in dispatching to respond to COVID-19. Methods: This study collected data through an online survey from September 21 to 29, 2022, targeting 193 primary health care practitioners. The data were analyzed by frequency, percentage, mean, standard deviation, and logistic regression analysis using the SPSS 25.0 program. Results: 74.1% of the study subjects were dispatched without receiving disaster medical training to respond to COVID-19. 59.6% of the study subjects' work fatigue was above the level of being very tired. The factors that affect the work fatigue of the subjects were disaster participation experience, work intensity, compensation regulations, compensation satisfaction, and understanding of COVID-19 guidelines. Conclusion: Based on the results of this study, an educational program for systematic disaster response and preparation for primary health care practitioners in charge of public health care should be developed to efficiently cope with the occurrence of new infectious diseases in the future.

• 가정∙방문간호학회지
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• 제30권3호
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• pp.298-310
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• 2023

Purpose: This study synthesized the literature on non-pharmacological interventions for chronic pain in older adults in long-term care facilities. Methods: Scoping review and thematic analysis methods were combined. On June 1, 2023, searches of primary electronic databases, including PubMed, Embase, PsycINFO, CINAHL DBpia, KMbase, NDSL, and RISS, were performed, restricting the publication date from January 1, 2010 to December 31, 2022. Guidelines from the Joanna Briggs Institute were used as a framework to set and conduct the scoping review. Results: The review identified 1,095 abstracts, from which 14 studies were included in the review. Consequent to the study, there were 10 randomized controlled experimental study designs, and 6 out of 14 studies were conducted in China. The numeric rating scale was widely used for pain assessment. Exercise intervention was provided in 7 studies and physiotherapy was provided in three studies. The outcome variables measured were pain self-efficacy, physical functions, and depression. Conclusion: This comprehensive overview guided nursing staff in long-term care facilities for planning and intervention of effective non-pharmacological interventions for chronic pain in the elderly.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제30권3호
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• pp.35-44
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• 2024

Purpose: The purpose of this study is to present basic data on installation location, functional connection, and arrangement to be considered when planning a neonatal intensive care unit in a certified tertiary general hospital. Method: Review the facility standards related to the neonatal intensive care unit, such as laws and guidelines, and select a Certified Tertiary General Hospital as a case hospital among the Neonatal Intensive Care Regional Centers designated by the Ministry of Health and Welfare to analyze the placement characteristics of major NICU components such as the location of the NICU installation, the connection of movement between adjacent facilities and functions, and the treatment room and accessory room. Results and Implications: NICU is a facility for critically ill babies among newborns and needs to consider more about infection and patient management compared to adult intensive care units, which not only install close to delivery-related facilities to enable immediate action after childbirth, but also divide the treatment room into open rooms and allow access to the attached rooms through dedicated corridors to minimize movement in the treatment room.

• Journal of Hospice and Palliative Care
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• 제19권3호
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• pp.201-210
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• 2016

섬망은 완화치료를 받는 말기암환자에서 흔히 나타나는 증상으로 임종기에 접어들수록 빈도는 증가한다. 섬망은 환자와 가족의 삶의 질에 부정적인 영향을 줄 뿐 아니라, 높은 사망률과 관련되어 있으나 실제 임상에서 의료진들이 적절히 인지하지 못하고 있다는 연구들이 보고되고 있다. 이는 우울이나 치매와 같은 정신질환과의 중복되는 특성, 섬망에 대한 평가 및 진단에 대한 지식의 부족 등이 원인으로 생각되고 있다. 이를 개선하기 위해 현재까지 알려진 섬망 선별검사를 통해 섬망환자를 정확히 인지하고, 진단하는 것이 완화의료 영역에서 섬망 증상 관리에 우선되어야 할 분야로 생각된다. 섬망이 진단되었을 때는 유발요인을 확인하고 약물이나 탈수, 감염 등의 가역적인 원인에 대해서는 이를 교정하는 것이 섬망을 조절에 가장 중요한 부분이다. 이와 함께 소음을 줄이거나, 적절한 조명을 유지하는 등의 환자의 주변 환경을 안정적으로 유지하는 등의 비약물적 치료가 병행되어야 한다. 비약물적 치료로 효과가 없거나, 증상이 심한 경우에 항정신병 약물과 벤조디아제핀과 같은 진정효과가 있는 약물을 사용할 수 있으며, 현재까지는 저용량의 할로페리돌 투여가 가장 효과적인 치료 약제로 인정되고 있다. 비정형적 항정신병 약물로는 Olanzapine, Quetiapine, Risperidone 등이 있으며 현재까지 보고된 바로는 할로페리돌과 비교하여 섬망 개선 효과는 비슷하나 추체외로 증상이 드물고 진정 효과가 있어 경구 섭취가 가능한 경우 고려해 볼 수 있는 약제로 생각된다. 현재까지 완화의료 영역에서의 섬망에 사용할 수 있는 약물에 대한 연구 결과는 근거가 충분하지 않은 상태이며, 이로 인해 임상에서 활용할 수 있는 임상진료 지침 또한 부족한 상태이다. 현재까지는 중환자실, 노인 환자에서의 연구 결과를 바탕으로 한 결과를 토대로 완화의료 영역에서의 섬망 치료에 이용하였지만 추후 말기암환자에서의 섬망에 대한 연구를 바탕으로 한 임상진료지침의 개발도 필요할 것으로 생각된다.

• 임상간호연구
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• 제21권2호
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• pp.154-168
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• 2015

Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.

• 대한지역사회영양학회지
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• 제18권2호
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• pp.112-124
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• 2013

This study was conducted to investigate how child-care teachers participate, practice mealtime instruction, and perceive difficulties in food service, focusing on comparison between the teachers caring two different age groups: children younger than three years (Younger Group) and those three years or older (Older Group). Questionnaires were distributed to 151 child-care centers in Kwanak-gu, Seoul, Korea during December, 2011. Only the data from 25 child-care centers, where two respective teachers in charge of Younger Group and Older Group completed the questionnaires, were analyzed. The results showed that there was no difference in terms of child-care teachers' participation in food service practice between the two groups, except for serving method; 'Pre-plated' serving was used significantly more often in Younger Group, whereas 'Line-up' serving was used in Older Group. Approximately, three quarters of the child-care centers had policies or guidelines on mealtime instruction. During mealtime, child-care teachers tended to use frequently verbal instructions such as "sit up straight when you eat" about eating manner, "don't be picky with your food" about eating habit, and "wash your hands before eating" about eating procedure in both the groups. There was no statistically significant difference regarding child-care teachers' perceived difficulties in food service between the two groups. These results indicated that child-care teachers' participation and mealtime instruction in food service did not differ between the two age groups, although children's development of digestion and eating skill differed by age. Therefore, training should be provided to child-care teachers about food service practices and mealtime instruction appropriate to children's age.

• 중환자간호학회지
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• 제17권1호
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• pp.68-82
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• 2024

Purpose : This scoping review was designed to identify gaps in knowledge and guide future directions for clinical nursing practices and research on oral hygiene care for endotracheally intubated patients in Korean intensive care units. Methods : We conducted a scoping review using the methodological framework proposed by Arksey and O'Malley. PubMed, CINAHL, RISS, Science On, and DBpia databases were searched. Two reviewers independently selected the studies and extracted data. A total of 445 studies were identified, of which 17 were included in the final analysis. Results : No research has been conducted from 2021 to the present. A total of 12 instruments were utilized in 13 studies to assess the effectiveness of oral hygiene care. All studies investigating the effectiveness of oral hygiene care have consistently documented that chlorhexidine has the most significant effect. The frequency and time of oral hygiene care were each examined in one study. Conclusion : A research study is necessary to develop a measurement tool for assessing the effectiveness of oral hygiene care suitable for endotracheal intubated patients in intensive care units. Interventional studies should be conducted to determine the effects of chlorhexidine and the appropriate frequency and time of oral hygiene care. Thereafter, revision of domestic evidence-based clinical practice guidelines by integrating these results will be necessary.

• 보건행정학회지
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• 제14권2호
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• pp.58-77
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• 2004

Cost containment has become high political issues since financial crisis of the Korean Health Insurance fund in 2000. Korean Government has developed and implemented several measures to reduce the pharmaceutical expenditures. Pharmaceutical economic evaluation can be a tool in decision to allocate scare resource efficiently. In order to increase the quality of economic evaluation for pharmaceuticals, the Korean Health Insurance Review Agency(HIRA) is considering the development of a guideline for economic evaluation. It mandates that pharmaceutical companies could submit the result of an economic evaluation when demanding reimbursement of new pharmaceutical drugs. The purpose of this study is to provide a critical review of the economic evaluations of health care technologies published in the Korean context whether they have been performed according to current guidelines and therefore whether their results are directly useful for decision making. We found there exist important problems and deviation from, good practice' both in the general features of the studies, like the study design and perspective, and in terms of cost measurement and valuation. There are needs to develop clear guidelines and to educate and train researchers in performing economic evaluations.