• 제목/요약/키워드: Day care service

검색결과 278건 처리시간 0.029초

고관절 전치환술 환자의 Critical pathway적용효과 (Effects of Critical Pathway(CP) on the patients with Primary Total hip replacement(THR))

  • 이미경;도복늠
    • 간호행정학회지
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    • 제8권2호
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    • pp.295-308
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    • 2002
  • Purpose: The purpose of this quasi-experimental research is to develop the CP for primary THR patients and verify its effectiveness. Method: The CP is designed for both patients and medical employees to meet the 14-day-long hospitalization with an expert and clinical validity test, and the standardized orders are also created. 21 eligible subjects for the control group(with common care plan) and 27 subjects for the experimental group(with CP service) were assigned. Data were collected from questionnaires to evaluate patients' satisfaction level of nursing care and CP, investigation of physical complications, inspection of LOS(length of hospital stay) and hospital charges from April 2000 to February 2001 at K-hospital in Daegu. The collected data were analyzed by using the SAS program. Results: After implementation of CP, there was a statistically significant reduction in mean length of stay. The hospital charges have no considerable difference between two groups. Frequency of physical complications is reduced considerably. The experimental group scored much higher than the control group on the satisfaction level toward nursing care. And in the analysis of CP satisfaction questionnaires, many subjects have high satisfaction in items of 'I see the treatment process and hospital life', 'I feel that I am participating in my treatment process with health care staff'. The analysis of variances which cause a prolonged LOS supports that it's necessary to strengthen an evaluation of pre-operative outpatients' condition and link the home nursing care system in discharge for more shortening of LOS. Conclusion: The above results show that CP can have a positive impact on satisfaction level of inpatients with primary THR and the hospital.

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어린이집에서의 아동학대와 아동권리 모니터링을 통한 해결방안 (Through Monitoring Solution Child Abuse and Children's Rights at Child Care Center)

  • 서진석
    • 융합보안논문지
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    • 제13권2호
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    • pp.55-66
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    • 2013
  • 아동 학대는 아동의 생명을 좌우하고 평생의 삶에 영향을 끼치는 긴박하면서도 중요한 사안이다. 특히 보육시설을 이용하는 아동의 경우, 나이가 어리기 때문에 학대에 취약하여 그 학대 후유증이 심각하며 심할 경우 아동은 사망에 이를 수 있다. 또한 학대받은 아동의 억울함을 대변하고 도움을 청할 주체가 부재하기 때문에 아동학대는 늘 아이들의 안타까운 희생으로 종결되는 경우가 많다. 그러므로 보육시설종사자들은 아동학대는 더 이상 가정 내의 사적인 문제가 아니라 심각한 범죄라는 사실을 인식하여야 할 것이고 신고의무자로서 학대조기발견 및 신고에 적극적으로 임해야 할 것이다. 보육시설 종사자들이 아동학대 신고의무자로서 역할을 충분히 수행하며, 신고 이후 아동보호전문기관과 보육시설간의 협력이 제대로 이루어질 때 보육시설은 사각지대에 놓인 아동을 보호하는 아동안전망의 역할을 할 수 있을 것이다.

위 절제술 환자의 진료계획표 개발 및 전자 의무 기록화 (Development of a Flexible Critical Pathway with Electronic Medical Record for Gastrectomy Patients in a University Hospital)

  • 배명순;송정흡
    • 한국의료질향상학회지
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    • 제18권1호
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    • pp.37-55
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    • 2012
  • Objectives : This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients. Methods : Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients. Result : The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful. Conclusion : Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.

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소이 직장 어린이집 교사가 인식하는 부모 태도에 대한 어려움과 극복 노력에 관한 탐색 (Exploration of Soie Employer-Supported Child-Care Center Teacher's Difficulties and Overcoming Effort in the Attitude of Parents)

  • 김보림
    • 한국콘텐츠학회논문지
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    • 제19권6호
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    • pp.553-564
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    • 2019
  • 본 연구는 연중무휴로 운영되는 소이 어린이집 교사가 부모 태도에 대하여 느끼는 어려움과 대처방안에 관하여 탐색하고자 하였다. 이를 위하여 1년 365일, 하루 18시간 운영되는 소이 어린이집 교사 7명을 대상으로 심층면담과 현장관찰을 진행하였다. 연구 결과 교사들은 부모의 연중무휴 운영을 위한 규정 미 준수, 휴무 시 과잉 이용, 근무 상황에 따른 지나친 개별적 요구, 직종 인식에 따른 CCTV분석의 일반화, 교실에 관여되는 직장 내 부모 직급, 부모의 서비스 직무적 요구태도 등에 어려움을 느끼는 것으로 나타났다. 이러한 어려움에 대하여 연구 참여자들은 부모의 직종과 개별적 특성 미리 파악 및 예방, 직장 어린이집 경력자 교사에게 조언 구하기, 직장 어린이집의 장점 생각하며 상황 객관화하기, 전문성 신장 등의 노력을 하고 있는 것으로 나타났다. 이는 확대되어 가고 다양화 되어가는 직장 어린이집 운영과 교사를 지원하는 프로그램 개발을 위한 기초 자료가 될 것이다.

의사결정나무기법을 활용한 노인장기요양보험 표준급여모형 개발 (A Decision-support System for Care Plan in Long-term Care Insurance)

  • 한은정;이정석;김동건;권진희
    • 응용통계연구
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    • 제27권5호
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    • pp.667-679
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    • 2014
  • 우리나라 노인장기요양보험에서는 수급자가 월 한도액 범위 내에서 필요한 서비스를 비용-효율적으로 이용할 수 있도록 지원하고자 표준장기요양이용계획서를 작성하여 제공하고 있다. 본 연구는 표준장기요양이용계획서의 객관성 확보와 업무 효율성 제고를 위하여 의사결정나무기법을 이용해 수급자의 건강 및 기능 상태에 맞는 최적의 급여계획을 도출하는 표준급여모형을 개발하였다. 타당도 높은 모형 개발을 위하여 국민건강보험공단의 전국 220개 장기요양운영센터로부터 장기요양인정조사와 표준장기요양이용계획서 작성 경험이 풍부한 직원(본 연구에서는 '훈련된 조사자'라고 함)을 추천받아 자료수집의 내용과 방법에 대해 교육을 실시하였고, 이들이 수급자의 건강 및 기능 상태를 평가하고 작성한 수급자 개인별 맞춤형 급여계획을 자료 분석에 활용하였다. 표준급여모형은 1단계로 시설 또는 재가 급여 권고 여부를 결정하는 모형을, 2단계로 재가급여를 권고했을 경우의 재가급여 세부 종류별 권고 여부를 결정하는 모형을 개발하였다. 본 연구에서 개발된 표준급여모형은 전산프로그램화 되어 국민건강보험공단 직원이 수급자에게 제공할 표준장기요양이용계획을 수립하는 과정에 실제로 활용되고 있어 표준장기요양이용계획서의 객관성 확보와 업무 효율화가 기대된다.

소방공무원의 구강건강관리 행태에 관한 융합연구 (The Convergence Research on Oral Health Care Behavior of Fire Officers)

  • 박영석;정수진;이미라
    • 융합정보논문지
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    • 제7권6호
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    • pp.9-17
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    • 2017
  • 본 연구는 소방공무원의 구강건강관리 행동에 대한 실태를 파악하고자 대전광역시의 일부 소방서에 근무하는 241명의 소방공무원을 대상으로 실시하여 다음과 같은 결과를 얻었다. 첫째, 1일 칫솔질 횟수는 남성은 3회, 여성은 4회라는 응답이 많았고, 칫솔질 시간은 20대 연령과 근무경력이 5년 이하인 근무자들이 3분 이상 닦는 것으로 나타났다. 둘째, 구강보조용품 사용은 20, 30대 연령과 근무경력이 10년 미만인 근무자들이 많이 사용하고 있었으며, 소방장 이하의 계급에서 구강보건교육 경험이 많았다. 셋째, 구강보건교육을 받은 경우 구강보조용품을 더 많이 사용하고 있었고, 1년 내 치석제거도 더 많이 시행한 것으로 나타났다. 연구결과 열악한 근무환경에 비해 소방공무원의 구강건강관리상태는 다행히 양호한 수준 이였으나, 향후 구강건강향상을 위한 IT와 로봇기술이 융합된 직무 맞춤형 구강건강 프로그램 개발과 홍보대책 방안을 마련하고 소방공무원의 처우를 개선한다면 소방공무원들의 구강건강관리 수준은 더 향상될 수 있을 것이라 사료되었다.

뉴로피드백 훈련이 장기요양시설노인의 뇌기능지수에 미치는 효과 (The Effects of Neurofeedback Training on Brain Function Quotient of Elderly with Long-term Care Insurance Service)

  • 윤미경;현경선;박병운;이광심;정동례;이정은
    • 동서간호학연구지
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    • 제18권2호
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    • pp.111-119
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    • 2012
  • Purpose: Recently, Neurofeedback training system that based on biofeedback of brain wave was introduced. This study was performed to identify the effects of the improvement of brain function by Neurofeedback training on elders(the 2nd or 3rd grade of long-term care insurance services). Methods: A quasi-experimental design using a nonequivalent control group, pre-post test was used. Total 11 elderly were enrolled in this study (experimental group 5, control group 6). The intervention was conducted 3 times a week for 30 minutes from January to June, 2012 (total 60 times). Chi-square test and Mann-Whitney U-test were used to analyze the data. Results: After the Neurofeedback intervention, attention quotient (AQ), anti-stress quotient (ASQ), emotion quotient (EQ) and brain quotient (BQ) of the experimental group were significantly better than those of the control group. Conclusion: The findings indicate that the Neurofeedback training program was effective in reducing fatigue by AQ, increasing the physical and mental stress resistance by ASQ, emotional balance by EQ and improving of total brain function by BQ. Therefore Neurofeedback training be used as an effective training intervention for the health of elderly in geriatric facility.

영유아 보육시설의 급식 운영 실태 조사 - 충남 아산 지역 중심으로 - (A Survey on the Foodservice Management System of the Child Care Centers in Chungnam Asan Area)

  • 송은승;김은경
    • 대한지역사회영양학회지
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    • 제14권6호
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    • pp.846-860
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    • 2009
  • We investigated the foodservice management practices in various operation types of childcare centers in Asan, Chungnam Province, with the intention of improving the quality of foodservice and providing the basic information for establishing more effective and efficient foodservice model system. Self-completed questionnaires were collected from the directors of 174 child care centers. The statistical analysis was completed using SPSS Ver. 12.0 program. The followings are about the results of this study. Approximately 94.8% of the directors were women with the average age of 40.3. All of the investigated facilities executed foodservice; the facilities of 96.2% had been self-operated, 1.9% was contract-managed and the remaining 1.9% served delivered meal from outside. Only 20.0% of the investigated centers employed a dietitian. In most of the centers, meals were prepared in a conventional manner and approximately 85.3% of the centers are serving only snacks twice a day as a supplementary due to financial difficulties. Menu planner of the facilities, which have no dietitian was the director (35.8%) or the cook (25.7%). In most centers, the directors purchased the food materials (67.5%). Material inspection was done by the director (54.9%) or the cook (40.5%). However, home care centers did not inspect the food material. These results indicate that food service management guidelines need to be established by the facility type with the government control and financial support. Especially, dietitian employment and the efficient foodservice model system establishment are questions that confront us.

한국농촌보건(韓國農村保健)의 문제점(問題點)과 개선방안(改善方案) (Innovative approaches to the health problems of rural Korea)

  • 노인규
    • 농촌의학ㆍ지역보건
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    • 제1권1호
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    • pp.5-9
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    • 1976
  • The categories of national health problems may be mainly divided into health promotion, problems of diseases, and population-economic problems which are indirectly related to health. Of them, the problems of diseases will be exclusively dealt with this speech. Rurality and Disease Problems There are many differences between rural and urban areas. In general, indicators of rurality are small size of towns, dispersion of the population, remoteness from urban centers, inadequacy of public transportation, poor communication, inadequate sanitation, poor housing, poverty, little education lack of health personnels and facilities, and in-accessibility to health services. The influence of such conditions creates, directly or indirectly, many problems of diseases in the rural areas. Those art the occurrence of preventable diseases, deterioration and prolongation of illness due to loss of chance to get early treatment, decreased or prolonged labour force loss, unnecessary death, doubling of medical cost, and economic loss. Some Considerations of Innovative Approach The followings art some considerations of innovative approaches to the problems of diseases in the rural Korea. 1. It would be essential goal of the innovative approaches that the damage and economic loss due to diseases will be maintained to minimum level by minimizing the absolute amount of the diseases, and by moderating the fee for medical cares. The goal of the minimization of the disease amount may be achieved by preventive services and early treatment, and the goal of moderating the medical fee may be achieved by lowering the prime cost and by adjusting the medical fees to reasonable level. 2. Community health service or community medicine will be adopted as a innovative means to disease problems. In this case, a community is defined as an unit area where supply and utilization of primary service activities can be accomplished within a day. The essential nature o the community health service should be such activities as health promotion, preventive measures, medical care, and rehabilitation performing efficiently through the organized efforts of the residents in a community. Each service activity should cover all members of the residents in a community in its plan and performance. The cooperation of the community peoples in one of the essential elements for success of the service program, The motivations of their cooperative mood may be activated through several ways: when the participation of the residents in service program of especially the direct participation of organized cooperation of the area leaders art achieved through a means of health education: when the residents get actual experience of having received the benefit of good quality services; and when the health personnels being armed with an idealism that they art working in the areas to help health problems of the residents, maintain good human relationships with them. For the success of a community health service program, a personnel who is in charge of leadership and has an able, a sincere and a steady characters seems to be required in a community. The government should lead and support the community health service programs of the nation under the basis of results appeared in the demonstrative programs so as to be carried out the programs efficiently. Moss of the health problems may be treated properly in the community levels through suitable community health service programs but there might be some problems which art beyond their abilities to be dealt with. To solve such problems each community health service program should be under the referral systems which are connected with health centers, hospitals, and so forth. 3. An approach should be intensively groped to have a physician in each community. The shortage of physicians in rural areas is world-wide problem and so is the Korean situation. In the past the government has initiated a system of area-limited physician, coercion, and a small scale of scholarship program with unsatisfactory results. But there might be ways of achieving the goal by intervice, broadened, and continuous approaches. There will be several ways of approach to motivate the physicians to be settled in a rural community. They are, for examples, to expos the students to the community health service programs during training, to be run community health service programs by every health or medical schools and other main medical facilities, communication activities and advertisement, desire of community peoples to invite a physician, scholarship program, payment of satisfactory level, fulfilment of military obligation in case of a future draft, economic growth and development of rural communities, sufficiency of health and medical facilities, provision of proper medical care system, coercion, and so forth. And, hopefully, more useful reference data on the motivations may be available when a survey be conducted to the physicians who are presently engaging in the rural community levels. 4. In communities where the availability of a physician is difficult, a trial to use physician extenders, under certain conditions, may be considered. The reason is that it would be beneficial for the health of the residents to give them the remedies of primary medical care through the extenders rather than to leave their medical problems out of management. The followings are the conditions to be considered when the physician extenders are used: their positions will be prescribed as a temporary one instead of permanent one so as to allow easy replacement of the position with a physician applicant; the extender will be under periodic direction and supervision of a physician, and also referral channel will be provided: legal constraints will be placed upon the extenders primary care practice, and the physician extenders will used only under the public medical care system. 5. For the balanced health care delivery, a greater investment to the rural areas is needed to compensate weak points of a rurality. The characteristics of a rurality has been already mentioned. The objective of balanced service for rural communities to level up that of urban areas will be hard to achieve without greater efforts and supports. For example, rural communities need mobile powers more than urban areas, communication network is extremely necessary at health delivery facilities in rural areas as well as the need of urban areas, health and medical facilities in rural areas should be provided more substantially than those of urban areas to minimize, in a sense, the amount of patient consultation and request of laboratory specimens through referral system of which procedures are more troublesome in rural areas, and more intensive control measures against communicable diseases are needed in rural areas where greater numbers of cases are occurred under the poor sanitary conditions.

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노인요양시설 입소자들의 의료적 요구에 대한 간호직 종사자들의 관리 경험 (Nursing Staffs' Experiences of Managing Medical Needs of the Elderly in Korean Long-term Care Facilities)

  • 박민정;서은영;이정면
    • 성인간호학회지
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    • 제25권4호
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    • pp.409-421
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    • 2013
  • Purpose: This qualitative study was designed to explore and describe the nursing staff reported experiences of managing the medical needs of nursing home residents in South Korea. Methods: Using a focus group interview method, qualitative data were collected from March to May 2012. Twenty five registered nurses and nurse aids working in nursing homes were recruited through a convenient sampling method. Participants participated in one of four focus group interviews lasted up to two hours in which their day-to-day experiences of taking care of the medical needs of the elderly residents. All interviews were recorded and transcribed in verbatim, and analyzed according to the qualitative thematic analysis method using MAXQDA software. Results: The overriding theme was 'experiencing differences between the requirements of the regulatory system and the actual reality of the work place.' The findings of differences between what were true and what is required was based in four subcategories. The nursing home residents had far more medical needs than what were reported. Another finding was that the family members were seen as non-supportive and negligent towards the residents. Conclusion: The findings of the study support the need for changes in the regulatory system. The regulatory limitations of current system with a shortage of resources pushed the participants to experience discrepancies between the required regulation and the reality. Additional research could contribute more exemplars to support changes.