• Journal of Korean Neurosurgical Society
• /
• v.65 no.1
• /
• pp.130-137
• /
• 2022

Objective : COVID-19 has spread worldwide since the first case was reported in Wuhan, China, in December 2019. Our institution is a regional trauma and emergency center in the northern Gyeonggi Province. The changing trend of patient care in the emergency room of this hospital likely reflects the overall trend of patients in the area. In the present study, whether changes in the surrounding social environment following the outbreak of COVID-19 changed the incidence of neurosurgical emergency patients and whether differences in practice existed were investigated. Methods : The overall trend was analyzed from January 2020 which is before the outbreak of COVID-19 to September 2020. To remove bias due to seasonal variation, the previous 2 year's records during the same period were reviewed and compared. Confirmed COVID-19 patients in the northern Gyeonggi Province were identified using data released by the government. And patients who came to the emergency department with head trauma and stroke were identified. Results : Based on the present study results, the total number of neurosurgery emergency patients decreased over the study period. In the trauma patient group, the number of patients not involved in traffic accidents significantly decreased compared with patients involved in traffic accidents. Among the stroke cases, the rate of ischemic stroke was lower than hemorrhagic stroke, although a statistically significant difference was not observed. Meanwhile, an increase in the risk of mortality associated with trauma or stroke cases was not observed during the COVID-19 outbreak compared with the same time period in the previous year. Conclusion : Due to the occurrence of COVID-19, non-essential activities have decreased and trauma cases not associated with traffic accidents appeared to decrease. Due to the decrease in overall activity, the number of stroke patients has also decreased. This trend is expected to continue even in the post-COVID-19 era, and accordingly, the results from the present study are relevant especially if the current situation continues.

• Korean Journal of Clinical Laboratory Science
• /
• v.55 no.3
• /
• pp.213-218
• /
• 2023

When it comes to 'Team Medical Care' in Japan, clinical laboratory technologists have actively engaged in various kinds of teams, such as a diabetes team, a nutrition support team, an infection control team and a medical practice support team. Overall, with continual changes in the medical environment, clinical laboratory technologists are recently being required to not only conduct phlebotomy, specimen collection, laboratory testing, and electrocardiography, but also get actively involved in 'medical practice assistance or support' in collaboration with medical doctors and nurses. Therefore, it is anticipated that resident clinical laboratory technologists in wards or emergency rooms in Korea will be better able to contribute to improving medical quality and securing medical safety by functioning as a link to the clinical laboratory, while medical doctors and nurses will have a reduced burden of work and can dedicate themselves to better patient care.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.15 no.1
• /
• pp.31-39
• /
• 2017

Purpose: Despite the clinical and socio-economic impact of acute poisoned patients, many of the treatments are not standardized in Korea. Moreover, no formal training that is specifically focused on clinical toxicology exists. Rather, training and education are conducted case by case in various institutions. This study was conducted to develop a standardized simulation-based clinical toxicology training curriculum for healthcare providers. This program will focus on specific assessment and treatment of critical toxicology patients, specifically those who have been poisoned with organophosphate. Methods: The study was performed using a pre- and post-design to determine the effects of implementation of this program. The study was conducted at eight different urban teaching hospitals in a simulated room in the clinical area. The study was targeted to 19 groups composed of emergency residents and nurses. Simulation-based learning was conducted for each group. Results: All 19 groups achieved the minimum passing score of 75%. Implementation of the program led to improved performance rates for overall management and cooperative moods competency (p<0.01). Inter-rater agreement between the two evaluators was excellent. In general, the participants thought the program was realistic and were able to recognize and improve the competencies needed to care for organophosphate poisoned patients. Conclusion: Simulation-based learning is an effective educational strategy that can be applied to improving and understanding proper care for rare but critical patients. This program was effective at improving team performance and cooperative moods when managing an organophosphate poisoned patient in the Emergency Department.

• Journal of Home Health Care Nursing
• /
• v.24 no.2
• /
• pp.121-132
• /
• 2017

Purpose: This study aimed to investigate the hospital nurses' knowledge, emergency coping ability and educational need about nursing care for patients applied the home mechanical ventilator (PaHMV) and to compare the variables between yes or not experienced on that. Methods: Participants were 91 hospital nurses who worked at the wards where PaHMV can be highly admitted such as respiratory internal medicine, rehabilitation medicine, neurology and emergency room. Data were collected by questionnaires. The analytic methods were $n(%)/M{\pm}SD$, t-test/ANOVA and $X^2-test/ANCOVA$. Results: Knowledge and emergency coping ability were low as $2.27{\pm}0.52$(4 points) and $78.72{\pm}8.06$(100 points) respectively. But educational need was high as $3.10{\pm}0.34$(4 points). Knowledge and emergency coping ability showed the significant differences between two groups (p<.001, p=.048), and the scores of experienced nurses were higher. But the educational need didn't show the significant difference (p=.974). Conclusion: These findings indicate that education on nursing care of PaHMV is needed for hospital nurse. So we have to develop the educational program on nursing care of PaHMV and then operate it with practice and site education.

• Journal of Korean Neurosurgical Society
• /
• v.63 no.4
• /
• pp.407-414
• /
• 2020

Objective : Since the first discovery of the 2019 novel coronavirus (COVID-19), rapid and wide spread of the disease has been reported and the World Health Organization announced that a 'pandemic' has started. Up to date there is little known regarding the impact of this outbreak on spinal specialists' daily clinical practice. We intended to evaluate how COVID-19 has affected the number of spinal disease patients we meet and operate in daily practice. Methods : The de-identified data regarding number of patients visiting the spine clinic at a tertiary referral hospital and a secondary level hospital from January, February and March of 2017 to 2020 were retrospectively reviewed. The number of out-patient department (OPD) visits, number of emergency room (ER) visits as well as number of surgeries performed during the reviewed period were collected and analyzed, comparing 2020 to the previous 3 years. Results : The number of daily OPD visits showed a steady decrease starting from January, and presented a statistically significant decrease by early March 2020, compared to the previous 3 years. During the same period, decrease in number of daily ER visits was statistically significant as well. The number of elective surgeries or number of surgeries for patients admitted via ER during COVID-19 outbreak remained similar to that of 2017-2019 suggesting, despite the decrease of patients visiting the hospital for spinal diseases, those whom required surgery still visited the hospital. The results were consistant among other hospital level. Conclusion : The outbreak of COVID-19 affected our daily practice as OPD and ER visits reduced but did not affect the number of surgeries. We believe that this report will be informative to spinal specialists worldwide fighting the COVID-19 pandemic.

• International Journal of Advanced Culture Technology
• /
• v.12 no.3
• /
• pp.37-46
• /
• 2024

This study was designed to identify factors affecting polyclinic (clinical practice) during COVID-19. Fourth-year medical students at K Medical University in Daejeon, South Korea were recruited, and 64 medical students ultimately agreed to participate in a survey about polyclinics in a regional emergency center over 4 weeks. Satisfy answers for 5^th grade and 6^th grade was 15 (53.6%) and 13 (46.4%) respectively. Dissatisfy answers of observation of the ICU for 5^th grade and 6^th grade was 10 (27.8%) and 26 (72.2%) respectively. Thus, there were more satisfy answers in 5^th grade and less satisfy answers in 6^th grade(p<0.05). Based on the results of confirming significance for regression coefficient, several factors influencing the polyclinic were identified, and the following categories showed statistical significance (p<0.05): for 6^th grade, satisfy answers of the clinic hours showed 3.656 times more than dissatisfy answers, exempt from the operation room showed 21.596 times more than dissatisfy answers, observation of the intensive unit care (ICU) showed 0.054 times less than dissatisfy answers, and cares of the COVID-19 patients showed 6.962 times more than dissatisfy answers. We suggest that hybrid or virtual medical education such as the polyclinic utilizing standardized patients (SP) or augmented reality (AR) technologies at the virtual hospital or the real hospital. More medical students would be encouraged to participate the problem-based learning (PBL) or team-based learning (TBL) in so-called 'hybrid or virtual' polyclinic.

• Proceedings of the Korea Society for Simulation Conference
• /
• 1998.03a
• /
• pp.86-90
• /
• 1998

The safety and reliability of nuclear power plant operations relies heavily on the plant operators ability to respond to various emergency situations. It has become standard industry practice to utilize simulators to improve the safety and reliability of nuclear power plants operations. The simulators built for Younggwang#3,4, which is the basic model of the Korean Nuclear Power Plant design, has been developed precisely for this purpose. Dynamic Model and Display Model are developed under US3(UNIX Simulation Software Support System) environment in simulator for Younggwang#3,4. Since these two models are developed under each own operating system, it is necessary to develop a method for transporting data between these two systems. This paper descirves communication environment between Dynamic Model and Display Model, and addresses a file generation method for the Display Model, which will be necessary for designing MMI of MCR(Main Control Room) in the furture.

• The Korean Society of Law and Medicine
• /
• v.9 no.1
• /
• pp.285-317
• /
• 2008

To accept the doctor's professional negligence in the medical malpractice, the mistakes, by which the doctor did not foresee the production of the results in spite of the possibility of foresight and did not avoid the production of the results in spite of the possibility of avoidance, must be considered, and to decide the presence of the doctor's professional negligence, the standard must be the attention standard of general-common doctor engaged in the same business and the same function, and the medical enviornments, the conditions, the extraordinary nature of medical behavior, and etc should be considered by the general level of medical science at the time of accident. This principlel must be applied to the medical malpractice case occurred being on duty without exception. But, because of the extraordinary nature of duty work, it is difficult for any doctor to do one's best technical practice by making all diagnosis, medical treatment with all the equipment on the same plane as the ordinary times. That cannot be also expected for any doctor to do one's best technical practice in the terms of a social idea. From this point of view looking into The Precedent case related to Medical-service person being on duty sentenced by The Supreme Court, unlike the general medical malpractice case, the presence of the professional negligence in the medical malpractice occurred being on duty seems to be decided with more consideration on the general level of medical science, the medical enviornments and the conditions, particularities of medical practice at the time of accident. Especially, the extraordinary nature of medical behavior of the medical service person being on duty in the emergency room seems to be admitted compared to that of the medical service person being on duty in ward.

• Journal of Korean Neurosurgical Society
• /
• v.55 no.1
• /
• pp.51-53
• /
• 2014

Mild traumatic brain injury is common in elderly patients, many of whom are on anticoagulant. The common practice is to discharge these patients from the emergency room if the computed tomography (CT) of the brain is normal. However, a very small proportion of these patients may develop a life threatening intracranial haematoma in the following days. We present here a case of a 66-year-old male on anticoagulant therapy that developed a subdural haematoma 48 hours after a mild head injury, with a normal initial CT scan of the brain. The patient underwent a craniotomy with evacuation of a large subdural clot. Postoperatively he had progressively improved and six months later has a Glasgow Outcome Score of three. This case is characterized by the delayed onset of a subdural haematoma in a patient on anticoagulation and we discuss here the possible pathogenesis related to this phenomenon. We also briefly review the pertinent literature and the current guidelines for the management of this type of head injuries.

• Korea Journal of Hospital Management
• /
• no.spc
• /
• pp.1-13
• /
• 2016

In a situation where competition becomes intense, health care organizations constantly strive to provide more services with given personnel and time. While not only the 'quantity' of the services but also the 'quality' becomes increasingly important, various problems that can occur during the 'process' of service provision can be effectively managed by applying the methods of management science. In this study, we introduce the cases where the methods of management science can be applied for the management of health care organizations in Korea and abroad. There are many cases where various scenarios for improving the patients' accessibility to the services and for maximizing the efficient use of limited resources are established, and simulation or basic statistical analysis methods are used to solve the problems more systematically or to develop improvement plans. In this study, several exemplary cases, such as no-show of patients, crowding in the emergency room, prediction of the number of available beds in the intensive care units, nurse scheduling, delay of arrival of patients, and ordering of the proper amount of therapeutic materials, are introduced and discussed. From the perspective of administrators or clinicians, however, it may not be easy to master the methodology that requires considerable mathematical background or apply the theories to practice directly. Therefore, it is suggested that more practical and relatively simple analytical methods should be applied. Also, having a more positive attitude toward improving the current performance (e.g., a belief that 'we can always be better than now'), and paying attention to improving the job satisfaction by addressing problems, with experimental spirit and data-driven decision management.