Purpose: This study aims to analyze design guidelines for hospice facilities in the US, UK, and Canada focused on design considerations and space requirements, and utilizes them as baseline data for establishing standards for Korean hospice facilities. Methods: Comparative review was carried out to investigate hospice care models, design consideration, and room sizes and requirements for design guideline of hospice facilities in United States, UK and Canada identified on electronic database and review articles, and to examine major characteristics and tendencies of hospice facilities. Results: The hospice care models characteristics in design guidelines is generally largely divided into hospital-based hospice facility, Nursing home-based hospice facility, and daycare hospice. The design considerations in hospice facilities focused on medical efficiency, flexibility, barrier-free environment, person-centered care, and stability. There is also a need for single resident room, rooms for the patient's family, and isolation room for infection control. Implications: it is recommended to establish standards for the installation and operation of required and recommended rooms and considerations when establishing the standards of hospice facilities in Korea. This Study is limited to a simple comparative analysis of the framework of guideline.
Purpose: This study is to address the spacial composition of a standard ward and bedroom size for sake of infection control and efficient medical service. Methods: Spacial composition of a standard ward has been proposed by comparative analysis of 5 big hospitals' wards. Bedroom sizes have been explored on the ground of Health care facility regulations from Korea, USA, Australia and Canada. Of course, Literature and field survey have been conducted in order to draw out various bedroom sizes. Results: 16 basic and some other additional spaces have been proposed for the composition of hospital standard ward. Area of Single bedroom is $11.6m^2$, and that of multi-beded room is $7.4m^2$. Bed to bed Clearance is 1.5m, spacing between bedsize and hard wall is 0.9m in 1~2 beded room, 0.75m in 4-beded room. Space clearance between Foot side of bed and curtain is proposed as 0.3m and additional 0.9m is necessary for the circulation. Implications: The result of this study can be applied to the new cons.
Purpose: This study aimed to present an analysis model evaluating evacuation performance considering patient types and procedural evacuation in the medical facility. The user group of the medical facility, including users challenged in evacuation behavior, entails the risk of many casualties. Therefore, it is necessary to plan an evacuation procedure that considers the evacuation characteristics of users. Methods: Through the review of precedent studies, the evacuation procedure of the medical facility, the classification of patient types, and the evacuation procedure was set as conditions and variables for the analysis. The result caused by a variety of conditions and variables were explored. Results: 1) The total evacuation completion time and congestion time were shortened at the procedural evacuation. Moreover, it derived many users from evacuating at the initial phase. 2) The proposed model can provide a basis for proposing a space planning direction that considers the possibility of not carrying out the evacuation plan. 3) It supports safe evacuation by identifying variables that reduce overcrowding by comparing the congestion time of overcrowded spaces. 4) The analysis model can identify the overcrowded space through the evacuation route and suggest the basis for architectural improvements that reduce overcrowding. Implications: The study results can be used to analyze the performance of evacuation procedures and support the establishment of evacuation procedures and building plans for safe evacuation for medical facilities.
Purpose: In terms of efficiency and safety, this study attempted to organize data on the operation methods and architectural planning of infectious diseases hospitals. Methods: The results obtained through on-site and interview surveys with hospital officials and medical staffs at four infectious diseases hospitals under construction were summarized based on those original business plans and facility guidelines. Results: First, the operational methods to secure safety and operational efficiency were summarized for each department which are major hospital functions of infectious disease hospitals. Second, as the architectural planning, the characteristics of space and circulation of each department are summarized. For safety of medical staff, negative pressure and non-negative pressure zone have to completely separated. In addition medical staff wears PPE and enters the negative pressure zone and returns in the order of admiral, shower, and gowning in the PPE undressing room after patient treatment. In case of operational efficiency, flexible operation is required in normal and crisis situations. For example, it is important for The Ward to gradually switch to negative pressure beds in times of crisis from normal situation and the outpatient department considers the composition of negative pressure and non-negative pressure outpatient spaces that can operate in parallel even in crisis situations. Implications: Infectious disease hospitals require flexible operation and appropriate facilities for normal and crisis situations.
Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.
Because the psychophysical symptoms of hearing loss and dementia in the elderly are very similar, untrained healthcare professionals in dementia facilities can easily overlook a severity of hearing loss in their patients. The present study identifies their knowledge, attitudes, and practices (KAP) on hearing loss using a survey whether they may help hearing problem of the patients with dementia. A total of 29 health-care professionals responded to the KAP survey. Also, 2 family members participated. The results showed that most of the nurses and caregivers in elderly medical welfare facilities who worked with dementia patients did not have knowledge of their hearing loss. Even the facility managers did not know how to conduct hearing tests for their patients although they did recognize that some of their patients had a hearing loss. Eventually, actual practice was not possible at this moment by the professionals. However, our respondents did have a positive attitude toward screening for hearing loss and help their patients with dementia wear hearing aids if a clinical guideline was provided. We suggest to develop clear and precise clinical guidelines of the hearing screening test for the dementia patients due to the interrelationship between dementia and hearing loss. When these guidelines apply to elderly residents in a medical welfare facility, early diagnosis and treatment of their sensory loss will help alleviate their dementia as well.
Because Korea has the excellent informational technology, it was expected to be able to improve the accessibility to healthcare and compete with other nations in excellence through u-Healthcare. But we can't complete the excellent u-Healthcare because of the law to be able to use only the tele-counselling between doctor to doctor or doctor to nurse. First of all, we must complete the law to be able to use the improved u-Health containing of telemedicine between doctor to patient. Though other factors, the procurement of safe IT, the credibility to healthcare service provider containing of nutritionist and occupational therapist etc. are prepared for erecting u-Healthcare, we can get the final and decisive u-Health policy only by means of Law for supporting u-Healthcare's Activation. The important sections of Law for supporting u-Healthcare's Activation are as follows. Sec. 4 The Minister for Health, Welfare and Family Affairs and the dean of associated administrative division have to erect the combined plan for u-Healthcare's Activation. Sec. 11 Government and local autonomous entity can support the facility and equipment to be necessitated for using u-Healthcare to improve the medical accessibility of person in the region with poor medicine. Sec. 13 Doctor can support other doctor's medical action through IT and if there are not medical risk, doctor can give medical act directly to the special patients. Sec. 21 If pharmaceuticals is necessitated in u-Healthcare, remote doctor has to send the patient the electronic prescription and the pharmaceutist to receive the electronic prescription has to delivery the pharmaceuticals in accordance with patient's demand.
Purpose: In 2012, the Child Welfare Act was revised to provide better support to children with severe disabilities in Japan. Previously, inpatient facilities had been classified according to the type of disabilities of patients. After the revision of the Act, however, these facilities were assigned into the category of "medical-type facilities for children with disabilities", or "welfare-type facilities for children with disabilities." The focus of the study is to evaluate the reorganization of the Child Welfare Act and to analyze the new layout of Center K after its transition from a facility for children with motional disabilities to a medical-type facility for children with disabilities. Methods: A literature review was conducted to identify the trend in the treatment for persons with disabilities and the process of policy making in Japan. Field research was performed twice in 2015 and 2016, before and after the renovation of the Center K facilities depending upon the revision of the Child Welfare Act. Results: There is an increasing tendency of the population of persons with disabilities in Japan, and the severity level of disability of children with disabilities. In the case of Center K, two types of ward constructed to meet the two types of disability has been reconstructed into three types of unit following the various severity level of disability. Implications: As a result, it could be argued that it is also necessary in Korea to reorganize the facilities for persons with disabilities to deal with the fact that the population of persons with disabilities in Korea has been growing and their degree of disabilities also getting severe.
Purpose: Seclusion room in a psychiatric facility limit the body and space for treatment or protection, so controversy over human rights violations arises despite their necessity. The seclusion room should be created as an environment that can promote the recovery and healing of patients, not the purpose of managing patients. while ensuring the safety of medical staff. Therefore, the purpose of this study is to compare and analyze the standards of overseas guidelines for the seclusion room in psychiatric facility, and through this, it is intended to contribute to the improvement of facility standards for seclusion rooms in Korea, which are at a very insufficient level. Method: This study takes the method of comparative analysis through literature review. We analyze the facility standards of seclusion room in Korea, and compare and analyze guidelines for seclusion rooms in Australia, US, UK, and Canada. Result: As a result, the elements of the guideline for seclusion room were classified into size, space, opening, furniture and equipment, and etc. The results of comparative analysis of details are presented. Implications: Korea should also prepare guidelines for psychiatric institutions, and among them, the standards for seclusion room, which are at the center of controversy over human rights violations, should be reviewed in depth.
Objectives: Studies examining healthcare workers' exposure to antineoplastic drugs have focused on the drug preparation or drug administration areas. However, such an approach has probably underestimated the overall exposure risk as the drugs need to be delivered to the facility, transported internally and then disposed. The objective of this study is to determine whether drug contamination occurs throughout a facility and, simultaneously, to identify those job categories that are potentially exposed. Methods: This was a multi-site study based in Vancouver, British Columbia. Interviews were conducted to determine the departments where the drugs travel. Subsequent site observations were performed to ascertain those surfaces which frequently came into contact with antineoplastic drugs and to determine the job categories which are likely to contact these surfaces. Wipe samples were collected to quantify surface contamination. Results: Surface contamination was found in all six stages of the hospital medication system. Job categories consistently found to be at risk of exposure were nurses, pharmacists, pharmacy technicians, and pharmacy receivers. Up to 11 job categories per site may be at risk of exposure at some point during the hospital medication system. Conclusion: We found drug contamination on select surfaces at every stage of the medication system, which indicates the existence of an exposure potential throughout the facility. Our results suggest that a broader range of workers are potentially exposed than has been previously examined. These results will allow us to develop a more inclusive exposure assessment encompassing all healthcare workers that are at risk throughout the hospital medication system.
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