• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제20권1호
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• pp.27-34
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• 2014

Purpose: The purpose of this study was to identify the role of the physical environment in task interruptions in the healthcare settings. Many dangerous events such as airplane crash and medical errors are the result of human errors and, these errors are often the result of interruptions during a critical task of professional workers. In fact, the physical environment that determines accessibility and visibility among people affects interruptions significantly, but architectural studies have given little attention to the management of interruptions. Methods: Therefore, the researcher reviewed research literature in other fields to find out how the physical environment affected interruptions. Many studies were from management, human factors, and health care, but few from architecture. First the author examined the impact of interruptions, second described the social context of interruptions and the role of the physical environment. Results: Findings included that description of the physical environment was not very clear in studies from management and human factors, while little work had been done on interruptions in architecture. The author proposed study design that compensated shortcomings of each field by combining approaches from management, human factors, and architecture. Implications: Unit design strategies such as distributed nurse stations can affect interruptions and layout analysis such as space syntax analysis can evaluate visibility and accessibility of floor plans in the preliminary design phase.

• 임상간호연구
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• 제19권1호
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• pp.143-151
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• 2013

Purpose: The purpose of this study was to evaluate the effect of illustrated children's book in providing information about tonsillectomy to improve post tonsillectomy pain control and compliance to treatment for preschoolers. Methods: The design of the study was a quasi-experimental, post-test only design. Subjects were preschoolers aged between 3 and 7 years old who were admitted to a hospital for tonsillectomy. A group of 25 children were assigned to an experimental group, and another 25 were assigned to a control group. The data were analysed using SPSS 12.0 program. The homogeneity between two groups was examined using $x^2-test$. The hypotheses testing was conducted using t-test. Results: The experimental group had lower pain score than control group at 8 hour after tonsillectomy (p<.05). Pain score was also lower in the experimental group after 24 hour after the surgery (p<.05). The experimental group had higher pain questionnaire score than control group at 8 hours after surgery, however the difference was not significant. The experimental group showed better compliance to treatment than the control group (p<.05). Conclusion: Providing illustrated children's book for the purpose of providing information about tonsillectomy was effective intervention for the control of post tonsillectomy pain and improvement of compliance to treatment for preschoolers. Illustrated children's book could be applied as a nursing intervention to relieve post tonsillectomy pain and improve compliance to treatment for preschoolers.

• Archives of Plastic Surgery
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• 제45권4호
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• pp.340-344
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• 2018

Background In performing extended latissimus dorsi (ELD) flap procedures, a skin paddle design on the bra line helps reduce visible scarring. This improves the patient's satisfaction with the outcome. However, such a design leads to a longer operation time and increased fatigue of the surgeon due to the narrow operative field. In this study, the authors propose a method that elongates the axillary incision line posteriorly by 1.5 cm from the lateral border of the latissimus dorsi muscle. We examined whether this method could shorten the operation time and compared the incidence of complications between patients who underwent this novel procedure and patients who underwent the traditional procedure. Methods In this study of patients who underwent ELD flap procedures for immediate breast reconstruction, 89 underwent surgery with the elongated axillary incision and 45 underwent surgery without the elongated incision. The total operation time and complications were retrospectively examined based on the patients' medical records, and we examined whether there was any statistically significant difference in the total operation time. Results In the experimental group with the elongated axillary incision, the operation time ranged from 125 to 255 minutes (median, 175 minutes). In contrast, in the control group without the elongated axillary incision, the operation time ranged from 142 and 340 minutes (median, 205 minutes). The operation time was statistically significantly different between the two groups, and no significant complications were observed in the experimental group. Conclusions Elongation of the axillary incision alone may shorten the operation time of the ELD flap procedure without causing additional complications.

• Hip & pelvis
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• 제35권3호
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• pp.175-182
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• 2023

Purpose: This study aims to compare patients in whom fixation failure occurred via cut-out (CO) or cut-through (CT) in order to determine patient factors and radiographic parameters that may be predictive of each mechanism. Materials and Methods: This retrospective cohort study includes 18 patients with intertrochanteric (IT) hip fractures (AO/OTA classification 31A1.3) who underwent treatment using a single lag screw design intramedullary nail in whom fixation failure occurred within one year. All patients were reviewed for demographics and radiographic parameters including tip-to-apex distance (TAD), posteromedial calcar continuity, neck-shaft angle, lateral wall thickness, and others. Patients were grouped into cohorts based on the mechanism of failure, either lag screw CO or CT, and a comparison was performed. Results: No differences in demographics, injury details, fracture classifications, or radiographic parameters were observed between CO/CT cohorts. Of note, a similar rate of post-reduction TAD>25 mm (P=0.936) was observed between groups. A higher rate of DEXA (dual energy X-ray absorptiometry) confirmed osteoporosis (25.0% vs. 60.0%) was observed in the CT group, but without significance. Conclusion: The mechanism of CT failure during intramedullary nail fixation of an IT fracture did not show an association with clinical data including patient demographics, reduction accuracy, or radiographic parameters. As reported in previous biomechanical studies, the main predictive factor for patients in whom early failure might occur via the CT effect mechanism may be related to bone quality; however, conduct of larger studies will be required in order to determine whether there is a difference in bone quality.

• 대한족부족관절학회지
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• 제28권3호
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• pp.102-106
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• 2024

A reverse sural flap is a surgical procedure to repair soft tissue defects, usually in the ankle region. This procedure involves moving a tissue flap from the calf to cover a defect in the ankle. The flap is turned 180° so that the tissue around the wound is supplied with blood by the vessels at the base of the flap, typically preserving the sural nerve and artery. This method is particularly valuable when thick and robust tissue is required to cover defects resulting from traumatic injuries, chronic wounds, or post-skin tumor removal when the local tissue is insufficient for direct closure. In this case, a patient who had undergone surgery for a chronic ulcerative lesion on the Achilles tendon three years prior to presentation at the authors' hospital was treated using a half-width reverse sural flap. Modifications to the sural flap design may be crucial considering the surgical history, blood supply, and defect size around the lower leg. In particular, previous surgeries for lower leg fractures or ligament damage may limit blood supply and require flap design modifications.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제30권3호
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• pp.45-56
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• 2024

Purpose: It is important to note that the relative importance of risk factors should be identified to successfully complete the remodeling project of general hospital. Approached by analytic hierarchy process (AHP), the present study aimed to systematically evaluate the risk factors for remodeling of general hospital. Methods: The present work classified the risk factors of general hospital remodeling into four major categories including the requirements survey stage, planning and design stage, dismantling and construction stage, and maintenance stage. In addition, four sub-categories were derived from each major category factor. Furthermore, five major categories and four subcategories were selected to be considered from the perspectives of two stakeholders of contractor and constructor. The relative importance of the major and sub-categories factors was calculated using the AHP technique on the survey data collected from 49 respondents who participated in the survey study. Results: The results indicate that, the risk factor of requirements survey stage was found to be the most important risk factor to consider among the four major categories of factors. Also, insufficient preliminary investigation, design inconsistencies in architecture/mechanics/electricity, occurrence of safety accidents, and insufficient review of various equipment capacities and performances were found to have the highest priorities of each subcategory factor group included in the four major categories. From the perspective of contractor, the error in predicting the construction period was found to be the most important risk factor. The occurrence of safety accidents during construction was found to be the most important risk factor to be considered by constructor. Implications: The result of the current work should provide important insights and guidelines for the risk management activity that contributes to controlling the project time, cost, and scope required for general hospital remodeling.

• 한국간호교육학회지
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• 제30권3호
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• pp.280-289
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• 2024

Purpose: This study aimed to develop and evaluate the effectiveness of a preceptor educational program in a children's hospital. The program's impact was assessed by measuring improvements in clinical competency, communication competency, and leadership competency. Methods: Four day pediatric nurse preceptor education program was developed using the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A single-group pretest-posttest design was employed to assess the program's effects with seventeen participants who were newly trained preceptors. Additionally, participant satisfaction with the program was measured. Results: Following the implementation of the program, significant improvements were observed in clinical competency (Z=-3.62, p<.001), communication competency (Z=-2.77, p=.006), leadership competency (Z=-2.08, p=.038), other competence (Z=-2.64, p=.008), and total competency (Z=-3.52, p<.001) among participants. The overall satisfaction score was 4.41±0.62 on a 5-point scale. Conclusion: The pediatric nurse preceptor educational program significantly enhances the overall nursing competencies of preceptor nurses in a children's hospital. Further research is needed to evaluate the effects of this preceptorship on newly graduated nurses.

• 보건의료산업학회지
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• 제8권4호
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• pp.1-12
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• 2014

This study is designed to develop a hospital communication program and to verify its effectiveness in graduate nurses self-esteem, communication conflicts, turnover intention and early resignation rate. The study method is a randomized control group with a pre-post test design. In order to help new graduate nurses adapt to the hospital, eight week hospital communication program is developed. The study participants are 104 nurses(47 experiment, 57 control) who have been working for less than six months. The data on self-esteem, communication conflict, and turnover intention was collected one week before the program and four weeks after the program. Then, the early resignation rate of the participating nurses was surveyed one year after the start of employment. The nurses who participated in the hospital communication program exhibit higher self-esteem, fewer communication conflicts, and lower early resignation rates than those who did not. However, effect in the turnover intention is not observed. Overall, the hospital communication program will help new graduate nurses adapt to hospitals.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권4호
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• pp.105-115
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• 2016

Purpose: This study is a case study of a small-mid sized hospital to promote a full-scale remodeling to ensure the quality and competitiveness of the medical services and trying to arrange the remodeling characteristics of small-mid sized hospital which is suffering from aging facilities as well as chronic congestion and lack of spaces. Methods: Research was conducted by consultation with hospital executives and each department operators, and on-site investigation, Results: The result of this study can be summarized into two points. The first one is that existing statistical value like area per bed, in the remodeling of the small-mid hospitals may not mean much. planners have to verify the necessary room space areas in close consultation with the department operators. And after confirming layout possibilities, they have to create the program. The second one is that remodeling planning can be a realistic plan with structural and installation diagnosis at the same time. If so, it is advisable to proceed architectural design from the beginning for cost and time savings. Implications: This results can be applied to small-mid hospitals to apply to the medical law revision and others.

• Journal of Acupuncture Research
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• 제37권2호
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• pp.69-78
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• 2020

Although there have been studies investigating the clinical effects of warm needling (WN) for specific diseases, a comprehensive review of WN is needed. Four Korean internet databases were used in the review of WN treatment performed in Korea. The search terms used to retrieve articles were "warm needling (in Korean; 온침)," "warm acupuncture," and "warm needle." A total of 29 articles were reviewed. The following aspects of WN were investigated: language and terminology, study design, use of Standards for Reporting Interventions in Clinical Trials of Acupuncture, research ethics, moxibustion types, number of moxa used, moxa combustion time, needle retention time, treatment time and frequency, acupoints, meridians, acupuncture size and depth, disease classification, pattern identification, outcome measures, and adverse effect. More sophisticated and precise studies on WN are required.