• 임상간호연구
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• 제27권2호
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• pp.187-198
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• 2021

Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.

• 품질경영학회지
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• 제38권4호
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• pp.491-503
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• 2010

This paper presents a research model, which identifies a relationship between medical error reduction, efficiency of organizational systems, and employee satisfaction with organizational support. The proposed model was tested through hypotheses, based on data collected from 210 respondents from the medical staff of large -sized (i.e., more than 500 beds) residential hospitals in cities of South Korea. The results of the study showed that medical error reduction is associated with corrective system and employee satisfaction with organizational support. Therefore, it is very important that organizations improve their employees' satisfaction by providing sufficient support (e.g., information support and sharing, work guide book, etc.) for their work. In addition, in organizational systems, the corrective system has positive relationship with medical error reduction. In terms of corrective procedures, leaders or managers can make improvements by providing and supporting a friendly work environment where errors may be reported without blame and discussed in order to be corrected.

• 한국실내디자인학회:학술대회논문집
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• 한국실내디자인학회 2005년도 춘계학술발표대회 논문집
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• pp.279-280
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• 2005

Recently, the Korean medical system changed with diversification & specialization and the field of medical service is also specialized in these days. The medical space settings are usually designed for staff needs rather than for patient needs. but The purpose of this project was to identify the design elements for the patient-focused. Main keyword of this project is 'high touch' and basic design concept is 'a sense of stability/velocity'. This medical space is located in Sanbon, and it has an area of 171m$^2$. The material scheme in the interior design of medical space is an important factor for the hospital users. Painting, stainless steel, wood veneer, fabric and p-tile were used as interior finishing material.

• 융합정보논문지
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• 제9권3호
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• pp.140-145
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• 2019

IT 기술의 발달과 함께 의료 서비스 환경이 과거에 비해 많은 변화가 일어나고 있다. 그러나, 의료 기술이 IT 기술과 융합하더라도 의료비 문제와 의료 서비스 관리에 대한 문제는 여전히 해결해야할 사항 중 하나이다. 본 논문에서는 IoT 시스템을 구축한 병원을 대상으로 의료 서비스를 제공받는 사용자의 개인 정보를 의료진이 효율적으로 분석 관리할 수 있는 모델을 제안한다. 제안 모델은 병원내 구축된 IoT 시스템을 통해서 사용자의 의료 정보를 효율적으로 체크하고 관리하는 것이 목적이다. 제안 모델은 다양한 이기종의 클라우드 환경에서 사용될 수 있으며, 사용자의 의료 정보를 추가적인 인적 물적 자원 없이 효율적이면서 빠르게 관리할 수 있다. 특히, 제안모델에서 수집된 사용자의 의료 정보는 IoT 게이트웨이를 통해 서버에 저장되기 때문에 의료진이 시간과 장소에 상관없이 사용자의 의료 정보를 정확하게 분석할 수 있다. 성능평가 결과, 제안 모델은 IoT 시스템을 사용하지 않은 기존 의료 시스템 모델보다 직군별 의료진의 의료 서비스에 대한 효율성이 19.6% 향상되었고, 의료 서비스를 제공받은 사용자의 사후 의료관리 개선율이 22.1% 향상된 결과를 얻었다. 또한, 의료진의 업무 부담률은 기존 의료 시스템 모델보다 평균 17.6% 낮게 나타났다.

• 보건행정학회지
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• 제34권1호
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• pp.78-86
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• 2024

연구배경: 본 연구를 통해 전문병원과 비전문병원에서 인공관절치환술(슬관절)을 받은 입원환자를 대상으로, 전문병원 지정 여부에 따른 입원환자의 의료이용을 비교하여 전문병원제도의 효과성을 파악하고자 한다. 방법: 본 연구는 2021-2022년 건강보험심사평가원(Health Insurance Review and Assessment Service) 요양급여비용 청구자료를 활용하였다. 종속변수는 입원환자의 의료이용으로, 건당 진료비와 재원일수를 선정하였다. 독립변수는 전문병원 지정 여부이며, 통제변수는 환자 단위 변수(연령, 성별, 보험자 유형, 수술 유형 및 Charlson comorbidity index)와 의료기관 단위 변수(설립 구분, 종별 구분, 소재지, 정형외과 의사 수 및 간호사 수)를 선정하였다. 결과: 건당 진료비와 전문병원 지정 여부 간 다중회귀분석 결과, 건당 진료비와 전문병원 지정 여부 간 통계적으로 유의미한 음(-)의 관계가 있었다. 이는 전문병원이 비전문병원에 비해 건당 진료비가 유의하게 낮다는 것을 의미하며, 전문병원과 비전문병원의 입원환자 간 의료이용 결과에 차이가 있음을 시사한다. 결론: 본 연구의 정책적 시사점은 다음과 같다. 첫째, 전문병원 지정기준의 완화가 필요하다. 본 연구결과, 전문병원이 비전문병원에 비해 건당 진료비가 유의하게 낮은 것으로 나타났다. 이러한 전문병원의 비용 효과성에도 불구하고 전문병원 지정에 대한 높은 진입장벽으로 인해 수도권 및 대도시 지역에 전문병원이 집중되어 있다. 전문병원의 지역불균형을 해소하기 위해 "준전문병원(가칭)"을 도입하는 등 비수도권 전문병원 지정기준을 완화한다면, 지역간 건강격차 해소 및 의료비 절감의 효과를 불러올 것으로 판단된다. 둘째, 병원 의료인력 규모의 적정성을 판단할 필요가 있다. 본 연구결과, 정형외과 의사 수 및 간호사 수에 따라 건당 진료비에 영향을 미치는 것으로 나타났다. 따라서 병원 의료인력 적정 배분을 바탕으로 의료서비스의 비용 효과성을 극대화함으로써 의료비를 절감하는 효과를 불러올 수 있을 것으로 판단된다.

• 한국병원경영학회지
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• 제17권1호
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• pp.79-112
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• 2012

The purpose of this study is to examine the differences of profitability based on the analysis of business and medical service performances of four hospitals in Incheon area with similar size. and to compare hospitals with the best and the worst performances and analyze the factors behind the differences. The differences could be caused by differences in medical service statistics, number of staff, and financial results, etc. The data was acquired through the homepage of the National Tax Service(financial statements for the fiscal year 2009) and the Medical Record Association of Incheon(medical service statistics for the years 2008 and 2009) along with questionnaire survey to the hospitals(personnel data for the year 2009). The results of the study are as follows. Medical profits to medical revenues ratio for the hospitals(referred as Hospital A, B, C, and D) shows, in order, C(8.2%), A(8.0%), B(7.8%), and D(7.4%). However, net income to medical revenues ratio shows otherwise: C(8.5%), D(5.8%), A(3.0%), and B(0.6%). Hospital B shows a high medical profit to revenue ratio but the lowest net income to revenue ratio due to large interest expenses. The leverage ratio of Hospital B is the highest (419.6%), resulting in a very low interest coverage ratio(1.1). On the other hand, Hospital C shows favorable results in both profit ratios, with 8.2% and 8.5% each. Hospital C has the lowest leverage ratio(53.0%) and the highest interest coverage ratio(34.9). Therefore, the results show Hospital C has the best performance while Hospital B the worst. The two hospitals(B and C) show similar results in certain areas and big differences in other areas. The area that has the biggest influence on financial results turns out leverage ratio. Hospital B shows 'very good' to 'good' results in terms of medical service statistics in general. However, the leverage ratio is too high and the liquidity ratio too low, resulting in a very low profit ratio. The results of this study have some limitations in terms of generalization as only four hospitals in Incheon area were selected for the study, resulting in a deficiency in the representativeness of the sample. Further studies with bigger sample size and deeper analysis are expected in this area.

• 간호행정학회지
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• 제3권1호
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• pp.37-50
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• 1997

The purpose of this study was to identify the gap between need-level and demonstration-level in nursing managerial competencies. In addition, the study proposes solutions to narrow this gap. The results of this study are as follows : 1) The mean score for need-level of each item was 4.0, and for demonstration-level, 3.5. This indicates that military hospital head nurses demonstrate a higher level of managerial competencies than the moderate level on all items. But items which were related to resource/ cost/ information managament, staff development management and professionalism management got relatively low ratings in the need-level. 2) The mean score for need-level of each category was 4.14, and for demonstration-level, 3.53. Categories on the individual dimension got a higher rating than categories on the group or organization dimension in both need-level and demonstration level. 3) The gap between need-level and demonstration-level appeared in all items(p<.05) and categories(p<.001). Although the gap was relatively low, it indicates that it is essential to plan a developmemt program for all nursing management competencies for military hospital head nurses. 4) There were significant differences in the gap between need-level and demonstration-level according to specific characteristics of the subjects. The gap did not appear in many categories on the individual dimension where the number of nursing staff was more than 10, a major grade, ICU head nurse or for head nurses having a long career. 5) Need-level and demonstration-level showed a difference according to specific characteristics of the subjects, because need-level and demonstration-level were higher where the number of nursing staff was more than 10, a major grade, and for ICU or Medical ward head nurses. The categories which showed need-level difference and demonstration-level differences according to specific characteristics of the subjects existed almostly completely in the group and organization dimension. Gap-level differences according to the number of hospital bed existed in only two categories. 6) The general causes of the gap were indicated to be 'Knowledge/ skill/ experience deficit', 'Limitation of rules and systems/ Inappropriate organizational environment' for most items, categories, and dimensions. The results of this study indicate that extensive competency developing strategies must be developed, because a gap was found in all items and categories. Specially, there is a need to concentrate attention on competencies in the group and organizational dimension which had a wider gap level. And it is important to take an individual approach according to the cause for each gap. In order to produce effective competency developing strategies, top managers must have sinsights into the importance of nursing staff development and nursing officer's efforts to develop themselves must be achieved. Further multi-dimensional(education, personnel-policy, nursing/ organizational environment) solutions to the gap must be developed and utilized.

• Journal of Hospice and Palliative Care
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• 제27권2호
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• pp.64-76
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• 2024

Purpose: End-of-life (EOL) care is a vulnerable period in an individual's life. Healthcare professionals (HPs) strive to balance the preservation of human life with respect for the patient's wishes. The aims of our study were to assess HPs' knowledge and perceptions of EOL care and to propose areas of improvement to improve the quality of care. Methods: We conducted a single-center, cross-sectional study involving HPs from a university hospital who encountered EOL care situations. We used a questionnaire divided into four sections: knowledge, practice, perception, and training. We calculated the rate of correct answers and the collective competence index. Results: Eighty-six questionnaires were analyzed, with 82.5% (71/86) completed by medical respondents and 17.5% (15/86) by paramedical respondents. Most of the respondents, 71.8% (51/71), were interns and residents. The study focused on palliative care, medical assistance in dying, aggressive medical treatment, and euthanasia, finding adequate knowledge in the first three areas. Respondents assigned to the intensive care unit and those with more than 8 years of experience had significantly higher correct answer rates than their counterparts. Seventy-five percent of respondents (65/86) reported feeling that they had little or no mastery of EOL care, primarily attributing this to insufficient training and the unavailability of trainers. Conclusion: Based on the findings of our study, which we believe to be the first of its kind in Tunisia, we can conclude that HPs possess an acceptable level of knowledge regarding EOL care. However, they require more exposure and training to develop expertise in this area.

• Journal of Korean Neurosurgical Society
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• 제51권6호
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• pp.383-387
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• 2012

Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

• Korean Circulation Journal
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• 제53권5호
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• pp.294-312
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• 2023

Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.