• 근관절건강학회지
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• 제27권3호
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• pp.247-254
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• 2020

Purpose: This was a descriptive observational study examining the reasons for, frequency of, and factors affecting work interruption among intensive care unit (ICU) nurses. Methods: Convenience sampling was used to recruit 46 regular nurses who had been working in an ICU at D tertiary hospital in B metropolitan city for at least six months. To measure the degree of work interruption, this study revised a tool used by Brixey et al. (2007) for analyzing the type of work interruption. Results: A total of 1,787 work interruptions occurred during 368 hours of observation, i.e., at an average of 4.85 times per hour. Communication-related factors caused work interruption most frequently, followed by environmental, work-related, and personal factors. As for the work-related characteristics of nurses, participants experienced work interruption more frequently while working on weekdays, when the medical staff were stationed, than on weekends. Conclusion: ICU nurses experienced work interruption frequently. With the health care system expected to become more complicated in the future, efforts should be made to reduce unnecessary work interruptions to improve the operation efficiency of ICUs.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.310-314
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• 2023

Pancreatic trauma from a blunt injury is fairly uncommon in the pediatric population. Furthermore, such trauma with associated disruption of the pancreatic duct (PD) is even less prevalent and is associated with high morbidity and mortality. Pancreatic injuries in the pediatric population are often missed and hence require a thorough workup in children presenting with any form of abdominal injury. This case report describes a young boy who presented with abdominal pain and did not initially inform medical staff about any injury. For this reason, his initial provisional diagnosis was appendicitis, but he was later found to have transection of the pancreas with injury to the PD on imaging. The management of such injuries in pediatric patients often poses a challenge due to a lack of pediatric physicians trained to perform interventions such as endoscopic retrograde cholangiopancreatography. Furthermore, such interventions carry a higher risk when performed on children due to the smaller size of their pancreatic ducts. As a result, our patient had to be transferred to an adult center to undergo this procedure. Thus, maintaining a high degree of suspicion, along with a detailed history and examination, is crucial for the early diagnosis and management of pancreatic injuries.

• 간호행정학회지
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• 제5권1호
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• pp.113-136
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• 1999

There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권3호
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• pp.47-54
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• 2022

Purpose: This study presents the analysis on space usage of delivery departments in regional public hospitals. The results intention is to achieve improvement of the delivery environment for the mothers and newborns regarding exposure prevention and efficient infection control. The purpose of this study is to provide fundamental data for architectural plans and guidelines for the delivery department. Method: The investigation and analysis were based on research papers, legal systems, public medical statistical data, and the architectural floor plan drawing. For research, 20 regional public hospitals with an operating delivery room were excluded. Regarding data accessibility, 15 regional public hospitals were selected. Results: To overcome the increased vulnerability of the delivery department, the research results of basic data is provided for the establishment to address urgent needs and rapid response. Thus, the research results are as follows: Firstly, the delivery department needs to respond promptly according to the type of patients. For example, in a case of emergency surgery, a connected circulation plan with the related departments is needed. Secondly, for the environment of the delivery area, alleviating anxiety is imperative for pregnant patients and guardians, labor, childbirth, and recovery. Therefore, these needs must be addressed for treatment space and circulation. Lastly, the delivery department is classified into three areas for analysis: access area, treatment area, and support area. In most of the delivery departments of the 15 selected hospitals, there is no space for the access and support area except for the labor and delivery rooms in the treatment area. For the access area, a waiting area, changing room for pregnant women and guardians, and a storage space for contaminated linens are required for infection prevention, safety, and efficiency. For the treatment area, childbirth processes and circulation should have space reserved for labor, delivery, recovery, examination, and treatment. In preparation for an emergency during childbirth, emergency response measures and supporting space needs to be established. For the support area, circulation and rooms are to be designed for medical staff support, activity space, storage and transportation of equipment, and urgent medical treatment. Implications: Along with the low fertility rate and the decrease of medical institutions that operate delivery departments, for the purpose of establishing a public medical service system and a healthy medical environment for mothers and newborns, the researched information demonstrates basic data on space plan of delivery departments in regional public hospitals.

• 한국치위생학회지
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• 제18권4호
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• pp.477-488
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• 2018

Objectives: The purpose of this study was to investigate career competency, tasks, and job satisfaction of public servants, public institutions, and researchers. Methods: The survey was conducted about career competency, job satisfaction, and satisfaction on work life. Next, they interviewed on the characteristics of each job by two or three dimensions. The following conclusions were obtained from July to August 2017. Results: Career competencies were GPA with 3.87, 818 points of TOEIC score, and ITQ certification. Public servants required the information on literacy skills for employment and job performance, while civil servants need more than one year of clinical experience in the dental hospital. The non-commissioned officer needed a written test and fitness training. The health insurance review and assessment center required more than one year of experience from general hospital or medical institutions. Researchers required a research career, language skill, and professors required research and teaching experiences with clinical experience more than three years. The main job tasks were as follows; for public servants, they were official document processing and community projects. For the civilian workers and military/noncommissioned officers, they were medical assistant and administrative works. The employees of the health insurance review and assessment service are examining the medical expenses and the medical examination, the researchers are experimenting, researching and writing articles, and the teaching staff are lecturing and conducting individual research. Conclusions: The results of job satisfaction survey showed that occupational satisfaction was the highest in civil servants, researchers, and teaching professions. Job security was the highest in health workers and health inspectors' evaluation centers, and time vacancy was the highest in civilian workers and military/noncommissioned officers. If you want to work in such an institution, you should prepare elements that match your basic literacy and job specific characteristics. And we should try to increase the satisfaction of work even after work.

• 의료법학
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• 제24권1호
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• pp.101-130
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• 2023

현재 한국은 OECD 국가 중에서 대학병원을 비롯한 상급병원의 접근이 매우 용이하고, 환자가 대학병원의 응급실에 한 두시간 내 당도 할 수 있는 반면, 적절한 시점에 수술을 받지 못해 사망하는 소위 '필수의료' 사각지대가 많이 발생하고 있다. 특히, 외과계 필수의료(외필의)의 경우 기본적인 수술임에도 현재 대학병원에서조차 응급상황에서 외필의 수술을 집도할 의료진이 부족하는 등 전체적인 의사수는 많지만 외필의 의사수는 매우 부족한 상황이다. 이러한 인력난은 수술에 대한 낮은 보험수가 문제도 있지만, 응급상황에서 발생률이 높아지는 의료사고에 대한 형사책임의 부담감도 매우 큰 영향을 미친다. 본 글에서는 필수의료에 대한 해결책으로 융합된 스마트 외과계 필수의료(SES) 병원에서 인력난을 해결하기 위해서 형사면책을 제시하고 있다. 현재 형사면책의 필요성에 대해서는 의료계에서는 공감하지만, 국민적 합의를 이루지 못하고 있는 것은 모호한 면책범위에 대한 부분이다. 이 글에서는 의료행위 중에서 형사면책이 가능한 필수의료 행위(수술)에 대한 명확한 범주를 마련하고자 한다.

• 디지털융복합연구
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• 제11권11호
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• pp.389-395
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• 2013

IT 기술과 의료기술이 융합되면서 환자의 체내에 의료장비를 부착한 환자의 수가 증가하고 있다. 그러나 환자의 생체정보를 제 3자가 악의적으로 도청 및 변경하는 문제점이 발생하고 있다. 본 논문에서는 환자와 병원관계자 사이에서 환자의 생체정보를 제3자가 도청하거나 변조없이 키를 공유하도록 양자 암호 기반의 키 분배 모델을 제안한다. 제안 모델의 양자 정보는 메시지 직접전달보다는 임의의 비트들을 전달하여 키를 공유하는 one-time pad 키를 사용한다. 또한, 제안 모델은 체내삽입장치의 생체정보가 제3자에게 불필요하게 노출되지 않아 환자의 익명성을 보장받는다.

• 유통과학연구
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• 제18권12호
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• pp.91-100
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• 2020

Purpose: The objective of this study is to deepen our understanding of the key factors that determine sustainability in terms of suppliers based on the transactions between suppliers (pharmaceutical companies) and buyers (medical institutions) in the pharmaceutical distribution industry. Research design, data and methodology: Transaction justice factors were derived from three main components: distributive, procedural and interpersonal, five hypotheses were set up. The respondents from the data collected through an online survey are sales staff of pharmaceutical companies. Total of 319 questionnaires are collected and used to verify the hypotheses through the SPSS 22.0 and AMOS 22.0 programs. Results: Justice of transactions perceived by the salesperson of pharmaceutical companies was found to have a significant effect on the relationship commitment. Among them, procedural justice was found to have greatest relative influences. In addition, relationship commitment was found to have a significant effect on sustainability performance. Thus, all hypotheses were adopted. Conclusions: The results of this study, can be used as basic data for the guidelines for fair trade between pharmaceutical companies and medical institutions. In addition, it is expected that the study will have significance in that it examined sustainability through transactions with buyers from the viewpoint of suppliers.

• International Journal of Computer Science & Network Security
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• 제24권7호
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• pp.11-23
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• 2024

Triage is a practice of accurately prioritizing patients in emergency department (ED) based on their medical condition to provide them with proper treatment service. The variation in triage assessment among medical staff can cause mis-triage which affect the patients negatively. Developing ED triage system based on machine learning (ML) techniques can lead to accurate and efficient triage outcomes. This study aspires to develop a triage system using machine learning techniques to predict ED triage levels using patients' information. We conducted a retrospective study using Security Forces Hospital ED data, from 2021 through 2023 during Hajj period in Saudia Arabi. Using demographics, vital signs, and chief complaints as predictors, two machine learning models were investigated, naming gradient boosted decision tree (XGB) and deep neural network (DNN). The models were trained to predict ED triage levels and their predictive performance was evaluated using area under the receiver operating characteristic curve (AUC) and confusion matrix. A total of 11,584 ED visits were collected and used in this study. XGB and DNN models exhibit high abilities in the predicting performance with AUC-ROC scores 0.85 and 0.82, respectively. Compared to the traditional approach, our proposed system demonstrated better performance and can be implemented in real-world clinical settings. Utilizing ML applications can power the triage decision-making, clinical care, and resource utilization.

• 산업진흥연구
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• 제3권2호
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• pp.21-31
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• 2018

본 연구는 간호 간병 통합서비스 품질이 의료서비스 성과에 미치는 영향을 알아보기 위해 가설 검정을 실시했다. 연구 결과는 간호 간병 통합서비스 품질의 반응성, 확신성, 공감성, 계산적 몰입, 신뢰성, 감정적 몰입은 의료서비스 성과의 지각된 성과, 충성도, 지각된 성과, 성과의 충성도와 의료서비스 성과의 지각된 성과는 충성도에 긍정적인 영향은 채택으로 나타났다. 즉, 통합서비스 품질은 의료서비스 역량에 매우 중요함을 검증하였다. 이를 위해서는 간호팀원의 인력확충을 위한 제도적 노력이 우선되어야 하며, 우수한 간호팀원 양성을 위해서 전문적 간호능력 외에도 환자와의 공감을 통해 긍정적 관계 형성을 위한 인성 교육에도 중점을 두어야 할 것이다. 본 연구에서 통합서비스 품질이 의료서비스 성과에 미치는 영향을 검중 하였다는데 연구의 의미를 찾을 수 있다.