• Journal of Chest Surgery
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• v.44 no.3
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• pp.229-235
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• 2011

Background: Following major lung resection, patients have routinely been monitored in the intensive care unit (ICU). Recently, however, patients are increasingly being placed in a general thoracic ward (GTW). We investigated the safety and efficacy of the GTW care after lobectomy for lung cancer. Materials and Methods: 316 patients who had undergone lobectomy for lung cancer were reviewed. These patients were divided into two groups: 275 patients were cared for in the ICU while 41 patients were care for in the GTW immediately post-operation. After propensity score matching, postoperative complications and hospital costs were analyzed. Risk factors for early complications were analyzed with the whole cohort. Results: Early complications (until the end of the first postoperative day) occurred in 11 (3.5%) patients. Late complications occurred in 42 patients (13.3%). After propensity score matching, the incidence of early complications, late complications, and mortality were not different between the two groups. The mean expense was higher in the ICU group. Risk factors for early complications were cardiac comorbidities and low expected forced expiratory volume in one second. The location of postoperative care had no influence on outcome. Conclusion: Immediate postoperative care after lobectomy for lung cancer in a GTW was safe and cost-effective without compromising outcomes in low-risk patients.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.16 no.2
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• pp.101-109
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• 2006

The objective of this study is to provide fundamental data for pertinent management of indoor air quality through investigating the size-based characteristics of bioaerosol distributed in the general hospital. Measurement sites are main lobby, ICU, ward and laboratory and total five times were sampled with six-stage cascade impactor. Based on the result of this study, concentrations of airborne bacteria and fungi were the highest in main lobby as followed by an order of ward, ICU and laboratory. Concentrations of airborne bacteria was generally higher than those of airborne fungi and the ratio of indoor and outdoor concentration of both exceeded 1.0 in all the measurement sites of the general hospital. The predominant genera of airborne bacteria identified in the general hospital were Staphylococcus spp.(50%), Micrococcus spp.(15-20%), Corynebacterium spp.(5-20%), and Bacillus spp.(5-15%). On the other hand, the predominant genera of airborne fungi identified in the general hospital were Cladosporium spp.(30%), Penicillium spp.(20-25%), Aspergillus spp.(15-20%), and Alternaria spp.(10-20%). In regard to size distribution of bioaerosol, the detection rate was generally highest on 5 stage($1.1-2.1{\mu}m$) for airborne bacteria and on 1 stage(>$7.0{\mu}m$) for airborne fungi. Cleanliness of facilities in the general hospital and condition of HVAC system should be monitored regularly to prevent indoor air contamination by airborne microorganisms.

• Korean Journal of Psychosomatic Medicine
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• v.17 no.2
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• pp.62-67
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• 2009

Objectives : The aim of this study was to evaluate the effect of sociodrama for reducing burnout among health care workers and to investigate relationship between the job satisfaction, conflict with other professions, and burnout. Methods：15 nurses in general hospital participated in sociodrama directed by psychiatrist. One week after acting sociodrama, they were requested to complete ward organizational feature scale(WOFS) and maslach burnout inventory(MBI). The other twenty nurses in same ward requested to complete questionnaire without participating in sociodrama at the same time. Results : Sociodrama group(N=15) showed significantly lower score in burnout when compared to control group(N=17). Nurse/physician relationship was significantly correlated with job satisfaction and burnout. After controlling for interaction between variables by multivariate regression analysis, only job satisfaction was significant predictive factor to burnout. Conclusion : Our result suggests that the sociodrama can be effective in reducing burnout of health care workers in general hospital. These finding also underline the importance of relationship with physicians in job satisfaction and burnout of healthcare workers in general hospital.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.2
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• pp.49-54
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• 2017

Purpose The high-dose administration of I-131 has been standing for the basic therapy method of thyroid cancer. In korea, it is not necessary for patients to be hospitalized if the administration dose are under 1.2 GBq. However, if the dose are over 1.2 GBq, the patients should be stay in special ward with radiation shield. In such cases, the radioactivity level upon release should be under a dose of $70{\mu}Sv/hr$ at a distance of approx. 1m. This regulation bring the patients to stay for about 2 to 3 days in ward before the release. Materials and Methods Using the inpatients' release data of severance hospital, an inpatient-days were retrospectively calculated and compared with practical data and estimate the inpatient-days with the conditions of korea ($70{\mu}Sv/hr$), Japan ($30{\mu}Sv/hr$), germany ($3.5{\mu}Sv/hr$ at a distance of approx. 2 m), and other european countries. Results When a effective half-life of 15.4 was used, the expected inpatient-days were calculated as 2.15 days in the condition of Japanese regulation and 1.37 days in the condition of korean regulation. The practical inpatient-days of patients in Severance hospital were 1.32 days. Conclusion As ICRP 94 has been mentioned that the release of patients administrated with I-131 for the therapy should be carefully considered because each patients has different thyroid uptake rate and their conditions with family members after the release from the ward. Nonetheless, efforts to bring more aquate data which is for getting closer to the practical data should be continuously studied.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.20-26
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• 2022

Background and objective: The Seoul National University Bundang Hospital (SNUBH) implemented ward-based clinical pharmacy system with designated pharmacists in 10 general wards. Designated pharmacists conduct inpatient medication review, medication intervention, and medication consultation, and provide drug information for health care providers. This study aimed to evaluate the clinical pharmacy services and to examine the perception and expectations of health care providers on the services provided by the designated pharmacists in general wards. Methods: A survey was constructed to include questions on the health care providers' recognition, satisfaction, and perceived needs of designated pharmacists. We determined the frequency and type of interventions of ward pharmacist and their acceptance rate through a retrospective observational study using electronic medical records. Results: A total of 59 health care providers responded the questionnaire and 79.7% of the respondents reported moderate to high levels of satisfaction. Satisfaction with the services was positively associated with clinical interventions and nutrition support team (81.4%). Of 59 respondents, 88.1% agreed that preventing drug-related problems by designated pharmacists' activities were effective. The most common interventions included inadequate dosage (27.4%), omission and additional prescription (14.6%) and inadequate drug form (9.6%). The acceptance rate of intervention was 91.5%, and 151 potentially serious risks and 523 significant risks were prevented by the intervention. Conclusion: Positive results were confirmed in the awareness, satisfaction, and perceived needs of the health care providers for designated pharmacists. Expansion of the ward-based clinical pharmacy system with designated pharmacists to other wards may be considered.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.193-195
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• 2009

Purpose: The work flow of international hospital's laboratory consists of rapid test and result report at the present day. However, the frequent inquiry of sample, which cause affairs to delay and efficiency to Lower, affects medical examination. In order to promote work's efficiency, we should improve the problem and make work smooth between a laboratory, outs and ward. Materials and Methods: This study runs as follows. First, Investigating test result, test schedule, test receipt, quick result, etc through the activity required from September to November 2007 about the inquiry of sample. After analysis of the problem in December, remaking the test schedule for improvement solution and reporting it to outs and ward. When the result is retest and dilution, we directly fill in a result space with the result situation of the patient to let them know beforehand. We also, prevent the omission of the result through checking the sample list and discriminate in vivo from in vitro by changing the laboratory's telephone number. We have improved the problem about the inquiry of sample through valuation and analysis since the improvement activity from January to March 2008. Result: The case about the frequent inquiry of sample has reduced by 57.8%. this improvement activity indicated that p-value<0.05 was statistically significant through paired t-test. This activity make study smooth and we rapidly report the result. Conclusion: By reducing the case regarding the inquiry of sample, work discontinuation, and concentration reduction, the work efficiency was increased.

• Journal of Korean Clinical Nursing Research
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• v.28 no.3
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• pp.289-298
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• 2022

Purpose: Nursing stress on life-sustaining treatment of nurses is a significant contributing factor to nursing care performance and patient care outcomes. We need to investigate the factors associated with nursing stress on life-sustaining treatment in hospital settings. The purpose of this descriptive study was to examine the relationship of role perception of life-sustaining treatment and good death perception with nursing stress on life-sustaining treatment among nurses in hospital settings. Methods: Using a cross-sectional study design, we recruited nurses at a hospital located in a metropolitan city in Korea. The nurses completed structured questionnaire questions which were composed of well-validated questionnaires. Descriptive statistics and hierarchical multiple regression model were utilized for data analysis. Results: A total of 205 nurses participated in the study (female 93.2%; aged 20~29 years 63.0%; single status 78.5%). In the hierarchical multiple regression model, there was a significant positive relationship between role perception of life-sustaining treatment and nursing stress on life-sustaining treatment (β=.27, p<.001). Higher education level and working at a ward setting were also significantly related to nursing stress on life-sustaining treatment (β=.13, p<.046 for education level; β=.22, p=.001 for work setting). However, there was no relationship between good death perception and nursing stress on life-sustaining treatment. Conclusion: Education programs to reduce nursing stress on life-sustaining treatment are needed to develop for nurses who have higher role perception of life-sustaining treatment with higher education level working at ward settings in hospitals.

• Journal of the Korean Academy of Child and Adolescent Psychiatry
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• v.10 no.2
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• pp.244-251
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• 1999

Self-injurious behavior is often showed in mental retardation, especially in autism. Self-injurious behavior has been regarded as a symptom cluster rather than a disease but it is an emergent clinical situation that can directly affect mortality. This case is about a refractory autistic patient who showed a self-injurious behavior of hitting the head repetitively. He was hospitalized and was treated by pharmacotherapy and behavior therapy and for this reason this clinical experience is reported with literature review. The patient is a 7-year old boy who was ward admitted from 1999 April 20 till July 10 into OO hospital OO ward because of self-injurious behavior. During the 12 weeks he had admission treatment. As for the pharmacotherapy, haloperidol was dosed up from 0.5mg to 1.0mg from the 4th week and combination drug therapy was done during the admission with naltrexone 25-50mg. As for the behavioral therapy, Differential Reinforcement of Other behavior was used and regular play therapy was done. To remove the physical restraint, headgear and hard sleeve was used. Currently, OPD follow up treatment is being done and haloperidol 0.5mg and naltrexone 50mg is maintained. The patient’s mother is educated and play therapy is done an hour daily at home. When the patient was released form the hospital, self-injurious behavior was decreased more than the moderate state and remission state is still being maintained at the outpatient clinic.

• Korean Journal of Adult Nursing
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• v.26 no.6
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• pp.603-613
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• 2014

Purpose: The purpose of this study was to explore and identify the role adaptation processes of family caregivers with patients transferred from intensive care unit to general ward. Methods: Using a grounded theory methodology, in-depth individual interviews were conducted. Data were collected from 11 participants. The participants were asked about their experiences of role adaptation considering situational contexts and interactional strategies. Transcribed data and field notes were analyzed using constant comparative analysis. Results: The core category was 'becoming almost a nurse with hope and fear'. The identified phenomena by the participants were the joy of being alive, having hope for a full recovery, anxiety and fear of uncertain future, feeling burdensome on a given role. The results included both role adaptation and mal-adaptation of caregivers. Conclusion: The role adaptation processes of family caregiver with patients transferred from intensive care unit to general ward can be explained as becoming almost a nurse with hope and fear. The findings of the study provided fundamental information for developing programs to support the given family caregivers for successful role adaptation.

• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.139-150
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• 2008

Purpose: The aim of this study was to develop instrument measuring the relocation stress syndrome for patients transferred from intensive care unit to general ward in Korea. Method: For item construction, components were drawn from an extensive review of the literature, existing instruments and the result of qualitative approach. A total 48 items were selected for the first draft. Ten experts evaluated this instrument for content validity and the number of items was reduced to 29. To refine and test reliability and validity of the instrument, data were collected from the 594 patients following transfer from intensive care unit. Results: Preliminarily twenty-nine items were generated through content validity and a pilot study. Using corrected items to total correlation coefficient, this instrument was further shortened to a 25 item scale. Factor analysis extracted a total of 23 items with a 5-point Likert-type scale. Relocation Stress Syndrome (RSS) included three subscales; physical factors (12 items), Patient's recognition to health care providers (8 items), and emotional factors (3 items). The RSS established content validity, construct validity, and reliability. Conclusion: This instrument demonstrates good reliability and validity, and therefore it is an appropriate measurement of assessing relocation stress syndrome in ICU to ward transition period.