일부 경북지역 산업장의 제특성에 따른 건강진단과 보건관리 실태 (A Study on The Status of Health Examination and Health Management of Industrial Companies in the Taegu and Kyungbook Areas)
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- 지역사회간호학회지
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- 제4권1호
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- pp.67-76
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- 1993
The purpose of this study was to find the status of health examination and health management of industrial companies located in Taegu and Kyung book areas. It will provide basic information for the provision of effective health management of industrial workers. 49 companies were selected as a study sample group, and data was collected by using a structured Questionnaire which was developed by the members of the Community Health Nursing Academy of Korean Nursing. The health managers of the companies filled out the Questionnaire. The data was gathered from Dec 20, 1992 to Jan 20. The results of the study was as follows : 1. The Study sample showed 85.7% manufacturing companies having 300 or more workers. 2. All the companies had health managers, and companies which had 1,000 or more workers had industrial physicians and nurses. Only 12.2% of the industrial physicians were full time employees, and almost all industrial nurses were full time employees. Except for industrial physicians and nurses, the proportion of hygienists (6.1%), nurses aids (4.1%), and environmental engineers (22.4%) with full time employment statuss was very low. The mean age of industrial physicians was 49.2 while that of industrial nurses was 27.2. The length of work experiences currently ranges for 1 to 3 years for all health workers: physicians, nurses, hygienists, and environmental engineers. 3. Health examination and follow up care 94.31% took general health examinations. Of those, the proportion of the workers, who were determined as C grade(in need of close examination) was 43.86%. The proportion of the workers who were determined as D grade was 22.19%. 13.28% of the workers evaluated at the D grade were taken as a gauge for temporary leave from work. While 8.7% and .09% of them were taken as gauge for a change in job, and or shortening work hours respectively. The proportion of workers who must have taken special examination was 65.04% and of those the proportion of the workers who actually took, the examination was 98.55%. 75% of the workers who were recommended for follow up care were given follow up care. The special examinations were done the most frequently to detect the effects of physical agents (59.2%). Direct notice to individual workers was used the most frequently as a method of notification after a special examination (61.2%). The length of time taken to receive the result of a special examination was less than 1 month (38.9%) and 36.7% had taken up to two months (36.7%.). Most results of special examination were obtained within 2 months. The referral rate of consulting special examination by health managers was estimated at 95.9%. 4. 89.8% of the companies had. their own company dispensaries and 75.5% of those. had separate dispensaries. 32.7% of the companies designated local clinics for health management of workers. Industrial nurses performed health examination the most frequently(1.4 points). Health appraisal for work places were. done the least(0.83 points).
클라우드 컴퓨팅은 서비스 사용자 요구에 따라 컴퓨팅 자원을 임대하여 사용하는 컴퓨팅 패러다임이다. 클라우드 컴퓨팅에서 컴퓨팅 자원은 사용자의 서비스 수요에 따라 컴퓨팅 자원을 확장 또는 축소가 가능하여 전체 서비스 비용 절감 효과를 가질 수 있다. 그리고, M&S (Modeling and Simulation) 기술은 컴퓨팅 자원과 CAE 소프트웨어를 통해 엔지니어링 분석 작업 결과를 얻어, 실제 실험 결과가 없이 제품의 상태를 시뮬레이션을 수행하여 분석하는 방법이다. M&S 기술은 FEA(Finite Element Analysis), CFD(Computational Fluid Dynamics), MBD(Multibody Dynamics) 및 최적화 분야에서 활용된다. M&S 통한 작업 절차는 전처리, 해석, 후처리 단계로 구분된다. CAE 소트프웨어를 통한 3D 모델링 작업인 전/후처리는 GPU 연산이 집약적이며, 3D 모델 해석은 CPU 또는 GPU 연산이 요구된다. 일반적인 개인 데스크톱에서 복잡한 3D 모델을 해석하는 시간이 많이 소요된다. 결과적으로, M&S를 원활하게 수행하기 위해서는 고성능 컴퓨팅 자원이 요구된다. 이 문제를 해결하기 위해 우리는 통합 클라우드 및 클러스터 컴퓨팅 환경인 HEMOS-Cloud 서비스를 제안한다. 제안한 클라우드 기반 방식에서는 M&S에 필요한 전/후처리 및 솔버 작업을 원활하게 수행할 수 있도록 구성했다. 이 시스템에서 전/후처리는 VDI(Virtual Desktop Infrastructure)에서 수행되고 해석은 클러스터 환경에서 수행된다. 각 용도에 맞게 서로 다른 환경에서 분리하여 컴퓨팅 자원 간에 간섭을 최소화했다. HEMOS-Cloud 서비스는 기업 또는 학교에서 M&S의 경험이 필요로 하는 사용자에게 CAE 소프트웨어와 컴퓨팅 자원을 제공한다. 본 논문에서는 HEMOS-Cloud 서비스의 경제적 파급효과를 산업연관분석을 활용하여 분석했다. 전문가의 의견을 반영하여 조정된 계수를 통한 분석 결과는 생산유발효과 74억원, 부가가치유발효과 41억원, 취업자유발효과 10억원당 50명으로 분석되었다.
Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.