Journal of Korean Academy of Fundamentals of Nursing
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v.6
no.1
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pp.64-77
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1999
This study was conducted to investigate the use of medical equipment in patients receiving home care service. The subjects of this study were 88 patients cared by seven home care nursed who were registered in the Seoul Nurses Association. Data was collected from Aug. 1, 1998 to Dec. 30, 1998. The findings are as follows. 1. The sample was found to be 55.7% female : 51.7% over 65 years old. 75% with neurologic disease including CVA, brain tumor, ICH, Parkinsonism & Spinal stenosis and 78.4% living in Seoul. The Clinical experience of the home care nurses was greater than five years. 2. Medical equipment which the patients possessed were foley catheters(61.4%), L-tubes(59.1%) and tracheostomy tubes(51.1%). 3. Technical difficulties in use of medical equipment were related to home care ventilators(60.0%), L-tubes(3.8%) and tracheostomy tubes(2.2%). 4. Most of the medical equipment were obtained from the hospital where they had been admitted previously or from medical equipment companies. 5. Complications from the use of this equipment were infection through invasive techniques including wound drainage tubes(50%), and IV injections(22.2%), The complications were resolved through referral to the doctor of the hospital where they were previously admitted or through community health centers. 6. Most of the equipment was disposable, and equipment was disinfected by using various methods including boiling and soaking in antiseptic solutions. These findings suggest that consistant policy on the management of medical equipment is necessary for the safety of home care patients.
Kim, Gi-Young;Yoo, Ki-Hoon;Park, Ho-Joon;Jang, Joong-Soon
Journal of Applied Reliability
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v.15
no.1
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pp.27-32
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2015
Functional safety is part of the overall safety relating to the equipment under control (EUC) and the EUC control system that depends on the correct functioning of the electrical/electronic/programmable electronic (E/E/PE) safety-related systems. Since the complexity of the medical equipment is increased, manufactures have to obtain functional safety as well as basic safety. This study proposes a perspective for applying functional safety to medical equipment. The research is carried out with respect to overall safety life-cycle of functional safety and essential performance of the medical equipment. The relationship between functional safety and essential performance is identified centered on the safety function. The essential performance using E/E/PE systems is defined as a safety function of functional safety. This approach is applied to a ultrasound imaging system as a case study.
This study gives an account of the collateral standards in IEC 60601-1-3: 2008 specifying the general requirements for basic safety and essential performance of diagnostic X-ray equipment regarding radiation protection as it pertains to the production of X-rays. The collateral standards establish general requirements for safety regarding ionization radiation in diagnostic radiation systems and describe a verifiable evaluation method of suitable requirements regarding control over the lowest possible dose equivalent for patients, radiologic technologists, and others. The particular standards for each equipment can be determined by the general requirements in the collateral standard and the particular standard is followed in the risk management file. The guidelines for radiation safety of diagnostic radiation systems is written up in ISO 13485, ISO 14971, IEC 60601-1-3(2002)1st edition, medical electric equipment part 1-3, and the general requirements for safety-collateral standards: programmable electrical medical systems. Therefore the diagnostic radiation system protects citizens' health rights with the establishment and revisions of laws and standards for diagnostic radiation systems as a background for the general requirements of radiation safe guards applies, as an international trend, standards regarding the medical radiation safety management. The diagnostic radiation system will also assure competitive power through a conforming evaluation unifying the differing standards, technical specifications, and recognized processes.
Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.
Kim, Juhye;Shin, Dong Oh;Choi, Sang Hyoun;Min, Soonki;Kwon, Nahye;Jung, Unjung;Kim, Dong Wook
Progress in Medical Physics
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v.29
no.4
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pp.123-136
/
2018
The complex dose distribution and dose transfer characteristics of intensity-modulated radiotherapy increase the importance of precise beam data measurement and review in the acceptance inspection and preparation stages. In this study, we propose a process map for the introduction and installation of high-precision radiotherapy devices and present items and guidelines for risk management at the acceptance test procedure (ATP) and commissioning stages. Based on the ATP of the Varian and Elekta linear accelerators, the ATP items were checked step by step and compared with the quality assurance (QA) test items of the AAPM TG-142 described for the medical accelerator QA. Based on the commissioning procedure, dose quality control protocol, and mechanical quality control protocol presented at international conferences, step-by-step check items and commissioning guidelines were derived. The risk management items at each stage were (1) 21 ionization chamber performance test items and 9 electrometer, cable, and connector inspection items related to the dosimetry system; (2) 34 mechanical and dose-checking items during ATP, 22 multileaf collimator (MLC) items, and 36 imaging system items; and (3) 28 items in the measurement preparation stage and 32 items in the measurement stage after commissioning. Because the items presented in these guidelines are limited in terms of special treatment, items and practitioners can be modified to reflect the clinical needs of the institution. During the system installation, it is recommended that at least two clinically qualified medical physicists (CQMP) perform a double check in compliance with the two-person rule. We expect that this result will be useful as a radiation safety management tool that can prevent radiation accidents at each stage during the introduction of radiotherapy and the system installation process.
Quality management of an x-ray unit drastically differs according to the type of establishment of medical institutions. Many primary medical institutions have it, but they do not pay much attention to quality management. In the study, Gyeongbuk area has been divided into four zones from January 4, 2010 to September 3, 2010, and four places were designated by city. Among medical institutions located at a total of 16 sites, the target was 8 places with X-ray emission equipment 10 years or more in use as well as 8 places with X-ray emission equipment less than 10 years in use. The 5 essential items of quality control were tested. In the test that checked for equipment it was found that sites with X-ray emission equipment 10 years or more in use didn't have ground connection (6.25%) while all of them passed the current leak test. In the exposure dose reproducibility test 4 sites with X-ray emission equipment 10 years or more in use (25%) and 1 site with X-ray emission equipment less than 10 years in use didn't pass the test. In the KVp accuracy test 5 sites with X-ray emission equipment 10 years or more in use (31.25%) and 2 sites with X-ray emission equipment less than 10 years in use (12.5%) didn't pass the test. In the tube current and tube current amount test 3 sites with X-ray emission equipment 10 years or more in use (18.75%) and 1 site with less than 10 years in use (6.25%) didn't pass the test. According to the findings of the present research, quality control at medical institutions with X-ray equipment 10 years or more in use was poorer than medical institutions with X-ray equipment less than 10 years in use. In this regard, administrative and technical measures need to be taken as soon as possible. In addition, owners of medical clinics or unit managers need to raise awareness, and it is necessary to revise a regular test cycle every year or every two years if they have old equipment or if the equipment is not used on a frequent basis. And it is also important to provide regular educational programs for quality management.
This study aims to measure in-patients' willingness to choose the same hospital, and to define the related factors. The willingness was measured by the fact whether in-patients would return to the same hospital for their future hospitalization and can be said as the essence of ascertaining patients' satisfaction. Data was collected from 236 patients hospitalized in two hospitals selected according to its superiority, one being superior in medical technique, the other being superior in facility and equipment. To enhance the comparability between the two hospitals, the department and the diagnosis were matched, and structured questionnaires were self-fill-up. The main findings are as follows. Hospitals were analyzed by their superiority : medical services, facility and equipment. In case of hospitals with superior medical services, the willingness was proportional to positive doctor-patient relationship, to satisfaction with the medical level, and to the acknowledgement of utility in cure. In case of hospitals with superior facility and equipment, the willingness was proportional to the satisfactory state of overall facility. Two types of hospitals were combined and analyzed. The willingness for choosing hospitals with superior medical services was stronger than that for choosing the other hospitals. The satisfaction with overall facility, satisfaction with medical level, acknowledgement of utility in cure, positive doctor-patient relationship, and better consultation produced higher willingness to choose the same hospital. The willingness for the option shows to what degree the hospital suffices patients' expectation. Patients' understanding views were obviously influential. The satisfaction level for medical aspect was more influential than the level for non-medical aspect.
Journal of the Korean Operations Research and Management Science Society
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v.37
no.4
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pp.95-109
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2012
Being able to quickly locate valuable medical equipment is critical inside hospitals. In order to utilize limited budget and resources efficiently, accurate locating or tracking is required in many fields. In this research, we focus on how to find the location of missing assets by using RFID in real time indoors to track equipment. When equipment needs to be searched, the purpose of a RFID device is to minimize the time, investment cost and effort spent searching for the equipment. Thus, this research presents a mathematical model of using RFID (both handheld reader and stationary reader) for efficient asset location. We derive the expected time of locating RFID-tagged objects in a multi-area environment where hand-held RF readers are used. We then discuss where to deploy stationary RF readers in order to maximize the efficiency of the search process.
This study is to grasp selection factors and habits of information searching of customers of ophthalmic service and to verify the differences in them and to investigate how they affect in selecting medical institute by demographic sociological characters, selection factors by classification and habits of information searching, how many times they used and the type of medical treatment. The result of analysis of importance of selection factors of medical institute, it showed that doctors' career were evaluated high by classification and it showed in order of university hospital, hospital, clinic in facilities and equipment and in order of university hospital, clinic, hospital in distance transportation Analysis of importance of selection factors by sex distinction, it showed that doctors' career were high for both male and female and according to the result of analysis of selection factors by an age, doctors' career variable was measured high and it showed in order of facilities, equipment, distance and convenient transportation. The result of analysis by the form of medical treatment, doctors' career were measured high in all diseases. Facilities and equipment were measured high in case of a corrective operation of eyesight and distance transportation variable showed high in simple eye diseases. According to the result of analysis of habits of searching information by utility frequency, one's own experience in the past(direct visits) was the highest over all and it showed in order of introduction of other ophthalmic department in case of people who go to the institutes many times.
This study was designed to find out the relations between the major investment decision-making behaviors and profitability of the hospital. A total of 57 hospitals were analyzed on this study. The major findings were as follows; 1. Among the types of the investment decision-making, major factors affecting the profitability were where the top management belongs among the defender, analyzer, prospector, and reactor type. Other factors were whether or not hospital analyzes which is more economical between the purchase by cash and lease of the medical equipment and whether or not hospital changes the decision before the actual investment. 2, Among the types of the investment decision-making, major factors affecting the financial structure and efficient operation of the assets were ranking of the priority and whether or not hospitals can get enough revenue and cash flow when hospitals have to borrow a big amount of fund from outside. 3. Among the financial indices regarding the financial stability, major factor affecting the profitability was fixed assets to long-tenn capital. Other factors affecting the financial structure and efficient operation of the assets were value added to medical equipment, normal profit to medical equipment, liability to total assets, current ratio, value added to payroll expenses. 4. Investment decision-making behaviors are partially influencing on the financial structure and efficient operation of the assets. However it was proved that the profitability was the most influencial factor than other factors related with the operation of the hospital. 5. To improve the irrational investment decision-making behaviors strategic management system should be introduced, and the top mamagement's investment decision-making style should be changed from reactor and analyser styles to prospector and reactor ones.
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