• 제목/요약/키워드: Medical practice

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혈액투석 환자의 기능부전 도관관리 실무지침개발 (Development of a Practice Guideline for Catheter Dysfunction in Hemodialysis Patients)

  • 이경미;김미연;홍진영;조용애;양원지
    • 임상간호연구
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    • 제22권2호
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    • pp.238-247
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    • 2016
  • Purpose: This study was done to develop an evidence-based practice guideline for catheter dysfunction in hemodialysis patients. Methods: Development of the guideline process was done according to the De Novo development version 1.0 by NECA which consists of 12 steps. Results: The developed guideline consisted of 5 domains and 14 recommendations. The number of recommendations for each domain were: 3 on catheter dysfunction assessment, 1 on conservative management of catheter dysfunction, 7 on drug management of catheter dysfunction, 1 on catheter function test and 2 on maintenance management. Of the recommendations, 7.15% were marked as A grade, 52.85% of B grade, and 50% of C grade. Conclusion: Findings in this study indicate that this guideline can be added to the evidence-based practice guidelines for fundamentals of practice and that this guideline can be disseminated to nurses nationwide in order to improve the care of hemodialysis patients with catheter dysfunction.

일반인에게 실시한 심폐소생술 교육효과 (CPR Training Effect for Civilian)

  • 고재문;김태민
    • 한국응급구조학회지
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    • 제16권1호
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    • pp.19-29
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    • 2012
  • Purpose: This study was focused on the training effects of the cardiopulmonary resuscitation(CPR) which is based on the AHA guideline 2010 for lay person. The purpose of this study was to investigate the effectiveness of the CPR training for civilian by checking the performance ability of the subjects before and after the CPR education. Method: This study was a single primary experimental study designed with pre and post test. Study subjects were 55 apartment managers who participated in all test on December 5 and December 11, 2011. The tools of this study were CPR performing evaluation sheet and CPR teaching program(AHA). Data were analysed by descriptive statistics, t-test, repeated ANOVA and Bonferroni with SPSS 18.0 program. Result: The CPR practice performing ability was significantly increased by test. The CPR practice performing ability of the learning experience group had significantly higher score than that of non-experience group. The self-confidence on CPR practice when faced emergency situation was highly increased after practice training. Conclusion: Practical performance evaluation score has improved step by step. The primary and secondary practical evaluation showed a significant difference in all items and practice-oriented education was found to be effective in CPR training.

7개 질병군 포괄수가제 도입에 따른 일개 대학병원의 진료행태 변화 모의실험 (Simulation on the Change of Practice Pattern after the Introduction of 7 Diagnosis-related Groups Prospective Payment System in a University Hospital)

  • 신삼철;강길원;김상원
    • 보건행정학회지
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    • 제23권2호
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    • pp.103-111
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    • 2013
  • Seven diagnosis-related groups (DRGs) prospective payment system is going to expand to all hospitals including university hospitals this year. However there are few studies on the change of practice pattern under prospective payment system in the university hospital setting. So This study was intended to predict the practice pattern change after the introduction of 7 DRGs prospective payment system in a university hospital setting. To predict the change of practice pattern, this study used simulation technique. Five hundred and nineteen patients classified as 5 DRGs in a university hospital were selected for simulation. The change of practice pattern were predicted based on clinicians' opinion. We also predicted payment change by service items. Major findings of this study are as follows. First, the total medical payment was reduced by 14.4%. The drug payment change (8.8%) took most of total payment reduction. The followings are the change of treatment material cost (3.2%), the change of laboratory tests cost (1.8%), the change of room charge (0.5%), and other payment change (0.1%), respectively. Second, most of the reduction in total medical payment resulted from the decreased amount of medical services themselves. The transfer of medical services to outpatient setting took up only 4.9% of the total payment reduction. The change of unit price or composition took up 5.5% of the total payment reduction. In this study we found that it is possible to reduce the inpatient services through practice pattern change in university hospital setting. However, it needs to be careful to adjust DRG payment after the reduction of provided services, because most of reduction was not due to service transfer but to service volume reduction. It is desirable to utilize the saving from practice pattern change as incentive to improve quality of care.

Factors associated with musculoskeletal pain in professional dancers, including lapse period of group practice due to the COVID-19 outbreak: repeated-measures analysis

  • Kiook Baek;Yu-Mi Choi;Joon Sakong
    • Journal of Yeungnam Medical Science
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    • 제41권3호
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    • pp.196-206
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    • 2024
  • Background: This study investigated the prevalence and associated factors of musculoskeletal pain among professional dancers who experienced a lapse in group practice due to coronavirus disease 2019. Methods: General characteristics, practice time, region of musculoskeletal pain due to injury using the visual numeric scale (VNS), and causative motion were surveyed among professional dancers. Pain of VNS 0 to 3 was categorized as "no or minor," 4 to 6 was categorized as "moderate," and 7 to 10 was categorized as "severe." The causal motions of musculoskeletal pain were analyzed according to body region. Factors other than motion associated with pain were also analyzed. Results: In total, 368 participants were included. In the univariate analysis, age and practice time were positively associated with "moderate" pain. Practice time, dance experience, and postural accuracy were positively associated with "severe" pain, as was performing Korean traditional dance. In the multivariable analysis, practice time, group practice, and age were positively associated with pain of VNS 4 to 10, and practice time, group practice, and Korean traditional dance were positively associated with pain of VNS 7 to 10. Conclusion: Among the factors related to dancer training, practice time, group practice, and dance type affect the occurrence of pain.

일부 개업의의 우울 및 Burnout 정도의 관련요인 (The Degree and Related Factors of the Depression and Burnout among Private Practice Physicians)

  • 신준호;김군수;박요섭;나백주;손석준;김병우
    • Journal of Preventive Medicine and Public Health
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    • 제28권3호
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    • pp.563-575
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    • 1995
  • In order to investigate the prevalence and the factors related to the depression and burnout among private practice physicians, a SDS(self-rating depression scale) and MBI(Maslach burnout inventory) -based questionnaire study was performed on 344 private practice physicians in Kwangju and Chonnam area. The results were summarized as follows. 1. Mean SDS score was 38.3 in total subjects and the prevalence rate of depression was 48.8%. As for the frequency order of the items of the SDS, decreased libido, diurnal variation and hopelessness were relatively high, and suicidal rumination, constipation and agitation were noted low. 2. Noticeable factors related with depression were smoking, coffee use, sleeping time and satisfaction with income. 3. As a result a factor analysis with the MBI data, five factors named as emotional exhaustion, depersonalization, personal accomplishment, involvement and self-interest were extracted. Statistical analysis of the data demonstrated that 48.8% of the physician sample reported high scores on emotional exhaustion, and 45.3% scored high on depersonalization. Personal accomplishment scores remained high with 45.3% reporting high personal accomplishment. 4. Variables related to the burnout were age, sleeping time, family size religion, medical speciality, duration of practice setting, visiting patient number, closing day per month and job satisfaction. 5. In the relationship with depression, burnout was closely related to depression. Above results showed that the high percentage of private practice physicians experiencing depression and burnout suggests the need for further research to establish trends, to identify causal factors, and to develop avenues to reduce stress.

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의학용어 수업에서 인체 모형을 이용한 관찰 실습 (Observation Practice Using a Human Body Model in Medical Terminology Class)

  • 정현우;염호준;박상수
    • 문화기술의 융합
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    • 제10권2호
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    • pp.35-42
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    • 2024
  • 의공학은 의학 및 생물학적 이해를 바탕으로 공학적 기술을 이용하여 인체 질병을 진단하고 치료하는 학문이다. 올바른 의공학 교육을 위해서는 교육과정에 의학용어, 인체해부학, 인체 생리학 등의 교육이 필요하지만 학생들은 이들 의학 기초 과목들을 암기 과목이라는 선입견을 가지고 있다. 이러한 학생들의 선입견을 해소시키기 위해서는 다양한 교육방법을 개발하여 학생들이 기초의학 과목들에 쉽게 접근할 수 있도록 해야 한다. 본 논문에서는 의학용어 과목에 인체 반신 해부 모형의 관찰 실습을 도입하여 학습 효과를 높이는 방법을 제시한다. 인체 반신 모형은 여러가지 장기가 조립되어 있는 형태이며 하나씩 분해하면서 관찰할 수 있다. 본 관찰 실습은 머리, 목, 가슴, 복부 부위의 장기들에 대한 질문으로 구성하여 학생들이 조별로 답을 찾아가도록 구성하였다. 학생들은 실습 후 이 실습이 학습동기를 유발하고 강의의 이해를 쉽게 해 주었다고 평가하였다.

일본 인지증 정책 종합 추진전략의 실천 사례: 쿠마모토현의 쿠마모토 모델 (Practical Examples of the Comprehensive Strategy of Japanese Dementia Policy: Kumamoto Model by Kumamoto Province)

  • 주정민;권용진
    • 보건행정학회지
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    • 제29권1호
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    • pp.11-18
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    • 2019
  • The purpose of this research is to introduce the best practice of the Japanese national dementia strategy and explore implications to the Korean national dementia strategy. Interview was conducted among professions those who is in charge of Kumamoto dementia care practice in Kumamoto province, upon review of related literature and public documents. The Kumamoto model is implemented by the department of neuropsychiatry in public university hospitals, which can offer dementia-specialized medical services. Medical centers for dementia in public university hospitals play a leading role for managing practice and training local dementia centers specialist, coordinating medical services among medical institutions and community welfare facilities. In reference to the Kumamoto model, the Korean national dementia strategy can find implications in the direction of current system, specifically its approaches toward policy governance.

1급응급구조사의 수급에 관한 연구 -응급의료에관한법률을 중심으로- (A Study on Projection of Demand and Supply for Paramedic in the Emergency Medical Services Act)

  • 엄태환
    • 한국응급구조학회지
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    • 제7권1호
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    • pp.55-64
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    • 2003
  • The purposes of this study which was conducted by applying three projection formulae to the data from admission quota for paramedic of the Ministry of Education & Human Resources Development the number of ambulances the number of emergency medical centers of the Ministry of Health & Welfare and rate of successful candidates of annual report of the National Health Personnel Licensing Examination Board were to find out demand and supply of paramedic from 2002 to 2045 and to expand scope of practice of paramedic in Korea. The conclusions from this study were summarized as follows; (1) The simple formulae derived from the projection formula of the Economic Planning Board were applied under the present Emergency Medical Services Act including qualifying over 3-years experienced EMT-Basic for paramedic examinee, stationing paramedic or EMT-Basic or physician or nurse per ambulance, stationing paramedic or EMT-Basic per emergency medical center and under the amended Emergency Medical Services Act including qualifying only paramedic graduate for paramedic examinee, stationing 4.5 paramedics per ambulance, stationing 10 to 2 paramedics per emergency medical center. (2) It was estimated that on the American basis of 5.6 EMTs per 10,000 in 1996, the number of paramedics under the present act will reach the basis before 2020, the number of paramedics under the amended act will reach the basis about 2040. (3) It was estimated that on the basis of 22,000 paramedics demanded from the number of ambulances, the number of emergency medical centers in 2001, the number of paramedics under the present act will reach the basis before 2015, the number of paramedics under the amended act will reach the basis about 2030. (4) There was relationship between requirements for emergency medical centers scope of practice of paramedic in the act and demand-supply of paramedic, this necessitates surveys, studies, amendment of the act, legalization for expanded scope of practice of paramedic including EMD, instructor, teacher of safety. (5) This study which includes only expanded scope of practice of paramedic and projection for paramedic in the act needs complementary studies such as decision-making process in health manpower policy and so on.

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Knowledge of Human Papillomavirus Infection, Cervical Cancer and Willingness to pay for Cervical Cancer Vaccination among Ethnically Diverse Medical Students in Malaysia

  • Maharajan, Mari Kannan;Rajiah, Kingston;Num, Kelly Sze Fang;Yong, Ng Jin
    • Asian Pacific Journal of Cancer Prevention
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    • 제16권14호
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    • pp.5733-5739
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    • 2015
  • The primary objective of this study was to assess the knowledge of medical students and determine variation between different cultural groups. A secondary aim was to find out the willingness to pay for cervical cancer vaccination and the relationships between knowledge and attitudes towards Human Papillomavirus vaccination. A cross-sectional survey was conducted in a private medical university between June 2014 and November 2014 using a convenient sampling method. A total of 305 respondents were recruited and interviewed with standard questionnaires for assessment of knowledge, attitudes and practice towards human papilloma virus and their willingness to pay for HPV vaccination. Knowledge regarding human papilloma virus, human papilloma virus vaccination, cervical cancer screening and cervical cancer risk factors was good. Across the sample, a majority (90%) of the pupils demonstrated a high degree of knowledge about cervical cancer and its vaccination. There were no significant differences between ethnicity and the participants' overall knowledge of HPV infection, Pap smear and cervical cancer vaccination. Some 88% of participants answered that HPV vaccine can prevent cervical cancer, while 81.5% of medical students said they would recommend HPV vaccination to the public although fewer expressed an intention to receive vaccination for themselves.

소화기관용약제 처방지침이 의사의 소화기관용약 처방률에 미치는 효과분석 (The Impacts of Guideline for Digestives on Physicians' Prescription of GI medication)

  • 김동숙;박춘선;장선미
    • 한국임상약학회지
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    • 제18권2호
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    • pp.124-131
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    • 2008
  • The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

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