• Title/Summary/Keyword: Multiple administration

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Factors Influencing Postoperative Urinary Retention Following Elective Posterior Lumbar Spine Surgery: A Prospective Study

  • Aiyer, Siddharth Narasimhan;Kumar, Ajit;Shetty, Ajoy Prasad;Kanna, Rishi Mugesh;Rajasekaran, Shanmuganath
    • Asian Spine Journal
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    • v.12 no.6
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    • pp.1100-1105
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    • 2018
  • Study Design: Prospective observational study. Purpose: To determine the incidence of postoperative urinary retention (POUR) in patients undergoing elective posterior lumbar spine surgery and identify the risk factors associated with the development of POUR. Overview of Literature: POUR following surgery can lead to detrusor dysfunction, urinary tract infections, prolonged hospital stay, and a higher treatment cost; however, the risk factors for POUR in spine surgery remain unclear. Methods: A prospective, consecutive analysis was conducted on patients undergoing elective posterior lumbar surgery in the form of lumbar discectomy, lumbar decompression, and single-level lumbar fusions during a 6-month period. Patients with spine trauma, preoperative neurological deficit, previous urinary disturbance/symptoms, multiple-level fusion, and preoperative catheterization were excluded from the study. Potential patient- and surgery-dependent risk factors for the development of POUR were assessed. Univariate analysis and a multiple logistical regression analysis were performed. Results: A total of 687 patients underwent posterior lumbar spine surgery during the study period; among these, 370 patients were included in the final analysis. Sixty-one patients developed POUR, with an incidence of 16.48%. Significant risk factors for POUR were older age, higher body mass index (BMI), surgery duration, intraoperative fluid administration, lumbar fusion versus discectomy/decompression, and higher postoperative pain scores (p<0.05 for all). Sex, diabetes, and the type of inhalational agent used during anesthesia were not significantly associated with POUR. Multiple logistical regression analysis, including age, BMI, surgery duration, intraoperative fluid administration, fusion surgery, and postoperative pain scores demonstrated a predictive value of 92% for the study population and 97% for the POUR group. Conclusions: POUR was associated with older age, higher BMI, longer surgery duration, a larger volume of intraoperative fluid administration, and higher postoperative pain scores. The contribution of postoperative pain scores in the multiple regression analysis was a significant predictor of POUR.

A Study on the Multiple Disaster Administration's Problem and Improvement (대형 재해관리의 문제점과 개선방안)

  • Kim, Hak-Soo;Koh, Jae-Moon
    • The Korean Journal of Emergency Medical Services
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    • v.7 no.1
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    • pp.179-198
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    • 2003
  • If see disaster administration system of our country, start in terms of is coping by countermeasure after four immediately after disaster occurrence many problems blessing with a sons by tribe and so on of link nature between formation, disaster administration complete charge utensil's absence, disaster charge manpower and budget be indicated and join. If examine improvement way accordingly, is as following ; Necessity of synthetic disaster administration system, Fire fighting formation's independence guarantee, Integration of fire fighting connection similarity business, Disaster administration's permanent establishment complete charge utensil's necessity, Disaster administration midautumn complete charge utensil at a metropolitan autonomous fire fighting system reorganization, Role division of labor between center and local government, Disaster administration professional human strength positivity, Disaster administration information system construction practical use, Equipment and improvement of budget state, Education public information for safety culture consciousness fixing, Internationalization of fire fighting business, globalization propulsion, Structure, member of rescue confrontation system and efficiency. Fire fighting environment is changing greatly, and fire fighting must become center to correspond to do confrontation that do one thing troble when produce disaster.

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A Study on the Relationship between Transformational Leadership and Organizational Commitment in Nursing Organization;Focusing on Moderating Effect of Personal Characteristics (간호조직에서 변혁적 리더쉽과 조직몰입의 관계에 대한 연구;성격특성의 조절효과를 중심으로)

  • Kim, Myoung-Sook;Park, Young-Bae
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.41-51
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    • 2001
  • Today's health care environment is rapidly changing and nurse administrators' leadership styles need to identify in nursing organization to achieve organizational objectives. By Bass(1985), transformational leadership stimulates the subordinates to be creative and achieve organizational objectives and is related to job satisfaction, job involvement, productivity, and organizational commitment. Transformational leadership process consists of charisma, intellectual stimulation, individual consideration. The purpose of this study is to identify the effect of transformational leadership and personal characteristics on nurses' organizational commitment. The subjects for this study consisted of 594 nurse from 8 University Hospitals and General Hospitals. The data were collected by personal characteristics scale, transformational leadership scale, and organizational commitment scale. The factor analysis, Cronbach's alpha analysis, Pearson correlation analysis, multiple regression analysis and hierarchical multiple regression analysis were used for the statistical method. The results of this study were found that (1) charisma dimension of transformational leadership has positive influence on nurses' organizational commitment; but another two dimensions(intellectual stimulation and individualized consideration) did not showed significant effect on organizational commitment (2) nurses' personal characteristic(internal locus of control) moderated the effect of transformational leadership on organizational commitment.

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A study on the hospital employee's attitude towards CSR (의료기관의 사회적 책임활동에 대한 종사자의 수용태도에 관한 연구)

  • Kim, Jin-Joo;Jin, Ki-Nam;Kim, Sung-Ho
    • Korea Journal of Hospital Management
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    • v.18 no.4
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    • pp.145-165
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    • 2013
  • The researches on corporate social responsibility(CSR) focused mostly on its effects on financial performance or consumer's behavior. However relatively few studies have dealt with employee's attitude towards CSR. The purpose of this study is to analyze determinants of hospital employee's attitude towards CSR. The data were collected from 163 employees at a general hospital in Gyeonggi-do from June 18 to July 18 in 2012. For the statistical analysis of data, t-test, ANOVA, and hierarchical multiple regression analysis were implemented. The result of hierarchical multiple regression analysis shows that first, perceived management support and direct benefits were positively related to the attitude towards the acceptance of CSR while interruption of work was negatively related. Second, as interruption of work was controlled, the statistically significant relationship between clinical department and attitude towards the acceptance of CSR was disappeared. In order to accommodate CSR in hospitals, first, the enterprise-wide support is more effective rather than expecting the action of each employee. Second, hospitals should provide the education about CSR to let employees expect direct benefits such as improving of their moral sense. Third, the burden of work causing interruption needs to be managed to cause employees to accept CSR.

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FMEA Measures for Service Failure Management (서비스 실패 관리를 위한 FMEA 이용 방안)

  • Kim, Hyun Jung;An, Qin Rui;Kim, Soo Wook
    • Journal of Korean Society for Quality Management
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    • v.42 no.1
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    • pp.43-61
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    • 2014
  • Purpose: This study identifies preventive measures for VOC management by analyzing the causes and effects of factors that contribute to high risk service failure using FMEA on KORAIL VOC data. Methods: Two research methods were used. First, a Risk Priority Number (RPN) was assigned to each KORAIL VOC based on Failure Mode and Effect Analysis (FMEA). Second, multiple regression analysis was run with RPN factors that include severity, occurrence, and detection as the independent variables and customer dissatisfaction as the dependent variable. Results: Multiple regression analysis showed that RPN factors including severity, occurrence, and detection had significantly positive relationship with customer dissatisfaction. Based on these results, an FMEA was performed on VOC categories with high RPN for railroad stations including platform, ticketing, ticket verification, parking, and escalator, and VOC categories with high RPN for trains including entrance doors, cafes, air quality, announcement, and ticket verification. Conclusion: This study has practical implications to service failure management. A priority order using FMEA was established for the list of customer dissatisfactions that should be addressed to actively manage service failure, and strategies for tackling this priority list are offered.

Economic Design of Local Area Networks using Genetic Algorithms (유전자 알고리즘을 이용한 경제적 LAN 설계)

  • Yum Chang-Sun;Lee Han-Jin
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.28 no.2
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    • pp.101-108
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    • 2005
  • In this paper, the design problem of local area networks is defined as finding the network topology minimizing cost subject to reliability constraint. The design problem includes issues such as multiple choices of link type for each possible link, multiple choices of hub type for each hub, and allocation of the users to the hubs. To efficiently solve the problem, a genetic approach is suggested. According to the experiments, the proposed approach improves search performance.

A Study on the Effect of Innovation Performance Through Business Innovation Activities and Techniques for the Small & Medium Size Company (중소기업의 혁신활동과 기법이 혁신성과에 미치는 영향에 관한 연구)

  • Moon, Hee Young;Chang, Seog Ju
    • Journal of Korean Society for Quality Management
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    • v.43 no.2
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    • pp.151-168
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    • 2015
  • Purpose: The purpose of this study was to investigate the effect of the innovation performance through business innovation activities by small and medium size company as well as to test the moderating effects on the innovation techniques'understanding and conformance. Methods: The data for the empirical analysis was collected from 132 companies mainly located in Jeolla and Gyeonggi Province. Cronbach's alpha factor analysis, multiple regression analysis and hierarchical multiple regression were used for statistical methods. Results: The Statistical analysis results show that innovation performance through business innovation techniques and activities was effected by CEO leadership, company capability and training for employees. Conclusion: Through this study we tried to give some suggestions for improving innovation performance through business innovation activities for the small and medium size company.

Effect of Nursing Organizational Culture on Job Satisfaction of Preceptors (간호조직문화가 프리셉터의 직무만족에 미치는 영향)

  • Yang, Nan-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.4
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    • pp.597-603
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    • 2006
  • Purpose: This study was to identify effect of nursing organizational culture on job satisfaction of preceptors. Method: The subjects were 73 preceptors who were working for the 4 of university hospitals in Seoul, Daejeon and Kyong Ki. This study was conducted from Aug to Oct 2005. The data was collected by questionnaires and were analyzed using descriptive statistics, pearson correlation coefficient, stepwise multiple regression. Result: Job satisfaction of preceptors were significantly correlated among nursing organizational culture. The stepwise multiple regression analysis on job satisfaction revealed that nursing organizational culture was a powerful predictor of job satisfaction. Conclusion: The findings indicate that nursing organizational culture is important for improving job satisfaction of preceptors. Therefore it is necessary to develop of good nursing organizational culture for successful preceptorship.

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