• 제목/요약/키워드: Patient evaluation

검색결과 3,008건 처리시간 0.032초

종합 병원 종사자 업무의 인간공학적 평가 및 개선 방안 (Ergonomic evaluation and improving measures of tasksperformed in a general hospital)

  • 기도형;송영웅
    • 한국산업보건학회지
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    • 제16권2호
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    • pp.161-171
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    • 2006
  • The objectives of this study were to ergonomically evaluate varying tasks performed in a general hospital and to propose their improving measures based on the evaluation results. The tasks found in the hospital were largely classified into two groups of manual materials handling and awkward posture related tasks. Ergonomic tools of NLE, 3-D SSPP and RULA were used for evaluating workload of the tasks. The major findings are: 1) L5/S1 compressive force of patient transferring by one person exceeded the maximum permissible limit(6,400N) by NIOSH. The L5/S1 compressive forces for most of the patient transferring tasks by 2-4 persons were larger than the action limit (3,400N), and the tasks by five persons were analyzed to be safe in the view of L5/S1 compressive force; 2) patient repositioning tasks by 2-3 persons were hazardous on the basis of L5/S1 compressive force, while most of the tasks by 4-5 persons were safe; 3) many tasks performed in wards were found to be stressful, most of which resulted from improper heights of their working tables or working points. Of varying tasks in general hospitals, patient transferring was the most stressful. Based on the results of this study and high prevalence of musculoskeletal disorders from other studies, it is recommended that the ergonomics program be introduced and enforced for doing improving activities systematically

댄디워커증후군에 동반된 점막 밑 입천장갈림증 치험례 (Dandy-Walker Syndrome with Submucous Cleft Palate: A Case Report)

  • 강범식;나영천
    • 대한두개안면성형외과학회지
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    • 제13권1호
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    • pp.54-56
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    • 2012
  • Purpose: Dandy-Walker syndrome is a rare congenital brain malformation that occurs one in every 25,000-35,000 live births, mostly in females. It is characterized by cystic enlargement of the fourth ventricle, agenesis or hypogenesis of the cerebellar vermis and enlargement of the posterior fossa. In this report, the authors aimed to address a rare case of a 14-months-old female Dandy-Walker syndrome patient that is presented with submucous cleft palate. Methods: A 14-months-old female patient admitted to our outpatient clinic, via the department of pediatrics, with the complaints of nasal regurgitation, choking and breathing difficulties. She was diagnosed as Dandy-Walker syndrome by magnetic resonance imaging evaluation, at another hospital and underwent a shunt operation for the hydrocephalus continuing treatments. On physical examination, she had structural abnormality of bifid uvula, and palpable notch in the posterior surface of the hard palate. Her submucous cleft palate was corrected, which used a double opposing Z-plasty under general anesthesia. Results: In a follow-up period of 2 months, no complications, such as wound dehiscence, necrosis and infection occurred, which shows satisfactory results. She consulted with pediatric neurologists and physical therapists for further evaluation and management of the abnormalities in the central nervous system. Conclusion: Dandy-Walker syndrome patient with a cleft palate is a very rare case to find, which only a few cases are reported around the world. Authors would like to share this case of Dandy-Walker syndrome patient, with submucous cleft palate, who underwent a double opposing Z-plasty that shows satisfactory results.

의료기관인증제도의 국내외 비교 연구 -한국, 미국 및 호주 중심으로- (A Comparative Study on National and International Hospital Accreditation Systems Focusing on Korea, the U.S., and Australia)

  • 유선주;김묘경;김유미;최윤경
    • 융합정보논문지
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    • 제7권4호
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    • pp.27-38
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    • 2017
  • 본 연구는 국내 의료기관인증제도와 미국과 호주의 의료기관인증제도 및 국제의료질향상학회의 국제인증프로그램에 대해 비교 고찰함으로써 우리나라 의료기관인증제도의 발전을 위한 시사점을 제시하고자 시도되었다. 본 연구에서 도출된 시사점은 다음과 같다. 첫째, 환자 및 지역사회 중심의 관점 강화, 인력배치 기준 강화 등 의료기관 인증기준의 개선이 필요하다. 둘째, 의료기관인증제도를 통한 환자안전의 강화가 필요하다. 셋째, 의료기관인증제도와 임상질지표 및 환자경험평가 연계를 강화해야 한다. 넷째, 조사위원의 역량을 강화해야 한다. 다섯째, 중소병원의 인증제도 참여 활성화가 필요하다. 여섯째, 의료 질 평가 결과 공개의 강화가 요구된다. 본 연구 결과는 우리나라 의료기관인증제도의 개선을 위한 기초자료로 활용될 수 있을 것이다.

Clinical Results of the Arthroscopic "Multiple Pulled Suture" Technique for Large or Comminuted Bony Bankart Lesion

  • Lee, Byung-Ill;Kim, Byoung-Min;Kho, Duk-Hwan;Kim, Hyeung-June
    • Clinics in Shoulder and Elbow
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    • 제20권3호
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    • pp.138-146
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    • 2017
  • Background: Arthroscopic fixations for large and comminuted bony Bankart lesions are technically difficult. We developed an arthroscopic multiple pulled suture (MPS) technique to restore large and comminuted bony Bankart lesions. Methods: Ten patients (mean age, 49.8 years; range, 31-79 years) underwent bony Bankart repair using the illustrated MPS technique and were then followed for a mean of 27.3 months. A plain radiograph series and three-dimensional computed tomography scans were taken at the initial clinical evaluation and 3 months postoperatively. Outcome measurements included the American Shoulder and Elbow Surgeons (ASES) score, Rowe score, University of California at Los Angeles (UCLA) score, and subjective patient satisfaction, along with surgical complications. Results: Union of an osseous fragment with the glenoid rim was confirmed in all patients on a computed tomography scan 3 months after operation. The osseous fragment was restored to proper articular congruence and reduction. The affected shoulder was stable in nine of the 10 patients. One patient presented with a redislocation after a sports injury 3 years postoperatively. The ASES, Rowe, and UCLA scores improved at the final evaluation, and median patient satisfaction at the final follow-up was 9 of 10 points (range, 6-10 points). Conclusions: The arthroscopic MPS technique for bony Bankart lesions with large or comminuted osseous fragments was a relatively easy and safe method for stable fixation of the osseous fragment. Therefore, the arthroscopic MPS technique resulted in good restoration of stability with high patient satisfaction and low complication rates.

PNF을 이용한 엉덩관절 강화운동이 피부 결손을 동반한 개방성 정강뼈 골절 환자의 균형과 앉았다 일어서기, 보행에 미치는 영향 - 단일사례연구 - (The Effect of a Hip Joint Strengthening Exercise using PNF on Balance, Sit-to-Stand Movement, and Gait in a Tibia Fracture Patient with Skin Defects - A Single Case Study -)

  • 정두교;정이정
    • PNF and Movement
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    • 제16권3호
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    • pp.317-332
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    • 2018
  • Purpose: Patients with tibial fractures can have functional problems with balance and gait, as well as lower extremity muscle weakness. This case report aimed to describe the effect of hip joint strengthening exercises using proprioceptive neuromuscular facilitation (PNF) on balance and gait and lower limb function in a patient with tibia fracture. Methods: One patient diagnosed with tibial fracture was treated for seven weeks with the basic procedure, pattern, and technique of PNF for a hip joint strengthening exercise. Results: The results of pre- and post-intervention treatment showed improvements in physical function and structure in the clinical tests, including the manual strength test; the modified Ashworth scale; sensory evaluation; balance, sit-to-stand, and gait performance; and evaluation of lower limb function. Conclusion: Based on the results of this study, it is suggested that the use of theory-based proprioceptive neuromuscular stimulation for hip joint strengthening exercises positively affects patients' functional improvement in tibial fracture patients, and this may be used as a therapeutic exercise method for those with orthopedic problems in the lower extremities. One limitation of this study was that it was performed on only one tibia fracture patient, which makes it difficult to extend the treatment effects to all patients with this condition.

Trastuzumab으로 장기 생존한 진행성 위암 증례 1예 (A Case of Long Term Survival of Gastric Cancer on Trastuzumab Based Treatment)

  • 박지혜;이상길
    • Journal of Digestive Cancer Research
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    • 제3권1호
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    • pp.39-41
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    • 2015
  • HER2 양성인 진행성 위암에서 어떤 치료 약제를 선택하는가에 대하여는 진료지침이 정립되어 있지만, 그 유지기간에 대하여는 아직 정립된 진료 지침은 없다. 저자들은 진행성 위암 환자에서 36개월 동안 trastuzumab을 기반으로 한 항암화학 요법을 하여 유지하고 있는 사례를 문헌 고찰과 함께 보고하는 바이다.

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Evaluation of dental status using a questionnaire before administration of general anesthesia for the prevention of dental injuries

  • Kyungjin Lee;Seo-Yul Kim;Kyeong-Mee Park;Sujin Yang;Kee-Deog Kim;Wonse Park
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제23권1호
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    • pp.9-17
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    • 2023
  • Background: Dental evaluation and protection are important for preventing traumatic dental injuries when patients are under general anesthesia. The objective of the present study was to develop a questionnaire based on dentition-related risk factors that could serve as a valuable tool for dental evaluation and documentation. Methods: We developed a questionnaire for dental evaluation before administration of general anesthesia, investigated the association between patient-and-dentist responses and mouthguard fabrication, and assessed response agreement between 100 patients. Results: Protective mouthguards were fabricated for 27 patients who were identified as having a high risk of dental injury. There was a strong association between dentists' responses and mouthguard fabrication, depending on the general oral health status, use of ceramic prosthesis, presence of masticatory pain related to periodontal diseases, gingival edema, and implants (P < 0.05). Response agreement between patients and dentists for items related to dental pain, loss of dental pulp vitality, root canal therapy, dental trauma, aesthetic prosthesis, tooth mobility, and implant prosthesis was high (Cohen's kappa coefficient κ ≥ 0.6). Conclusions: A high agreement was observed between patient-dentist responses and a strong association with mouthguard fabrication for items pertaining to ceramic prosthesis, masticatory pain, and dental implants. Patients with a "yes" response to these items are recommended to undergo a dental evaluation and use a dental protective device while under general anesthesia.

가정간호사업 운용을 위한 정보전달체계 개발 I (가정간호 데이터베이스 구축과 뇌졸중 환자의 가정간호 전산개발) (Development of the Information Delivery System for the Home Nursing Service)

  • 박정호;김매자;홍경자;한경자;박성애;윤순녕;이인숙;조현;방경숙
    • 가정간호학회지
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    • 제4권
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    • pp.5-22
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    • 1997
  • The purpose of the study was to development an information delivery system for the home nursing service, to demonstrate and to evaluate the efficiency of it. The period of research conduct was from September 1996 to August 31, 1997. At the 1st stage to achieve the purpose, Firstly Assessment tool for the patients with cerebral vascular disease who have the first priority of HNS among the patients with various health problems at home was developed through literature review. Secondly, after identification of patient nursing problem by the home care nurse with the assessment tool, the patient's classification system developed by Park (1988) that was 128 nursing activities under 6 categories was used to identify the home care nurse's activities of the patient with CAV at home. The research team had several workshops with 5 clinical nurse experts to refine it. At last 110 nursing activities under 11 categories for the patients with CVA were derived. At the second stage, algorithms were developed to connect 110 nursing activities with the patient nursing problems identified by assessment tool. The computerizing process of the algorithms is as follows: These algorithms are realized with the computer program by use of the software engineering technique. The development is made by the prototyping method, which is the requirement analysis of the software specifications. The basic features of the usability, compatibility, adaptability and maintainability are taken into consideration. Particular emphasis is given to the efficient construction of the database. To enhance the database efficiency and to establish the structural cohesion, the data field is categorized with the weight of relevance to the particular disease. This approach permits the easy adaptability when numerous diseases are applied in the future. In paralleled with this, the expandability and maintainability is stressed through out the program development, which leads to the modular concept. However since the disease to be applied is increased in number as the project progress and since they are interrelated and coupled each other, the expand ability as well as maintainability should be considered with a big priority. Furthermore, since the system is to be synthesized with other medical systems in the future, these properties are very important. The prototype developed in this project is to be evaluated through the stage of system testing. There are various evaluation metrics such as cohesion, coupling and adaptability so on. But unfortunately, direct measurement of these metrics are very difficult, and accordingly, analytical and quantitative evaluations are almost impossible. Therefore, instead of the analytical evaluation, the experimental evaluation is to be applied through the test run by various users. This system testing will provide the viewpoint analysis of the user's level, and the detail and additional requirement specifications arising from user's real situation will be feedback into the system modeling. Also. the degree of freedom of the input and output will be improved, and the hardware limitation will be investigated. Upon the refining, the prototype system will be used as a design template. and will be used to develop the more extensive system. In detail. the relevant modules will be developed for the various diseases, and the module will be integrated by the macroscopic design process focusing on the inter modularity, generality of the database. and compatibility with other systems. The Home care Evaluation System is comprised of three main modules of : (1) General information on a patient, (2) General health status of a patient, and (3) Cerebrovascular disease patient. The general health status module has five sub modules of physical measurement, vitality, nursing, pharmaceutical description and emotional/cognition ability. The CVA patient module is divided into ten sub modules such as subjective sense, consciousness, memory and language pattern so on. The typical sub modules are described in appendix 3.

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지식 구조화 경정맥 완전 영양공급 시스템의 개발에 관한 연구 (I) (A Study on the Knowledge-Based T.P.N. System (1))

  • 전계록;최삼길;변건식
    • 대한의용생체공학회:의공학회지
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    • 제11권2호
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    • pp.305-314
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    • 1990
  • In this paper we have implemented and tested TPN which is system to supply sufficent nutrition to nutritionally deficient patient by means of ES (expert system) a kind of A.1 (artificial intelligence) . This system affords to evaluation of nutritional state of patient which is essential to physi- cian. who performs TPN, decision of performing TPN and management of patient-data & calculation of information needing to making TPN fluid. The features were as follolv 1. we input data, take ideal weight of patient and 24hr's creatlnln In urine according to chart in system compare TSF (triceps skin fold), MAC (mid-arm circumference), AMC (arm muscle circumference) to 5th, 15th, 50th percentile and evaluate the nutritional state of patient. 2. Calculation of protein & nonprotein calorie needing to treament of patient can be made exactly by stress factor, activity factor and body temperature. 3. patient's personal recording needing to management of patient date name of chief doc- tor, name of department of admission, chart number, history can by taken very easily. 4. The way of system operating is pull-down Menu one, It can be processing very efficiently. 5. Date processing in system, we can manage memory volume of computer verlr efficiently using of dynamic allocation variables. 6. We can make it very easy to edit & revise the input data, processed data is saved to diskette in 2 files (TDF, THF) , these are semipermanent preservation.

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중증 치매환자복 형태에 따른 근육 부하 및 피로도 평가 (Evaluation of Muscle Load and Fatigue According to the Shape of Severe Dementia Patients' Clothing)

  • 박광애;양정은;정하영
    • 한국의류산업학회지
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    • 제25권2호
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    • pp.185-198
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    • 2023
  • The purpose of this study is to obtain information necessary for the development of patient clothes that can reduce physical fatigue of caregivers by quantitatively measuring the muscle load and fatigue. The patient clothes used in this study can be broken down into three types: A type (back center zipper open suit), B type (top-to bottom separated patient clothes), and C type (front zipper open suit). The EMG measurement sites are as follows: hand muscle (brachioradialis), upper arm (biceps, triceps), shoulder (anterior deltoid, medial deltoid, posterior deltoid, upper trapezius), and waist (erector spinae); additionally, the EMG signals were measured. Through this experiment, muscle load, muscle energy consumption, and muscle fatigue generation tendency were analyzed. The results of the study revealed that the C type patient clothes required the most strength in the muscles of the shoulders, upper arms, hands, and back when being put on and taken off compared to other patient clothes. The A type clothes required a relatively large force in opening the zipper. In terms of muscle energy consumption, B type generally called for more strength when it came to the zip-up and putarmsup motions. With regard to the cover the body and put legs/hips up motions, C type used the highest amount of muscle energy, whereas A type used relatively little energy. In terms of the occurrence of muscle fatigue during the putting on and taking off of the patient's clothing, there was a difference in the area and degree of muscle fatigue in the A, B, and C types, and there was also a tendency for muscle fatigue to occur when performing repetitive movements.