• 대한방사선기술학회지:방사선기술과학
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• 제44권6호
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• pp.599-605
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• 2021

The International Electrotechnical Commission (IEC) 62494-1 has defined the exposure index (EI) that have a proportional relationship with the dose incident on the image receptor, and target exposure index (EI_T), deviation index (DI). In this study, an appropriate EI_T for skull radiography was established through the diagnostic reference level (DRL) and changes in DI were confirmed. Entrance surface dose (ESD) and EI were obtained using the computed radiography system displayed the EI as per IEC on console and skull phantom by experiment based on the national average exposure conditions announced in 2012 and 2019. And appropriate EI_T was established by applying the DRL in 2012 and 2019. As a results, the EI_T is changed according to the change in the DRL, and the exposure condition that becomes the ideal DI according to the change in the EI_T also has a difference of about 1.41 times. DRL is recommended to optimize the patient dose, however it is difficult to measure in real time at medical institutions whereas EI and DI are displayed on the console at the same time as exposure. When the EI_T is set based on the DRL and the DI is closed to an ideal value, it is useful as a patient dose management tool. Therefore, when the EI_T is periodically managed along with the revision of the DRLs, the patient dose can be optimized through the EI, EI_T and DI.

• 한국병원경영학회지
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• 제7권1호
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• pp.105-120
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• 2002

In the United States, the prospective payment system(PPS), under which diagnosis related groups (DRGs) are used to reimburse hospitals for the care of Medicare patients since 1983, Study results showed that the PPS is having a major impact on the quantity of services especially of hospital length of stay. The PPS has increased the likelihood that a patient will be discharged home in an unstable condition and the use of nursing homes or long term care facilities increased. Still, it is insufficient to conclude that the PPS has decreased the Medicare total expenditure, but relatively sufficient to conclude that the quality of care hasn't changed. The maintenance of the quality resulted from the systemic "check-and-balance" composed of three factors; (1) The doctors are reimbursed based on the fee-for-service system, (2) hospitals contact with doctors under the attending system, and (3) there are some public hospitals. In Korea, the reimbursement for hospitals and doctors are not divided, the hospitals have doctors as employees, and 90% of hospitals are private. These differences may weaken the "check-and-balance" existing in the U.S. system. And there are few long term care facilities and the diagnostic coding system using in pilot test are not suitable for Korean situation. In conclusion, for successful implementation of the DRG payment system in Korea, the government should establish the "check-and-balance" system in the health sector to make sure the quality of care before the implementation.

• 전자공학회논문지SC
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• 제48권5호
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• pp.74-80
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• 2011

본 연구는 유통되는 이식형(implantable) 의료기기의 추적(tracking) 및 회수(recall) 처리를 신속하고 정확하게 수행할 수 있는 통합 전산 관리시스템 설계하는 것을 목적으로 한다. 이를 위해 최신 FDA 규정을 만족하는 시스템을 MSF/CD 설계방법론을 기반으로 설계하였다. 추적과 회수의 주요한 4가지 가상 시나리오를 설정하고 workflow diagram을 작성하여 개념설계하였다. 또한 business workflow를 만족하는 서버의 논리 DB를 개발하여 논리설계 단계까지 시스템을 설계하였다. 제안된 시스템으로 이식형 의료기기의 심각한 부작용 등 문제 발생 시 신속하고 정확한 추적과 회수 처리가 가능하여 이식형 의료기기를 장착한 환자의 생명유지 및 국민 건강 보호를 위한 정부 차원의 효율적인 관리가 가능할 것으로 사료된다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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• pp.19.1-19.7
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• 2015

Background: The purpose of this retrospective study was to investigate the usefulness of tracheostomy scoring system in the decision of postoperative airway management in oral cancer patients. Materials and methods: A total of 104 patients were reviewed in this retrospective study, who underwent radical resection with or without neck dissection and free flap reconstruction due to oral cancer. The patients were classified into three groups according to the timing of the extubation; extubated groups (n = 51), overnight intubation group (n = 45), and tracheostomy group (n = 8). Cameron's score was used to evaluate the relation between the state of the patient's airway and the type of the operation. Results: Tracheostomy was performed in eight patients (8/104, 7.7 %). A total of 22 patients (21.2 %) had more than 5 points of which 17 patients (77.3 %) did not have a tracheostomy and any postoperative emergency airway problems. The tracheostomy scores were significantly different among the three groups. Hospital stay showed a significant correlation with the tracheostomy score. Conclusions: The scoring system did not quite agree with the airway management of the authors' clinic; however, it can be one of the clinical factors predicting the degree of the postoperative airway obstruction and surgical aggressiveness for recovery. The further studies are needed for clinically more reliable scoring systems.

• 지역사회간호학회지
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• 제11권1호
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• pp.231-244
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• 2000

Parish nursing is a community health nursing role developed in 1983 by Lutheran Chaplain Granger Westberg. An increasing emphasis on holistic care, personal responsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The purpose of this study is to investigate what the korean parishioners want in parish nursing and what type of role expectation from parish nurse. The subjects were 1138 parishioners of 23 churches of various denominations in nationwide Korea. Data were collected by self-reported question naires from Feb 4 to June 25. 1999. The data were analyzed by using percentage. frequency. $x^2-test$. multiple Response set with SPSS program. The results are as follows: 1. Desired parish nursing contents by parish nurses are: psychological counselling(23.4%) out of private counselling. stress management(21.1 %) out of private health education. Emergency care(14.1%) out of group health education. Blood Pressure check-ups (19.0%) out of Health check ups. home visiting(44.9%) out of patient visiting method. B T. pulse, respiration and blood pressure check(15.0%) in Care to serve in home visiting. spiritual preparation to accept the death(41.7%) in hospice care, advices to choice of medical treatment using guide(50.1%) in introducing and guiding of health care facilities, pray(21.7%) in spiritual care' faith support. 2. Desired Health Teaching Content According to Period of Clients by Parish Nurse are: Vaccination(22.5%) in infant and toddler health management. sexual education(25.3%) in adolescent health management. prenatal care (29.5%) in pregnant health management. osteoporosis prevention and management (22.4%) in Middle aged health management. dementia prevention and management(25.5%) in elderly health management. 3. The expectant role from parish nurse is spiritual care faith support(14.1%). patient visiting care(13.2%), hospice care(12.9%), private counseling(12.8%), health check ups (11.1 %), volunteer organization and training out of believer(11.0%), private health education (9.3%), group health education (8.3%). 4. In Necessity of Performing Parish Nursing according to Region, Most(over 95%) responded that nursing program is needed. so there is no significance between regions. In Performing Parish Nursing in their church, Most(92.2%) responded they want to perform program. 5. In case of performing parish nursing, 52% out of the subjects responded they want to participated in parish nursing volunteer's activity, for example. to be in active to be a companion to chat(42.1%), necessity support (25.3%), donation support(25.0%), exercise support(18.2%), vehicles support (9.9%). As a result. in holistic care and spiritual care, the need of parish nursing and the role expectation from parish nurse are very high among korean believers. Therefore, I suggest parish nursing centering around Taegu and Kyungbuk province should be extended to nationwide. For extending parish nursing program. more active advertisement and research is needed. After performing parish nursing program through out the country, further comparative research between regions should be practiced and Korean parish nursing program will be developed and activated.

• 지역사회간호학회지
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• 제15권3호
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• pp.450-459
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• 2004

Purpose: The purpose of this study is to grasp the welfare service for the demented people staying at home and the service that caregivers want to use. Therefore, we are going to develop a Korean senile dementia-care management model. Method; It analyzed the data of 185 demented people and caregivers, who registered in 16 public dementia care centers in B city since June 2002. Results: 1) The types of services used by the aged people with dementia staying at home were, in the order of frequency of use, the day-care center(26.5%), and home-help service (21.6%). 2). The types of services according to the degree of dementia were as follows; mild cases: home care service (5.4%), moderate cases: day-care service (40.0%) and severe cases: day-care service (26.0%). 3). The caregivers who want to use senile welfare institutions accounted for 23.3%, and the major reason they could not use the institutions was due to their economic situation. 4) The Korean senile dementia care management system must be excuted, considering caregivers' economic state and severity of dementia. Since the system was actively operated, many small sized welfare service institutions showed development. Conclusion: The welfare services appropriate to the severity of dementia should be provided. With the model developed in this study, the dementia management requires sufficient care and should be achieved to reduce the caregivers burden.

• Journal of Trauma and Injury
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• 제36권3호
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• pp.224-230
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• 2023

Purpose: Patients with penetrating injuries are at a high risk of mortality, and many of them require emergency surgery. Proper triage and transfer of the patient to the emergency department (ED), where immediate definitive treatment is available, is key to improving survival. This study aimed to evaluate the epidemiology and outcomes of patients with penetrating torso injuries in Incheon Metropolitan City. Methods: Data from trauma patients between 2014 and 2018 (5 years) were extracted from the National Emergency Department Information System. In this study, patients with penetrating injuries to the torso (chest and abdomen) were selected, while those with superficial injuries were excluded. Results: Of 66,285 patients with penetrating trauma, 752 with injuries to the torso were enrolled in this study. In the study population, 345 patients (45.9%) were admitted to the ward or intensive care unit (ICU), 20 (2.7%) were transferred to other hospitals, and 10 (1.3%) died in the ED. Among the admitted patients, 173 (50.1%) underwent nonoperative management and 172 (49.9%) underwent operative management. There were no deaths in the nonoperative management group, but 10 patients (5.8%) died after operative management. The transferred patients showed a significantly longer time from injury to ED arrival, percentage of ICU admissions, and mortality. There were also significant differences in the percentage of operative management, ICU admissions, ED stay time, and mortality between hospitals. Conclusions: Proper triage guidelines need to be implemented so that patients with torso penetrating trauma in Incheon can be transferred directly to the regional trauma center for definitive treatment.

• 한국재난정보학회 논문집
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• 제14권1호
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• pp.28-35
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• 2018

본 연구에서는 재난현장 또는 일상에서 발생할 수 있는 다수사상자의 중증도 분류를 신속하고 정확하게 수행하기 위한 시스템을 설계하여 구현하였으며, 중증도 분류 알고리즘의 정확도뿐만 아니라 사용자 편의성 등 현장의 요구사항을 적극 반영하였다. 개발된 e-Triage System은 IoT개념을 활용하여 다양한 중증도 분류 알고리즘을 적용하였으며, 기존의 중증도 분류표의 단점을 극복하기 위하여 NFC 모듈 등 전자적 요소를 반영한 e-Triage Tag를 구현하였다. 앱으로 구현된 중증도 분류 알고리즘을 사용하여 신속하고 정확한 환자의 평가가 가능함을 입증하였고, 시인성을 위해 전자 중증도 분류 결과를 4가지 LED램프로 표출하였으며, 2차 분류를 통해 RTS 점수를 FND(Flexible Numeric Display)로 표출하였다.

• 한국인터넷방송통신학회논문지
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• 제10권2호
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• pp.167-172
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• 2010

최근 병원에서는 전반적으로 의료정보시스템의 전산화가 진행되고 있으며, 시스템 간에 효율적인 정보 교환을 위하여 HL7, DICOM 등의 의료 표준이 존재한다. 그러나 병원별로 이질적으로 구축된 시스템으로 인해 환자의 의료정보의 데이터 구조가 다르므로 서로 다른 병원 간에 정보를 공유하기 어렵다. 본 논문에서는 XML을 기반으로 하여 다양한 의료정보를 단일 구조로 결합하고, 병원마다 독립적으로 관리되고 있는 의료정보시스템을 일괄적으로 관리하는 통합의료정보 시스템을 제안하였다. 따라서 제안 시스템은 타 병원의 내부 시스템에 따라 별도의 구조를 고려하지 않는 효과적인 정보 공유가 가능하다. 이로 인하여 의료기관들은 환자들에게 시간과 비용의 절감과 함께 정확한 진료를 제공할 수 있게 된다.

• 한국직업건강간호학회지
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• 제12권1호
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• pp.31-38
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• 2003

This study is an attempt to analyze the physical load by the type of the nursing tasks at the neurosurgical ICU nurses through the quantitative analysis of the working postures by the type of the nursing tasks with the OWAS(Ovako Working Postures Analysis System). Data collection was conducted through the video recording of the 13 nurses working at the neurosurgical ICU. For the analysis of the work postures by the type of the nursing tasks, and were interviewed regarding the subjective degree of the difficulties with the work postures related to the tasks. Collected data was analyzed through the WinOWAS program. The results were as follows : AC3 or AC4 tasks among the 18 nursing tasks types are "occupied bed making and change of the patient gown", "back massage", "suction", "elimination management", "change of position", "adjustment of bed", "helping the patient to move","measurement of CVP"and "measurement of urine volume". It appears that these tasks are harmful to the musculoskeletal system and the improvement or change of the work is required. The results stated above indicate that improper working postures during the nursing tasks influence the musculoskeletal system. Therefore, making use of assistant devices for the improvement of the working environment at the nursing tasks, based on human technological diagnoses, is required regarding the duty types with massive work pressure known to be harmful to the musculoskeletal system among those performed by the nurses. And there is a need of the education about the employment and maintenance of the vocational back pain prevention.