• 제목/요약/키워드: Physician's work

검색결과 54건 처리시간 0.022초

일개 종합병원 간호사의 간호근무환경, 조직공정성이 직무만족에 미치는 영향 (Impact of Work Environment and Organizational Justice on Job Satisfaction among General Hospital Nurses)

  • 김세영;윤연옥;하영숙;김은정;송보경;송성민
    • 한국직업건강간호학회지
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    • 제32권4호
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    • pp.205-214
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    • 2023
  • Purpose: This study investigated the impact of nurse practice environment and organizational justice on nurses'job satisfaction. Methods: We identified the factors between nursing work environment and organizational justice to job satisfaction for 189 nurses working at a general hospital in city C. Data were collected from June 1st to 15th, 2023, and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple stepwise regression, using IBM/SPSS 27.0 for the Windows program. Results: The mean job satisfaction was 3.24±0.55 points on a 5-point scale. Multiple stepwise regression revealed that the factors affecting nurses'job satisfaction included nursing foundations for quality of care (β=.26, p=.005), staffing and resource adequacy (β=.40, p<.001), collegial nurse-physician relations (β=-.24, p=.007), and distributive justice(β =.27, p<.001).These variables explained 55.0% of job satisfaction. Conclusion: The research findings indicate that higher job satisfaction is associated with a better nurse practice environment and positive perceptions of organization justice. These findings indicate that it is necessary to enhance the nurse practice environment and improve organizational justice to enhance job satisfaction among nurses.

Telemedicine Software Application

  • UNGUREANU, Ovidiu Costica;POPESCU, Marius-Constantin;CIOBANU, Daniela;UNGUREANU, Elena;SARLA, Calin Gabriel;CIOBANU, Alina-Elena;TODINCA, Paul
    • International Journal of Computer Science & Network Security
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    • 제21권2호
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    • pp.171-180
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    • 2021
  • Currently, hospitals and medical practices have a large amount of unstructured information, gathered in time at each ward or practice by physicians in a wide range of medical branches. The data requires processing in order to be able to extract relevant information, which can be used to improve the medical system. It is useful for a physician to have access to a patient's entire medical history when he or she is in an emergency situation, as relevant information can be found about the patient's problems such as: allergies to various medications, personal history, or hereditary collateral conditions etc. If the information exists in a structured form, the detection of diseases based on specific symptoms is much easier, faster and with a higher degree of accuracy. Thus, physicians may investigate certain pathological profiles and conduct cohort clinical trials, including comparing the profile of a particular patient with other similar profiles that already have a confirmed diagnosis. Involving information technology in this field will change so the time which the physicians should spend in front of the computer into a much more beneficial one, providing them with the possibility for more interaction with the patient while listening to the patient's needs. The expert system, described in the paper, is an application for medical diagnostic of the most frequently met conditions, based on logical programming and on the theory of probabilities. The system rationale is a search item in the field basic knowledge on the condition. The web application described in the paper is implemented for the ward of pathological anatomy of a hospital in Romania. It aims to ease the healthcare staff's work, to create a connection of communication at one click between the necessary wards and to reduce the time lost with bureaucratic proceedings. The software (made in PHP programming language, by writing directly in the source code) is developed in order to ease the healthcare staff's activity, being created in a simpler and as elegant way as possible.

공공병원 의료 질 관리 전담자의 의료 질 향상 활동 경험연구 (Quality Improvement Nurses' Experiences of Working for Healthcare Quality in Public Hospitals)

  • 황정해;박성희;최윤경
    • 한국콘텐츠학회논문지
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    • 제17권10호
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    • pp.19-29
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    • 2017
  • 본 연구는 공공병원 질 관리 전담자들의 병원 진료부문과 전반적 질 향상 활동의 경험 탐색을 통해 공공병원 질 향상 활동 방안을 수립하고자 수행되었다. 공공병원의 질 관리 전담자 10명을 대상으로 질 향상 활동 경험에 대해 포커스 그룹 면담을 수행하였다. 질 향상 경험 면담을 통해 '진료 부문과 전반적 의료질 향상 활동에 대한 성공과 실패', '현재 질 향상 활동의 활성화 정도', '공공병원 질 향상 활동의 특성' 그리고 '향후 질 향상 활동의 활성화를 위해 필요한 것들'의 범주화를 통해, '공공병원 고유의 특성에 따른 질 향상 활동의 성공', '리더십과 역량강화를 통한 공공병원 질 향상 활동의 활성화', '공공병원의 지역 중점 병원의 역할 재정립'의 주제를 도출하였다. 공공병원 진료 부문의 질 향상 활동은 의사의 참여가 중요하며 이러한 의사참여를 이끌어내기 위해서는 의사의 질 향상 활동의 성공적 경험을 공유하고 질 향상 활동에 필요한 지식을 제공하여 질 향상 전문성과 자율성을 보장하는 지원들이 필요하다. 또한 공공병원의 질 관리 전담자는 국가 의료 질 향상을 위한 핵심위치에서 질 향상 활동의 견인역할을 하고 지역 의료기관간 협력적 소통을 통해 의료 질 향상 활동을 이끌어가야 한다.

한방물리요법 상대가치 산출과 급여 확대 시 재정부담 추계 (Measuring the resource-based relative value scale scores for physical therapies of traditional Korean medicine and estimating the insurer's expenditure in National Health Insurance)

  • 임병묵;신미숙;신병철;송윤경;송미연;신승우;김호준;이명종
    • 대한예방한의학회지
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    • 제14권2호
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    • pp.57-66
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    • 2010
  • Backgrounds : Since December 1, 2009, National Health Insurance began to reimburse for three physical therapies of Korean medicine. The extension of insurance coverage is demanded by Korean medicine societies. Objectives : This study aimed to measure the resource-based relative value scale (RBRVS) scores for thirty four physical therapies of Korean medicine and to estimate the insurer's expenditure for them in National Health Insurance. Methods : To measure the physician's work and the practice expense, the 'magnitude estimation method (MEM)' and the 'fully distributed cost - attributable cost method (FDC-ACM)' were applied respectively. We collected the frequency data of physical therapies from Korean medicine hospitals and clinics to estimate the total expenditure. Results : The resource-based relative value scale scores of physical therapies were measured from 23.44 to 160.66. Total insurer's expenditure was calculated to be 95.5 billion won as of 2009. Conclusions : Based on the result that showed minor increase of total expenditure, most physical therapies of Korean medicine need to be reimbursed in the National Health Insurance.

라몬 삼페드로: 존엄하게 죽을 권리를 찾아서 -알레한드로 아메나바르의 영화 <씨 인사이드> 를 중심으로- (Ramon Sampedro: Finding the Right to Die with Dignity - Focused on Alejandro Amenabar's Movie <Sea Inside>-)

  • 김동균
    • 문화기술의 융합
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    • 제10권2호
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    • pp.27-33
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    • 2024
  • 본 연구에서는 '조력존엄사'에 대한 부분을 살펴보며, 라몬이 소송을 통해서 아름답게 죽음을 맞이할 수 있는 권리는 자기에게 있다고 주장하는 모습에 대해 고찰하였다. 영화<씨 인사이드>의 주인공 라몬 삼페드로는 전신마비로 26년 이상을 침대에서 움직임도 없이 생활하고 있는 중증환자이다. 그가 할 수 있는 유일한 것은 가족들에게 말로 부탁하는 것이다. 라몬은 이러한 무가치한 삶을 더이상 지탱할 수 없기에 인간으로서 존엄하게 자신의 삶을 마치고 싶다는 열의로 '조력존엄사'를 추구하는 것이다. 라몬은 합법적인 틀안에서 조력존엄사를 허가받기 위해 소송을 제기하였지만 삶은 의무라는 이유로 기각당한다. 라몬은 결국 자신이 추구하고자 하는 조력존엄사를 자신의 친구들의 도움으로 행한다. 라몬은 자신의 죽음에 대한 과정을 기록으로 남기기 위해서 촬영을 위한 카메라를 설치하고, 조력존엄사에 사용하는 치사약인 청산가리를 소개하면서 담담하게 카메라 앞에서 청산가리를 흡입하면서 조용히 죽음을 맞이한다. 결국 라몬은 자신이 원했던 조력존엄사를 실행한 것이며 현재의 삶에서 해방된 것이다. 라몬이 비록 식물인간이나 임종을 앞둔 환자는 아니지만 자신의 결정으로 실행한 조력존엄사를 어느 누가 비난할 수 있겠는가. 우리는 라몬과 같은 중증환자들이 조력존엄사를 할 수 있도록 사회적인 공감을 얻어서 법제화할 수 있도록 노력해야 할 것이다.

부모의 관심이 많은 소아 정형외과 질환 (The common orthopedic problems in parent's concern)

  • 신동은;윤병호;정주환
    • Clinical and Experimental Pediatrics
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    • 제51권2호
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    • pp.122-128
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    • 2008
  • Roughly one third of medical problems in children are related to the musculoskeletal system. Most of these problems are common and can be precisely diagnosed. For these problems, nonoperative treatment or reassurance can be given by the pediatrician. Occasionally, a problem needs surgical treatment, but a precise diagnosis must be made. There is little agreement about what types of orthopedic problems a primary care pediatrician should understand in order to effectively care for children. Many pediatric residencies lack an organized teaching curriculum that effectively covers these topics or that includes a required pediatric orthopedic rotation. In this article the authors delineate pediatric orthopedic problems that require recognition and urgent surgical treatment and are relatively common, but have different treatment options (observation, conservative treatment, and surgery) depending on their natural history. Whenever possible, the diagnosis should be made before a decision to refer is made. An accurate diagnosis allows the pediatrician to discuss the natural history of the condition properly. Referral to the wrong specialty can needlessly generate expensive tests and further delay in treatment or generate inappropriate treatment. The parents can be reassured rather than waiting to hear the same information from another physician. In particular, orthopedic problems are known to generate pressure from the parents to seek specialty consultation for reassurance. It is important to communicate to the specialist that the reason for the referral is for parental reassurance rather than for further work-up or treatment. After a proper diagnosis, communication directly between the pediatrician and the appropriate specialist can often avoid an unnecessary referral, and avoid unnecessary tests. The authors reviewed our experience at our outpatient clinic over last 1 year and found that it is useful to classify conditions as common or uncommon, and whether they require surgical or nonsurgical treatment. Many conditions fall in between. The following is a discussion of some of these more important or common conditions.

의원 자율인증제에 대한 개원의사 태도 및 관련 특성 분석 (Physicians' Attitude towards Accreditation of Ambulatory Health Care Organization and Related Characteristics)

  • 김민지;신의철;박성희;김지윤
    • 한국의료질향상학회지
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    • 제19권2호
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    • pp.36-46
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    • 2013
  • Objectives: The purpose of this study is to find a way to effectively introduce accreditation for ambulatory health care organization by identifying the physicians' attitude for accreditation and characteristics that affect thei r attitude. Methods: A web survey was conducted from February 15 to March 4, 2011 for 183 physicians who work in ambulatory health care organizations throughout the nation. Self-reported questionnaire was used for this study. SPSS WIN(version 12.0) was utilized for statistical analysis. Results: Physician's attitude towards accreditation for ambulatory health care organization was positive(25.7%), moderate(39.3%), and negative(35.0%). Clinics that practice as a group or which treat more patients per day showed more positive attitude(p<0.05). The result of ordinal regression analysis indicates the groups with daily patients over 100 showed 36.3 times more positive attitude than the one under 75(p<0.05). Conclusion: The accreditation for ambulatory health care organization has not been throughly discussed yet. Many physicians did not have knowledge about accreditation. Clinics that see more patients per day had more positive attitude for accreditation. It indicates the cost may play important role in voluntary participation in accreditation.

직업성 피부질환에 대한 현황 파악 및 관리 대책 수립을 위한 연구 (A Study on the Establishment of Management Methods about Occupational Dermatoses)

  • 임현술;정해관;최병순;김지용;성열오;김양호
    • Journal of Preventive Medicine and Public Health
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    • 제29권3호
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    • pp.617-637
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    • 1996
  • Occupational dermatosis is one of the most prevalent occupational disorders. However, the extent of the occupational dermatoses including incidences and prevalencies of each disease entity, and etiologic materials are not yet welt stated in Korea. Authors reviewed the literatures on the statistic data and reports on the occupational dermatoses, and surveyed on the occupational dermatoses in two factories, and surveyed the physicians responsible to the occupational dermatoses with formed questionnaire. The results are as follows; 1. Among medical journals published since 1964, there were 31 articles on the occupational dermatoses. Of 31 articles, 18 were case reports and all others were review articles. Of 18 case reports, 9 were epidemiologic survey. The Workers' Periodic Health Examinations revealed that prevalence of the occupational dermatoses was highest(4.36 per 10,000 workers) in 1974, but number of the cases reported were decreased sharply since 1978 with some tendency to increase since 1981. There were 2,240 reported cases of occupational dermatoses between 1966 and 1992, which is 1.90% of all the reported occupational diseases. Skin infection and injuries due to chemicals were most frequent and there were 6 cases of skin cancer. 2. In an epidemiological survey on the dermatoses among 995 workers in a metal product manufacturing factory and 225 workers in a coal chemical factory, there were 794 with dermatomycosis, 296 workers with acne, 130 workers with scar, 123 workers with deformity of toe nails. Scars, photosensitivity dermatitis, deformity of finger and toe nails, and acne were more prevalent in the metal product manufacturing factory(p<0.05). In the metal prouct manufacturing factory, workers treating organic solvents and oils had more dermatoses than those without treating the materials(p<0.05). On the skin patch performed on 16 workers in the metal product manufacturing factory, there were 8 cases of irritation dermatitis and 5 cases of contact dermatitis. Prevalence of contact dermatitis in the metal product manufacturing factory was 1.3%. 3. On the questionnaire survey, 34 dermatologists, 29 doctors of preventive medicine, and 22 family physician replied. The proportion of occupational etiology among all dermatoses assumed by the physicians were below 9%, and the most important occupational dermatosis in Korea was contact dermatitis. Main etiologic materials related to the occupational dermatosis were organic solvent, acid and alkali, and metals. The reason for the scarcity of report of occupational dermatoses were difficulty in diagnosis and physician's ignorance of the occupational etiology. They replied that to prevent the occupational dermatoses in the workplace, the use of protective devices was most important, and development of diagnostic criteria on the occupational dermatoses is urgent. Above results shows us that there is many workers with occupational dermatoses, but they are mostly unreported. Measures to prevent and manage the occupational dermatoses are not satisfactory at present. Hence, authors suggest measures for the precise diagnosis, report and prevention of the occupational dermatoses. a. Dermatologist, preventive physician, and industrial hygienist should work as a team to examine the high risk group and establish the preventive measures. b. Disease entities, diagnostic criteria of occupational dermatoses should be listed, criteria for the compensation and job fitting at recruitment should be established, and manual for the proper treatment and effective prevention of each occupational dermatosis should be developed. c. Patch test antigens against each occupational category should be developed and it should be available to any physicians responsible. d. To facilitate the diagnosis of occupational dermatoses by the doctors responsible for the Workersr Periodic Health Examination, development of standardized questionnaire, education on the techniques of the patch test, and cooperation with the dermatologist in diagnosis of occupational dermatoses is essential.

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호스피스.완화의료 표준교육 프로그램 시범교육의 효과 (The Effects of the Pilot Program in Standard Curriculum of Hospice and Palliative Care Education)

  • 강진아;유양숙;박진노;김원철;남은정;고수진;이영선;허정식;최성은;김정이;신동욱
    • Journal of Hospice and Palliative Care
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    • 제11권4호
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    • pp.206-212
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    • 2008
  • 목적: 호스피스 완화의료 전문인력을 위한 기본단계 교육과정으로 개발된 표준교육 프로그램 시범교육의 결과를 평가하기 위함 방법: 표준교육 프로그램을 개발하기 위하여 미국의 Education in Palliative and End-of-life Care (EPEC)교육을 벤치마킹하여 국내 실정에 맞게 수정 보완하였다. 표준교육 프로그램은 총 19개의 세부 주제로 구성하였으며, 강의와 쌍방향식 강의, 소그룹 토론, 역할극 등의 다양한 교육방법을 적용하도록 설계하였다. 개발한 표준교육 프로그램의 내용과 교육방법의 타당성을 검증하기 위하여 3개 주제를 선택하여 호스피스 고위과정을 수료한 23명을 대상으로 시범교육을 실시하였다. 결과: 표준교육 프로그램 시범교육 대상자들은 피교육자 중심의 교육방법과 현장에서 활용할 수 있는 교육 내용에 대하여 만족하였으며, 강의를 위주로 하는 기존의 교육보다 효과적인 교육이라고 평가하였다. 결론: 표준교육 프로그램 시범교육은 그 효과가 긍정적이었으며 호스피스 완화의료 교육의 표준화와 교육 방법의 발전에 기여할 것으로 기대된다. 앞으로 표준교육 프로그램을 성공적으로 실행하기 위해서는 교육자 (Trainer)를 위한 교육이 실행되어야한다.

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간호전달 체계 개선 방안 - 일 병동을 중심으로 - (Nursing Delivery System Improvement Plan in A Hospital)

  • 이진희;이승애;함용희;양명주;김옥선
    • 한국의료질향상학회지
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    • 제3권2호
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    • pp.52-59
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    • 1997
  • Background : In many Nursing Delivery System, Nursing Department at D Hospital had used to traditional nursing practice model what is called functional activities based system. It has a lot of merit that carried out specialized and rapid works but tend to ignore indivisual professional responsibility and task-based work assignments. In addition this system showed high turnover rates due to heavy workload, timesum of handing over duties, lack of support from peers and interstaff communication. So we performed conversion of Nursing Delivery System to My Patients Nursing Care System for providing comprehensive nursing to patient and reducing turnover rates and increasing job satisfaction to nurse. Method : 1. 1st step(96.4.9): Detected the problem of Nursing delivery System and estabilished improving planning 2. 2nd step(96.4.26): Visited other hospital on job training 3. 3th step(96.4.29): Discussed to premonitoring problem after conversion Nursing Delivery System and prepared structure 4. 4th step(96.5.6): My Patients Nursing Care System practical application 5. 5th step(96.7.20): Held complementary meeting 6. 6th step(96. 7): The other ward application 7. 7th step(96. 10): Extended application to whole wards Results: 1. Workload: (1) reduction(55.6%) (2) addition(44.4%) 2. Strong points after conversion: (1) decreased timesum of handing overduties (35.2%) (2) increased responsibility(33%) (3) broaden nurse's outlook to duties(14.8%) 3. Shortcoming after conversion: (1) understanding difficulties except my patient(57.8%) (2) weak teamwork(23.3%) (3) intensive stress to low grade nurse(12.2%) 4. Effective complemental way: (1) manpower(76.7%) (2) conversion of though (8.9%) (3) education(14.4%) 5. Patient's satisfaction: (1) satisfaction(64%) (2) no effect(36%) 6. Physician and peer's satisfaction: (1) satisfaction(12.5%) (2) dissatisfaction(21.6%) (3) no interest(44.3%) 7. Nurse's satisfaction: (1) satisfaction(74.7%) (2) dissatisfaction(5.5%) (3) unknown(20.5%) 8. Want to continued: (1) want(76.4%) (2) try to any other system(18%) Conclusion : Even though Nursing Delivery System conversion still has many problem, we gained more merits than traditional nursing delivery system. So we suggest that My Patients Nursing Care System should be encouraged for comprehensive nursing care and satisfaction to nurses.

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