• 대한간호학회지
• /
• 제16권1호
• /
• pp.67-80
• /
• 1986

The use of intravenous solutions for fluid replacement has become an integral part of patient care, This widespread use of intravenous solutions has increased the risk of contamination that can lead to septicemia and phlebitis. The literature regarding contamination of in use intravenous solutions recommends a standard 24-hour time limit on the use of these fluids. But the desings of these studies did not incorporate a time variable related to contamination. In other studies, however, time was a manipulated variable: but data regarding the onset of contamination were conflicting. Because published reports conflict with regard to a time standard related to the use of intravenous therapy, additional empirical data are needed upon which to base the standards of care regulating use of intravenous therapy. This study investigated rate of contamination in simulated in-use intravenous solutions to obtain data from which to recomend a standard time period for the administration of intravenous solutions. In this study samples were drawn from 60 bottles of 5% D/W solution at predetermined time intervals over 48 hours and samples were inoculated to Thio-glychollate Broth. After 10 days' culturing in that Broth, samples were cultured on blood agar plates for 18∼48 hours to determine the rate of contamination. was found at all time Period, regardless of the presence or absence of nurse's gloving in the preparation of fluids, the location in which the experimentations were performed, the contamination level of surrounding air, or the length of time during which solutions were opened. Data from this study support the use of a 48-hour time period on which to base the standard involved in ready-to-use simple intravenous solutions without additives. In emergency departments and critical care areas where intravenous solutions are prepared in advance, the suggested time standard supported by the data generated from this study is 48 hours, not 24 hour. Data from this study support a 24-hour time standard for changing in-use intravenous solutions when the contamination results from the manipulation of intravenous infusion system by hospital personnel, or from some other exogenous sources during administration. Because contamination that does occur within 48 hours in intravenous solutions must be introduced from some exogenous sources, further empirical studies based on the identification of sources of contamination and factors that affect the rate of contamination, are needed to investigate the currently employed standard of intravenous therapy and to provide the patient with more efficient and safer intravenous thereapy.

• 대한방사선기술학회지:방사선기술과학
• /
• 제40권1호
• /
• pp.63-70
• /
• 2017

본 연구는 세기변조방사선 치료기술을 이용한 성문암 환자에게 사용되는 두 가지 상이한 열가소성 고정기구 마스크로 인한 환자위치잡이 오차를 비교 평가하고 자 하였다. 치료가 종료된 총 16명의 성문암 환자를 두 그룹으로 나누었고(기존마스크 vs. 변형마스크), 평균, 3D오차, 시스템과 랜덤오차를 구하여 환자위치잡이 오차를 비교하였다. 또한, 치료계획종양체적(PTV)에 대한 여백(margin)을 분석하였다. 3D오차에 대하여 기존 그룹은 $5.2{\pm}1.3mm$고, 변형그룹은 $5.9{\pm}0.7mm$로써, 변형마스크가 변형보다 13.6% 높았다. 시스템오차는 기존그룹(변형그룹)에서 좌표 x, y, z방향은 각각 1.7 mm (1.1 mm), 1.0 mm (1.8 mm), 1.5 mm (2.0 mm)였고, 회전각(roll angle)은 $0.8^{\circ}$ ($0.8^{\circ}$)였다. 랜덤오차는 변형그룹이 기존그룹에 비하여 좌표 x, y, z방향으로 10.9%, 1.7%, 23.1%로 낮았으나, 회전각은 12.4% 높았다. PTV여백에서 변형그룹은 좌표 x방향에 대하여 기존그룹에 비하여 31.8% 낮았으나, 반대로 좌표 y와 z방향에서는 기존그룹보다 각각 52.6%와 21.6%로 높았다. 성문암 세기변조방사선치료에서 변형된 마스크 사용은 고정기구의 변형으로 인한 환자위치잡이 오차는 수치적으로는 영향을 줄 수 있지만, 다양한 관점에서 고정기구 마스크에 대한 연구가 임상적인 측면에서 연구가 필요할 것으로 사료된다.

• 의료법학
• /
• 제11권1호
• /
• pp.331-393
• /
• 2010

Psychiatrists who treat violent or potentially violent patients may be sue for failure to control aggressive outpatients and for the discharge of violent inpatients. Psychiatrists may be sued for failing to protect society from the violent acts of their patients if it was reasonable for the psychiatrists to have known or should have known about the patient's violent tendencies and if the psychiatrists could have done something that could have safeguarded in public. The courts of a number of jurisdictions have imposed a duty to protect the potential victims of a third party on persons or institutions with a special relationship to that party. In the landmark case of Tarasoff v Regents of University of California, the California Supreme Court held that the special relationship between a psychotherapist and a patient imposes on the therapist a duty to act reasonably to protect the foreseeable victims of the patient. Under Tarasoff, when a therapist has determined, or under applicable professional standards should determine, that a patient poses a serious threat of violence to another, he incurs an obligation to use reasonable care to protect the intended victim against such danger. In addition to a Tarasoff type of action based on a duty to warn or protect foreseeable victims of psychiatric outpatients, courts have also imposed liability on mental health care providers based on their custody of patients known to have violent propensities. The legal duty in such a case has been stated to be that where the course of treatment of a mental patient involves an exercise of "control" over him by a physician who knows or should know that the patient is likely to cause bodily harm to others, an independent duty arises from that relationship and falls on the physician to exercise that control with such reasonable care as to prevent harm to others at the hands of the patient. After going through a period of transition, from McIntosh, Thompson and Brady case, finally, the narrow rule of requiring a specific or foreseeable threat of violence against a specific or identifiable victim is the standard threshold or trigger element in the majority of states. Judgements on these kinds of cases are not enough yet in Korea, so that it may be too early to try find principles in these cases, however it is hardly wrong to read the same reasons of Tarasoff in the judgements of Korea district courts. To specific, whether a psychiatric institute was liable for violent behavior toward others depends upon the patients conditions, circumstances and the extent of the danger the patients poses to others; in short, the foreseeability of a specific or identifiable victim. In this context if a patient exhibit strong violent behavior toward others, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly attack others or unidentifiable victim. And the standard of conduct that is required to meet the obligation of "due care" is based on what the "reasonable practitioner" would do in like circumstances. The standard is not one of excellence or superior practice; it only requires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. All these principles have been established in cases of the U.S.A and Japan. In this article you can find the reasons which you can use for psychotherapist's liability for failure to protect third person in Korea as practitioner.

• 전자공학회논문지
• /
• 제51권10호
• /
• pp.128-136
• /
• 2014

온라인에서 공유 및 활용되고 있는 정보들이 기하급수적으로 생성되는 인터넷 정보 시대에서, 개별 의료기관의 환자 정보는 의료기관 고유의 데이터베이스 구성 및 환자 사생활 정보 보호 문제 등의 이유로 인해 병원들 간의 환자 데이터 공유가 원활히 이루어지지 않고 있다. 환자 사생활 정보를 보호하면서 각 의료기관 고유의 환자 정보를 의료기관들 간에 상호 공유하는 것은 의료 정보화를 위해 아직도 해결해야 할 과제로 남아있다. 본 논문에서는 환자 사생활 정보를 보호하면서 환자의 의료정보를 공유하기 위해서, 국내외 의료정보 공유 현황 및 관련 국제 의료정보 표준안을 고찰 및 국내 의료기관의 데모그래픽 데이터를 활용하기 위해 실제 국내 의료기관의 환자 데이터 구조 및 특성을 분석하고 의료 정보 공유 시스템 구조 설계를 제안하고자 한다.

• 한국콘텐츠학회논문지
• /
• 제14권10호
• /
• pp.10-19
• /
• 2014

최근 병원에서 수집되는 데이터를 전자적으로 저장, 관리 및 공유하기 위하여 병원정보시스템이 널리 활용되고 있다. 이러한 시스템들은 현대 병원들의 업무 효율성 제고에 크게 기여해왔으나, 건강관리 서비스 제공자들의 의사 결정을 지원하기 위해서는 수집된 환자 관련 데이터를 적절히 가공하고 재사용하는 것이 필요하다. 특히, 본 논문은 만성 질환과 관련된 외래진료과 운영관리를 위한 환자 플로우 모니터링을 제안하고, 이와 관련된 사항들에 대해 토의하고자 한다. 제안하는 시스템은 환자 이력 데이터에 프로세스 마이닝 기법을 적용하여 추출한 표준 프로세스 모형 및 여러 가지 평가 지표들을 시각화하며, 이를 통해 관리자들은 외래진료과의 운영을 평가하고 개선할 수 있다. 본 논문에서는 환자 플로우 모니터링 시스템을 류머티스 진료과에 적용하였으며, 아이패드 기기에 최적화된 프로토타입 시스템을 예시로 보이고자 한다.

• 대한간호학회지
• /
• 제46권1호
• /
• pp.39-49
• /
• 2016

Purpose: This study was done to develop a postural-stability patient transfer technique for care helpers in nursing homes and to evaluate its effectiveness. Methods: Four types of patient transfer techniques (Lifting towards the head board of the bed, turning to the lateral position, sitting upright on the bed, transferring from wheel chair to bed) were practiced in accordance with the following three methods; Care helpers habitually used transfer methods (Method 1), patient transfer methods according to care helper standard textbooks (Method 2), and a method developed by the author ensuring postural-stability (Method 3). The care helpers' muscle activity and four joint angles were measured. The collected data were analyzed using the program SPSS Statistic 21.0. To differentiate the muscle activity and joint angle, the Friedman test was executed and the post-hoc analysis was conducted using the Wilcoxon Signed Rank test. Results: Muscle activity was significantly lower during Method 3 compared to Methods 1 and 2. In addition, the joint angle was significantly lower for the knee and shoulder joint angle while performing Method 3 compared to Methods 1 and 2. Discussion: Findings indicate that using postural-stability patient transfer techniques can contribute to the prevention of musculoskeletal disease which care helpers suffer from due to physically demanding patient care in nursing homes.

• 한국응급구조학회지
• /
• 제28권1호
• /
• pp.97-112
• /
• 2024

Purpose: This study compared the relative importance of educational content, teaching methods, and evaluation methods in the patient assessment curricula of 119 emergency medical technicians (EMTs). Methods: First, we identified the educational content, training hours, and teaching and evaluation methods of the existing patient assessment curriculum based on the National Competency Standard learning module. Second, we surveyed 30 EMTs affiliated with 119 services using the Analytic Hierarchy Process (AHP) method. Subsequently, we compared the differences between the current curriculum and the AHP analysis results. Results: Currently in operation, the "Advanced EMT Course" comprises three learning modules: assessment of patient status, scene size-up and triage, and assessment using monitoring devices. Among these, content related to the assessment of patient status received the most allocated time and was deemed the most important according to the AHP survey results. Conversely, while less time was allocated to scene size and triage compared with assessment using monitoring devices, the former was assessed as more important than the latter in the AHP results. Furthermore, scenario-based team training and procedure-focused individual practice were evaluated as relatively important teaching methods, while practical examination using a checklist was deemed the most appropriate evaluation method for all learning content. Conclusion: To improve the patient assessment curriculum, we propose adjusting teaching hours and introducing new teaching and evaluation methods based on the results of relative importance. The proposed improvement plan will contribute to enhancing the competency of 119 EMTs.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제21권2호
• /
• pp.67-73
• /
• 2015

Purpose: This study examines areal composition of ward applying to 4 bedroom in provincial medical center. Methods: The existing five-bed patient rooms, general type of multiple-bed rooms in Korea causes many problems for the amenity of patients. We should reconsider their inconvenience carefully and try to provide the right to keep their privacy and enjoy amenity. The number of patients of multi-bed rooms is very critical point to improve the environmental condition of the patient rooms. This study separate 5 bedroom group and 4 bedroom group. Net area from space program was surveyed and analyzed. Results: The result of this study can be summarized into two points. The first one is that Group-4(4 bedroom) ward has more 23% patient's area and -23% convenience area than Group-5(5 bedroom). The second one is that Group-4 has more single bedroom and Group-5 has more dayroom. Implications: Consideration Should be taken into account for the effective bedroom composition and allocation in ward. This Study hopefully may serve as a stepping stone for the standard design of space program in ward.

• 한국응급구조학회지
• /
• 제13권1호
• /
• pp.73-85
• /
• 2009

Purpose : The purpose of this study was to analyze the nursing care needs which can properly cope with patients' needs in emergency room, and grasp the patients' satisfaction level which can assess the care quality. It was aimed to check the level of today's care and provide basic data for care performance and care standard. Method : Data were collected from 192 patients in general hospitals in Daegu. The results are as followed. Results : First, the result of analysis conducted on the degree of overall patients' need for nursing care revealed that the need for nursing information (4.21+57) was the highest, followed by the order of information of patient's condition (4.05+53), emotional support (3.98+47), and nursing participation (3.65+54). Secondly, our study revealed that there was a significant negative correlat interrelation between care need and care satisfaction (r=.516, p<.01), indicating the higher the overall emergency room patients' nursing care need, treatment and nursing information, patient's condition, emotional support and nursing participation were, the lower the actual feeling of their satisfaction turned out. Conclusion : The study shows that treatment and nursing related information is the most highly needed and the patients' satisfaction level relies on actual care participation.

• Journal of Nutrition and Health
• /
• 제33권4호
• /
• pp.464-476
• /
• 2000

The purpose of this study was to measure patient satisfaction with hosptial foodservices, and thereby identify areas for improvement and provides basic data for the introduction of total quality management into hospital foodservice in the Taegu·Kyungpook area. This survey was carried out on 676 hospitalized patients in 11 hospitals with over 200 beds to determine the quality satisfaction with foodservices. The subjects were 62.4% male and 37.6% female. Sixty-two percent of the subjects were over age 40, 46.7% were only educated to middle school or below, 41.8% were hospitalized for 1 - 10 days. Eighty-seven precent of the subjects did not receive any nutrition education. The expectation and perception grid showed that the high expectation to the low perception items were the seasoning of the meals, taste of the meals, and prompt dealings with meal complaints. The quality satisfaction values of all the attributes indicated a minus. The unsatisfied quality attributes were the opportunity to meet with a dietitian, seasoning of the meals, taste of the meals, explanation of the meals, and prompt dealings with meal complaints. Among the demographic characteristics, age, education, length of admission, and experience with nutrition education produced significant differences in the quality satisfaction scores. In conclusion, it would seem to be desirable that hospital foodservice department introduce selective menus, hygiene education for foodservice employees, standard recipes, quality assurance, and increase the meal rounding of dietitians in the patient foodservice.