• 대한간호학회지
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• 제12권2호
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• pp.57-66
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• 1982

This study was undertaken to delineate the relationship between numerical score and the amount of nursing hours required in the nursing process. Score was a numerical description of the patients functional nursing needs. Therefore this study focused on standard nursing hours required by patient's self-care status. This study observed the 62 patients and 15 R.N. in H. university hospital from Aug. 7, 1982 to Aug. 13, 1982. 1. For the first time, each head nurse assessed self-care status by Schoening's self-care score-Minimal care patient (self-care score: 23, 24) was placed in Group Ⅰ, intermediate care patient (self-care score: 11∼22) was Group Ⅱ, and special care score: 0∼10) was Group Ⅲ. 2. We observed and recorded the nursing care received from nurses according to patient's group. (8AM∼4PM) 3. And, We observed and recorded the activities of nurses in order to determine standard nursing hours required. (8AM∼4PM) 4. If we apply the content of paragraph 3 to paragraph 2, we will predict the number of patient that nurse can care during day time by self-care status. The following results were obtained: 1) Patient's mean self-care score were Group I : 23.9 score Group Ⅱ：17.8 score Group Ⅲ : 1.6 score 2) Nursing hours required by patient's physical function(self-care status) status were Group I : 35 min. Group Ⅱ: 47.5 min. Group Ⅲ : 104.6 min. 3) Nurse's nursing time and distribution required in nursing activities during day duty were A.D.L. : 84.3min. (17.56％) Functional nursing activities : 279.9min. (58.31 ％) Education ＆ Emotional support : 11.3min. (2.35%) Task unrelated patients : 54min. (11.25%) Non Productive nursing care : 50. 5min. (10.52％) 4) Mean nursing hours required by each patient and the number of patient that nurse can rare during day duty by self-care status were Group I : 38.6min. 11.1 patients/1 nurse Group Ⅱ : 51.1min: 8.4 patients/1 nurse Group Ⅲ： 108.2min. 4 patients/1 nurse It seems reasonable that this could be done effectively as each-unit has an established standard for hours required, This not only allows time for planning of staff but helps to avoid the very human inclination to predict excessive staffing requirements by placing the majority of patients in high care group.

• 한국의료질향상학회지
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• 제19권1호
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• pp.16-26
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• 2013

Health information technology (HIT) is one of the most familiar tools to healthcare providers. It is used in routine practice to reduce cost, to improve clinical performance, and to improve patient safety. Patient safety is the driving force of recent expansion of HIT industry. But there are many evidences that it can be harmful to patient safety. Role of HIT and HIT-related error became big issues because more and more healthcare providers and healthcare organizations are willing to adopt it. Adoption rate of HIT in Korea is higher than that of United States. But researches of HIT regarding patient safety are rare. In this article, types of HIT, their mechanisms of improving patient safety and HIT-related errors were reviewed. Status of HIT in terms of patient safety in Korea was also reviewed. Knowledge of how HIT can improve patient safety, its' limitation, and how to make it safer is crucial to whom have to use it to improve patient safety. Impact of HIT on patient safety must be evaluated actively in Korea. HIT which was proven to improve patient safety must be widely adopted. Government must prepare a strategic plan to improve HIT quality, support hospitals financially and institutionally to introduce qualified HIT, and develop HIT infrastructures and standard designed for patient safety.

• Journal of Korean Neurosurgical Society
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• 제59권3호
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• pp.306-309
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• 2016

Using diffusion tensor tractography (DTT), we demonstrated injury of the arcuate fasciculus (AF) in the nondominant hemisphere in two patients who showed subfalcine herniation after intracerebral hemorrhage (ICH) in the dominant hemisphere. Two patients (patient 1 and patient 2) with ICH and six age-matched control patients who have ICH on the left corona radiata and basal ganglia without subfalcine herniation were recruited for this study. DTT was performed at one month after onset in patient 1 and patient 2. AFs of both hemispheres in both patients were disrupted between Wernicke's and Broca's areas. The fractional anisotropy value and tract numbers of the right AFs in both patients were found to be more than two standard deviations lower than those of control patients. In contrast, the apparent diffusion coefficient value was more than two standard deviations higher than those of control patients. Using the configuration and parameters of DTT, we confirmed injury of the AF in the nondominant hemisphere in two patients with subfalcine herniation following ICH in the dominant hemisphere. Therefore, DTT would be a useful tool for detection of underlying injury of the AF in the nondominant hemisphere in patients with subfalcine herniation.

• 산업기술연구
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• 제24권B호
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• pp.47-57
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• 2004

This study is aiming to obtain the pabulum of architectural planning about out-patient clinic department in armed force hospital with search. The discussion was about characteristic problems and differentiated planning characteristics of common general hospital, So the conclusion of research is as follows. In army medical facilities, Because of architectural standard of out-patient clinic department about scale of facilities and characteristic in each examination-part is unprepared, it may have to be readied. Out-patient clinic department was become plan to scale about whole 7~8% in hospital to SB hospital in 95 but was planed about 5% of whole scale from PS hospital in 97. When plan hospital, increase of equipment and increase of module size about bed for the convenience of patient or employees are judged for cause in hospital since 97 years than previous hospital in 95.

• Asian Pacific Journal of Cancer Prevention
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• 제14권12호
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• pp.7701-7706
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• 2013

Background: In a prospective cohort study of antiemetic therapy conducted in Malaysia, a total of 94 patients received low emetogenic chemotherapy (LEC) with or without granisetron injections as the primary prophylaxis for chemotherapy-induced nausea and vomiting (CINV). This study is a retrospective cost analysis of two antiemetic regimens from the payer perspective. Materials and Methods: This cost evaluation refers to 2011, the year in which the observation was conducted. Direct costs incurred by hospitals including the drug acquisition, materials and time spent for clinical activities from prescribing to dispensing of home medications were evaluated (MYR 1=$0.32 USD). As reported to be significantly different between two regimens (96.1% vs 81.0%; p=0.017), the complete response rate of acute emesis which was defined as a patient successfully treated without any emesis episode within 24 hours after LEC was used as the main indicator for effectiveness. Results: Antiemetic drug acquisition cost per patient was 40.7 times higher for the granisetron-based regimen than for the standard regimen (MYR 64.3 vs 1.58). When both the costs for materials and clinical activities were included, the total cost per patient was 8.68 times higher for the granisetron-based regimen (MYR 73.5 vs 8.47). Considering the complete response rates, the mean cost per successfully treated patient in granisetron group was 7.31 times higher (MYR 76.5 vs 10.5). The incremental cost-effectiveness ratio (ICER) with granisetron-based regimen, relative to the standard regimen, was MYR 430.7. It was found to be most sensitive to the change of antiemetic effects of granisetron-based regimen. Conclusions: While providing a better efficacy in acute emesis control, the low incidence of acute emesis and high ICER makes use of granisetron as primary prophylaxis in LEC controversial.

• 의료법학
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• 제8권2호
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• pp.167-193
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• 2007

Medical demand has been increased explosively since health insurance was introduced in 1977. Person has taken a growing interest in increase of medical service supply while that period. We must understand the legal aspects of medical quality management. There have been many legislative efforts for securing the right of patient. Patient's legal right is secured through the declaration of patient's right and all hospital person deal with patients according to the standard and criterion of the declaration of patient's right. The patient's right is set up on a basis of the right to live and the expectation right of patient. It is important to prevent medical accidents because the right of patient's health is violated by medical accident. We must manage well the medical quality to prevent the medical accident. The effort to escalate the medical quality is the best method to decrease the medical dispute. Nowadays a person take a growing interest medical quality. Our government make an effort to secure the medical quality through the legal system to be contained health organization evaluation system.

• 보건행정학회지
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• 제16권3호
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• pp.37-51
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• 2006

This study evaluates the reliability of the discharge status variable m health insurance claims for identifying in-hospital patient deaths. This study used 2002 national health insurance claims and the cause of death statistics from Korean national statistical office. The Study data set included acute myocardial infarction (AMI) and coronary artery bypass graft (CABG) surgery patients in 133 general and tertiary hospitals. The gold standard containing patient death information was made and then compared with that of claims data. The hospitals were classified into four groups based on the number of deaths in each hospital. Simple kappa coefficients were calculated to evaluate the agreements of patient deaths between the gold standard and the insurance claims. CABG (83.9%) showed higher agreements than AMI(73.0%) in matched in-hospital patient death information between data sets. Simple kappa coefficients of CABG (0.63) and AMI (0.59) showed moderate or good agreements. The agreements, however, varied depending on the disease or hospital types. The fact that the agreements are only moderate to good indicates that the accuracy of in-hospital death information in claims is not high. n the variable is used to identify patient deaths, it may mislead people. Therefore, efforts should be made to improve the reliability of the discharge status variable in health insurance claims.

• Investigative Magnetic Resonance Imaging
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• 제20권3호
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• pp.152-157
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• 2016

Purpose: Operating room management is the serious and complex task for hospital managers and the common approach is to develop relevant standard operational procedures. From patient and staff safety perspective, operating room management should be well-studied and hospital should identify and address any potential risks. Simultaneous usage of different imaging and less-invasive treatment technologies demands strong management control. Materials and Methods: We have formed the multidisciplinary expert panel (surgeons, anesthesiologists, radiologists, healthcare managers etc.) for hybrid theater management standard operational procedure development. On the first stage the general concept of hybrid room design and patient routing was developed. The second stage included the technical details discussion. For patient safety improvement we modified the Surgical Safety Check-list in accordance with potential MRI-related safety challenges and concerns. Results: WHO Surgical Safety Checklist is a simple and easy-to use tool which includes three blocks of question (grouped by the surgery process). We have developed two additional blocks of questions for the intraoperative magnetic resonance investigation. It is very important to have a special detailed routing with a strong control of ferromagnetic devices and anesthesiology care. Conclusion: High-energy MRI (1.5-3.0T) is characterized by potential influence on patient and staff safety in case of hybrid surgery. It is obvious to have a strong managerial control of ferromagnetic devices and anesthesiology care. Surgical Safety Checklist is the validated tool for improving patient safety. Modification and customization of this check-list potentially provides the opportunity for surgery processes improving.

• 의료법학
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• 제7권2호
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• pp.9-74
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• 2006

Due to the awareness of their rights for medical liability and the advancement of legal principles, it becomes also not hard to find those who seek damages against hospitals, doctors and nurses for the suicide committed under the protection of psychiatric institute in Korea these days. Judgements on these kinds of cases are not enough yet, so that it may be too early to try to find principles used in these cases, however it is hardly wrong to read following things from above cases. That is, to gain the case, plaintiffs should show (1) there exists an obligation of "due care"(there is a special relation between patients and hospitals), (2) the duty is violated on the basis of the applicable standard of care, (3) whatever injures or damages are sustained are proximately caused by the breach of duty and (4) the plaintiff suffers compensable damages. To specific, whether a psychiatric institute was liable for wrong death or not depends upon the patients conditions, circumstances and the extent of the danger the patients poses to himself or herself; in short, the foreseeability of self-inflicted harm(the doctor should have or could reasonably have foreseen the patient's suicide and the doctor's negligence actually caused the suicide). In this context if a patient exhibit strong suicidal tendencies, constant observation should be required. Negligence has been found not exist, however, when a patient abruptly and unexpectedly dashes from an attendant and jumps out a window or otherwise attempts to injure himself or herself. 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 re quires that the physician exercise that degree of skill and care that would be expected of the average qualified practitioner practicing under like circumstances. Most of these principles have been established at cases of the U.S.A and Japan. In this article you can also find the legal organizations of medical liability and medical contacts on the suicide of patients who have psychiatric diseases under Korean negligence law.

• Journal of Korean Neurosurgical Society
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• 제56권2호
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• pp.130-134
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• 2014

Objective : A groove technique for securing an electrode connector was described as an alternative surgical technique in deep brain stimulation (DBS) surgery to avoid electrode connector-related complications, such as skin erosion, infection, and migration. Methods : We retrospectively reviewed 109 patients undergoing one of two techniques; the standard technique (52 patients using 104 electrodes) and the groove technique (57 patients using 109 electrodes) for securing the electrode connector in DBS surgery, regardless of patient disease. In the standard percutaneous tunneling technique, the connector was placed on the vertex of the cranial surface. The other technique, so called the groove technique, created a groove (about 4 cm long, 8 mm wide) in the cranial bone at the posterior parietal area. Wound erosion and migration related to the connectors were compared between the two techniques. Results : The mean follow-up period was 73 months for the standard method and 46 months for the groove technique. Connector-related complications were observed in three patients with the groove technique and in seven patients with the standard technique. Wound erosion at the connector sites per electrode was one (0.9%) with the groove technique and six (5.8%) with the standard technique. This difference was statistically significant. The electrode connector was migrated in two patients with the groove technique and in one patient with the standard technique. Conclusions : The groove technique, which involves securing an electrode using a groove in the cranial bone at the posterior parietal area, offers an effective and safe method to avoid electrode connector-related complications during DBS surgery.