• 제목/요약/키워드: Standard patient

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A Case Report of Hormone Receptor Positive and HER-2 Receptor Positive Metastatic Breast Cancer Stage IV Patient Treated with a Combination of Traditional Korean Medicine and Chemotherapy for 6 Years (호르몬 수용체 및 HER-2 수용체 양성 유방암 4기 다발성 전이 환자의 6년간의 한양방 병용치료 치험 1례)

  • Park, Kyeong Ju;Lee, A-ram;Kim, Sung su;Seong, Sin
    • Journal of Korean Traditional Oncology
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    • 제24권2호
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    • pp.13-21
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    • 2019
  • Objective : The purpose of this study is to report and observe effects of Traditional Korean Medicine (TKM) on stage IV metastatic breast cancer patient. Method : A right breast cancer patient diagnosed with metastatic lesions on liver, lung, spleen, multiple bones and skin on right breast April 2013. The patient received Herceptin + Docetaxel + Zometa from May 2013 and started to receive TKM since July 2013 to decrease side effects of chemotherapy. From December 2013 to November 2014, she had received Herceptin 18 times more. The clinical outcomes were measured by computed tomography, laboratory findings including tumor markers (CEA, CA15-3), liver function test (AST, ALT), and numeric rating scales (NRS). Results : After 6 years of TKM treatment combined with standard chemotherapy, tumor size was partially decreased in lung, liver, right pleura and spleen. Levels of tumor markers also showed decrease. There were no severe adverse events induced by TKM based on National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE) version 4.0. Conclusion : This case suggests that TKM combined with standard chemotherapy could be a promising method for treating metastatic stage IV breast cancer.

Computerization of Nurse Staffing and Scheduling according to Patient Classification (환자분류에 의한 간호인력 산정 및 배치과정 전산화)

  • Park, Jung-Ho;Park, Hyeoun-Ae;Cho, Hyon;Choi, Yong-Sun
    • Journal of Korean Academy of Nursing
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    • 제26권2호
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    • pp.399-412
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    • 1996
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current nursing productivity of nurses is not desirable unless the quality of care considered. Moreover. nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. As for the nurse scheduling, the critical problem of it in the hospital is determining the day-to-day shift assignments for each nurse for the specified period in a way that satisfies the given requirements of the hospital. Nurse scheduling, however, involves many factors and requirements, manual scheduling requires much time and effort to produce an adequate schedule. Under these backgrounds, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. This study was performed to develop a system computerizing nurse staffing and scheduling based on the patient classification. As a preliminary step for the system development, nursing workload in a secondary hospital was measured from Sep. to Oct. 1994. On the grounds of this result, computerization of nurse staffing and scheduling was proceeded with three options. First one is based on the current medical law. Second one is based on the assigned number of nursing staff. And the last is based on the request by patient classification. Computer languages used in this study were MS Visual Basic 3.0 for the staffing and Access 2.0 for the scheduling, respectively. Prospective users may operate this system easily because icons and mouse are used for easier graphic user interface and reducing the need for typing efforts. This system can help nurse administrators manage nursing manpower efficiently and nurses develop quick and easy schedule generation and allow more time for the patient care.

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CDSS enabled PHR system for chronic disease patients (만성 질병환자를 위한 CDSS를 적용한 PHR 시스템)

  • Hussain, Maqbool;Khan, Wajahat Ali;Afzal, Muhammad;Ali, Taqdir;Lee, Sungyoung
    • Proceedings of the Korea Information Processing Society Conference
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    • 한국정보처리학회 2012년도 추계학술발표대회
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    • pp.1321-1322
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    • 2012
  • With the advance of Information Technology (IT) and dynamic requirements, diverse application services have been provided for end users. With huge volume of these services and information, users are required to acquire customized services that provide personalized information and decision at particular extent of time. The case is more appealing in healthcare, where patients wish to have access to their medical record where they have control and provided with recommendation on the medical information. PHR (Personal Health Record) is most prevailing initiative that gives secure access on patient record at anytime and anywhere. PHR should also incorporate decision support to help patients in self-management of their diseases. Available PHR system incorporates basic recommendations based on patient routine data. We have proposed decision support service called "Smart CDSS" that provides recommendations on PHR data for diabetic patients. Smart CDSS follows HL7 vMR (Virtual Medical Record) to help in integration with diverse application including PHR. PHR shares patient data with Smart CDSS through standard interfaces that pass through Adaptability Engine (AE). AE transforms the PHR CCR/CCD (Continuity of Care Record/Document) into standard HL7 vMR format. Smart CDSS produces recommendation on PHR datasets based on diabetic knowledge base represented in shareable HL7 Arden Syntax format. The Smart CDSS service is deployed on public cloud over MS Azure environment and PHR is maintaining on private cloud. The system has been evaluated for recommendation for 100 diabetic patients from Saint's Mary Hospital. The recommendations were compared with physicians' guidelines which complement the self-management of the patient.

Patient Safety Culture, Perception of Importance on Patient Safety Management, and Patient Safety Management Activities of Care Workers in Nursing Homes: Mixed-method Approach (노인요양시설 요양보호사의 환자안전문화, 환자안전관리 중요성 인식 및 환자안전관리활동: 혼합연구방법 적용)

  • Kim, Soon Ock;Kim, Jeong Ah
    • Journal of Korean Public Health Nursing
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    • 제34권3호
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    • pp.473-489
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    • 2020
  • Purpose: This study investigated the patient safety culture (PSC), the perception of importance on patient safety management (PIPSM) and the patient safety management activities (PSMA) of care workers in nursing homes. This was a descriptive study that attempted to provide basic data for the patient safety education program of care workers. Methods: Data were collected using questionnaires and interviews from July 1 to 31 in 2020. One hundred and seventy-four care workers participated in quantitative research. The collected data were analyzed by the SPSS/WIN 25.0 program using descriptive statistics, t-test, ANOVA, Bonferroni, and Pearson's correlation. The qualitative data were collected through semi-structured, audio-recorded interviews with six representatives and six care workers from six nursing homes. Content analysis was performed to analyze the data. Results: Positive correlations were observed between PSC and PIPSM, and between PIPSM and PIPSM. Care workers' experience in patient safety management was in the following six categories: "Safety accident risk factors", "Type of safety accidents", "How to prevent safety accidents", "Effective safety management education", "Emphasis on occupational ethics of care workers", and "Needs for standard protocol" Conclusion: These findings indicate that considering the care workers' age and facility size, nurses should enhance patient safety education for care workers and establish a management activity system.

The Impact of Doctors' Communication Styles on Patient Satisfaction: Empirical Examination (의사의 커뮤니케이션 스타일이 환자만족에 미치는 영향에 관한 연구)

  • Seo, Pan-Soo
    • Korea Journal of Hospital Management
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    • 제7권4호
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    • pp.57-101
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    • 2002
  • These days, the environment of hospital marketing is changing rapidly. The level of expectation and demand of patients have become greater and more diversified, and patients have more alternatives in selecting hospitals. The standard of hospital selection and the type of using hospital have been changed, and competition among hospitals has been accelerated due to the opening of the medical market through globalization. Accordingly, differentiation strategies are critical in hospital marketing. The quality of medical service oriented toward patient satisfaction becomes a strong strategic weapon to secure a hospital's competitive advantage. Therefore, marketing and communication strategies should be focused on patient-oriented, rather than hospital-oriented. Considering the changes in the hospital environment and the increase in the patients' expectation level, this study categorizes doctors' communication styles into four different ones: trust-type, professional-type, cooperation-type, and control-type. The effects of these communication styles on patient satisfaction were empirically examined. The moderating roles of the patient's characteristics and clinical characteristics between the doctors' communication styles and patient satisfaction were also investigated to find out managerial implications for hospital management. To achieve such goals, data were collected from patients of 12 general hospitals in Busan. The data were analyzed to test research hypotheses that examine 1) the relationships between doctors' communication styles and patient satisfaction, 2) the moderating roles of the patient characteristics and clinical characteristics in the research model, and 3) the impact of patient satisfaction on positive word-of-mouth and repurchase. The following summarizes the major results of this research. First, the data showed that patient satisfaction varied across doctors' communication styles. Trust-type style had the strongest impact on patient satisfaction while control-type style had the weakest influence on patient satisfaction. Professional-type style and cooperation-type style also had positive effects on patient satisfaction but the impact of the two are not statistically different. Second, significant differences in terms of patient satisfaction were found depending upon demographic variables such as gender, marital status, age, occupation, and education. Patient satisfaction, however, was consistent across varying income groups. Third, patients' medical insurance types were also related to patient satisfaction. It implies that a doctor may need to use different communication styles depending on a patient's medical insurance type. Fourth, out-patient and in-patient showed a different level of satisfaction with varying communication styles. Fifth, highly professional knowledge and strong control can influence patient satisfaction depending on the characteristics of the patient treatment field. Sixth, patient satisfaction were proved to have significantly positive effects on word-of-mouth and repurchase. The implications drawn from this study must be tempered by its limitations. First of all, the subjects used in this study were patients in Busan and small- and medium-size hospitals were excluded from the research. Therefore, future research should examine the research model by using a variety of hospitals and clinics throughout Korea. Another research agenda has to do with finding more determinant and moderating variables which will increase an explanatory power of the model. In short, this study may be the first empirical research that investigates the effects of doctors' communication styles on patient satisfaction. Interestingly enough, the results showed that each communication style had a unique impact on patient satisfaction. The findings from this research can be very useful in developing hospital marketing strategies.

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Development of the Nursing Database for Gastric Cancer Patients (위암환자를 위한 간호 데이터베이스 개발)

  • Jung, Kwuy-Im;Lee, Byung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • 제7권3호
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    • pp.571-588
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    • 2001
  • Purpose : This study was to develop the nursing database for gastric cancer patients for clinical application. Method : Nursing data that development of this data base is comprehensive connected with gastric cancer patient nursing process frame to foundation as classification. Result : Each stage was processed based on the System Development Life Cycle. At the Strategy Planning stage, gastric cancer patient nursing process were analyzed. At the system Analysis Stage, database flowchart was drawn up based on frame of nursing process was drawn up. At the system Design Stage, a system was developed based on the flowchart and named the Nursing Database. The Nursing Database consisted of the patient's Basic Information, Patient's Nursing History, Discharge summary, Nursing Assessment, Nursing Diagnosis, Nursing Intervention/activity, Nursing Evaluation, Statics, Code Registration. Each element in flowchart was coded and made into a database. Nursing Assessment classified according to Gorden's Health Pattern Typology, and nursing diagnosis draws the standard 27 name of Hanguls and connected with nursing assessment. Nursing intervention and nursing activity draw 192 of thing that present in NIC, connected this with nursing assessment. Nursing evaluation is linked with nursing assessment, diagnosis and intervention by achievement availability of nursing goals. Conclusion : The biggest advantage of this database nursing process that can manage nursing information exactly and rapidly to foundation be.

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Torque Curves and Cardiovascular Response to Isometric Exercise at the Elbow Joint in Normal and Hemiplegic Subjects (정상인과 편마비 환자의 주관절 등척성 운동시 우력양상과 심혈관계에 미치는 영향)

  • Shin, Hyung-Soo;Hwang-Bo, Gak;Lim, Weon-Sik;Kim, Chung-Sun
    • The Journal of Korean Physical Therapy
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    • 제13권3호
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    • pp.537-549
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    • 2001
  • The isometric torque of the elbow flexor and extensor muscles were measured for 6 seconds at a joint angle of 90$^{\circ}$ , in 10 normal subjects (control group) and 10 hemiplegic subjects(patient group), using the Cybex NORMTM System. The peak torque, the time to peak torque were measured for each exercise. In addition, heart rate and blood pressure were recorded simultaneously at rest and immediately following exercise completion at 1 and 3m mutes. Statistical analysis was performed using SPSS 8.0 for Windows software and mean and standard deviations were calculated. The results are as follows. 1) In the patient involved group. the isometric values for flexors and extensors were significantly lower than in the normal nondominant group(p<.05). 2) The extensor to flexor strength ratio in the isometric mode was 121.0% in the patient involved group compared with 78.7%in the normal nondominant group, a significant difference(p<.05). 3) The mean increment ratio was increased 19.0% for systolic blood pressure and 25.2% for disatolic blood pressure in the patient group. 4) The mean increment ratio was increased 36.0% heart rate in the patient group.

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Implementation of ISO/IEEE 11073-10404 Monitoring System Based on U-Health Service (유헬스 서비스 기반의 ISO/IEEE 11073-10404 모니터링 시스템 구현)

  • Kim, Kyoung-Mok
    • Journal of Advanced Navigation Technology
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    • 제18권6호
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    • pp.625-632
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    • 2014
  • The u-health service is using portable device such as smart device and it consists of small computing device. The u-health service carry out same performance with desktop computer. We designed message structure based on Bluetooth HDP. This message structure is used to transmit patient's biometric data on the smart device of medical team, patient and family over the mobile network environment. ISO/IEEE 11073 PHD standard was defined based on the method of communication between the agent and the manager. And We are confirmed the reliable transmission of biometric data at the smart device by implementing the android OS based patient information monitoring application to check the status of patient for medical team, patient and family.

Effects of Perceived Patient Safety Culture on Safety Care Activities among Nurses in General Hospitals (지방 중소병원 간호사의 환자안전문화 인식이 안전간호활동에 미치는 영향)

  • Kim, Hye Young;Lee, Eun Sook
    • Journal of East-West Nursing Research
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    • 제19권1호
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    • pp.46-54
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    • 2013
  • Purpose: An objective of this study was to investigate nurses' perceptions toward patient safety culture and to examine the factors affecting safety care activities. Methods: The participants were 429 nurses, at 6 hospitals located in regions, which have 150 to 300 beds, and HSOPSC (AHRQ, 2009) and questionnaire on safety care activities were used as measurement tools. Descriptive statistics, independent t-test, one way ANOVA, and stepwise multiple regression with SPSS/WIN version12.0 were used to analyze the data. Results: Supervisor manager expectations and actions promoting patients safety and frequency of events reported were the highest as positive responses, whereas staffing and nonpunitive response to errors showed the lowest scores as positive responses. Scores of medication surveillance is the highest while firefighting surveillance is the lowest in terms of safety care activities. Significant predictors influencing safety care activities were frequency of events report, handoffs and transitions, work unit a patient safety grade, organizational learning-continuous improvement, and teamwork across units. These predictors account for 23% of the variance. Conclusion: These results suggest that hospital policies and systems should be built to settle patient safety culture effectively. Development of standard manuals for safety care activities is another critical element for promoting patient safety.

Study on Educational Needs of Patient Safety Nursing Activities in Intensive Care Units: Utilizing Importance-Performance Analysis (중환자실 간호사의 환자안전간호활동 교육요구도 조사 : IPA 활용)

  • Lee, Seung Hee;Park, Nam Hee
    • Journal of Korean Critical Care Nursing
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    • 제15권3호
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    • pp.1-11
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    • 2022
  • Purpose : The purpose of this study was to not only examine the importance and performance status of patient safety nursing activities in the intensive care unit but also to understand nurses' educational needs in this respect. Methods : In this descriptive study, 196 nurses working in the intensive care units of university hospitals located at B City and G Province were enrolled. They completed the Importance-Performance Analysis (IPA) questionnaire, and the data were statistically analyzed. Results : Mean±standard deviation item scores of importance and performance of patient safety nursing activities were 4.75±0.33 and 4.48±0.38, respectively. In the IPA results, a total of 10 items were included in the second quadrant, including 1 item related to 'transfer,' 1 to 'infection,' and 1 to 'firefighting surveillance.' As the second quadrant contains the high-importance, low-performance items, these 10 items resemble the nurses' educational needs that should be prioritized. Conclusion : The results of this study can be used as a basis for the development of nursing educational programs for patient safety in the intensive care unit.