• Quality Improvement in Health Care
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• v.27 no.2
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• pp.18-29
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• 2021

Purpose: Patients with hematologic malignancy (HM) typically have a high mortality rate when their condition deteriorates. The chronic progressive course of the disease makes it difficult to assess the effect of intervention on acute events. We investigated the effectiveness of a rapid response team (RRT) on in-hospital mortality in patients with HM. Methods: We retrospectively analyzed the data of patients with HM who admitted to the medical intensive care unit between 2006 and 2015. Clinical outcomes before and after RRT implementation were evaluated. Results: A total of 228 patients in the pre-RRT period and 781 patients in the post-RRT period were included. The overall in-hospital mortality was 55.4%. Patients in the post-RRT period had improved survival; however, they required more vasopressor therapy, continuous renal replacement therapy, and extracorporeal membrane oxygenation. Multivariate analysis revealed that in-hospital mortality was associated with RRT activation (hazard ratio [HR], 0.634; 95% confidence interval [CI], 0.498-0.807; p < .001), neurological disease (HR, 2.007; 95% CI, 1.439-2.800; p < .001), sequential organ failure assessment score (HR, 1.085; 95% CI, 1.057-1.112; p < .001), need for continuous renal replacement therapy (HR, 1.608; 95% CI, 1.206-1.895; p< .001), mechanical ventilation (HR, 1.512; 95% CI, 1.206-1.895; p< .001), vasopressor (HR, 1.598; 95% CI, 1.105-2.311; p = .013), and extracorporeal membrane oxygenation (HR, 1.728; 95% CI, 1.105-2.311; p = .030). Conclusion: RRT activation may be associated with improved survival in patients with HM.

• Journal of Korean Biological Nursing Science
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• v.6 no.1
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• pp.33-42
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• 2004

Background : Intravenous(IV) access is becoming an increasingly important part of health care today. The current drive for clinical effectiveness and cost-effective health care serves to increase the need for reliable vascular access. Venous access devices were developed to overcome problems associated with limited peripheral access and frequent venipuncture in patients with long-term therapy. Although the peripherally inserted central catheter(PICC) have become popular during recent years in USA, its procedure is rare in Korea. Purpose : The goal of this study was to analyze the PICC inserted patient data by IV CNS intervention. Method : A Total of 62 PICCs were inserted into 51 patients by the IV CNS during a 10-month period form November, 14, 2002, to October 2, 2002. Data was obtained retrospectively through chart review. Result : The patient population included 34(54.8%) men and 28(45.2%) women, with a mean age 50.6 years. The main indication for PICC placement was to access vein in poor peripheral venous status(40.3%). The mean served interval for PICC insertions was 16.7 days(range, $2{\sim}61$ days). The reasons for removal were completed therapy in 18 cases(29.0%), patient death in 13 cases(21.0%), and mechanical or functional PICC problem in 10cases(16.1%). The three PICCs removed for presumed infection, and one had only positive tip cultures(0.2%). Conclusion : PICCs are rapidly growing popularity and required an extended course of IV therapy.

• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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• pp.83-93
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• 2010

Purpose: The purpose of this study is to determine potential differences in pre-hospital cases of cardiac arrest and drug Intoxication between elderly group and non-elderly group on local emergency activity sites of rescue 119 team for those cases, so that it can provide useful reference materials for a system of corresponding emergency medical services. Methods: Patients with cardiac arrest and drug intoxication in the elderly and the non-elderly group were analyzed by analyzing the Ambulance Run Report for 3 years from January 2007 to December 2009. Results: According to analysis on potential differences between elderly and the non-elderly group, it was found that there was no significant difference between elderly cases (evacuated to hospital due to cardiac arrest and drug poisoning) and non-elderly cases in year of onset (p = .247), quarter of onset (p = .813), sex (p = .235), consciousness state (p = .126), place of onset (p = .215) and number of first aid services (applied to emergency cases) respectively, but there were significant differences between elderly cases and non-elderly cases in guardian availability (p = .042), time zone of onset (p = .050), distance from the site of onset (p = .278), type of onset (p = .000), number of first aid services depending on distance of evacuation (p = .008) and effectiveness of emergency care (p = .003) on statistical basis. Conclusion: It is important to establish a system of early emergency case reports for rational emergency case management with lower mortality; shorten distance from the site of onset at each time zone of onset in emergency cases; employ more emergency team members; facilitate firsthand / secondhand medical instructions for emergency teams in specialized emergency care depending on distance of evacuation for each kind of onset (elderly group vs. non-elderly group); and improve rate of resuscitated emergency cases by extending the scope of works for emergency medical technicians into wider applications, so that it will be possible to take timely and appropriate measures for emergency settings of ever-increasing aged population in near future.

• Journal of Korean Institute of Industrial Engineers
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• v.32 no.4
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• pp.323-337
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• 2006

Samsung, recognized as a global leading company, has huge and complex supply chain structures and has been improving them continuously for its fast-growing global businesses. SCM 6 Sigma is the state-of-the-art methodology developed through a combination of SCM innovation concepts accumulated from SCM Business Group in Samsung SDS and 6 Sigma which has successfully settled down as the management innovation tool for many companies in Samsung. The ultimate goal of SCM 6 Sigma is to train and develop future supply chain leaders who are more capable of leading SCM innovations. By leveraging the established 6 Sigma Belt System, Samsung aims to alleviate a shortage of SCM talents that has been a bottleneck in improving SCM performances at its group companies. This explains why SCM 6 Sigma is created. SCM 6 Sigma is the unique and critical component for Samsung to implement its various strategies for continuous improvement of its operations at a higher level of effectiveness and systematically as well. In return on these efforts, many SCM innovation projects have been successfully executed through SCM 6 Sigma up to today. In this paper, we introduce the methodology and explain the business rationale behind it together with its deployment case.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.10
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• pp.7098-7108
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• 2015

This sturdy examined the effectiveness of Team-Based Learning(TBL) program according to learning attitude, learning motivation and self-directed learning of nursing students learning the anatomy. A 12week TBL program which they were made small group as 6-7 students aimed at anatomy aspects was given 145 freshmen. A triangulation that quantitative Research used paired t-test, Pearson Correlation Coefficient by SPSS WIN 18.0 and qualitative research was conducted content analysis. Through this subject, significant improvement was found in learning motivation(t=-2.97, p<.003) and self-directed learning(t=-2.40, p<.018). There was a significant positive correlation. TBL is useful teaching and learning method on nursing students. We suggest that it is needed to measure the educational effects of TBL against other subjects.

• The Journal of Korean Academic Society of Nursing Education
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• v.21 no.1
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• pp.119-128
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• 2015

Purpose: This study was conducted to evaluate the effectiveness of an evidence-based nursing (EBN) course using action learning-based team learning in undergraduate nursing students. Methods: A quasi-experimental pretest-posttest control group design was employed. The participants who consented were 45 second-year nursing students (22 in the experimental, 23 in the control group) from a university in G-city, Korea. The intervention included lectures, practicals, team activities and reflection on overviewing EBN, formulating clinical questions, searching the evidence, and criticizing the research articles. At the beginning and the end of the 7-week EBN course, the participants completed self-reported questionnaires. Frequencies, $x^2$-test, t-test, and ANCOVA with the SPSS program 18.0, were used to analyze the data. Results: The experimental group showed significantly higher scores on EBN competency (F=25.80, p<001), information literacy (F=13.75, p=.001), and proactivity in problem solving (F=5.32, p=.026) than the control group. Conclusion: This study provides evidence that an EBN course improves undergraduate nursing students' EBN competencies, information literacy, and proactivity in problem solving. Team learning in EBN education can be an effective teaching strategy.

• Journal of the Ergonomics Society of Korea
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• v.30 no.5
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• pp.651-657
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• 2011

Objective: The aim of this study is to investigate the system to integrate and manage the in-vehicle interactions between the drivers and the in-vehicle mobile IT devices. Background: As the mobile IT technology is being used anywhere, the drivers are interacting with the mobile IT device on driving situations. The distraction of the driver's attention causes the car accidents. It is necessary to develop the HVI(Human Vehicle Interface System) to integrate and manage the in-vehicle interactions with IT devices. Method: The HVI System is designed not as the interfacing subject but as the supervising system to monitor the driver's status and support the driver to concentrate on the primary tasks. The HVI system collects the status information of the car and driver and estimate the driving workload. Results: The HVI system controls how to provide the output information based on the driving workload. We implemented the HVI system prototype and applied in the real vehicle with the HVI cell phone and the HVI car navigation system. Conclusion: Depending on the driving situations, the HVI system prevented the information output in dangerous situation and diversified the modality and the intensity of the output information. Application: We will extend the HVI system to be connected the other various IT devices and verity the effectiveness of the system through various experiments.

• Quality Improvement in Health Care
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• v.18 no.1
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• pp.71-78
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• 2012

Background : The objective of this study was to examine the effect of management system for the appropriate prophylactic use of antibiotics in surgical patients at a tertiary hospital from 2007 to 2010. Methods : We collected clinical data of three different surgical procedures(colectomy, heart surgery, hysterectomy) for three months of 2007 and 2010, respectively. The number of total cases was 245(137, 54, 54) in 2007, 240(133, 42, 65) in 2010. We measured the rate of use of inappropriate prophylactic antibiotics, administration within 1 hour prior to the incision and the antibiotics prescription days after surgery. To evaluate the effectiveness of the management system, the results of the two groups(Group1=2007, Group2=2010) were compared by t-test, chi-square test or Fisher's exact test. Result : The rate of Aminoglycoside uses decreased drastically from 11.4% to 0.8%(P<.001). The selection of 3rd/4th Cephalosporin dropped from 11.8% to 5.8%(P=.020). The combination of antibiotics decreased from 27.8% to 11.7%(P<.001). The antibiotic prescription rate on discharge declined from 11.8% to 2.5%(P<.001) and the number of antibiotics prescription days after surgery was shortened from 4.2 days to 2.3 days(P<.001). No significant difference in the rate of administration within 1 hour between two groups was found. Through 3-year management, 5 out of 6 measures were significantly improved(except the administration within 1 hour). The rate of surgical site infection decreased from 2.4% to 1.3%(P=.504). Conclusion : The findings demonstrate that the management system for the prophylactic use of antibiotics in surgical patients was effective in decreasing the rate of surgical site infection during 3 years.

• Clinical and Experimental Emergency Medicine
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• v.5 no.4
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• pp.256-263
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• 2018

Objective We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. Methods This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. Results Most of the patient's physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. Conclusion The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a twotier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.

• Safety and Health at Work
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• v.15 no.1
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• pp.96-101
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• 2024

Background: Silicosis among workers who fabricate engineered stone products in micro or small-sized enterprises (MSEs) was reported from several countries. Workplace exposure data of these workers at high risk of exposure to respirable crystalline silica (RCS) dust are limited. Methods: We surveyed workers performing cutting, shaping and polishing tasks at 6 engineered stone fabricating MSEs in Sydney, Australia prior to regulatory intervention. Personal exposure to airborne RCS dust in 34 workers was measured, work practices were observed using a checklist and worker demography recorded. Results: Personal respirable dust measurements showed exposures above the Australian workplace exposure standard (WES) of 0.1 mg/m³ TWA-8 hours for RCS in 85% of workers who performed dry tasks and amongst 71% using water-fed tools. Dust exposure controls were inadequate with ineffective ventilation and inappropriate respiratory protection. All 34 workers sampled were identified as overseas-born migrants, mostly from three linguistic groups. Conclusions: Workplace exposure data from this survey showed that workers in engineered stone fabricating MSEs were exposed to RCS dust levels which may be associated with a high risk of developing silicosis. The survey findings were useful to inform a comprehensive regulatory intervention program involving diverse hazard communication tools and enforcing improved exposure controls. We conclude that modest occupational hygiene surveys in MSEs, with attention to workers' demographic factors can influence the effectiveness of intervention programs. Occupational health practitioners should address these potential determinants of hazardous exposures in their workplace surveys to prevent illness such as silicosis in vulnerable workers.