• 임상간호연구
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• 제25권2호
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• pp.120-132
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• 2019

Purpose: This study aimed to investigate the performance of patient engagement nursing services perceived by nurses and necessity in Korea. Methods: This study was a descriptive research. A total of 205 nurses participated in the study. The Smart Patient Engagement Assessment Checklist was developed by the investigators to assess patient engagement nursing services performance and necessity. The data were collected using online survey. Descriptive analysis and $x^2$ analysis were performed using SPSS 25.0 program. Results: The mean age of participants was $36.6{\pm}8.5years$ and the mean working experience was $12.92{\pm}9.23years$. Seventy eight percent of participants reported that patients and family participated in care as advisors through customer's suggestion or patient satisfaction assessment. The rate of patients' and family's engagement in care as advisors was significantly higher in tertiary hospitals ($x^2=28.54$, p<.001). About 89% of participants communicated with patients and family to make clinical decisions with a multidisciplinary approach. The rate of communication for multidisciplinary decision making was significantly higher in tertiary hospitals ($x^2=6.30$, p=.012). With regards to nurses' bedside patient handoff, 22.0% of participants reported that they were performing bedside patient handoff, and there was no significant difference between type of hospitals. About discharge planning, 72.2% of participants reported utilizing discharge checklist. Conclusion: Currently, patient engagement nursing services are applied partially in Korea. It seems that care protocols to be applied for patient engagement nursing services are insufficient. Therefore, patient engagement care protocols need to be developed to improve patient's health outcome and safety.

• 한국조경학회지
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• 제42권6호
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• pp.72-88
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• 2014

본 연구는 정신병원 옥외공간의 이용행태와 선호요인을 분석하기 위하여 실시하였다. 연구대상 정신병원은 250병상 이상의 병원 중 정원의 규모와 도입요소의 다양성을 고려하여 5개소를 선정하였다. 피험자는 경증의 정신분열증 환자로 한정하였으며, 5개의 병원에서 각각 30~50명씩을 주치의로부터 추천을 받아 선정하였다. 물리적 환경은 연구대상지를 직접 방문하여 공간구성요소를 중심으로 분석하였다. 설문조사방법은 환자의 인지능력을 고려하여 1:1 면접법을 선택하였으며, 분석에 사용된 설문매수는 총 230매이다. 연구결과는 다음과 같이 요약된다. 정원구성요소는 휴게시설, 조경시설, 산책/운동시설, 체험시설의 순으로 많았다. 옥외 산책/운동 프로그램은 단체산책과 자유산책으로 구분되는데, 대부분 단체산책을 실시하고 있다. 옥외공간은 매일 이용자가 대부분이지만, 거의 이용하지 않는 환자도 일정 부분을 차지하고 있다. 옥외공간의 이용 효율성을 제고하기 위해서는 통제력 확보를 위한 공간과 사회적 접촉을 유도하는 공간의 비율이 적절히 조화되어야 한다. 옥외 주 이용 공간의 선호 이유는 경관/환경성이 가장 중요하고, 다음이 기능성, 접근성이다. 선호공간에서의 주요행위는 산책/운동과 휴식이 주를 이루고 있으며, 선호시설은 연못, 폭포, 분수 등의 수경시설과 퍼골라, 녹음수 등의 휴게시설 그리고 잔디밭이다. 새로운 치유정원 조성 시 가장 중요하게 고려해야 할 분야는 자연성이며, 그 다음이 심미성과 쾌적성으로 파악되었다. 도입되기를 선호하는 단일시설로는 꽃밭, 산책로 및 잔디밭이며, 유형별로는 분수, 연못, 폭포 및 물레방아 등의 수경시설을 가장 선호한다. 가장 선호하는 기능공간은 자연적인 기분전환을 할 수 있는 공간이며, 프로그램은 꽃밭가꾸기가 가장 선호되었다. 치유정원의 이상적인 이미지는 산뜻하면서도 친근하며, 정원에 도입시설이 풍부하되, 전체적으로는 질서 있는 정원이었다. 위요되는 것보다는 개방적인 공간을 선호하였으며, 마음을 차분하게 하는 정원을 가장 이상적인 정원의 이미지로 생각하였다.

• 지역사회간호학회지
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• 제10권2호
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• pp.455-466
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• 1999

Western missionary nurses practiced in Korea from 1891. and the first trial to begin missionary public health nursing service in 1909 could not put into practice for short of nursing staff and budget. The main focus of missionary medical practice was not in public health program but in the management of missionary hospitals. A few of missionary western R.N. tried district nursing in 1910s. but their activities were personal and focused on the rescue of poor and sick patients. In 1917 the North American Methodist Church dispatched R.N. Elizabeth S. Roberts to begin district nursing in Korea. Roberts began maternal and child district nursing service. Her service was focused on teaching the method of bringing up children. bathing service, and home visiting for delivery. She could not but stop district-nursing service in 1918 to serve for a hospital in Siberia. The North American Methodist Church dispatched a few of R.N. to Korea in early 1920s and the missionary public health nursing of Korea could be activated. R.N. E. T. Rosenberger began public health nursing program in Seoul with Korean graduate nurse, Shin-gwang Han, and missionary M.D. Hall. Their public health nursing program was focused on maternal and childcare. They did home visiting in the morning, and served at a well baby clinic in the afternoon. The first baby competition began in 1925. and contributed to the teaching the method of bringing up children. They expanded public health nursing activity to school health nursing and milk station. Their public health nursing program was such a success that In 1929 Severance hospital. Eastgate Hospital. Taehwa Social Evangelistic center organized Seoul Child Health Union. Maren P. Bording, another missionary R.N. and midwife dispatched by the North American Methodist Church began public health nursing program at Kongjoo in 1924. Her program was focused on the maternal and childcare and close to that of Seoul. She started the first milk station in Korea in 1926. As she was a midwife and could get M. D. license in Korea, her program was more focused on maternal care than that of Seoul. The first day nursery school in Korea and the first graduate course for public health nursing in Korea began at Kongjoo in 1930. As the city of Choongcheongnam Province moved from Kongjoo to Daejeon in 1932, missionary public health nursing service in Kongjoo extended to Daejeon. There were lots of public health nursing program in Korea in 1920s and 1930s by missionary western nurses and Korean nurses. There were 13 missionary public health-nursing center in Korea in 1932. But in the late 1930s. Japan extended colonial war and drove out western missionaries. The missionary service in Korea was daunted. and the missionary public health nursing service could not but shrink.

• Journal of Trauma and Injury
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• 제25권4호
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• pp.159-165
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• 2012

Purpose: For trauma patients, an early-transport and an organized process which are not delayed in hospital stage are necessary. Our hospital developed a procedure, the trauma Critical Pathway (CP), through which a traumatic patient has the priority over other patients, which makes the diagnostic and the therapeutic processes faster than they are for other patients. Methods: The records of patients to whom Trauma CP were applied from January 1, 2011 through April 15. 2012. were reviewed. We checked several time intervals from ER visiting to decision of admission-department, to performing first CT, to applying angio-embolization, to starting emergency operation and to discharging from ER. In addition, outcomes such as duration of ICU stay, hospital stay and mortality were checked and analyzed. Results: The trauma CP was applied to a total of 143 patients, of whom, 48 patients were excluded due to pre-hospital death, ER death, transferring to other hospital and not severe injury. Thus 95 patients (male 64, 67.3%) were enrolled in this study. Fifty-nine patients(62.1%) were injured by the traffic accident. The mortality rate was 10.5% and the mean Revised Trauma Score (RTS) of the patients was $6.4{\pm}2.0$. After visiting ER, decision making for admission was completed, on average, in 3 hours 10 seconds. The mean time intervals for the first CT, angio-embolization, surgery and discharge were 1 hour 20 minutes, 5 hours 16 minutes, 7 hours 26 minutes and 6 hours 13 minutes, respectively. Conclusion: The trauma CP did not show the improvement of time interval outcome, as well as mortality rate. However, this test did show that the trauma CP might be able to reduce delays in procedures for managing trauma patients at the university-based hospitals. To find out the benefit of CP protocol, a large scaled data is required.

• Journal of Preventive Medicine and Public Health
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• 제35권4호
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• pp.340-350
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• 2002

Objectives : To evaluate the annual visit days, the annual prescription days and the medical costs of hypertensive patients. Methods : The medical insurance records of 40,267 incident patients with the diagnostic code of hypertension from September 1998 through August 1999 in Daegu city were reviewed. Results : The proportion of the most proper medical care pattern group (Group VIII) who visited for 6-15 days with 240 prescription days or more a year was only 6.2%. The proper care group (Group IX) who visited for more than 16 days with 240 prescription days or more a year was 9.3%. The overall proper care group (Group VIII+IX) was therefore 15.5%. The proportion of the insufficient care group (Group I, IV) in both the number of visiting days and prescription days was 57.4%. The mean prescription day of the most proper group (Group VIII) was 29 days; the mean annual medical expenses,453,587won; the mean annual amount paid by patients, 218,013won; and mean medical expenses per prescription day, 1,483won. The proportion of the overall proper care group (Group VIII+IX) was significantly higher in adults aged 50-59, those who were enrolled in industrial workers health insurance as well as government employees and private school teachers health insurance, and those who made a higher contribution per month (p<0.01). According to the type of medical facilities, the proportion of the most proper medical care pattern group was highest in the general hospitals (9.3%) but the overall proper care group was higher in the public health centers (22.1%) and private clinics (17.1%). Conclusions : The management system of hypertension should be reinforced urgently. Therefore, it is necessary to develop guidelines including the number of visiting days per year and prescription days per visit day, and make the system provide medical facilities to more properly care for hypertensive patients.

• 벤처혁신연구
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• 제4권3호
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• pp.49-67
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• 2021

본 연구는 병원고객의 만족도와 관련한 중요한 원인으로 제안될 수 있는 병원서비스품질과 감정적 애착, 지각된 가치가 어떠한 영향을 미치는지를 구조적으로 파악하고, 특히 병원서비스품질과 고객만족도 간의 관계에서 감정적 애착과 지각된 가치의 역할을 파악하였다. 이를 위해 중소병원을 찾는 고객을 대상으로 설문조사를 실시하여 수집한 자료로 구조방정식모형분석을 실시한 결과는 다음과 같다. 첫째, 고객이 느끼는 병원서비스품질은 감정적애착과 고객만 족도에 유의한 영향을 미쳤으며, 지각된 가치에는 유의한 영향을 미치지 못하였다. 둘째, 고객이 느낀 감정적 애착은 지각된가치와 고객만족도에 유의한 영향을 미쳤다. 셋째, 서비스품질과 고객만족도 간의 관계에서 고객이 느낀 감정적 애착은 유의한 매개효과를 가졌다. 이상의 결과를 통해 병원을 찾는 고객이 느끼는 서비스품질은 의사역량과 의료기술 역량에 대한 애착으로 이어져 이러한 애착에 의해 고객만족도가 높아지는 것을 확인하였다. 이 결과를 토대로 얻은 시사점은 다음과 같다. 즉, 병원을 찾은 고객들이 느끼는 서비스품질이 고객만족도로 이어지기 위해서는 무엇보다도 그들이 가질 수 있는 감정적 애착에 중점을 두고 서비스품질의 개선전략방안을 모색해야 한다는 것이다. 즉, 고객이 의사의 역량과 의료기술에 대한 역량에 대해 높은 신뢰를 가질 수 있도록 우수한 의료진과 의료기술을 구축해야 하며, 이러한 역량을 효과적으로 나타낼 수 있는 홍보전략을 수립해야 할 것이다. 이러한 노력에 의해 고객들은 의사와 의료기술에 대한 애착을 강하게 느끼게 됨으로써 병원에 대한 만족도가 제고될 수 있을 것이다.

• 한국의료질향상학회지
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• 제1권2호
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• pp.60-72
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• 1994

Background: The number of outpatients visiting large university teaching hospitals has increased drastically with the introduction of a nationwide health care insurance in 1989 and the improvement of the socio-economic status of the population. This resulted in long waiting times for services, particularly prescribed drugs, which have been patients' chief complaints. Hospitals have tried to solve the problem with limited success because their approach lacked comprehensive research. The objective of this study is to investigate associations between waiting times and variables defining a total work system. Methods: Data for the outpatient pharmacy department in a tertiary care university teaching hospital located in Seoul was analyzed to achieve the study objective. Associations of pharmacy system variables -- work load, work force, pharmacist work schedule, machine problems, and inventory control -- with mean and 99th percentile of waiting times were examined by the hierarchical stepwise regression method. Day was a unit of the analyses. Results: The regression models explained 65.8% of variance in the mean waiting time and 61.34% in the 99th percentile of waiting times. The break-down of the printer for drug envelops, Automatic Tablet Counters (ATCs), and main computer system lasted longer than 30 minutes increased the mean for 7.7 minutes, 4.5 minutes, and 7.0 minutes, respectively, and the 99th percentile for 14.8 minutes, 9.0 minutes, and 15.7 minutes, respectively. Concerning the work force, study results showed that there were significant differences in the productivity of pharmacists with work experience more than three years, one to three years, and less than one year, and showed that peak time aid work by pharmacists at job assignments other than the outpatient pharmacy, part-time pharmacists, and the installation of ATCs were effective in reducing waiting times, Finally, study findings indicated that the operational policy of work assignment and rotation schedule, supply and inventory of drugs at work tables, and readiness for undisrupted work during the work hours could have a significant effect on waiting times. Conclusion: The study results indicated that efforts to reduce waiting times for prescribed drugs should be geared toward every components of the pharmacy work system ranging from work schedule of pharmacists and supply of dugs at work tables. These findings should provide hospital managers with right directions in battling the problem.

• 한국보건간호학회지
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• 제11권1호
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• pp.138-162
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• 1997

This study was conducted to, develop the social workers role participating health and welfare services production of health centers The sharp increase rate on the elderly population in Korea lead the social issues as that health and social services are not developed enough to cope with the increase on the elderly's hearth care needs. The priority in the elderly's care service development should be put on public sectors. so that could prevent financial catastrophy of the elderly's care. The pulbic sector was concerned with health center services : as health center in Korea provide :mainly medical-oriented services. this study focused on to combine the existing health center's services into social services. The study method was based on needs survey with 322 patients aged over than 55 in rural area. "The needs survey include general health and disease care needs and daily life caring needs. The latter was applied with ADL and IADL with modificiation for the use of Korea environment. The findings were as follows : Social workers should be able to care diseases of muscular and skeletal. circulatory, digestive and general chronic disease in social service needs. aspect. Mostly the chronic pateints quit their care services because of shortage of finanical support$(18.3\%)$ and transportation problem$(19.5\%)$, but still prefer to be cured and cared from general hospitals. and at least clinic and health centers in community. The univisible dramatic effect. of health. care services also should be concerned and cared by xocial workers. The ADL and! IADL shown the most needs on transportation needs and problems caused by weaken legs. Mostly daily activities were supported by family members $(53.3\%\;spousers\;and\;35.0\%\;children)$, and the most demands were shown on helps for transportation visiting hospitals$(37\%)$ and getting similar care services for health care needs $(31.2\%)$ and daily hygeieal needs$(11.2\%)$ Social workers' role should include health care participation with social and health promotion approach as well as socio-economic supports: during health care receiving. Social workers also should provide social services for the elderly's daily needs solving for these are not in available family supporters.

• 대한지역사회작업치료학회지
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• 제2권1호
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• pp.1-11
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• 2012

목적 : 부산 울산 경남 지역의 장애인복지관과 병원에서 근무하는 작업치료사를 대상으로 지역사회중심재활에 대한 인식도와 필요성을 조사하여 향후 지역사회중심재활에서 작업치료사의 역할을 구축하고, 지역사회중심재활 참여에 대한 활성화 방안을 모색하고자 한다. 연구방법 : 2010년 12월 1일부터 2011년 5월 4일까지 한국장애인복지관협회에 등록된 부산 울산 경남 지역에 소재한 장애인복지관에 근무하는 작업치료사 23명과 부산 지역에 소재한 병원에서 근무하는 작업치료사 49명을 대상으로 설문을 실시하였다. 통계분석은 SPSS12.0 통계 패키지 프로그램을 이용하였다. 결과 : 지역사회중심재활에 대한 작업치료사의 인식도와 필요도는 두 집단 모두 높은 것으로 나타났고 두 집단 간 유의한 차이는 없었다(p>.05). 또한 지역사회중심재활 중 작업치료사가 필요하다고 생각되는 영역에 대해 재활상담 및 정보제공, 가정방문재활치료, 직업재활, 재활기구대여, 장애예방교육으로 조사되었으며, 지역사회중심재활에서 작업치료사의 활성화를 위해서는 인력 수급과 국가적 차원의 법적/제도적 장치 마련과 관련 전문가와의 팀웍 조성 등이 필요한 것으로 나타났다. 결론 : 본 연구는 지역사회중심재활에 대한 작업치료사들의 인식도와 작업치료사들의 필요성은 높은 것으로 나타났으나, 현재 시행되는 기관은 부족한 것으로 나타났다. 따라서 지역사회중심재활에 있어 작업치료의 활성화를 위한 법적/제도적 장치 마련이 시급하다.

• 디지털융복합연구
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• 제14권4호
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• pp.285-294
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• 2016

본 연구는 병원직원의 인식과 근무환경 만족도를 조사하여 친환경 병원 도입의 필요성에 미치는 영향력을 분석하는데 목적이 있다. 설문조사는 2014년 4월에 진행하였으며 서울시, 경기도, 충청북도의 5개 중소병원을 대상으로 하였다. 213부를 활용하여 빈도분석, T-test, 분산분석(ANOVA) 및 구조방정식모형 분석을 실시하였다. 연구결과 응답자의 교육수준과 직급이 높고, 근속연수가 길수록 친환경 병원에 대한 인식이 높았으며, 남성과 의사가 그리고 교육수준과 직급이 높을수록 근무환경 만족도가 높았다. 친환경병원의 도입필요성은 남성이 그리고 교육수준과 직급이 높을수록 높게 인식하였다. 구조방정식모형의 분석결과 친환경병원에 대한 인식과 근무환경의 만족도 모두 친환경병원 도입필요성에 영향력을 미치는 변수로 나타났다. 따라서 친환경 병원경영을 도입하고자 하는 병원들의 직원들의 친환경병원 인식과 근무환경 만족도를 모두 높이기 위한 전략이 필요할 것으로 판단된다.