• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.8
• /
• pp.230-238
• /
• 2018

The purpose of this study is to examine the effects of park type and inner elements of parks on the number of walking days of walking out of Ulsan Metropolitan City, And to make policy suggestions for them. The elderly people aged 65 and 1,274 persons or over in Ulsan Metropolitan City were selected as the subjects using the raw data of the 2015 community health survey. A multilevel analysis was conducted using a hierarchical linear model to find out the factors affecting the number of days of walking according to the level of regional level factor according to the five wards of Ulsan Metropolitan City. The number of walking days increased with the number of sports facilities and the number of walking days decreased with the number of amusement facilities mainly used by children. In the case of Jung-gu in Ulsan, the number of walking days was low even though the number of parks and the area of the park were large, In the case of Buk-gu, the number of walking was high even though the number of parks and the area of the park were small. Elderly people in Jung - gu, Ulsan metropolitan city are expected to need a health promotion project to promote walking, and it is necessary for seniors in Buk - gu, Ulsan Metropolitan City to make a good walking environment.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.19 no.10
• /
• pp.194-205
• /
• 2018

This study investigated knowledge and attitudes of long-term care hospital nursing assistants such as nursing aides and direct care workers toward patient safety and their safety care activities. This was a descriptive study that attempted to enhance the competence of nursing assistants' patient safety management, and the data were used to develop a training program for nursing assistants. A total of 230 nursing assistants working at six hospitals whose wards were over 200 participated and were assessed with a rating 1 or 2 in 2013 in B city. Data were collected using questionnaires from March 2 to March 26 in 2017. The collected data were analyzed by the SPSS/WIN 20.0 program using number, percentage, mean, standard deviation, t-test, ANOVA, $Scheff{\acute{e}}$ test, correlation coefficient, and multiple regression. In conclusion, the findings show that patient safety care activities were better performed by nursing aides than direct care workers. Higher education and a higher number of patient safety training programs and patient safety care activities were frequent. In addition, nursing assistants' knowledge of patient safety affected attitudes toward patient safety, and attitudes affected patient safety care activities. Therefore, an actual regular training program for patient safety should be executed over five times a year to improve patient safety perception. Furthermore, a hospital system including adequate working time needs to be improved. Based on the results of the study, patient safety in long-term care hospitals should be improved, and this study could be utilized as basic data to develop a training course for improvement of knowledge and attitudes of nursing assistants toward patient safety.

• Asian Oncology Nursing
• /
• v.4 no.2
• /
• pp.124-134
• /
• 2004

The major results of this study were as follows : 1. The percentage of nurses who know the complementary and alternative therapies was 50.1% Most of them(70.6%) acknowledged the therapies from newspapers, television and magazines. 2. The complementary and alternative therapy was perceived as effective by 64.9% of the nurses and as trusted by 60.2% of them The effective methods of the therapy are acupuncture herb medicine and massage. 3. Most of the nurses 93.4% experienced getting inquiries from patients or their guardians whether to use the therapies. 4. The complementary and alternative therapies was experienced by 38.9% of nurses and 7.1% of them use the therapies frequently 92.9% of patients and families were satisfied with the result 'Massage Therapy' was used the most with no side-effects and thus higher need of education for nurses. 5. They wanted to be trained for massage therapy finger-pressure, music therapy, acupuncture, aroma therapy in order. 6. Reliance on the complementary and alternative therapies, 75.2% of nurses completed the course trusted the therapies and the result of others uncompleted was similar as 52.2% Moreover both 79.5% of nurses completed it and 61.6% of the others said that the complementary and alternative therapy's nursing interventions is possible to develop. 7. It shows high relation to recognition having possibilities for applying and developing as the nursing intervention. if the confidence is as high as about the complementary and alternative therapies. Based of the results of this study as above this study proposes as follows. First, The nurses should understand mentality of the patients so that the nurses have to put in operation appropriate nursing intervention as accurate knowledge of the alternation therapies using to cancer patients for having on damages to patients from their rash using way. Furthermore, it is necessary to supply the special place and the professional nurses taking complete charge at them. Next politic interest and support from government are required to develop and practice systematic and resonable education programs for the complementary and alternative therapies. Moreover, it is necessary for nurses to be educated about the therapies continually. Finally, it is compulsory that the research and development for complementary and alternative therapies is needed. In addition, it has to be made standard and legal equipment for safety efficacy and theory about the therapies.

• Quality Improvement in Health Care
• /
• v.5 no.2
• /
• pp.324-334
• /
• 1998

Background : Strategic planning is an organizationwide or systemwide, ongoing look into the future usually of 2~3 years, based on objective analysis of the current environment and trends, but it can incorporate both short-term and long-term goals. The strategic planning process includes external analysis, internal analysis, issue analysis, development of mission, vision and values, and lastly development of organizational goals and objectives. As a part of the strategic quality planning process, certain service lines, important organizationwide functions, or key processes supporting these functions can be prioritized to expedite and roll out certain strategic goals. This is called strategic quality initiatives. Methods : We organized a quality improvement team, a subgroup of 21st century vision planning corps of our medical center, and pursued QI activities for improvement of healthcare environment, particularly in the admission setting. We developed a strategic quality initiative based on the results of patient satisfaction surveys, and carried out functions of self-directed work team. Results : The strategic goal was to be the benchmark for peer group hospitals in Korea for providing cost-effective best-practice. The QI team included 3 medical doctors, 1 nurse, 1 social worker, and 1 QI consultant as well as many operational members to support services and quality initiatives met every Tuesday for 18 weeks. Outcome objectives were to improve patient satisfaction score. The issues included in the objectives were comfort, temperature, noise, cleanliness of the admission wards, quality and education of patient meals, matters regarding the admission process, and an appurtenant facility such as restaurant or convenience store. Every issue was discussed and recommendations, conclusions and opportunities were implemented. Conclusions : By developing a strategic quality initiative as a part of the strategic quality planning process, and pursuing a self-directed work team, certain sen/ice lines, important organizationwide functions, or key processes supporting these functions can be improved effectively within a short period. Strategic quality initiatives serve to support, or roll out, certain strategic goals that are relevant to performance improvement and development of specific measurable outcome objectives, and associated performance measure for each initiative. Each strategic quality initiative should include a statement of intent outcome objectives, and performance measures. We will come back with follow up of the strategic quality initiative, for improvement of healthcare environment, and results of patient satisfaction re-survey.

• Quality Improvement in Health Care
• /
• v.5 no.2
• /
• pp.258-276
• /
• 1998

This study was conducted to justify the "prescribed shelf life" currently used in Samsung Medical Center and give recommendations based on scientific data to adopt for safe and cost-effective storage times for sterile goods Since the early 1970's, predetermined expiration dating policy has been used in Korea on all in-house sterilized products like any other countries; six months for the supplies wrapped in polyethylene peel pouches and two weeks for the rest. Recently, however, the studies suggest that current standards for preserving the sterility can be changing. It looks like we unnecessarily have too-short expiration date of sterilized supplies, that is far from being cost effective. Certainly, this research is an exciting project, especially in Korea, and will be leading and contributing to the paradigm shift of the conservative concept of shelf life for sterile supplies in Korean healthcare facilities. The major goal of this study was placed on the measurement of the recontamination time in packs wrapped in all kinds of wrapping materials used in S.M.C and stored in various conditions for periods ranging from three months to six months, and then develop a practical standard of "shelf life" based on the analyzed data. Objectives: To measure and compare the recontamination time of sterile packs among wrapppers and storage conditions, and develop a practical standard for the shelf life and storage conditions of sterile products. Samples and Method: The sterile integrity was investigated of the total 1,440 sterile sample packs containing gauze strip($1.5cm{\times}0.5cm$) we prepared and wrapped in nine wrapping materials (randomized reprocessed linens, linens reprocessed 99 times, linens reprocessed 120 times, new kraft paper, used kraft paper, new nonwoven fabrics, 6-time reprocessed nonwoven fabrics, new polyethylene peel pouches, used polyethylene peel pouches), and stored in four locations(closed cabinet of one of the typical wards, open shelf of one of ICUs, open shelf of separate storage room in ER, open shelf in OR), for three to six months, respectively in 1998. Each type of packs were opened weekly and the gauze strips inoculated into Brewer's thioglycollate broth at $35^{\circ}C$ for seven days. Results: There was no growth found for any types of the pack and storage conditions studied. Discussion: This study was conducted in an attempt to identify the possibility of extending the current shelf life for sterile goods we use in a sense of cost effectiveness. The findings suggest that we could extend our expiration dates, that means we can save a lot of materials and personnel time meeded for resterilizing, outdating, recleaning, wrapping, and reshelving. Then it will initiate a great reform in the field of healthcare in Korea, and now we are looking forward to this valuable revolution. We are going to continue this study and take all steps need to apply this new concept to our practice, and then trying to extend to other hospitals.

• Quality Improvement in Health Care
• /
• v.2 no.2
• /
• pp.156-171
• /
• 1996

Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.

• The Journal of the Korea Contents Association
• /
• v.20 no.10
• /
• pp.424-435
• /
• 2020

The study was descriptive survey research for establishment of patient safety culture in small and medium-sized hospitals as providing baseline data of educational program regarding safe medication and prevention of near miss on medication, checking influencing factors of nurses near miss experience on medication in small and medium-sized hospital. The collected data was analyzed by SPSS/WIN 20.0 program to obtain mean, frequency, x²-test, independent t-test, one-way ANOVA, logistic regression. The influencing factors of near miss experience on medication was working department and patient safety culture among general characteristic. The nurses who were working in general ward had lesser chance to experience near miss rather than nurses working in special department (Odds ratio:2.23, 95%, Confidence Interval: 1.07~4.67, p=.032). The 1 point higher in patient safety culture, the lesser chance to experience in near miss (Odds ratio: 2.24, 95% Confidence Interval: 1.02~4.95, p=.045). To sum up the result of this study, nurses working in special department had higher chance to experience near miss rather than nurses working in general wards. The higher patient safety culture awareness was the lower near miss was experienced. Thus, miss surveillance system for improvement of nurses' patient safety culture awareness should be developed. Moreover, educational program for medication considering nurses' career and department' character should be requested with simulation training considering and theory education.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.23
• /
• pp.10121-10128
• /
• 2015

Background: Cancers impose an increasing burden on health of the populations and individuals, but little is known about cancer patient satisfaction with care. The aim of this study was to assess the psychometric properties of the Persian version of European Organisation for Research and Treatment of Cancer (EORTC) In-Patsat32, as a recently developed questionnaire to assess cancer patient satisfaction with care and information provided during hospital admission. Materials and Methods: Complying with EORTC protocols, the Persian version of Inpatsat32 was translated and piloted in a small group of patients, then applied to 380 cancer patients admitted to different oncology wards in Tehran. Validity (convergent, discriminant, and divergent) and reliability of the tool was assessed through using multitrait analysis, factor analysis, intraclass correlations, Chronbach's alpha and test-retest (on a sample of 70 patients). Results: Good acceptance and high sensitivity of the questionnaire with low floor and ceiling effects were recognized, indicating power of the instrument to detect differences between groups with heterogeneous levels of satisfaction. Multitrait scaling analyses supported the convergent validity of the majority of scales (correlation coefficient >0.4) and favorable discriminant validity (item own scale correlation >0.8). There was no correlation between In-patsat32 scales and the EORTC-C30, which measures different concepts, confirming divergent validity of the tool. Internal consistency for all domains was high (${\alpha}$ >0.70) except for the hospital access score and the test-retest reliability was excellent (r=0.86-0.96). There was a weak responsiveness to change except for nurses technical skills. Principle component analysis confirmed five domains with much improved internal consistency (${\alpha}$ >0.9). Conclusions: The Persian version of the EORTC-in-patsat32 module is a reliable and valid instrument to measure cancer patient satisfaction with care received during their hospitalization period and can be utilized in clinical cancer research.

• Quality Improvement in Health Care
• /
• v.8 no.1
• /
• pp.10-21
• /
• 2001

Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.

• Journal of Nutrition and Health
• /
• v.51 no.2
• /
• pp.132-139
• /
• 2018

Purpose: The aim of this study was to determine the effects of nutritional intervention focused on a Nutrition Support Team (NST) in patients receiving enteral nutrition (EN) in general hospital wards. Methods: The electronic medical records of 95 adult patients admitted in C university hospital and received EN supply for more than 3 days at a general ward were analyzed retrospectively. The subjects were classified into the intervention group (n = 40) and non-intervention group (n = 55). Results: The calorie support rate (%) and protein support rate (%) increased significantly only in the intervention group after 2 weeks compared to the rate upon admission. The serum albumin levels increased in the intervention group after 2 weeks compared to the levels at admission, but decreased in the non-intervention group. The glucose levels decreased only in the intervention group compared to that at admission. Conclusion: The nutritional status of the patients was improved by the proper planning of nutrition management from the beginning of hospitalization and systematically managing the nutrition intervention of the NST.