Recently hospitals are implementing a One Stop Service as part of patient-care service. With the One Stop Service, medical treatment including consultation, inspection, and results are changing to be made available in one visit. Therefore most examinations are reserved for the same day; however, there are cases in which additional visits are necessary because of certain properties related to exams. This study compares and analyzes the number of reinspections before and after reforms. By designating the order of priority for BMD examinations and implementing education from information obtained in the OCS E-manual update, the number of reinspections for wards was reduced from 58 to 21, Outpatient departments were reduced from 51 to 12, and errors in reservations made by employees in the department of radiology were reduced from 98 to 11. Reinspections can be reduced with full understanding the factors related to reinspection and a background check prior to inspection in order to determine the order of priority for inspections. This will also reduce workers' stress and increase their efficiency and at the same time decease patient dissatisfaction and improve hospital reliability.
Kim, Yong-Soon;Park, Jee-Won;Park, Yon-Ok;Cho, Eun-Sook;Kim, Myung-Wook
Quality Improvement in Health Care
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v.2
no.2
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pp.32-45
/
1996
Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.
Artists using exhibition spaces can select exhibition spaces considering marketing activities provided by operators or organizations of exhibition spaces, so it is necessary to study the relationship between marketing activities and satisfaction factors. This study examines marketing mix 7P factors, satisfaction, and prior studies as a theoretical background to demonstrate the decisive factors of the artist's exhibition hall satisfaction. As a result of analyzing the questionnaire collected from 144 artists used the exhibition hall, among the 7P factors of marketing mix, product, price, and progress process influenced the satisfaction of the exhibition hall, and the influence was in order of progress, product, and price. The suggestions are as follows. First, among the 7P factors in marketing mix, the fact that products, prices, and progress influencing the satisfaction of the exhibition place emphasizes factors related to the actual exhibition. Second, among the 7P factors in the marketing mix, the process had the greatest influence on the satisfaction of the exhibition hall, which means that the service delivery process is important.
BACKGROUND/OBJECTIVES: Arsenic, which causes human carcinogenicity, is ubiquitous in the environment. This study was designed to evaluate modulation of arsenic induced cancer by resveratrol, a phytoalexin found in vegetal dietary sources that has antioxidant and chemopreventive properties, in arsenic trioxide ($As_2O_3$)-induced Male Wistar rats. MATERIALS/METHODS: Adult rats received 3 mg/kg $As_2O_3$ (intravenous injection, iv.) on alternate days for 4 days. Resveratrol (8 mg/kg) was administered (iv.) 1 h before $As_2O_3$ treatment. The plasma and homogenization enzymes associated with oxidative stress of rat kidneys were measured, the kidneys were examined histologically and trace element contents were assessed. RESULTS: Rats treated with $As_2O_3$ had significantly higher oxidative stress and kidney arsenic accumulation; however, pretreatment with resveratrol reversed these changes. In addition, prior to treatment with resveratrol resulted in lower blood urea nitrogen, creatinine and insignificant renal tubular epithelial cell necrosis. Furthermore, the presence of resveratrol preserved the selenium content ($0.805{\pm}0.059{\mu}g/g$) of kidneys in rats treated with $As_2O_3$. However, resveratrol had no effect on zinc level in the kidney relative to $As_2O_3$-treated groups. CONCLUSIONS: Our data show that supplementation with resveratrol alleviated nephrotoxicity by improving antioxidant capacity and arsenic efflux. These findings suggest that resveratrol has the potential to protect against kidney damage in populations exposed to arsenic.
Background: Limited human papillomavirus (HPV) related knowledge might be a barrier to future vaccine acceptance. From 2008-2010, PATH conducted an HPV vaccination demonstration project in partnership with the government immunization program in Vietnam, which included awareness campaigns prior to vaccination. Objective: To assess and compare knowledge and attitudes about cervical cancer and HPV vaccines between mothers and daughters, and whether knowledge was associated with vaccination status. Methods: We analyzed HPV-related knowledge and attitude data from mother-daughter paired responses to a cross-sectional household survey. After parents completed the survey, daughters were asked the same questions. We calculated the frequency of responses for each question and devised a scaled composite measure for knowledge. Results: Participants believed they had received enough information about cervical cancer and HPV vaccines and it was sufficient to make a decision about vaccination. Fifty percent of the participants knew HPV causes cervical cancer and 80% knew the HPV vaccine prevented cervical cancer. Mothers had more knowledge about cervical cancer and HPV infection (p<0.01), compared to daughters, who had more vaccine specific knowledge (p<0.01). However, the total mean knowledge score was similar for the groups. Girls not fully vaccinated had a lower mean knowledge score than fully vaccinated girls (p<0.001). Conclusions: Our results suggest that the purpose of the HPV vaccine was clearly messaged; however, some misconceptions about cervical cancer and HPV still exist. Limited knowledge about the magnitude of cervical cancer, HPV as a cause of cervical cancer, and HPV vaccines may have contributed to incomplete vaccination.
Al-Hashimi, Muzahem Mohammed Yahya;Wang, Xiang Jun
Asian Pacific Journal of Cancer Prevention
/
v.15
no.1
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pp.385-390
/
2014
Background: Lung cancer is the most frequent malignancy of men worldwide. In Ninawa in Iraq, lung cancer ranks first among cancers diagnosed in men. Since no prior studies have been conducted on incidence trends in our population the present investigation of rates during 2000-2010 was therefore performed. Materials and Methods: Registy data for lung cancer cases were collected from the Directorate of Health in Ninawa-Mosul Continuing Medical Education Center. We restricted our analyses to men categorized according to the age groups of 0- 39, 40-49, 50-59, 60-69 and 70+ years. The significance of incidence rate trends during 2000-2010 was tested using Poisson regression. Age-standardized rates (ASR), and age-specific rates per 100,000 population were calculated. Results: A total of 1,206 incident lung cancer were registered among males, accounting for 15.5% of all male cancers registered during 2000-2010. It ranked first throughout the period. Median age at diagnosis was 69 (mean $66.8{\pm}11.0$) years. The incidence rate of all male lung cancers in Ninawa (all ages) decreased from 26.4 per 100,000 in 2000 to 12.7 in 2010 (APC=-6.55%, p<.0001). The incidences in age groups 40-49, 50-59, 60-69 and 70+ decreased in earlier years and recently appeared (2007-2010) stable. The incidence in age group (0-39) remained stable between 2000-2010. Squamous cell carcinoma (SCC)was the most common type of lung cancer, while adenocarcinoma was relatively rare. Conclusions: With the data from Directorate of Health in Ninawa during the period 2000-2010, lung cancer is the most common cancer but generally declining. Among all age groups, the recent incidence of lung cancer remained stable. The SCC predominance suggests change in tobacco habits as an important factor in the trends observed.
Background: The study aimed to determine if ultrasonography of masseter can be used to evaluate the outcome of transcutaneous electrical nerve stimulation (TENS) in subjects with temporomandibular disorders (TMDs) such as myositis and myofascial pain. Methods: Fifteen TMD subjects with myofascial pain/myositis who satisfied the RDC/McNeil criteria were included in the study. All the subjects were administered TENS therapy for a period of 6 days (30 minutes per session). The mouth opening (in millimeters) and severity of pain (visual analogue scale score) and ultrasonographic thickness of the masseter (in millimeters) in the region of trigger/tender areas was assessed in all the subjects both prior and post TENS therapy. A comparison of the pre-treatment and post-treatment values of the VAS score, mouth opening and masseter thickness was done with the help of a t-test. Results: There was a significant reduction in the thickness of masseter muscle (P = 0.028) and VAS scores (P < 0.001) post TENS therapy. There was also a significant improvement in the mouth opening (P = 0.011) post TENS therapy. Conclusions: In the present study, ultrasonography was found to be an effective measuring tool in the assessment of TENS therapy in subjects with myositis and myofascial pain.
Kim, Won-Ho;Kim, Sang-Kwon;Lee, Chul-Joong;Kim, Tae-Hyeong;Sim, Woo-Seok
The Korean Journal of Pain
/
v.23
no.1
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pp.11-17
/
2010
Background: The target of lumbar sympathetic ganglion block is the anterolateral surface of the L2, 3 and 4 vertebral bodies, where the lumbar sympathetic ganglion usually lies. In most cases, a block-needle is inserted approximately 5-8 cm lateral to spinous process on the skin and directed to the anterolateral surface of vertebral body obliquely. The purpose of this study is to determine the safe entry angle and entry point in Korean by using the abdominal CT scan images. Methods: The abdominal CT images of eighty five patients were recruited to this study. The minimal angle aimed at the lumbar sympathetic ganglion that can pass through the lateral aspect of body and maximal angle that avoids puncturing the kidney, ureter or retroperitoneal space were measured. The distance from midline to skin entry point was also measured. Results: There was no significant difference in entry angle among L2, 3, and 4 level. The entry angle was similar in the right and left side, and in males and females. The entry angle of old age group was significantly smaller than that of young age group. The calculated safe entry angle was $30.5{\pm}0.4^{\circ}$ and entry point was $7.7{\pm}0.2\;cm$ and $6.7{\pm}0.1\;cm$ lateral from midline in males and females respectively. Conclusions: These measurements can be used as a reference for lumbar sympathetic ganglion block and radiofrequency lesioning. Prior to performing the lumbar sympathetic ganglion block for cancer patients, the abdominal CT scan should be reviewed to prevent complications.
Park, Hyeon-Min;Kim, Tae-Wan;Choi, Hong-Gyu;Yoon, Kyung-Bong;Yoon, Duck-Mi
The Korean Journal of Pain
/
v.23
no.2
/
pp.142-146
/
2010
Background: Stellate ganglion block (SGB) is known to increase blood flow to the innervations area of the stellate ganglion. Near infrared spectroscopy reflects an increased blood volume and allows continuous, non-invasive, and bedside monitoring of regional cerebral oxygen saturation ($rSO_2$). We investigated the influence of SGB on bilateral cerebral oxygenation using a near infrared spectroscopy. Methods: SGB was performed on 30 patients with 1% lidocaine 10 ml using a paratracheal technique at the C6 level and confirmed by the presence of Horner's syndrome. The blood pressure (BP), heart rate (HR) and rSO2 were measured before SGB and 5, 10, 15 and 20 minutes after SGB. Tympanic temperature of each ear was measured prior to SGB and 20 minutes after SGB. Results: The increments of the $rSO_2$ on the block side from the baseline were statistically significant at 5, 10, 15 and 20 minutes. The $rSO_2$ on the non-block side compared with the baseline, however, decreased at 15 and 20 minutes. The difference between the block and the non-block sides was significant at 15 and 20 minutes. The BP at 10, 15 and 20 minutes was increased and the HR was increased at 10 and 15 minutes. Conclusions: We observed an increment of the $rSO_2$ on the block side from the baseline; however, the $rSO_2$ on the non-block side decreased.
Hong, Ji Hee;Lee, Yong Chul;Lee, Han Min;Kang, Chul Hyung
The Korean Journal of Pain
/
v.21
no.1
/
pp.38-43
/
2008
Background: Spinal stenosis and herniated intervertebral discs are the principal causes of lumbosacral radiculopathy. This study was conducted to compare the therapeutic value and duration of pain relief of fluoroscopic guided transforaminal epidural steroid injections (TFESIs) in patients with refractory radicular leg pain. Methods: Between August 2006 and March 2007, 87 patients (H group: patients with herniated intervertebral disc, S group: patients with spinal stenosis) who met the inclusion criteria were treated with fluoroscopic guided TFESIs. Prior to treatment, the VAS and ODI scores were determine to evaluate the degree of pain and level of disability. The degree of pain relief was then assessed 1 month after treatment with the TFESIs and graded as excellent (no residual pain), good (improvement of pain symptoms by more than 50%), fair (improvement of pain symptoms by less than 50%) and Poor (no improvement of pain). In addition, the duration of pain relief was evaluated by regular outpatient visits for 6 months, and by telephone interviews after 6 months. Results: The H and S group both had excellet results at 1 month after treatment with TFESIs showing improvements of 44.1% and 20.8% respectively. However this difference was not significant between groups. In addition, a duration of pain relief greater than 6 months was achieved in 32.4% of the patients in the H group and 37.7% of those in the S group. Conclusions: TFESIs had a similar degree of therapeutic effectiveness and duration of pain relief in patients with spinal stenosis and herniated intervertebral discs.
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