• Title/Summary/Keyword: client services

검색결과 659건 처리시간 0.027초

가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 - (An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service -)

  • 서미혜;허혜경
    • 가정∙방문간호학회지
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    • 제3권
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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노인장기요양보험 재가서비스의 문제점과 개선방안 (A Study on Problems and Improvement of Home-help Services of Long-term Care Insurance)

  • 이준우;서문진희
    • 한국노년학
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    • 제29권1호
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    • pp.149-175
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    • 2009
  • 본 연구는 제도 시행 초기인 2008년 10월 현재 여러 부분에서 동시다발적으로 발생하는 노인장기요양보험 재가서비스의 다양한 문제점과 원인을 파악하여 분석한 후, 그에 대한 개선방안을 마련하는 데 목적이 있다. 연구방법은 크게 선행 연구된 2차 자료를 분석하는 문헌조사와 관련 전문가를 대상으로 하는 서베이 조사방식을 통해 진행되었다. 자료의 분석은 길버트와 스펙트의 정책분석틀에 근거하여 대상자체계, 급여(서비스)체계, 재정체계, 전달체계의 영역으로 구분하여 분석하였다. 본 연구를 통해 도출된 노인장기요양보험 재가서비스의 문제점은 첫째, 대상자체계에서는 가입대상자와 서비스 대상자의 불일치, 수요자 추계의 문제점 및 등급판정 관련 문제 등이 있으며, 둘째, 서비스 체계에서는 서비스 인력의 전문성 결여, 방문요양기관 인력기준 완화로 인한 서비스 질 저하, 서비스 이용시간 제한의 불합리성 및 방문요양 수가의 등급별 균등지급의 문제가 있는 것으로 나타났다. 셋째, 재정체계에서는 본인부담금과 비급여항목으로 인한 이용자 부담과중, 기존운영비 지원 기관에 대한 지원중단으로 인한 서비스의 사각지대 발생 및 구조조정 및 파트타임 증가로 서비스 질 저하 문제가 나타났으며, 마지막으로 전달체계에서는 서비스의 질 관리체계 미비, 재가장기요양기관 남설로 인한 과다 경쟁, 영리적 운영으로 인한 서비스 공공성과 질저하, 대상자 모집의 어려움으로 인한 운영난 및 요양보호사 교육기관 난립으로 인한 과다배출과 부실교육 등의 문제가 있는 것으로 조사되었다. 이상의 결과에 근거하여 다음과 같이 제언하였다. 첫째, 장기적으로 가입자와 서비스 대상자를 일치시킬 필요가 있다. 둘째, 공단직원의 전문성 향상 및 인력충원이 필요하며, 셋째, 등급외자에 대한 효율적 서비스 연계, 넷째, 체계적인 요양보호사 관리시스템 구축 및 서비스 표준지침서 개발, 다섯째, 서비스 내용과 절차에 관한 일부 법규의 수정이 필요하며, 여섯째, 본인부담금의 일부 조정도 필요하다. 일곱째, 노인복지법에 의한 재가시설에 운영비를 지원해야 하며, 여덟째, 관리감독 기관의 모니터링 시스템 강화 및 서비스 제공 기관과 서비스 인력에 대한 평가 체계 마련, 그리고 마지막으로 기관설치 기준의 강화가 필요하다.

RTP 기반 실시간 MPEG2 스트림 전송 시스템 (A MPEG2 stream transport systems based on Real-time Transport Protocol)

  • 박대훈;홍윤식
    • 대한전자공학회:학술대회논문집
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    • 대한전자공학회 2000년도 하계종합학술대회 논문집(3)
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    • pp.141-144
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    • 2000
  • Current Internet and Intranet developments are focusing on network multimedia services involving the transport of real-time multimedia streams. In this paper, we present a real-time MPEG2 Encoding/Decoding systems and a MPEG2 stream player running on client systems based on real-time transport protocol(RTP). The MPEG2 player has been implemented by using JMF and java applet. We have tested our prototype systems with one of possible multimedia sources, camcoder, to verify its functional correctness and measure its performance.

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스마트 카드와 PAM을 이용한 사용자 인증 (User Authentication by using SMART CARD and PAM)

  • 강민정;강민수;박연식
    • 한국정보통신학회:학술대회논문집
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    • 한국해양정보통신학회 2003년도 춘계종합학술대회
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    • pp.637-640
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    • 2003
  • Authentication between Server and Client is necessary in most of Internet Service because of increasing of using of Internet. Unix-based Server upgraded security of user authentication using "Shadow Password" instead of "crypt" function. But "Shadow Password" most use same authentication method about all services. But we individually can set user authentication method using PAM(Pluggable Authentication Module). This paper will propose user authentication system using Linux-PAM that use SMART CARD as authentication token.

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MPOA 망에서의 차등화 서비스 구조 (Architecture of Differentiated Services over MPOA Network)

  • 강남희;김영한;박창민;이종협;이형호
    • 한국통신학회논문지
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    • 제26권6A호
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    • pp.1041-1050
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    • 2001
  • 본 논문에서는 MPOA(multi-protocol over ATM) 망에서 인터넷 차등화 서비스를 지원하기 위한 구조를 설계하고 이를 분석하였다. ATM(asynchronous transfer mode) 기반 서비스로는 UBR(unspecified bit rate)을 확장한 방안을 적용하였고 이에 따라 변화되어야 할 MPC(MPOA client)와 MPS(MPOA server)의 전달 및 제어 구조와 신호 제어 절차를 설계하였다. 또한 시뮬레이션을 통해 제안된 구조의 ATM 스위치에서 차등화서비스의 지원 가능성을 고찰하고, 트래픽 특성에 따른 차등적 처리 성능을 검증하였다.

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Mobile Client Webservice Architecture for Personal Navigation Service

  • Hong, Sang-Gi;Kim, Kyong-Ho;Park, Jong-Hyun
    • 대한원격탐사학회:학술대회논문집
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    • 대한원격탐사학회 2003년도 Proceedings of ACRS 2003 ISRS
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    • pp.691-693
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    • 2003
  • The development of an open LBS platform makes it easy to use of the location information between telecommunication companies which have different platforms and to develop various LBS solutions using position information. This paper proposes a mobile webservice solution providing public transportation services to the mobile subscribers.

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웹 서비스 등록/검색 도구 기능 정의 (Characterization of a Client for Web Service Registry System)

  • 김미혜;이경하;이규철
    • 한국정보과학회:학술대회논문집
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    • 한국정보과학회 2002년도 가을 학술발표논문집 Vol.29 No.2 (1)
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    • pp.106-108
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    • 2002
  • 웹 서비스(web services)는 표준화된 XML 메시지를 통해 네트워크상에서 접근 가능한 연산들의 집합을 기술하는 인터페이스로 정의된다[1]. 이러한 웹 서비스는 크게 서비스 교환과 기술(description), 그리고 등록(registration)과 발견(discovery)이라는 개발 단계를 가지고 있으며, 각각의 단계에서 사용되어지는 기술에는 SOAP, WSDL, UDDI 등이 존재한다. 본 논문에서는 웹 서비스에 관한 정보를 저장하기 위해 개발된 UDDI 레지스트리에 웹 서비스에 관한 정보를 등록하고 검색/발견할 수 있도록 지원해주는 웹 서비스 등록/검색 도구의 기능들을 정의하고, 개발에 필요한 사항들을 기술한다.

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Efficient Real-time Multimedia Streaming System Using Partial Transport Stream for IPTV Services

  • Lee, Eun-Jo;Park, Sung-Kwon
    • Journal of Ubiquitous Convergence Technology
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    • 제2권2호
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    • pp.88-96
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    • 2008
  • IPTV Content delivery systems over wired networks confront scalability problems due to their high network bandwidth requirement for real-time services. Especially, VoD service provides Trick Mode features such as pause, fast forward and similar operations. However, Trick Mode services are delivered by the method of unicast only for controlling of the stream. With a point of views, this paper propose a new real-time multimedia streaming architecture over IP Networks, which tries to achieve bandwidth efficiency and supporting for mass clients better than traditional unicast services. The proposed methods divide the Transport Stream into a series of segments. After that, this divided partial Transport Stream makes multicast streaming periodically. Meanwhile Set-top Box of a client makes a rearrangement orderly by using Presentation Time Stamp field from the served Transport Stream packets. While the current Transport Stream segment is playing, it should be guaranteed that the next segment is downloaded on time. Consequently, the original video content can be played out continuously. The detail introduction of a new real-time multimedia streaming system with analysis and simulation follows as below.

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Server-Based User-Created Contents Processing System

  • Yeo, Myung-Ho;Kim, Hak-Sin;Roh, Kyu-Jong;Cho, Yong-Jun;He, Li;Kim, Hak-Cheol;Bok, Kyung-Soo;Yoo, Jae-Soo
    • International Journal of Contents
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    • 제4권4호
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    • pp.12-17
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    • 2008
  • The web 2.0 is leading a rapid change of internet services. The UCC(User Created Contents) service is one of the representative internet services with web 2.0 paradigm. In this paper, we design and implement the UCC services prototype system for image and video. The proposed system does not need to install ActiveX and client programs on devices of users to edit their contents. All processes for editing UCC are conducted on the server. Our proposed system consists of the two components such as the multimedia editing subsystem and the metadata management system. They provide the API to UCC service developers or vendors. The multimedia editing subsystem supports editing for image and video, and the streaming services of video. The metadata management subsystem supports the metadata management and retrieval of image and video.

ECC 알고리즘 기반 모바일 웹 서비스 시스템의 성능 향상 (Performance Enhancement of ECC Algorithm-based Mobile Web Service System)

  • 김용태;정윤수;박길철
    • 정보처리학회논문지D
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    • 제15D권5호
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    • pp.699-704
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    • 2008
  • 인터넷의 대중화로 웹에 대한 의존도가 높아지고 사용자가 증가로 인하여 웹 서비스 성능과 커뮤니케이션의 보안 문제가 중요한 이슈가 되고 있다. 기존의 웹 서비스 기술은 동시 클라이언트 개수의 제한과 서버 처리량의 감소 그리고 평균 응답 시간을 증가시켜 웹 어플리케이션 서버의 성능을 감소시킨다. 그리고 커뮤니케이션 보안을 위한 메시지 암호화 작업과 초기 handshake 비용은 연결에 필요한 계산 시간을 증가시켜 전송 속도와 서버 성능을 감소시킨다. 따라서 본 논문에서는 보안 요구사항을 만족하고 동시에 웹 서비스를 위하여 서버의 과부하를 개선하고 웹 서버 아키텍처의 신뢰성과 안전성을 위하여 타원곡선 암호화(ECC) 알고리즘을 이용하여 암호화 처리를 수행하고, 향상된 성능과 지연처리에 필요한 기술을 제공하는 개선된 모바일 웹 서버를 제안한다.