• Title/Summary/Keyword: clinical management

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양.한방 협진 의료서비스 최적화를 위한 Clinical Pathway 도입과 진료패턴 분석 (Development of Clinical Pathway and Analysis of Clinical Patterns for Optimizing the Integrative Medical Service)

  • 오가은;박원숙;양형인;한상숙;유명철;박상찬;이상철
    • 대한한의진단학회지
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    • 제16권2호
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    • pp.23-32
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    • 2012
  • Objectives : The purpose of this research is to develop the clinical pathway for optimizing the integrative medical service (oriental-western integrated medical service) and to analyze the clinical pattern of the integrative patients who received the oriental-western integrated medical service. Methods : This research developed the clinical pathway by interviewing with doctors, nursing and experts at K Medical Center. To analyze the clinical patterns, this research used 860 integrative patients and 6345 non-integrative patients at K Medical Center since 2007. Results and Conclusions : 1. We developed the clinical pathway for optimizing the integrative medical service. 2. Comparing the clinical pattern of the integrative patients with the non-integrative patients, the results indicated that the interval and frequency of the integrative patients is shorter than that of the non-integrative patients. 3. Comparing the medical treatment type, the integrated patients take much more medical care and more frequently participate in medical treatment. 4. In conclusion, it is different that the clinical pathway of the integrative medical service from the non-integrative medical service and the integrative medical treatment is more effective than the non-integrative medical treatment.

간호관리학 실습에서의 근거기반간호 교육 적용: 결과평가와 확산 전략 (Implementation of Evidence Based Nursing Education into Nursing Management Clinical Practicum: Outcome Evaluation and Diffusion Strategies)

  • 박명화
    • 간호행정학회지
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    • 제19권1호
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    • pp.39-47
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    • 2013
  • Purpose: This practice study was done to describe the process and outcomes of application of Evidence Based Nursing (EBN) Education to nursing management clinical practicum and suggest strategies to diffuse EBN into nursing management education. Methods: Education on the evidence based nursing management process was provided to 65 senior nursing students from a university. Nursing management clinical practicum integrated with EBN. The setting was a five full day-clinical practicum. Group and individual training on EBN process with lectures, small group discussions, conferences, and educational prescription were provided. Outcomes were analyzed using paired t test for 65 participants. Results: Evidence based nursing competency increased significantly showing improvement in understanding EBN, formulating clinical question, searching & classifying the evidence, recognizing level of evidence, considering patient preference, and evaluating outcomes. Nursing students' access and use of evidence based information resource also improved. Conclusion: The results of this study indicate that the application of EBN to nursing management clinical practicum is effective to improve EBN competency in undergraduate students and should be further applied in nursing education using the systematic strategies.

디지털 병원의 CDSS구현을 위한 CPG 개발 (Developing CPG for Implementation of CDSS in Digital Hospitals)

  • 이형래;원장원;이상철;박상찬
    • 품질경영학회지
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    • 제42권1호
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    • pp.81-89
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    • 2014
  • Purpose: The purpose of this study is to propose Clinical Practice Guideline(CPG) model and Clinical Index(CI) for implementing CDSS in digital hospitals. Methods: This study uses EMR data at department of family practice in A hospital; 636 patients, 570 diseases (based on ICD 10-CM criteria), and 37,000 data related with labs and treatments. This study focuses on disease J342 which is the most high rate of incidence. Results: Using the suggested model, this study calculates frequency matrix and probability matrix to find out the correlation of diseases and labs. This study indicates the lab sets of Disease (J342) as CI for CPG. Conclusion: This study suggests CPG model including Lab-based, Disease-Based and Case-based modules. Through 6 level cased-based CPG model, especially, this study develops Clinical Index(CI) such as the Incidence Rate, Lab Rate, Disease Lab Rate, Disease confirmed by Lab.

A Comparison of the Clinical Competence, Knowledge of Patient Safety Management and Confidence of Patient Safety Management according to Clinical Practice Experience of Nursing Students

  • Lim, Jae-Ran;Song, Hyo-Suk
    • 한국컴퓨터정보학회논문지
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    • 제26권7호
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    • pp.65-73
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    • 2021
  • 본 연구의 목적은 간호대학생의 임상실습 경험에 따른 임상수행능력, 환자안전관리지식 및 환자안전관리 수행자신감의 차이를 비교하기 위함이다. 간호대학생 3학년을 대상으로 임상실습을 경험한 73명, 임상실습을 경험하지 못한 35명으로 총 108명 분석하였다. 분석방법으로는 동질성 검정은 X2-test, 두 그룹간의 차이비교는 independent t-test로 분석하였다. 연구결과로 두 그룹간의 임상수행능력(t=.88, p=.377), 환자안전관리지식(t=-.29, p=.773) 및 환자안전관리 수행자신감(t=1.11 p=.267)의 차이는 통계적으로 유의하지 않았다. 두 그룹에서 각 변수의 하위영역별 가장 점수가 낮은 항목을 살펴보면, 첫째, 임상수행능력에서는 간호과정에 대한 영역에서 대체로 점수가 낮았고, 둘째, 환자안전관리 지식은 근접오류에 대한 개념에 대한 지식 측정 영역에서 가장 낮았으며, 셋째, 환자안전관리 수행자신감에서는 오류 발생 시 사건 보고서 작성에 대한 수행 자신감 영역에서 점수가 가장 낮은 것으로 확인되었다. 따라서 간호대학생의 임상수행능력의 질적 향상을 위해서 임상실습교육환경 개선이 절실하게 요구되며, 간호대학생의 환자안전관리 역량 증진 및 환자안전관리에 대한 올바른 태도 함양을 위해 전략적인 교육지침의 개발이 필요하다.

일부지역 치위생(학)과 학생들의 임상실습 스트레스와 대처 (Stress and coping of dental hygiene students in clinical practice)

  • 심형순;이향님
    • 한국치위생학회지
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    • 제14권2호
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    • pp.139-145
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    • 2014
  • Objectives : The purpose of the study is to investigate the clinical practice stress reduction and to improve clinical practice satisfaction in dental hygiene students. Methods : The subjects were 354 dental hygiene students in Gwangju and Jeonnam. A self-reported questionnaire was filled out from June 3 to 21, 2013. The questionnaire included stress management in the clinical practice. Results : As for clinical practice stress, there was a significant relevance between satisfaction in major and clinical practice. Clinical practice stress coping had a significant relevance to clinical practice satisfaction and clinical practice stress. Conclusions : In order to reduce clinical practice stress in dental hygiene students and to enhance clinical practice satisfaction, it is important to develop clinical practice stress management program and to develop the appropriate measurement tool for stress.

간호대학생의 임상수행능력에 영향을 미치는 요인 (Factors Affecting Clinical Competence among Nursing Students)

  • 서보민;박현주
    • 보건의료산업학회지
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    • 제8권4호
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    • pp.149-161
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    • 2014
  • The purpose of this study was to identify the association of factors related to clinical practice training for clinical competence among nursing students, and to analyze those factors influencing clinical competence, providing recommendations for improving their clinical competence and clinical learning environment. This descriptive correlative study completed organized questionnaires from 557 nursing students. The data was analyzed by SPSS 19.0. The most important factor affecting the clinical competence among nursing students was teaching effectiveness (${\beta}=.22$). followed by critical thinking (${\beta}=.19$). and the professional self-concept (${\beta}=.19$). The explained variable for clinical competence was 45.2% in nursing students. Thus, the development of an effective clinical internship program is important for strengthening nursing students' clinical competence. We suggest that the capability of nursing students should be strengthened and effective clinical internship programs should be developed to improve the clinical competence of nursing students.

간호대학생이 인식한 간호관리학 실습 중요도와 실습경험도 비교 (A Comparison between Importance of Nursing Management Clinical Practicum and Practical Experience recognized by Nursing Students)

  • 황성우;구옥희
    • 한국융합학회논문지
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    • 제10권9호
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    • pp.351-361
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    • 2019
  • 3개 대학 간호학과 4학년 간호관리 임상실습을 경험한 학생 289명을 대상으로 간호관리학 실습교육내용에 대한 중요도 인식 및 실제 실습경험에 대하여 비교 조사하였다. 연구결과 평가 항목에서 책임감, 대인관계, 신뢰, 의사소통, 도덕성 순으로 중요하게 인식하였다. 간호관리 실습교육내용의 중요도에서는 간호단위관리를 4.37(최대 5점)로 가장 중요하게 인식하였다. 실제로 임상에서 직접 경험할 수 있었던 항목은 간호단위관리(22.0%), 간호관리의 이해(20.7%), 인적자원관리(19.8%)가 빈도순으로 가장 높았으며 실제 경험을 전혀 못 한 항목으로는 마케팅(52.4%), 재무관리(44.0%)였다. 학생들이 인식한 실습내용의 중요도와 실제 실습경험을 한 항목 간에는 여전히 불일치가 나타나 표준화된 간호관리학 임상실습 프로토콜의 완성과 관리실습 전담 프리셉터 제도의 시행을 제언하고자 한다.

임상실습 중 치위생학과 학생들의 감염관리에 대한 인식과 수행정도에 관한 연구 (The study of awareness and performance of Dental hygiene students for infection control during clinical training)

  • 박영남
    • 디지털융복합연구
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    • 제15권11호
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    • pp.307-315
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    • 2017
  • 본 연구는 임상실습을 경험한 치위생학과 학생들을 대상으로 임상실습지에서 치과감염관리에 대한 인식과 수행정도를 조사하여 병원내 감염을 최소화 시키고 교육과정개발과 교육프로그램을 마련할 때 감염관리 지침과 행동지침에 필요한 기초자료를 제공하기 위해 시행하였다. 경북에 소재하는 4년제 대학에서 임상실습을 실제 경험한 치위생학과 학생을 대상으로 설문조사하였으며 치과의원, 치과병원, 대학병원이나 종합병원에 실습한 학생을 구분하여 각 실습지에 따른 치과감염관리에 대한 인식과 수행정도를 비교하였다. 연구결과 학생들은 감염방지에 대한 교육 경험자가 많았으나 실습지에 따라 감염방지관리의 수행정도는 대학병원이나 종합병원에서 높았으며 실습지에 따라 차이가 나타났다. 따라서 학생들이 임상실습시 감염관리에 대한 인식과 수행정도를 높이기 위해서는 감염관리 지침서를 제작하여 임상실습기관에 배부하고 담당자를 통해 관리하며 학교 측에서는 임상실습과 연계성 있는 감염관리 교육프로그램을 운영하여 체계적인 제도를 마련해야 할 것으로 생각된다.

중풍환자에 대한 일차 한의임상진료 가이드라인 (Clinical Practice Guideline of Korean Medicine for Stroke : Preliminary Guideline and Recommendation)

  • 한창호
    • 대한한방내과학회지
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    • 제33권4호
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    • pp.347-366
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    • 2012
  • The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

시뮬레이션 기반 응급기도관리 교육이 간호사의 자기효능감, 임상수행능력에 미치는 효과 (The Impact of a Simulation-based Education Program for Emergency Airway Management on Self-efficacy and Clinical Performance among Nurses)

  • 이미자;정덕유
    • 성인간호학회지
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    • 제26권1호
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    • pp.1-10
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    • 2014
  • Purpose: This study was conducted to test the impact of simulation-based education program for emergency airway management on self-efficacy and clinical performance ability. Methods: A quasi-experimental non-equivalent control group pre-post test design was used. A total of 60 nurses, 30 nurses assigned to the simulation-based education group and 30 nurses to a traditional lecture group. The treatment group received a lecture, small group workshop and team simulation whereas the comparison group received lectures. Results: The participants in the simulation-based education group reported significantly higher self-efficacy of emergency airway management compared to participants in the lecture only group (t=5.985, p<.001). The simulation-based education group showed significantly higher clinical performance ability of emergency airway management compared with the lecture group (t=5.532, p<.001). Conclusion: Simulation-based education was verified to be an effective teaching method to improve the self-efficacy, clinical performance skills of nurses in the learning of emergency airway management.