• Title/Summary/Keyword: clinical management

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Time Measurement Study of Certified Clinical Dietitians from Tertiary Hospital in Seoul and Gyeonggi-do (병원 임상영양사의 업무별 소요시간 분석: 서울 및 경기 일부의 상급종합병원을 중심으로)

  • Um, Mi Hyang;Park, Yoo Kyung;Lee, Song Mi;Cha, Jin A;Lee, Eun;Lyu, Eun Soon
    • Journal of the Korean Dietetic Association
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    • v.21 no.2
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    • pp.123-139
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    • 2015
  • The objective of this study was to document how clinical dietitians working at tertiary hospitals spend their time based on several categories of activities using a time measurement study. The questionnaires were distributed to 14 tertiary hospitals, and dietitians answered by classifying their work activities into several categories such as general care, indirect care, direct care, outpatient care, and food service management. A total of 129 clinical dietitians replied and their answers were analyzed according to the categories of activities. The times spent on the categories are as follows: general care (76.7 mins/day, 14%), indirect care (228.4 mins/day, 35%), direct care (120.1 mins/day, 22%), outpatient care (61.5 mins/day, 11%), and food service management (99.0 mins/day, 18%). The total working hours for dietitians was 590.0 mins, which exceeds the standard working hours of 540.0 mins (9 hrs) a day. From this study, we found that clinical dietitians spent very limited time on direct care. Times spent on activities were different according to type of employment and food service. Internship dietitians spent their more time on general care (P<0.001) while irregular dietitians spent more time on outpatient care (P<0.05). In contracted managed food service hospitals, clinical dietitians spent significantly less time on food service management (P<0.001). Regardless of doctors' order and consultation fees, clinical dietitians performed more than 95 percent of free consultation to patients. Entry-level knowledge and skills of dietitians working at hospitals are very important for quality service, but it is equally important to create an administrative and social environment that encourages clinical dietitian to spend more time on direct patient care.

Pharmacological Behavioral Management for children and adolescence (소아청소년의 약물적 행동유도)

  • Shin, Teo Jeon
    • The Journal of the Korean dental association
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    • v.54 no.11
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    • pp.923-931
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    • 2016
  • Managing uncooperative behaviors related to dental treatment is necessary for guiding children and adolescence to more favorable behaviors. The first approach should be controlling their behaviors using non-phamarcologic behavior management techniques. However, if this approach fails, it is helpful to control negative behaviors pharmacologically. Accordingly, sedation is frequently used to relieve anxiety related to dental treatment. Also, general anesthesia has been applied to the situations in which sedation is either ineffective or impossible to gain cooperation during treatment. This article discusses the pharmacology of widely used sedatives for children and adolescence and clinical considerations of managing uncooperative children and adolescence with the use of sedation. Furthermore, we recommend clinical indication of selecting general anesthesia rather sedation for the purpose of behavior management.

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Order Communication System for Clinical Laboratory Tests (임상병리검사 처방전달 시스템)

  • 차은종;이태수
    • Journal of Biomedical Engineering Research
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    • v.14 no.4
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    • pp.355-364
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    • 1993
  • Clinical laboratory order communication system was developed to run fast and effective laboratory tests at the Chungbuk National University Hospital. The present system incorporated with the main Hospital Management Information System accepts :aboratory orders, classifies them based on the predefined logical system, and outputs various practical informations for the user. These assist sample taking, sample management, and work plan organization. A special care was taken to the sample management by introducing the bar code system. The system was written in the INFOS hierarchical database and COBOL, and is currently in the practical use for both in - and out-ward patients. The present system enabled fast and effective data communication as well as reducing the time and man power indispensable when the manual slips are used for order communication.

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Overview of management of children with COVID-19

  • Wati, Dyah Kanya;Manggala, Arya Krisna
    • Clinical and Experimental Pediatrics
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    • v.63 no.9
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    • pp.345-354
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    • 2020
  • The widespread and contagious coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 has become a burden in the global health domain. The subsequent discovery of the virus features and pathogenesis, and prompt and adequate management are still lacking and remain inconclusive. Children usually present milder symptoms than adults, and management focuses on providing symptomatic and respiratory supports. Several treatment modalities, including the utilization of mechanical ventilation (MV), antivirals, immune-modulating drugs, or other agents, may present promising results in reducing the symptoms of COVID-19, particularly in severe cases. Although no randomized clinical trials have been published to date, it is interesting to explore potential modalities for treating COVID-19 in children, based on review articles, case reports, and recent guidelines.

Applications of Cause-Selecting Control Charts in Hospitals

  • Zhang, Gongxu;Zheng, Huiying;Park, Sung H.
    • Journal of Korean Society for Quality Management
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    • v.22 no.3
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    • pp.142-151
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    • 1994
  • In a hospital, there are many clinical departments. In general, the hospital management often uses the index of cure rate (i.e. the rate of patients recovered by the cure of this hospital) to evaluate the medical quality of each clinical department. But, since the cure rate varies significantly with the rate of patient with severe disease, the evaluation by cure rate is unreasonable and incomplete. This paper proposes a new evaluation method called the cause-selecting evaluation method proposed by Prof. Gongxu Zhang (1990). Besides, this method can also be used to diagnose the abnormality of cure rate. The practical case studies check with the theory very well.

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An Update on Hypertriglyceridemia-Induced Acute Pancreatitis (고중성지방혈증 급성췌장염의 최신 지견)

  • Kim, Hong Ja
    • The Korean Journal of Medicine
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    • v.93 no.6
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    • pp.518-524
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    • 2018
  • Hypertriglyceridemia a major cause of acute pancreatitis, accounting for up to 10% of all cases. The pathophysiological mechanism of hypertriglyceridemia-induced acute pancreatitis (HTGP) is presumed to involve the hydrolysis of triglycerides by pancreatic lipase resulting in an excess of free fatty acids and elevated chylomicrons, which are thought to increase plasma viscosity and induce ischemia and inflammation in pancreatic tissue. Although the clinical course of HTGP is similar to other forms of acute pancreatitis, the clinical severity and associated complications are significantly higher in patients with HTGP. Therefore, an accurate diagnosis is essential for treatment and prevention of disease recurrence. At present, there are no approved guidelines for the management of HTGP. Different treatment modalities such as apheresis/plasmapheresis, insulin, heparin, fibric acids, and omega-3 fatty acids have been successfully implemented to reduce serum triglycerides. Following acute phase management, lifestyle modifications including dietary adjustments and drug therapy are important for the long-term management of HTGP and the prevention of relapse. Additional studies are required to produce generalized and efficient treatment guidelines for HTGP.

Neuropathic cancer pain: prevalence, pathophysiology, and management

  • Yoon, So Young;Oh, Jeeyoung
    • The Korean journal of internal medicine
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    • v.33 no.6
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    • pp.1058-1069
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    • 2018
  • Neuropathic cancer pain (NCP) is caused by nerve damage attributable to the cancer per se, and/or treatments including chemotherapy, radiotherapy, and surgery; the prevalence is reported to be as high as 40%. The etiologies of NCP include direct nerve invasion or nerve compression by the cancer, neural toxicity, chemotherapy, and radiotherapy. NCP is subdivided into plexopathy, radiculopathy, and peripheral neuropathies, among several other categories. The clinical characteristics of NCP differ from those of nociceptive pain in terms of both the hypersensitivity symptoms (burning, tingling, and an electrical sensation) and the hyposensitivity symptoms (numbness and muscle weakness). Recovery requires several months to years, even after recovery from injury. Management is complex; NCP does not usually respond to opioids, although treatments may feature both opioids and adjuvant drugs including antidepressants, anticonvulsants, and anti-arrhythmic agents, all of which improve the quality-of-life. This review addresses the pathophysiology, clinical characteristics and management of NCP, and factors rendering pain control difficult.

The development of CAMBRA; Updated CRA (Caries management by risk assessment (CAMBRA)의 발전; CRA 업데이트)

  • Lee, Su-Young
    • Journal of Korean society of Dental Hygiene
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    • v.21 no.4
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    • pp.321-336
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    • 2021
  • The aim of this study was to investigate the caries management by risk assessment (CAMBRA) development process and the latest updated caries risk assessment for the domestic settlement of the CAMBRA program and the activation of dental clinics. A system for CAMBRA was published in California Dental Association (CDA) in 2007. To investigate whether CAMBRA can be successfully implemented outside a university setting, a practice-based research network (PBRN) was created in the San Francisco Bay Area. Based on the CAMBRA-PRAN clinical studies, the caries risk assessment (CRA) tool was updated for patients aged 6 through adults in 2019. The CAMBRA system is expected to be widely and actively used in the dental field in Korea to contribute to oral health care.

Customer Experience Management for Cancer Patients in a Tertiary Hospital (일 상급종합병원 암환자 고객경험관리)

  • Won, Young Hwa;Kim, Ji Hye;Jung, Eun Hee;Kwak, Eun Ah;Yang, Yun Jung;Shin, Soon Ja;Kim, Yeon Hee;Kim, Jeong Hye
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.3
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    • pp.321-331
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    • 2017
  • Purpose: The purpose of this study was to investigate the effect of customer experience management on nursing service satisfaction of cancer patients and their intent to revisit the hospital and also to identify empathy ability of oncology nurses. Methods: Participants were 376 cancer patients and 190 oncology nurses from a tertiary hospital in Korea. Cancer patients' satisfaction with nursing care and intent to continue using the hospital were measured and empathy of oncology nurses was measured using Empathy Construct Rating Scale. Data were analyzed using descriptive statistics, ${\chi}^2$ test, t-test, one-way ANOVA and stepwise multiple regression analysis. Results: Patient satisfaction with nursing care and intent to continue using the hospital were higher in patients who received the customer experience management program than those who did not. Oncology nurses' ability to empathize was high. Clinical career, participate in customer experience management and education level together explained 20% of variance in empathy ability of oncology nurses. Conclusion: Findings from this study confirm that customer experience management affects patient satisfaction with nursing service and intent to continue using the hospital. Further research is necessary to reaffirm the empathy ability of the oncology nurses and to identify the related various factors.