• Journal of the Korean Dietetic Association
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• v.22 no.1
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• pp.53-69
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• 2016

The purpose of this study was to analyze the importance-performance of clinical nutrition management in convalescent hospitals. The research was carried out based on questionnaires administered from March to April, 2015 to 73 dietitians at 40 convalescent hospitals in the Gyeongnam area. There was a statistically significant difference between the mean scores for importance (4.01/5.00) and performance (2.95/5.00) of clinical nutrition management. The importance and performance grid analysis showed that participation in a nutritional management committee, administration of patients using a cooperation program among hospital departments, cooperation with a medical team on patient's nutrition status, nutrition initial assessment, nutrition care process for patients showing malnutrition, nutrition care process for tube feeding patients, management of a therapeutic diet, meal management using dietary slip instructions including a therapeutic diet, and explication of a therapeutic diet for patients scored high regarding importance and performance (doing great area). Medical records on patient's nutrition management, and nutrition counseling for requested patient scored low regarding the importance and high regarding performance (overdone area). Participation in medical rounds, personal nutrition education for patients, group nutrition education for patients, nutrition education for medical teams, development of a menu for therapeutic diet and standardized recipes, and provision of information on diet therapy for patients after discharge scored low regarding importance and performance (low priority area). Accreditation of convalescent hospitals and interest of medical professionals in clinical nutrition management were effective variables for the importance-performance gap of clinical nutrition management. In conclusion, the accreditation process and positive awareness of medical professionals with regard to clinical nutrition management had positive effects on reduction of the importance-performance gap in clinical nutrition management at convalescent hospitals. The strength of clinical nutrition management in the accreditation and development of an education program for increasing medical team or administrator interest in clinical nutrition management could lead to improvement of clinical nutrition management for elderly patients in convalescent hospitals.

• Journal of the Korean Dietetic Association
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• v.20 no.3
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• pp.199-211
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• 2014

The increasing elderly population has created an urgent need for well-managed convalescent hospitals, which should provide appropriate clinical nutrition services. The new accreditation policy requiring participation of all convalescent hospitals since 2013 may promote improvement of clinical nutrition services. This study examined whether or not the accreditation policy has increased practice level and dietitians' perception of the importance of clinical nutrition management. Of the 177 convalescent hospitals accredited by January 30, 2014, dietitians from 73 hospitals (41.2%) completed the survey questionnaire. The pre-tested questionnaire surveyed general characteristics of the hospital and dietitians, current status of clinical nutrition management, and changes in the perception and practice levels of various aspects of food and clinical nutrition management. In average, dietitians with more than 5 years of work experience (68.1%) provided food and clinical nutrition services (71.2%). After accreditation, dietitians' perception of the importance and practice level of clinical nutrition service increased (P<0.001). Level of perception, however, was significantly (P<0.001) higher than practice level before and after accreditation. During perception and practice level of initial nutrition assessment, a compulsory accreditation item, notably and significantly (P<0.001) improved after accreditation. The significant difference between perception and practice level disappeared after accreditation. In conclusion, the accreditation process had positive effects on clinical nutrition management in terms of dietitians' perception and practice levels. Making more accreditation items compulsory and providing motivation and professional education to dietitians in convalescent hospitals could lead to additional improvements.

• Quality Improvement in Health Care
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• v.25 no.2
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• pp.56-72
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• 2019

Purpose: The purpose of this study was to determine the factors that influence the performance and importance of clinical nutritionists. Methods: Ninety-nine nutritionists working in mental health institutions were assessed. Results: Factors affecting the performance of clinical nutritionists in certified hospitals were shown to have a significant positive effect on the description of treatment diet, status of clinical nutrition management, and presence of a nutrition counselor. The factors affecting importance were the number of permission beds and total work experience. Conclusions: In order to improve the accreditation system of mental hospitals, it is necessary to expand the scope of this study to include hospitals with fewer beds, and clinical nutrition management should be mandatory.

• Journal of the Korean Dietetic Association
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• v.2 no.2
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• pp.199-215
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• 1996

In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.

• Journal of the Korean Dietetic Association
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• v.6 no.2
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• pp.148-160
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• 2000

The purpose of this research was to analyze the tasks on foodservice ․ clinical nutrition service in hospital dietetic departments. A survey of 30 hospital food and nutrition service departments was undertaken and detailed informations were collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Regarding dietitian's training period, 38.6% dietitians answered that they spent 1~2 years in mastering food service management. 28.4% dietitians replied that they needed 2~3 years in learning clinical nutrition management. It was shown that 48.9% dietitians were engaged in food service management, while 26.7% were engaged in clinical nutrition and 26.7% were engaged in both. The 13 elements of food service management showed low performance level. These elements were food temperature, food intake, menu selection, contaminated substances and serving mistake and reliance on hospital food. These should be controlled with caution. The average score of dietitian's life satisfaction within the work place was 3.42 out of 5. The most dissatisfactory element was physical environment of the workplace. 5 elements for improving nutrition service activities showed low performance level with high importance score. Problem analysis showed low difference score between importance and performance level. Hospitals under contract foodservice management received higher points on clinical nutrition performance(P<.05) than hospitals under self-operated foodservice management.

• Journal of the Korean Dietetic Association
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• v.18 no.3
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• pp.266-275
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• 2012

The purpose of this study was to evaluate the perception and needs of doctors on clinical nutrition services. A cross-sectional survey design was used. The doctors' perception and needs were assessed by questionnaires that had been specifically designed for the study. The research was conducted from February 14 to March 15, 2011 for 544 doctors at 42 large hospitals (with over 400 beds). Ninety-eight percent of doctors responded that clinical nutrition service was important. The mean scores of importance on clinical nutrition service were 4.45 for 'nutrition screening at admission', 4.50 for 'treatment of malnutrition', and 4.43 for 'nutrition education and counseling'. The mean scores of needs for clinical nutrition service were 4.42 for 'individual nutrition counseling & education' 4.39 for 'nutrition management for malnourished patients' and 'nutrition management for tube fed patients'. The medical specialists showed significantly (P<0.01) higher scores than the residents on the importance and needs for clinical nutrition services. Eighty-five percent of the doctors recognized the necessity of the specialized dietitians classified by diseases. The medical specialists (93.8%) showed significantly (P<0.01) higher recognition of this necessity than the residents (77.7%). The low residents' perceptions of the importance and needs for clinical nutrition services will necessitate clinical nutrition education plans. The departments of clinical nutrition in universities should improve the ability and skills of the clinical dietitians.

• Korean Journal of Community Nutrition
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• v.24 no.6
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• pp.512-524
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• 2019

Objectives: The purpose of this study was to examine the food allergy-related knowledge, awareness, and performance of dietitians at children's hospitals, depending on whether or not they have a clinical dietitian certificate. Methods: A questionnaire survey was administered to 41 dieticians at children's hospitals registered as a part of the Korean Hospital Association. The survey consisted of questionnaires examining general characteristics, nutritional counseling-related characteristics, and food allergy-related characteristics (food allergy-related knowledge, awareness, and performance). We examined differences according to the status of clinical dietitian certification. Results: The proportion of subjects who were holders of clinical dietitian certificates was 48.8%. There were differences between holders of clinical dietitian certificates and non-holders as follows. Regarding nutritional awareness and performance, 'needs to provide nutrition counseling in children's hospitals', 'providing nutrition counseling services in working hospitals', and 'whether there is a nutrition counseling room' scored higher among holders of clinical dietitian certificates than non-holders. Holders of clinical dietitian certificates showed higher scores for knowledge of food allergy symptoms and food allergy management than non-holders. For food allergy awareness and performance, 'self-assessment of food allergy knowledge understanding level', 'awareness of open oral food challenge (OFC)', 'recognition of the need for education and counseling on food allergy for patients / guardians', and 'food allergy related educational experience' scored higher among holders of clinical dietitians certificates than in non-holders. Conclusions: Children's hospital dietitians with a clinical dietitian certificate showed high knowledge, awareness, and performance related to food allergies. It is thus necessary to employ a clinical dietitian for food allergy management in children's hospitals. In addition, training and conservative education are necessary for the management of food allergies for children's hospital dietitians.

• The Journal of the Korea Contents Association
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• v.20 no.6
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• pp.156-166
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• 2020

This study was intended to investigate differences in the recognition of the importance and performance of clinical nutrition management by using IPA. For the study, 100 clinical nutritionists working at medical institutions were analyzed. In all 17 categories of nutritional management, significant differences were observed in awareness of performance and importance. The categories with the greatest difference in importance and performance awareness were the nutritionist's participation in clinical nutrition education and related job development activities(1.38), and the lowest categories were the provision of therapeutic meals(0.69). Since IPA analysis results showed that participation in clinical nutrition education and related task development were both low in importance and performance, it should be improved first. A way to improve is for nutritionists to receive internal and external education. Above all things, for effective treatment, policies to include clinical nutritionist in the category of medical personnel, and cooperation between the medical sector and nutrition service management are necessary.

• Journal of Ginseng Research
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• v.34 no.4
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• pp.264-273
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• 2010

While ginseng is reported to have a wide array of applications, there is growing evidence for its indications in diabetes and vascular disease. A clear connection, however, has not been established between ginseng's composition, dose and its targeted efficacy in humans. We therefore developed and initiated the Korean Red Ginseng Clinical Testing Program for diabetes and vascular function which is an efficacy and safety-based clinical screening model for ginseng. The most efficacious sources, ginsenoside profiles, doses, and modes of administration were examined in sequential, acute, followed by long term, randomized-controlled trials to investigate the efficacy and safety profiles. This review discusses the current state of the clinical research of Korean red ginseng program conducted in Toronto, paving the way for the use of clinically selected ginseng and its ginsenoside fractions in the management of diabetes and vascular diseases.

• Journal of the Korean Dietetic Association
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• v.6 no.2
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• pp.136-147
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• 2000

The aim of this research was to examine the management practices related to foodservice.clinical nutrition service provided by hospital foodservice operations. A survey of 30 hospital food nutrition service departments was undertaken and detailed information was collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Out of 30 hospitals, 73.3%(22) were directly operated and 26.7%(8) were under contract foodservice management. Licensed number of beds were 768.7, with an average length of 11.4 days. The general characteristics of the dietitians were that 49.4% were aged between 25-29, and 60.8% were ordinary dietitians. 76.7% had bachelor's degree, 15.9% with master's degree and 7.4% were college graduates. Most hospital dietitians had internship training and 35.2% took a training course of 6 to 12 months. The average space of kitchen was 452.52 $m^2$, with 133.63$m^2$ for modified diet space and 18.13$m^2$ for nutrition counselling room space. The total number of normal meals was 1,255.47, with 502.93 of modified meals. The average calorie of normal meals was 2,145.04kcal, with 91.9g of protein contained in normal meal. The total food waste was 351.40kg. An average monthly cost for disposing food waste was 745,171.67 won. 83.3% of the kitchens were on the 1st basement and only 66.7%(20) of 30 hospitals had its own nutrition counselling room. 80% used dishwashers and 66.7% had an exclusive elevator for delivering meals. 80.0% of hospitals used centralized delivery service. 90% had established an area for hygiene division, 70% used dry zone within the dishwashers for sterilization, 66.7% provided spoon and chopstick, and 100% used dish cover. As means of food waste treatment, most hospitals(56.7%) used animal feed by contracters, followed by means of collection by contracters(30%) and in-house high speed fermentation machines(13.3%). It was found that only 33.3% hospitals regularly checked temperatures of the meals given to patients. Total productivity index was 3.72(meals/hour) in average, with an average productivity index for normal diet of 5.41. Average productivity index for modified diet was 4.62. Productivity indices for patient meals and clinical nutrition were 5.01(meals/hour) and 1.12(cases/hour) respectively and hospitals under self-operated foodservice management received higher points on clinical nutrition productivity index(P<0.01) than hospitals under contract foodservice management.