• 한국의료질향상학회지
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• 제14권1호
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• pp.55-59
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• 2008

Background : The purpose of inner cannula is to protect the upper air way and permit air to pass freely, in addition, to provide endotracheal suction, artificial respiration and to maintain adequate oxygen saturation. The tube needs to be sterilized for maintenance and cleanness of air way and for prevention of bronchospasm. However, it has been reported that there is no guideline for sterilization and many hospitals conduct their own sterilization methods, for example, once a day(13's general hospital), three times a day(The Catholic University of Korea ST Mary's hospital) or even no cleansing. Consequently, the QI team of our hospital suggested the SOP(standard operating procedure) of sterilization and evaluate cost and time effect in nursing. Method : 1) Benchmarking of 13's neurosurgery department of general hospital in Seoul 2) Investigation of test records of sputum culture from patients with intubation for tracheotomy 3) Check of results of O2 Sat. monitoring to confirm of maintaining opened air way Result : 1) Improvement of process: decrease of excess sterilization of inner cannula (from 3 times a day to once a day) 2) Cost effects: saving over 10 million won per one year 3) Providing better nursing: time effects (30 min a day) permit to conduct more nursing activities Conclusion : It can get Cost and time effects in nursing with improved sterilization method of inner cannula. It needs to do research on improvement of the monthly exchange protocol of outer cannula and provide supporting data for the proper exchange schedule. The result of additional microorganism detection from patients with new process needs to be evaluated further more.

• 한국산학기술학회논문지
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• 제18권5호
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• pp.111-119
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• 2017

본 연구는 치과의원에 내원한 환자의 치과서비스에 대한 차별감이 재이용의사에 미치는 영향을 파악하기 위하여 충청북도 J시 소재 치과의원에 내원한 만 20세 이상 환자 432명을 대상으로 2015년 3월 9일부터 2015년 3월 31일까지 설문조사를 실시하여 다음과 같은 결과를 얻었다. 재이용의사에 영향을 미치는 중요한 변수로는 치과 의료서비스 질의 의료진, 친절성, 병원 이미지, 이용 편의성, 및 서비스 가치, 치과 서비스에 대한 차별감이 있었고, 이 변수들의 전체 설명력은 78.2%이었다. 또한 고학력군, 월평균 가족수입 400만원 이상군, 사무직군, 임플란트 치료의 방문목적군, 주위소개군 뿐만 아니라 서비스 가치, 의료진, 환경시설, 이용 편의성, 친절성, 병원 이미지가 높을수록 유의한 관련성이 있었다. 따라서 치과서비스 제공자들은 환자들의 치과 서비스에 대한 차별감을 인지하여 외적인 요인뿐만 아니라 환자가 느끼는 차별감이 최소화 될 수 있도록 양질의 치과 서비스를 통해 이를 충족시키기 위한 노력이 필요하다고 본다.

• 아동학회지
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• 제13권2호
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• pp.217-228
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• 1992

The purpose of this study is to examine the effects of early full-time nonparental care during infancy/toddlerhood on children's socioemotional behaviors during the preschool period. Subjects for this study were 105 three- to five-year-olds from middle-class families in the U. S. A. Children were assigned to one of three groups according to their early care history. Children's social interactions with peers and caregivers during indoor free-play sessions in day care centers were observed for 20 minutes. The head teachers rated the children's social and emotional behaviors on two questionnaires. Mothers completed the Attachment Q-sort for attachment assessment for the preschoolers. In addition, mothers were asked to fill out a questionnaire on their parenting practices. Children who had received full-time nonparental care during infancy and/or toddlerhood were rated by their teachers as being more intellectually competent than children who did not receive full-time nonparental care during first three years of life. They were, however, rated by teachers and were observed by the researcher as being more aggressive than children with no full-time nonparental care. These children were observed to engage in less wandering/onlooking behaviors than children who had not had any full-time nonparental care. Children's attachment security scores and dependency scores did not differ as a function of early nonparental care histories. When the effects of early care patterns, sex of child, and current attachment security to mothers on aggressive behaviors of the preschoolers were examined by a hierarchical regression model, then any "pure" effects of nonparental care and of attachment security on child aggression were minimal after controlling for family background, child care center quality, and maternal childrearing practices. Strong buffering factors for the preschool children (family characteristics, parenting styles, and high quality nonparental care) mediated a possible risk factor of early nonparental care and promoted optimal outcomes for the children.

• 한국의료질향상학회지
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• 제18권1호
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• pp.37-55
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• 2012

Objectives : This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients. Methods : Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients. Result : The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful. Conclusion : Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.

• 아동학회지
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• 제26권5호
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• pp.105-121
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• 2005

Data were collected from 120 teachers at 67 childcare centers in Seoul and Kyunggi-Do. The Assessment Scale for Day Care Programs(Rhee et ai., 2003) was used to observe teachers' interaction behaviors. Subjects responded to the teachers' job stress scale developed by the author and a modified version of teachers' efficacy scale based on the Science Teaching Efficacy Belief Instrument(Enochs & Riggs, 1990). Data were analyzed with descriptive statistics, Pearson correlations, and hierarchical regressions. Results showed that quality of teachers' interaction behaviors correlated negatively with teachers' job stress, and positively with teachers' personal efficacy; teachers' belief of efficacy moderated the relationship between job stress and teachers' interaction behaviors.

• 한국의료질향상학회지
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• 제19권1호
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• pp.74-81
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• 2013

Research Problem: 45-65% of all medical supplies in hospital are used in operating rooms. Medical supplies in operating rooms are difficult to manage in general because many of them are frequently used and come in a variety of types. Purpose: Our aim was to strive for user-friendliness and reduce the inventory through efficient management of medical supplies stocked in operating rooms. Medical Facility: Korea University, Ansan Hospital Quality Improvement Activity: On the last day of each month, we checked the inventory of medical supplies in all operating rooms by identifying the amount of medical supplies in each room, warehouse, and OCS, identified problems, and presented the ways to improve. Improvement Outcome: We increased the number of post-processing medical supply items by 8%, and reduced the inventory cost by 15% through improved management of medical supplies.

• Journal of Hospice and Palliative Care
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• 제22권2호
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• pp.67-76
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• 2019

포괄적이고 총체적 돌봄을 제공하는 호스피스 완화의료의 경우 평가도구를 사용하여 문제목록의 객관화하고 돌봄 계획의 구체화하는 것이 필요하다. 초기평가는 입원 당일 혹은 1일 이내에 환자의 증상과 사회적, 영적 문제, 완화의료에 대한 요구가 무엇인지 파악하며 개괄적인 돌봄의 방향을 설정하는 과정이다. 현재 병에 대한 인식과 예후를 파악하는 것부터 연명의료계획서 작성까지 함께 검토한다. 초기평가도구로는 간단하지만 포괄적으로 신체적, 정신적, 사회적, 영적 영역을 아우르는 13개의 간단한 질문으로 구성된 NEST를 추천한다. 초기평가에서 파악된 문제에 대하여 구체적인 평가도구들을 활용하여 돌봄 계획을 수립하며 입원 후 3일이내 시행하는 것이 좋다. 신체적 영역의 경우 기능상태를 포함하여 통증과 비 통증 증상, 삶의 질을 함께 파악할 수 있는 다증상 평가도구가 도움이 될 수 있다. 환자의 증상은 단독으로 의미를 가지는 것이 아니라 복합적인 상호작용으로 발생하며, 그에 따라 포괄적으로 접근해야 하기 때문이다. 정신심리적 영역은 심리적 고통과 불안, 우울을 평가한다. 사회적 영역의 평가는 의사결정, 사회경제적 환경 파악, 가족 평가 및 임종 준비의 단계로 이루어진다. 영적 평가 역시 중요한데 FACIT-Sp나 SHI를 사용할 수 있다. 평가도구를 활용하는 것은 환자의 고통을 경감시키고 삶의 질을 향상시킬 뿐 아니라 의료진이 체계적으로 훈련되는 방안이 될 수 있으며 그 과정 자체가 더 나은 돌봄 제공을 위한 발판이 될 수 있다.

• 지역사회간호학회지
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• 제14권1호
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• pp.106-119
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• 2003

This study was executed to develop the model of the format of the day care center which supplies the total service on the health care in the day time and social program related with the work and to evaluate the processing courses which was adjusted for 3 years from March 1999 to December 2001 in order to improve the quality of life of the family who experience dementia, dementia prevention, and the old and the burden of daily activities. The processing courses of this business model were evaluated to the confirmation on the health condition, application of the nursing processes, and the precise medical examination, and 20 sorts of social programs. The methods used in this model were the simplified MMSE-K, Ability for ,Daily Life(ADL), Instrumental Activities of Daily Living(IADL), and nursing process, and so on. The execution effects of this model are as follows. 1. It can contribute to the delay in the dementia process of the old people who are related with the dementia and maintenance and improvement of the health by confirming the stopping of the process of the dementia as the objective estimation method while the dementia symptom is maintained as the current condition through the medical and social total services. 2. The reduction of the burden for the daily care of the subject people and their families for the old people who are concerned with the dementia helped to improve the quality of life of the subject people and their family by enabling them to have jobs. 3. It enabled them to positively cope with the demand for the health and nursing of the local residents related to the old people. 4. It enabled them to enhance the recognition for the socialization of the local social organization and residents for the old people. 5. It enabled them to reinforce the related system among the local social organizations, and develop and provide the various social programs which are proper for the old people.

• 대한가정학회지
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• 제46권4호
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• pp.25-35
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• 2008

The purpose of this study was to investigate the relationship pattern among the children's negative and aimless behaviors, and the variables related to teachers (characteristics, stress, efficacy, and quality of teachers' behaviors). Subjects were 190, 5 year-old children and 48 teachers at 45 child care centers. The children's negative and aimless behaviors were observed with time sampling method. The quality of teachers' interaction behaviors was rated by the Assessment Scales for Day Care Programs during the free play activities. Teachers responded to the Scale for the Teachers' Job Stress and Teachers' Efficacy. The data were analyzed with descriptive statistics, Pearson's correlations, multiple regressions, and partial correlations. The results were as follows. The teachers' experience and the quality of teachers' behaviors significantly explained the children's negative behaviors. The quality of teachers' behaviors significantly explained the children's aimless behaviors. Lastly, the quality of teachers' behaviors mediated the relationship between the teachers' job stress and the children's aimless behaviors.

• 근관절건강학회지
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• 제27권2호
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• pp.169-176
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• 2020

Purpose: This study aims to investigate the factors affecting fatigue of care helpers in long-term care facilities. Methods: The subjects consisted of 131 care helpers at six long-term care facilities in Chungcheongnam-do. A survey was conducted between July and September 2019 to collect data, which were analyzed using t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis.Results: An increase in fatigue of care helpers owing to taking care of over 10 patients a day, increase in emotional labor and sleep disturbance, and a decrease in economic status was observed. Their fatigue decreased when there was an increase in their subjective health status and job satisfaction. Work-related stress (β=.37, p<.001), emotional labor (β=.21, p=.014), and sleep disturbance (β=.18, p=.026) significantly predicted fatigue. These factors explained 37% of the total variance in fatigue (F=10.48, p<.001).Conclusion: In addition to improving the work environment, interventions that alleviate emotional labor and improve sleep quality, are needed to lower the fatigue of care helpers.