• 한국의료질향상학회지
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• 제5권1호
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• pp.76-91
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• 1998

Background : The purpose of this study was to understand general attitudes of physicians toward hospital quality improvement activities who have been members of QA committee in 32 Korean university hospitals. Methods : A postal survey about opinions of hospital quality improvement activities and desirable policy directions was sent to 328 QA committee member physicians. The questionnaires were composed of 48 items. In total 152 physicians responded to this survey(response rate: 49.3%). This study was carried out from January to February 1996. Results : Most physicians(97.5%) recognized the necessity of hospital QA activities. The most dominant supporting reason for quality activities was to improve clinical outcome. Two thirds of physicians regarded their own hospital activities for quality improvement as inactive. They considered that the obstacles were too little concern(33.6%), unclear objectives(28.9%), lack of human resources(14.3%), and insufficient education and training for quality improvement(10.1%). The most favoring policy among respondents was to give health care providers economic incentives. Provision of education and training for implementing quality improvement was the next to it. Physicians revealed their preferences for professional society, government, health insurance societies, consumer groups, hospital labor unions, and mass media in sequence as sponsoring agencies for hospital accreditation program. Conclusion : These study suggested that the concrete means for motivating physicians and promoting constructive partnership among related parties should be developed in order to activate current hospital quality activities in Korea.

• 가정간호학회지
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• 제17권2호
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• pp.85-94
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• 2010

Purpose: The study aimedto provide basic data to improve the quality of home healthcare nursing services by evaluating quality of care in representative nationwide sites. Method: The current quality of home care service in 104 nationwide sites was evaluated in terms of structures, processes, and outcomes based on published standards of the Joint Commission on Accreditation of healthcare Organizations. Results: The mean score for three dimensions of quality of home care service was as follows in descending order: structures (77.6), outcomes (60.4), and processes (38.7). Additionally, by specific item compared level of quality of home care servicein each site, the highest score was 97.3 and the lowest score was 42.3 out of 100, with a mean score of 74.7. Conclusions: These findings provide a base for establishing the quality management system and to develop a tool for evaluating the quality of home healthcare nursing. The result should be continuous management and improvement of home healthcare nursing quality.

• 한국의료질향상학회지
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• 제5권2호
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• pp.224-237
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• 1998

Background : This is an investigative study to analyse the importance of works perceived by Quality Improvement(QI) Coordinators and to evaluate their current work performances using the questionnaires developed by the investigator. Methods : The data were collected from 37 subjects over two weeks period from Oct. 1 to Oct. 17, 1998 and analysed by the descriptive statistics of SPSS program. The items of questionnaire are consisted of 13 work domains including 73 activities based on Quality Management(QM) Coordinator's job description of National Association for Healthcare Quality:data collection & analysis, communication, monitoring, evaluation, accreditation, tool development, policy development, program development, self development, education & trainning, system design, planning, and consultation & support. Results : 1) Of the performances in 13 work domains, the frequencies of the work performed were accreditation(89%), planning(88%), communication(83%), data collection & analysis(82%), monitoring(76%), policy development(72%), consultation & support (71%), education & trainning(70%), self development(68%), evaluation(63%), tool development(61%), program development(44%) and system design(43%) in order. 2) For the importances (1=not important, 5=very important), the policy development(4.46) scored highest then monitoring(4.42), planning(4.41), education & trainning(4.38), communication(4.35), evaluation(4.34) tool development (4.30), data collection & analysis(4.29), program development(4.22), consultation & support(4.22), accreditation(4.15), self development(4.05) and system design(3.98) in order. 3) There was a difference between the work performance and the perceived importance. The results showed the low performances in policy development, monitoring, education & trainning and evaluation which ranked high by the perceived importance and the high performances in accreditation, data collection & analysis, self development, communication and consultation & support which ranked middle to low by the perceived importance. 4) The reasons for low performances of QI Coordinators were the lack of clear assignment for the responsibility and allowed authority for work to QI Coordinators(30.8%), insufficient member of QI Coordinators(13.9%), lack of hospital director's interest(11.5%), low motivation of QI Coordinators (10.6%) and insufficient knowledge & experience of QI Coordinators (8.8%). Conclusion : Most works were perceived important by QI Coordinators, but there was a difference in the work performance. The works performed over 70% were related with accreditation, data collection & analysis, communication, planning and monitoring, on the other hand under 50% in performances were related with system design, program development, tool development and evaluation.

• 여성건강간호학회지
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• 제5권1호
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• pp.133-145
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• 1999

The purposesof the study are to analyze the community nursing center in U.S.A and to develop the model of nursing care system based on nurse-midwifery clinic in community for women's health in Korea. 1. In America nursing center is defined as nurse-anchored system of primary care delivery or neighborhood health center. Nursing centers are identified the following four types: (1) community outreach centers, which are similar to traditional public health clinics: (2) institutional-based centers following the mission of a large institution, such as a hospital or university: (3) wellness/health promotion centers, which offer screening, education, counseling, triage, and health maintenance services: and (4) independent practice. Nursing centers are a concept of services provided by nurses in practice arrangements in a community. Nursing centers offer a variety of services, ranging from primary care provided by advanced practice nurses with medical acute management and nursing care to the more traditional education, health promotion, screening wellness and coordination services. Some services, such as the care provided by advanced practice nurses are reimbursed under various insurance plan in some instances and states, where as others, such as preventive and educational services, are not. Thus, lack of reimbursement has threatened the survival of some centers. Licensing of nursing centers varies by state and program and accreditation of nursing centers is also limited. 52% of centers are affiliated with another facility and 48% are freestanding centers. The number of registered nurse at the nursing centers ranges from just one to 115, with a mean of eight RNs peragency and a median of three. Nursing centers avail ability varies: 14% are open 24 hours, 27% have variable short hours, 23% are open 6-7 days per week, and 36% are open Monday- Friday. As the result of my visiting three health centers in Seattle and San Francisco, the women's primary care nurse practitioners focus on a systematic and comprehensive assessment of the health status of women and diagnosis and management of common physical and psychosocial health concerns of women in ambulatory settings. Therapeutic nursing strategies are directed toward self-care, risk reoduction, health surveillance, stress reduction, healthy nutrition, social support, healthy coping, psychological well-being, and pharmacological therapy. They function as primary care providers for the well ness and illness care of women from adolescence through the older adult years and pregnant families. 2. In Korea a nurse-midwife practices independently for pregnant women's health including childbearing family at her own clinic in community. Her services are reimbursed under national health insurance but they are not paid on a fee-for-service schedule covering items. Analyzing the nursing centers in America, I suggest that nurse-midwifery clinics offer primary care for women and home care for chronic ill patients. The health law and health insurance policy should be reovised in order to expand nurse-midwife's and home care nurse's roles at nurse-midwifery clinic.

• 한국의료질향상학회지
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• 제21권1호
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• pp.80-95
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• 2015

Objectives : A safety culture is the bedrock for all patient safety improvement initiatives; thus, many resources have been invested in measuring hospital culture. However, many of these endeavors have failed to yield meaningful results. This article proposes a practical checklist to ensure successful administration of a safety culture survey and describes current methodologies for analyzing survey results to develop safety improvement programs. Methods : We reviewed currently used safety culture surveys and summarized their strengths and weaknesses. We also reviewed studies using safety culture surveys and found several pitfalls leading to failure in survey administration. With this information, we developed a checklist that covers critical items in the survey process. We also reviewed newly developed methodologies for survey results analysis and application and described them using the Korean version of the Safety Attitudes Questionnaire as an example. Results : The checklist consists of three steps: survey preparation, administration, and analysis and application. Each step contains clear action items. The content even describes how to get buy-in from hospital executives and manage communication channels with them. Also, common misunderstandings regarding survey scores are described and possible solutions are suggested. In the analysis section, we demonstrate new methods for obtaining more accurate survey results and how to utilize these methods to develop and implement hospital-wide safety improvement programs. Conclusion : A successful safety culture survey is the foundation of all future safety improvement projects. This review is intended to guide hospitals in enhancing safety.

• 중환자간호학회지
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• 제10권3호
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• pp.1-8
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• 2017

Purpose : This study examined the status of critical care nursing education in bachelor of science in nursing (BSN) to suggest future directions. Methods : The target of the survey was 185 BSN programs that were certified by the Korean Accreditation Board of Nursing Education as of October 31, 2016. We structurally reviewed the curriculums and the course syllabi. Results : Forty-eight courses of 42 BSN programs were analyzed. Only five programs offered both theoretical and practical courses in critical care nursing; 22 offered theoretical courses and 26 offered practical courses. Most courses were offered as electives with 1 or 2 credits, and were taught by faculty who were experts in adult health nursing. Conclusion : The results show that there is a quantitative shortage of critical care nursing education in the curriculum of BSN programs in Korea. The lack of knowledge and skills on critical care can lead to a burden of new intensive care unit nurses and is a threat to patients' health. It is necessary to develop a practical and integrative curriculum for critical care nursing education.

• 융합정보논문지
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• 제7권4호
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• pp.27-38
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• 2017

본 연구는 국내 의료기관인증제도와 미국과 호주의 의료기관인증제도 및 국제의료질향상학회의 국제인증프로그램에 대해 비교 고찰함으로써 우리나라 의료기관인증제도의 발전을 위한 시사점을 제시하고자 시도되었다. 본 연구에서 도출된 시사점은 다음과 같다. 첫째, 환자 및 지역사회 중심의 관점 강화, 인력배치 기준 강화 등 의료기관 인증기준의 개선이 필요하다. 둘째, 의료기관인증제도를 통한 환자안전의 강화가 필요하다. 셋째, 의료기관인증제도와 임상질지표 및 환자경험평가 연계를 강화해야 한다. 넷째, 조사위원의 역량을 강화해야 한다. 다섯째, 중소병원의 인증제도 참여 활성화가 필요하다. 여섯째, 의료 질 평가 결과 공개의 강화가 요구된다. 본 연구 결과는 우리나라 의료기관인증제도의 개선을 위한 기초자료로 활용될 수 있을 것이다.

• 아동학회지
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• 제30권6호
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• pp.281-295
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• 2009

Representative services of the afterschool in Korea are After-Schools of the Ministry of Education, Science and Technology, Community Child Centers, After-school Child Care, and Youth After-school Academy of the Ministry of Health, Welfare and Family. Each service is distinguished with its own founded laws, subject children, specialists, principle management agent, a number of participants, and more. Research issues of afterschool are development of new afterschool programs, evaluatjon of the effectiveness of the afterschool, establishment of policies related to cooperative efforts among the different services of the afterschool, obtainment of legal status, and enhancement of the credential of its personnels. To guarantee the quality of the Afterschool and improve personnels' working conditions, various means are to be implemented. In regard to programatic and policy issues, the afterschool is needed to establish a system for training the afterschool coordinators and of its accreditation and to develop more child-centered afterschool programs. Also, it is needed to legislate fundamental law and consolidate communication system among the services of the Afterschool in pursue of their effective utilization and actual expansion.

• 대한임상검사과학회지
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• 제55권3호
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• pp.227-233
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• 2023

미국 세포병리사가 되는 길은 최소 학사학위와 Commission on Accreditation of Allied Health Education Programs에서 인증 받은 세포병리사 양성 교육 과정 이수가 필요하다. 이를 기본으로 American Society for Clinical Pathology Board of Certification에서 주관하는 자격시험을 통과함으로써 세포병리사로 인정받는다. 현재 미국 세포병리사 양성 교육과정은 18개의 대학교와 병원에서 제공하며 그중 6개 대학교에서 석사 교육과정을 제공하는데 이는 병리의사의 부족과 의료체계의 발달에 따른 세포병리사 업무 영역 확장으로 기존의 프로그램을 석사학위 교육 수준으로 전환하는 추세다. 미국 세포병리사 전문성 향상을 위해 교육과정의 개선과 단일화, 자격 갱신제도, cytologist로의 명칭 전환 노력 등은 빠르게 변해가는 의료 체계에 발맞출 뿐 아니라 세포병리사의 역량 강화로 보인다. 본 연구는 미국 세포병리사 양성교육제도와 전문성 강화 노력을 보고함으로써 대학 교수와 해외 취업을 준비하는 학생들에게 정보를 제공하고 우리나라 세포병리사의 전문성 향상을 위한 연구에 도움을 줄 것이라 사료된다.

• Perspectives in Nursing Science
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• 제6권1호
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• pp.39-53
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• 2009

The purpose of this study is to grasp the present system of Advanced Practice Nurse(APN) and to suggest strategies for enhancing the recognition of APNs institutionally in Korea. We searched and reviewed literature and materials about the APN development process and present situation and related laws. We recognized that there were many kinds of problems in the APN system of Korea: a weak support from health care system, obscured classification of APN's services, confusion of qualifications, and lack of compensation from the national health insurance system. We should, therefore, identity the list of Korean APN's services and provide further studies about patient's outcome cared by APNs. Also, there is a need to create a demand for APNs to keep the quality of services guaranteed by APN. APN system must be established to progress forward in order to provide good benefits for the people.