• Title/Summary/Keyword: medical manager

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Meta-analysis of Outcomes Compared between Robotic and Laparoscopic Gastrectomy for Gastric Cancer

  • Liao, Gui-Xiang;Xie, Guo-Zhu;Li, Rong;Zhao, Zhi-Hong;Sun, Quan-Quan;Du, Sha-Sha;Ren, Chen;Li, Guo-Xing;Deng, Hai-Jun;Yuan, Ya-Wei
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.8
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    • pp.4871-4875
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    • 2013
  • This meta-analysis was performed to evaluate and compare the outcomes of robotic gastrectomy (RG) and laparoscopic gastrectomy (LG) for treating gastric cancer. A systematic literature search was carried out using the PubMed database, Web of Knowledge, and the Cochrane Library database to obtain comparative studies assessing the safety and efficiency between RG and LG in May, 2013. Data of interest were analyzed by using of Review Manager version 5.2 software (Cochrane Collaboration). A fixed effects model or random effects model was applied according to heterogeneity. Seven papers reporting results that compared robotic gastrectomy with laparoscopic gastrectomy for gastric cancer were selected for this meta-analysis. Our metaanalysis included 2,235 patients with gastric cancer, of which 1,473 had undergone laparoscopic gastrectomy, and 762 had received robotic gastrectomy. Compared with laparoscopic gastrectomy, robotic gastrectomy was associated with longer operative time but less blood loss. There were no significant difference in terms of hospital stay, total postoperative complication rate, proximal margin, distal margin, numbers of harvested lymph nodes and mortality rate between robotic gastrectomy and laparoscopic gastrectomy. Our meta-analysis showed that robotic gastrectomy is a safe technique for treating gastric cancer that compares favorably with laparoscopic gastrectomy in short term outcomes. However, the long term outcomes between the two techniques need to be further examined.

Effective Medical Tourism manager System Using Digital Management (디지털 경영학을 활용한 효율적인 의료관광 관리 시스템)

  • Park, Sung-Jun;Jo, Moon-Il;Kim, Hee-Cheol
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2018.05a
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    • pp.555-557
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    • 2018
  • The average lifespan of humans is expected to rise to 100 years, not 80 years, as a result of the advances in medical technology, and soon the age of 100 era is expected to open. The fourth industrial revolution, which is the core of the convergence, is emerging as a major issue in the modern society. Therefore, the importance of services along with medical technologies is increasing. Accordingly, medical tourism, a combination of medical technology and tourism, is emerging as a promising industry, and countries around the world classify the medical tourism industry as one of the core strategic industries and nurture it actively. In accordance with this, contents and marketing that can impress a user with a management strategy are developed and provided, but the management system maintains the existing ones, which is a limitation. Therefore, there is a need for an efficient medical tourism management system along with a user-oriented system such as marketing and contents.

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A Study on the development of leadership training program for first-line nurse managers (일선 간호관리자를 위한 리더십 훈련 프로그램 개발)

  • Koh, Myung-Suk;Han, Sung-Suk
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.333-345
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    • 2000
  • The health care environment becomes more competitive every day. It has fallen to nurse managers - from vice presidents of patient care to nurse managers and their assistants - to recruit and develop a workforce that successfully meets the needs of both patients and the organization. This means employees who demonstrate advanced critical thinking skills, creative problem solving, and sound decision making skills combined with clinical skills and patient advocacy. The environment which nurse managers create and the way they relate to their workforce, are pivotal to organizational viability. Especially leadership of first -line nurse managers contributes to the success of their organizations. First-line nurse managers are deserved to be one of the most administrative supervisors through the middle stratum in a hospital organization as being a manager in the field service if assessed from the overall aspects of hospital, as being an interim managers in the nursing department as well as being a supreme supervisor in a unit in terms of an organizational structure in the hospital. Similarly, as a compete leader, the first-line nurse managers have not only a professional which is qualified to perform a role of appropriate coordination with medical staff and key personnel but also hold an important key position a being responsible for performing his or her given role. The first-line nurse manager is expected to manage human and fiscal resources in ways not required before. While an identified need for well-prepared first-line nurse manager continues to plague the profession, first-line nurse managers often have difficulty providing the leadership required. The need leadership training to function effectively in their positions. But we hardly find a useful leadership training program for first-line nurse managers, therefore the purpose of this study was to developed the leadership training program for them. The steps of leadership program development were below: 1st step, 2 studies were done before develop a leadership program. One was done to ask to first-line nurse managers what they want to learn through leadership training, the other one was to ask the staff nurses what their opinions are for their first-line nurse managers leadership. 2nd step was searching other leadership programs contents. The results of this study were below: The total amount of hours is 24. Leadership training program contents are : Future of nursing profession (210min), understanding basic factor's of leadership and leadership theories(310 min), self understanding as first- line nurse managers(320 min), basic principle and practice of interpersonal relationship(210 min), assertiveness training, conflict management (180min), and group study(210min). This is challenging time to be a leader, especially in nursing. As nurse managers look toward the new millennium, it seems as through the same struggles are ahead that are behind. So nurse managers need to embrace change with a positive attitude. They need to demonstrate risk taking and support it in their staffs. All these things are possible that after they participate the leadership training program.

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Analysis of Hospital Services for Elderly Inpatients (노인 입원환자 병원서비스 분석)

  • Chang, Hyun Sook
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.18-31
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    • 2000
  • Background : This study is to identify the inappropriate hospital services for elderly inpatients over 65 years in general hospital with acute care functioning. Consequently elderly inpatient care and the management of long-term care facilities are key issues for current government health policy. Method : The survey was conducted for two months for all inpatients over 65 in 7 general hospitals, 6 work sampling days randomly selected. In each survey day, the subjective judgement by medical staff on the degree of acute care needs and by nursing unit manager on hospital services of each inpatients was also conducted. Result : The total number of cases collected are 2,541 elderly inpatients, according to subjective judgements by medical staff on inpatient condition. However 46.8% of cases are turned out to be non-acute care group. The frequency of medical services provided to non-acute group are 2~3 vital sign checks per day 78.2%, IV injection 40.1%, antibiotics medication 20.2%. Conclusion : Lots of elderly patients' who are staving in acute hospitals, at present need to be transferred to long-term care facilities. However, there was been shortage of long-term care facilities. It is expected to identify the need of elderly inpatients and therefore, to provide cost-effective, appropriate and good quality health services to elderly inpatients depending on their needs.

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Effects of an Integrated Case Management Program on Medication Adherence, Pain, Physical Function and Depression among Korean Medical Aid Beneficiaries with Osteoarthritis (의료급여 관절염환자의 복약순응향상을 위한 통합중재프로그램의 효과)

  • Ahn, Yang Heui
    • Journal of Korean Public Health Nursing
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    • v.28 no.1
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    • pp.32-45
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    • 2014
  • Purpose: The purpose of this study was to test the effectiveness of an eight session integrated case management program for improvement of medication adherence, physical function, pain, and depression among medical aid beneficiaries with osteoarthritis. Method: A nonequivalent control group pre-posttest design was employed. Participants were 55 medical aid beneficiaries who agreed to participate in this study, and were assigned to an experimental group (n=28) or control group (n=27). The framework of this research derived from Cox's Interaction Model of Client Health Behavior guided the overall intervention and the components. The program led by a case manager with a medication calendar, motivating interviewing and coaching strategies and collaboration with a pharmacist. Analysis included change in scores, ${\chi}^2$-test, and t-test. Result: The results showed significant increase in medication adherence, physical function and decrease joint pain, joint stiffness and depression in the experimental group compared to the control group. Conclusion: The eight session integrated case management program indicated an effect on medication adherence, pain, physical function, and depression. Partnership with a pharmacist is recommended for medication adherence and conduct of further studies will be needed in order to determine the long-term effect of an extended integrated program on health outcomes.

A Study on Patients' Perception of Nurse's Behavior in Protecting Patient Privacy (간호사의 환자 프라이버시 보호행동에 대한 환자의 인식도)

  • Lee, Mi-Young;Song, Young-Shin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.2
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    • pp.204-212
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    • 2007
  • Purpose: The purpose of this study was to investigate the patient's perception of the nurse's behavior in protecting patient privacy and to make suggestions for medical facilities to increase protection of patient privacy. Method: The research was a survey study The data on protection of privacy in primary nursing, for physical privacy, of patient information and in private conversations were collected in October 2005 from 187 patients in a university hospital. Frequencies, means, t-test, ANOVA, and $x^2$-test were used to analyze the data. The SPSS 13.0 for Windows program was used. Results: The mean score for patients' perception of nurse protection of their privacy was 3.33. There were significant differences in perception of protecting patients' privacy according to gender for private conversation, according to level of education for all but physical nursing and for number of admissions for total score and for primary nursing. Conclusion: The results of this study suggest the following: a) Institutional polices and nursing guideline should be clearly stated as to the nurses' duty to protect patient privacy. b) Medical facilities should be arranged in a way that allows for the protection of patients' medical information, and should focus on patient privacy. c) It is necessary of nurses to receive periodic in-service education on protecting patient privacy.

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The CHEK2 I157T Variant and Colorectal Cancer Susceptibility: A Systematic Review and Meta-analysis

  • Liu, Chuan;Wang, Qing-Shui;Wang, Ya-Jie
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2051-2055
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    • 2012
  • Background: The cell cycle checkpoint kinase 2 (CHEK2) gene I157T variant may be associated with an increased risk of colorectal cancer, but it is unclear whether the evidence is sufficient to recommend testing for the mutation in clinical practice. Materials and Methods: We systematically searched PubMed, EMBASES, Elsevier and Springer for relevant articles before Apr 2012. Summary odds ratios (ORs) and 95% confidence intervals (95% CIs) were calculated using a fixed-effects or random-effects models with Review Manager 5.0 software. Results: A total of seven studies including 4,029 cases and 13,844 controls based on the search criteria were included for analysis. A significant association of the CHEK2 I157T C variant with unselected CRC was found (OR = 1.61, 95% CI = 1.40-1.87, P < 0.001). We also found a significant association with sporadic CRC (OR = 1.48, 95% CI = 1.23-1.77, P < 0.001) and separately with familial CRC (OR = 1.97, 95% CI = 1.41-2.74, P < 0.001). Conclusion: This meta-analysis demonstrates that the CHEK2 I157T variant may be another important CRC-predisposing gene, which increases CRC risk, especially in familial CRC.

Role Transition from Clinical Nurse to Case Manager for Medical-aid Beneficiaries: Taking Root in a Barren Land (임상간호사에서 의료급여관리사로의 역할 전이 과정: '척박한 땅에 뿌리내리기')

  • Park, Eun-Jun;Kim, Chun-Mi;Lim, Seung-Joo
    • Journal of Korean Academy of Nursing
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    • v.42 no.2
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    • pp.149-160
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    • 2012
  • Purpose: The purpose of this study was to explain the role transition process to nurse case managers (NCMs) for Medical-aid beneficiaries in Korea. Methods: Fourteen NCMs were interviewed regarding their experiences of becoming proficient in the new role of case manger. Data were analyzed through the application of grounded theory. Results: 'Taking root in a barren land' was the core category explaining the role transition process of NCMs. They engaged in four stages: launching, trial and error, proficiency, and wait-and-see stages. NCMs showed not only fear but also passion for case management practice. Despite their passion and effort, NCMs went through a period of trial and error. After becoming skilled, NCMs went through a stage of wait-and-see often because of job insecurity related to temporary position or few opportunities for promotion. Factors influencing NCMs' role transition process included their understanding of client characteristics, belief in case management, and support from their colleagues and families. Conclusion: NCMs experience many challenges in the process of becoming proficient NCMs. To help with their role transition, there is a need for education programs, preceptorship programs, research on their roles and functions, and regulation for securing NCMs' employment and career stability.

A Study on Ways of Improving Radiology Department Services (영상의학과 서비스 개선방안에 관한 연구)

  • Yeo, Jin-Dong;Kim, Hye-Sook
    • The Korean Journal of Health Service Management
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    • v.3 no.1
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    • pp.5-13
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    • 2009
  • The purpose of this study is to find ways of improving radiology services provided at hospitals through examining current problems of the services and measuring patient satisfaction about them For the purpose, this researcher made a questionnaire survey of 209 patients who used the radiology departments of two university hospitals as tertiary medical institutions located in Busan. The survey was carried out from June 1 to July 30, 2008. Results of the study can be summarized as follows. The patients' satisfaction about the kindness of radiologists was generally low since it Was measured to be scored 3.0 or below in average. This indicates that they were dissatisfied with the equipment and environment. The patients' anxiety about the process of radiology was measured and scored 3.0 or below in average, indicating they generally felt anxious about the process. Factors affecting the above reliability such as their skillfulness, qualification, persuasiveness and expertise were found positively correlated with the patients' satisfaction about the radiologists. To realize Better radiological department services, in conclusion, radiologists are required to resort to conventional practices of radiology no longer, and reconsider current radiological technologies. They are also required to firmly establish their pride as a professional, and make best efforts to keep pace with this era of rapid scientific development by constantly training themselves.

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Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care (간호·간병통합서비스 제공을 위한 간호인력 배치기준 개발)

  • Cho, Sung-Hyun;Song, Kyung Ja;Park, Ihn Sook;Kim, Yeon Hee;Kim, Mi Soon;Gong, Da Hyun;You, Sun Ju;Ju, Young-Su
    • Journal of Korean Academy of Nursing Administration
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    • v.23 no.2
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    • pp.211-222
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    • 2017
  • Purpose: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. Methods: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. Results: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. Conclusion: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.