• Korean Journal of Clinical Pharmacy
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• v.13 no.2
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• pp.82-90
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• 2003

Dopamine is an effective pressor for the treatment of shock and hypotension when patients do not respond to plasma volume expansion. Two dopamine intravenous delivery systems are currently available in Korea. The objective of this study was to compare dopamine premixed with prefilled system in terms of supply costs (preparation costs + personnel time), contamination rates and convenience. Time-and-motion studies were conducted to determine the time and costs associated with preparation and administration of the two systems. They were analyzed and compared by Mann-Whitney test. To evaluate the contaminaton rates of the two systems, both systems were prepared in an open environment similar to that of practical situations. Premixed and compounded solutions were then filtered by $0.22{\mu}m$ membrane filters, which were cultured at $37^{\circ}C$ for 10 days and their contents were visually checked for bacterial contamination. The convenience of the two systems was compared by itemized user assessments on preparation, dose calculation, admixture, administration and disposal of waste matters. They were analyzed by Wilcoxon's signed rank test and 100 part percentage. It was found that the preparation costs $(mean{\pm}SD)$ for premixed and prefilled systems were $271.70\pm293.55\;Won$ (Korean currency) and $1521.04\pm510.63\;Won$, respectively. The preparation time $(mean{\pm}SD)$ for premixed system was $68.10\pm35.69\;sec.$ while at for prefilled system was $154.03\pm50.06\;sec.$ (n=59 each, p<0.001). No bacterium was observed in the samples of both systems (n=20, each). User assessments indicated that the premixed system was more convenient than the prefilled system except for the item of dose calculation (n=24, p<0.001). Subjective evaluations have proven that the use of the dopamine premixed system resulted in increased efficiency of intravenous preparation by allowing personnel to devote more time to other labor-intensive duties and lower total medical costs.

• Journal of Nutrition and Health
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• v.34 no.4
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• pp.458-471
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• 2001

To evaluate the infra structure supporting hospital nutrition services, we conducted a survey on the unit of organization, unit of dietitians work system, number of personnel engaged on nutrition services, productivity of food service, management of dietitians works, computerization of nutrition services etc. Total ninety-six hospitals were participated in the survey, and they were varied in terms of hospital classification, location, number of beds and type of food service management. All of the large hospitals with more than 400 beds conducted nutrition services under the department of nutrition, but some of the middle and small hospitals with less than 400 beds conducted nutrition services under the other department such as administration. In most of the tertiary hospitals, the work of dietitians were separated in which food services and medical nutrition services were conducted independently by different dietitians, whereas, in most of general hospitals and all the hospital, food services and medical nutrition services were conducted by the same dietitians in all time. The numbers of dietitians and cooks per 100 beds were fewer in the large hospitals with more than 400 beds than the hospitals with less than 400 beds, and the number of cooking and meal serving assistants were the just opposit. The average productivity of food service was 44.5 meals per hour for each dietitian, 84.8 meals per hour for a cook and 7.0 meals per hour for a cooking and meal serving assistant. The productivities for dietitians and cooks tend to be higher in large hospitals than middle and small hospitals, whereas the productivities for cooking and meal serving assistants were just opposite. The large hospitals seemed to solve the problem on the lack of working personnels by hiring part-time workers and by utilization of computer system for their works. The pattern of daily work management in food service area was not much different between dietitians duties, but the pattern of daily work management in medical nutrition service area was different in a way which the analysis of patients nutrient intakes was almost not conducted by dietitians handling both food services and medical nutrition services. Therefore, this study demonstrates that there are significant differences in the infra structures conducting nutrition services among hospitals, suggesting that the strategies to improve this improve this structure in relation to the improvement of service qualities need to be investigated in the future. (Korean J Nutrition 34(4) : 458∼471, 2001)

• Journal of Nutrition and Health
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• v.30 no.6
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• pp.704-714
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• 1997

The purpose of this survey was to investigate the operation and the environment of foodservice in elementary schools nationwide. A questionnaire about foodservice management to practice and foodservice operation was mailed to dietitians of each school . Of the 1, 416 schools that participated in this survey, 388 schools were selected for analysis. The main results of this study are as follows. More schools in small cities . Education levels of dietitians were significantly different from area to area. Mean total length of employment for dietitians at school foodservice was 4.7 years and varied significantly by area and the type of foodservice system. Foodservice has been operated for 2-5 years in most of schools. Schools in large cities served more people than those in small cities and rural areas. Also , schools adapting conventional foodservice system served more people than those adapting commissary or joint management system. Foodservice expense also veried significantly by area and foodservice systems. Mean foodservice expense per meal were significantly higher in schools adapting commissary system than those adapting other systems. Most schools employed dietitians, cooks, and assistant cooks, but not engineers not drivers. Mothers of students were working voluntarily. The degree of participation by mothers in cooking , serving , and cleaning was higher in schools of small cities and rural areas than those in large cities, in schools adapting commissary or joint management system than those adapting conventional system. Education and training ranked as personnel management had one of the hardest tasks. Education and training of employees were also difficult for dietitians, especially in commissary or joint management systems. Percentage of schools having separate lunchroom was higher in small cities rural areas than in large cities, in joint management or commissary system than conventional system. Most difficult matters in serving was the portion control. Over 40% of schools did not use standard recipes. Menu cycles were shorter in schools in small cities and rural areas which adapted the joint management system than area other schools. Except refrigerators, thermos , display racks, sterilizers, sinks, worktables, and table, all other equipment were insufficient in most of schools. More than half of the schools didn't have rice cookers, flatware racks, and distributing carts which are stated plainly in detailed enforcement regulations for school foodservice. Cooking equipments were described as the most needed by dietians. According to the results of this survey, many and urgent problems need to be addressed improve the quality of school foodservice . Lunchroom setups, effective personnel management and expenses, recipes standardization, serving size control and regular checking and repairing of equipments are all problems to be addressed.

• The Journal of Korean Academic Society of Nursing Education
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• v.5 no.1
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• pp.118-132
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• 1999

To improve the effectiveness and efficiency of public health personnel training, we evaluated not only how appropriate the students felt the objectives, contents, methods and multimedia used in the train ing courses, but also how much the students accomplished the objectives and applied skill and knowledge to their own works. We selected 5 courses for the study : Tuberculosis control, Radiological technique, Public health information, Immunization, Mental health management courses used by Kirkpatrick's evaluation model. Reaction evaluation was carried out in final day by questionnaire. The results showed that all of them were very satisfied with educational input and curricula, learn Ing environment. Secondly, we measured the degree of learning achievement on pre and post training by questionaire of specific behavioral objectives. The degree of learning achievement was statistically higher just after training than pre training (paired t-test, p<0.01). Thirdly, evaluation of behavioral change to job was conducted to find out how much students applied skill and knowledge to their own job in 3 months after training by questionnaire. The results of behavioral change evaluation showed that 43.5% of the students who were performing job related with the training courses in 3 months after training applied the learned skill and knowledge to their own job quite well and 37.8% of them applied relatively well, therefore total 81.4% of them applied to their own job. And effectiveness of training for the above mentioned students showed that 41.9 % of them had improved or enforced their jobs after training, 35.5% of them had had no remarkable changes, and 15.7% had newly applied the learned skill and knowledge to their jobs. For evaluating the degree of usefulness of material predistribution in two weeks before training, we compared experimental groups with control groups. The results showed that general reactions are helpful but the degree of learning achievement is no discrepancy.

• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.77-83
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• 2016

Background: Oversight on the bioethical compliance of national R&D projects or research personnel is currently conducted exclusively by IRB (Institutional Review Board) within the relevant research institute. Considering current state of affairs in Korea, there is an imperative to establish a national oversight system for bioethical compliance, conduct comprehensive oversight on bioethical compliance of national R&D projects, and enhance subject protection system. Methods: We examined opinions from researchers and IRB personnels regarding ethical oversight system on R&D projects. Additionally, we looked at IRB assessment by KAIRB (Korea Association of Institutional Review Board) in order to identify status and problems with current IRB system in Korea. Assessment was also done for four other countries (US, UK, Germany, Singapore) through in-person visits as well as surveys in writing for a total of 6 months (2012.12.1~2013.5.31). The research comprised of two aspects: system management and R&D project audit. Based on this, we examined current status and problems of the existing system in Korea and made recommendations for improvement. Results: Regulatory objectives and backgrounds of biomedical researches are different from each country due to different characteristics of bioethical oversight system. This shows that each country sets up its own regulations and procedures to fit each situation. Bioethical compliance oversight system greatly varied between the countries. From this study, it can be seen that improvement of existing procedures and oversight system or establishment of new ones are essential in Korea. Conclusion: In terms of system management, a dedicated government organization need to be established for bioethical compliance, subject protection, IRB inspection, training, evaluation, and certification of systems, and also support for IRB e-system. Regarding R&D project oversight, it is essential to confirm IRB review results before start of a research, to conduct a review on ethical aspects of research plans, and to carry out continued oversight on bioethical compliance through interim reports.

• Korea Journal of Hospital Management
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• v.2 no.1
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• pp.162-182
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• 1997

This study was carried out to assess the current status of hospital wage structure and to find out the characteristics and problems in the current hospital wage structure. so as to provide empirical data for establishing a rational wage structure. The data were collected from administrative personnels in charge of wage management in 31 hospitals by using a structured questionnaire through direct visiting and mailing in Pusan Metropolitan City. The major findings in this study were as follows: First, the hospital wage structure applied differently to the basic wages between doctors and the other employees. The wage structure for doctors included performance rate of 51.6%, followed by a synthesis rate of 29.0%, while the wage for the other employees had the synthesis rate of 74.2%, followed by the seniority rate of 12.9%. Second, the wage consisted of a basic wage for 57.5%. the allowance for 21.1% and monthly installed bonus for 21.4%, and the basic wage comprised 68.3% of the total wage for doctors, as compared to 51.9% for nurses and medical technicians and 52.4% for administrative and managerial personnel. The annual rate of the bonus was average 460%, and 96.8% of the hospital did not consider personnel preformance appraisal when paying the bonus. Third, 80.6% of the hospitals applied the legal rate to the retirement allowance while 19.4% applying cumulative rates more than the legal rate, and all of university hospitals applied cumulative rates. Retirement reserves were practiced only in 54.9% of the hospitals. Forth, many hospitals seemed to be interested in applying graded wage system according to performance, by showing that 42.9% of the hospitals were planning to apply it in the future, despite only 9.7% practicing it. Fifth, the wage structure appeared to be complicated due to various kinds of allowances. The kind of the allowances varied among hospitals, ranging from 2 to 26 kinds, and increased as the size of hospital was larger. Sixth, the opinions leading to improve the basic wage structure favored the seniority rate for 51.6% either to maintain the present seniority rate(16.1%) or to apply the incentive pay in addition to the senior rate(35.5%). and also favored the performance rate for 35.5%, followed by the job rate for 12.9%. In conclusion, the current hospital wage structure seemed to be too complicated to reflect personal ability, contribution and performance and to become a big barrier to inducing worker's motivation and to strengthening in competitveness. Therefore it is suggested that the current wage structure should be revised to the one emphasizing on job and ability base with considering characteristics and situation of the hospital, rather than seniority factors.

• Journal of Korean Academy of Nursing
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• v.16 no.3
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• pp.108-122
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• 1986

Changing concepts of health care, are stimulating the demand for health care, thereby orienting society to health care rights to such an extent that they are deemed as fundamental ones inalienable to man. Concomitantly, qualitative as well as quantative improvement is being sought in the nursing service field. Today, efforts are being made in various areas, especially to qualitatively improve nursing services. A second issue concerns proper staffing. It is important to study staffing, in as much as it continues to be the most persistent and critical problem facing hospital nursing administrators today. It involves quantity, quality, and utilization of nursing personnel. A great deal of attention has been focused on this problem since mid 1930's when nursing services began to be felt as an important segment of hospital operation representing the largest single item of hospital budgets. Traditionally, the determination and allocation of nursing personnel resources has relied heavily on gloval approaches which make use of fixed staff-to-patient ratios. It has long been recognized that these ratios are insensitive to variations between institutions and among individual patients. Therefore, the aim of this thesis is to point to the urgent need for the development of methodology and criteria suited to the reality of Korea. The present research selected one place, the W Christian Hospital, and was conducted over a period 10 days from January, and nurses who were them on duty in their unit. The total num-her of patients surveyed was 1,426 and that of 354. The research represents many variables affecting the direct patient care time using the result from the direct observation method, then using a calculation method to estimate the relationship between the patients care time and selected variables in the hospital setting. The amount of direct patient care time varies with many factors, such 89 the patients age. diagnosis and time in hospital. Differences are also found from hospital, clinic to clinic, ward to ward, and even shift to shift. In this research, the calculation method of estimating the required member of nursing staff is obtained by dividing the time of productive patient care activity(with the time of patient care observed), by the sum of the productive time that each the staff can supply, i.e., 360 minutes, which is obtained by deducting the time for personal activities. The results indicate a substantial difference between the time of productive patient care observed directing and the time of the productive patient care estimated using calculating method. If we know accurately the time of the direct patient care on a shift, there required number of staff members calculated if the proper method can be determinded should be able the time of the direct patient care be estimated by the patient classification system, but this research has shown this system to be in accurate in Korea. There are differences in the recommended time of productive patient care and the required number of nursing staff depending upon which method is used. The calculated result is not very accurate, so more research is needed on the patient classification system.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.126-132
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• 2014

Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

• Anxiety and mood
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• v.10 no.1
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• pp.59-67
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• 2014

Objective : To obtain the incidence rate of anxiety disorders among the active duty Korean military personnel, who visited the military hospitals from 2011 to 2013, this descriptive epidemiological study was performed. Methods : After acquiring the data for the anxiety disorders from Defense Medical Statistics Information System, the annual incidence rates were analyzed by forces, position status, and specific disease entities. Results : One thousand, nine hundred and thirteen (1,913) active duty male military personnel were diagnosed with any kinds of anxiety disorders in their first visit to the psychiatric outpatient department (OPD). The total OPD visit counts were 7,870 during the same period. Anxiety disorder, NOS was the most frequent disorder, followed by panic disorder. While the incidence rate for anxiety disorder, NOS decreased, panic disorder displayed increasing tendency. Stress-related disorders and obsessive-compulsive disorder were positioned third and fourth, respectively, for the number of first visit and they both showed decreasing tendency in annual incidence rates. Social anxiety disorder, specific phobias, generalized anxiety disorder (GAD) and mixed anxiety-depressive disorder followed next. The annual incidence rates for anxiety disorders showed decreasing tendency, particularly evident in army soldiers. However, naval officers showed higher anxiety disorder incidence rate compared to those of the army and the air forces. Conclusion : Comparing to general population, panic disorder was higher while specific phobias and GAD were lower in the Korean military. It is interesting to observe higher incidence rate for anxiety disorder in naval officers and warrants further evaluation.

• The Journal of the Convergence on Culture Technology
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• v.2 no.2
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• pp.45-49
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• 2016

It may be summarized to four kinds of innovation through global convergence, and the convergence of adjacent areas according to mega-trends in medical services market and actively introduced ICT technologies, public and private partnership. Health care is no longer a local industry, it is becoming Global Convergence. In the case of developed countries, it is increased to income levels, the development of new medical technologies, while the increase in specialized medical services and need of aging population. It increases migration of foreign medical personnel, geographical proximity and choice of the best medical technology, regardless of the cost. The increasing demand for high quality yet relatively low foreign prices of medical services. Hospitals are especially spread of international certification such as the US JCI standards. Hospital exports are being evaluated and opened the way for the export industrialization as ICT convergence hospital that can be exported to the fusion-related technologies more efficiently. Current local hospital has already reached saturation, globalization of Korean hospital is being the time necessary. Thus, unlike a strategy for each country, as well as technology transfer it is also possible, such as total exports provided the building, medical equipment procurement, local medical personnel (doctors and nurses) selection and training, PR and marketing. In the current medical law and need to be revised prospectively maintained for publicity and abroad, there is a need for further legal dragons and actively support a more flexible policy on the application of national law overseas medical services.