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Characteristics of Nursing-related Patient Safety Incidents and Qualitative Content Analysis: Secondary data Analysis of Medical Litigation Judgment (2014~2018) (간호 관련 환자안전사건의 특성과 질적 내용 분석: 의료 소송 판결문(2014~2018년)을 이용한 이차자료 분석)

  • Min-Ji Kim;Won Lee;Sang-Hee Kim;So-Yoon Kim
    • Quality Improvement in Health Care
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    • v.29 no.2
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    • pp.15-31
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    • 2023
  • Purpose: This study aimed to identify the characteristics of patient safety incidents (PSIs) related to nursing and to provide primary data for preventing the recurrence of similar incidents. Methods: This secondary analysis study included damage claims rulings filed for clinical negligence from 2014 to 2018 that contained the keyword 'nurse'. It excluded judgments irrelevant to nursing care and in which clinical negligence or causal damages were overruled. A total of 93 cases were analyzed. The characteristics of PSIs were derived through descriptive statistics, and two instances of nursing-related PSIs were examined by qualitative content analysis focusing on root causes. Results: The analysis of PSIs related to nursing suggested that the medical institutions where the PSIs occurred most frequently were hospitals, and the most common types of PSIs were medication, surgery, and treatment/procedure, in that order. In addition, it indicated that nursing-related PSIs occurred most frequently in general wards during the day shift, with the most common related nursing practice being managing potential risk factors. The qualitative analysis showed that careless monitoring and institutional inertia were causes of PSIs. Conclusion: To prevent nursing-related PSIs, nurses need to individually monitor and assess patient conditions. In addition, support should be accompanied by the improvement in the systems in place aimed at preventing the recurrence of nursing-related PSIs at the institutional and national level, such as securing appropriate nursing personnel and improving labor conditions.

Rome IV Clinical Criteria and Management of Functional Constipation: Indonesian Health Care Professionals' Perspective

  • Andy Darma;Khadijah Rizky Sumitro;Leilani Muhardi;Yvan Vandenplas;Badriul Hegar
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.27 no.2
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    • pp.125-135
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    • 2024
  • Purpose: The updated ROME IV criteria for functional constipation (FC) in children were published in 2016. However, information on the use of these criteria is scarce. This study aimed to report the frequency of the use of the ROME IV criteria by Indonesian pediatricians and general practitioners (GPs) in FC management in infants and toddlers. Methods: An anonymous cross-sectional online survey was conducted between November 2021 and March 2022. Results: A total of 248 respondents (183 pediatricians and 65 GPs) from 24 Indonesian provinces completed the survey. Most respondents reported an estimated prevalence of FC to be less than 5% both in infants and toddlers. On average, only 64.6% of respondents frequently used the ROME IV criteria. Pediatricians used the ROME IV criteria more often than GPs did (p<0.001). The most frequently used criteria were painful or hard bowel movements (75.0%) and ≤2 defecations/week (71.4%). Lactulose as a laxative was the preferred treatment choice, followed by changing the standard formula to a specific nutritional formula. Most of the respondents carried out parenteral reassurance and education. Normal growth, as a marker of good digestion and absorption function, and normal stool consistency and frequency were the most reported indicators of gut health. Conclusion: The ROME IV criteria for functional constipation are not extensively used by pediatricians and GPs in Indonesia. Laxatives and specific nutritional formulas were the most used management approaches in infants and toddlers. Medical education, especially for general practitioners, should be updated.

A Study of Changes in Body Shape, Temperament, Symptoms and Sasang Constitutional Values Using the Korea Sasang Constitutional Diagnostic Questionnaire (KS-15) : 5 Year Follow Up (사상체질 진단설문지(KS-15)를 이용한 외형, 성정, 병증의 추적관찰 및 체질값 변화 연구 : 5년 추적)

  • Kyoungsik Jeong;Bok-Nam Seo;Yunyoung Kim;Eunsu Jang
    • Journal of Sasang Constitutional Medicine
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    • v.36 no.2
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    • pp.1-11
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    • 2024
  • Objectives The purpose of this study was to compare between baseline and follow up data after 5 years about the change of Sasang constitutional value. Methods Cohort data of educational personnel in D University was used. Korean Sasang Constitutional Diagnostic Questionnaire was used to compare Sasang value including body shape, temperament, and pathological symptoms in baseline with those of follow up. Paired t test, chi-square test, correlation analysis and cohen's kappa coefficient was used. Results Total 150 subjects participated in this analysis. Taeeumin, Soeumin and Soyangin was 71, 46 and 33 respectively. Height decreased in follow-up, and weight increased, accordingly body mass index increased(p<.05). The score of nocturia was significantly increased, and the temperature of drinking water was significantly decreased. The consistency rate of the Sasang constitutional values in KS-15 between baseline and follow up was 76%, and the kappa value was 0.607. Compared to the expert's diagnosis, the agreement rate was 66.7% in baseline and 69.3% in follow up. Conclusion As times goes by, Sasang Constitutional phenotype, such as body mass index, nocturia, and temperature of drinking water, and accordingly, the predicted value of Sasang constitution may be changed. Those who use Sasang constitutional type and therapy in clinics should consider these factors.

A Study of Teaching Effectiveness on Clinical Nursing Education (임상간호 실습교육의 교수효율성에 관한 연구)

  • 김미애
    • Journal of Korean Academy of Nursing
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    • v.26 no.4
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    • pp.946-962
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    • 1996
  • The purpose of this study was to contribute to the development of clinical instruction by students' ratings of teaching effectiveness in clinical nursing education. The subjects were comprised of graduating class 618 students from 24 nursing colleges in the nation. The instruments used in this study were "general characteristics & status of clinical nursing education" developed by the researcher and "Instrument to Measure Effectiveness of Clinical Instructors" by Reeve(1994). The 50 questions used in the questionaire were categorized into 13 components subject to factor analysis. The 13 components were interpersonal relationships, communication skills, role model, resource for students, favorable to students, encouraging to think for selves, teaching methods, evaluation, finding assignments for objectives, organization of subject matter, professional competence, knowledge of subject matter & working with agency personnel. The results of this study are as follows 1. Status of clinical nursing educaion : 1) Clinical nursing education were led by nursing professors(44.9%), a team of both nuring professor & head nurse(6.8%), instructors from specific hospital(15.1%), instuctos for a specific subject(14.6%), & head nurse(6.8%). For 3-year program students, 34.6% of the clinical nursing education were led by instructors from specific hospital & 51.4% of the education by nursing professors for Bachelor's program. 2) The contents for clinical education comprised of Conference being the most frequent of 34.5% ; a combination of Nursing skills, Orientation, Conference etc.22.0% : Nursing process 21.7% : Orientation 13.5% : Inspection(making rounds ) 6.4%, & Nursing skills of 2% being the least frequent. 3) Students' preference of clinical teachers from the highest to the lowest were instructors for a specific subject being the most desired (44.9%) followed by nursing professor, head nurse, a team of both nursing professor & head nurse, & instructors from specific hospital being the least desired. 4) Students felt that the qualification for clinical teachers should be at least a master's degree holder and 5 or more years of clinical experience. The reason they felt was because knowledge & experience are imperative for professional education. 2. Clinical teaching effectiveness : The total points for teaching effectiveness was 147.97(mean of 2.95±0.98) where the total score is considered to be an average rating. 3. Teaching effectiveness as status of clinical nursing education : 1) The score ratings for the clinical instructors from the highest to the lowest were as follows : instructors for a specific subject, instructors from specific hospitals, a team of both nursing professors & head nurses, nursing professors, head nurses, which resulted in significunt difference(F=4.53, P<0.001). 2) The rating scores based on the teaching program from the highest to the lowest were as follws ; nursing skills, nursing process, a combination of nursing skills, orientation, conference etc. , conferences, orientation, inspection, which resulted in significunt difference(F=10.97, P<0.001). 4. Based on 13 categorized components from the questionaires, questions related to communication skills scored the highest points of 3.20 where inquiries regarding resource for students scored the lowest points of 2.38. 5. Among the 13 categorial components from the questionaire, Interpersonal relationship, Communication skills, Resource for students, Encouraging to think for selves, Evaluation, Teaching method, Finding assignment for objectives, Organization of subject matter, Professional competence, & Working with agency personnel, instructors for a specific subject scored the highest points and head nurse scored the lowest, which resulted in significant difference. Favorable for students, instructors for a specific subject scored highest points and nursing professor scored the lowest, which resulted in significant deference (F=5.39, P<0.001). Role model & Professional competence, instructors for a specific subject scored the highest points and head nurse scored the lowest, with minimum variation(F=1.29, P>0.05 : F=1.64, P>0.05) 6. Based on 13 categorial components as a whole, the highest points scored among the 5 groups of clinical teachers was instructors for a specific subject and the lowest, by head nurse(F=1.94, P<0. 001). A team of both nursing professor & head nurse attained higher score in clinical education than their independent education.

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A Study on Effective Management & Administration System for Deluxe Hotel Kitchen in Seoul Area. (관공호텔 조리직무의 분업과 통합에 따른 문제점과 개선방안에 관한 연구)

  • 라영선
    • Culinary science and hospitality research
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    • v.1
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    • pp.57-89
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    • 1995
  • Despite prologed business stagnation of both international and domestic economy, hotel business as well as tourist industry has continuously been keeping growing, owing to increase of surplus income and world flowing population. During recent 4 years, growth rate of yearly mean in domestic hotels reached 9.9% and especially that of the superior class hotels 15.2%. In the composition of domestic tourist hotel's revenue, the earnings of guest rooms form 37.4%, on the other hand those of food & beverage 39.9%. This result is that our hotel business is concentrated on its interest in FOOD & BEVERAGE of which productivity per unit dimension can be increased to an unlimited extent and extent and superior class hotels strengthened in F&B are increasing in comparison with European or American hotels which are focused on guest rooms in their management. For value added rate of F&B is low as compared with increase of their earnings, they are interested in the management techniques which focus on rising the rate. As for the cost of Food & Beverage, personnel expenditure forms 36.5% and the direct materials 31.5%. Therefore how to manage personnel and materials costs which compose as much as 68% of total revenue will greatly affect net profit. We can say that an effective management technique in cost of Food & Beverage is one of the most important know-hows in hotel management. Especially management know-how for the Kitchen Department where the most of foods come out makes a great effects on various expenses, productivity and it is the achievement from hotel management. For the most of the hotel's top managers, they don't seriously take the fact that KITCHEN SYSTEM affects greatly total expenditure. This study starts from the point of recognizing the question of fundamental cause affecting tow largest cost elements incurred in Food & Beverage and trying to present an effective kitchen system. To settle the questions raised, I compared and analyzed productivity and cost of food & beverage and unit kitchen centered around superior class hotels in Seoul, which vary in Kitchen Systems. In order to attain the aforementioned study effectively purpose of this study, I compared Room-Service and Coffee-Shop Menu, flow of basic food in the kitchen, extent and result of division of labor and integration in the kitchen, scale of outlet kitchen, productivity, the turnover rate of food in store, food cost rate one another which all vary in Kitchen Systems. All these elements are compared and analyzed each other being divided into two main groups such as①. Main Production kitchen and Banquet Kitchen, and ②. coffee-shop kitchen and Room-service Kitchen. Therefore this study is to point out the problems in managing kitchens of superior class hotels which are different in systems. An effort was made to find out the better Kitchen System for superior deluxe hotels. I emphasize the followings on the proper scale of division of labor and integration of unit kitchen and a disposition plan for outlet kitchens of restaurant. First, KITCHEN SYSTEM as a sub-system of Hotel Management System is composed of sub-systems of outlet unit kitchen. Basic food materials are cooked and served for the guests while support kitchen and out restaurant kitchen interact organically each other. So Kitchen should be considered as a system composed of integrated sub-systems. Second, support and banquet kitchens should be integrated to be managed. And these unit kitchens have to be designed to be placed in the back of banquet rooms area. Third, coffee-shop kitchen and room-service kitchen should be integrated to be managed. Fourth, several unit business kitchens should be place on the same floor. Fifth, main production kitchens ought to be located near the loading duck, food store and large refrigerator. Sixth, considering the limits of supervision, duties should be adjusted as 12-20 cooks in two shifts a day for a sub-kitchen, and 18-30 cooks in three shifts a day so that labor division can be made. Last, I would like to two points for direction and task of future study. Firstly, I compare the effective income and increasing costs each other, which are incurred by increasing the use rate of the second processing materials for foods perched outside and through the results. I can find out the better points of the processing production and circulation system, and then I study this effects made on hotel kitchen system. Secondly, I can point out that more efficient kitchen system shall be established through comparing and analyzing the matter of amount of indirect costs and flow of food in different kitchen systems.

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Using Analytic Network Process to Establish Performance Evaluation Indicators for the R&D Management Department in Taiwan's High-tech Industry

  • Liu, Pang-Lo;Tsai, Chih-Hung
    • International Journal of Quality Innovation
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    • v.8 no.3
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    • pp.156-172
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    • 2007
  • The high-tech industry is the economic lifeline for Taiwan. Its characteristics are short product life cycle, rapid changes in the market, and a high obsolescence rate for new products. Under globalization, the high-tech industry has adopted Information Technology (IT) to shorten the manufacturing process, reduce costs and conduct product research and development (R&D) to increase the core competence of enterprises and achieve the goal of sustainable operations. Enterprises should actively strengthen their integration with internal and external resources and lead in R&D management to increase industrial operating performance. Effectively managing operations and R&D management evaluation in Taiwan's High-tech Industry has become a critical subject. This study adopted 4 major Balanced Scorecard (BSC) perspectives to establish the Total Performance Evaluation Indicators for the R&D management department in Taiwan's High-tech Industry. The Analytic Network Process (ANP) was applied to evaluate the overall performance of the R&D management department. The research framework is divided into 2 phases. The first phase is combined with the 4 major perspectives, Financial, Customer, Internal Business Process and Learning and Growth, as the related indicators for each measurement perspective. The Key Performance Indicators (KPI) were selected using Factor Analysis to identify the key factor from the complicated indicators. The relationship between the characteristics of each BSC's evaluation perspective is dependence and feedback. This study applied ANP to conduct the calculation and adjustment of correlation between each KPI, and determine on their relative weights for the objective KPI. The "Financial Perspective" for R&D management department in Taiwan's High-tech Industry focused on the budget achievement rate of R&D management. The weight indicator value is (0.05863). The "Customer Perspective" focused on problem-solving satisfaction. The weight value of this indicator is (0.17549). The "Internal Business Process Perspective" focused on the quantity and quality of R&D. The weight value of this indicator is (0.13506). The "Learning and Growth Perspective" focused on improving competence in the research personnel's professional techniques. The weight value of this indicator is (0.02789). From the total weighting indicators, the order of the Performance Indicators for the R&D management department in Taiwan's High-tech Industry is: (1) Customer Perspective; (2) Internal Business Process Perspective; (3) Financial Perspective; and (4) Learning and Growth Perspective.

Assessment of Foodservice management practices and Nutritional adequacy of foods served in child-care centers (보육시설 급식소의 운영현황 및 급식실태 조사)

  • Kwak, Tong-Kyung;Lee, Hye-Sang;Jang, Mi-Ra;Hong, Wan-Soo;Yoon, Gae-Soon;Lyu, Eun-Soon;Kim, Eun-Kyung;Choi, Eun-Hui;Lee, Kyung-Eun
    • Journal of the Korean Society of Food Culture
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    • v.11 no.2
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    • pp.243-253
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    • 1996
  • The purpose of this study was to evaluate the foodservice management practices in child-care centers in order to provide basic information for the development of a model of a centralized food service information center. This approach was achieved using a variety of qualitative and quantitative information including general foodservice management practices and plate waste. A self-completed questionnaire survey of 651 child-care centers in Korea was undertaken and detailed information was carefully collected at 6 representative child-care centers. The results of the empirical survey were as follows: 1. Child-care centers categorized by location were in large cities (59.9%), medium cities (27.6%) and in provincial areas (12.5). 2. Private sector of child-care centers was 46.4% of the total followed by National/public (44.2%) and licensed home day-care programs (9.4%). 3. Total average number of children in child-care centers was $63.3{\pm}43.1$ with a very significant difference (p<0.001) in types of child-care centers. 4. The average space of kitchen and dining room was $5.0{\pm}3.8\;and\;10.8{\pm}11.0$ pyung ($1pyung=3.3058\;cm^2$). 5. The average cost of interim snack in morning and afternoon in child-care centers were $345.9{\pm}459.3$ won and $359.3{\pm}226.6$ won respectively. The average cost of lunch was $644.0{\pm}481.1$ won. There was a significant difference (p<0.001) by types of child-care centers with a highest cost of 863.9 won in licensed home day-care programs. 6. Only a limited number of dietitian were employed, therefore most of food service management practice was not conducted by professional personnel. 7. The result of nutritional analysis of the food revealed that the level of energy and nutrients contained in the food was below the recommeded level (RDA/3).

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A Study on the Employment Circumstances and Employment Status of Temporary Librarians (비정규직 사서의 근무환경 및 고용실태에 대한 연구)

  • Noh, Younghee;Ahn, In-Ja;Oh, Se-Hoon
    • Journal of the Korean BIBLIA Society for library and Information Science
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    • v.24 no.4
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    • pp.259-280
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    • 2013
  • There has been a dramatic increase in the proportion of temporary employees in LIS fields, due to current trends of restructuring, automation, complete personnel systems, and complete wage systems. This research, therefore, conducted a survey exploring the current status and working environment of the temporary posts in LIS fields, in order to understand and direct the employment prospects of potential librarians. Results show that the average working period of more than half of temporary librarians are between 1-3 years. The total working period as a temporary librarian, including former experiences in their career, were evenly distributed between 1-5 years. Among those, being temporary often persisted, as 32% of temporary librarians stayed in their temporary status for more than 5 years. Second, temporary librarians perceived themselves as working the same hours as regular librarians, having independent or assistant tasks to regular librarians, and having a neutral or larger amount of tasks than regular librarians. Third, temporary librarians are employed and contracted from the work place, generally having contracts of less than 2 years or an open contract, which shows a serious level of job instability. Therefore, we should consider the following: proper remuneration for work of equal value, professional contractors, the supplementation of the total wage system and the number of public employees in the system as well as changing temporary positions to permanent positions and so on.

A Study on the characteristics of Chinese medical care consumers and choice of medical care providers (중국 현지 의료소비자의 특성 및 의료기관 선택 연구)

  • Kim, Ji Man;Lee, Sang Gyu;Shin, Jaeyong;Song, Joo Young;Lee, Ye Seol;Kim, Tae Hyun
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.78-86
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    • 2018
  • Purposes: This study identifies local Chinese consumers' standard for selecting medical care provider and their standard for choosing medical staff, as well as their expectations and concerns regarding Korean medical care providers. Methodology: A survey was conducted in China, to identify Chinese medical care consumers' standards for selecting a medical provider and the factors that influence their use of general hospitals. A total of 1,500 people across three cities, between the ages 18 and 60 participated in the survey. Moreover, a multiple logistic regression analysis was used to analyze the factors that affect Chinese medical care consumers' use of general hospitals. Findings: A total of 75.5 percent respondents chose general hospitals as their most frequently-used medical provider. Those who have health insurance, visit general hospitals as outpatients or are hospitalized more frequently than those who do not have a health insurance. Furthermore, those who have private insurance visit general hospitals as outpatients or are hospitalized more frequently than those who are not signed up for private insurance. Major standards for selecting a hospital included: the doctor's skills, word-of-mouth regarding the hospital, and distance to the hospital from the respondents' home. Standards for choosing medical personnel included word-of-mouth regarding the medical team, recommendations from family members or acquaintances, and medical team's notoriety. Friends and neighbors, family members, television and other media outlets were the channels for acquiring information on a hospital. It was found that Chinese people mostly visit the cardiovascular department of Korean hospitals for treatment. For using Korean hospitals in China, the majority of respondents answered that they were concerned about the cost. Practical Implications: Backed by highly skilled medical experts and cutting-edge technology, Korean medical care providers are attempting to enter China's medical care market. To succeed in China's medical care market, it is vital to conduct a clear and precise analysis.

Health Services Utilization and Financial Performance of For-Profit versus Nonprofit Hospitals: A Study of General Acute Care Hospitals in the United States (미국 영리병원과 비영리병원의 의료이용도와 재무성과 비교)

  • Choi, Man-Kyu;Lee, Keon-Hyung;Lee, Bo-Hye
    • Health Policy and Management
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    • v.18 no.4
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    • pp.148-169
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    • 2008
  • As the Korean Government began to perceive healthcare as one of foundational industries for national dynamics, there has been mounting advocacy for the introduction of for-profit hospitals with a view to bringing efficiency in healthcare services industries and improvement of their international competitiveness. The Government is now considering the issue from all angles in favor of permitting for-profit hospitals. However, There have been few precedent studies on this subject to provide helpful data for the discussion and in the health policy making. This study used private hospitals - for-profit and nonprofit - in Florida, USA as study subjects to accumulate basic data that may be utilized for those involved in debates and health policy making relating to the introduction of for-profit hospitals in Korea. Among all the private general hospitals in Florida, those surveyed by AHA(American Hospital Association) for four consecutive years from 2001 and 2004 and others reported about to MCR(Medicare Cost Report) included in the collected data for analysis. In total 139 private general hospitals consisting of 73 for-profit hospitals and 66 nonprofit hospitals were included in the collected analysis data. Results of analysis revealed no significant difference between for-profit hospitals and nonprofit hospitals in the usage aspects of healthcare services including the average length of stay and the ratio of Medicare vs Medicaid patients. However, financial performances indicated by such factors. as the pre-tax return on assets and the pre-tax operating margin showed to be significantly higher in for-profit hospitals compared with nonprofit hospitals. And the ratio of personnel expenses and the turn period of total assets showed to be significantly lower in for-profit hospitals. Based on the hypothesis that arguments about the introduction of for-profit hospitals have considerably different viewpoints depending on the size of hospital represented by the number of bed, these two hospital types were compared again using the number of beds as a controlled factor, but the results were similar. We, therefore, could conclude that the for-profit hospitals in Florida included in this study could, in their for-profit operation, improve their financial performance by pursuing cost reduction and effectively utilizing their assets without limiting the amount and the range of their services or avoiding less medically protected groups such as Medicare and Medicaid patients.