• Title/Summary/Keyword: 병원 감염 관리

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A Case Study on Nosocomial Infection Control Activities in A General Hospital in Pusan (일 병원에서의 병원감염관리활동 사례연구)

  • Bae, Young-Soon
    • Quality Improvement in Health Care
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    • v.2 no.2
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    • pp.156-171
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    • 1996
  • Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.

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Disease monitoring of Alaska pollock (Gadus chalcogrammus) based on growth stages (명태 (Gadus chalcogrammus)의 성장 단계별 질병 모니터링)

  • Kim, Kwang Il;Byun, Soon-Gyu;Kang, Hee Woong;Nam, Myung-Mo;Choi, Jin;Yoo, Hae-Kyun;Lee, Chu
    • Korean Journal of Ichthyology
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    • v.29 no.1
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    • pp.62-68
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    • 2017
  • The Alaska pollock (Gadus chalcogrammus) belongs to the family Gadidae; it is a cold water fish, and has been developed as a novel aquaculture species in Korea. In this study, we describe ongoing surveillance for aquatic animal pathogens based on growth stages. We investigated bacterial flora in rearing water, and monitored pathogens; we also analyzed histopathological traits of abnormal fish. In rearing water, the total bacterial counts were $2.1{\times}10^3cfu/mL$ and Vibrio spp. (52%) were predominant in the larvae stage. In the juvenile and adult stages, the total bacterial counts were $3.4{\times}10^3$ and $3.2{\times}10^2cfu/mL$, respectively (with Pseudomonas sp. as the predominant species; 90% and 52%). This result revealed that the bacterial flora in rearing water changed depending on the feeding types. No virulent-bacteria or problematic viruses (VHSV, viral hemorrhagic septicemia virus; NNV, nervous necrosis virus; MBV, marine birnavirus) were detected from outwardly healthy fish using either culture or PCR assay. Some juveniles (less than 5%) had gas bubbles on the gill lamellae, degeneration of the corneal epithelium, and choroid gland degeneration, suggesting that these symptoms were caused by external injury and secondary infection by opportunistic bacteria. Disease management is important to cope with disease emergence in the novel aquaculture species Alaska pollock.

Occurrence of Sclerotinia Rot on Perilla Caused by Sclerotinia sclerotiorum under Structured Cultivation Condition (Sclerotinia sclerotiorum에 의한 시설재배 들깨 균핵병 발생특성)

  • Shin, Dong-Bum;Song, Seok-Bo;Moon, Byung-Ju
    • Research in Plant Disease
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    • v.12 no.3
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    • pp.158-163
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    • 2006
  • Sclerotinia rot caused by Sclerotinia sclerotiorum frequently causes serious and unpredicable yield losses of the leaves of perilla growing under structured cultivation as vegetable in Korea. Temperature for mycelial growth ranged from 5 to $30^{\circ}C$ with optimum temperature d $20^{\circ}C$. Sclerotia were formed fewer at low temperature, but their dry weight was heavier than that at high temperature. The apothecia were formed from the sclerotia that buried up to 3 cm soil depth at $15^{\circ}C$ in moisture condition. The incidence of perilla Sclerotinia rot caused by S. sclerotiorum was observed throughout the growing season at greenhouse. The occurrence of this disease was especially severe from January to February of low temperature period. The average incidence rates of this disease was up to 15%. The significant occurrence of this disease was showed mainly in the continuous cropping field for more than five years. The incidence of this disease increased according to the increase of continuous cropping year. The incidence rates of this disease reached up to 20% in the continuous cropping field for ten years. Also it was firstly investigated the natural infection caused by S. sclerotiorum on weed plants, Gnaphalium affine and Mazus pumilus in farmer's field. The casual fungus showed pathogenicity on 11 weed plants species tested, and more severe pathogenicity on G. affine, Latuca indica and Ixeris dentata included in the family Compositae. This result suggests that effective crop rotation and weed eradication can be the method for organic control of perilla sclerotinia rot, and sudden outbreaks of this disease on perilla growing under structure after paddy rice call be explained by the presence of weed hosts.

Convergence Research on Periodic Changes in the Quality Assessment of Surgical Prophylactic Antibiotics (수술 예방항생제 적정성 평가의 주기별 융합 변화 연구)

  • Yang, Sae-Yie;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.14 no.6
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    • pp.325-333
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    • 2016
  • This study was conducted to provide the base line for the use of prophylactic antibiotics and the standard of antibiotic use and the evaluation based on analysis of current use, quality assessment and periodic changes of prophylactic antibiotics in a university hospital. We chose the year 2008, 2009, 2010, 2012, and 2014 as the study periods since the primary evaluation on the first year of implementation in 2007. For this study, healthcare benefit quality assessment data from the Health Insurance Review and Assessment Service was used. We analyzed the differences each year of treatment period; one category for initial treatment timing, three categories for selecting antibiotics, and two categories for the length of treatment from multiple evaluation indices of gastric surgeries, colorectal surgeries, and cholecystectomy. The analysis revealed the followings: Regarding length of antibiotics treatment, total days of treatment decreased down to 1.5, 1.5, and 0.6 days in the year 2014, from 13.5, 12.8, and 6.9 days in the year 2007, for gastric surgeries, colorectal surgeries, and cholecystectomy. Based on these outcomes, the efforts to devise efficient delivery and distribution of the recommendations or indices which medical staff could adhere for quality improvement of the prophylactic antibiotics would be necessary. Also implementing monitoring system to help the hospitals to acknowledge their own faults may be helpful.

Appropriate App Services and Acceptance for Contact Tracing: Survey Focusing on High-Risk Areas of COVID-19 in South Korea (코로나 19 동선 관리를 위한 적정 앱 서비스와 도입: 고위험 지역 설문 연구)

  • Rho, Mi Jung
    • Korea Journal of Hospital Management
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    • v.27 no.2
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    • pp.16-33
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    • 2022
  • Purposes: Prompt evaluation of routes and contact tracing are very important for epidemiological investigations of coronavirus disease 2019 (COVID-19). To ensure better adoption of contact tracing apps, it is necessary to understand users' expectations, preferences, and concerns. This study aimed to identify main reasons why people use the apps, appropriate services, and basis for voluntary app services that can improve app participation rates and data sharing. Methodology/Approach: This study conducted an online survey from November 11 to December 6, 2020, and received a total of 1,048 survey responses. This study analyzed the questionnaire survey findings of 883 respondents in areas with many confirmed cases of COVID-19. This study used a multiple regression analysis. Findings: Respondents who had experience of using related apps showed a high intention to use contact-tracing apps. Participants wished for the contact tracking apps to be provided by the government or public health centers (74%) and preferred free apps (93.88%). The factors affecting the participants' intention to use these apps were their preventive value, performance expectancy, perceived risk, facilitative ability, and effort expectancy. The results highlighted the need to ensure voluntary participation to address participants' concerns regarding privacy protection and personal information exposure. Practical Implications: The results can be used to accurately identify user needs and appropriate services and thereby improve the development of contact tracking apps. The findings provide the basis for voluntary app that can enhance app participation rates and data sharing. The results will also serve as the basis for developing trusted apps that can facilitate epidemiological investigations.

Discharge Analysis of Chungcheongbuk-do Residents using National Hospital Discharge In-depth Injury Survey in the Recent 5 Years (퇴원손상심층조사 자료를 이용한 최근 5년간의 충청북도 거주민의 퇴원 분석)

  • Kim, Hae-Sook
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.389-401
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    • 2021
  • This study was performed to generate basic data to establish a health promotion plan for residents of Chungcheongbuk-do by identifying characteristics of discharged patients residing in the Chungcheongbuk-do area from an In-Depth Post-Discharge Injury Survey reported by the Korea Centers for Disease Control and Prevention(KCDCP). The Report provided data on demographic characteristics, medical institution use characteristics, medical use characteristics, and disease characteristics of patients discharged from medical institutions with 100 or more beds from 2013 to 2017. The total number of Chungcheongbuk-do residents who were admitted and discharged from 2013 to 2017 was estimated to be 1,656,590, and the discharge rate was 21,089, which was higher than the national average of 13,882 in 2016. The regions where the discharge rate increased during this period include Goesan, Yeongdong, Boeun, Okcheon, Jeungpyeong, and Eumseong-gun, which are mainly rural areas. Among the patients hospitalized and discharged from hospitals outside the Chungcheongbuk-do area, the discharge rate of patients who used hospitals in Incheon/Gyeonggi areas and Daejeon/Chungnam areas increased slightly. Among the malignant tumor patients, the number of lung cancer(included trachea & bronchial cancer) patients was the highest. In addition, the discharge rate was highest for patients with respiratory diseases. This study suggests that efforts need to be made to lower the discharge rate for infection, circulatory disease, genitourinary disease, and musculoskeletal disorder patients

A STUDY OF PARENTAL KNOWLEDGE AND ATTITUDE ABOUT INFANT ORAL HEALTH CARE (유아의 구강관리에 관한 보호자의 인지도 조사)

  • Kim, Myoung-Jin;Shun, Ye-Kyung;Shim, Youn-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.27 no.2
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    • pp.292-299
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    • 2000
  • The purpose of this study was to investigate parental knowledge and attitude and practices relating to infant oral health care and to promote their motivations to their children's oral health care. Authors interviewed 350 persons in Ilwon-Dong and whose children were between 0 to 36 months old and acquired questionnaire from them. The questionnaire constituted of questions about general knowledge of tooth eruption, methods of oral hygiene care, and opinions about preventive dental visit. The collected data were analysed and compared with other researches. The important results obtained from this study were : 1. Females and highly educated persons had more dental knowledge than males and poorly educated persons. But age and economic status did not affect their level of dental knowledge. 2. Fifty nine percents of respondents thought that tooth began to be formed before birth. 3. Seventy six percents of respondents thought that infant oral health care should begin before tooth eruption, but actually only 63% started oral hygiene care before age one. 4. Seventy percents of respondents used gauze for infant oral care. 5. Fifty seven percents of respondents still gave bottles to their children after they reached age one or more and 55% of respondents never heard of nursing caries. 6. Ninety percents of respondents agreed that carious deciduous teeth need restorations, and 31% of respondents thought that age two is the appropriate time for the first dental visit. 7. Forty seven percents of parents did not think that dental caries is an infectious disease. 8. Only Thirty three percents of parents visited dental clinics for examination and prevention during pregnancy and only 11% of expecting parents were offered dental health care education in pediatric or obstetrician clincs. 9. Information about oral health care was mostly given from baby megazines. 10. Overall parental knowledge about infant oral health care was not sufficient to maintain appropriate dental care for infants.

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Difference of perception of the duties of dental hygienist between dentists and dental hygiene students in an area (일개 지역 치과의사와 치위생학과 학생 간 치과위생사의 업무에 대한 인식의 차이)

  • Hwang, Soo-Jeong;Koong, Hwa-Soo;Lee, Sang-Hoon
    • Journal of Korean Academy of Dental Administration
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    • v.5 no.1
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    • pp.1-12
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    • 2017
  • Although dental hygienists have performed chair-side assisting and other dental cares as well as preventive dental cares in Korea, medical technician law confines duties of dental hygienists as closed narrative. The aim of this study was to investigate difference in perception of duties of dental hygienists in dental clinic between dentists and dental hygiene students. A total of 245 copies of questionnaires were distributed to dentists and students by post-mail. Only 42 dentists and 30 students in an area replied these questionnaires about the present and future duties of dental hygienists after providing written consent. Both groups agreed that intra and extra oral X-ray taking, education about oral health behavior, instruction after dental treatment, chair-side assisting, consulting for patients, scaling, initial impression taking, management of dental materials and equipment, sterilization of equipment, and receiving dental bills are duties of dental hygienists. However, they had different perceptions about various dental treatments as duties of dental hygienists even if they were under instructions of a dentist, including infiltration anesthesia, filling in cavity, intramuscular injection, FC change, canal irrigation, orthodontic treatment including separating, ligature bracket bonding and removing, setting crown and bridge, making individual, removing implant screw, and so on. These findings demonstrated that there were different perceptions about duties of dental hygienists between dentists and dental hygiene students, especially on dental treatment.

Epidemiological investigation on the outbreak of foodborne and waterborne disease due to Norovirus with delayed notification (노로바이러스에 기인한 수인성·식품매개감염병 집단발생의 지연신고에 대한 역학조사)

  • Ha, Mikyung;Kim, Hyeongsu;Kim, Yong Ho;Na, Min Sun;Yu, Mi Jung
    • Journal of agricultural medicine and community health
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    • v.43 no.4
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    • pp.258-269
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    • 2018
  • Objectives: There was an outbreak of foodborne and waterborne disease among high school students at Okcheon in June, 2018. First attack occurred June $5^{th}$ but seven days later it was notified. The purpose of this investigation was to evaluate the pathogen of outbreak and cause of delayed notification. Methods: First, we did a questionnaire survey for 61 cases and 122 controls to find what symptoms they had and whether they ate foods or drank water from June $2^{nd}$ to June $12^{th}$. Second, we investigated the environment of cafeteria and drinking water. Third, we examined specimen of cases and environment to identify bacteria or virus. Results: Attack rate of this outbreak was 7.8%. Drinking water was strongly suspected as a source of infection in questionnaire survey but we could not find the exact time of exposure. Norovirus was identified in specimen of cases (2 students), drinking water (at main building and dormitory) and cafeteria (knife, dishtowel, hand of chef) Conclusions: We decided norovirus as the pathogen of this outbreak based on the clinical features of cases with diarrhea vomiting, abdominal pain and recovery within 2 or 3 days after onset, outbreak due to drinking water and microbiologic examination, And the cause of delayed notification might be the non-existence of the nurse teacher at that time and the lack of understanding of teachers on immediate notification under the outbreak. To prevent the delayed notification, notification system about outbreak of foodborne and waterborne disease in school is needed to be improved.

Professional Certification of Medical Technologists in Korea, Japan, and United States of America (한국, 일본, 미국 임상병리사 전문자격)

  • Koo, Bon-Kyeong
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.1-14
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    • 2019
  • The names of medical technologist in Korea, Japan, and the United State of America vary depending on the medical system, educational system, and work areas. Conventionally, jobs equal or similar to medical technologist (commonly known as clinical laboratory technologist, medical laboratory technologist, clinical laboratory scientist, and medical laboratory scientist), histotechnologist, cytotechnologist, and genetic technologist. Jobs, such as extracorporeal technologist, medical electrophysiology technologist, and medical sonographer, allow other allied health professionals including medical technologists, to obtain their qualification. The work areas of medical technologists are classified into clinical pathologic technology, pathologic technology, clinical genetics technology, nuclear medicine in vitro technology, and clinical physiologic technology. New titles of Korean specialized medical technologists refer to certification systems, such as CLMJ, CMAJ, ASCP, IAC, ABRET, and ARMDS. Currently, there are eight types of specialized medical technologists under the cooperation of specialized academic societies. They are hematology, transfusionology, chemistry, immunology, microbiology, histology, cytology, nuclear medicine. It can be further divided into 20 categories according to the work areas such as mass spectrometry, infection control, Pathologists' Assistant, flow cytometry, HLA, cytogenetics, molecular genetics, cardiopulmonary physiology, neurophysiology (EEG/EMG/PSG/etc.), cardiac sonography, neurosonography (TCD/carotid), and medical device quality manager.