• Title/Summary/Keyword: 상급종합병원

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Factor Associated with Injury Related to Home Mechanical Ventilation in General Ward Patients: A Retrospective Study (가정용 인공호흡기 관련 안전사고 특성 및 손상 영향 요인 분석: 상급종합병원 일반병동 환자 중심으로)

  • Kim, Hyang Sook;Choi, Mona;Yang, Yong Sook
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.2
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    • pp.131-140
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    • 2020
  • Purpose: This study aims to describe the characteristics of safety incidents and factors associated with injury for patients with Home Mechanical Ventilation (HMV) at the hospital. Methods: This is a retrospective study. Data were collected from the work log of respiratory home care nurses and the patients' electronic medical records were investigated. In order to compare group differences, independent t-test and χ2 test were used. Associated factors with injury development were identified by generalized mixed modeling analysis controlling for age and gender. Results: A total of 304 patients on HMV were included in this study, among which 129 (42.4%) experienced 352 HMV-related incidents. Mean frequency of incidents for each patient was 5.11±3.98, ranged from 1 to 15 times. In 19.0% of the incidents, injury was developed. Types of incident and persons involved in the incidents were significantly associated with the patient's injury. In the case of the safety incidents, patient's injury was significantly higher in accidents caused by respiratory circuit problems compared to those caused by problems with the ventilator operation by the medical staff (coefficient=1.25, p=.020). In addition, in the case of those involved in the safety incidents, patient's injury was significantly higher in the accident caused by the patient family members or caregivers than that caused by the medical personnel (coefficient=1.25, p=.019). Conclusion: In order to minimize injury caused by incidents in patients with HMV, hospitals need to provide systemic education to their medical staff and caregivers to enhance awareness of the importance of reporting and safety management.

The Recent Trends in Telemedicine in the era of COVID-19 and Policy Recommendations for the Balanced growth of Healthcare Service Industry in Korea (COVID-19 시대 국내외 원격의료 동향과 의료서비스산업의 균형 성장을 위한 정책 제언)

  • Lee, Jaehee
    • The Journal of the Convergence on Culture Technology
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    • v.6 no.4
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    • pp.591-598
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    • 2020
  • Since COVID-19's 1st pandemic came in February 2020, the demand for telemedicine grew greatly that in most countries the deregulation for telemedicine policy have been implemented in more countries. Also in Korea, with the name of 'Non-face-to-face Treatment' telemedicine began to be approved. Telemedicine having strength in chronic disease management has been effective in more and more specialties along with the recent development of ICT that it is expected to contribute to the improvement of the quality of healthcare service and creation of new treatment model. On the contrary it may also exacerbate the distortion in the hospital healthcare service industry in Korea, which is the excessive tipping toward large hospitals. So the dual promotion policy approach in which the settlement of family doctors system extensively utilizing telemedicine for chronic disease management and the support for tertiary hospitals and hospitals focusing on treating foreign patients to provide quality service using telemedicine technology are pursued simultaneously are recommended.

Risk Factors, Symptoms, and Intervention Analysis of Delirium Subtypes in Hospitalized Patients (입원환자에게 나타나는 섬망 아형별 위험요인과 증상 및 중재 분석)

  • Ryu, Ahyun;Kang, Young-Ok;Song, Rhayun
    • Journal of the Korea Convergence Society
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    • v.12 no.10
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    • pp.353-363
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    • 2021
  • This study aimed to investigate subtypes, risk factors, symptoms and the interventions to inpatients with delirium. The data of 108 inpatients who had the diagnosis of delirium during their hospital stay were collected from Electronic Medical Record at a university hospital and were analyzed by SPSS for Windows V. 26.0 program. As a results, Patients had a high proportion of elderly, male, orthopedic, and with fractures or amputations. The subtypes of delirium were hyperactive (51.9%), hypoactive (6.5%), and mixed (41.7%). Among the risk factors, depression and use of psychotropic agent were more common in those with hypoactive delirium. Among delirium interventions, behavioral symptom management and aggressive behavioral intervention were mainly implemented for those with hyperactive or mixed types, and emotional support was mainly implemented for those with hypoactive or mixed types. The delirium related intervention was more likely given immediately when the patients showed aggressive behaviors. Therefore, intervention strategies and protocol development are required for early detection of delirium in inpatients.

Influence of Positive Psychological Capital and Death Awareness on Terminal Care Performance of Hematooncology Unit Nurses (혈액종양내과 병동간호사의 긍정심리자본과 죽음인식이 임종간호 수행에 미치는 영향)

  • Jung, Seo Yeon;Kim, Jeong Hye
    • Journal of Hospice and Palliative Care
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    • v.22 no.2
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    • pp.77-86
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    • 2019
  • Purpose: The purpose of this study was to confirm the influence of hematoonchology unit nurses' positive psychological capital and death awareness on their terminal care performance. Methods: This descriptive study data were collected from self-reported questionnaire filled by 127 oncology nurses at a tertiary hospital in Seoul, Korea. The variables were positive psychological capital, death awareness, and terminal care performance. Data were analyzed using SPSS version 22.0 software. Results: The participants scored $3.93{\pm}0.83$ on positive psychological capital, $3.68{\pm}0.99$ on death awareness and $2.86{\pm}0.65$ on terminal care performance. The three variables were positively correlated. The factors affecting the nurses' terminal care performance were hope and resilience in the subcategory of positive psychological capital and experience of death of family members, relatives or friends within the past year; The explanatory power was 32.1%. Conclusion: It is necessary to develop educational programs to foster hope, resilience, etc. in hematooncology unit nurses to improve their quality of terminal care performance.

Post-traumatic Stress Disorder and Burnout of Healthcare Providers who cared for Patients with Coronavirus Disease-19 (COVID-19) in a Tertiary General Hospital (코로나바이러스감염증 환자를 돌본 일개 상급종합병원 의료인의 외상 후 스트레스 장애와 소진)

  • Kim, Kyung Deok;Yi, Young Hee
    • Journal of Korean Critical Care Nursing
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    • v.15 no.3
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    • pp.101-114
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    • 2022
  • Purpose : This study aimed to identify post-traumatic stress disorder (PTSD) and burnout experienced by healthcare providers who cared for patients with Coronavirus Disease 2019 (COVID-19) and their influencing factors. Methods : Data were collected from 135 healthcare providers who cared for patients with COVID-19 in a tertiary general hospital from June 8 to September 2, 2021, using a questionnaire. Descriptive statistics, Mann-Whitney U test, Kruskal-Wallis test, t-test, ANOVA and Scheffe's test, Pearson's correlation coefficients, and multiple regression were used for analysis using SPSS/WIN 27.0. Results : Participants' average PTSD score was 9.31 ± 11.80, and 8.9% were in the high-risk group. Participants' average burnout score was 51.77±21.28, and 62.2% were at high risk. PTSD scores differed significantly according to participants' age, education, job, position, and current workplace. Burnout scores differed significantly according to their age, gender, marital status, parental status, and education. There was positive correlation between participants' PTSD and burnout. The factors influencing participants' PTSD were term of self-isolation and age (R2=.09). There were no significant influencing factors on participants' burnout. Conclusion : This study reconfirmed that healthcare providers who cared for patients with COVID-19 experienced both PTSD and burnout, suggesting that interventions are needed such as regular pre-training or simulation training and establishing a support system.

Awareness of good death, perception of life-sustaining treatment decision, and changes in nursing activities after decision to discontinue life-sustaining treatment among nurses in intensive care units at tertiary general hospitals (상급종합병원 중환자실 간호사의 좋은 죽음인식, 연명의료결정 인식 및 연명의료중단 결정 후 간호활동의 중요도 변화)

  • Cho, Gyoo Yeong;Bae, Hye Ri
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.109-122
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    • 2023
  • Purpose : This study aims to explore nursing activities after the decision to discontinue life-sustaining treatment, awareness of a good death, and perception of life-sustaining treatment decisions among nurses in intensive care units (ICUs) at tertiary general hospitals. Methods : Participants were 173 nurses working in two tertiary general hospitals. The data were collected using structured questionnaires and analyzed using an independent t-test, paired t-test, one-way ANOVA, Scheffé's test, and Pearson's correlation coefficient. Results : Participants were 173 nurses working in two tertiary hospitals. The nursing activity increase was the greatest in the spiritual domain, and the physical domain was where the activities decreased the most. There were significant associations between Awareness of good death (Clinical) and Perception of life-sustaining treatment decision(r=.26, p <.001), Awareness of good death (Closure) and Perception of life-sustaining treatment decision(r=.36, p <.001), and Awareness of good death (Personal control) and Perception of life-sustaining treatment decision(r=.49, p <.001). Conclusion : Based on the results, systematic education programs and job training are required to improve the awareness regarding good death and perception of life-sustaining treatment decision for nurses in ICUs where discontinuing life-sustaining treatment decisions are made.

Awareness of Hospital Safety Culture and Safety Activities of Workers in a Tertiary Care Hospital (상급종합병원종사자의 병원안전문화 인식과 안전활동)

  • Ha, Eun-Ho;Hyun, Kyoung-Soon;Cho, Jin-Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.22 no.2
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    • pp.191-201
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    • 2016
  • Purpose: The purpose of this study was to identify awareness of hospital safety culture (AHSC) and safety activities (SA) of workers in a tertiary care hospital, and the factors influencing safety activities. Methods: 303 Participants from the tertiary care hospital in Seoul were invited. Collected data were analyzed using SPSS 18.0. Results: The level of AHSC and SA was 3.61 and 4.17, respectively. There were differences between AHSC and SA according to gender, religion, employment status, job class, working period, safety education, need for safety education, and number of safety accident reports. There was a positive relationship between AHSC and SA. The factors influencing SA were communication and process, employment status, and safety accident reports. Conclusion: AHSC and SA are important factors to improve hospital safety, as well as increasing chances to receive hospital accreditation.

A Utilization Strategy of Nursing Staff by Types of Medical Institutions - nurse staffing level of medium and small-sized hospitals (의료기관별 간호인력 활용방안-중소병원 간호사 확보를 중심으로)

  • Hong, Ji Yeon;Chae, JungMi;Song, Mi Ra;Kim, Eun Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.8
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    • pp.162-170
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    • 2017
  • This study analyzed the current situation of medium and small-sized hospital nursing staff and related policies, and identified the factors that affect staffing level to provide evidence for planning and adopting policy. By analyzing the statistical data published by public institutions such as the Ministry of Health and Welfare and Health Insurance Review and Assessment Service, the result was viewed based on the understanding of various internal and external health care environments. The number of active nurses was less than 50% of the number of licensed nurses and has decreased every year. This means that the cost-effectiveness of increases in nursing college enrollment should be reconsidered. Inpatient nursing fees by staffing grades has caused nurses to move from medium and small-sized hospitals, where there is a severe lack of staff, to more advanced general hospitals. As a result, the lack of nursing staff in medium and small-sized hospitals has worsened. In conclusion, reexamination is needed to improve effectiveness of inpatient nursing fees by staffing grades as a policy to secure the workforce of medium and small-sized hospitals. Furthermore, the tracking management system of licensed nurses must be able to solve the imbalance between demand and supply of nursing staff.

Clinical pharmacist services in general wards and perception and expectation of healthcare providers towards the services at a tertiary healthcare center (상급종합병원 병동담당약사 업무 현황 및 의료인의 인식과 기대 분석)

  • Kim, Jeongun;Baek, Sijin;Choi, Nayae;Jeon, Sujeong;Namgung, Hyung Wook;Lee, Junghwa;Lee, Euni;Lee, Ju-Yeun
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.1
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    • pp.20-26
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    • 2022
  • Background and objective: The Seoul National University Bundang Hospital (SNUBH) implemented ward-based clinical pharmacy system with designated pharmacists in 10 general wards. Designated pharmacists conduct inpatient medication review, medication intervention, and medication consultation, and provide drug information for health care providers. This study aimed to evaluate the clinical pharmacy services and to examine the perception and expectations of health care providers on the services provided by the designated pharmacists in general wards. Methods: A survey was constructed to include questions on the health care providers' recognition, satisfaction, and perceived needs of designated pharmacists. We determined the frequency and type of interventions of ward pharmacist and their acceptance rate through a retrospective observational study using electronic medical records. Results: A total of 59 health care providers responded the questionnaire and 79.7% of the respondents reported moderate to high levels of satisfaction. Satisfaction with the services was positively associated with clinical interventions and nutrition support team (81.4%). Of 59 respondents, 88.1% agreed that preventing drug-related problems by designated pharmacists' activities were effective. The most common interventions included inadequate dosage (27.4%), omission and additional prescription (14.6%) and inadequate drug form (9.6%). The acceptance rate of intervention was 91.5%, and 151 potentially serious risks and 523 significant risks were prevented by the intervention. Conclusion: Positive results were confirmed in the awareness, satisfaction, and perceived needs of the health care providers for designated pharmacists. Expansion of the ward-based clinical pharmacy system with designated pharmacists to other wards may be considered.

Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design (일 상급종합병원 병동간호사의 업무량 측정 및 간호사 배치수준의 적절성 연구: 혼합연구 설계 적용)

  • Kim, Hyun-Joo;Lee, Sun-Hee;Lee, Jai-Jung;Seong, Sun-Suk;Yang, Hee;Lee, Hyang-Yuol
    • Journal of Korean Academy of Nursing
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    • v.54 no.2
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    • pp.237-249
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    • 2024
  • Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.