• Title/Summary/Keyword: 지침의 질

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Survey of Point-of-Care Testing Devices for Pre-hospital EMS Equipment of Glucometer on Local Area (지역 EMS의 현장검사 혈당측정기 사용에 대한 실태조사)

  • Byeong-Hyun, Kim;Dai-Hai, Choi;Gyoung-Yim, Ha
    • Journal of agricultural medicine and community health
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    • v.47 no.4
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    • pp.220-228
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    • 2022
  • Objective: glucometer is one of POCT(point-of-care testing) devices used by EMS. Accurate measurement value is important for patient decision making. Quality control is necessary for this, but most EMS are still using glucometer without quality control it. Therefore, management status and quality control status of glucometers used by 119 paramedics waswere investigated. Methods: 6 and 8 of glucometers and blood glucose test strips were submitted from 4 safety centers in 2010 and 8 safety centers in 2012, respectively. Glucometers submitted by local safety centers were analyzed in 2010 and 2012. The control glucometer, which was well managed at A University Hospital, was assumed to be accurate for at blood glucose measurement. Glucose values of various quality control materials control solutions were measured and analyzed using linear regression and Pearson's correlation test. Error rates were obtained via error tolerance range required by the 2011 ISO(International Organization for Standardization) guideline. For statistics, Excel and MedCalC programs were used. Results: mong 14 safety centers in the region, 4 centers(28.5%) in 2010 and 8 centers(57.1%) in 2012 submitted 6 and 8 glucometers. In the first evaluation in 2010, 2 out of 6(33.3%) glucometers were untestable due to error, and 45 out of 6(66.683.3%) blood glucose test strips' validity were expired. In the second evaluation in 2012, 1 out of 8(13.5%) glucometers were untestable due to lack of battery, and 2 out of 8(25%) blood glucose test strips' validity were expired. All correlation coefficients were above 0.989 in 2010 and above 0.997 in 2012. Error rates were generally high when using expired blood glucose test strips. Conclusion: Among 119 paramedics' guideline, quantity and operation status of POCT devices are well managed, but quality control is not. Therefore, it is necessary to add management status and quality control status of POCT devices to the EMS' field work guideline.

A Study on Seawater Quality Criteria and Assessment of Thermal Discharge from Nuclear Power Plant (원자력발전 온배수 영향에 대한 해수질 환경조사 지침 연구)

  • Park, Yong-Chul;Kim, Sung-Jun;Kim, Eun-Soo;Lee, Hee-Jun;Lee, Hyo-Jin;Kim, Dong-Hwa
    • The Sea:JOURNAL OF THE KOREAN SOCIETY OF OCEANOGRAPHY
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    • v.12 no.1
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    • pp.50-56
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    • 2007
  • Impact of thermal discharge of nuclear power plant on marine environment is naturally reflected in biogeochemical changes of seawater. Until now, many investigation activities and reports of impact analysis of marine environment were occasionally inadequate to provide sufficient justification in resolving controversial conflict of interests related with thermal discharge of nuclear power plant. From the scrutinized examination of recent 17 reports published in Korea between 2002 and 2004, the most apparent issue was inadequacy of sampling design and absence of significance of many measured parameters. In many cases, lack of statistical interpretation of raw data incurred subjective or ambiguous assessment results, which failed in deducing mutual concurrence between the parties of interest. In overall all, the main reasons for impairing integrity of previous reports seem to be inconsistency of environmental investigation procedures between research institutions, inadequate sampling design at the discretion of institutions and lack of objectivity of impact assessment based on statistical interpretation. Therefore, the primary goal of this study is to (1) discuss the blown issues on previous routine practice of seawater quality assessment procedures, and to (2) provide improved investigation procedures and rational standard criteria strictly based on statistical analysis for the better seawater quality assessment, which could be supported by scientific community, public agency, investigation institution and the other parties of interest.

Survey of COPD Management among the Primary Care Physicians in Korea (우리나라 일차 진료의사의 만성폐쇄성폐질환(COPD) 진료실태조사)

  • Park, Myung Jae;Choi, Cheon Woong;Kim, Seung Joon;Kim, Young Kyoon;Lee, Sung Yong;Kang, Kyung Ho;Shin, Kyeong-Cheol;Lee, Kwan Ho;Lee, Jin Hwa;Kim, Yu-Il;Lim, Sung-Chul;Park, Yong Bum;Jung, Ki-Suck;Kim, Tae-Hyung;Shin, Dong Ho;Yoo, Jee-Hong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.109-124
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    • 2008
  • Background: The incidence of chronic obstructive pulmonary disease (COPD) is increasing and the disease is becoming an important cause of morbidity and mortality worldwide. It is important to implement evidence-based guidelines by primary care physicians (PCPs) to establish qualified management of COPD patients. The aim of this survey is to investigate the pattern of COPD management among PCPs and to apply it to the development of Korean COPD guidelines. Methods: A web-based questionnaire was prepared that consisted of 25 questions on the pattern of COPD management. A total of 217 PCPs participated in the survey from June 2006 to May 2007. Results: Many PCPs (61.8%) possessed a spirometer, but the application rate was relatively low (35.8%) and more than half of the COPD patients (57%) did not receive a diagnosis based on spirometry. Administration of oral medication was preferred than the administration of inhaled medication for both stable COPD and acutely exacerbated COPD. More than 90% of the PCPs endorsed educational measures to quit smoking and vaccinate against influenza. It was noted that 56.7% of the PCPs were aware of the GOLD guidelines, but only 7.3% tended to fully implement the recommendations of the guidelines in daily practice. Conclusion: The results of the survey indicate that despite the high awareness rate of the current COPD guidelines, deficits exist among the PCPs with respect to the diagnosis and treatment of COPD. The results of this survey should be applied for the development of new COPD guidelines in order to decrease the discrepancy between the guidelines and the daily practice of the PCPs.

Activity to reduce the record missing for nursing care charge (간호수가 누락률 감소활동)

  • Kim, Nan Ja;Lee, Yong Kyo;Kim, Hye Jin;Cheung, Ok Ju;Song, Nam Gyoung;Jun, Mi Sun
    • Quality Improvement in Health Care
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    • v.15 no.1
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    • pp.73-78
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    • 2009
  • 문제: 오늘날 간호사는 과거와 달리 현대적 보건의료 요구를 해결할 수 있는 체계적인 이론과 기술을 습득하도록 훈련된 고급 전문 인력이고, 간호행위를 생산하기 위해서는 서비스의 생산원가 뿐만 아니라 전문 인력으로서의 훈련 및 유지비용 등도 투입되어야만 가능하게 함으로서 2008년 7월부터 시행한 중환자실 간호등급에 따른 간호수가 책정으로 인해 중환자실 내에서 이루어지고 있는 많은 간호행위 중 수가를 받을 수 있는 부분이 생기게 되었고 간호행위의 중요성과 더불어 간호를 시행 후 받을 수 있는 수가에 대한 간호사들의 입력에 대한 의무도 늘어나게 되었다. 이에 빈번히 누락되고 있는 간호수가 관리를 통한 경제적 손실을 방지해야 할 필요성을 느껴 개선활동을 하고자 한다. 목적: 2008년 7월부터 시행한 중환자실 간호등급에 따른 간호수가 책정으로 인해 중환자실내에서 이루어지고 있는 간호 행위의 중요성을 인식하고 구체적인 문제 분석과 간호 현장에서의 개선안을 도출함으로써 경제적 손실을 방지할 수 있는 간호수가 누락률을 감소시키고자 함이다. 의료기관: 대구파티마병원 내과 중환자실. 질 향상 활동: 업무개선의 방법으로 환자 개인별 간호수가 입력 누락 방지 체크 리스트 사용 및 처방 전달 시스템의 간호수가 재입력 화면을 이용하여 입력의 용이성 도모하였고 입력된 간호수가를 처방 전달 시스템 간호수가 조회 프로그램을 이용해 익일 누락여부를 매일 모니터링 하였다. 교육 및 홍보활동으로는 간호수가 입력누락 방지를 위한 간호수가 입력 지침을 제작하여 전체간호사는 년 2회, 신규간호사는 개별 교육을 실시하였으며, 월별 간호수가 누락통계를 실명 공고 하여 간호수가 다 빈도 누락 간호사는 추가 개별교육을 실시하였다. 개선효과: 간호수가 입력 프로세스 개선을 통해 간호수가 평균 누락률이 개선 전 6.5%, 개선 후 1.2%로 5.3%의 누락 감소율을 보였으며 역치 5%를 달성하였고 간호수가 누락금액은 개선 전 2,992,752원, 개선 후 590,787원으로 2,401,965원의 누락 효과 비용을 구할 수 있었다. 본 QA활동으로 중환자실 간호수가 전산입력에 대한 체계적인 교육부재와 신규간호사들의 잦은 전산누락이 있어왔으나 표준화 된 체크리스트 지침과 입력확인 작업으로 전산입력 누락률이 감소하는 효과를 가져왔다. 추후 심평원 청구 작업을 하는 부서와 연계되어 실제 청구 누락률에 대한 비교와 간호사 근무연수와 간호수가 입력 누락률에 대한 상관관계 조사를 제언 해 본다.

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EFFECT OF SELF-ETCHING PRIMER APPLICATION ON THE CHARACTERISTICS & STRENGTH OF DENTIN BONDING IN PRIMARY TOOTH (자가부식 프라이머의 처리가 유치의 상아질과 레진 간의 결합 형태와 강도에 미치는 효과)

  • Lee, Jun-Haeng;Kim, Yong-Kee;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.26 no.4
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    • pp.595-607
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    • 1999
  • The purpose of this in vitro study was to evaluate the efficacy of self-etching primer which was developed to simplify the bonding procedures by measuring the shear bond strength and observing the interfacial morphology. 90 flat dentinal surfaces were prepared by grinding the buccal and lingual areas of caries-free human deciduous molars. After bonding of composite resin to sample surfaces according to the manufacturer's direction and thermocycling, shear bond strengths were measured using Universal testing machine(Instron). Another groups of specimens were treated by hydrochloric acid to secure the resin only and those tags were evaluated under SEM for their length and forms and the morphology of the bonding sites were also observed. The result as follows. 1. Group III showed higher shear bond strength than group I and II but no statistically significant difference was founded between group I and II(p>.05). 2. Adhesive failure was predominant in group II whereas dentin detachment was the main failure pattern in group I and III. 3. Relating long resin tags of $100-200{\mu}m$ were observed in samples of all groups under SEM. In group I, homogeneously long resin tags were arranged rather tight whereas rather loosely arranged resin tags of various length were found in group II. Lateral branching of resin tags was the characteristic finding observed in group III.

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Barriers on Development of Clinical Practice Guidelines for Cardiopulmonary Resuscitation (임상진료지침 개발과정의 장애요인 - 심폐소생술을 중심으로 -)

  • Park, Seong-Hi
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.46-58
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    • 2000
  • Background : Despite favorable effects of guidelines on patient care, guidelines often fail to achieve their objectives. Poorly implemented medical practice guidelines can produce only weak effects on the process of health care delivery. Therefore, we performed this study to investigate barriers related development of clinical practice guidelines. Methods : Cardiopulmonary resuscitation was selected as a target problem. Self questionnaires about management of cardiopulmonary resuscitation were developed by a researcher with advisory 8 experts. The questionnaires were designed as a unstructured methods. The data were collected from March 1 to May 31, 1999. A total 50 death case admitted inpatient to Inha University Hospital were subjected to evaluate the development and application of clinical practice guidelines for cardiopulmonary resuscitation. The data were examined by frequency, t-test with SPSS. Result : The article reviewed several common barriers that might limit successful implementation of guidelines in clinical practice, as illustrated by evaluating recommendations for cardiopulmonary resuscitation clinical practice guidelines. Some major problems with guidelines were characterized as follows (1) ethical problem : euthanasia, (2) occurrence on various emergency event and setting, (3) non-medical problems (4) unreliable of medical record etc. Conclusion : Careful analysis of guideline attributes, anticipated effect on medical care, and organizational factors revealed several barriers to successful guideline implementation that should be addressed in the design of future guideline-based interventions.

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The Study on Welfare bureaucrats' Discretion (사회복지전담공무원의 재량행사에 관한 연구: 동사무소 사회복지전담공무원을 중심으로)

  • Kim, So-joung
    • Korean Journal of Social Welfare Studies
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    • v.45 no.2
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    • pp.349-374
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    • 2014
  • The purpose of this study is to examine variation and result of welfare bureaucrats' discretion. To achieve this research purpose, ten welfare bureaucrats participated depth interview. The major findings of this study are as follows. welfare bureaucrats exercised high degree of discretion in the process of implementing public welfare programs. As a result they influenced recipient selection process and the recipients' allowance level. These results suggest that welfare bureaucrats' professional accountability is as important as public welfare programs' institutional standardizations and monitoring to approve the quality of public welfare service. And limitations and implications of this study were discussed with respect to further studies.

Software Development Methodology-based Instruction Process Modeling (소프트웨어개발방법론에 기반한 교수-학습프로세스모델링)

  • Park, ChoongShik;Lee, SaeNa;Kim, JaeHong;Bak, YongWhan
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2009.05a
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    • pp.822-826
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    • 2009
  • 학습 프로세스는 학습참여자인 학습자들과 교수자의 상호적인 활동에 의하여 교수-학습이 이루어지는 과정이라고 할 수 있다. 이러한 과정에서 일련의 학습자료들이 제공되고 만들어진다. 교수-학습이론에서 여러 가지 모델이 제안되어 이용되고 있지만 각 학습참여자의 역할과 학습자료간의 관계가 명시적으로 정의되어 운영되지 못하는 점이 있다. 한편 서비스제공이나 소프트웨어개발과 같은 추상적인 결과물을 생산해야하는 경영학이나 소프트웨어공학에서는 프로세스(과정)의 관리만이 그 결과물의 질을 담보할 수 있다고 생각한다. 결과물의 질관리를 위한 프로세스의 관리는 프로세스의 역할별 활동에 의한 투입/산출물, 프로세스들의 관계를 명시하고, 그에 따른 측정가능한 지표를 개발-분석함으로써 이루어진다. 본 논문에서는 소프트웨어 개발 방법론에 기반하여 구성주의적 교수-학습 프로세스를 정의함으로써 교수활동에 구성주의적 교수-학습이론을 용이하게 적용할 수 있는 지침을 제공하고, 향후 프로세스를 기반으로 하는 교육 서비스사이언스의 기본적 구성요소를 제공하고자 한다.

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The Guideline for Colorectal Cancer Screening (대장암 선별검사 권고안)

  • Dong Il Park
    • Journal of Digestive Cancer Research
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    • v.4 no.1
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    • pp.17-20
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    • 2016
  • Colorectal cancer is the 2nd most common cancer in men, and the 3rd most common cancer in women in Korea. This incidence has been increasing steadily since the data analysis began in 1999. Guidelines from many countries including Korea recommend annual or biennial fecal occult blood test as a national colorectal cancer screening program, however, colonoscopy, stool DNA test, double contrast barium enema, and sigmoidoscopy are recommended in some countries. I will summarize the Korean National Screening Guideline for colorectal cancer revised by multi-society expert committee in Korea last year. They recommend annual or biennial fecal immunochemical test between 45 and 80 year-old asymptomatic average risk people. Selective use of colonoscopy is recommended, taking into consideration of individual preference and the risk of colorectal cancer. There is no evidence for the risks or benefits of double contrast barium enema or computed tomographic colonography for colorectal cancer screening.

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Development of Korean Healthy Eating Index for adults using the Korea National Health and Nutrition Examination Survey data (국민건강영양조사 자료를 이용한 한국 성인의 식생활평가지수 개발)

  • Yook, Sung-Min;Park, Sohee;Moon, Hyun-Kyung;Kim, Kirang;Shim, Jae Eun;Hwang, Ji-Yun
    • Journal of Nutrition and Health
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    • v.48 no.5
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    • pp.419-428
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    • 2015
  • Purpose: The current study was conducted in order to develop the Korean Healthy Eating Index (KHEI) for assessing adherence to national dietary guidelines and comprehensive diet quality of healthy Korean adults using the 5th Korea National Health and Nutrition Examination Survey (KNHANES) data. Methods: The candidate components of KHEI were selected based on literature reviews, dietary guidelines for Korean adults, 2010 Dietary Reference Intakes for Koreans (2010 KDRI), and objectives of HP 2020. The associations between candidate components and risk of obesity, abdominal obesity, and metabolic syndrome were assessed using the 5th KNHANES data. The expert review process was also performed. Results: Diets that meet the food group recommendations per each energy level receive maximum scores for the 9 adequacy components of the index. Scores for amounts between zero and the standard are prorated linearly. For the three moderation components among the total of five, population probability densities were examined when setting the standards for minimum and maximum scores. Maximum scores for the total of 14 components are 100 points and each component has maximum scores of 5 (fruit intakes excluding juice, fruit intake including juice, vegetable intakes excluding Kimchi and pickles, vegetable intake including Kimchi or pickles, ratio of white meat to read meat, whole grains intake, refined grains intake, and percentages of energy intake from carbohydrate) or 10 points (protein foods intake, milk and dairy food intake, having breakfast, sodium intake, percentages of energy intake from empty calorie foods, and percentages of energy intake from fat). The KHEI is a measure of diet quality as specified by the key diet recommendations of the dietary guidelines and 2010 KDRIs. Conclusion: The KHEI will be used as a tool for monitoring diet quality of the Korean population and subpopulations, evaluation of nutrition interventions and research.