• Quality Improvement in Health Care
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• v.14 no.2
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• pp.117-123
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• 2008

문제: 장기 입원 치료를 받은 미숙아의 퇴원교육을 퇴원당일 짧은 시간에 시행함으로써 간호사는 제한된 인력으로 교육시간을 길게 할애하지 못하고, 표준화된 지침의 부재로 인해 퇴원교육을 누락하는 경우가 있으며 보호자는 교육내용을 충분히 이해할 시간이 부족하여 퇴원에 대한 필요 이상의 두려움을 가지고 있었다. 목적: 미숙아에 대한 퇴원교육을 표준화된 지침에 따라 단계적이고 체계적인 방법으로 개선함으로써 불필요한 퇴원지연을 예방하여 재원일수 단축시키고 보호자의 양육 자신감을 향상시킨다. 의료기관: 부산광역시에 소재한 대학병원의 신생아실 질 향상 활동: 미숙아의 퇴원을 지연시키는 원인을 분석하고 개선된 미숙아 퇴원교육 방법을 적용한 후 미숙아 재원일수와 보호자의 양육자신감을 측정하였다. 개선효과: 개선 활동 후 미숙아의 재원일수가 11.33일에서 8.28일로 3.05일 단축되었고 보호자 양육자신감 점수는 68점에서 76.25점으로 8.25점 향상되었다. 교훈: 퇴원을 앞둔 미숙아들이 좀 더 개방적으로 가족과 함께 지내면서 퇴원준비를 할 수 있는 여건과 미숙아의 성장과 발달에 대한 보호자들의 이해를 돕기 위한 인터넷강좌나 공개 강좌 등이 필요하다. 보호자들의 양육 자신감 향상과 정보교환을 위해 자조조직을 활성화하고 보다 질 높은 서비스를 위해서는 현실적으로 간호사의 인원 충원이 필요하다.

• The Journal of the Korea institute of electronic communication sciences
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• v.11 no.7
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• pp.707-716
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• 2016

The current research focused on the needs for discharge education and the educational performance of nurses perceived by mothers of premature infants. The subjects for the current research were 54 mothers of premature infants hospitalized in the neonatal intensive care unit at K general hospital in G metropolitan city. The data was collected between June 9, 2014 and September 30, 2014 through self-recording surveys. The needs for discharge education were $4.21{\pm}0.60$ and the perceived educational performance of nurses was $3.95{\pm}0.73$. There was a significant difference between the needs for discharge education and the perceived educational performance in abnormal symptom monitoring and management ($0.55{\pm}0.97$, p=0.001), excrement management ($0.45{\pm}1.11$, p=0.004) and growth development ($0.41{\pm}1.08$, p=0.007). The needs for discharge education was significantly different according to delivery type (vaginal delivery: $4.41{\pm}0.47$, caesarean section: $4.03{\pm}0.47$, p=0.040) and birth order (first: $4.37{\pm}0.53$, second: $4.25{\pm}0.51$, over third: $3.75{\pm}0.72$, p=0.031). Perceived educational performance of nurses was significantly different according to baby sitter (yes: $4.15{\pm}0.66$, no: $3.48{\pm}0.67$, p=0.002). ]

• The Journal of the Korea institute of electronic communication sciences
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• v.12 no.5
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• pp.957-964
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• 2017

In this study, It developed a program to carry out the training courses for NCS based medical information management tasks and to can understand the practical working knowledge of learners. This program is an educational program that can generate medical information by analyzing data of medical records after generating and storing data of medical records. Because the contents of the medical records vary and there are quantitative differences in the medical records, the contents of the medical records can be summarized and stored in the discharge analysis program for the standard of educational data. The medical terminology DB, medical terminology related DB, medical care related DB by the NCS ability unit element can be constructed and managed using the program. The following are the contents that can be learned through operation of the program. first, it's can understand Medical information DB management regulations through understanding sturucture of database. Second, it can understand the structure and function of the diagnostic code and medical practice code that are input to the discharge analysis program. The diagnostic codes and medical practice codes entered in the discharge analysis program can be searched and analyzed by each fields. Third, It can be advance medical information management ability by inputting and extracting data and generating medical information. In this study, It developed program that Students can be obtained Knowledge of medical information management and improved management competency by generate and analyze medical record data using discharge analysis program.

• Proceedings of the Korea Information Processing Society Conference
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• 2019.10a
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• pp.833-835
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• 2019

교육열이 강한 우리나라에서는 사교육은 언제나 뜨거운 감자이다. 교육대상 연령층의 인구수가 1990 년부터 빠르게 감소하기 시작했으며, 2005 년을 전후로 초등학생 수의 감소가 더욱 빨라지고 있다. 통계청 데이터에 따르면 2016 년 출생아 수는 40 만 6 천여명에서 2017 년은 35 만 7 천여명으로 향후에도 지속적으로 줄어들 추세이다. 이렇듯 매년 학생수가 감소함에도 불구하고 2018 년 사교육비 총액은 19 조 5 천억수준으로 2017 년 18 조 7 천억보다 8 천억원이 늘어 났다. 학생수는 전년보다 2.5% 줄었지만 사교육비는 반대로 4.4% 늘어났다. 이렇듯 사교육 시장이 심화 되게 되면 경쟁은 더욱 치열해 질 수 밖에 없으며 이 경쟁에서 살아 남기 위해서는 다양한 비즈니스 전략이 필요하며 특히 학생들의 이탈을 줄이는 것은 사업의 가장 중요한 포인트라고 볼 수 있을 것이다. 학원에서의 학생이 퇴원을 하는 이유에 대한 영향도를 분석하고 그 영향도 분석을 통해 학원 학생들의 퇴원 방지에 활용하고자 한다. 본 논문의 주요 연구 내용은 사교육을 대표하는 국내 사설 학원에서의 성적, 출결사항 및 학원 상담 내역 등의 다양한 학원 데이터들을 최적의 딥러닝 알고리즘 분석을 통한 퇴원 학생을 사전 예측하기 위한 논문임을 밝힌다.

• Child Health Nursing Research
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• v.12 no.2
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• pp.268-276
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• 2006

Purpose: this study is attempted to provide basic data on development of systematic discharge educational programs for discharging cancer patients. Method: The subjects of this study were 132 mothers whose children were diagnosed with cancer and being treated at 3 university hospitals in Busan. The data were collected from December 1 to February 28, 2005, and were analyzed Using SPSS WIN 10.0. Result: The degree of education at the time of discharge from hospital was statistically significantly lower than that of educational demand after the discharge. Such demand significantly varied in accordance with the length of period passed after the discharge. Mother’s educational demand was significantly different in accordance with generation characteristics of her child with cancer, especially the first period of hospitalization and change in weight Conclusions: mothers of children with cancer were higher in educational demand after the child’s discharge from hospital than in education provided at the time of the discharge. Such demand was different in accordance with the length of period passed after the child's discharge from hospital.

• The Journal of Korean Physical Therapy
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• v.10 no.1
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• pp.7-21
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• 1998

An analysis of 101 stroke patients who were enrolled in 10 hospitals of Cities of Pusan, Taegu, and Andong from November 1, 1996 to April 31. 3997 was conducted using the modified Barthel Index(BI) and the adapted PULSES profile index(PS) to evaluate their function. Patients were examined at the following intervals: Initial assessment, one month after initial. at discharge, and one month after discharge. The mean BI score of patients initial assessment was 27.18, and that of PS was 17.54. There were statistically significant between initial score and one month after initial (21.39: p<0.001), at discharge(37.47: p<0.001), one month after discharge(46.49: p<0.001). PS scores were also improved .significantly(-2.62, -4.52. and -6.26(p<0.001). And the score between dischange and one month after discharge was significant (9.01: p<0.001) and in PS score(-1.73: p<0.001). Age and BE score were significantly associated with the improved in BI score between initial and discharge(T3-T1)(p<0.05). Below age forty the Bower initial BI score showed significantly higher improvement(T3-T1) after physical therapy(p<0.05). Initial Bl score, patients' attitude for physical therapy after discharge, age, and surgical operation were significantly associated with the improvement of BI score between initial and one month after discharge(T4-T1)(p<0.05). The lower initial BI score, patients' positive attitude for physical therapy after discharge, below age forty. and no surgical operation showed significantly higher improvement(p<0.05). BI score at discharge, side of hemiparesis and religion were significantly associated with the improvement of BI score between at discharge and one month after discharge(T4-T3) (p<0.05). The lower BI score at discharge. left aide of hemiparesis, with religion showed significantly higher improvement (p<0.05). Age, initial PS score were significantly associated with the improved in PS score between initial and discharge(T3-T1)(p<0.05). The higher initial PS score and below age forty showed significantly higher improvement(T3-T1)(p<0.05). Initial PS score, patient' attitude for physical therapy after discharge, age, educational level, physical therapy hour after discharge, and surgical operation were significantly associated with the improvement of PS score between initial and one month after discharge(T4-T1)(p<0.05). The higher initial PS score, patients' positive attitude for physical therapy after discharge, below age forty, higher education, the shorter physical therapy hour, and no surgical operation showed significantly higher improvement(T4-T1)(p<0.05). PS score at discharge, educational level, patient' attitude far physical therapy after discharge, physical therapy hour after discharge, and gender were significantly associated with the improvement of PS score between discharge and une month after discharge(T4-T3) (p<0.05), The higher PS non at discharge, higher education, patients' positive attitude for Physical therapy after discharge, the shorter physical therapy hour, and male showed significantly higher improvement (T4-T3)(p<0.05). In conclusion, initial BI score and age were significantly associated with BI score improvement and initial PS score, age, and educational level were also significantly associated with PS score improvement in stoke patients.

• Quality Improvement in Health Care
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• v.16 no.1
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• pp.65-76
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• 2010

문제: 퇴원 환자의 문의 전화가 많아지면서 병동 간호사는 이 문의에 응하는 일로 업무량 과다, 전화 상담에 대한 자신감 저하 및 부담 등을 느끼고 있었다. 부적절한 전화문의 관리는 환자와 간호사 모두에게 시간 소모 및 만족도 저하 등의 부정적인 경험을 남길 수 있다. 목적: 전화문의 응대 매뉴얼 구축 및 활용으로 병동 간호사 및 퇴원 환자의 만족도를 향상시키고자 한다. 의료기관: 서울시 종로구에 소재한 대학병원. 질 향상 활동: 표준화된 전화문의 응대 매뉴얼을 개발하였다. 또한 간호사의 업무 효율성 및 지식 향상을 위해 간호사 대상 매뉴얼을 교육하여 실무에서 활용하기 쉽도록 하였다. 개선효과: 표준화된 전화문의 응대 매뉴얼을 안과 병동 간호사와 전보자 및 신규 간호사 교육에 활용할 수 있었다. 간호사의 전화문의 응대 관련 직무 만족도가 향상되었다. 환자 역시 표준화된 매뉴얼에 따라 일치되고 일관성 있는 정확한 정보를 제공받게 되어 환자의 만족도와 이해도가 증가할 것이다.

• The Journal of Korean Academic Society of Nursing Education
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• v.17 no.2
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• pp.287-295
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• 2011

Purpose: This study was done to compare educational needs for discharge after thyroid cancer surgery between patients and nurses. Methods: The participants were 107 patients who had thyroid cancer surgery and 70 nurses who have had experience of taking care of patients with thyroid cancer surgery at P hospital in Busan. The researcher reviewed the literature and conducted a preliminary survey to develop a questionnaire. Results: Although there was no significant difference in total perceived nursing discharge educational needs after thyroid cancer surgery between patients and nurses, both had a high level of nursing educational needs for discharge. The degree of patients' needs was higher than nurses in areas of dietary management after discharge and the degree of nurses' needs was higher than patients in the other areas. Although the first ranking area of educational needs was medication management for both patients and nurses, dietary management after discharge was the second ranking for patients and operation site and complication management was those for nurses. Conclusions: As the patients had different educational needs from the nurses, nurses need to focus on the patient's educational needs and provide relevant information. Educational programs should be developed and applied to post-surgical thyroid cancer patients.

• Journal of Korean Public Health Nursing
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• v.5 no.1
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• pp.53-69
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• 1991

가정간호사업 도입에 대한 대상자의 필요성에 대한 인식을 알아보고자, 1988년 7월 1일부터 동년 8월말까지 서울시내 5개 대학병원에서 퇴원하는 환자 390명과 환자 보호자 380명, 주민 780명, 총 1550명을 대상으로 조사한 결과 다음과 같은 결론을 얻었다. 1. $81\%$의 대상자가 가정간호 사업 도입이 필요하다고 한 반면 $7.5\%$는 필요 없다고 하였으며, $11.5\%$는 잘 모르겠다고 하였다. 필요성 인식 율은 주민이 $83\%$, 환자보호자가 $79\%$, 환자가 $78\%$로서 세 집단 간에 유의한 차이 가 있었다. (P<.01). 인구학적 변수별로 보았을 때, 교육수준과 가정수입에 따라 인식 율에는 유의한 차이가 있어서 (P<.001, P<.01), 교육수준이 높을수록, 수입이 많을수록 높았다. 2. 필요성 인식 율은 가정간호사업 이용의사에 따라서도 유의한 차이가 있어서 (P<.001), 이용의사가 많은 군이 인식 율도 높았다. 3. 환자들의 필요성 인식 율은 퇴원시기에 대한 의견과 병원비 지출액에 따라 유의한 차이가 있어서 (P<.05, P<.02), 퇴원시기가 적절하다는 군이 부적절, 하다는 군보다, 또한 병원비 지출액이 적을수록 인식 율이 높았다. 진단명에 따라서는 피부 및 피하조직 진환$(100\%)$, 임신 및 출산에 관련된 합병증$(90\%)$, 신경 및 감각기계 질환$(85\%)$, 부상 및 중독$(83\%)$, 신생물$(79\%)$, 등에서 필요성 인식 율이 높았다. 4. 가정간호사업 이용에 대한 대상자의 의견을 $47.8\%$가 이용할 의사가 있었고, $49.9\%$는 상황에 따라 결정하겠다고 하였으며, $3.2\%$는 이용하지 않겠다고 응답하였다. 인구학적 변수별로 보았을 때, 연령별로는 노년층, 성별로는 남성이, 교육수준은 낮은 군이, 의료보험을 가진 군이 이용할 의사가 많았으며, 통계적으로 유의한 차이가 있었다. (P<.01, p<.001, p<01, p<.01). 5. 환자들의 가정간호사업 이용 의사는 퇴원시의 상태에 따라서 유의한 차이가 있어서 (P<.02), 상태 가 입원 시와 변화가 없거나 악화된 군이 이용할 의사가 많았다. 진단별로는 내분비계 질환$(63\%)$, 신생물$(57\%)$, 혈액 및 조혈기능 장애$(55\%)$, 부상 및 중독$(55\%)$, 등이 이용할 의사가 많았다. 6. 대상자들이 가정간호사업의 장점으로 생각하는 것은 환자의 심리적 안정$(66\%)$, 시간 절약$(57\%)$, 가족의 편이$(57\%)$, 환자 간호에 대해 배운다$(53\%)$, 질병 과정을 배운다$(51\%)$ 등이었다. 7. 대상자들이 가정간호사업의 단점으로 생각하는 것은 응급시에 대처하기가 어렵다$(49\%)$, 환자가 불안해 할 것이다$(41\%)$ 가정환경이 환장에게 부적합하다$(43\%)$ 등이었다. 8. 가정간호사업에서 수용할 수 있는 간호 업무로$50\%$ 이상의 대상자가 지정한 것은 활력징후측정, 경구 및 비경구 투약, 운동과 휴식지도, 개인 위생관리, 보건교육, 정신 심리 간호 등이었다. 9. 가정간호사업에 대한 지불방법은 $32.9\%$가 제공된 업무에 따라 지불해야 한다는 의견으로 가장 많았다.

• The Journal of the Korea Contents Association
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• v.22 no.2
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• pp.794-802
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• 2022

This retrospective study was to investigate the characteristics of unplanned readmission and factors affecting readmission within 30 days of discharge in patients who underwent heart valve surgery through electronic medical records. The participants were 423 unplanned re-hospitalization within 30 days after heart valve surgery at a tertiary hospital in Seoul from January 2018 to August 2019. A total of 48 patients (11.3%) were unplanned readmissions, and the most common causes were atrial fibrillation in 13 cases (27.1%) and pain at the surgical site in 13 cases (27.1%). Other causes were: 10 cases (20.8%) of warfarin inappropriate treatment concentration, 7 cases of general weakness (14.6%), 5 cases of hypotension (10.4%), 4 cases of pericardial effusion (8.3%), 3 cases of surgical wound infection (6.3%), 3 cases of hemorrhage (6.3%), 3 cases of high fever (6.3%), and 1 case of cerebral infarction (2.1%). Variables influencing readmission were history of cancer (OR = 2.60, 95% CI 1.13-6.03, p = .025) and the patients who went to a home rather than a hospital after discharge (OR = 2.91, 95% CI 1.33-6.36, p = .008), as a type of valve surgery, mitral valve valvuloplasty had a higher readmission rate than aortic valve replacement (OR = 1.21, 95% CI 1.21-4.98, p = .012). In order to reduce unplanned readmissions, an tailored education program is needed to enable patients and caregivers to manage their comorbid chronic diseases before discharge and assess risk factors for readmission in advance.