• The Journal of Korean Academic Society of Nursing Education
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• v.30 no.2
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• pp.182-191
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• 2024

Purpose: The purpose of this study was to explore the characteristics of social networks among registered nurses in acute nursing care units. Methods: This study used a survey design. Four nursing units from two acute hospitals were selected using a convenience method, and 83 nurses from those nursing units participated in the study in July 2022. The positive influences among nurses included friendship, collaboration, advice, and referent networks, and the negative influences included avoidance and bullying networks. Using the NetMiner program, the k-means clustering technique was applied to create groups of nodes with similar characteristics. The general characteristics of the participants were analyzed by mean, standard deviation, frequency, and ANOVA or chi-squared test. Results: As a result of dividing the 83 nurse participants into four clusters, positive influencers, silent peers, unwelcome peers, and active bullies were identified. Positive influence group nurses were frequently mentioned in the friendship, collaboration, advice, and referent networks. On the other hand, nurses in the unwelcome group and the active bullying group were frequently mentioned in the avoidance and bullying networks. Conclusion: Social networks that have a positive or negative impact on nursing performance are created through different relationships between nurses. Nurse managers can use the findings to create a more supportive and collaborative environment. Further research is needed to develop intervention programs to improve interactions and relationships between fellow nurses.

• The Korean Journal of Health Service Management
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• v.5 no.3
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• pp.53-61
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• 2011

This study was to assess the differences in rehabilitation outcomes between the different facilities in Japan, and to determine if there was any variation in patients' functional recovery at hospital discharge across the different facilities. This study focused on acute patients in the rehabilitation ward using the data of 1,830 patients from 8 hospitals after adjusting for triage at admission obtained from the Rehabilitation Patients Databank in Japan (issued in February, 2011) and compared the therapeutic results of each hospital. We estimate the expected value of levels of activities of daily living(ADL) at discharge for rehabilitation patients using regression analysis and Cluster analysis. There were differences among hospitals in their therapeutic results. The differences in the participation of physicians registered as rehabilitation specialists, amount of exercise, self-exercise without therapist, and exercise in wards, were statistically significant differences between hospitals.

• Health Policy and Management
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• v.25 no.3
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• pp.221-228
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• 2015

Background: This study explored the relationship between hospital resources and services uses in outpatient/inpatient-based hospital service area (HSA) in Korea. Methods: Study hospitals included all acute care hospitals except tertiary hospitals. Inpatient and outpatient hospital claims from the Korean National Health Insurance (NHI) program in 2010 were used to identify the service uses. Hospital resources and the degree of insurance premium in study areas were identified with the NHI corporation data. Study variables were computed by summing the service uses or hospital resources of study hospitals in each HSA. Service uses were represented by the total medical charges and number of visits/inpatient days. Hospital resources were measured by number of beds, number of doctors, and number of computed tomography (CT). The economic status of NHI enrollees in each HSA was controlled by the average monthly premium of NHI program per household in each HSA. The degree of using local hospitals was controlled with the localization index. Results: Analysis results showed that hospital resources such as beds, CT were statistically related to the service uses. And also localization index was found to have positive significant relationships with service uses. Conclusion: Hospital resources such as beds, CT had not only positive impacts on inpatient service uses, but also influences on the outpatient setting. Health policy makers will require monitoring and assessing the hospital resources in Korea.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.33-43
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• 2024

Purpose:The acute hospital accreditation program launched in South Korea has shown positive effects on safety culture and quality of care. However, relative weights have not yet been investigated for accreditation criteria with a hierarchical structure. This study aimed to derive the relative weights of acute-care hospital accreditation criteria. Methods: We conducted an online survey using the analytic hierarchy process (AHP) technique to assess the validity, importance, and urgency of acute hospital accreditation criteria. The AHP online survey link was distributed in November 2022 after obtaining informed consent from 10 experts in hospital accreditation. Results: 'Basic value system' ranked highest, while 'patient care system' ranked second in terms of validity, importance, and urgency. 'Performance management system' had the lowest validity and urgency, while 'organizational management system' carried the lowest importance. Within the 'patient care system' domain, 'surgery and anesthesia sedation management' scored highest in validity and importance, and 'patient care' scored highest in urgency. 'Care delivery system and evaluation' received the lowest scores for all three aspects. In the 'organizational management system' domain, infection control ranked highest in terms of validity, importance, and urgency. The lowest validity was observed for 'management and organizational operation' and the lowest importance and urgency were noted for 'human resource management'. Conclusion: The weights for validity, importance, and urgency, as shown in each domain and chapter, and the number of measurable elements included, are largely inconsistent. This study will contribute to the development of the structure and scientific improvement of accreditation standards.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.5-24
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• 1984

There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 to February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% $O_2$ group(38.0%) 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation ana all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.

• Tuberculosis and Respiratory Diseases
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• v.83 no.2
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• pp.167-174
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• 2020

Background: The purpose of this study was to investigate the effect of early tracheostomy on clinical outcomes in patients requiring prolonged acute mechanical ventilation (≥96 hours). Methods: Data from 575 patients (69.4% male; median age, 68 years), hospitalized in the medical intensive care unit (ICU) of a university-affiliated tertiary care hospital March 2008-February 2017, were retrospectively evaluated. Early and late tracheostomy were designated as 2-10 days and >10 days after translaryngeal intubation, respectively. Results: The 90-day cumulative mortality rate was 47.5% (n=273) and 258 patients (44.9%) underwent tracheostomy. In comparison with the late group (n=115), the early group (n=125) had lower 90-day mortality (31.2% vs. 47.8%, p=0.012), shorter stays in hospital and ICU, shorter ventilator length of stay (median, 43 vs. 54; 24 vs. 33; 23 vs. 28 days; all p<0.001), and a higher rate of transfer to secondary care hospitals with post-intensive care settings (67.2% vs. 43.5% p<0.001). Also, the total medical costs of the early group were lower during hospital stays than those of the late group (26,609 vs. 36,973 USD, p<0.001). Conclusion: Early tracheostomy was associated with lower 90-day mortality, shorter ventilator length of stay and shorter lengths of stays in hospital and ICU, as well as lower hospital costs than late tracheostomy.

• Journal of the East Asian Society of Dietary Life
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• v.25 no.4
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• pp.631-642
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• 2015

The purpose of the study was to examine health status and mini nutritional assessment (MNA) according to self-esteem status of elderly in care hospital. The survey was carried out from $13^{th}$ to $31^{st}$ of September, 2014 in five care hospitals. Analysis was performed for 226 subjects. Evaluation criteria included demographics, clinical status, MNA, health-related quality of life (EQ-5D) and self-esteem. The SE I, SE II and SE III groups were divided by self-esteem scores. Data were analyzed one-way ANOVA, Duncan' multiple range test and Pearson's correlation using SPSS 15.0. Education level, religion, dental condition and medical endurance type were significantly different in all groups. Many elderly people were normal BMI ($20.94{\sim}21.67kg/m^2$). Self-esteem significantly increased in order of SE I, SE II and SE III. Mobility, usual activity and anxiety or depression were significantly different in all groups, and EQ-5D of SE II and SE III groups were significantly higher than that of SE I group. Comparison of MNA screening score in elderly patients was as follows : Score for food intake, psychological stress or acute disease, neuropsychological problems, pressure scores or skin ulcer, protein intake, mode of feeding, nutritional status and health status in SE I group were significantly lower than those of SE II and SE III groups. Mobility and drug intake of SE I group were significantly lower than those of SE III groups. Fruit and vegetable intake SE I group were significantly higher than those of SE II and SE III groups. MIS (Malnutrition Indicator Score) was significantly different among the SE I, SE II and SE III groups. We conclude that self-esteem score is positively correlated with protein intake, nutrition status, health status and MIS in elderly care hospital. To improve nutritional status of elderly in care hospitals, systematic nutrition management and self-esteem education program should be implemented.

• Korea Journal of Hospital Management
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• v.6 no.1
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• pp.1-17
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• 2001

According to the increase of the proportion of aged people, the medical demand for a senile chronic disease has been increased; therefore, aged people call for a geriatric hospital for special geriatric medical service. The main purpose of this study was to analyze the general characteristics and financial status of geriatric hospitals. For the study, a questionnaire was designed and sent to the geriatric hospitals to fill out the patient statistics, number of headcount by department, etc. to find out the stability, profitability, activity and so on financial statements of the hospitals were analyzed. The major findings of this study were as belows. 1. The ratio of the medical expenses to the revenue of the geriatric hospitals is much lower than acute care hospitals. But the probability of bankruptcy is higher due to the high ratio of the liabilities therefore it is required to stabilize the financial position by donating more money. 2. Government budget for the elderly people is not enough. To support the geriatric hospitals by going subsides, government should increase the budget. 3. Portion's of the patient of the geriatric hospitals are government support patient. Since the government doesn't pay the medical charges quickly, geriatric hospitals have a serious cash flow problem. Therefore, it is required that government is to prepay the bill. 4. Since geriatric hospitals treat elderly patient and most patients are government support patients, geriatric hospitals can be said to operate under the strict. 5. When we introduce the daily medical charge, the self-liability will be reduced on approximately 50% of current. This affection will bring a huge progressing financial structure to the medical profit of the geriatric hospital, and also patient family will feel less economical burden.

• Journal of East-West Nursing Research
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• v.24 no.2
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• pp.163-170
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• 2018

Purpose: The purpose of this study was to identify the influences of type D personality, burnout and work environment on nurses' intention to stay at the hospitals among nurses. Methods: A cross-sectional descriptive design was used. Participants were 135 nurses working at general hospitals. Data were collected using self-report questionnaires. Data were analyzed using the SPSS/WIN 23.0 program for descriptive statistics, independent t-test, ANOVA, $Scheff{\acute{e}}$ test, Pearson's correlation, and hierarchical multiple regression. Results: The score of nurses' intention to stay was 4.78. 39.3% of participants were classified as type D personality group. The scores of burnout and work environment were 2.92 and 2.39, respectively. Intention to stay was negatively correlated with burnout and positively correlated with nurse participation in hospital affairs, nursing foundations for quality of care, nurse manager ability, leadership, and support of nurses, staffing and resource adequacy. Burnout and manager ability, leadership, and support for nurses explained 46.0% of variance of nurses' intention to stay in the hospitals. Conclusion: The results of the study indicate that nursing intervention programs for increasing intention to stay for nurses should include strategies for decreasing the burnout and increasing manager ability, leadership, and support for nurses.

• The Journal of the Korea Contents Association
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• v.9 no.10
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• pp.258-267
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• 2009

This study purposed to develop GIS model for evaluating hospital location in a metropolitan city. Secondly, the suitability score of hospital was compared with the number of outpatient/inpatients of hospitals. This study used administrative data collected from the annual report of the 5 ward offices from Daejeon in Korea in 2004. 7 Acute care hospitals operated in Daejeon in 2004 were selected for the analysis. The suitability of hospitals in a metropolitan city was evaluated by the economic factors which were assumed to influence the health care demand. Each criterion was measured from each Dong. Correlation coefficients between the suitability score of hospital and the number of patients were varied depending on the buffering size. The relationship showed positive relationship with the number of inpatient (0.15) and outpatients (0.10) on the 0.5km buffering size. However, the correlation coefficients were changed to a negative direction or decreased when the buffering size was increased to 1.0km, 1.5km, and 2.0km.