• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권2호
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• pp.47-61
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• 2017

Purpose: This study aims to suggest the spatial composition and area of the intensive care units through analysis of current situation for the standards establishment of the intensive care units in public district hospitals in the future. Methods: Three Methods have been used in this paper. 1) Literature reviews about composition, location, foreign standards on intensive care units. 2) Comparative analysis on the architectural drawing for the space program and the area. 3) Field survey in order to confirm differences between architectural drawing and current situation. Results: 1) The intensive care units is required to be linked by the operating department, the emergency department and the sterile supply department upon considerations of accessibility of emergency patients and the infection control. 2) The intensive care unit consists of five areas such as the patient area, the medical staff area, the material and equipment area, the patient family area, and the public area. 3) The location of spaces in the intensive care unit is classified by three methods such as connection by view, circulation and connection to corridor. The [table 20] summarizes the type of space and the average size of the space in intensive care unit. Implications: This study is a basic research for guideline of intensive care units, and need to be followed by further study using various perspectives and methods in the future.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권3호
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• pp.27-34
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• 2016

Purpose: The purpose of this paper is to develop a predictive model for patient visibility in Korean ICUs (corridor or continental type). Methods: The measures of static visibility were used to quantify the patient visibility (upper third part of the patient bed) from the nurse station. The measure of space programme and area distribution (patient zone percentage, staff zone percentage and departmental gross square meter per patient bed) were calculated by using AutoCAD and MS Excel programs. Regression analysis was conducted for visibility as dependant variable with independent variables of patient area percentage, staff area percentage as well as departmental gross square meter per bed by using IBM SPSS. Results: (1) Average patient visibility and percentage of patient area in ICU shows a strong negative correlation ($r^2$=0.66), p=0.01. (2) Patient visibility in Korean ICU (corridor or continental type) can be calculated as below with the given conditions: Y= $-1.449(X)+124.3{\pm}6$, Y is the total visibility of the ICU (corridor or continental type) and X is the percentage of patient area in the unit. Conditions:1. Given that the unit has a mixed programme of open bed and closed patient rooms and 2. The unit have a minimum of 20% patient rooms. Implications: This study may contribute to the visibility analysis of existing and future ICU design (corridor or continental type) in Korea to achieve maximum patient visibility and reduced patient mortality.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권4호
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• pp.37-45
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• 2016

Purpose: The purpose of this paper is to analyze a sample of single corridor, pod type and composite type of ICUs in terms of patient visibility, spatial configurations and nurse walking distance focused on Korean cases. Methods: The measures of static visibility were used to quantify the patient visibility (upper third part of the patient bed) from the nurse station. The measure of space programme and area distribution (patient zone percentage, staff zone percentage, circulation zone percentage, corridor length per bed, distance from nurse station (NS) to patient bed and departmental gross square meter (DGSM) per patient bed) were calculated by using AutoCAD and MS Excel programs. In the second step of analysis the values of space distribution were compared among the three type of ICUs as well as the nurse walking distance, DGSM per bed and gross factor. in the third step of analysis regression analysis was conducted for the possible correlation between visibility and space programme and area distribution factors as well as nurse walking distance factors. Results: (1) It was found that on average composite type unit offer highest value of patient visibility followed by pod type, while single corridor type unit offers the minimum value of patient visibility among the three plan typologies. (2) Average patient visibility and DGSM per bed shows a strong positive correlation ($r^2=0.75$) and p=0.026. (3) Average patient visibility and average distance from NS has a strong negative correlation ($r^2=0.78$), and P=0.02. (4) On average composite type unit offer the minimum walking distance from NS (7.22 meter) followed by pod type unit (8.35 meter) and single corridor (9.76 meter). (5) Maximum distance from NS was noted in single corridor (18.19 meter) followed by pod type unit (15.14 meter) and Composite type unit (11.1 meter). Implications: This study may contribute to the visibility analysis of existing and future ICU design in Korea to achieve maximum patient visibility and reduced nurse walking distance.

• 기본간호학회지
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• 제5권2호
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• pp.280-292
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• 1998

Pressure sores are a serious concerns in that respect to increasing risk of medical complications and medical costs. Prevention and care of pressure sores is an essential area of nursing practice. The nurse at ICU should be more careful of maintaining the skin integrity of patients especially than at any other place. This study was conducted to determine if the risk facotrs of pressure sores and nutritional status of the patients at risk for pressure sores is related the occurance of pressure sore. The risk group refers the patients having the below 14 scores of the braden scale. The 100 subjects were recruited from the ICU ward at an university hospital in Choongnam. The parameters for nutritional status are the blood chemistry including plasma protein, albumin, hemoglobin and the anthropometric measurements consisting of weight, BMI, LBM, the proportion of body fat, body fluid and triceps skin fold using bioimpedence analizer and caliper. The results are as follows : 1. The subjects were 55 years and stayed 8 days on average. Of the 100 subjects, males were 61%, neurologic/neurosurgical diseases were 68% and the incidence of pressure sores was 17% mainly occuring within 3days after the admission. 2. The present paralysis(or paraplegia) and edema(arm, leg, trunk) were showed more significantly the subjects with pressure sores than those without pressure sores. 3. Regarding with the nutritional status, the subjects with pressure sores had significantly lower the weight, BMI, LBM, body fluid, albumin than the ones without pressure sores. This results were supported the reports of previous studies that the decreased weight and albumin could be the important predictors of pressure sores. Thereafter we should encourage these factors to be utilized in predicting pressure sores for a comprehensive assessment. Nurse should identify patients at risk of the development of pressure sores, assess their nutritional status and dietary intake at regular intervals.

• Journal of Trauma and Injury
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• 제32권1호
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• pp.1-7
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• 2019

Purpose: The present study aimed to evaluate the influence of how the trauma care system applied on the management of trauma patient within the region. Methods: We divided the patients in a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in the Halla Hospital after designation of a trauma center. We compared annual general characteristics, injury severity score, the average numbers of the major trauma patients, clinical outcomes of the emergency department, and mortality rates between the two groups. Results: No significant differences were found in the annual patients' average age ($54.1{\pm}20.0$ vs. $52.8{\pm}18.2$, p=0.201), transportation pathways (p=0.462), injury mechanism (p=0.486), injury severity score (22.93 vs. 23.96, p=0.877), emergency room (ER) stay in minutes (199.17 vs. 194.29, p=0.935), time to operation or procedure in minutes (154.07 vs. 142.1, p=0.767), time interval to intensive care unit (ICU) in minutes (219.54 vs. 237.13, p=0.662). The W score and Z score indicated better outcomes in post-trauma system group than in pre-trauma system group (W scores, 2.186 vs. 2.027; Z scores, 2.189 vs. 1.928). However, when analyzing survival rates for each department, in the neurosurgery department, in comparison with W score and Z score, both W score were positive and Z core was higher than +1.96. (pre-trauma group: 3.426, 2.335 vs. post-trauma group: 4.17, 1.967). In other than the neurosurgery department, W score was positive after selection, but Z score was less than +1.96, which is not a meaningful outcome of treatment (pre-trauma group: -0.358, -0.271 vs. post-trauma group: 1.071, 0.958). Conclusions: There were significant increases in patient numbers and improvement in survival rate after the introduction of the trauma system. However, there were no remarkable change in ER stay, time to ICU admission, time interval to emergent procedure or operation, and survival rates except neurosurgery. To achieve meaningful survival rates and the result of the rise of the trauma index, we will need to secure sufficient manpower, including specialists in various surgical area as well as rapid establishment of the trauma center.

• 간호행정학회지
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• 제7권3호
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• pp.455-472
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• 2001

The purpose of this study was to serve as a basis for mapping out successful strategies to build the professional self-image of nurses through uniform, by examining their satisfaction with uniform and professional self-image by general characteristics, and identifying the correlational relationship between the two factors. The subjects in this study were 205 nurses who served in general departments of two university hospitals in Seoul. The departments where special uniform was required, including ICU, RR, OR and CSR, were excluded. The data were collected from September 15 through 22, 2000. For measurement of uniform satisfaction level, a uniform satisfaction scale was prepared by myself, and Arthur(1990)'s PSCNI translated and modified by Song Kyong Ae and Rho Chun Hee(1996) was employed. The Cronbach a of the uniform satisfaction scale and PSCNI was 0.90 and 0.86 respectively. The collected data were analyzed by SAS, and real number, percentage, average and standard deviation were calculated. Besides, t-test, one-way ANOVA, Pearson's r procedures were utilized, and Scheffe test was conducted as a posttest. The findings of this study were as below: 1. The uniform satisfaction of the nurses investigated was scored 2.52 on the basis of 4 points, which was on the medium level. By subarea, symbolicity satisfaction was 2.48, and aesthetic satisfaction was 2.60. The functionability satisfaction was 2.44. So the esthetic satisfaction was greatest. 2. Among general characteristics of the subjects, two factors made a significant difference to their uniform satisfaction : age(F=4.05, P=.0189), and total career(F=4.25, P=.0061). 3. Their professional self-image got 2.75 on the basis of 4 points, which was on upper middle level. The subarea score was 2.79 for professional work, 2.52 for satisfaction and 2.97 for communication. The communication area was rated highest, and the satisfaction area was scored lowest. 4. Among the general characteristics of the subjects, professional self-image was different according to five factors : age(F=17.83, P=.001), marital status(T=5.18, P=.0000), educational background(F=8.72, P=.0002), position(T=-5.29, P=.0000) and total career(F=15.23, p=.0001). Better professional self-image was possessed by the older group than the younger one, by the married group than the singles, by the better-educated group than the less-educated, by the nurses in position equal to or higher than charge nurse, or by the higher-career group. 5. The correlational relationship of uniform satisfaction to professional self-image was statistically significant, yet very weak(r=.1978, p=.0045). The satisfaction area of professional self-image was correlated to every uniform satisfaction area, including symbolicity(4=.4393, p=.0001), aesthetics(r=.2471, p=.0004), functionability(r=.3094, p=.0001) and total satisfaction(r=.4050, p=.0001). Therefore, the uniform satisfaction gave an impact on the satisfaction area of professional self-image of the nurses, and there was a significant correlational relationship between uniform symbolicity area and total professional self-image(r=.2416, p=.0005).

• 한국산학기술학회논문지
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• 제13권11호
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• pp.5238-5246
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• 2012

본 연구는 신경계 중환자에 적용한 간호행위에 따른 중환자 중증도 분류도구를 신경계 중환자에게 적용하여 그 결과를 분석하고 그에 따른 중환자 중중도 분류도구에 미치는 영향을 규명하여 신경계 중환자의 간호중재를 위한 기초자료를 파악하고자 시도되었으며 2008년 1월부터 2009년 5월, 2011년 10월부터 2011년 12월까지 서울시 소재 C 대학 병원 중환자실에 입원한 만 18세 이상의 신경계환자 203명의 의무기록지를 분석하였다. 신경계 중환자의 일반적 특성 및 임상관련 특성에 따른 중환자 중증도 분류도구 차이는 사망, 생존(p=<.001), 혈색소(p=<.001), 중탄산(p=<.001), 백혈구(p=<.001), 기관 내 삽관 유무(p=<.001), 중심 정맥관 삽입 유무(p=<.001), 중증도(p=<.001)가 통계적으로 유의한 차이를 보였다. 본 연구의 대상자 203명 중 64명이 사망하여 사망률은 31.5%였다. 중환자 중중도 분류도구로 측정된 신경계 중환자의 평균 점수는 $112.09{\pm}18.91$로 나타났고 중중도가 높아질수록 중환자 중중도 분류도구 점수도 유의하게 높아지는 경향을 보였다. 각 영역별로는 활력징후 측정 $3.74{\pm}2.15$, 감시 측정 $28.97{\pm}4.31$, 일상 활동 $34.99{\pm}3.66$, 영양 $.19{\pm}.98$, 정맥 주입 및 약물요법 $18.20{\pm}8.27$, 치료 및 시술 $16.93{\pm}4.90$, 호흡치료 $8.61{\pm}7.07$로 확인되었다. 감시 측정, 일상 활동, 정맥 주입 및 약물요법, 치료 및 시술, 호흡치료영역이 포함된 모형은 유의한 것으로 나타났으며(F=678.789, p<.001) 이들이 중환자 중증도 분류도구를 설명하는 설명력은 98.1%를 나타내어 신경계 중환자의 중중도를 예측하는데 유용한 영역이라 사료된다.