• Journal of Hospice and Palliative Care
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• v.24 no.3
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• pp.184-193
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• 2021

Purpose: This study attempted to develop clinical guidelines to help patients use hospice and palliative care (HPC) at an appropriate time after writing physician orders for life-sustaining treatment (POLST) by identifying the characteristics of HPC use of patients with terminal cancer. Methods: This retrospective study was conducted to understand the characteristics of HPC use of patients with terminal cancer through decision tree analysis. The participants were 394 terminal cancer patients who were hospitalized at a cancer-specialized hospital in Seoul, South Korea and wrote POLST from January 1, 2019 to March 31, 2021. Results: The predictive model for the characteristics of HPC use showed three main nodes (living together, pain control, and period to death after writing POLST). The decision tree analysis of HPC use by terminal cancer patients showed that the most likely group to use HPC use was terminal cancer patients who had a cohabitant, received pain control, and died 2 months or more after writing a POLST. The probability of HPC usage rate in this group was 87.5%. The next most likely group to use HPC had a cohabitant and received pain control; 64.8% of this group used HPC. Finally, 55.1% of participants who had a cohabitant used HPC, which was a significantly higher proportion than that of participants who did not have a cohabitant (1.7%). Conclusion: This study provides meaningful clinical evidence to help make decisions on HPC use more easily at an appropriate time.

• The Journal of the Korea Contents Association
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• v.11 no.4
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• pp.312-320
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• 2011

The goal of this paper is to examine the effects of a CDSS(Clinical Decision Support System) for drug prescription on organizational performance in medical institutions using POC(Point Of Care) systems. For achieving this goal, evaluation factors for influencing performance of information system were identified by using the performance evaluation model for CDSS. In the results, there was significant causality between each evaluation domain except system quality domain. In addition, the system quality of CDSS for optimal drug prescription has no influence on user satisfaction. But information quality has positive influence on user satisfaction which has also a positive influence on organizational performance.

• Restorative Dentistry and Endodontics
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• v.49 no.1
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• pp.8.1-8.12
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• 2024

Objectives: The purpose of this study was to evaluate the effect of Dental Practicality Index (DPI) training using an online video on the treatment planning decisions and confidence level of dental undergraduates (DUs). Materials and Methods: Ninety-four DUs were shown 15 clinical case scenarios and asked to decide on treatment plans based on 4 treatment options. The most appropriate treatment plan had been decided by a consensus panel of experienced dentists. DUs then underwent DPI training using an online video. In a post-DPI-training test, DUs were shown the same clinical case scenarios and asked to assign the best treatment option. After 6 weeks, DUs were retested to assess their knowledge retention. In all 3 tests, DUs completed the confidence level scale questionnaire. Data were analyzed using the related-samples Wilcoxon signed rank test and the independent-samples Mann-Whitney U test with the level of significance set at p < 0.05. Results: DPI training significantly improved the mean scores of the DUs from 7.53 in the pre-DPI-training test to 9.01 in the post-DPI-training test (p < 0.001). After 6 weeks, the mean scores decreased marginally to 8.87 in the retention test (p = 0.563). DPI training increased their confidence level from 5.68 pre-DPI training to 7.09 post-DPI training. Conclusions: Training DUs using DPI with an online video improved their decision-making and confidence level in treatment planning.

• Journal of Korea Multimedia Society
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• v.19 no.7
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• pp.1197-1207
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• 2016

The purpose of this study was to develop an evidence-based Nursing Process System on Nursing Diagnosis, Nursing Outcomes, and Nursing Interventions Classification targeting nurse students. We use standard classification-focused research data on the basis of Nursing Diagnosis Classification established by NANDA (North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification) and NIC (Nursing Interventions Classification) mainly developed by Iowa Sate University. The existing research methods are difficult to be applied the consistent nursing process, since such methods need to repeatedly enter the same nursing process without systematic guidelines. But, this study was coded data of standardized nursing process in accordance with the 10 clinical condition in order to implement the nursing process macro, and developed a system that reflects the needs of nursing educators. Therefore, nurse students can improve clinical decision-making ability, and naturally learn the nursing process through a system developed.

• Korean Journal of Adult Nursing
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• v.22 no.5
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• pp.488-498
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• 2010

Purpose: The purpose of this study was to explore clinical nurse's reported conflict experience toward end-of-life medical decision making. Methods: Data were collected by in-depth interviews with eight nurses from three different wards of university hospital in D city of Korea. Conventional qualitative analysis was used to analyze the data. Results: Results were three major themes and twelve categories from the analysis. The three major themes were prioritization of treatment, non-disclosure of diagnosis, and hierarchical and power relations. Conclusion: The results of this study suggest that shared decision making in end of life among patient, family members, physician, and nurse may contribute to improve end-of-life care performance as well as dignified dying of patient in end of life.

• Health Policy and Management
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• v.16 no.3
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• pp.70-85
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• 2006

The purposes of this study were (1) to describe patients' behaviors to protect themselves from medical errors and their involvement in decision making on the diagnostic and treatment procedures (2) to examine whether patients' characteristics, such as age, sex, education, experience of hospitalization and/or surgery influence their self protect behaviors and involvement in decision making on the diagnostic and treatment procedures. A survey was conducted with 99 patients visited one university hospital in Seoul, Korea. A 20-item questionnaire, a 4-point Likert scale, was used to measure the degree of patients' active involvement in decision making; patients' self protect behaviors regarding medication, hospitalization, and surgery; and communication (Cronbach's alpha=0.801). SPSS 12.0 was used for the descriptive and correlation analysis. Only 6.1% of the participants were involved in the decision making process for the diagnostic tests and treatment. More patients did self-protect behaviors associated with the medication than other areas but widely varied from 18.2 to 94.3 % among various items. More people with age of 60 or older compared to people in younger age groups reported more protect behaviors particularly associated with medication. Patient education is needed to improve their active role in preventing medical errors and to promote patients' safety.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.7
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• pp.73-81
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• 2020

This study is a single-group study to check the effectiveness of nursing students on their communication credibility, communication confidence and clinical decision-making ability by implementing SBAR-applied simulation training to improve the difficulty of delivering clear information to medical personnel during transition. By combining simulation practices and SBAR training based on emergency situations of mothers and newborns, programs were developed and applied to communicate clearly and briefly to the medical staff about emergencies and to enhance communication skills. The subjects were 91 fourth-year nursing college students from one university in B metropolitan city. The data were collected from Feb. 18, 2019 to Feb. 28, 2019 and were analyzed using the SPSS/WIN 18.0 program as a paired t-test. The results revealed that the communication clarity measured after the simulation exercise (t=-3.99, p<.001), Communication Confidence (t=-8.60, p<.001), Clinical Decision Capacity (t=-4.66, p<.001) Statistically, it has increased significantly. Therefore, the purpose of this research is significant in that it seeks to promote the expertise of nursing college students by developing and applying simulation practical education programs to enhance the communication skills and clinical decision-making skills of nursing college students as prospective medical personnel.

• Journal of Korea Society of Digital Industry and Information Management
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• v.8 no.1
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• pp.221-229
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• 2012

A model for expressing meta data syntax in the eXtensible Markup Language(XML) was developed to increase the portability of the Arden Syntax in medical treatment. In this model that is Arden syntax uses two syntax checking mechanisms, first an XML validation process, and second, a syntax check using an XSL style sheet. Two hundred seventy-seven examples of MLMs were transformed into MLMs in ArdenML and validated against the schema and style sheet. Both the original MLMs and reverse-parsed MLMs in ArdenML were checked using a Arden Syntax checker. The textual versions of MLMs were successfully transformed into XML documents using the model, and the reverse-parse yielded the original text version of MLMs.

• Journal of Information Technology Applications and Management
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• v.21 no.2
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• pp.81-98
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• 2014

Recently, due to external environment like the changes in health policy and various healthcare accreditations, along with hospital's internal efforts to improve the quality of medical services, demands for the development of medical information systems are increasing. Some examples are clinical information like DUR (Drug Utilization Review), CVR (Critical Value Report), and automatic benefit processing by treatment purposes, or hospital DSS (Decision Support System) on overall medical practice. Such systems act as a guide in making clinic judgments during practice or in other medical practice, and their effects on the medical treatment improvements are being proven by previous studies. In the reality of increasing attention in the effects of medical treatment improvement, studies related to hospital DDS were mostly focused on clinical, technical, and engineering points of view, and studies focusing on the user viewpoint are very limited. In order to verify the effects of DSS on practice improvements and hospital's management performance, this study used a research model constructed to verify how SERVQUAL of hospital DSS affects hospital management performance in BSC (Balanced Score Card) point of view. To empirically verify the research model, a questionnaire was conducted on the basis of "K-University Hospital's DSS" on clinicians and hospital employees related to system development, and the relationships between the factors were analyzed through path analysis. As a result of path analysis, excluding reactivity, tangibility, confidence, reliability, empathy among service qualities, had partially significant effects on management performance factors (learning and growth, internal process, financial affairs). This study is to prepare the theoretical ground on the management performance analysis of hospital DSS, and suggest the service quality of the system that should be considered in the planning and development stages for improved system.

• Journal of Pharmacopuncture
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• v.22 no.4
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• pp.260-268
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• 2019

Objectives: The Clinical Decision Support System (CDSS), which analyzes and uses electronic health records (EHR) for medical care, pursues patient-centered medical care. It is necessary to establish the CDSS in Korean medical services for objectification and standardization. For this purpose, analyses were performed on the points to be followed for CDSS implementation with a focus on herbal medicine prescription. Methods: To establish the CDSS in the prescription of Traditional Korean Medicine, the current prescription practices of Traditional Korean Medicine doctors were analyzed. We also analyzed whether the prescription support function of the electronic chart was implemented. A questionnaire survey was conducted querying Traditional Korean Medicine doctors working at Traditional Korean Medicine clinics and hospitals, to investigate their desired CDSS functions, and their perceived effects on herbal medicine prescription. The implementation of the CDSS among the audit software developers used by the Korean medical doctors was examined. Results: On average, 41.2% of Traditional Korean Medicine doctors working in Traditional Korean Medicine clinics manipulated 1 to 4 herbs, and 31.2% adjusted 4 to 7 herbs. On average, 52.5% of Traditional Korean Medicine doctors working in Traditional Korean Medicine hospitals adjusted 1 to 4 herbs, and 35.5% adjusted 4 to 7 herbs. Questioning the desired prescription support function in the electronic medical record system, the Traditional Korean Medicine doctors working at Korean medicine clinics desired information on 'medicine name, meridian entry, flavor of medicinals, nature of medicinals, efficacy,' 'herb combination information' and 'search engine by efficacy of prescription.' The doctors also desired compounding contraindications (eighteen antagonisms, nineteen incompatibilities) and other contraindicatory prescriptions, 'medicine information' and 'prescription analysis information through basic constitution analyses.' The implementation of prescription support function varied by clinics and hospitals. Conclusion: In order to implement and utilize the CDSS in a medical service, clinical information must be generated and managed in a standardized form. For this purpose, standardization of terminology, coding of prescriptions using a combination of herbal medicines, and unification such as the preparation method and the weights and measures should be integrated.