• Title/Summary/Keyword: Community hospital

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Comparison of Antibiotic Regimens for the Treatment of Community Acquired Pneumonia (원외획득 폐렴 환자치료에서 항생제 regimen 별 효능비교)

  • Moon, Hong-Seop;Choe, In;Lee, Seung-Il
    • Korean Journal of Clinical Pharmacy
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    • v.16 no.2
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    • pp.81-85
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    • 2006
  • Community acquired pneumonia(CAP) is the most prevalent disease among pneumonia patients and progressed to severe pneumonia. A retrospective study was performed to evaluate antibiotic regimens according to guidelines of Infectious Disease Society of America. From January to October 2005, chart review of 50 patients with CAP was peformed in terms of microbiology and laboratory data of each regimen. Temperature, WBC count, ALT, AST and alkaline phosphatase of each patient were examined for liver toxicity. In three patients received levofloxacin appeared to have normalized temperature and improved cough. The patients who received cefmetazole -aminoglycoside appeared to have worsen LFT(Liver function test). Many patients in flomoxef-aminoglycoside group received mechanical ventilation because of the basis diseases like tuberculosis, diabetes mellitus and hypertension. In conclusion, antibiotic therapy for the treatment of CAP should be selected according to tolerance, bacteria and severity of disease.

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Job Analysis of School and Hospital Dietitians : Factor Analysis of Human Attributes (학교 및 병원 영양사의 직무분석 : 인적특성의 요인구조 비교)

  • 송은승;김명소
    • Korean Journal of Community Nutrition
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    • v.4 no.3
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    • pp.431-440
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    • 1999
  • This study was mainly done by factors analyzing to find out the structure and the dimension of the results of a previous study; analyzing the school and hospital dietitians'human attributes needed for successful job performance(Song 1998). The results were as follows: 1) Through factor analysis, the 12 knowledge items were categorized into 4 groups ; ‘basic knowledge of food and nutrition’, ‘knowledge of clinical nutrition and diet therapy’, ‘knowledge of medial science’, and ‘knowledge from experience and common sense’. These 4 knowledge factors were more frequently used and importantly recognized by hospital dietians compared with school dietitians. 2) The 38 skill and ability items were categorized into 7 groups ; ‘ability of program development and research’, ‘ability of counseling and nutrition education’, ‘ability of production control and facility management’, ‘ability to use computer’, ‘ability to cooperate with others’, ‘ability to manage consignment marketing’, and ‘ability of managing situations and informations’. Different skills and abilities were required for each group. 3) The 11 personality items were categorized as 3 groups ; ‘respoinsibility and sincerity’, ‘positive personality’, and ‘affirmative and inquisitive personality’.

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Community-acquired Achromobacter xylosoxidans infection presenting as a cavitary lung disease in an immunocompetent patient

  • Hwang, Chan Hee;Kim, Woo Jin;Jwa, Hye Young;Song, Sung Heon
    • Journal of Yeungnam Medical Science
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    • v.37 no.1
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    • pp.54-58
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    • 2020
  • Achromobacter xylosoxidans is a gram-negative bacterium that can oxidize xylose. It is commonly found in contaminated soil and water but does not normally infect immunocompetent humans. We report a case of a cavitary lung lesion associated with community-acquired A. xylosoxidans infection, which mimicked pulmonary tuberculosis or lung cancer in an immunocompetent man. The patient was hospitalized due to hemoptysis, and chest computed tomography (CT) revealed a cavitary lesion in the superior segment of the left lower lobe. We performed bronchoscopy and bronchial washing, and subsequent bacterial cultures excluded pulmonary tuberculosis and identified A. xylosoxidans. We performed antibiotic sensitivity testing and treated the patient with a 6-week course of amoxicillin/clavulanate. After 2 months, follow-up chest CT revealed complete resolution of the cavitary lesion.

Clinico-pathological Features of Gynecological Malignancies in a Tertiary Care Hospital in Eastern India: Importance of Strengthening Primary Health Care in Prevention and Early Detection

  • Sarkar, Madhutandra;Konar, Hiralal;Raut, Deepak
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.6
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    • pp.3541-3547
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    • 2013
  • Background: This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. Materials and Methods: In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. Results: The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. Conclusions: This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.

The Development of a Quality Measurement Tool for a Contract-Managed Hospital Foodservice (병원 위탁급식 품질관리를 위한 품질평가도구 개발)

  • 양일선;김현아;이영은;박문경;박수연
    • Korean Journal of Community Nutrition
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    • v.8 no.3
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    • pp.319-326
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    • 2003
  • The purposes of this study were: a) to develop the a quality measurement tool for the contract-managed hospital foodservice, and b) to evaluate their performance with the developed quality measurement tool, and c) to verify the reliability and validity of the quality measurement tool. The developed quality measurement tool comprised two parts, which were foodservice management and medical nutrition care service. The foodservice management part was classified into six functional categories which were Menu, Procurement and Storage, Production and Distribution, Facility and Utility, Sanitation and Safety, and Management and Evaluation. The medical nutrition care service part indicated the medical nutrition care provided. Quality measurement tool had 91 standards and 324 indicators. The quality measurement tools were distributed to the hospital foodservice manager employed by the foodservice company. The 324 indicators were measured by foodservice manager on the 5-Likert-type scales, and then adapted to a 100 point scale. The SPSS Ver. 11.0 was used for statistical analysis. The categories whose scores were evaluated as being high were Procurement', General Sanitation', Personal sanitation' and Waste' and the categories whose scores were evaluated as being low were Diet Order Manual', Standard Recipe', Appropriateness (Facility and Utility)', Check (Facility and Utility)'and Information Management'. All the categories of medical nutrition service were evaluated as having seriously low scores. Therefore, it was necessary for the contract-managed hospital foodservice to improve its performance in the area of medical nutrition care service. For the verification of the developed quality measurement tool, the reliability obtained by calculating Cronbach's α was 0.8747, and the content validity was also proved by scrutiny of the modification of the Professional group's techniques. (Korean J Community Nutrition 8(3) : 319∼326, 2003)

The Trend of Antimicrobial Resistance of Escherichia coli isolated from Healthy Volunteers of Community and Hospital Patients in Incheon (지역사회 및 병원 임상검체에서 분리한 대장균의 항생제 내성 양상)

  • Kim, Yong-Hui;Go, Jong-Myeong;Gong, Young-Woo;Oh, Bo-Young;Kim, Jung-Hee;Kim, Hye-Young;Lee, Mi-Yeon;Koh, Yeon-Ja;Hwang, Kyoung-Wha;JeGal, Seung;Lee, Jae-Mann
    • Korean Journal of Microbiology
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    • v.42 no.4
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    • pp.252-256
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    • 2006
  • We monitored antibiotic resistance of Escherichia coli isolates from healthy volunteers of community and hospital patients from February to July in 2006. From disc diffusion test on 4915 E. coli isolates from healthy volunteers of the community, the resistance rates were as follows; tetracycline resistant, 46.6%; ampicillin resistant, 41.1%; ticarcillin resistant,37.9%. From disc diffusion test on 120 E. coli isolates from hospital patients, the resistance rates were as follows: ampicillin resistant, 66.9%; ticarcillin resistant, 63.8%; tetracycline resistant, 47.2%. Extended spectrum $\beta$-lactamase producing E. coli were isolated 0.6% and 4.1% from healthy volunteers and hospital patients.

Current Status of Hospital-based Health Promotion Programs in Korea and the Factors Influencing Their Introduction (우리 나라 병원들의 건강증진 서비스 도입 현황과 이에 영향을 미치는 요인)

  • Lee, Sang-Gyu;Park, Choon-Seon;Kang, Myung-Guen;Hahm, Myung-Il;Lee, Soon-Young;Cho, Woo-Hyun
    • Journal of Preventive Medicine and Public Health
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    • v.34 no.4
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    • pp.399-407
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    • 2001
  • Objectives : To investigate the current status of hospital-based health promotion programs in Korea and to elucidate the factors which affect to the process of implementation. Methods : We conducted a mail survey of all 875 hospitals in Korea from March to May 2001. In reference to 12 specific kinds of health promotion programs, hospital CEOs were asked whether their hospital have such programs, whether they are fully staffed and whether the program is paid for by the patients. Contextual factors(location, hospital type, number of beds, length of operation, public/private status, economic level of the community, the level of competition) and organizational factors (the extent of market, compatibility with vision, formalization), strategic types of the CEOs (defender/analyser/prospector) were also surveyed. The relationships between each variable and the implementation of health promotion services, activation of services, and the target groups(patient/community resident) were analyzed by univariate analysis and the independent effects of these variables were examined with multiple logistic regression. Results : 100 of 125 hospitals responding (84.8%) had mere than one health promotion program. However, they showed fluctuations in the adoption rate of each programs, meaning that comprehensive health promotion services were not provided. Many programs were not fully staffed and few hospitals had paid programs. In factors affecting health promotion service implementation, private hospitals showed a higher rate in implementation than public hospitals. In contrast, when the competition among nearby hospitals was intense, the level of implementation of service lowered. In the strategic type of the CEOs, the prospectors were shown to have instituted more health promotion programs in their hospitals and the analysers had a greater tendency to have programs for community residents than the defenders. Conclusion . Considering the above results, contextual factors may contribute greatly to the introduction of health promotion services in Korean hospital, although the CEO's personal preference and organizational factors play a larger role in the activation of services. Additionally, the CEO's personal preference may be the major influencing factor in the introduction of programs for community residents.

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Nurse Manager Competency: Views from Executives in Thai Community Hospitals

  • Tongmuangtunyatep, Kanjananat;Lynn, Marry;Kunaviktikul, Wipada
    • Asian Journal for Public Opinion Research
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    • v.4 no.2
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    • pp.88-107
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    • 2017
  • Background: Adolescent mothers may find the transition to motherhood to be Aim: The aim of this study was to investigate the viewpoints of nurse managers and directors of nursing services in community hospitals regarding the essential competencies of head nurses. Methods: A qualitative descriptive design was used to investigate the perspective of nurse managers and directors of nursing services about essential competencies of nurse managers in community hospitals. A total of ten participants (four directors of nursing services and six nurse managers) were interviewed. Findings: Nurse managers and directors of nursing services identified leadership, management, communication, professional ethics, and policy and healthcare environment as the essential competencies for their positions in community hospitals. Conclusions: These findings can be used by executives of community hospitals and nursing institutes to plan for competency development for nurse managers. They should be included in nursing administration programs.

Monopsony Power of General Hospitals in Nurse Labor Market (간호사 노동시장의 수요독점에 대한 연구 - 종합병원을 중심으로 -)

  • Jeong, Hyun-Jin;Yang, Bong-Min
    • Korea Journal of Hospital Management
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    • v.5 no.2
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    • pp.40-58
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    • 2000
  • Nurses are medical personnel, who play a key role in supporting patient care, so it is important to supply them adequately in balance with ever increasing medical demand. But there appears severe shortage of nurses in some hospitals because of their uneven distribution, especially in small sized-hospitals and rural-hospitals. As nationwide distorted distribution of nurses in Korea is just like what monopsony model(a kind of market structure model) tells us, it is attempted to explain this situation of nurse labor market in Korea on the basis of monopsony model and presented in this paper. Specifically, determinants of nurse wage and the level of their relative employment were examined, and monopsony impact on their wage and the level of relative employment controlling those determinants were studied. Major results of this study arc as follows. The most important determinant of nurse wage level in this study was the wage level of a local community where each hospital located Hospital owner's characteristics an educational function of each hospital were also important factors. With these factor controlled, it was found that monopsony power of each hospital was negativel associated with nurse wage level as expected. 1% increase in monopsony power of hospital(measured by Herfindah-Hirschman Index) reduced nurse wage by $5,674{\sim}19,19$ won(in Korean currency). With regard to the level of relative employment, the most important determinant wa the capacity for supplying nurses of the local community. Again, hospital owner characteristics and educational function of each hospital were also important. With these factors controlled, it was found that monopsony power of each hospital was negative associated with the number of nurses per bed, as expected. 1% increase in monopsony power of each hospital(again measured by Herfindah-Hirschman Index) reduced the number of nurses per 100 bed as much as $0.46{\sim}0.67$. In conclusion. structural factors of nurse labor market influence the instability of nurse labor supply in Korea. Further consideration for these market structural characteristics needed for policy making related to nurse resource allocation.

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A Study of Hospital Foodservice Management after Covering Hospital Foodservice in The National Health Insurance (식대 급여화에 따른 입원 환자 병원 급식 실태 조사)

  • Hwang, Rah-Il;Kwon, Jin-Hee;Jeong, Hyun-Jin;Kim, Jung-Hee;Lee, Ho-Young
    • Korean Journal of Community Nutrition
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    • v.13 no.2
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    • pp.244-252
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    • 2008
  • The purpose of this study is to investigate the overall operations of National Hospital Food service after it was benefited by National Health Insurance (NHI). The survey was conducted between July and August, 2007. Among questionnaires mailed to 2,558 medical care institutions, 2,090 returned (81%) questionnaires were analyzed by descriptive statistics, $x^2$-test and ANOVA using the SPSS 13.0. The general foodservice characteristic of medical care institutions were as follows. The type of foodservice operations were 'self-operated' (86.9%), 'contracted' (10.5%) and 'Both' (2.6%). Only 6.4% of medical care institutions provided 'hospital food menu not benefited by NHI'. The number of dietitians and cook for medical care institutions were 1.1 and 1.0, respectively. The cost of a general diet meal was 4,205 won and therapeutic diet meal was 4,434 won. The overall operations of hospital foodservice were different depending on the types of medical care institution. After hospital foodservice was benefited by NHI, the overall quality of hospital foodservice including manpower, facilities, and environment was improved. The future direction of hospital foodservice should 1) differentiate the cost of hospital foodservice by the types of medical care institution, 2) increase in co-payment, and 3) provide same service with equal expenses in each party as medical aid or NHS beneficiary.