• 제목/요약/키워드: Critical period

검색결과 1,318건 처리시간 0.026초

화병 표준진료지침 적용효과에 대한 Pilot 분석 (A Pilot Study on Effects of Critical Pathway Application for Hwa-Byung)

  • 엄윤지;권도형;김윤나;이현우;정선용;조성훈
    • 동의신경정신과학회지
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    • 제32권4호
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    • pp.337-343
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    • 2021
  • Objectives: To investigate effectiveness and satisfaction of applying critical pathway (CP) to Hwa-byung outpatients. Methods: Subjects were 32 outpatients who were diagnosed with Hwa-byung between January 1 and 2021 to October 31, 2021. Among these patients, 18 patients were applied with CP and 14 patients received treatment without applying CP. Their medical records and administration records were retrospectively analyzed. Data were analyzed by mean, standard deviation, and t-test using SPSS 26.0 program. Results: Mean total treatment period significantly decreased in the CP group compared with the non-CP group. Medical expenses were classified by treatment period, per visit, and patient charges per type of visit. When analyzed specifically by detailed items, there was a decreasing tendency in total medical expenses, uncovered medical expenses, and patient charges but an increasing tendency in covered medical expenses, although some of these changes were not statistically significant. Satisfaction score increased in the CP group compared with the non-CP group in general, although not all increases were statistically significant. Conclusions: Applying CP may contribute to the reduction of medical expenses and improvement of medical service quality. Further research on the development of CP for various diseases and the application of CP under various circumstances is needed.

Assessment of Critical Temperature for the Growth and Development of Early Transplanted Temperate Rice

  • Wbonho Yang;Shingu Kang;Dae-Woo Lee;Jong-Seo Choi
    • 한국작물학회:학술대회논문집
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    • 한국작물학회 2022년도 추계학술대회
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    • pp.171-171
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    • 2022
  • Effect of temperature during the period of 10 days from transplanting (10 DFT) on the growth and development of rice plants was investigated by transplanting semi-adult seedlings six times from 5 April to 15 May at 10-day interval in the field conditions of 2020 and 2021, with aims to investigate the critical temperature for early transplanting of temperate rice. In the two experimental years, mean temperature for 10 DFT appeared 9.1, 10.5, 11.6, 13.8, 13.9, 16.2, 16.4, 16.7, 17.1, 17.8℃ depending on the transplanting date. Mean temperature of 9.1℃ and 10.5℃ for 10 DFT appeared in the April 5 and April 15 transplants in 2020 showed negative or no effect on the increase of rice growth and acceleration of heading date when compared to those of right after transplanting treatments in the same year. Mean temperature of 11.6℃ for 10 DFT appeared in the April 5 transplant in 2021 demonstrated greater biomass from early to heading stage but the same heading date compared to April 15 transplant, indicating that 11.6℃ for 10 DFT had a positive effect on rice growth but no effect on advanced heading. Both more biomass and advanced heading stage were observed when the mean temperature for 10 DFT was 13.8℃ or higher, compared to those of right after transplanting treatments. These findings indicate that effective 10-DFT mean temperature for rice growth exists between 10.5 and 11.6℃, and that for rice development in terms of heading stage lies between 11.6 and 13.8℃ in natural condition. Further field and indoor studies are suggested to narrow down the critical temperature for early transplanting of temperate rice, which will enable to maximize the crop period in high altitude regions with low temperature.

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치과의원 외래환자 예약관리체계의 계량적 평가 (Quantitative Evaluation of Appointment System for Outpatients in Dental Clinic)

  • 이형주;장혜정
    • 한국병원경영학회지
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    • 제8권2호
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    • pp.49-69
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    • 2003
  • This study purported to evaluate the performance of the appointment system for outpatients in primary care dental clinic. The data of patients' time flow for 1,245 patients in Y Dental Clinic were collected for one month in 2002 and then analyzed. Specifically, the time periods of treatment and patients' waiting as well as rates of appointment and it's failure are estimated. The accuracy of expected treatment time period was also evaluated. The results showed that 72% of patients visited the clinic with appointments, and only 56% kept their appointments. The patient's waiting time period turned out to be 11 minutes in Y clinic. The expected treatment time period is turned out to be very important because they influence significantly on patient's waiting time period. Practically, the expected treatment time period should be overestimated about 9 minutes in general, and the characteristics of dentist, each patient's diagnosis and age need to be especially considered. Hospitals and clinics also need to make the systematic and detailed critical pathways for a variety of patient cases by analyzing the patients' treatment pattern. With the improved appointment systems, healthcare institutions will approach the goal of effective and efficient management of the institution and also satisfy their customers.

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Characteristics, Management, and Clinical Outcomes of Patients with Hospital-Acquired and Ventilator-Associated Pneumonia: A Multicenter Cohort Study in Korea

  • Ko, Ryoung-Eun;Min, Kyung Hoon;Hong, Sang-Bum;Baek, Ae-Rin;Lee, Hyun-Kyung;Cho, Woo Hyun;Kim, Changhwan;Chang, Youjin;Lee, Sung-Soon;Oh, Jee Youn;Lee, Heung Bum;Bae, Soohyun;Moon, Jae Young;Yoo, Kwang Ha;Jeon, Kyeongman
    • Tuberculosis and Respiratory Diseases
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    • 제84권4호
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    • pp.317-325
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    • 2021
  • Background: Hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP) are significant public health issues in the world, but the epidemiological data pertaining to HAP/VAP is limited in Korea. The objective of this study was to investigate the characteristics, management, and clinical outcomes of HAP/VAP in Korea. Methods: This study is a multicenter retrospective cohort study. In total, 206,372 adult patients, who were hospitalized at one of the 13 participating tertiary hospitals in Korea, were screened for eligibility during the six-month study period. Among them, we included patients who were diagnosed with HAP/VAP based on the Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) definition for HAP/VAP. Results: Using the IDSA/ATS diagnostic criteria, 526 patients were identified as HAP/VAP patients. Among them, 27.9% were diagnosed at the intensive care unit (ICU). The cohort of patients had a median age of 71.0 (range from 62.0 to 79.0) years. Most of the patients had a high risk of aspiration (63.3%). The pathogen involved was identified in 211 patients (40.1%). Furthermore, multidrug resistant (MDR) pathogens were isolated in 138 patients; the most common MDR pathogen was Acinetobacter baumannii. During hospitalization, 107 patients with HAP (28.2%) had to be admitted to the ICU for additional care. The hospital mortality rate was 28.1% in the cohort of this study. Among the 378 patients who survived, 54.2% were discharged and sent back home, while 45.8% were transferred to other hospitals or facilities. Conclusion: This study found that the prevalence of HAP/VAP in adult hospitalized patients in Korea was 2.54/1,000 patients. In tertiary hospitals in Korea, patients with HAP/VAP were elderly and had a risk of aspiration, so they were often referred to step-down centers.

서촌조생 단감의 숙기촉진에 관한 에세폰 효과 (Effects of Ethephon Treatments on Accelerating of Maturity of Sweet Persimmon 'Nishimurawase' Cultivar)

  • 김인하;서광기;안광환;윤영황;김성철;손길만;노치웅
    • 한국환경농학회지
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    • 제18권4호
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    • pp.339-343
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    • 1999
  • 추석용으로 출하하고 있는 단감 `서촌조생`의 조기 수확을 위하여 착색증진용 생장조절물질인 에세폰의 적정농도를 구명코자 본 연구를 수행한 결과를 요약하면 다음과 같았다. 에세폰 적정농도 설정에서 에세폰을 고농도인 30∼40㎎/l로 처리하면, 과피색도가 증가하나 과육경도 및 연화과발생율이 많았고 또한 유통한계기간도 짧아 상품성 유지가 어려웠다. 반면 저농도인 10∼20㎎/l에서는, 과피색도, 과육경도, 연화과발생율 및 유통한계기간 등 모든 면에서 상품성이 높게 유지되었다. 그리고, 에세폰 처리에 의해 조기 수확한 과실의 가용성고형물 함량은 일반적인 수확기의 그것에 비해 매우 낮았는데, 가용성고형물 함량도 동시에 증가시킬 수 있는 연구가 앞으로의 과제라 하겠다.

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Modeling for Drying of Thin Layer of Native Cassava Starch in Tray Dryer

  • Aviara, Ndubisi A.;Igbeka, Joseph C.
    • Journal of Biosystems Engineering
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    • 제41권4호
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    • pp.342-356
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    • 2016
  • Purpose: The drying of a thin layer of native cassava starch in a tray dryer was modeled to establish an equation for predicting the drying behavior under given conditions. Methods: Drying tests were performed using samples of native cassava starch over a temperature range of $40-60^{\circ}C$. We investigated the variation in the drying time, dynamic equilibrium moisture content, drying rate period, critical moisture content, and effective diffusivity of the starch with temperature. The starch diffusion coefficient and drying activation energy were determined. A modification of the model developed by Hii et al. was devised and tested alongside fourteen other models. Results: For starch with an initial moisture content of 82% (db), the drying time and dynamic equilibrium moisture content decreased as the temperature increased. The constant drying rate phase preceded the falling rate phase between $40-55^{\circ}C$. Drying at $60^{\circ}C$ occurred only in the falling rate phase. The critical moisture content was observed in the $40-55^{\circ}C$ range and increased with the temperature. The effective diffusivity of the starch increased as the drying temperature increased from 40 to $60^{\circ}C$. The modified Hii et al. model produced randomized residual plots, the highest $R^2$, and the lowest standard error of estimates. Conclusions: Drying time decreased linearly with an increase in the temperature, while the decrease in the moisture content was linear between $40-55^{\circ}C$. The constant drying rate phase occurred without any period of induction over a temperature range of $40-55^{\circ}C$ prior to the falling rate period, while drying at $60^{\circ}C$ took place only in the falling rate phase. The effective diffusivity had an Arrhenius relationship with the temperature. The modified Hii et al. model proved to be optimum for predicting the drying behavior of the starch in the tray dryer.

The Effect of Systematic Approach to Tracheostomy Care in Patients Transferred from the Surgical Intensive Care Unit to General Ward

  • Jung, Yooun-joong;Kim, Younghwan;Kyoung, Kyuhyouck;Keum, Minae;Kim, Taehyun;Ma, Dae seong;Hong, Suk-Kyung
    • Acute and Critical Care
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    • 제33권4호
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    • pp.252-259
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    • 2018
  • Background: The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time ($26.7{\pm}25.1$ vs. $12.1{\pm}16.0days$, P=0.003), length of stay in the general ward ($70.6{\pm}89.1$ vs. $40.5{\pm}42.2days$, P=0.008), length of total hospital stay ($107.5{\pm}95.6$ vs. $74.7{\pm}51.2days$, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010). Conclusions: Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.

당일 감마나이프수술 환자의 표준진료지침 개발을 통한 질 향상 효과 측정 (Measuring Effects of Quality Improvement through the Development of Critical Pathway for Gamma Knife Radiosurgery)

  • 김무성;하소영;배윤혁;정용태;김성태;이원희;고연주
    • 한국의료질향상학회지
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    • 제18권1호
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    • pp.27-36
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    • 2012
  • Objectives : A protocol called "critical pathway" was developed to standardize the management of hospital patients the day after they underwent gamma knife radiosurgery. The quality of improvement in patient outcomes was evaluated. Methods : Critical pathway was developed, according to the regulations of the I hospital, by analyzing the medical records of 22 inpatients who underwent gamma knife surgery within the period from January to April 2011 on the day of the surgery. The study included a group of 22 patients admitted to the hospital the day after they underwent gamma knife radiosurgery, between July and September 2011. The control group included 22 patients who had surgery employing the same method within the period from May to June 2011. To measure the effects on quality improvement, the average length of stay, the execution rate of the hospital discharge notice system, daily hospital revenue, and the satisfaction of the patients and the medical team were assessed. The patient questionnaire employed a four-point Likert scale while the medical-staff questionnaire employed a five-point Likert scale. Result : The average length of stay was significantly shorter in the study group compared to the control group (2.3 days vs. 3.8 days, P<0.05). The execution rate of the hospital discharge notice system was higher in the study group (100% vs. 72%) than in the control group. Daily hospital revenues were higher by 264,178 Korean won in the study group when compared to the control group. The study group showed greater satisfaction of patients compared to the control group based on a four-point Likert scale (P<0.05). The study group showed greater satisfaction in medical team compared to the control group based on a five-point Likert scale (P<0.05). Conclusion : The development and implementation of a critical pathway protocol for hospital admission the day after gamma knife radiosurgery is an effective care process that improves the clinical quality.

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IT 중소벤처기업의 외부 정보 네트워크의 다양성과 생산성 향상 : 생산 기간 단축의 매개적 역할 (IT SME Ventures' External Information Network Diversity and Productivity Improvement : The Mediating Role of the Production Period Reduction)

  • 허용석
    • 산업경영시스템학회지
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    • 제40권1호
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    • pp.144-149
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    • 2017
  • This study empirically analyzes the effect of IT SME ventures' external information network diversity on their production period reduction and productivity improvement generated from technology development. This research constructs a mediating model based on the open innovation perspective and tests it with the 138 samples of South Korean IT SME ventures based on the ordinary least squares regression. This research is expected to make a good contribution by shedding a new light on the following three points about the critical role of IT SME ventures' external information network diversity in increasing their production period reduction and productivity improvement generated from technology development which has scarcely been illuminated in the extant studies in the field of the management of technology for SMEs. First, IT SME ventures' external information network diversity positively influences their production period reduction. Second, the external information network diversity positively influences IT SMEs' ventures' productivity improvement. Third, IT SME ventures' production period reduction partially mediates the influence of IT SME ventures' external network diversity on their productivity improvement. These three fresh points are expected to provide useful theoretical and practical implications. Related to the theoretical implication, this research provides a fresh implication that IT SME ventures' external information network diversity positively influences not only their production period reduction but also productivity improvement generated from technology development. Concerning the practical implication, this study suggests that the CEOs in IT SME ventures make strategic efforts to use more diverse external information sources in order to increase their production period reduction and productivity improvement generated from technology development.

시뮬레이션을 활용한 급성 흉통환자간호 실습교육의 효과 (Effects of High-fidelity Simulation-based Education on Nursing Care for Patients with Acute Chest Pain)

  • 한상영
    • 한국산학기술학회논문지
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    • 제15권3호
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    • pp.1515-1521
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    • 2014
  • 본 연구는 간호학생의 급성 심근경색증 간호에 대한 시뮬레이션 기반 교육을 적용하고 비판적 사고, 문제해결력 및 학업성취도의 효과를 규명한 단일군 전후 원시실험설계이다. 대상자는 총 137명이었으며 중재기간은 2011년 9월부터 10월까지 총 6주간 시뮬레이션 기반 교육을 시행하고 중재 전후를 평가하였다. 자료분석은 SPSS Win17.0을 사용하였고, 평균과 표준편차, Paired t-test, 피어슨 상관계수를 이용하였다. 연구 결과 시뮬레이션 기반 교육프로그램은 비판적 사고, 문제해결력 및 학업성취도를 향상시키는 것으로 나타났다. 비판적사고가 증대될수록 문제해결력은 향상되는 것으로 나타났다. 반면 비판적사고 능력과 문제해결력은 학업성취도와 유의한 차이가 없었다. 시뮬레이션 기반 교육프로그램은 간호학생의 실무능력을 향상시키기 위해 유용한 학습방법임을 알 수 있었고, 임상현장에서 흔히 접할 수 있는 다양한 사례의 시나리오를 개발하여 실습교육에 적극 활용할 필요가 있다. 이를 위해서는 더 다양하고 적절한 실습교육방법에 대한 개발과 운영이 필요할 것으로 보인다.