• 한국병원경영학회지
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• 제23권1호
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• pp.1-15
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• 2018

Recently, the importance of emergency medical services has emerged, as rapid advances in urbanization and industrial development. Accordingly, the need for effective emergency medical services is increasing, and the evaluation of an emergengy medical services centers is conducted to meet these policy needs. The purpose of this study was to analyse the relationship between the structure and the process domain of the evaluation of an emergency medical services center based on the Donabedian's model and to verify the validity as an index of quality evaluation through the results. As a result of the analysis, there were some indicators that showed a different direction than expected, but generally there was a significant correlation between the structure and process domains of the evaluation of an emergency medical services center. This suggests that the process can be improved by improving the structure. In conclusion, as structure and process indicators in evaluation of an emergency medical services center show significant relationship, it can be evaluated as validity as a tool to measure the quality of emergency medical services.

• 가정∙방문간호학회지
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• 제29권1호
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• pp.70-81
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• 2022

Purpose: This study was performed to explore the trend of nursing research in the Korean long-term care system. Methods: Articles published between 2008 and 2021 were searched using the terms "long-term care system" and "nursing." Ninety-one articles were analyzed and classified into five categories according to research methods. Data were extracted through a systematic review process and underwent descriptive statistics and content analyses. Results: The most analyzed variable in the survey studies was job satisfaction. Many variables were classified into input and output factors using Donabedian's model. The content analysis showed that most suggestions were about improving the political regulation system. Conclusion: It is necessary to establish a research foundation to provide research funding and support to cultivate future nursing research in long-term care. Systematic improvement of research in nursing should be continuously pursued to revitalize nursing services, expand nursing service interventions, and improve management competency programs in nursing institutions.

• 한국보건간호학회지
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• 제37권1호
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• pp.97-110
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• 2023

Purpose: This study sought to determine the effect of the competence of nurses and their, work environment on the quality of nursing service in long-term care hospitals using the Donabedian model as a theoretical framework. Methods: This descriptive investigative study analyzed nursing competency, the work environment, and nursing service quality in a group of 182 nurses directly in charge of patient care at long-term care hospitals in special cities, metropolitan cities, and small and medium-size cities. The data were analyzed using IBM SPSS/WIN 27.0 version. Results: In long-term care hospitals, nurses' competence (r=.674, p<.001) and work environment (r=.444, p<.001) were correlated with quality of nursing service, and the nurses' competence was correlated with the work environment (r=.443, p<.001). The factors affecting the quality of nursing service in long-term care hospitals were competence, the work environment, and the age of nurses. Conclusion: In this study, both competence and the work environment of nurses were observed to be important factors in improving nursing service quality in long-term care hospitals. Therefore, efforts aimed at enhancing these factors are necessary to ensure the high quality of nursing service in these hospitals.

• 대한간호학회지
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• 제49권6호
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• pp.724-735
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• 2019

Purpose: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model. Methods: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24. Results: In the final model, admission via emergency department (Β=.06, p=.019), age over 65 years (Β=.11, p=.001), unconsciousness (Β=.18, p=.001), dependent activities (Β=.12, p=.001), abnormal vital signs (Β=.12, p=.001), pressure ulcer risk (Β=.12, p=.001), enteral nutrition (Β=.12, p=.001), and use of restraint (Β=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (Β=.06, p=.038), hospital length of stay (Β=5.06, p=.010), and discharge to another facility (not home) (Β=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium. Conclusion: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.

• 한국의료질향상학회지
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• 제2권1호
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• pp.86-109
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• 1995

Clinical trials of drugs on humans is the final and most important stage in evaluating the safety and efficacy of the drugs. Good Clinical Practice(GCP) standards were announced in 1987 to protect testees' rights as well as to ensure validity of the clinical trial results, but its implementation has been delayed until now. The purpose of this study is to evaluate the preparedness of the designated institutions to abide by GCP standards during clinical trials, and thereby to determine GCP implementability at the institutions. Survey on the status of clinical trials was conducted for the designated 83 clinical trial hospitals. Response rate was 95.2%. Donabedian's quality assessment model was applied as the basic framework for the study. And the relative - weights for the evaluation items were determined by expert's evaluation. Among the designated 83 hospitals, 39 conducted clinical trials to obtain drug manufacturing approval from 1990 to 1994. Only 19 institutions are found to be able to meet the requirements of KGCP. Structure variables - manpower, organization, and facility -, which are the basic elements for GCP, are evaluated as unsatisfied in many hospitals. Institutions which established IRB accounted for 41 or 51.9%, but those who have a protocol evaluation guideline, or Adverse Drug Reaction(ADR) reporting system were only 12 and 21 institutions, respectively. Also, the institutions providing educational programs on conducting clinical trials are few - 20. The study results indicates that the level of conducting KGCP is unsatisfactory. However, more institutions are expected to be able to meet the standards soon because GCP standards does not require so much regulation on facilities, but stress importance on research methodology and human right. At present as the institutions for clinical trials are primarily training hospitals with residency programs, such efforts as education will accelerate the implementability of GCP in Korea. Institutions must build the appropriate infrastructure and government must prepare to strongly enforce KGCP before it can successfully take place.

• 보건행정학회지
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• 제30권4호
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• pp.433-437
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• 2020

Cancer is a disease which has the huge burden in worldwide, and cancer is the number one cause of death in Korea. At this point, the new framework for cancer monitoring index is required for regional cancer monitoring. Especially, cancer survivors are the important target which is rapidly increasing recently, also cancer survivor's quality of care should be considered in the cancer monitoring index framework. To develop the Multidimensional Cancer Monitoring Index considering cancer survivor's quality of care, we took into account cancer continuum which including prevention, detection, diagnosis, treatment, survivorship, assessment of quality of care and monitoring cancer patient, and end-of life care for stage. For target, components of health care delivery system such as patient, family, provider, payer, and policy maker are included. Also, Donabedian model which is a framework for examining health services and evaluating quality of health care such as structure, process, and outcome is applied to contents. This new cancer monitoring framework which includes multidimensional components could help to develop regional cancer monitoring index, and to make national cancer management and prevention policy in the future.