• Journal of Korean Neurosurgical Society
• /
• v.66 no.5
• /
• pp.573-581
• /
• 2023

Objective : Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited. Methods : The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire. Results : During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor's explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time. Conclusion : In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.

• Korean Journal of Clinical Laboratory Science
• /
• v.54 no.1
• /
• pp.49-60
• /
• 2022

This study attempted to provide the basic data for developing a system to identify the role of medical technologists and ensure an efficient response for quick and accurate diagnostic tests in the COVID-19 era. The research method involved using focus group interviews for a survey and analysis of 15 medical institutions. Eleven sample collection institutions, 10.4 medical technologists, 2.1 minutes of collection time, 5.4 hours of test time, 9,670 tests, 6.2 member test workforce size, and 7 screening center operating institutions were surveyed. The results of the focus group interview analysis revealed that there were no standardized guidelines covering working hours, area, and environment to protect sample collectors and testers in relation to the COVID-19 tests. Also, legal protection measures were insufficient in the event of accidental infections and there were no personnel regulations related to COVID-19. In addition, the professional training of sample collectors and molecular diagnostic testers was required for reliable COVID-19 testing. In conclusion, it is necessary to provide professional education through special test short-term training institutions to cope with emergency infectious diseases such as COVID-19. Legal systems should be put in place to protect the workforce and ensure stability.

• Korean Medical Education Review
• /
• v.25 no.2
• /
• pp.139-158
• /
• 2023

Defining a competent doctor is important for educating and training doctors. However, competency frameworks have rarely been validated during the process of their development in Korea. The purpose of this study was to validate the patient-centered doctor's competency framework, which had been developed by our expert working group (EWG). Two rounds of Delphi questionnaire surveys were conducted among a panel of experts on medicine and medical education. The panel members were provided with six core competencies, 17 sub-competencies, and 53 enabling competencies, and were asked to rate the importance of these competencies on a 5-point Likert scale. Between April and July 2021, a total of 28 experts completed both rounds. The data of the Delphi study were analyzed for the mean, standard deviation, median, inter-rater agreement (IRA), and content validity ratio (CVR). A CVR >0.36 and IRA ≥0.75 were deemed to indicate validity and agreement. This study found that five enabling competencies were not valid, and agreement was not reached for three sub-competencies and two enabling competencies. In consideration of CVR and the individual opinions of panel members at each session, the final competencies were extracted through consensus meetings of the EWG. The competencies were modified into six core competencies, 16 sub-competencies, and 47 enabling competencies. This study is meaningful in that it proposes patient-centered doctor's competencies enabling the development of residents' milestone competencies, an assessment system, and educational programs.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.29 no.2
• /
• pp.124-137
• /
• 2023

Purpose: This study's aim was to confirm the importance and performance of the clinical practice of nurses working in the general wards of a tertiary hospital and to analyze their educational needs. Methods: The study employed a descriptive research design, and a self-reported questionnaire was developed and used for nurses in a tertiary hospital. Data were collected from July 22 to July 29, 2022, analyzed by an independent t-test, paired t-test, and one-way ANOVA for the importance and performance of each clinical nursing practice according to general characteristics, and then a post hoc verification was performed by Scheffé's test. An Importance-Performance Analysis and Borich needs assessment model were used to analyze clinical nursing education needs. Results: Clinical nursing practice performance showed a significant difference according to length of total clinical career, time working in current department, and preceptor experience. According to the results of the Importance-Performance Analysis, neurological evaluation, and nursing intervention, artificial respirator and high-flow oxygen inhalation nursing, chemotherapy, emergency nursing, and cardiopulmonary resuscitation were identified as belonging to the "concentrate here" quadrant. All these items ranked in the top 10 in the Borich needs assessment model. Conclusion: Based on these results, the current education system should be reviewed, and short and long term education strategies based on educational needs should be established to strengthen the competence of nurses.

• Industry Promotion Research
• /
• v.9 no.2
• /
• pp.37-44
• /
• 2024

This study selected the worst-case scenario for fireball and vapor cloud explosion (VCE) of a styrene monomer storage tank installed in a petrochemical production plant and performed damage prediction and accident impact analysis. The range of influence of radiant heat and overpressure due to fireball and vapor VCE during the abnormal polymerization reaction of styrene monomer, the main component of the mixed residue oil storage tank, was quantitatively analyzed by applying the e-CA accident damage prediction program. The damage impact areas of radiant heat and explosion overpressure are analyzed to have a maximum radius of 1,150m and 626m, respectively. People within 1,150m of radiant heat of 4kW/m2 may have their skin swell when exposed to it for 20 seconds. In buildings within 626m, where an explosion overpressure of 21kPa is applied, steel structures may be damaged and separated from the foundation, and people may suffer physical injuries. In the event of a fire, explosion or leak, determine the risk standards such as the degree of risk and acceptability to workers in the work place, nearby residents, or surrounding facilities due to radiant heat or overpressure, identify the hazards and risks of the materials handled, and establish an emergency response system. It is expected that it will be helpful in establishing measures to minimize damage to workplaces through improvement and investment activities.

• Quality Improvement in Health Care
• /
• v.30 no.1
• /
• pp.120-131
• /
• 2024

Purpose: This study aimed to evaluate the impact of implementing a clinical pathways (CPs) on the clinical outcomes and costs of patients undergoing breast cancer surgery. Methods: This retrospective cohort study included patients who were newly diagnosed with primary breast cancer at the Samsung Medical Center between 2014 and 2019 (N=8482; 2931 patients in the pre-path and 5551 patients in the post-path). Clinical outcomes included reoperation during hospitalization, readmission, and emergency room visits within 30 days of discharge. The cost data for each unit were obtained from an activity-based management accounting system. We performed an interrupted time series analysis. Results: The post-path period showed a significantly shorter hospital length of stay (LOS) than the pre-path period (6.3 days in pre-path vs. 5.0 days in post-path; -1.3 days' difference; p=.001), and fewer reoperations during hospitalization and within 30 days after discharge than the pre-path period. After adjusting for inflation rates and relative value scores, the model demonstrated savings of $146 per patient in the post-path for total costs, and $537 per patient for patient out-of-pocket costs (p=.001). Conclusion: CPs can help reduce costs without compromising the quality of care by reducing the number of reoperations, readmissions, and complications.

• The Journal of the Korea institute of electronic communication sciences
• /
• v.19 no.1
• /
• pp.149-156
• /
• 2024

The increased intelligence and speed of vehicle infotainment, whose main purpose was emergency and external communication, is showing the potential for application to various services such as navigation and autonomous driving. In particular, functionality for linking external devices and infrastructure is being strengthened due to advances in communication and networks. Under this trend, it is necessary to consider the direction of linkage with the cooperative intelligent transportation system (C-ITS) for advanced vehicle services and driving. In addition, in the case of automobiles, future vehicle development concepts are being established based on the concept of software-defined vehicles (SDVs) in line with the trend of electrification beyond telematics and infotainment advancements, and such SDV linkage must be considered at the same time. In this paper, we consider the future direction of ITS and SDV linkage based on analysis of vehicle infotainment structure. First, for this purpose, we analyze the existing vehicle infotainment structure and architecture, and also present the structure of the SDV linked to it. Based on this, analysis and implications are drawn on the possibility of applying and linking standard-based C-ITS services with SDV devices.

• Journal of the Korea Institute of Information Security & Cryptology
• /
• v.34 no.1
• /
• pp.115-127
• /
• 2024

The recent increase in digital audio media has greatly expanded the size and diversity of sound data, which has increased the importance of sound data analysis in the digital forensics process. However, the lack of standardized procedures and guidelines for sound data analysis has caused problems with the consistency and reliability of analysis results. The digital environment includes a wide variety of audio formats and recording conditions, but current audio forensic methodologies do not adequately reflect this diversity. Therefore, this study identifies Life-Cycle-based sound data elemental technologies and provides overall guidelines for sound data analysis so that effective analysis can be performed in all situations. Furthermore, the identified elemental technologies were analyzed for use in the development of digital forensic techniques for sound data. To demonstrate the effectiveness of the life-cycle-based sound data elemental technology identification system presented in this study, a case study on the process of developing an emergency retrieval technology based on sound data is presented. Through this case study, we confirmed that the elemental technologies identified based on the Life-Cycle in the process of developing digital forensic technology for sound data ensure the quality and consistency of data analysis and enable efficient sound data analysis.

• Journal of Preventive Medicine and Public Health
• /
• v.33 no.3
• /
• pp.334-342
• /
• 2000

Objectives . This study was conducted in order to investigate the degree of recognition, acceptability, and altitude towards day surgery of patients who were hospitalized with diseases that were candidates for day surgery; in order to analyze the average length of stay for treatment of the ailments; and to analyze the percentage of patients who could be discharged on the same day after the surgery ,using the post-anesthesia discharge scoring system. Methods : Data was collected between February 1 and March 31, 1999 from 353 patients who received surgery for cataract, adenoid hypertrophy, inguinal hernia, strabismus, ptosis, cholelithiasis, hemorrhoid, or anal fistula, at a general hospital in Daegu city. The patients were interviewed and surveyed by a post-anesthesia discharge scoring system(PADS) in order to collect data on patient condition such as vital signs, activity and mental status, pain, nausea and vomiting, surgical bleeding, intake and output after the surgery. Results : Among the 353 patients, 52.7% were after of the day surgery and 52.7% were interested in day surgery. Of the respondents, 43.1% said 'my ailment was not serious and the surgery was simple' and 30.4% said 'according to my condition rest at home was desirable' as the reasons for wanting day surgery Alternatively, 56.5% of those declining day surgery said the 'uncertainty of staying home' was the reason. The greatest concern in discharging within 24 hours after surgery was a post-op emergency situation. On the other hand, the shortened hospitalization was the largest advantage of day surgery with 39.1% responding this way, followed by the savings in hospitalization costs (25.8%) and emotional stability (13.7%). The majority of those surveyed (47.6%) believed that discharge should be determined within 1-2 days after the surgery. The average hospital stay was 3.1 days for dischargeable ailments. Pain (45.6%), nausea and vomiting (10.5%), and headache (7.9%) were the common symptoms following surgery. The percentage of patients who were able to be discharged within 24 hours after surgery revealed 95.2% were dischargeable after approximately 3 hours, 99.2% dischargeable after 12 hours, and 100% dischargeable after 24 hours. Conclusions : According to the PADS score, the cataract extract and strabismus correction patients were eligible for day surgery and the further evaluation concerning the reason for delayed recovery of the other diseases is needed.

• Journal of the Korean Society of School Health
• /
• v.17 no.1
• /
• pp.1-12
• /
• 2004

Purpose : this study purposed to investigate school nursing phenomena in Korea by applying ICNP, the international standard nursing classification system developed by ICN, and to compare school nursing phenomena at elementary, middle and high schools. Method : The subjects of this study are 110 nursing teachers from 82 elementary schools, 16 middle schools, and 12 high schools. In the survey, subjects were asked to score the degree to which phenomena and characteristics of Korean school nursing, identified in previous research, on a 5 point scale. Questionnaires were distributed and recovered by mail and email. The period of data collection was 6 months from July to December 2003. The general characteristics of schools and nursing teachers were represented with frequencies and percentages, the phenomena and characteristics of school nursing with the mean score of the questions, and the phenomena school nursing by school grade with ANOVA and Duncan's posterior analysis. Results : 1) As for the characteristics of schools according to school nursing phenomena related to human behavior, the mean score of questions on inadequate stress management was highest at 3.24 points followed by the score on inadequate weight control (3.23), inadequate eating habits (3.22), the risk of spine disorders (2.68), inadequate emergency management (2.62), inadequate response to sex -related problems (2.19), and smoking and drug use (1.85). 2) As for the characteristics of schools according to school nursing phenomena related to human function, the mean score of questions on oral health management was highest at 3.11 points followed by the score on the risk of digestive system disorder (2.87), improper eyesight management (2.81), the risk of respiratory system disorders (2.75), lack of sexual identity (2.52), and inadequate contagious disease control (2.12). 3) As for the mean score according to school nursing phenomena related to environment, the score of the risk of accidents in classroom was highest as 2.68 points followed by the score of the risk of accidents around the school (2.65), maladjustment to school (2.62), the risk of accidents outside the classroom (2.43), inadequate learning environment (1.83), the risk of exposure to socially and physically harmful environment factors (1.82), and inadequate waste disposal (1.77). 4) This study tested the mean scores of questions corresponding to each school nursing phenomenon in order to see if there is a difference in the school nursing phenomenon among elementary, middle and high schools, and performed Duncan's posterior comparison for school nursing phenomena. A significant difference was found at p<.1. According to the results, school nursing phenomena found to be significantly different among elementary, middle and high schools was smoking and drug use (p<.05), which appeared more problematic in high school than in elementary school. phenomena such as inadequate eating habits, inadequate weight control, inadequate response to sex-related problems and inadequate waste disposal were also found to be statistically different at p<.1; however, according to the result of Duncan's posterior comparison, no difference was found among groups in improper eating habits and improper response to sex-related problems, and a significant difference was found between middle and high schools in inadequate weight control and inadequate waste disposal. Conclusion: Based on the results of this study, it is necessary to plan school health projects focused on the characteristic school nursing phenomena that had high scores and to develop and execute school healthe projects in accordance with the characteristics of elementary, middle and high schools. Considering that the scores of school nursing phenomena related to human behavior are high, it is necessary to introduce school health promotion projects in a systematic way.