• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.37-50
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• 1997

The purpose of this study was to identify the gap between need-level and demonstration-level in nursing managerial competencies. In addition, the study proposes solutions to narrow this gap. The results of this study are as follows : 1) The mean score for need-level of each item was 4.0, and for demonstration-level, 3.5. This indicates that military hospital head nurses demonstrate a higher level of managerial competencies than the moderate level on all items. But items which were related to resource/ cost/ information managament, staff development management and professionalism management got relatively low ratings in the need-level. 2) The mean score for need-level of each category was 4.14, and for demonstration-level, 3.53. Categories on the individual dimension got a higher rating than categories on the group or organization dimension in both need-level and demonstration level. 3) The gap between need-level and demonstration-level appeared in all items(p<.05) and categories(p<.001). Although the gap was relatively low, it indicates that it is essential to plan a developmemt program for all nursing management competencies for military hospital head nurses. 4) There were significant differences in the gap between need-level and demonstration-level according to specific characteristics of the subjects. The gap did not appear in many categories on the individual dimension where the number of nursing staff was more than 10, a major grade, ICU head nurse or for head nurses having a long career. 5) Need-level and demonstration-level showed a difference according to specific characteristics of the subjects, because need-level and demonstration-level were higher where the number of nursing staff was more than 10, a major grade, and for ICU or Medical ward head nurses. The categories which showed need-level difference and demonstration-level differences according to specific characteristics of the subjects existed almostly completely in the group and organization dimension. Gap-level differences according to the number of hospital bed existed in only two categories. 6) The general causes of the gap were indicated to be 'Knowledge/ skill/ experience deficit', 'Limitation of rules and systems/ Inappropriate organizational environment' for most items, categories, and dimensions. The results of this study indicate that extensive competency developing strategies must be developed, because a gap was found in all items and categories. Specially, there is a need to concentrate attention on competencies in the group and organizational dimension which had a wider gap level. And it is important to take an individual approach according to the cause for each gap. In order to produce effective competency developing strategies, top managers must have sinsights into the importance of nursing staff development and nursing officer's efforts to develop themselves must be achieved. Further multi-dimensional(education, personnel-policy, nursing/ organizational environment) solutions to the gap must be developed and utilized.

• Korea Journal of Hospital Management
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• v.7 no.3
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• pp.44-62
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• 2002

Advanced surgical technology demands more precise, meticulous, and time-consuming procedures. In addition, the patient's preference of tertiary health providers makes over crowding of the University Hospitals. Therefore, it has been necessary to maximize utilization of the operating room of such hospitals to accommodate these requirements. This study, targeting 1,302 surgical cases performed in 22 operating rooms at a university hospital in Seoul from October 8 to November 1, 2001, analyzed reasons for delay, and factors that caused delayed use of operating rooms. This study also assessed that the rate of operating room use would increase if the sources for possible reform were improved. 1. Among total of 1,302 cases of surgery, the incidence of surgeries in which there were no time delays and no factors for delay were discovered is 71.4% or 930 cases: the incidence in which surgeries were delayed was 28.6% or 372 cases. 2. As results of logistic regression for delay, procedures involving women were delayed 1.4 times more frequently than those of men. Compared to Department A, Department B was 1.8 times more likely to be delayed, and Department H was 0.4 times less likely to be delayed. Regional anesthesia was 2.4 times more likely to be delayed than general anesthesia, and surgeries that PCA was applied were 0.6 times less likely to be delayed than those when it was not. Surgeries performed on the Thursday were 1.7 times more likely to be delayed than those performed on the Monday. Compared to surgeries performed between 07:00-07:59, those performed between 08:00-08:29 were 4.3 times higher. 3. The reasons for delay were related to surgeon, surgical department, patient, anesthesia, administrative system, sick ward, and support services. Among these, 5,755 minutes for 276 delayed cases could be resolved easily, and resolving delays of 3,320 minutes for 131 cases would be more difficult. Among the causes for delay that could be improved, delays due to patient's transfer and surgeon's factor were the most common, 21.6% and 17.4% respectively. 4. If resolvable delays are improved, pre-anesthesia room is administered, and regional anesthesia and PCA are done ahead of time, use of emergency operating rooms will increase, we can increase overall utilization by 4.09%, we will save 744 minutes a day, we can reduce the time the operation room is used after 4 PM by 35%, and we can resolve the operation cancellations due to insufficient operating rooms. For the increase in the use of operating rooms, we need to maximally decrease the delays that could be improved, by allocating block time based on used totals hours of elective cases, giving accurate information on surgery schedule, voluntary cooperation by staff participating in surgeries in reducing delay time, and the hospital management's will to improve delay.

• Clinical and Experimental Pediatrics
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• v.54 no.5
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• pp.207-211
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• 2011

Purpose: This study was conducted to investigate the immune responses of children with moderate and severe novel influenza A virus (H1N1) pneumonia, and to compare their clinical and immunological findings with those of control subjects. Methods: Thirty-two admitted patients with H1N1 pneumonia were enrolled in the study. The clinical profiles, humoral and cell-mediated immune responses of the 16 H1N1 pneumonia patients who were admitted to the pediatric intensive care unit (severe pneumonia group), 16 H1N1 pneumonia patients admitted to the pediatric general ward (moderate pneumonia group) and 13 control subjects (control group) were measured. Results: Total lymphocyte counts were significantly lower in patients with H1N1 pneumonia than in the control group (P=0.02). The number of CD4+ T lymphocytes was significantly lower in the severe pneumonia group ($411.5{\pm}253.5/{\mu}L$) than in the moderate pneumonia ($644.9{\pm}291.1/{\mu}L$, P=0.04) and control ($902.5{\pm}461.2/{\mu}L$, P=0.01) groups. However, the number of CD8+ T lymphocytes was significantly higher in the severe pneumonia group ($684.2{\pm}420.8/{\mu}L$) than in the moderate pneumonia ($319.7{\pm}176.6/{\mu}L$, P=0.02) and control ($407.2{\pm}309.3/{\mu}L$, P=0.03) groups. The CD4+/CD8+ T lymphocytes ratio was significantly lower in the severe pneumonia group ($0.86{\pm}0.24$) than in the moderate pneumonia ($1.57{\pm}0.41$, P=0.01) and control ($1.61{\pm}0.49$, P=0.01) groups. The serum levels of immunoglobulin G, immunoglobulin M and immunoglobulin E were significantly higher in the severe pneumonia group than in the 2 other groups. Conclusion: The results of this study suggest that increased humoral immune responses and the differences in the CD4+ and CD8+ T lymphocyte profiles, and imbalance of their ratios may be related to the severity of H1N1 pneumonia in children.

• Journal of Hospice and Palliative Care
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• v.17 no.2
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• pp.75-84
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• 2014

Purpose: This study was conducted to explore predictors of health status of family caregivers of hospice patients. Methods: This study included 118 family caregivers of patients who were admitted to the hospice ward of three general hospitals in D city. The collected data were analyzed by frequency, percentage, t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression using the SPSS WIN 18.0 program. Results: The mean score for overall health of family caregivers was 2.68 (${\pm}0.42$). Mean scores for variables related to health were 2.55 (${\pm}0.37$) for sleep quality, 1.91 (${\pm}0.41$) for anxiety and 2.78 (${\pm}0.33$) for hope. Variables such as sleep quality, gender, anxiety and hope explained 59.8% of variance among family caregivers' health conditions. Conclusion: These results suggest the need for nurses to search for ways to promote health of hospice patients' family caregivers, such as improving the quality of sleep, easing their anxiety and encouraging hope.

• Korean Journal of Childcare and Education
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• v.8 no.4
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• pp.185-206
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• 2012

The purpose of this study was to investigate the general tendency of styles for handl ing conflict and organizational effectiveness perceived by head teachers in child-care centers, and the relationship between head teacher's styles for handling conflict and organizational effectiveness. A total of 194 child-care head teachers who work in the Busan and Gyeongnam area responded to the questionnaire. The main results of the study were as follows; First, among the styles for handling conflict, the head teacher s used the most obliging type toward their principal, and also used the most integrati ng type toward colleague teachers. The head teachers perceived moderate or higher level of organizational effectiveness in child-care centers, and there were partial diffe rences in styles for handling conflict and organizational effectiveness depending on ag e, academic achievement, career of head teachers and facility type. Finally, it was fou nd that organizational effectiveness of child-care center were positively correlated wit h integrating type, dominating type and compromising type among all styles for hand ling conflict which head teachers adopted, but was negatively correlated with avoidin g type. Particularly, it was found that the head teacher's styles for handling conflict having most significant effects on organizational effectiveness were avoiding type to ward their principal and integrating type toward colleague teachers.

• Journal of the Korean Geographical Society
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• v.43 no.4
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• pp.544-560
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• 2008

This study seeks to clarify the background and factors for the expansion of bus networks that connect Incheon International Airport with its hinterlands. For this research objective, this paper analyzes the relationships among the change of bus routes, competitive transportation modes, passenger fares, and the shortest time distance. Previously, the hinterlands of route bus networks that connect Gimpo International Airport were Seoul metropolitan area, Chungcheong region, Jeonju and Iksan in Jeollabuk-do(province). However, the opening of Incheon International Airport resulted in the expansion of the hinterlands of bus networks to Gangwon-do, Gwangju, and major cities in Youngnam region. Simultaneously, route bus networks also expanded in Seoul metropolitan area. Each bus route connecting Incheon International Airport with its hinterlands was opened by a single bus company or various bus companies. In many cases, due to the uncertainty of revenues or bus company's regional ties, a bus route was opened by various bus companies. In this paper, the analysis of the number of one-way route bus service and density of flight passengers shows that the frequency of the route bus service for Seoul except Gangseo-gu(ward) and for Seoul's satellite cities(Suwon, Seongnam, Anyang, Gunpo, Guri, and Osan) should be decreased. The analysis also shows that the frequency of the route bus services for the other cities, counties(Guns), and wards(gus) should be increased. In Seoul metropolitan area, although route bus fares are more expensive than subway fares, passengers use route bus more frequency than subway because time distance of route bus is shorter than that of subway and subway transfer is inconvenient. In general, outside Seoul metropolitan area, air flight is preferred in the regions that have airports. In contrast, the route bus is preferred in Daegu and other regions that do not have airports.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.6
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• pp.345-354
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• 2018

This study was conducted to identify the levels of patient safety culture, critical thinking disposition, and patient safety nursing activities and determine the factors affected by patient safety nursing activities among nurses in comprehensive nursing care service wards. Subjects consisted of 150 nurses from general hospitals in B city, Korea, and data were analyzed using the SPSS Win 21.0 program. The mean scores of awareness of patient safety culture, critical thinking disposition, and patient safety nursing activities were $3.32{\pm}0.32$, $3.50{\pm}0.31$, and $4.28{\pm}0.46$, respectively. The awareness of patient safety culture was significantly different by clinical career in the present unit (F=4.79, p=0.001). The critical thinking disposition was significantly different by age (F=3.89, p=0.010) and position (F=6.40, p=0.002). There were differences in the scores of patient safety nursing activities according to position (F=3.19, p=0.044). Additionally, hospital environment (${\beta}=0.25$, p=0.014), supervisor attitude (${\beta}=0.20$, p=0.046), and position (${\beta}=0.14$, p=0.040) accounted for a 44.4% variance in patient safety nursing activities. To promote patient safety nursing activities in comprehensive nursing care service wards, positive awareness of the hospital's safety environment and support from the manager are required.

• Journal of Korean Academy of Nursing
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• v.30 no.3
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• pp.720-730
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• 2000

Malnutrition is a common problem in cancer patients. In addition anticancer drugs used in chemotherapy as a major therapeutic mode are famous as the side effect like nausea, vomiting, which lead the patients to malnourished state. This study was to determine the relationship of anorexia, nausea, vomiting and oral intake and identify the influence these side effects on the nutritional status in patients receiving chemotherapy. To assess the nutritional status, anthropometry such as weight, height, body mass index(BMI), body fat proportion, and triceps skinfold thickness, and biochemistry test such as hemoglobin and lymphocyte were measured at the pre- and post- chemotherapy and the readmission time, all three times. During chemotherapy, anorexia, nausea, and vomiting using a VAS or 5-point scale and 24 hour oral intake using a food record were measured daily. Forty-nine patients knowing their diagnosis and receiving chemotherapy were recruited from an oncological ward in a general hospital for 5 months and they were reduced 31 at readmission time for a next chemotherapy. The results were as follows. Most subjects (93.6%) were in the 4th stage of cancer and 57.1% of subjects were in the first or the second chemotherapy. In most subjects(82.6%), their weight was decreased 10.7% than as usual. The degree of anorexia, nausea, and vomiting was significantly higher and the amount of oral intake was significantly less during the chemotherapy than at the pre-chemotherapy. Weight, BMI, triceps skinfold were reduced more at the post- chemotherapy than the pre-chemotherapy and were recovered the nearly same but less level at the readmission time. Body fat proportion was increased at the post chemotherapy and then decreased at the readmission phase. Hemoglobin and the number of lymphocyte were below normal at the pre-chemotherapy and more reduced at the readmission time. Anorexia, nausea, and vomiting were related positively and oral intake was negatively related with nausea and vomiting. The nutritional status at the post- chemotherapy and the readmission time was explained 20% over by the side effect like anorexia, nausea, vomiting and oral intake during the chemotherapy. The significant nutrition predictors at the post- chemotherapy were vomiting and the significant predictors at the readmission time were anorexia, vomiting, and oral intake. These results indicated the patients receiving chemotherapy were continued to deteriorate the nutritional status. Therefore nurse should have knowledge how much the nutritional status can be affected and assess the nutritional status periodically and try to find out the intervention for side effects from the series of chemotherapies.

• The Journal of Internal Korean Medicine
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• v.27 no.4
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• pp.905-914
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• 2006

Background and Purpose : The purpose of this study was to classify according to the TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) acute stroke patients (first-ever stroke) treated at the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital. Methods : In the time period Oct. 2005 to Oct. 2006. 101 patients with a first-ever stroke admitted to the Department of Internal Medicine of Kyungwon University In-cheon Oriental Medical Hospital were included. Patients were hospitalized within 14 days after the onset of stroke. They had neurological deficits for a time more than 24 hours. We classified patients according to the original TOAST classification (Trial of Org 10172 in Acute Stroke Treatment) Results : The incidence in males was 54.4%, in females was 45.6%. Ischemic stroke (86.l%) was more common than hemorrhagic stroke (13.9%). The results of TOAST classification in this study were as follows: small-vessel occlusion, 72.4% large-artery atherosclerosis. 14.9 % cardioembolism, 4.6% stroke of other determined etiology, 4.6%: stroke of undetermined etiology, 3.5%. Patients in the small-vessel occlusion subgroup in this study were the most frequent. The result of this study is that Korean stroke registry is not in accordance with western medicine. Conclusions : The TOAST classification system is the most widely accepted tool to categorize stroke subtypes in western medicine, but in oriental medicine, it is not yet widely accepted. The authors suggest the general use of the TOAST classification to determine adequate management for stroke patients, to predict the prognosis and recurrence of stroke and to develop a Korean standard of stroke in oriental medicine.

• Journal of Preventive Medicine and Public Health
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• v.6 no.1
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• pp.43-49
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• 1973

In this study noise source in a ward at four general hospitals in Seoul area has been investigated and analysed. The degree of reaction against noise by 171 randomly has also been examined. The results of the study have shown that the source of noise is the speakers of wired broadcasting or from visiting guests in two hospitals located in residential area. The patients at the two other hospitals located at commercial site have been suffered more from traffic noise. However, because of their separated living at hospital from their ordinary houselife, sixty one percent of the inpatients have wished a music sound of around 60 dB (A). After having considered the results of the investigation and wishes of the inpatients, following suggestions have been made: 1. Reduce the number of guests or their length of stay. 2. Wired broadcasting system should be substitued by wireless one, or if it's unavoidable, it should be used in office rooms only. 3. Since the stops and starts of vehicles induce much noise, Seoul City Government be requested to prepare an appropriate administrative measure for the vehicles around hospital area and it should prevent the establishment of new hospitals along high way site. 4. By using earphone, inpatients can choose a wireless channel according to each individual's taste. This through the masking effect, would cover up the noise source. 5. Rooms along the streets should be utilized as offices, otherwise double windows should be set up for inpatient's wards.