• Quality Improvement in Health Care
• /
• v.2 no.2
• /
• pp.156-171
• /
• 1996

Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.

• Korea Journal of Hospital Management
• /
• v.6 no.3
• /
• pp.109-129
• /
• 2001

The purpose of this study was the acquisition of the optimum scale of the apportionment of standard & high-class bed for the maximum profit representative of the desire of customers in a General Hospital with 1,100 beds located in Seoul. This investigation was proceeded by the analysis of the result of the simulation with the survey of both the patients' needs for bed and the degree of the medical service by the grade of the ward. And finally the consequence was obtained as follows: 1. The result of the investigation of the inpatients' preference for the grade of ward classes shows that a private ward reflected 4.3 percent, a semi-private ward 1.7 percent, a three-bed ward 0.1 percent, and a ward with six beds 93.9 percent each other. 2. A questionnaire poll was paralleled of service terms of a medical doctor and a nurse by ward class, the data were used for the standard of the allotment of labor cost by the ward class. The poll shows that the service tenn of a medical doctor and a nurse based on a ward with six beds by ward class showed 1.7 times in internal medicine and 1.9 times in surgery at a private ward; 1.4 times in internal medicine and 1.7 times in surgery at a semi-private room; and 1.2 times both in internal medicine and in surgery at a three-bed ward 3. The resultant findings revealed the most profit per bed and per patient in a private ward. However, an analysis of profit with a standard of unit area by ward class represented a higher profit in both the internal medicine and the surgery semi-private ward than other ward classes. 4. The result of the analysis through simulation based on the data of the prime cost per the ward class proved the optimum scale of the distribution of beds by class as follows: sixteen beds of the internal medicine and twenty three beds of the surgery in the private ward; two hundreds and two of the internal medicine and one hundred and ninety eight of the surgery in the semi-private room; three of both the internal medicine and the surgery each other in the three-bed ward; one hundred and ninety eight of the internal medicine and two hundred and fifty two of the surgery in the ward with six beds. The result of this research exhibits that the income and expenditure of the hospital could be improved by changing parts of wards into private ones(containing the maximum profit per a unit of width) in case the scale of the number of beds is reset with the consideration of the profit per the unit width. In the near future it's strongly expected that the research for the more scientific standard of the allotment of labour cost by ward class and for definition of the optimum scale of the number of beds that actualize the maximum profit with the change of the three elements of the prime cost: cost of materials; labor costs; management expenses.

• Journal of Korean Academy of Nursing
• /
• v.15 no.3
• /
• pp.5-20
• /
• 1985

The purpose of this study was to assess the value-of post-operative treatment in terms of nursing care in the allevation of pain. More specifically, the effects of supportive touch and patient education were examined. On the date before each patient's operation, the Bevels of anxiety, depression and affiliation were examined. The post-operative treatment was adminis. tered after an initial measurement of the patient's fain, according to the experimental category for the three days following the operation. On the final day, the level of anxiety and depression were again measured. The subjects of this study were 138 patient from the general surgical and gynecological wards in H university Hospital in Seoul. The study was conducted over a three-month period from June 24, 1984 to September 18, 1984. All patients had undergone laparatomies. Various standard instruments were used to measure the pain, anxiety, depression and affiliation levels. for pain, 5 grate Simple Descriptive Scale, and the Mclachlan four-range Observational Pain Scale were employed. For anxiety and depression, respectively the Spielberger State Anxiety Inventory and Beck Depression Inventory (B.D.I.) were used. Lastly, the affiliation was determined by the Mehrabian Affiliation Scale. The outcome of the research was as follows: 1. The first hypothesis concerning the existence of lower pain levels of Experimental Group A and Experimental Group B than the pain levels of Control Croup C was not supported. 2. The second hypothesis concerning the existence if lower anxiety levels of Experimental Group A and Experimental Group B than the anxiety levels of Control Group C was supported at the level of F=3.58 (p=.03). 3. The third hypothesis concerning the existence of lower depression levels of Experimental Group A and Experimental Group B than the depression levels of Control Group C was not supported. 4. The fourth hypothesis concerning the existence of different levels of pain in accordance with the levels of affiliation in Experimental Group A was not supported. 5. A positive correlation did exist between pain and anxiety after surgery (r=.34, p=.0001). Thus, the fifth hypothesis was supported. 6. A positive correlation did exist between pain and depression following surgery(r=.36, p=.0001). Thus, the sixth hypothesis was supported. Based on the above results, it was found that supportive touch and patient education either through human sources or via tape recorder do influence the anxiety of a patient after surgery, that a Positive correlation between pain, anxiety and deparession exist, that affiliation does not alter the influence of supportive touch, and that the graph on which pain levels were depicted indicates the possibility of development even if the effects of supportive touch did not reach a meaningful level. Thus it can be concluded that patient education, regardless of its form, is essential for the patient after surgery and that supportive touch, when reasonably modified and supplemented, can be an effective method of alleviating pain.

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

• Korean Journal of Adult Nursing
• /
• v.13 no.2
• /
• pp.209-222
• /
• 2001

The environment in the ICU leads to negative changes in a patient's usual sleep pattern and so contributes negatively to the patient's health condition as compared to patients in general wards. Therefore, it is thought that an important nursing intervention would be to identify the relation between noise and sleep patterns which play an important role in illness recovery. The purpose of the present study was to explore the relationship between noise in the ICU and the sleep pattern of patients admitted to the ICU. A descriptive correlation design was used to examine the relationship. Thirty-four subjects were recruited from a Medical ICU (MICU), Surgical ICU (SICU) and Coronary Care Unit (CCU) at a large university hospital in Suwon. Data were collected from September 28 to October 31 in 1999. In the present study, noise was categorized into noise level and patients' perception of noise. The objective noise level was measured using the A-Weighted Sound Level Meter. The patients' preception of noise was measured using a self-reported questionnaire developed by the researcher. Sleep patterns in this study includes both quantity and quality of sleep. These were measured using open ended questionnaires and the 'Korean Sleep Scale A' developed by Oh, Song, Kim(1998). The data was analyzed using the SPSS-WIN to test the research question, Pearson product moment correlation coefficient was run. Ancillary analysis were conducted with demographic variables to determine their relation to the main study variables. For the ancillary analysis, t-test and one-way ANOVAs were performed. The results of the present study are summerized as follows : 1. The total mean of objective noise level (10pm-6am) was 56.2dB. The means for night time noise level in individual ICUs for the SICU, MICU and CCU, were 58.7dB, 58.6dB and 48.3dB, respectively. The total mean for patients' noise perception was 42.8 out of a maximum possible score of 76. For item means of noise perception, the one ranked highest was "conversations between doctors and nurses" (3.2). The one ranked lowest was "noise from the radio" (1.2). Regarding the degree of perception for each type of noise source, the one ranked highest was "equipment noise" (2.6), the second was "conversation between medical staff" (2.4), the third was "conversation between patients, caregivers and visitors" (2.3), and the one ranked lowest was "environment noise" (1.8). 2. Looking at quantity of sleep of ICU patients, the mean nocturnal sleep time was found to be 4.9 hours. The total mean of sleep quality for ICU patients was 21.0 out of a maximum possible score of 40. 3. The relationship between perception of noise and quantity of sleep was statistically significant(r= - .41, p<.05). The relationship between perception of noise and quality of sleep was also statistically significant(r= - .47, p<.01). The results of the study indicate that personal perception of noise is related to sleep patterns. Therefore, it is suggested that nursing interventions be developed to reduce the degree of personal perception of noise and, thus, decrease sleep pattern disturbances in patients in the ICU.

• Journal of radiological science and technology
• /
• v.40 no.1
• /
• pp.7-12
• /
• 2017

The study was performed to investigate the bacteriological contamination of portable digital radiography system and their detectors in a university hospital. CNS and VRE were detected in the samples collected from vinyl cover on detectors used for the infection control patients. On the other hand, no bacteria was detected in the samples collected from detectors with vinyl cover removed. In the series of imaging of patients from general wards, no bacteria was detected from the patient 1. However, CNS was detected from the patients 2 and 3, CNS and Enterococcus faecalis detected from the patient 4, CNS and Enterococcus casseliflavus detected from the patient 5, and CNS, Enterococcus casseliflavus, and Klebsiella pneumoniae all detected from the patient 6. CNS and Enterococcus faecium were detected in the controller handle of collimator. Also, CNS was detected from the handle of detector and exposure switch. In the treatment gloves of the radiological technologist after the imaging, CNS, Enterococcus gallinarum, and Klebsiella pneumoniae were detected. Therefore, it is recommended for DR portable to take images after sterilizing the detector after taking each image and to use disposable vinyl covers on detectors to remove after imaging. And treatment gloves must be changed after each imaging. Also, hospital infection via portables must be prevented by complete sterilization of the controller handles of collimator which are in frequent contact during imaging and infection education of employees.

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

• Journal of Hospice and Palliative Care
• /
• v.18 no.3
• /
• pp.235-244
• /
• 2015

Purpose: The aim of this study was to investigate pediatric nurses' perception and knowledge about pediatric hospice and palliative care. Methods: A cross-sectional descriptive study was conducted with 132 nurses who are stationed in pediatric wards and intensive care units. The participants were requested to fill out a questionnaire comprising 23 items for perception and 20 items for knowledge. Data were collected after obtaining written consent. Data were analyzed using SPSS 21.0. Results: Participants perceived difficulties in pediatric hospice palliative care, especially communication with patients and their families. The differences of perception among participants were observed according to pediatric hospice and palliative care experience, but not general characteristics. Participants' knowledge was $8.83{\pm}2.64$. Nurses who work in a ward showed higher level of knowledge about pediatric hospice/palliative care. Conclusion: An education program should be developed and provided to pediatric nurses to improve their perception and knowledge about pediatric hospice/palliative care.

• The Journal of the Convergence on Culture Technology
• /
• v.7 no.2
• /
• pp.107-116
• /
• 2021

Purpose : To examine the relationship among osteoporosis knowledge, osteoporosis preventive behaviors, self-efficacy and health-related quality of life of middle aged women and to find out factors which influence health-related quality of life. Methods : For study subjects, female patients aged 40 to 64 and hospitalized at the surgical wards of two general hospitals in G city were conveniently sampled. The data have been collected from January 11 to March 10, 2018. Data were analyzed by descriptive statistics, t-test, ANOVA, Scheffe's test, Pearson's correlation coefficient, and multiple regression. Results : The average score of osteoporosis knowledge was 12.50±3.47, the average score of osteoporosis preventive behaviors was 44.96±8.16 and the average score of osteoporosis self-efficacy was 40.38±8.07. The factors influencing EQ-5D Index in health-related quality of life were comorbidity, osteoporosis preventive behaviors, osteoporosis knowledge and average monthly income, which could account for health-related quality of life at 18.0%. The factors influencing EQ-5D VAS were osteoporosis preventive behaviors, self-efficacy, osteoporosis knowledge and age of menarche, which could account for health-related : Higher osteoporosis knowledge, osteoporosis preventive behaviors and self-efficacy, the better the subjects health-related quality of life. Therefore, as a way to promote health-related quality of life of middle aged women, the constant development and the application of a program which may promote osteoporosis knowledge, osteoporosis preventive behaviors and self-efficacy are needed.

• Journal of The Korean Society of Clinical Toxicology
• /
• v.16 no.2
• /
• pp.131-140
• /
• 2018

Purpose: The National Emergency Medical Center has been running a project for the storage and delivery of antidotes for acute poisoning patients of the Department of Health and Welfare, Korea. This study analyzed the results of this project over the past two years. Methods: The requests received by the National Emergency Medical Center and the data on the delivery process were analyzed. Results: This study analyzed a total of 121 patients with acute poisoning, who were requested to receive an antidote reserved at 20 key hospitals in 2015-2017, and whose age was $52.3{\pm}23.5\;years$; old; 54 were women. Intentional poisoning were 58.7%, and the home was the most common place of exposure (66.9%). The toxic substances were chemicals (32.2%), pesticides (27.3%), medicines (24.8%), and snake venom (4.1%). The patient's poison severity score was $2.4{\pm}0.7$ (median 3) indicating moderate-to-severe toxicity. Antidote administration was the cases treated in key hospitals 67.8% (82/121), in which transferred patients accounted for 57.3% (47/82). After receiving an antidote request from a hospital other than the key hospitals, the median was 75.5 minutes (range 10 to 242 minutes) until the antidote reached the patient, and an average of 81.5 minutes was required. The results of emergency care were intensive care unit (70.3%), general wards (13.2%), death (10.7%), and discharge from emergency department (5.0%). Conclusion: This study showed that the characteristics of acute poisoning patients treated with an antidote were different from previous reports of poisoned patients in the emergency department, and basic data on the time required for delivery from key hospitals was different.