• 한국의료질향상학회지
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• 제14권1호
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• pp.49-54
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• 2008

Background : This study was to reduce incidence of falls by analyzing actual problem and drawing out improvement plan applicable to the clinical practice through operation of the staff nurses-centered fall peer review group. Method : The fall peer review group was composed of 8 nurses having patient nursing experience for over 5 years, and each of fall cases was reviewed and the root cause was analyzed. As a result, it was found that the patients and their families did not fully understandthe content of the education, and the staff nurses did not completely inspect the risk factors of falls and perform immediate intervention when patient's condition changed. Based on the above-mentioned results, improvement activity was conducted for the purposes of consolidating patients education method and supplementing computerized system to support nurses' decision making as well as devices and facilities. Result : As a result of conducting improvement activity in the aspects of education for patients, support of nurse's decision-making, and devices and facilities through operation of the staff nurses-centered fall peer review group, falls decreased by 9.5% compared to before improvement activity. Conclusion : It is concluded that operation of the clinical nurses-centered fall peer review group played a role of promoter to draw out practical and applicable improvement plan to the clinical practice and apply directions of the field-centered, and increased nurses' interest in falls and ultimately, reduced incidence of falls. Therefore the Center will continue to operate the staff nurses-centered peer review group, and recommends participation of nurses who actually take the charge of nursing patients in further analysis of patients' safety accidents.

• 한국산학기술학회논문지
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• 제11권1호
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• pp.335-340
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• 2010

신종 및 재출현 전염병이 지속적으로 유행하고 해외 전염병의 국내유입 가능성이 증대됨에 따라 국립검역소의 검역관리 사업의 효율성 평가는 매우 중요하다. 본 연구는 평가 구성요소 사이의 상대적 중요도, 즉 가중치(weight) 부여에 있어서 과학적 타당성을 인정받고 있는 계층분석절차(Analytical Hierarchy Process; AHP) 기법에 의한 이원비교방법을 사용하여 설정하였다. AHP기법은 복잡한 다기준 의사결정문제(multi-criteria decision making problem)를 계층화하여 단순화 체계화시킴으로써 그 영향도를 계량화하는데 탁월한 기법이라는 평가를 받고 있다. 평가지표별 가중치는 기관평가 영역이 0.2, 서비스 및 프로그램 영역이 0.8로 분석되었으며, 서비스 및 프로그램 영역내에서 검역 업무가 0.45로 가장 높게 나타났다. 대영역(기관평가영역, 서비스 및 프로그램평가 영역), 중영역(투입, 과정, 결과, 검역업무, 검사업무, 위생관리업무, 병원체조사감시업무, 전염병예방홍보 교육업무)으로 구분하여 최종적으로 평가지표로 선정된 지표는 실제 국립검역소 사업에 적용하였으며, 이에 대한 최소한의 평가지표를 최종 선정하여 향후 국립검역소 사업평가 체계를 보다 체계화 하였다.

• Journal of Preventive Medicine and Public Health
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• 제21권1호
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• pp.195-206
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• 1988

Two major issues of the blood bank management are quality assurance and inventory control. Recently, in Korea blood donation has gained popularity increasingly to allow considerable improvement of the quality assurance with respect to blood collection, transportation, storage, component preparation skills and hematological tests. Nevertheless the inventory control, the other issue of blood bank management, has been neglected so far. For the supply of blood by donation barely meets the demand, the blood bank policy on the inventory control has been 'the more the better.' The shortage itself by no means unnecessitate inventory control. In fact, in spite of shortage, no small amount of blood is outdated. The efficient blood inventory control makes it possible to economize the blood usage in the practice of state-of-the-art medical care. For the efficient blood inventory control in Korean hospitals, this tudy is to develop formulae forecasting the standard blood inventory level and suggest a set of policies improving the blood inventory control. For this study informations of $A^+$ whole bloods and packed cells inventory control were collected from a University Hospital and the Central Blood Bank of the Korean Red Cross. Using this informations, 1,461 daily blood inventory records were formulated.48 varieties of blood inventory control environment were identified on the basis of selected combinations of 4 inventory control variables-crossmatch, transfusion, inhospital donation and age of bloods from external supply. In order to decide the optimal blood inventory level for each environment, simulation models were designed to calculate the measures of performance of each environment. After the decision of 48 optimal blood inventory levels, stepwise multiple regression analysis was started where the independent variables were 4 inventory control variables and the dependent variable was optimal inventory level of each environment. Finally the standard blood inventory level decision rule was developed using the backward elimination procedure to select the best regression equation. And the effective alternatives of the issuing policy and crossmatch release period were suggested according to the measures of performance under the condition of the standard blood inventory level. The results of this study' were as follows ; 1. The formulae to calculate the standard blood inventory level($S^*$)was $S^*=2.8617X(d)^{0.9342}$ where d is the mean daily crossmatch(demand) for a blood type. 2. The measures of performace - outdate rate, average period of storage, mean age of transfused bloods, and mean daily available inventory level - were improved after maintenance of the standard inventory level in comparison with the present system. 3. Issuing policy of First In-First Out(FIFO) decreased the outdate rate, while Last In-First Out(LIFO) decreased the mean age of transfused bloods. The decrease of the crossmatch release period reduced the outdate rate and the mean age of transfused bloods.

• 한국콘텐츠학회논문지
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• 제14권5호
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• pp.107-116
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• 2014

본 연구는 지역사회네트워크 기반 사회복지프로그램 기획을 준비함에 있어 컨셉트 맵핑을 활용하고 그 적용가능성을 경험적으로 확인하는 것이다. 컨셉트 맵핑은 다양한 이해관계자들 사이의 모호하고 복잡한 아이디어를 구조화하여 시각적으로 제시해 주는 의사결정 도구이다. 이미 상담, 간호, 공중보건 등 휴먼서비스 영역을 중심으로 프로그램 기획 및 평가 과정에서 나타나는 복잡하고 추상적인 아이디어를 개념화하는데 활용되고 있다. 최근, 우리나라에서도 상담 및 의료 영역에서 서비스 제공자와 이용자 간의 존재하는 성과의 차이를 경험적으로 인지하고, 합의를 이끌어 내는 도구로 활용하고 그 효과성이 발표되고 있다. 본 연구에서는 부산광역시 북구에서 아동 청소년을 대상으로 진행되고 있는 부산공동모금회지원 CI사업의 3차년도 사업기획을 준비하면서 사업주체들이 기대하는 성과를 컨셉트 맵핑을 활용하여 개념화하였다. 컨셉트 맵핑은 준비 단계, 아이디어 수집 단계, 서술문 구조화 단계, 표현 단계, 분석결과 해석 단계, 유용화 단계로 이루어졌다. 참여자들은 부산 북구 사회복지기관 종사자 11명이였으며, 이들이 제시한 서술문은 총 60개였다. 이들이 제시한 서술문을 유사성 행렬 형태로 전환하여 다차원 척도법 분석을 실시하였다. 군집은 총 5개로, '아동 청소년의 인식 및 태도변화', '아동 청소년 체계의 변화', '우호적인 지역사회 형성', '지역주민의 변화', '사업공급주체의 변화'였다. 이 중 가장 우선적으로 성취되어야 할 성과는 '아동 청소년의 인식 및 태도 변화'로, 이 성과를 중심으로 3차년도 사업을 기획하게 되었다. 컨셉트 맵핑을 활용하여 성과를 개념화하는 의사결정과정을 거치면서, 참여 구성원들은 사업의 성과에 대해 명확하게 개념화하였고, 이 성과에 대한 합의가 도출되었다.

• Journal of Multimedia Information System
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• 제7권2호
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• pp.147-156
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• 2020

The author Nakajima was involved in the field of disaster communications and emergency medical care as guest research scientist at the Fukushima Nuclear Accident Independent Investigation Commission established by the National Diet of Japan and reviewer of the Commission's report, and Kurokawa was the chairman of this Commission. Looking back over a decade, we are on the liability issue of bureaucrats and telecom operators, so it's becoming clear what was hidden at the time. The battery of NTT DoCoMo's mobile phone repeaters had a capacity of only about 24 hours, and communication failures increased after one day. The Government also failed to issue an announcement of "Vent from reactor" under the Telecommunications Act Article No. 129. This mistake lost the opportunity to use the third-party telecommunications (e.g. taxi radios). Furthermore, as a result of LASCOM (telecommunications satellite network for local governments via GEO) and a variety of unexpected communication failures, the evacuation order "Escape!" could not be notified to the general public well. As a result, the general public was exposed to unnecessary radiation exposure. Such bureaucratic slow action in emergencies is common in the response to the 2020 coronavirus.

• 간호행정학회지
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• 제15권4호
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• pp.571-580
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• 2009

Purpose: The purpose of this study was to explore roles of cancer care coordinator's by developing job description, job specification and job process map using dynamic job analysis. Method: The development process consisted of three stages of vertical job analysis and three stages of horizontal job analysis by modifying Song(1997)'s dynamic job analysis. Focus group interview was used to validate the content of the job analysis. Results: Cancer care coordinator's job description was categorized into six major categories, fourteen intermediate categories and one hundred forty specific jobs. Major categories are professional nursing practice, consultation and counsel, coordination and collaboration, education, research and leadership. Cancer care coordinator's job specification included master's degree with over five years of clinical experience preferably relevant clinical area, professional knowledge on pathophysiology of cancer, case management and cost control, competency for communication and counselling skills and clinical decision making. Cancer care coordinator's job process map was framed with time(horizontal) and activities(vertical). Conclusion: The Outcomes of this study will guide to develop possible areas of oncology advanced practice nurses in hospital setting and facilitate the use of oncology nurse practitioners by developing care coordinator roles in cancer care.

• 생물정신의학
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• 제14권1호
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• pp.14-20
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• 2007

Objectives : The diagnosis of depression is based on a highly variable set of symptoms. Therefore, depression should not be viewed as a single disease, but a heterogenous syndrome comprised of different pathophysiologies. There are several subtypes of depression which were already incorporated in DSM-IV. This article provides a systematic review of pharmacological treatments of two recognized subtypes of depression-dysthymic disorder and atypical depression. Methods : Systematic search of relevant literatures on dysthymic disorder and atypical depression was performed by proposed search strategy of the Clinical Research Center for Depression of Korean Health 21 R&D Project. All identified literatures were carefully reviewed and classified according to SIGN grading system and summarized in a narrative manner. Results : For the treatment of dysthymic disorder and atypical depression, selective serotonin reuptake inhibitors( SSRIs) and moclobemide have more evidence than the other antidepressants. SSRIs and moclobemide showed superior tolerability than tricyclic antidepressants. Conclusions : The authors proposed treatment recommendations for dysthymic disorder and atypical depression by the methods of evidence-based medicine(EBM). However, guideline developing methods of EBM also have several inevitable limitations. Therefore, in the absence of clear and significant differences in efficacy, the choice of medication must be individualized for a particular patient based on psychiatrist's own clinical decision.

• Journal of Preventive Medicine and Public Health
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• 제51권1호
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• pp.1-5
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• 2018

Smokers keep smoking despite knowing that tobacco claims many lives, including their own and others'. What makes it hard for them to quit smoking nonetheless? Tobacco companies insist that smokers choose to smoke, according to their right to self-determination. Moreover, they insist that with motivation and willpower to quit smoking, smokers can easily stop smoking. Against this backdrop, this paper aims to discuss the addictive disease called tobacco use disorder, with an assessment of the addictiveness of tobacco and the reasons why smoking cessation is challenging, based on neuroscientific research. Nicotine that enters the body via smoking is rapidly transmitted to the central nervous system and causes various effects, including an arousal response. The changes in the nicotine receptors in the brain due to continuous smoking lead to addiction symptoms such as tolerance, craving, and withdrawal. Compared with other addictive substances, including alcohol and opioids, tobacco is more likely to cause dependence in smokers, and smokers are less likely to recover from their dependence. Moreover, the thinning of the cerebral cortex and the decrease in cognitive functions that occur with aging accelerate with smoking. Such changes occur in the structure and functions of the brain in proportion to the amount and period of smoking. In particular, abnormalities in the neural circuits that control cognition and decision-making cause loss of the ability to exert self-control and autonomy. This initiates nicotine dependence and the continuation of addictive behaviors. Therefore, smoking is considered to be a behavior that is repeated due to dependence on an addictive substance, nicotine, instead of one's choice by free will.

• 한국지하수토양환경학회:학술대회논문집
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• 한국지하수토양환경학회 2003년도 총회 및 춘계학술발표회
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• pp.25-39
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• 2003

Risk and exposure assessment for subsurface environment is very important for both aspects of health and environmental protection as well as making decision of remedial goal for engineering activities. Exposure due to hazardous chemicals in the subsurface environment is essential to assess risk lev121 to individual person, especially from soil and groundwater environmental media. In this paper, the status of soil and groundwater contamination is presented to discuss on the problem for environmental risk assessment. The methodologies of fate and exposure models are also discussed by conducting the case studies of exposure assessment for heavy metals, organic compounds, and dioxin compounds. In addition, the structure of exposure models and available data for model calculation are examined to make clear more realistic exposure scenarios and the application to the practical environmental issues. Three kinds of advanced remediation techniques for soil and groundwater contamination are described in this paper, The most practical method for VOCs is the bio-remediation technique in which biological process due to consortium of microorganisms can be applied. For more effective remediation of soil contaminated by heavy metals we have adopted the soil flushing technique and clean-up system using electro-kinetic method. We have also developed the advanced techniques of geo-melting method for soil contaminated by DXNs and PCB compounds. These techniques are planed to introduce and to apply for a lot of contaminated sites in Japan.

• 대한안전경영과학회지
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• 제14권1호
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• pp.33-42
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• 2012

This paper dealt with developing conceptual model for making public policy on consumer product safety. The matters of consumer safety, public health and environmental protection are essential parts of making policy for consumer products. Moreover, policy authority should consider all measures based on consumer safety. In the process making regulations, policy authority has to have some methods to prevent errors on treating eligible persons as persons disqualified under uncertainty decision making of public policy. To recognize and ensure fairness on public policy, policy authority needs to establish basic policy making and fundamental concepts. Therefore, we developed conceptual model for consumer products safety, CPSPcon in this paper. The conceptual model is one part of SSM(Soft System Methodology) and can support specific policy target. The CPSPcon model can assist in evaluation of responses to an adapting or considering model.