Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
Quality Improvement in Health Care
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v.7
no.2
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pp.138-155
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2000
Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.
Journal of the Korea Academia-Industrial cooperation Society
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v.11
no.12
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pp.4863-4872
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2010
This study examined the disease conditions of patients from a farming and fishing village area. In order to analyze the medical service utilization, the necessary data were obtained from established health and medical care service plans from medical treatment related organizations. The following results were based on the analysis of data from the medical records of 2,365 discharged patients during a six months period from July to December 2009 at a general hospital in an aging farming and fishing village area. Results: The sex of the patients investigated was male 55.3%, female 44.7%, and the most frequent age category at 42.0% was 70 years of age or older. Based on type of hospital admission, 65.5% of patients who were admitted were originally outpatients. Patients were admitted according to the following departments: 49.7% for the department of internal medicine, 16.7% for the department of orthopedics, and 13.8% for the department of neurosurgery. The average number of days hospitalized was 14.8 days. The following ranks the principal diagnosis among patients in this study: S00-T98 18.4%, J00-J99 15.5%, and I00-I99 11.5%. The average number of diagnosis listed per patient was 5.6. There was a statistically significant difference for the following general characteristics according to principal diagnosis list: gender, type of insurance, admission process, and age category distribution had statistically significant differences. Monthly distribution of principal diagnoses were statistically significant difference. There was a statistically significant difference for principal diagnosis lists according to the average number of days admitted and the number of diagnosis. The results of this study showed the types of disease from typical farming and fishing village regions as disease from external injury due to the work environment of farming and fishing village regions and excessive labor throughout the year, respiratory disease, and various chronic disease from aging.
The purpose of this study was to evaluate community dental hygiene practice education, by verifying its effect after applying project-based learning in improving the practical and social skills of learners. A 15-week project-based community dental hygiene practice course was held for 27 senior students, who took community dental hygiene practice course in the Department of Dental Hygiene, Gangneung-Wonju National University. Twenty-seven students were composed of 4 teams. Each team selected a target group for four workplaces for adult workers to apply the oral health promotion project. The project was then planned and conducted based on a survey on the health problems confronting each group, and an evaluation was carried out after 4 weeks. From the results obtained in comparing confidence in problem solving ability, project value, teamwork competency, and community dental hygienist competence before and after course, the improvement in project value and teamwork competence scores was not statistically significant, but all four areas showed positive results. After analyzing the project actuality, learning outcomes, and project satisfaction after course results, the actuality of the project was 19.30 points, the learning achievement was 45.19 points, and the satisfaction was 19.19 points, demonstrating that the aim of achieving actual performance competence and a learning performance exceeding expectations was accomplished. After conducting an interview survey with 8 students, it was found that they had learned social skills involving problem-solving abilities and confidence, and teamwork competence such as cooperation, role responsibility, creative thinking ability, and communication skills. Community dental hygienists should be able to acquire learner-level practical skills and social skills in the community dental hygiene and practical courses, according to their competencies and job needs. It is necessary to develop a project?based systematic learning module to enable the community dental hygiene practice to operate as a subject closely related to fields in other dental hygiene departments.
Journal of Korean Academy of Nursing Administration
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v.1
no.1
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pp.147-211
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1995
Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.
This research was conducted in order to examine the effect of tooth brushing room M elementary school in Changwon-city and to provide foundation data for effective project operation afterwards. The subjects were 347 students at the M elementary school where the tooth brushing room was being taught. The control group is 289 students at J elementary school where the tooth brushing room was not being taught. Research and analysis were carried out with structured survey and examination of decayed, missing, filled teeth (DMFT) index, decayed, missing, filled tooth surface (DMFS) index and O'leary index. The data was analysed by IBM SPSS Statistics ver. 19.0 program and the result is as follows: Depends on the tooth brushing room there was difference in statistical significance in filling teeth, sealant tooth surface, filling tooth surface, missing tooth surface, DMFS, O'leary index between the subject and control group. The less the frequency of brushing, the higher the DMFT index. Negative correlation was statistically significant. With incorrect brushing method, the less the frequency, the higher the DMFS index, Negative correlation was statistically significant. When the tooth brushing room was being implemented, O'leary index became low, negative correlation was statistically significant. As a result, in order to continue the effective operation of tooth brushing room, constant supervision and monitoring on students should be acutely needed by a principal, a school nurse and teachers in charge. Also together with a systemized cooperation between a health center and a nearby university's related majors departments, the research proposes to execute constant oral health education and to expand the implementation project of the tooth brushing room at nearby elementary schools.
Journal of the Korea Academia-Industrial cooperation Society
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v.22
no.3
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pp.679-687
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2021
The purpose of the present study was to document the standardization and management process of interface terminology regarding the chief complaints, diagnoses, and procedures, including surgery in a four-hospital consortium. The process was proposed, discussed, modified, and finalized in 2016 by the Terminology Standardization Committee (TSC), consisting of personnel from four hospitals. A request regarding interface terminology was classified into one of four categories: 1) registration of a new term, 2) revision, 3) deleting an old term and registering a new term, and 4) deletion. A request was processed in the following order: 1) collecting testimonies from related departments and 2) voting by the TSC. At least five out of the seven possible members of the voting pool need to approve of it. Mapping to the reference terminology was performed by three independent medical information managers. All processes were performed online, and the voting and mapping results were collected automatically. This process made the decision-making process clear and fast. In addition, this made users receptive to the decision of the TSC. In the 16 months after the process was adopted, there were 126 new terms registered, 131 revisions, 40 deletions of an old term and the registration of a new term, and 1235 deletions.
The evaluation of malocclusion has to be done quantitatively and qualitatively. This will be lead toward an analysis of malocclusion severity as well as treatment difficulty. The method of proper evaluation of malocclusion severity and treatment difficulty is necessary to assess treatment effect and efficiency for the orthodontists and to establish fundamentals for planning and executing the health-related policies in private and public institutions. The purposes of this study as the first part of the objective and quantitative analysis of malocclusion were 1) to measure treatment difficulty based on the opinions of several orthodontists. and 2) to investigate the relationships between objective malocclusion severity and subjective treatment difficulty 100 pairs of dental casts that had various types and severity of malocclusion were selected from the orthodontic departments of Kyurghee University and Samsung Medical Center The objective malocclusion severity was measured with the PAR (Peer Assessment Rating) index and the subjective treatment difficulty was evaluated by 8 experienced orthodontists. The relationships between objective malocclusion severity and subjective treatment difficulty were statistically evaluated. There were significant relationships between objective malocclusion severity and subjective treatment difficulty especially in the measurements of the upper anterior alignment, the buccal occlusion. the overjet, the overbite and the midline discrepancy en the malocclusion components. The results of this study can provide the background knowledge to develop a new occlusal index. which contains both the malocclusion severity and treatment difficulty for Korean orthodontists.
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