• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.4
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• pp.61-69
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• 2022

Purpose: In response to the rapid spread of COVID-19 in 2020, the government supported facilities and equipment through the 'Urgent Isolation Ward Expansion Project'. Design and remodeling of efficient negative pressure isolation facilities had to be done in a short period of time, and the performance gap between facilities was very large because the types of hospitals and wards of existing medical facilities were diverse. In order to secure the stability of isolation wards between medical facilities and reduce the facility gap, guidelines for planning isolation wards considering the diversity of each hospital should be appropriately presented. In consideration of these points, this study aims to provide basic data for future remodeling guidelines for each plan type of the negative pressure isolation ward first. Methods: We analyzed the plans before and after the change of 13 case hospitals that performed the urgent care bed expansion project for COVID-19 confirmed patients. Before the remodeling, the current status of the facility was analyzed according to the type of corridor, the location of the nursing station, and the location of the elevator. After remodeling, the flow of medical staff and patients, the flow of entry and exit of clean and contaminated items, and the space of negative pressure and non-negative pressure areas. Results: The ward type was divided into three types according to the corridor type and room arrangement: double loaded corridor type with two side wards, race track type with one side ward, and race track type with two side wards. Based on these three types, the standard floor plan type of the isolation ward was proposed in terms of the location of the elevator bank and Nurse station. Implications: When the existing general ward is converted into a negative pressure isolation ward, this study can be a basic data to present customized guidelines for each ward type.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.2
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• pp.7-16
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• 2023

Purpose: Seclusion room in a psychiatric facility limit the body and space for treatment or protection, so controversy over human rights violations arises despite their necessity. The seclusion room should be created as an environment that can promote the recovery and healing of patients, not the purpose of managing patients. while ensuring the safety of medical staff. Therefore, the purpose of this study is to compare and analyze the standards of overseas guidelines for the seclusion room in psychiatric facility, and through this, it is intended to contribute to the improvement of facility standards for seclusion rooms in Korea, which are at a very insufficient level. Method: This study takes the method of comparative analysis through literature review. We analyze the facility standards of seclusion room in Korea, and compare and analyze guidelines for seclusion rooms in Australia, US, UK, and Canada. Result: As a result, the elements of the guideline for seclusion room were classified into size, space, opening, furniture and equipment, and etc. The results of comparative analysis of details are presented. Implications: Korea should also prepare guidelines for psychiatric institutions, and among them, the standards for seclusion room, which are at the center of controversy over human rights violations, should be reviewed in depth.

• Journal of Digital Convergence
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• v.20 no.3
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• pp.367-376
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• 2022

The purpose of this study is to investigate the current status of work performance of public health doctors(PHDs) involved in quarantine of COVID-19, and to suggest a plan to support PHDs for effective national epidemic prevention and control in the future. As a result of the study, it was found that PHDs mainly performed sample collection, interview, and treatment. 39% of PHDs worked in places without negative pressure facilities, and personal protective equipment and welfare support were poor. In addition, it was investigated that they experienced high-risk infectious diseases, mental distress, exclusion from the decision-making process, conflicts with officials, problems with work guidelines, and lack of prior education. For effective infectious disease management, it is necessary to assign appropriate ranks and to participate in the decision-making process for quarantine, to specify appropriate compensation and regulations, to education, and to support mental health.

• Journal of Chest Surgery
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• v.56 no.2
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• pp.128-135
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• 2023

Background: Pneumonia caused by severe acute respiratory syndrome coronavirus 2 can cause acute respiratory distress syndrome, often requiring prolonged mechanical ventilation and eventually tracheostomy. Both procedures occur in isolation units where personal protective equipment is needed. Additionally, the high bleeding risk in patients with extracorporeal membrane oxygenation (ECMO) places a great strain on surgeons. We investigated the clinical characteristics and outcomes of percutaneous dilatational tracheostomy (PDT) in patients with coronavirus disease 2019 (COVID-19) supported by ECMO, and compared the outcomes of patients with and without ECMO. Methods: This retrospective, single-center, observational study included patients with severe COVID-19 who underwent elective PDT (n=29) from April 1, 2020, to October 31, 2021. The patients were divided into ECMO and non-ECMO groups. Data were collected from electronic medical records at Ajou University Hospital in Suwon, Korea. Results: Twenty-nine COVID-19 patients underwent PDT (24 men [82.8%] and 5 women [17.2%]; median age, 61 years; range, 26-87 years; interquartile range, 54-71 years). The mean procedure time was 17±10.07 minutes. No clinically or statistically significant difference in procedure time was noted between the ECMO and non-ECMO groups (16.35±7.34 vs. 18.25±13.32, p=0.661). Overall, 12 patients (41.4%) had minor complications; 10 had mild subdermal bleeding from the skin incision, which was resolved with local gauze packing, and 2 (6.9%) had dislodgement. No healthcare provider infection was reported. Conclusion: Our PDT approach is safe for patients and healthcare providers. With bronchoscopy assistance, PDT can be performed quickly and easily even in isolation units and with acceptable risk, regardless of the hypo-coagulable condition of patients on ECMO.

• Journal of The Korea Institute of Healthcare Architecture
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• v.30 no.1
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• pp.37-44
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• 2024

Purpose: The planning of medical facilities involves formulating a comprehensive medical basic plan, translating it into spatial dimensions through a space program. Feasibility assessment often relies on empirical methods like floor area per bed. However, with the shift towards specialized medical concepts, proportional scaling to bed numbers is challenging. This study proposes scale planning improvements during the feasibility assessment stage for comprehensive hospitals, analyzing cases using area determination factors and standard areas based on medical resources. Methods: The Korean Development Institute's Public Investment Management Center (KDI) identified issues in the scale determination of medical facilities in the Preliminary Feasibility Study Guidelines and investigated alternative approaches for determining the scale of a case that passed the preliminary feasibility study in 2019. The study assessed the feasibility of applying individual factors to determine not only the number of beds but also the scale at the sector and department levels. Additionally, a statistical analysis was conducted to examine the correlation between the total number of beds and various area determination factors. Results: Results suggest a strong correlation between total beds and major equipment needs, but in hospitals with <500 beds, this correlation weakens. Ward section scale is better calculated per ward type, not just total beds. Outpatient department scale depends on specialists, influencing treatment room numbers. Medical personnel play a crucial role in determining the scale of sections like rehabilitation therapy rooms, operating rooms, dialysis rooms, and overall facility scale.

• Journal of The Korea Institute of Healthcare Architecture
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• v.30 no.3
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• pp.45-56
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• 2024

Purpose: It is important to note that the relative importance of risk factors should be identified to successfully complete the remodeling project of general hospital. Approached by analytic hierarchy process (AHP), the present study aimed to systematically evaluate the risk factors for remodeling of general hospital. Methods: The present work classified the risk factors of general hospital remodeling into four major categories including the requirements survey stage, planning and design stage, dismantling and construction stage, and maintenance stage. In addition, four sub-categories were derived from each major category factor. Furthermore, five major categories and four subcategories were selected to be considered from the perspectives of two stakeholders of contractor and constructor. The relative importance of the major and sub-categories factors was calculated using the AHP technique on the survey data collected from 49 respondents who participated in the survey study. Results: The results indicate that, the risk factor of requirements survey stage was found to be the most important risk factor to consider among the four major categories of factors. Also, insufficient preliminary investigation, design inconsistencies in architecture/mechanics/electricity, occurrence of safety accidents, and insufficient review of various equipment capacities and performances were found to have the highest priorities of each subcategory factor group included in the four major categories. From the perspective of contractor, the error in predicting the construction period was found to be the most important risk factor. The occurrence of safety accidents during construction was found to be the most important risk factor to be considered by constructor. Implications: The result of the current work should provide important insights and guidelines for the risk management activity that contributes to controlling the project time, cost, and scope required for general hospital remodeling.

• Korean Journal of Applied Biomechanics
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• v.21 no.3
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• pp.369-382
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• 2011

The purpose of this study was to verify the validation of exercise effect with loading deviation during rowing exercise. We performed evaluation of based physical fitness and joint torque before the experiment for finding muscle unbalance. So we recruited twenty four subjects who have bigger muscle strength in more 20% than average one. Subjects divided two groups. One is dominant upper limbs(DU) and the other was dominant lower limbs(DL). Subjects performed rowing exercise using electric equipment (Robo.gym.Humonic.korea). Exercise is performed four sets a day including 25 times a set, and three days a week. Measurement consist of evaluation of based physical fitness and joint torque using biodex(biodex system3.USA). Evaluation of exercise effect performed each week in joint torque of shoulder, lumbar and knee joint and each month in based physical fitness. Also we adapted 30% of 1RM for muscular endurance and 70% of 1RM for muscle strength as exercise load. The results showed that the difference of maximal peak torque were getting increase significantly during exercise. Also difference of various factor in based physical fitness were getting increase significantly except flexibility and agility. This interpreted that rowing exercise with loading deviation types could provide muscle strength and muscular endurance exercise in same time. These results could be interpret to two ways. One is effect of improving physical fitness for rowing exercise and the other meaned validation of loading deviation in rowing exercise. Our study is going to verify the validation of loading deviation during rowing and we found out that loading deviation could provide muscle strength and muscular endurance exercise for improving muscle unbalance. Our study can be used development of exercise equipment and program for normal people with muscle unbalance. Also that provide effect of whole body exercise to anybody.

• Journal of rehabilitation welfare engineering & assistive technology
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• v.12 no.1
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• pp.53-62
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• 2018

In this study, we developed a smart 1RM system for national health management and physical fitness, which enables quantitative 1RM measurement in various types of exercise using digital pulley technology, and to test the effect on training by using it. We developed the smart 1RM system, which is composed of portable muscle strength measuring device, Bluetooth communication based mobile phone data transmission and circuit diagram, and height adjustable system body. We recruited the 30 participants with 20th aged and divided into training and non-performing groups with 15 participants randomly. The participants performed 5 sets of elbow, lumbar, knee extension / flexion 10 times using smart 1RM system and the experimental period was 3 days a week for a total of 8 weeks. The experimental results showed that the maximum strength of the elbow, lumbar, and knee joints was significantly improved before and after maximal muscle strength training in the training group. Oxygen intakes during 1RM exercise mode showed 10.91% than endurance. To verify the validity of the smart 1RM maximal strength data, the reliability was 0.895 (* p <0.00). This study can be applied to the early rehabilitation treatment of the elderly and rehabilitation patients more quantitatively using the national health care.

• Safety and Health at Work
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• v.13 no.3
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• pp.263-268
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• 2022

Health care workers (HCWs) are more than ten times more likely to be infected with coronavirus infectious disease 2019 (COVID-19) than the general population, thus demonstrating the burden of COVID-19 among HCWs. Factors that expose HCWs to a differentially high-risk of COVID-19 acquisition are important to elucidate, enable appropriate public health interventions to mitigate against high risk and reduce adverse outcomes from the infection. We conducted a systematic review and meta-analysis to summarize and critically analyze the existing evidence on SARS-CoV-2 risk factors among HCWs. With no geographical limitation, we included studies, in any country, that reported (i) the PCR laboratory diagnosis of COVID-19 as an independent variable (ii) one or more COVID-19 risk factors among HCWs with risk estimates (relative risk, odds ratio, or hazard ratio) (iii) original, quantitative study design, and published in English or Mandarian. Our initial search resulted in 470 articles overall, however, only 10 studies met the inclusion criteria for this review. Out of the 10 studies included in the review, inadequate/lack of protective personal equipment, performing tracheal intubation, and gender were the most common risk factors of COVID-19. Based on the random effects adjusted pooled relative risk, HCWs who reported the use of protective personal equipment were 29% (95% CI: 16% to 41%) less likely to test positive for COVID-19. The study also revealed that HCWs who performed tracheal intubations were 34% (95% CI: 14% to 57%) more likely to test positive for COVID-19. Interestingly, this study showed that female HCWs are at 11% higher risk (RR 1.11 95% CI 1.01-1.21) of COVID-19 than their male counterparts. This article presents initial findings from a living systematic review and meta-analysis, therefore, did not yield many studies; however, it revealed a significant insight into better understanding COVID-19 risk factors among HCWs; insights important for devising preventive strategies that protect them from this infection.

• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.33 no.2
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• pp.115-125
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• 2023

Objectives: This study was conducted to measure the level of radon in the air at a highway tunnel construction site in a gneiss area using the New Austrian Tunneling Method (NATM) and to evaluate exposure levels by occupation. Methods: Radon concentrations in the air were measured using E-PERM at points 300 m, 600 m, and 900 m from the tunnel entrance during the excavation and waterproofing work inside the tunnel. In addition, radon concentrations were measured during external excavation to compare with the inside of the tunnel. Personal exposure levels for major occupations including tunnel workers, construction equipment operators, waterproofers, shotcrete workers, and safety and health managers who participated in the construction were estimated using radon concentration measured in the work process area and working hours by occupation. Results: As a result of a total of 77 radon measurements, the geometric mean (GM) concentration was 71.1 Bq/m³, and the maximum concentration was 127.3 Bq/m³, which was below the indoor air quality criteria. Radon concentration by process decreased in the order of the tunnel excavation process (GM= Bq/m³, GSD=1.2), waterproofing process (GM=73.35 Bq/m³, GSD=1.2), and outside excavating process (GM=45.28 Bq/m³, GSD=1.2). Processes inside the tunnel were significantly higher than outside excavating processes (p<0.05). There was no statistically significant difference in radon concentration measured inside by distance from the tunnel entrance, but the innermost point of the tunnel, 900 m (GM=79.24 Bq/m³, GSD=1.27), measured the highest. Conclusions: The occupation with the highest individual exposure to radon was tunnel worker (64.16 Bq/m³), followed by construction equipment driver (64.04 Bq/m³) and waterproofer (63.13 Bq/m³).