• 보건행정학회지
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• 제24권3호
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• pp.254-260
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• 2014

Background: The purpose of this study is to assume appropriate outpatient consultation time for each clinical department on the basis of measured outpatient consultation time and satisfaction of outpatient. Methods: We surveyed the feeling and satisfactory outpatient consultation time, satisfaction, revisiting intention and recommendation to others to 1,105 patients of single general hospital in Gyeonggi-do and measured their real outpatient consultation time from October 28 to November 27 in 2013. On the basis of satisfaction, we estimated appropriate outpatient consultation time through area under the receiver operating characteristic curve in logistic regression model. Results: Feeling outpatient consultation time was 5.1 minutess, satisfactory outpatient consultation time which was suggested by patient was 6.3 minutes, and real outpatient consultation time was 4.2 minutes. Department which had longest real outpatient consultation time was infection (7 minutes) and department which had longest satisfactory outpatient consultation time was neurology (9.4 minutes). From the univariate and the multiple linear regression analysis, real outpatient consultation time was longer in pulmonology patient, new patient and afternoon patient, satisfactory outpatient consultation time was longer in infection, neurology, neuropsychiatry, neurosurgery, and rehabilitation patient. Appropriate real outpatient consultation time was suggested as 5.6 minutes which differentiated high and low satisfied patient group. However, we could not assume appropriate outpatient consultation time for each clinical department because the number of patient who had bad satisfaction was too low. Conclusion: To improve patient's satisfaction, we hope outpatient reservation system is operated as each patient's outpatient consultation time is at least 5.6 minutes.

• 임상간호연구
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• 제22권3호
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• pp.276-284
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• 2016

Purpose: The purpose of this study was to identify the factors related to blood-borne infection prevention behaviors based on the risk perception of the health belief model among operating room nurses. Risk perception factors included perceived susceptibility, barriers, benefits, and perceived severity. Methods: Data were collected from 121 operating room nurses working in four different hospitals in Daejeon and Seoul from June 30 to May 11, 2016. Results: The mean age was 31.2 years, and the average years of clinical experience in operating room was 7.9 years. The mean score of knowledge was 13.15. The mean score of perceived susceptibility, barrier, benefit, and perceived severity were 3.76, 3.70, 3.95, and 4.64, respectively. Blood-borne infection prevention behaviors had positive correlation with perceived benefits (p=.010), but negative correlation with sensitivity (p=.009) and barrier (p=.012). The hierarchical regression model on infection prevention behavior was statistically significant (F=4.85, p<.001). The sixteen percent of variance in behavior was explained by age (${\beta}=.18$, p=.038), perceived benefit (${\beta}=.20$, p=.030), perceived susceptibility (${\beta}=-.25$, p=.005), and perceived barrier (${\beta}=-.18$, p=.042). Conclusion: In order to increase infection prevention behaviors among operating room nurses, there is a need for developing specific education program focusing on appropriate management of equipment, instruments, and environment in operating room. In addition, support from the hospital organization level need to be provided as well.

• 한국병원경영학회지
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• 제23권4호
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• pp.15-25
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• 2018

Purposes: The objectives of this study present the direction of the criteria for the separately reimbursement of therapeutic medical device. Methodology: We summarized experts' opinion using Delphi survey and Analytic Hierarchy Process(AHP). 48 experts were gathered from Medical Insurance Review Nurses Association, medical device industry, academy and association, Medical Device Expert Evaluation Committee. Descriptive statistics, consistency index, content validity ratio were analyzed. Findings: Clinical utility, patient safety, infection control, cost-homogeneity, cost-effectiveness showed high feasibility and importance, but market contribution and functional utility showed low feasibility and importance in a relative sense. The results of functional utility differed between clinical and non-clinical experts. Measurability was low across the whole area. Among the criteria for the separately reimbursement of therapeutic medical device. Patient safety/infection control and clinical utility showed the highest relative importance values, analyzed using AHP. Practical Implications: Patient safety and infection control are needed to be considered as one of Value Assessment Criteria. It is important to find out how to improve the measurability of therapeutic medical device.

• Tuberculosis and Respiratory Diseases
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• 제70권2호
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• pp.105-112
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• 2011

Pneumonia is frequently encountered in the clinical fields, both as a cause for admission and as a complication of the underlying disorder or as the course of treatment. Pneumonia is the second most common hospital-acquired infection and is associated with the highest morbidity and mortality rates among hospital-acquired infections. The guidelines for the management of hospital-acquired pneumonia by the American Thoracic Society include identifying individuals who have recently received antibiotics therapy or have been in medical facilities; these individuals are at higher risk for infection with multiple drug resistant organisms. Individuals, who have acquired pneumonia according to this clinical scenario, have what is known as healthcare-associated pneumonia (HCAP). Patients with HCAP should be considered to have potentially drug-resistant pathogens and should receive broad spectrum empiric antibiotic therapy directed at the potentially resistant organisms. In this paper, the diagnosis, risk factors, and treatment of HCAP are discussed.

• 대한관절경학회지
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• 제3권2호
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• pp.142-145
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• 1999

대퇴골두의 연골 용해증은 관절 연골의 진행성 파괴로 인해, 이차적으로 발생하는 관절 간격의 감소와 강직이 특징이며, 이는 특발성으로 발생하는 경우가 가장 많고, 이차적 원인으로는 감염이나 외상 또는 장기간 고정 등이 거론되고 있다. 저자들은 45세 남자에서 화농성 고관절염 후 발생한 대퇴골두 연골 용해증을 경험하고 관절경하에서 치험하였기에 보고하는 바이다.

• Clinics in Shoulder and Elbow
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• 제25권3호
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• pp.244-254
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• 2022

Radiographic osteolysis after total shoulder arthroplasty (TSA) remains a challenging clinical entity, as it may not initially manifest clinically apparent symptoms but can lead to clinically important complications, such as aseptic loosening. A thorough consideration of medical history and physical examination is essential to rule out other causes of symptomatic TSA-namely, periprosthetic joint infection-as symptoms often progress to vague pain or discomfort due to subtle component loosening. Once confirmed, nonoperative treatment of osteolysis should first be pursued given the potential to avoid surgery-associated risks. If needed, the current surgical options include glenoid polyethylene revision and conversion to reverse shoulder arthroplasty. The current article provides a comprehensive review of the evaluation and management of osteolysis after TSA through an evidence-based discussion of current concepts.

• Asian Pacific Journal of Cancer Prevention
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• 제13권3호
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• pp.743-752
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• 2012

Hepatocellular carcinoma is a common disorder worldwide which ranks 5th and 7th most common cancer among men and women. In recent years, different incidence trends have been observed in various regions, but the reasons are not completely understood. However, due to the great public efforts in HCC prevention and alternation of lifestyle, the roles of some well documented risk factors played in hepatocarcinogenesis might have changed. This paper summarizes both the environmental and host related risk factors of hepatocellular carcinoma including well established risk factors such as hepatitis virus infection, aflatoxin and alcohol, as well as possible risk factors such as coffee drinking and other dietary agents.

• 치위생과학회지
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• 제15권4호
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• pp.399-406
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• 2015

치과의료기관의 감염관리 수행 조사를 위해 2014년 6~7월 기간 동안 일부 지역사회 치과위생사 158명을 대상으로 기관, 감염관리자, 환자의 감염관리 수행을 자기기입식 설문조사하였다. 치과병원은 감염관리지침서 구비, 감염관리 담당자 지정, 정기감염관리 교육지원, 1인 멸균핸드피스 사용 비율은 57~74%였으나 치과의원은 13~20% 수준이었다(p<0.05). 감염관리자의 감염관리지침 인지는 치과병원 17.4%, 치과의원 5.9%였고 정기예방접종 시행은 치과병원 60.9%, 치과의원 34.1%였다(p<0.05). 환자의 손 위생 수행, 진료 전 칫솔질, 교차 감염 교육경험은 20% 미만이었고, 병력조사 협조는 90% 이상이었다(p<0.05). 감염관리 실천 상관분석 결과 기관 지원은 치과위생사 감염관리자실천, 환자감염관리협조, 개인방호실천, 진료실감염관리실천, 폐기물관리실천과 양의 상관관계를 나타내었으며 통계적으로 유의하게 분석되었다(p<0.05). 감염관리 실천을 위해 의료진, 환자, 기관의 지원과 협조가 요구되며 감염관리 관리자는 지속적인 교육을 통해 감염관리지침을 인지하고 실천할 것이 요구된다.

• The Korean Journal of Pain
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• 제18권2호
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• pp.210-213
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• 2005

Acute viral meningitis and myositis are rare complications of varicella-zoster virus (VZV) reactivation. A 71-years-old immunocompetent man, who presented with lower back pain radiating to the left lower extremities, developed vesicles on the L5 dermatomal area. The next day, he had complained of aberrant vesicles on the trunk, face and scalp, with generalized myalgia, headache and dizziness. He was confirmed with VZV meningitis and myositis, as demonstrated by the presence of VZV DNA in the blood and cerebral spinal fluid using a polymerase chain reaction (PCR) amplification. PCR has been used in patients with a VZV infection associated neurological symptoms, and provides a useful tool for the early diagnosis of VZV-associated neurological disease. The patient was treated with bed rest, with intravenous acyclovir for the VZV infection, and intravenous Patient-controlled Analgesia for pain management and the prevention of postherpetic neuralgia. When he visited the outpatient department 3 months later, the skin lesion, leg pain, headache and myalgia had all improved, without sequelae. Here, this case is reported, with a discussion of the relevant literature on its diagnosis and management.

• Archives of Plastic Surgery
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• 제48권2호
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• pp.189-193
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• 2021

Breast implant insertion is one of the most commonly used methods for breast reconstruction after total mastectomy. However, infection is a common postoperative complication of implant insertion. In most cases, these infections can be managed with antibiotics and supportive therapy. However, severe septic conditions, such as toxic shock syndrome (TSS), can sometimes occur. TSS is an extremely rare but life-threatening complication, for which early diagnosis and proper management play a crucial role in determining patients' outcome. Although only 16 cases of TSS after breast implant insertion have been reported in the literature, most of those cases involved a serious clinical course. The reason for the seriousness of the clinical course of TSS in these cases is that the initial impression and presentation of these patients are nonspecific, and patients can easily be misdiagnosed as having a simple upper respiratory infection, causing the underlying condition to be neglected. Herein, we present two patients who were diagnosed with TSS after receiving breast reconstruction surgery via a silicone implant after total mastectomy. Both patients were misdiagnosed at the initial examination since they showed no local infectious signs on the postoperative wound.