• Title/Summary/Keyword: Hospital Organization

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A Preliminary Study for Evaluating on Demonstration Project of Community-based Home Health Care Nursing Services by the Seoul Nurses Association (지역사회중심 가정간호 시범사업 성과평가를 위한 기초연구- 서울시 간호사회 주관 -)

  • 유호신;이소우;문희자;황나미;박성애;박정숙;최행지;정기순;한상애
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1488-1502
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    • 2000
  • This study, based on current home nursing services, aims at promoting measures for establishing a community-based home nursing system derived from the pilot home nursing demonstration project conducted by the Seoul Nurses Association. The study was based on an analysis of home nursing records from march 1993 to December 1999. The following is a summary analysis, based on individual characteristics of the patients, the organization, which recommended the service for their patients and personnel services. 1. The service has been used by many elderly people 60years of age or older(66.4%). and married people(60.9%). The average number of visits by service personnel for patients of city government was 23.5. This is 2.5 times as many visits by general patients. General patients(20.2%) had only one visit from service personnel, while 65.5% of patients of city government had 10 or more visits. Particularly, for government recommended patients, 72.7% of the patients were recommended by nurses, while only 21.9% where referred to the services by doctors. The main focus of a home nursing service was to maintain present health status (53.4%), and hospice(11.6%). Also to increase hospital-based home nursing services focused on recovery(55.9%) and maintain present health conditions (19.0%). 2. For general patients, 42.0% of patients were suffering from problems related to CVA, 11.3% from high blood pressure, and for patients referred from city, 21.2% from skeletal muscular disease. Results of home nursing services 29.4% of patients were able to recover or maintain their health status, but 48.9% of the patients died. Another main point of community-based home nursing services is medication(6.7%), other basic nursing services(6.1%), special treatment, instructions on how to use medical devices(5.9%), change of physical posture(4.6%), and training on changing physical positions(4.7%). As mentioned above there were some differences between the characteristics of patients who used the pilot home nursing service conducted by the Seoul Nurses Association and those hospital-based service users. The results are believed to be useful to support a community-based home nursing service model. Particularly, patients under medical supervision and patients recommended by government-run health clinics show a higher frequency and longer use of home nursing services compared to general patients or hospital-based home nursing service users. According to the study, nurses accounted for a large number of recommendations for home nursing services. Many patients with CVA, high blood pressure, skeletal muscular disease and bedsores used community-based home nursing services, while others used the service for minor treatments or maintaining their current health status. Based on the study, the researchers make several suggestions to establish a community- based home nursing service system. First, different ways of setting up a community-based home nursing system have to be mapped out based on the evaluation of the pilot home nursing service conducted by the Seoul Nurses Association. Secondly, a new, community-based, home health care nursing service model, and reimbursement payment system have to be developed. This is based on the outcome of the analysis, and implemented policy. Accordingly, efforts are needed to develop a community- based home nursing system with an intermediary role to promote the visiting nursing services of government-run health centers.

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<Field action report> Development and Application of Participatory Action Oriented Training(PAOT) for Improvement of Agricultural Working Environment in Korea (<사례보고> 농작업 환경개선을 위한 한국형 참여형 개선활동 교육(PAOT)의 개발과 실제 적용 사례)

  • Kim, J.S.;Woo, K.H.;Min, Y.S.;Kim, B.K.;Choi, K.S.;Park, K.S.
    • Journal of agricultural medicine and community health
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    • v.35 no.4
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    • pp.417-427
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    • 2010
  • Objectives: This study was conducted to develop a Korean version of the Participatory Action Oriented Training (PAOT) program and training materials for improvement of agricultural working environments. Methods: The PAOT manual and checklist were developed on the basis of the original English version of the training materials, a questionnaire survey of agricultural health and safety professionals, and a brainstorming conference. Good example pictures were collected through visits to agricultural workers' houses, and an easily understandable picture was drawn by an animation specialist. A PAOT action manual and five types of action checklists were developed for use in different agricultural environments. Each action checklist contained six categories and 38 items of agricultural health and safety principles; the six categories were material storage and handling, work stations and tools, machine safety, physical environment, working schedule and organization, and basic health and safety management. Incorporating these training materials, a one-day Korean PAOT program was developed. Results: Among 307 candidate agricultural workers from four rural Korean villages, 94 workers (59 males, 35 females) participated in a PAOT from July 2007 to Oct 2008. The PAOT program was successful and the mean self-estimated satisfaction score of the participants was greater than 90%. Conclusions: A Korean PAOT program and training materials were successfully developed and applied to Korean agricultural workers. Although more studies are needed, it is expected that PAOT will greatly contribute to the improvement of agricultural working conditions and health and safety through the use of agricultural workers' self initiatives.

Application of Patient Safety Indicators using Korean National Hospital Discharge In-depth Injury Survey (퇴원손상심층자료를 이용한 환자안전지표의 적용)

  • Kim, Yoo-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.5
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    • pp.2293-2303
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    • 2013
  • Objective: This study aims to determine whether national patient safety indicators (PSIs) can be calculated. Methods: Using PSI criteria from Organization for Economic Co-Operation and Development (OECD) Health Technical Papers 19 based on the Agency for Healthcare Research and Quality (AHRQ), PSIs were identified in the Korean National Hospital Discharge In-depth Injury Survey (KNHDIIS) database for 875,622 inpatient admissions between 2004 and 2008. Logistic regression was used to estimate factors of variations for PSIs. Results: From 2004 to 2008, 3,084 PSI events of 8 PSIs occurred for over 80 thousands discharges. Rates per 1,000 events for decubitus ulcer (PSI3, 4.88), foreign body left during procedure (PSI5, 0.05), postoperative sepsis (PSI13, 1.32), birth trauma-injury to neonate (PSI17, 7.92) and obstetric trauma-vaginal delivery (PSI18, 32.81) are all identified between ranges from maximum to minimum of OECD rates, respectively. However, rates per 1,000 events for selected infections due to medical care (PSI7, 0.22), postoperative pulmonary embolism or deep vein thrombosis (PSI12, 0.90) and accidental puncture or laceration (PSI15, 0.71) are below the minimum of OECD range. 7 PSIs except PSI 18 showed statistically significant relationship with number of secondary diagnoses. When adjusting patient characteristics, there are statistically significant different rates according to bed size or location of hospitals. Conclusion: This is the first empirical study to identify nationally number of adverse events and PSIs using administrative database. While many factors influencing these results such as quality of data, clinical data and so on are remain, the results indicate opportunities for estimate national statistics for patient safety. Furthermore outcome research such as mortality related to adverse events is needed based on results of this study.

Predictors of the Psychological Well-being of Nurses in small-and Medium-sized Hospital: the Mediating Effects of Emotional Intelligence (중소병원 간호사의 심리적복지감 예측요인: 감성지능의 조절효과)

  • Shin, So-Hong;Kim, You-Jeong;Kim, Chang-Tae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.7
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    • pp.162-174
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    • 2017
  • This study is descriptive research conducted to determine the levels of depression, emotional intelligence, and psychological well-being of nurses employed in small-and medium-sized hospitals, as well as to identify the correlations of these variables, predict factors influencing nurses' psychological well-being, and finally, test the mediating effects of emotional intelligence in the relationship between depression and psychological well-being. The subjects of the study included 336 nurses employed in small-and medium-sized hospitals located in the Daegu-Gyeongbuk region. Using a structured questionnaire, a sample was taken from December 17, 2016 to January 8, 2017. The results that the nurses showed an average level of depression with a mean score of 1.55 points, while their mean scores of emotional intelligence and psychological well-being were above average (3.05 and 3.51 scores, respectively). Depression exhibited negative (-) correlations with emotional intelligence and psychological well-being, whereas emotional intelligence had a positive (+) correlation with psychological well-being. The significant predictors of psychological well-being were found to include sleep hours (${\beta}=0.111$), working department (${\beta}=0.236$), and depression (${\beta}=-0.245$). Moreover, evaluation of the mediating effects of emotional intelligence revealed significant relationships between depression and regulation of emotion (${\beta}=0.527$) and between depression and emotional utilization (${\beta}=0.167$). In conclusion, the work environment and depression were predicted to be major factors influencing psychological well-being, while emotional intelligence was found to be a partially mediating factor. Overall, these results demonstrate that easing depression and improving emotional intelligence can be very positive countermeasures in revitalizing the hospital organization, as well as in ensuring the happiness of individual nurses. Therefore, interventions aimed at improving work environments and easing depression are required to improve nurses' psychological well-being.

THE INFLUENCE OF FAMILY ENVIRONMENT AND MORAL DEVELOPMENT TO CONDUCT DISORDER IN ADOLESCENTS (청소년의 가정환경과 도덕발달단계가 행동장애에 미치는 영향)

  • Chin, Tae-Won;Kim, Sa-Jun;Lee, Heung-Pyo;Cho, Soo-Churl
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.2
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    • pp.163-174
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    • 1997
  • This study was to know the influence of familial environment and moral development on conduct disorder. Subjects were composed of 47 male and female patients with conduct disorder(patients group), 113 general male and female students(normal group), and 173 juvenile prisoners(JP group). The Korean Form of the Family Environment Scale(FES) was used to assess the family environment of the subjects and the Korean Defining Issues Test(DIT) was used to assess the moral development. Conduct disorder was diagnosed with the DSM-III-R criteria for conduct disorder. The influence of familial environment and moral development on conduct disorder was analyzed with ANOVA and the differences among groups were verified with Scheffe test. There was no difference in the socioeconomic status and the physical abuse by the parents among the three groups. But the rates of divorce or separation of the parents were significantly highest in the JP group and higher in the patients group than in the normal group. Especially the subjects of the JP group experienced the divorce or separation of their parents during the preschool or the elementary school periods. In regard to the family environment, there was no difference among the three groups in the Subscales of Expressiveness, Independence, Intellectual-cultural orientation, Moral-religious emphasis, Organization, and Control. ‘Cohesion Subscale’ was significantly higher in the normal group than in the JP group. ‘Conflict Subscale’ was significantly higher in the JP and patients groups than in the normal group. ‘Achievement orientation Subscale’ was significantly lower in the JP group than in the patients and normal groups. ‘Activerecreational orientation’ was significantly lower in the normal group than in the JP and patients groups. In gegard to the moral developmental stage, the lower moral developmental step was higher in the JP and patients groups than in the normal group. The higher steps were significantly higher in the normal group than in the JP group. There was no significant correlation between the degree of ‘Moral-religious emphasis Subscale’ and the moral development. The clinical implication and limitation of present study were listed and discussed.

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A study of Diagnostic Significance of Simultaneous Examination of Proteinuria and Hematuria in the Urinary Mass Screening (집단뇨검사(Urinary mass screening) 방법으로 단백뇨와 혈뇨의 동시검사가 가지는 진단적 가치에 대한 연구)

  • Kim, Young-Kyoun;Lee, Chong-Guk
    • Childhood Kidney Diseases
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    • v.3 no.1
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    • pp.57-63
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    • 1999
  • Purpose : To evaluate the diagnostic significance of simultaneous examination of hematuria and proteinuria in the urinary mass screening for early detection ot incipient renal diseases. Method and Object : During the period of 4 months from August to December in 1997, we did urinary mass screening on students of first grade of high school (16 years aged group) nationwide together with Korean Association of Health(KAH). In the first screening test, Comber-10 $N^{(R)}$ M dipsticks were used to detect proteinuria, hematuria, pyuria and nitrite simultaneously. Total 26,508 students (16 years aged group) from 33 high schools in every province in Korea, respectively, complied to the urinary mass screening. After then, one high school in Seoul was selected to reveal the true incidence of incipient renal diseases among students who showed hematuria in the initial screening through intensive examinations. Those who had hematuria and/or proteinuria visited the Paik hospital, and underwent blood tests and ultrasonographic examinations. The results were evaluated. Results 1) The initial screening revealed that the prevalence of proteinuria, hematuria, pyuria and positive nitrite urine, were $0.73\%,\;2.69\%,\;0.23\%\;and\;0.03\%$, respectively. 2) The first urinary screening among 875 students from one high school in Seoul selected fir the second test showed proteinuria, hematuria, pyuria and positive nitrite urine, were $0.91\%,\;4.68\%,\;0.34\%\;and\;0\%$, respectively. a) Total 8 among 875 students showed proteinuria, but one of them had orthostatic proteinuria and those remaining 7 students had transient proteinuria. b) There were 41 students who had hematuria in the initial screening. Among 33 who complied the second test, only one student showed asymptomatic isolated hematuria and those remaining students were normal. Conclusion : 1) Because of high false positive hematuria rate in the urinary mass screening, it dosen't seem to be appropriate that hematuria screening using dipsticks be included in the urinary mass screening. 2) A unified organization is needed from the fret that so various results of urinary mass screening came out. 3) Positive rates of pyuria and nitrite were so low that validity of urinary mass screening for urinary tract infection needs more studies.

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A Study on the Patient Exposure Doses from the Panoramic Radiography using Dentistry (치과 파노라마 촬영에서 환자의 피폭선량에 관한 연구)

  • Park, Ilwoo;Jeung, Wonkyo;Hwang, Hyungsuk;Lim, Sunghwan;Lee, Daenam;Im, Inchul;Lee, Jaeseung;Park, Hyonghu;Kwak, Byungjoon;Yu, Yunsik
    • Journal of the Korean Society of Radiology
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    • v.7 no.1
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    • pp.17-24
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    • 2013
  • This study estimate radiation biological danger factor by measuring patient's exposed dose and propose the low way of patient's exposed dose in panoramic radiography. We seek correcting constant of OSL dosimeter for minimize the error of exposed dose's measurement and measure the Left, Right crystalline lens, thyroid, directly included upper, lower lips, the maxillary bone and the center of photographing that indirect included in panoramic radiography by using the human body model standard phantom advised in ICRP. In result, the center of photographing's level of radiation maximum value is $413.67{\pm}6.53{\mu}Gy$ and each upper, lower lips is $217.80{\pm}2.98{\mu}Gy$, $215.33{\pm}2.61{\mu}Gy$. Also in panoramic radiography, indirect included Left, Right crystalline lens's level of radiation are $30.73{\pm}2.34{\mu}Gy$, $31.87{\pm}2.50{\mu}Gy$, and thyroid's level of measured exposed dose can cause effect of radiation biological and we need justifiable analysis about radiation defense rule and substantiation advised international organization for the low way of patient's exposed dose in panoramic radiography of dental clinic and we judge need the additional study about radiation defense organization for protect the systematize protocol's finance and around internal organs for minimize until accepted by many people that is technological, economical and social fact by using panoramic measurement.

A Study on Radiation Dose for General Radiography Examination at First Medical Institution (Around the Radiology Clinic of National Capital Region) (일차 의료기관에서 일반촬영 검사의 피폭선량 연구 (수도권 영상의학과를 중심으로))

  • Hwang, Su-Lyun;Jung, Hong-Ryang;Lim, Cheong-Hwan
    • Journal of the Korean Society of Radiology
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    • v.5 no.5
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    • pp.245-253
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    • 2011
  • The hazard level will be increased with the augmentation of the dose received by patients. Therefore, patients radiation dose have been analyzed by this study for the radiology clinics located at Seoul and Gyeongin area from August 2009 to September 2010. In the case of the front and rear directional inspection of skull, patient radiation dose was turned out to be 1.75mGy for radiology clinic, 3.00mGy for UK, 3.00mGy for Japan, and 5.00mGy for Germany, therefore, radiology clinic was the lowest. In the case of lateral directional inspection of skull, patient radiation dose was turned out to be 1.49mGy for radiology clinic, 1.50mGy for 3rd medical institution, therefore, radiology clinic was measured lower, and it was lower than 3.00mGy which is the recommended dose of IAEA. In order to reduce medical exposure of patient, optimization of efficient protection of radiation and reduction of medical radiation exposure are thought to be required by observing recommendation of international organization based on the result of this study.

Clinical study of keratocystic odontogenic tumors

  • Tomomatsu, Nobuyoshi;Uzawa, Narikazu;Michi, Yasuyuki;Kurohara, Kazuto;Okada, Norihiko;Amagasa, Teruo
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.38 no.1
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    • pp.55-63
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    • 2012
  • The odontogenic keratocyst (OKC) was originally classified as a developmental cyst, and OKCs were histologically divided into orthokeratotic (O-OKCs) and parakeratotic (P-OKCs) types. Clinical features differ between O-OKCs and P-OKCs with P-OKCs having a tendency to recur after surgical treatment. According to the revised histopathological classification of odontogenic tumors by the World Health Organization (2005), the term keratocystic odontogenic tumor (KCOT) has been adopted to describe P-OKCs. In this retrospective study, we examined 186 KCOTs treated at the Maxillofacial Surgery Department of the Tokyo Medical and Dental University Hospital from 1981 through 2005. The patients ranged in age from 7 to 85 years (mean, 32.7) and consisted of 93 males and 93 females. The most frequently treated areas were the mandibular molar region and ramus. The majority of KCOTs in the maxillary region were treated by enucleation and primary closure. The majority of KCOTs in the mandibular region were enucleated, and the wound was left open. Marginal resection was performed in the 4 patients with large lesions arising in the mandible. In patients who were followed for more than a year, recurrences were observed in 19 of 120 lesions (15.8%). The recurrences were found at the margins of the primary lesion in contact with the roots of the teeth or at the upper margins of the mandibular ramus. Clinicians should consider aggressive treatment for KCOTs because the recurrence rate of P-OKCs is higher than that of other cyst types such as O-OKCs, dentigerous cysts, primordial cysts that were non-keratinized, and slightly keratinized stratified squamous epithelium. Although more aggressive treatment is needed for KCOTs as compared to other cystic lesions, it is difficult to make a precise diagnosis preoperatively on the basis of clinical features and X-ray imaging. Therefore, preoperative biopsy is necessary for selecting the appropriate treatment for patients with cystic lesions.

Factors Influencing Job Embeddedness Toward Nurses in Small-and Medium-Sized Hospitals (소규모 중소병원 간호사의 직무착근도에 미치는 영향요인)

  • Hyeon, lI-Seon;Lee, So-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.6
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    • pp.425-431
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    • 2020
  • The purpose of this study was to provide nurses with the basic data to prepare nurses for systematic job embeddedness, job stress, and burnout in small and medium-sized hospitals and to identify any correlations. The data were collected between 1 November 2018 and 28 February 2019. The factors and general characteristics influencing the job embeddedness were found to be position (t=3.53, p<.001), total career (F=3.46, p=.034), current career (F=5.59, p=.004), and turnover experience (t=-1.72, p=.008). The job embeddedness was negatively correlated with the awareness of burnout (r=-.570, p<.001) and job stress (r=-.349, p<.001). Burnout (β=-.570, p<.001) and job stress (β=-.552, p<.001) had significant effects on job embeddedness (F=46.21, p<.001); the explanatory power of these variables was 34.9%. In other words, nurses in hospitals with fewer than 200 beds experienced higher job stress because they were exhausted. This suggests that it has a negative effect on job arrival, which is the intention to remain in the current organization. Therefore, it is necessary to manage exhaustion and job stress appropriately for the job.