• Title/Summary/Keyword: Hospital Service Quality

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Comparison of compression pause time between different rescue ventilation maneuvers in two-rescuer cardiopulmonary resuscitation (2인구조자 심폐소생술 시 환기방법에 따른 가슴압박 중단시간의 비교: 일개 대학병원 간호사를 대상으로)

  • Hyun, Kwang-Rok;Moon, Jun-Dong
    • The Korean Journal of Emergency Medical Services
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    • v.19 no.2
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    • pp.7-17
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    • 2015
  • Purpose: This study aimed to compare the effects of rescue ventilation maneuvers on the quality of two-rescuer cardiopulmonary resuscitation (CPR). Methods: We implemented mouth to mouth (MMV), mouth to pocket mask (MPV) and bag-valve mask ventilation (BMV) maneuvers. Each team of two-nurses was randomized to perform three consecutive sessions of two-rescuer CPR by using three artificial ventilation maneuvers. Results: The subjects were 26 teams of nurses (female: 96.2%, male: 3.8%, age: 26.6 years). Failed ventilation was more frequent in BMV ($2.23{\pm}2.21$, p <.001) than MMV ($0.31{\pm}0.74$) and MPV ($0.38{\pm}0.64$). BMV had more compressions per minute ($93.7{\pm}5.7$) than MMV ($87.0{\pm}7.2$, p = .001) and shorter total compression pause time ($46.1{\pm}5.8sec$) and compression pause fraction ($23.3{\pm}2.2%$) than MMV ($54.8{\pm}10.3sec$, p = .001, $25.5{\pm}3.5%$, p = .001, respectively) and MPV ($53.1{\pm}7.1sec$, p =. 006 and $25.8{\pm}2.6%$, p = .006, respectively). Conclusion: In our simulation study, BMV reduced the compression pause time and increased the number of compressions per minute, thus indicating CPR provided to patients was effective. However, considering the high rate of ventilation failure, we recommend periodic training.

Survival Rate of Cancer Patients of National Merit (국가유공자 암환자의 생존율)

  • Park, Un-Je
    • Health Policy and Management
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    • v.31 no.1
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    • pp.35-45
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    • 2021
  • Background: As a descriptive study targeting 2,068 cancer patients as men of national merit in 2013, this study aims to provide the basic data for systematizing the early diagnosis and treatment of cancer by comparatively analyzing the 5-year survival rate. Methods: This study researched the survival of cancer patients through Electronic Medical Record and Patriots-Veterans Qualification Program, targeting 2,068 newly-diagnosed cancer patients verified in five veterans hospitals and consigned management system. This study verified differences between general characteristics of cancer patients as men of national merit and analyzed their survival rate. Results: The cancer patients as men of national merit were super-aged as their average age was 72.5. In the analysis of general characteristics of five major prevalent cancers, there were statistically significant differences according to age, region, cancer diagnostic path, differentiation, diagnostic method, treatment method, SEER stage, and survival period, except for the types of the man of national merit (p<0.001). The whole survival rate of cancer patients as men of national merit was 50%. The 5-year survival rates of predisposing cancers were shown as prostate cancer (79%), colorectal cancer (64%), gastric cancer (57%), liver cancer (32%), and lung cancer (12%). In the cancer diagnostic path, all the predisposing cancers showed the highest survival rate in medical examination. In the treatment method, the surgery showed the highest survival rate. The cancer patients as men of national merit showed a lower survival rate than the general cancer patients of Korea. Conclusion: It would be needed to guarantee the honorable and happy life through health recovery as special treatment of contribution and sacrifice of super-aged men of national merit by increasing the cancer survival rates through regular checkup, early diagnosis, and high-quality treatment system that could have important effects on the survival rate according to the occurrence of cancers.

School Novice Health Teachers' Perception of Job Performance Difficulties and Job Satisfaction (초임 보건교사의 직무수행 어려움과 직무만족도에 대한 인식)

  • Jang, Seomoon;Lee, Gyuyoung
    • Research in Community and Public Health Nursing
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    • v.32 no.4
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    • pp.566-577
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    • 2021
  • Purpose: This study aimed to determine the correlation between job performance difficulties and job satisfaction that novice health teachers experienced in a new school environment, and provide the basic data necessary for policy development. Methods: Data were collected from 196 novice health teachers without in-service training program for the qualification of 1st grade and with less than four years of work experience in Korea. The self-report questionnaire consisted of general characteristics, perception of difficulties in job performance, and job satisfaction. The data were analyzed using the x2 test, t-test, ANOVA, and Pearson's correlation coefficient. Results: Novice health teachers had the most difficulty in health education during their job performance, whereas teachers without hospital clinical experience encountered difficulties in health management. Those with less than two years of teaching experience or no experience of being contract health teachers had higher job performance difficulties. The results revealed that the lack of experience in performance at a school site had a considerable influence on the difficulty in job performance. In terms of job satisfaction, novice health teachers had the highest satisfaction with status recognition and the lowest satisfaction with their tasks in charge. Additionally, as the difficulty in job performance increased, job satisfaction decreased. Conclusion: The study results indicated the need for training to provide novice health teachers with sufficient experience in job performance before being placed in a school. The provision of support to respond to difficulties in job performance will improve job satisfaction and contribute not only to the development of novice health teachers, but also to the improvement of the quality of school health.

A study on the definition and development direction of manual therapy (도수치료의 정의에 대한 고찰 및 발전 방향에 관한 연구)

  • Park, Jong Hang;Park, Hyun Sik;Shin, Young Il;Lee, Ho Jong
    • Journal of Korean Physical Therapy Science
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    • v.29 no.1
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    • pp.1-14
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    • 2022
  • Background: The legal and academic definitions of manual therapy in domestic and foreign countries are reviewed, and problems and improvement plan of manual therapy are established through comparative analysis of the current status and system of manual therapy in Korea and abroad. Design: Review. Methods: In this study, the development direction of manual therapy in Korea was derived by analyzing the definition, application status, and service system of domestic and foreign manual therapy. Results: Firstly, it lays the foundation for a more comprehensive national health promotion by solving problems arising from the current unclear definition of manual therapy. Secondly, the subject of manual therapy is a physiotherapist but the subject of claiming non-benefit costs is a doctor, moreover illegal manual therapy by an unqualified or non-professional who is not a physiotherapist is being carried out in the medical field. Thirdly, in order to provide quality physiotherapy services (manual therapy) under a cooperative relationship between medical staff and physiotherapists, it is appropriate that physiotherapist have a clear "prescription" or "request" by a doctor. Fourth, there is no provision for the preparation of medical records in the current Medical Technicians Act, and this causes safety accidents of patients during manual treatment. Conclusion: As described above, the current manual therapy in Korea is being performed indiscriminately without a clear interpretation, resulting in various problems. I think it is necessary to lay the foundation for institutional and legal re-establishment of manual therapy through additional research on manual therapy in the future.

East Asian Traditional Medicine Treatment for Patients after Heart Valve Replacements: A Systematic Review with Meta-Analysis (심장판막 치환술 후 한의학적 치료에 대한 체계적 문헌고찰 및 메타분석)

  • Ahn, Mu-hyeok;Kim, Ji-ho;Shin, Bong-jin;Kwon, Jung-nam
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.720-737
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    • 2022
  • Objectives: To compare the effectiveness and safety of East Asian traditional medicine treatments (EATMT) versus conventional management in patients following heart valve replacement surgery. Methods: We searched several databases, including the Korean Studies Information Service System, PubMed, China National Knowledge Infrastructure, and Citation Information by NII. The search range included randomized controlled trials from each first issue until June 27, 2021. Two review authors independently extracted the data. We assessed the risk of systematic errors by evaluating risk domains using the "Risk of bias" tool. Results: We included 5 trials in the review. In the EATMT, the investigators reported significant improvements in reshaping of the heart structure: left ventricular end diastolic diameter (MD -4.43, 95% CI -6.06 to -2.79; 130 participants; 2 studies; high evidence). Comparisons with usual care revealed a significant decrease in gastrointestinal complications rate (OR 0.30, 95% CI 0.20 to 0.47; 503 participants; 2 studies; high evidence). We assessed 4 studies as having a low risk of bias and 1 study as having a high risk of bias. Conclusion: This systematic review suggests that East Asian traditional medicine interventions may be effective in preventing and alleviating complications, but we found evidence of important trade-offs between known benefits and known adverse effects in cardiac dysfunction and inflammation following heart valve replacement. Consequently, additional high-quality studies should be conducted.

A Pilot Study on Effects of Critical Pathway Application for Hwa-Byung (화병 표준진료지침 적용효과에 대한 Pilot 분석)

  • Eom, Yoon-Ji;Kwon, Do-Hyung;Kim, Yun-Na;Lee, Hyun-Woo;Chung, Sun-Yong;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.32 no.4
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    • pp.337-343
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    • 2021
  • Objectives: To investigate effectiveness and satisfaction of applying critical pathway (CP) to Hwa-byung outpatients. Methods: Subjects were 32 outpatients who were diagnosed with Hwa-byung between January 1 and 2021 to October 31, 2021. Among these patients, 18 patients were applied with CP and 14 patients received treatment without applying CP. Their medical records and administration records were retrospectively analyzed. Data were analyzed by mean, standard deviation, and t-test using SPSS 26.0 program. Results: Mean total treatment period significantly decreased in the CP group compared with the non-CP group. Medical expenses were classified by treatment period, per visit, and patient charges per type of visit. When analyzed specifically by detailed items, there was a decreasing tendency in total medical expenses, uncovered medical expenses, and patient charges but an increasing tendency in covered medical expenses, although some of these changes were not statistically significant. Satisfaction score increased in the CP group compared with the non-CP group in general, although not all increases were statistically significant. Conclusions: Applying CP may contribute to the reduction of medical expenses and improvement of medical service quality. Further research on the development of CP for various diseases and the application of CP under various circumstances is needed.

Investigation of the Time Required for General Radiography (일반 방사선검사의 소요 시간 실태조사)

  • Lim, Woo-Taek;Joo, Young-Cheol;Kim, Yon-Min
    • Journal of radiological science and technology
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    • v.45 no.3
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    • pp.255-262
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    • 2022
  • In this study, by analyzing the examination time for each procedure, the appropriate workload of radiologic technologist is analyzed based on the actual examination time in the current clinical setting by comparing with the examination time in the radiology field setting of the health insurance review and assessment service. In addition, this result is introduced into the calculation of relate value units; it was attempted to provide accurate and objective evidence in the field of radiology. From May 2020 to December 2021, the study retrospectively investigated the examination times recorded in the electronic medical record and picture archiving and communication system at 5 tertiary general hospitals and 1 general hospital. The total of 16 examination parts are applied in this study, including the head, sinuses, chest, ribs, abdomen, pelvis, cervical, thoracic, lumbar, shoulder, elbow, wrist, hip, femur, knee, and ankle. The minimum number of images that could be obtained per radiation generator was 3.6 images for one hour, and the maximum was 6.4 images. When 50% median of procedure time is calculated, the minimum number of images that could be obtained was 16.7 images and maximum was 35.3 images; in addition, minimum examination time is 1.7 minutes, and maximum time is 3.6 minutes. In conclusion, it is judged that there will be insufficient explanation time for basic infection instructions such as hand hygiene during the examinations in current clinical practice. It is believed that radiologic technologists will contribute to providing higher-quality of radiation examination services to the public by complying with guidelines for work and setting appropriate workload on their own.

A Study on the Nursing Performance of the Home Care Nurses in Seoul (서울지역 가정간호사의 업무수행능력 실태조사)

  • Suh, Moon-Ja;Park, Ho-Ran;Kang, Hyun-Sook;Kim, So-Sun;Shin, Kyung-Lim;Kim, Keun-Soon;Kim, Hae-Sook
    • Journal of Home Health Care Nursing
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    • v.6
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    • pp.46-58
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    • 1999
  • The purpose of this research was to find out the state of the nursing performance of the home care nurses in Seoul in order to provide the data for the practical work guide. The data were collected from fifty home care nurses working in 22 institutions located in Seoul. The research tool used for this research was modified and tested by Song Jong-Rye(1999) which was originally modified the standard tool of American Nurses Association (1998) and was partly supplement and adjusted for this research. The reliability of this tool was Cronbach's $\alpha$=.0982. The collected data were statistically processed using SAS for t-test, ANOVA. $Scheff\'{e}$ test. Among the surveyees, 50% have been working as a home care nurse more than three years and 74.0% of them were married. And 52% have B.S degree with certification of home care nurse from the certification program for Home Care Nurses affiliated at nursing schools. Half of the home care nursing organizations were based on the general hospitals, and most(78%) of the responsible senior personnels of those organizations were nurses. The following results are drawn from this research. 1) The level of nursing performance by the task sectors General performance level of home care nurses was relatively high in grade of 3.06 from total 4.00. Among the task sectors. the ethical field scored the highest points, and the next were nursing intervention, professional training, and data gathering, and the research sector scored the lowest point. 2) The level of nursing performance by general features of home care nurses Statistically relevant correlation between performance according to the duration of working experience as a nurse(p=0.8951) and performance according to the duration of working as home care nurse(p=0.2263) did not emerge. Also, performance by marriage status(p=0.2218), education(p=0.5733), and taking the certification program for home card nurse(p =0.1560) has no statistically meaningful correlation. 3) The level of nursing performance by the type of home care nursing organizations There exists a significant difference(p=0.002) between performances by the types of organizations. Most of the responsible senior personnels of the home care nursing organization were nurses. The level of nursing performance of the home care nursing organization under nurse management was relatively higher than that of home care nursing organizations led by medical doctors or non-medical professional, but this was not proved as statistically meaningful(p =0.3617). 4) The level of nursing performance by task sectors according to the characteristic of home care nursing service organization There exists a significant difference between nursing performances by task sectors according to the characteristics of home care nursing organization(p=0.002). In case of model research center of one College of Nursing, the nursing performance in the sectors of organization, theory, and data gathering were lower than that of in hospital based home care nursing service. And in case of local home care centers, performances in sectors of organization, theory, data gathering, nursing intervention. professional training, and research sectors were significantly low. Based on the obtained results, overall performance of home care nurses can be appraised as relatively good. Especially, performances in sectors of the nursing intervention, nursing plan. and data gathering including the in direct nursing were recorded high scores. From this, it can be concluded that high quality of nursing is relatively practicing for home patients at these days. Since the high quality of nursing for patients was directly related to the level of nursing performances of home care nurses, it is required to improve practical performance level of them by making constant evaluation and running continual education program and supplementing curriculum for the sectors with low scores.

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The Alignment Evaluation for Patient Positioning System(PPS) of Gamma Knife PerfexionTM (감마나이프 퍼펙션의 자동환자이송장치에 대한 정렬됨 평가)

  • Jin, Seong Jin;Kim, Gyeong Rip;Hur, Beong Ik
    • Journal of the Korean Society of Radiology
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    • v.14 no.3
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    • pp.203-209
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    • 2020
  • The purpose of this study is to assess the mechanical stability and alignment of the patient positioning system (PPS) of Leksell Gamma Knife Perfexion(LGK PFX). The alignment of the PPS of the LGK PFX was evaluated through measurements of the deviation of the coincidence of the Radiological Focus Point(RFP) and the PPS Calibration Center Point(CCP) applying different weights on the couch(0, 50, 60, 70, 80, and 90 kg). In measurements, a service diode test tool with three diode detectors being used biannually at the time of the routine preventive maintenance was used. The test conducted with varying weights on the PPS using the service diode test tool measured the radial deviations for all three collimators 4, 8, and 16 mm and also for three different positions of the PPS. In order to evaluate the alignment of the PPS, the radial deviations of the correspondence of the radiation focus and the LGK calibration center point of multiple beams were averaged using the calibrated service diode test tool at three university hospitals in Busan and Gyeongnam. Looking at the center diode for all collimators 4, 8, and 16 mm without weight on the PPS, and examining the short and long diodes for the 4 mm collimator, the means of the validation difference, i.e., the radial deviation for the setting of 4, 8, and 16 mm collimators for the center diode were respectively measured to 0.058 ± 0.023, 0.079 ± 0.023, and 0.097 ± 0.049 mm, and when the 4 mm collimator was applied to the center diode, the short diode, and the long diode, the average of the radial deviation was respectively 0.058 ± 0.023, 0.078 ± 0.01 and 0.070 ± 0.023 mm. The average of the radial deviations when irradiating 8 and 16 mm collimators on short and long diodes without weight are measured to 0.07 ± 0.003(8 mm sd), 0.153 ± 0.002 mm(16 mm sd) and 0.031 ± 0.014(8 mm ld), 0.175 ± 0.01 mm(16 mm ld) respectively. When various weights of 50 to 90 kg are placed on the PPS, the average of radial deviation when irradiated to the center diode for 4, 8, and 16 mm is 0.061 ± 0.041 to 0.075 ± 0.015, 0.023 ± 0.004 to 0.034 ± 0.003, and 0.158 ± 0.08 to 0.17 ± 0.043 mm, respectively. In addition, in the same situation, when the short diode for 4, 8, and 16 mm was irradiated, the averages of radial deviations were 0.063 ± 0.024 to 0.07 ± 0.017, 0.037 ± 0.006 to 0.059 ± 0.001, and 0.154 ± 0.03 to 0.165 ± 0.07 mm, respectively. In addition, when irradiated on long diode for 4, 8, and 16 mm, the averages of radial deviations were measured to be 0.102 ± 0.029 to 0.124 ± 0.036, 0.035 ± 0.004 to 0.054 ± 0.02, and 0.183 ± 0.092 to 0.202 ± 0.012 mm, respectively. It was confirmed that all the verification results performed were in accordance with the manufacturer's allowable deviation criteria. It was found that weight dependence was negligible as a result of measuring the alignment according to various weights placed on the PPS that mimics the actual treatment environment. In particular, no further adjustment or recalibration of the PPS was required during the verification. It has been confirmed that the verification test of the PPS according to various weights is suitable for normal Quality Assurance of LGK PFX.

The Effect of Virtual Reality Programs on Upper Extremity Function in Stroke Patients : A Meta-Analysis (뇌졸중 환자의 가상현실 프로그램이 상지기능에 미치는 영향 : 메타분석)

  • Cho, Sung-Hyoun;Choi, Ki-Bok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.8
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    • pp.429-439
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    • 2020
  • This study examined the effect size of virtual reality programs on the upper extremity function of stroke patients through a meta-analysis. Databases, such as the Research Information Sharing Service, the Korean Studies Information Service System, the National Library of Korea, the Korean Citation Index, and the National Digital Science Library, were used. Previous articles were surveyed for virtual reality programs between January 2010 and June 2019. A meta-analysis was performed by selecting the final 14 studies based on the PICO standard. The RoB and RoBANS tools were used as quality assessment tools for randomized and non-randomized control trials, respectively. The CMA 3.0 program was used to calculate the effect size of each study. Sub-group analysis, meta-regression analysis, and publication bias were performed. The total effect size of the virtual reality programs on the upper extremity function was Hedges's g=0.390 (95% CI: 0.192~0.587) (p<.05). The virtual reality program positively affects the upper extremity function of stroke patients. Therefore, the development of various virtual reality programs and industry-academia cooperation technology for stroke patients is required in accordance with the fourth industry. Randomized control trials and detailed upper extremity function studies for virtual reality programs will be needed in follow-up studies.