• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권4호
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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 Hospice and Palliative Care
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• 제24권4호
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• pp.226-234
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• 2021

Purpose: The accessibility of medical facilities for cancer patients affects both their comfort and survival. Patients in rural areas have a higher socioeconomic burden and are more vulnerable to emergency situations than urban dwellers. This study examined the feasibility and effectiveness of a cancer care model integrating a regional cancer center (RCC) and public health center (PHC). Methods: This study analyzed the construction of a safety care network for cancer patients that integrated an RCC and PHC. Two public health institutions (an RCC in Gyeongnam and a PHC in Geochang County) collaborated on the development of the community care model. The study lasted 13 months beginning in February 2019 to February 2020. Results: The RCC developed the protocol for evaluating and measuring 27 cancer-related symptoms, conducted education for PHC nurses, and administered case counseling. The staff at the PHC registered, evaluated, and routinely monitored patients through home visits. A smartphone application and regular video conferences were incorporated to facilitate mutual communication. In total, 177 patients (mean age: 70.9 years; men: 59%) were enrolled from February 2019 to February 2020. Patients' greatest unmet need was the presence of a nearby cancer treatment hospital (83%). In total, 28 (33%) and 44 (52%) participants answered that the care model was very helpful or helpful, respectively. Conclusion: We confirmed that a combined RCC-PHC program for cancer patients in rural areas is feasible and can bring satisfaction to patients as a safety care network. This program could mitigate health inequalities caused by accessibility issues.

• 대한방사선기술학회지:방사선기술과학
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• 제46권2호
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• pp.151-157
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• 2023

The purpose of this study was to develop an assist device that could correct and support patient position during biopsy on computed tomography (CT) using 3D printing technology. The development method was conducted in the order of 3D design, 3D output, intermediate evaluation for product, final assist device evaluation. The 3D design method was conducted in the order of prior research data survey, measurement, primary modeling, 3D printing, output evaluation, and supplementary modeling. The 3D output was the 3D printer (3DWOX 2X, Sindoh, Korea) with additive manufacturing technology and the polylactic acid (PLA) materials. At this time, the optimal strength was evaluated to infill degree of product as the 3D printing factors into 20%, 40%, 60%, and 80%. The intermediate evaluation and supplementation was measured noise in the region of interest (ROI) around the beam hardening artifact on the CT images. We used 128-channel MDCT (Discovery 75 HD, GE, USA) to scan with a slice thickness of 100 kVp, 150 mA, and 2.5 mm on the 3D printing product. We compared the surrounding noise of the final 3D printing product with the beginning of it. and then the strength of it according to the degree of infill was evaluated. As a result, the surrounding noise of the final and the early devices were measured at an average of 3.3 ± 0.5 HU and 7.1 ± 0.1 HU, respectively, which significantly reduced the noise of the final 3D printing product (p<0.001). We found that the percentage of infill according to the optimal strength was found to be 60%. Finally, development of assist devices for CT biopsy will be able to minimize artifacts and provide convenience to medical staff and patients.

• 융합정보논문지
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• 제12권2호
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• pp.107-115
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• 2022

본 연구의 목적은 중소병원 간호사의 감염관리 지식, 표준주의 수행도를 파악하고 표준주의 수행도에 미치는 영향 요인을 규명하기 위함이다. 본 연구는 횡단적 서술적 조사연구 방법으로 7개 중소병원 간호사 258명을 대상으로 수행되었다. 감염관리 지식은 평균 7.25점, 표준주의 수행도는 평균 3.61점이었으며, 임상경력(r=.123, p=.047)과 직위(F=5.356, p=.005)에 따라 표준주의 수행도에 차이를 보였다. 감염관리 지식과 표준주의 수행도 간에는 통계적으로 유의한 양의 상관관계가 있었으며(r=.421, p<.001), 표준주의 수행도에 영향을 미치는 요인은 직위(β=-.187, p=.025)와 감염관리 지식(β=.408, p<.001)으로 나타났다. 중소병원 간호사의 의료관련감염 관리를 위한 표준주의 수행도를 증진시키기 위한 방안으로 일반간호사를 대상으로 감염관리에 대한 융복합 교육이 요구된다.

• 중환자간호학회지
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• 제17권1호
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• pp.44-56
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• 2024

Purpose : This study sought to explore intensive care unit (ICU) nurses' perceptions regarding the disclosure of patient safety incidents (DPSI) and identify the relationship between the perception of DPSI and communication barriers. Methods : This study used a descriptive research design. A total of 110 ICU nurses from a tertiary hospital were surveyed online between September 14 and October 5, 2022. The mean DPSI score ranged between 1.0 and 4.0, with a higher score indicating a higher perception of DPSI. Results : The mean score for ICU nurses' perceptions of DPSI was 2.92 (SD=0.37). Among the characteristics of ICU nurses, differences were observed in perceptions of DPSI according to gender, age, total work experience, and ICU work experience. Communication barriers among ICU nurses were negatively correlated with negative results as a sub-factor of perceptions of DPSI. Ambiguity in the nurse's position, lack of confidence, differences in perspectives with patients, and inadequate nurse-patient relationships as sub-factors of communication barriers exhibited a negative correlation with negative results as a sub-factor of perceptions of DPSI. Conclusions : ICU nurses' perceptions of DPSI and the sub-factors related to communication barriers are negatively related to DPSI. To improve ICU nurses' perceptions, open and non-punitive circumstances, staff education, practical guidelines, and support systems are required.

• 한국의료질향상학회지
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• 제29권2호
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• pp.2-14
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• 2023

Purpose: This study aimed to identify strategies to enhance the competencies of patient safety coordinators in Korea. Methods: Fourteen participants from nine hospitals were interviewed between May and November 2022. Qualitative content analysis was used to analyze the data. Results: As for the strategies to enhance patient safety management competency, 3 themes and 11 sub-themes were derived. The first theme was 'Having individual competence as a patient safety coordinator', and the sub-themes were 'Communication skills with members', 'Flexible thinking from multiple perspectives', and 'Preparing for administrative work competencies that they had not experienced as a nurse.' The second theme was 'Responding strategically to promote improvement activities', and the sub-themes for it were 'Multi-angle approach to the problem', 'A careful approach so as not to be taken as criticism in the field', 'Increasing the possibility of improvement activities through awareness', 'Activating the network between patient safety coordinators', and 'Expanding learning opportunities through patient safety case analysis.' The third theme was 'Obtaining support to facilitate patient safety activities', and the sub-themes for this were 'Improving staff awareness of patient safety', 'Providing a training course for nurse professional of patient safety', and 'Expanding the manpower allocation standard of patient safety coordinators.' Conclusion: This study explored personal competencies such as document writing and computer utilization capabilities, focused on ways to improve the field of patient safety management, and emphasized the need for organizational and political support.

• 스마트미디어저널
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• 제13권1호
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• pp.60-66
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• 2024

센서들을 네트워크로 연결하면서 시작된 사물인터넷은 인공지능 기술과 결합하면서 지능형 IoT로 발전되고 있다. 도심 고층 건물들은 승강기가 필수적으로 설치되고, 승강기는 층을 이동하며 화물 운반과 사용자 이동의 기능을 수행한다. 고층 건물이나 특수 환경(병원 등)의 승강기 사용자에게 안전하고 편리한 서비스를 제공해야 한다. 대형 병원과 같이 신속한 환자 운송이 중요한 환경에서 병원 직원 및 환자용 승강기에 일반인들도 수시로 이용하는 문제점이 존재한다. 특히, 골든 타임이 중요한 환자 이동 시 승강기를 탑승하기 위한 대기 시간은 큰 방해 요소이다. 이러한 문제를 해결하기 위해서 본 연구에서 스마트폰 블루투스를 이용하여 승강기 호출 지능형 IoT 시스템을 제안한다. 먼저 스마트폰 블루투스를 이용하여 승강기 호출 IoT 시스템을 실험하고, 실험결과, 승강기 사용자의 인증 및 불필요한 탑승 대기시간을 감소시킬 수 있음을 확인하였다. 또한 지능형 IoT로 연계하는 승강기 호출 지능형 IoT 시스템을 제안한다.

• 대한간호학회지
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• 제19권2호
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• pp.212-222
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• 1989

When the head nurse who is pivotal in the nursing service administration of the hospital performs efficiently as a first-line manager, the effectiveness of the nursing unit, which includes the quality of nursing care, the jab satisfaction of staff members, and the cohesiveness of staff members is increased. With this point of view in mind, the researcher carried out a study to determine the actual work (the content of the work, the work process, the role of the head nurse, the activity media, and the purpose of the work) of the head nurse in a university hospital in Korea. In addition, this study was also carried out for the purpose of preparing an ideal model for the work of the head nurse. The research subjects were 39 head nurses. This included all the head nurses in two university hospitals except those who were working in outpatient care, operating rooms, central supply, nursing administration, in-service education and emergency care. Data were collected from September 24th to October 21th, 1987 and April 4th to 12th, 1988. A work activity record on which the head nurse recorded directly in a chronological narrative form, was used as the research instrument. The 234 work activity records, 39 head nurse's continuous recording over 6 days(from Monday to Saturday) were collected and analysed. The results were as follows ; 1. With regard to the work content for the total daily work of the head nurse, 45.2% of the activities were managerial activities but 58.1% of the head nurse' s time was spent in direct patient care. 2. With regard to the work process of the head nurse, specifically the location, the size and membership of groups contacted, the results were as follows : 1) Of the total daily work activities 92.4% were carried out in the nursing unit and this occupied 84.5% of total daily work time. Direct patient care was generally performed on the nursing unit and managerial work was performed in other areas. 2) Of the total daily work activities, 73% was with one or more persons and 51.2% of total daily work time was spent in groups. 3) A total of 51 persons, working in different capacities were contacted. These included 21 persons giving patient care, 19 persons working in nursing unit management, and 7 persons working in human resource management. 3. With regard to the head nurse's role in work activity, 53.3% of total daily work activities involved the informational role, 26.9%, the interpersonal role and 19.9%, the decisional role. With regard to time, 57.7% was spent in the informational role, 23.9%, in the interpersonal role and 18.3%, in the decisional role. When the head nurse performed managerial work, she gave nearly equal emphasis to all three roles when she gave direct patient care the informational role was increased. 4. With regard to the activity media, the number of unscheduled activities accounted for 27.1% of the activities, scheduled activities, 24.3%, desk work activity, 22.1%, rounds, 12.5% and telephone calls, made or received, 14.0%. In daily total work time managerial work related to desk work and scheduled activities were high, ranging from 29.8% to 29.9% but for direct patient care time, scheduled activities and unscheduled activities were high, ranging from 23.6％ to 35.3%. 5. With regard to the purpose of the work performed, 54.4% of the total daily work was concerned with the team and 41.4% was concerned with the agency. The managerial work was concerned mainly with the team and the direct patient care was concerned mainly with the patient. When the frequency of an activity and time were compared no significant difference was found between the days for which the work was recorded for any of the variables : the work content, the work process, the work role, the activity media and purpose of the work. On the basis of this study the following are proposed as an ideal model for head nurse work in Korea : The managerial work should be increased to 70%. The decisional role activities should be increased to 40%. Twenty percent of the work activity should be allocated to agency, community and profession. It is believed that this model for the head nurse's work can contribute to guidelines for job description development. Finally, educational programs, organizational and structural devices, and administrative support are needed for the proper function of the head nurse in this proposed model.

• Radiation Oncology Journal
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• 제21권1호
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• pp.1-9
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• 2003

목적 : 계명대학교 의과대학 치료방사선과학교실의 의료진들이 개발하여 사용하고 있는 방사선수술 시스템인 Photon Knife를 이용하여 뇌동정맥기형을 치료하고 그 효과를 보고자 하였다. 대상 및 방법 : 1993년 12월부터 2000년 10월까지 뇌동정맥기형으로 계명대학교 동산의료원 치료방사선과를 방문하여 Photon Knife로 방사선수술을 받은 환자는 30명이었다. 성별분포는 남자 20명, 여자 10명이며 연령분포는 7세부터 63세로 평균 34세이었다. 뇌동정맥기형(AVM nidus)의 위치는 전두부, 두정부, 시상부 순이었고 변소의 장경은1.2 cm에서 5.5 cm으로 평균 2.9 cm이었으며 표적용적은 0.5 cc에서 20.6 cc로 평균 6.8 cc이었다. 대부분에서 회전 중심선량의 80% 등선량곡선(Isodose line)에 1,500~2,500 cGy (중앙값 2,000 cGy)를 조사하였다. 1개의 회전중심점을 사용한 환자는 25명이었고 2개의 회전중심점을 사용한 환자는 4명이었으며 1명은 4개의 회전중심점을 사용하였다. 추적검사는 방사선수술 후 6개월에서 1년 간격으로 전산화단층촬영이나 자기공명영상을 시행하여 병소(nidus)의 완전소실이 관찰되면 뇌혈관조영술이나 자기공명영상 혈관조영촬영술로 확인하였다. 추적관찰기간은 10개월에서 103개월로 중앙추적기간은 39개월이었다 결과 : 전체환자 중 영상학적으로 20개월 이상 추적 관찰된 환자는 20명이었으며 그 중 70% (14/20)에서 완전폐색을 관찰하였다. 병소의 장경에 따라 작은 뇌동정맥기형(<2 cm) 환자 4명은 모두 완전폐색이 되었고 중간크기 뇌동정맥기형(2~3 cm은 80%, (8/10)에서 완전폐색이 되었으며 2명은 부분폐색이 되었다. 큰 뇌동정맥기형(> cm)에서는 환자 6명 중 1명만 완전폐색을 보였고 5명에서는 부분폐색은 되었으나 3년재에도 남아 있는 환자 3명은 재 방사선수술을 하였고 이 중 20개월 이상 추적검사를 받은 1명은 재 방사선수술 후 완전폐색이 되었다. 방사선 수술전 신경발작(seizure)을 주소로 내원한 환자 10명은 방사선수술과 약물투여로 신경발작의 재발은 없었다. 뇌출혈이 있었던 11명 중 1명에서 방사선수술 후 19개월, 61개월에 다시 출혈하였으나 입원 치료 후 회복되었다. 방사선수술에 의한 심각한 부작용은 관찰되지 않았다. 결론 : 이상으로 볼 때 저자들에 의해 개발된 Photon knife를 이용한 방사선수술은 뇌동정맥기형에서 수술이 불가능한 위치에 있거나 수술을 거부하는 환자 중 병소의 장경이 3 cm 이하이거나 병소의 용적이 10 cm$^{3}$ 이하인 뇌동정맥기형의 치료에 안전하고 효과적인 방법으로 사료된다. 또한 10 cm$^{3}$ 이상의 용적이 큰 뇌동정맥기형에서는 순차적(staged) 방사선수술을 처음부터 고려할 필요가 있을 것으로 사료된다.

• 간호행정학회지
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• 제5권1호
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• pp.113-136
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• 1999

There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.