• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권4호
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• pp.17-25
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• 2017

Purpose: Since hospitals have a big impact on the natural and social environment, hospitals' sustainability must be considered in various aspects including environmental, social, and economical aspects. So far, research on sustainable hospitals has mainly been conducted on indoor environment, but outdoor space of hospital is as important as well. The purpose of this research is to study the sustainability of hospital outdoor space and to make proposals for improving sustainable regional public hospitals. Methods: Through preceding research analysis and literature review, the concept of sustainable outdoor space of hospital was defined. Also, the evaluation contents of outdoor space were extracted from domestic and foreign green building certification criteria. With this analytic frame, we visited 4 regional public hospitals in Korea, interviewed the facility managers, and analyzed sustainability of hospital outdoor space. Results: Analysis of 4 regional public hospitals reveals that there is a lack of consideration for sustainability in all 4 categories; urban and network, natural environment, community, and user. In terms of community, sustainability has rarely been applied to all four hospitals. The site selection and terrain of the site were essential to sustainability. Implications: Establishing a master plan considering future expansion is critical. Also more attempt to show regional characteristics is needed. It is necessary to design a comprehensive outdoor space that considers sustainability and also healing environment. Level difference in the site can be used as a design element.

• 대한의용생체공학회:의공학회지
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• 제45권1호
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• pp.49-55
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• 2024

Accurate measurement of blood pressure is essential for classifying an individual's disease, identifying blood pressure-related risks, and managing health. Due to the environmental and health hazards of mercury sphygmomanometers, automatic sphygmomanometers using the oscillometric method are widely used in hospitals as well as in general homes, and have established themselves as a practical standard sphygmomanometer. In this study, we developed a blood pressure simulator using an actuator that provides simulated pressure to an automatic blood pressure cuff. The developed blood pressure simulator adopts an arm-shaped cylindrical shape similar to the situation in which a person measures blood pressure with an automatic blood pressure monitor, and implements a method of transmitting pressure to the cuff using a pressure plate. Accuracy was evaluated through the mean and standard deviation of the difference with the commercialized blood pressure simulator BP PUMP 2, and reproducibility was confirmed using two automatic blood pressure monitors. The developed blood pressure simulator enables automatic blood pressure monitoring in a simple manner and also meets the evaluation standards for accuracy and reproducibility. In the future, as a standardized blood pressure simulator, it is expected to be of great help in evaluating and verifying the performance of automatic blood pressure monitors by supplementing precise hardware and software and building a blood pressure database.

• 대한임상검사과학회지
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• 제48권4호
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• pp.348-354
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• 2016

병원정보시스템에 저장되어 있는 자료들은 적절성 평가 및 질관리를 향상시키는 데 있어 많은 잠재력을 가지고 있으며 이를 기반으로 하는 데이터웨어하우스의 구축은 질 관리의 향상과 임상진료에 많은 도움을 줄 수 있는 것으로 알려져 있다. 본 연구는 감염관리 정보의 체계적이고 효과적인 자료 분석을 위한 일환으로 항생제 사용량 분석이 가능한 데이터마트를 구축하였다. 감염관리의 구성요소 및 평가 척도를 선정 후 XML DTD 방법으로 메타데이터를 설계하였고 모델링을 통해 데이터마트를 구축하여 항생제 사용량 분석을 위한 다차원 분석 도구인 OLAP를 시현하였다. 실험 자료는 1997년 7월 한 달 동안의 천안 지역의 일개 대학병원의 항생제 사용량 자료를 이용하였다. 감염관리 메타데이터의 상위요소는 항생제 내성 정보, 항생제 사용량 정보, 감염 정보, 검사 정보, 환자 정보 및 감염 관련 비용으로서 구성하였다. 이 중 항생제 사용량 정보를 스타 스키마에 적용하기 위한 데이터베이스의 설계를 하여 데이터마트를 구축하였다. 그리고 일 개월 간 사용된 항생제 사용량에 대해 OLAP을 시현하였다. 본 연구는 XML과 OLAP 기술의 구현을 통해 항생제 사용량에 대한 감염관리 데이터마트를 수립하였다. 개념적이고 구조화된 데이터마트의 구축은 감염관리 정보에 대해 신속하고 다양한 분석을 제공할 것으로 사료되었다.

• 한국실내디자인학회논문집
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• 제24권2호
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• pp.189-196
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• 2015

In case of Senior Hospitals, meticulous care is required in both amount and quality of natural lighting because of the semi-long term residence of patients. Natural lighting has a huge impact on the physical and psychological part for the seniors. Likewise, natural lighting is an important factor considered for hospital design because it can also effect hospitalization period of patients. Research subject was K Senior Hospital which was determined as the courtyard-type building made to provide healing environment through natural lighting. Analysis was performed by dividing the space of K Senior Hospital into Central Treatment Department directly used by patients, Outpatient Department(OPD), Ward Department, Common Use Department. Research was carried out in two ways of integration value analysis using SPACE SYNTAX and illumination intensity analysis using ECOTECT. K Senior Hospital intended to actively let in natural light through courtyard and to make patients exposed to natural light when they walk along the circuit corridor built around the courtyard. This environmental consideration affected the utilization rate of Common Use Department and residence time of patients raising the average of Common Use Department on every floor. As a resuit of this study presenting type C and type D, part of four types of illumination intensity, takes higher percentage of almost every spaces compare to the others therefore K Senior Hospital was designed on the assumption of healing environment composition through natural light. The result of this research would be used meaningfully in the space programming phase of Senior Hospitals in the future. Utilization rate can be adjusted using illumination intensity value in the space that integration rate should be planed to be high. The use(purpose) of space and integration rate can be used as a guideline to set illumination intensity of natural.

• Journal of Genetic Medicine
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• 제13권1호
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• pp.41-45
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• 2016

Marfan syndrome (MFS) is an inherited connective tissue disorder with a mutation in the fibrillin-1 (FBN1) gene. Fibrillin is a major building block of microfibrils, which constitute the structural component of the connective tissues. A 10-year-old girl visited our hospital with the chief complaint of precocious puberty. According to her medical history, she had a pulmonary wedge resection for a pneumothorax at 9 years of age. There was no family history of MFS. Mid parental height was 161.5 cm. The patient's height was 162 cm (>97th percentile), and her weight was 40 kg (75th-90th percentile). At the time of initial presentation, her bone age was approximately 11 years. From the ophthalmologic examination, there were no abnormal findings except myopia. There was no wrist sign. At the age of 14 years, she revisited the hospital with the chief complaint of scoliosis. Her height and weight were 170 cm and 50 kg, respectively, and she had arachnodactyly and wrist sign. We performed an echocardiograph and a test for the FBN1 gene mutation with direct sequencing of 65 coding exons, suspecting MFS. There were no cardiac abnormalities including mitral valve prolapse. A cytosine residue deletion in exon 7 (c.660delC) was detected. This is a novel mutation causing a frameshift in protein synthesis and predicted to create a premature stop codon. We report the case of a patient with MFS with a novel FBN1 gene missense mutation and a history of pneumothorax at a young age without cardiac abnormalities during her teenage years.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제19권3호
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• pp.21-28
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• 2013

Purpose: General hospital in korea is getting large-scaled, specialized and upgraded. So, nursing unit of race track type has been advanced along with a spatial organization, building equipment and environmental approach. This study is to search the guidelines for renovation of nursing unit with race track type in the case of K university hospital in Daejeon. Methods: 9 cases of recently opened general hospital has been analyzed for spatial and environmental design solution. Questionnaires and interviews about user needs of nursing staff, patient and visitors, have been conducted for a nursing care system and facility of nursing units in K university hospital. Results: The user needs are represented as followings. Center core public zone in each floor plan and center core nursing station and supporting areas in nursing unit are good for an adjacency and separation of spatial organization. Toilet of group patient room is necessary to equip for easy, safe and infective aspects, and so toilet install will decrease the patient number and increase the nursing care service. Hall type of station front is good for visibility and observation. It is appropriate to renovate into south facing group patient room for privacy, enough space for nursing care facility and supporting area, enough width of door to move portable medical equipment, room for medical doctor and practical student, noise absorbing of day room. Implications: Upgrading the nursing care service and facility equipment is necessary to reflect the user needs and cooperate with hospital management.

• 지역사회간호학회지
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• 제30권1호
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• pp.99-107
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• 2019

Purpose: This study aimed to assess hand hygiene (HH) compliance among visitors at a long-term care hospital in South Korea. Methods: The study was conducted at a 502-bed long-term care hospital located in Gyeonggi-do Province. From July 1 to August 15, 2017, including more than 6 weekends and one holiday, a trained observer covertly assessed visitors' HH at all five units (360 beds in total) of the study hospital building until the completion of 1,000 HH opportunities (i.e., 200 opportunities per unit). The modified World Health Organization (WHO) HH observation form was used. Instead of professional categories and the "before clean/aseptic procedure" moment, the estimated age range for each visitor were recorded in four categories: children (<14 years old), adolescents (14~18), adults (19~64), and the elderly (${\geq}65$). The collected data were analyzed using SPSS 22.0. Results: A total of 1,000 HH opportunities were observed from 766 visitors (an average of 1.31 per visitor) and the overall HH compliance rate was 20.3%. Overall, 53.7% of the HH cases were performed with soap and water. Among the 4 HH moments, the "after body fluid exposure risk" moment showed the highest compliance rate (83.5%); 93.9% used soap and water. The most commonly exposed potential body fluid among visitors was saliva (48.1%). Conclusion: For hospital visitors in long-term care hospitals, HH education programs including HH moments need to be developed and implemented. Further studies are necessary to evaluate visitors' HH compliance in various hospital settings and find the related variables influencing visitors' HH.

• 한국병원경영학회지
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• 제28권3호
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• pp.1-14
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• 2023

Purposes: It is very important to establish a clinical data warehouse based on a common data model to offset the different data characteristics of each medical institution and for drug surveillance. This study attempted to establish a clinical data warehouse for Dankook university hospital for drug surveillance, and to derive the main items necessary for development. Methodology/Approach: This study extracted the electronic medical record data of Dankook university hospital tracked for 9 years from 2013 (2013.01.01. to 2021.12.31) to build a clinical data warehouse. The extracted data was converted into the Observational Medical Outcomes Partnership Common Data Model (Version 5.4). Data term mapping was performed using the electronic medical record data of Dankook university hospital and the standard term mapping guide. To verify the clinical data warehouse, the use of angiotensin receptor blockers and the incidence of liver toxicity were analyzed, and the results were compared with the analysis of hospital raw data. Findings: This study used a total of 670,933 data from electronic medical records for the Dankook university clinical data warehouse. Excluding the number of overlapping cases among the total number of cases, the target data was mapped into standard terms. Diagnosis (100% of total cases), drug (92.1%), and measurement (94.5%) were standardized. For treatment and surgery, the insurance EDI (electronic data interchange) code was used as it is. Extraction, conversion and loading were completed. R language-based conversion and loading software for the process was developed, and clinical data warehouse construction was completed through data verification. Practical Implications: In this study, a clinical data warehouse for Dankook university hospitals based on a common data model supporting drug surveillance research was established and verified. The results of this study provide guidelines for institutions that want to build a clinical data warehouse in the future by deriving key points necessary for building a clinical data warehouse.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제43권1호
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• pp.57-60
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• 2017

Stevens-Johnson syndrome (SJS) is characterized by mucocutaneous tenderness and typical hemorrhagic erosions, erythema and epidermal detachment presenting as blisters and areas of denuded skin. SJS is often observed after drug use as well as after bacterial or viral infections. Several drugs are at high risk of inducing SJS, but there are no cases in the English literature regarding anabolic steroid use triggering SJS. In our paper, we describe a case in which use of anabolic androgenic steroids (AAS) was associated with SJS. The patient participated in competitive body-building and regularly took variable doses of AAS. Initial symptoms (headache, weakness, pharyngodynia, and fever) were ignored. After a week he presented to the Emergency Department with a burning sensation on the mouth, lips, and eyes. Painful, erythematous, maculopapular, and vesicular lesions appeared all over the body, including on the genitals. During hospitalization, he also developed a cardiac complication. The patient had not taken any drugs except AAS.

• 한국병원경영학회지
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• 제spc호
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• pp.51-60
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• 2016

The forms of healthcare service delivery emerges from the interaction between technological progress and institutional changes. Building a healthcare system which enables effective and efficient patient care is a imperative to a sustainable operation of a society. Identifying of a promising medical technologies and diffusing them consists of the basic tasks of a good healthcare system. Inducing of a promising innovation in healthcare and utilization of the innovation requires a deep understanding of healthcare innovation system and delicate governmental intervention to the effective functioning of the system. Therefore, the support for R&D in healthcare field should be given to social and institutional technologies for the better organization of healthcare delivery and consumption system as well as basic and applied medical sciences.