• Journal of Korean Clinical Nursing Research
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• v.27 no.2
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• pp.187-198
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• 2021

Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.

• Journal of Korean Society for Quality Management
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• v.38 no.4
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• pp.491-503
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• 2010

This paper presents a research model, which identifies a relationship between medical error reduction, efficiency of organizational systems, and employee satisfaction with organizational support. The proposed model was tested through hypotheses, based on data collected from 210 respondents from the medical staff of large -sized (i.e., more than 500 beds) residential hospitals in cities of South Korea. The results of the study showed that medical error reduction is associated with corrective system and employee satisfaction with organizational support. Therefore, it is very important that organizations improve their employees' satisfaction by providing sufficient support (e.g., information support and sharing, work guide book, etc.) for their work. In addition, in organizational systems, the corrective system has positive relationship with medical error reduction. In terms of corrective procedures, leaders or managers can make improvements by providing and supporting a friendly work environment where errors may be reported without blame and discussed in order to be corrected.

• Proceedings of the Korean Institute of Interior Design Conference
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• 2005.05a
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• pp.279-280
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• 2005

Recently, the Korean medical system changed with diversification & specialization and the field of medical service is also specialized in these days. The medical space settings are usually designed for staff needs rather than for patient needs. but The purpose of this project was to identify the design elements for the patient-focused. Main keyword of this project is 'high touch' and basic design concept is 'a sense of stability/velocity'. This medical space is located in Sanbon, and it has an area of 171m$^2$. The material scheme in the interior design of medical space is an important factor for the hospital users. Painting, stainless steel, wood veneer, fabric and p-tile were used as interior finishing material.

• Health Policy and Management
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• v.34 no.1
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• pp.78-86
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• 2024

Background: The purpose of this study was to determine the effectiveness of the specialty hospital system by comparing the medical use of inpatients who had artificial joint replacement surgery in specialty hospitals and non-specialty hospitals. Methods: This study utilized 2021-2022 healthcare benefit claims data provided by the Health Insurance Review and Assessment Service. The dependent variable is inpatient medical use which is measured in terms of charges per case and length of stay. The independent variable was whether the hospital was designated as a specialty hospital, and the control variables were patient-level variables (age, gender, insurer type, surgery type, and Charlson comorbidity index) and medical institution-level variables (establishment type, classification, location, number of orthopedic surgeons, and number of nurses). Results: The results of the multiple regression analysis between charges per case and whether a hospital is designated as a specialty hospital showed a statistically significant negative relationship between charges per case and whether a hospital is designated as a specialty hospital. This suggests a significant low in charges per case when a hospital is designated as a specialty hospital compared to a non-specialty hospital, indicating that there is a difference in medical use outcomes between specialty hospitals and non-specialty hospitals inpatients. Conclusion: The practical implications of this study are as follows. First, the criteria for designating specialty hospitals should be alleviated. In our study, the results show that specialty hospitals have significantly lower per-case costs than non-specialty hospitals. Despite the cost-effectiveness of specialty hospitals, the high barriers to be designated for specialty hospitals have gathered the specialty hospitals in metropolitan and major cities. To address the regional imbalance of specialty hospitals, it is believed that ease the criteria for designating specialty hospitals in non-metropolitan areas, such as introducing "semi-specialty hospitals (tentative name)," will lead to a reduction in health disparities between regions and reduce medical costs. Second, it is necessary to determine the appropriateness of the size of hospitals' medical staff. The study found that the number of orthopedic surgeons and nurses varied in charges per case. Therefore, it is believed that appropriately allocating hospital medical staff can maximize the cost-effectiveness of medical services and ultimately reduce medical costs.

• Journal of Convergence for Information Technology
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• v.9 no.3
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• pp.140-145
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• 2019

With the development of IT technology, many changes are taking place in the health service environment over the past. However, even if medical technology is converged with IT technology, the problem of medical costs and management of health services are still one of the things that needs to be addressed. In this paper, we propose a model for hospitals that have established the IoT system to efficiently analyze and manage the personal information of users who receive medical services. The proposed model aims to efficiently check and manage users' medical information through an in-house IoT system. The proposed model can be used in a variety of heterogeneous cloud environments, and users' medical information can be managed efficiently and quickly without additional human and physical resources. In particular, because users' medical information collected in the proposed model is stored on servers through the IoT gateway, medical staff can analyze users' medical information accurately regardless of time and place. As a result of performance evaluation, the proposed model achieved 19.6% improvement in the efficiency of health care services for occupational health care staff over traditional medical system models that did not use the IoT system, and 22.1% improvement in post-health care for users who received medical services. In addition, the burden on medical staff was 17.6 percent lower on average than the existing medical system models.

• Korea Journal of Hospital Management
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• v.17 no.1
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• pp.79-112
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• 2012

The purpose of this study is to examine the differences of profitability based on the analysis of business and medical service performances of four hospitals in Incheon area with similar size. and to compare hospitals with the best and the worst performances and analyze the factors behind the differences. The differences could be caused by differences in medical service statistics, number of staff, and financial results, etc. The data was acquired through the homepage of the National Tax Service(financial statements for the fiscal year 2009) and the Medical Record Association of Incheon(medical service statistics for the years 2008 and 2009) along with questionnaire survey to the hospitals(personnel data for the year 2009). The results of the study are as follows. Medical profits to medical revenues ratio for the hospitals(referred as Hospital A, B, C, and D) shows, in order, C(8.2%), A(8.0%), B(7.8%), and D(7.4%). However, net income to medical revenues ratio shows otherwise: C(8.5%), D(5.8%), A(3.0%), and B(0.6%). Hospital B shows a high medical profit to revenue ratio but the lowest net income to revenue ratio due to large interest expenses. The leverage ratio of Hospital B is the highest (419.6%), resulting in a very low interest coverage ratio(1.1). On the other hand, Hospital C shows favorable results in both profit ratios, with 8.2% and 8.5% each. Hospital C has the lowest leverage ratio(53.0%) and the highest interest coverage ratio(34.9). Therefore, the results show Hospital C has the best performance while Hospital B the worst. The two hospitals(B and C) show similar results in certain areas and big differences in other areas. The area that has the biggest influence on financial results turns out leverage ratio. Hospital B shows 'very good' to 'good' results in terms of medical service statistics in general. However, the leverage ratio is too high and the liquidity ratio too low, resulting in a very low profit ratio. The results of this study have some limitations in terms of generalization as only four hospitals in Incheon area were selected for the study, resulting in a deficiency in the representativeness of the sample. Further studies with bigger sample size and deeper analysis are expected in this area.

• Journal of Hospice and Palliative Care
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• v.27 no.2
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• pp.64-76
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• 2024

Purpose: End-of-life (EOL) care is a vulnerable period in an individual's life. Healthcare professionals (HPs) strive to balance the preservation of human life with respect for the patient's wishes. The aims of our study were to assess HPs' knowledge and perceptions of EOL care and to propose areas of improvement to improve the quality of care. Methods: We conducted a single-center, cross-sectional study involving HPs from a university hospital who encountered EOL care situations. We used a questionnaire divided into four sections: knowledge, practice, perception, and training. We calculated the rate of correct answers and the collective competence index. Results: Eighty-six questionnaires were analyzed, with 82.5% (71/86) completed by medical respondents and 17.5% (15/86) by paramedical respondents. Most of the respondents, 71.8% (51/71), were interns and residents. The study focused on palliative care, medical assistance in dying, aggressive medical treatment, and euthanasia, finding adequate knowledge in the first three areas. Respondents assigned to the intensive care unit and those with more than 8 years of experience had significantly higher correct answer rates than their counterparts. Seventy-five percent of respondents (65/86) reported feeling that they had little or no mastery of EOL care, primarily attributing this to insufficient training and the unavailability of trainers. Conclusion: Based on the findings of our study, which we believe to be the first of its kind in Tunisia, we can conclude that HPs possess an acceptable level of knowledge regarding EOL care. However, they require more exposure and training to develop expertise in this area.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.37-50
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• 1997

The purpose of this study was to identify the gap between need-level and demonstration-level in nursing managerial competencies. In addition, the study proposes solutions to narrow this gap. The results of this study are as follows : 1) The mean score for need-level of each item was 4.0, and for demonstration-level, 3.5. This indicates that military hospital head nurses demonstrate a higher level of managerial competencies than the moderate level on all items. But items which were related to resource/ cost/ information managament, staff development management and professionalism management got relatively low ratings in the need-level. 2) The mean score for need-level of each category was 4.14, and for demonstration-level, 3.53. Categories on the individual dimension got a higher rating than categories on the group or organization dimension in both need-level and demonstration level. 3) The gap between need-level and demonstration-level appeared in all items(p<.05) and categories(p<.001). Although the gap was relatively low, it indicates that it is essential to plan a developmemt program for all nursing management competencies for military hospital head nurses. 4) There were significant differences in the gap between need-level and demonstration-level according to specific characteristics of the subjects. The gap did not appear in many categories on the individual dimension where the number of nursing staff was more than 10, a major grade, ICU head nurse or for head nurses having a long career. 5) Need-level and demonstration-level showed a difference according to specific characteristics of the subjects, because need-level and demonstration-level were higher where the number of nursing staff was more than 10, a major grade, and for ICU or Medical ward head nurses. The categories which showed need-level difference and demonstration-level differences according to specific characteristics of the subjects existed almostly completely in the group and organization dimension. Gap-level differences according to the number of hospital bed existed in only two categories. 6) The general causes of the gap were indicated to be 'Knowledge/ skill/ experience deficit', 'Limitation of rules and systems/ Inappropriate organizational environment' for most items, categories, and dimensions. The results of this study indicate that extensive competency developing strategies must be developed, because a gap was found in all items and categories. Specially, there is a need to concentrate attention on competencies in the group and organizational dimension which had a wider gap level. And it is important to take an individual approach according to the cause for each gap. In order to produce effective competency developing strategies, top managers must have sinsights into the importance of nursing staff development and nursing officer's efforts to develop themselves must be achieved. Further multi-dimensional(education, personnel-policy, nursing/ organizational environment) solutions to the gap must be developed and utilized.

• Journal of Korean Neurosurgical Society
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• v.51 no.6
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• pp.383-387
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• 2012

Spinal epidural abscess, if especially caused by Brucellosis is a very rare disease which is usually a consequence of spondylodiscitis. The spinal column can be affected at any joint; however, the lumbar spine is the most common region, especially at the level of the L4-5 and L5-S1. The frequency of spinal involvement usually seen at the lumbar, thoracic and cervical spine respectively. As an occupational disease in farmers, veterinaries, butchers, laboratory staff and shepherds, brucellosis can also occur by direct contact to animals and infected materials or ingestion of raw cheese, milk or unpasteurized milk products. In this study, we presented two cases with cervical spinal epidural abscess caused by brucella melitensis, which was successfully treated by surgical approach. Initial treatment was combined with antibiotic therapy after the surgery for 3 months.

• Korean Circulation Journal
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• v.53 no.5
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• pp.294-312
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• 2023

Heart failure (HF) is a global health problem closely related to morbidity and mortality. As the burden of HF increases, it is necessary to manage and treat this condition well. However, there are differences between real-world practice and guidelines for the optimal treatment for HF. Patient-related, healthcare provider-related, and health system-related factors contribute to poor adherence to optimal care. This review article aims to examine HF treatment patterns and treatment adherence in real-world practice, identify clinical gaps to suggest ways to improve the quality of care for HF and clinical outcomes for patients with HF. Although it is important to optimize treatment based on evidence-based guidelines to the greatest extent, it is known that there is still poor treatment adherence, and many patients do not receive guideline-directed medical therapy, especially at the early stages. To improve medication adherence, qualitative evaluation through performance measurement, as well as education of patients, caregivers and medical staff through a multidisciplinary approach are important.