• Title/Summary/Keyword: Hospital medical staff

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Current status of interprofessional education learning activities in wards provided by tertiary hospitals and secondary general hospitals and barriers

  • Kang, Joonsung;Sin, Hye Yeon
    • Korean Journal of Clinical Pharmacy
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    • v.32 no.2
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    • pp.106-115
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    • 2022
  • Background: The World Health Organization (WHO) has focused on the need for interprofessional education (IPE) to improve interprofessional collaboration competency and patient health outcomes. Accordingly, most European and North American medical colleges have established IPE for students. However, IPE learning activity in medical wards for the clinical experience of pharmacy students has not been fully reviewed in Korea. Therefore, this study aims to examine the current status of IPE learning activities in wards at tertiary and secondary hospitals in order to identify ways to improve the program. Methods: The official document of cooperation consists of six self-administered questions regarding IPE learning activities in wards. The preceptor's response in each hospital was evaluated. Results: Of the 22 hospitals, 9 tertiary hospitals and 12 secondary general hospitals responded. For the introductory pharmacy practice experience (IPPE), participating in intensive care (IC) was provided at one secondary general hospital (8.3%) and no tertiary hospital. Ward rounds with medical staff members were provided at two tertiary hospitals (22.2%) and one (8.3%) secondary general hospital. A major barrier to executing IPE was lack of rewards and incentives for the faculty and preceptors who participated in the program. Conclusion: In both tertiary hospitals and secondary general hospitals, pharmacy students have limited exposure to IPE learning activities in wards at hospital, and IPPE at most hospitals was carried out in pharmacy settings only. This study suggests that it is necessary for the hospitals to improve and support IPE learning activities in wards in order to improve learners' competency.

2021 Korean Society of Gastrointestinal Endoscopy Clinical Practice Guidelines for Endoscopic Sedation

  • Hong Jun Park;Byung-Wook Kim;Jun Kyu Lee;Yehyun Park;Jin Myung Park;Jun Yong Bae;Seung Young Seo;Jae Min Lee;Jee Hyun Lee;Hyung Ku Chon;Jun-Won Chung;Hyun Ho Choi;Myung Ha Kim;Dong Ah Park;Jae Hung Jung;Joo Young Cho;Endoscopic Sedation Committee of Korean Society of Gastrointestinal Endoscopy
    • Clinical Endoscopy
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    • v.55 no.2
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    • pp.167-182
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    • 2022
  • Sedation can resolve anxiety and fear in patients undergoing endoscopy. The use of sedatives has increased in Korea. Appropriate sedation is a state in which the patient feels subjectively comfortable while maintaining the airway reflex for stable spontaneous breathing. The patient should maintain a state of consciousness to the extent that he or she can cooperate with the needs of the medical staff. Despite its benefits, endoscopic sedation has been associated with cardiopulmonary complications. Cardiopulmonary complications are usually temporary. Most patients recover without sequelae. However, they may progress to serious complications, such as cardiovascular collapse. Therefore, it is essential to screen high-risk patients before sedation and reduce complications by meticulous monitoring. Additionally, physicians should be familiar with the management of emergencies. The first Korean clinical practice guideline for endoscopic sedation was developed based on previous worldwide guidelines for endoscopic sedation using an adaptation process. The guideline consists of nine recommendations based on a critical review of currently available data and expert consensus when the guideline was drafted. These guidelines should provide clinicians, nurses, medical school students, and policy makers with information on how to perform endoscopic sedation with minimal risk.

Analysis of Nursing Activities and Cost of Nursing Service Based on the ABC System (활동기준원가계산(ABC)을 이용한 간호활동 분석 및 간호서비스 원가분석;일 산부인과 간호단위를 중심으로)

  • Kang, Kyeong-Hwa
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.389-400
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    • 1999
  • The purpose of this study is to examine a possibility of applying the ABC system to analyze the cost of nursing service on one obstetrics and gynecology (OB/GYN) unit in a major medical center. The activities of nurses on an OB/GYN unit were analyzed for 4 days for 96 hours. 2 week days and 2 days on weekend. Total cases included in the study were activities of 12 charge nurses and 12 staff nurses. Activities were categorized into direct and indirect activities in order to calculate the cost of activities. Nursing activities were defined multidimesionally in order to utilize the ABC system. The 60 nursing activities were classified into the direct nursing activities and the indirect nursing activities based on a literature review, interview, and survey results. The direct activities were further categorized into the single nursing activities and the multiple nursing activities. The indirect activities were classified into the indirect nursing service activities and the general management activities. The major findings of this study were as follows : 1. There were differences in activities according to the positions and duties of the nurses. The charge nurses mostly performed the indirect nursing service activities and the general management activities. Almost all of their indirect nursing activities spent on each patient were similar. The staff nurses performed the single nursing activities and the multiple nursing activities. 2. The activities of staff nurses included medication, patient assessment, rounding and organizing the unit. patient education, nursing treatment, admission and discharging of patients. There was no differences in types and amount of time spent between the nurses on day-time duty and evening-time duty, but the patient assessment activity increased during the night-time. 3. The cost of post partum nursing services for women who had a normal vaginal delivery using the ABC system included the cost incurred by direct nursing activities provided by the staff nurses (85.9%), indirect nursing activities incurred by the staff nurses(19.0%) and the nursing activities by the charge nurses and the head nurse(14.1%). The ABC system is a relatively new method of cost analysis. The results of this study can provide the nursing and hospital managers with useful information on cost control. It is suggested that more studies should be done using the ABC system and extend the scope of studies to include value analysis to aid the Activity-Based Management(ABM) and/or the reengineering of hospital process.

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Factors Affecting Use Satisfaction with Hospital Information System of Hospital Administrator (병원행정직원의 병원정보시스템 이용만족도에 영향을 미치는 요인)

  • Choi, Jun-Young;Ko, Min-Seok;Lee, Hyun-Suk
    • The Korean Journal of Health Service Management
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    • v.5 no.3
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    • pp.157-168
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    • 2011
  • This study was designed to identify satisfaction with Hospital Information System(HIS) and the factors affecting them in hospital administrators. The data was collected for 24 days from Mar. 02 to 25, 2011. Among a total of 82 cases of the questionnaires, only 76 cases were used. From the survey, it was made known that there was statistically significant difference in speed, preciseness and stability of environmental factors depending on the type of hospitals while significant difference was found in stability by number of beds. Among the factors of system operation, the administrational method affected speed, preciseness, stability and convenience statistically significantly whereas, however, preciseness, stability and convenience became significantly different depending on the number of staff members. As for the factors that could exercise influence upon satisfaction with administrative service of the HIS, it was revealed that statistically considerable impact could be caused under management of own EDPS expert as well as under comanagement by the medical institution and professional business entity in case of hospital.

The Relationships among the Service Education Satisfaction, Service Involvement, and Customer Orientation of Hospital Employees (의료기관 종사자의 고객접점 (MOT)서비스교육만족도, 고객지향성 및 서비스몰입 간의 관계)

  • Lee, Seung-Hee;Choi, Yeon-Hee
    • Korean Journal of Occupational Health Nursing
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    • v.20 no.3
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    • pp.337-345
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    • 2011
  • Purpose: This study was conducted to evaluate the relationships among the service education satisfaction, service involvement, and customer orientation of hospital employees after yearly-planned MOT service education. Methods: The data collection was done through the questionnaire survey in a university hospital located in D city from March 15 to 31, 2010. The statistical analysis was done by SPSS/WIN 18.0 program. Results: The enrolled employees were two hundred and seventy six. Among the characteristics of employees, adequate work load, good payment, reasonable promotion system, suitability of work aptitude and good relationships with staff improved the service education satisfaction, customer orientation, and service involvement of hospital employees. For the customer orientation, old age and lower educational background were positive factors. The correlations among the service education satisfaction, customer orientation, and service involvement of hospital employees were significant. The factors that affect customer orientation and service involvement were found to be age, suitability of work aptitude and service education satisfaction. Conclusion: In conclusion, customer orientation and service involvement were related with the satisfaction of employees for working condition and service education. In terms of good medical service quality, plans for maintaining adequate working environment and systematic service education should be established.

Infection Control through Emergency Room Layout (응급의료센터 감염예방을 위한 동선분리를 고려한 평면계획 연구)

  • Kim, Joong-gi;Seo, Hyun-Bo
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.26 no.1
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    • pp.7-15
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    • 2020
  • Purpose: Emergency room(ER) is the first place to enter a hospital where patients who might have been infected with contagious disease. Therefore, ER should be designed with infection control in mind. Researchers examined hospital ER layouts to identify layout design that support infection control. Methods: This study analyzed the hospital ER layout of Korean and other hospitals abroad. Researchers focused on route of incoming patients who potentially have infectious disease. Crossing of this route with other routes such as for imaging and testing should be avoided for infection control. Results: There were certain hospital ERs with better control of infection related incidents. ER floor plan layout is analyzed about allocation of key functions with movement routes for each role such as patients and medical staff in mind. To identify layout strategies for ER functions researchers simplified the routes in ER into diagrams. Layout options show that bypassing infection suspected routes over other routes is possible. Implications: Hospitals can control infection easier when they adopt strategic ER layout identified in this study.

Analysis of Operational Characteristics and Substantiality Plan of Inpatient Diets for Foreigners in Hospitals (의료기관의 외국인 대상 환자식 운영 현황 및 내실화 방안 분석)

  • Kim, Hyung-Mi;Kim, Eun-Mi;Kim, Hye-Jin;Baek, Hee-Joon;Park, Mi-Sun;Lee, Geum-Ju;Lee, Hae-Young
    • Journal of the Korean Dietetic Association
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    • v.22 no.2
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    • pp.118-130
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    • 2016
  • The objectives of this study were to analyze the operational characteristics and to explore the substantiality plan of inpatient diets for foreigners in hospitals. Questionnaires were mail-delivered to 128 hospitals, and a total of 62 questionnaires were usable with a response rate of 48.4 percent. Statistical data analysis was completed using SPSS Win 11.0 for descriptive analysis, independent t-test, and ${\chi}^2$ test. Results can be summarized as follows. The average number of inpatient meals for foreigners in the last 6 months were 405 and 53 for general therapeutic diets and special therapeutic diets, respectively. The rates of hospitals with an exclusive department and exclusive staff for foreign inpatients were 48.4% and 53.2%, respectively. Major nationalities of foreign inpatients were China (37.5%) and Russia (31.3%), and their major medical departments were internal medicine (43.9%) and surgery (39.0%). The number of hospitals that provided inpatient diet only for foreigners was 42 (72.4%) and influencing factors were number of permitted beds (P<0.05), an exclusive department (P<0.001), and exclusive staff (P<0.01). The main type of menu was USA European style (61.1%), and the price of inpatient meals for foreigners was mostly \10,000~\25,000 (62.0%). As 75.9% of hospitals did not possess dietary slip manuals for foreigners, the case of preparing inpatient meals for foreigners in the form of a general therapeutic diet partially-modified according to disease was the majority (55.4%). Dietitians felt the need for nutrition management guidelines and dietary slip manuals (47.3%) as a substantiality plan of inpatient diets for foreigners. There is a need for exclusive foodservice standards for foreign inpatients in the changing medical environment.

Measuring Effects of Quality Improvement through the Development of Critical Pathway for Gamma Knife Radiosurgery (당일 감마나이프수술 환자의 표준진료지침 개발을 통한 질 향상 효과 측정)

  • Kim, Moo Seong;Ha, So Young;Bae, Yoon Hyuk;Jung, Yong Tae;Kim, Sung Tae;Lee, Won Hee;Go, Yeon Joo
    • Quality Improvement in Health Care
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    • v.18 no.1
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    • pp.27-36
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    • 2012
  • Objectives : A protocol called "critical pathway" was developed to standardize the management of hospital patients the day after they underwent gamma knife radiosurgery. The quality of improvement in patient outcomes was evaluated. Methods : Critical pathway was developed, according to the regulations of the I hospital, by analyzing the medical records of 22 inpatients who underwent gamma knife surgery within the period from January to April 2011 on the day of the surgery. The study included a group of 22 patients admitted to the hospital the day after they underwent gamma knife radiosurgery, between July and September 2011. The control group included 22 patients who had surgery employing the same method within the period from May to June 2011. To measure the effects on quality improvement, the average length of stay, the execution rate of the hospital discharge notice system, daily hospital revenue, and the satisfaction of the patients and the medical team were assessed. The patient questionnaire employed a four-point Likert scale while the medical-staff questionnaire employed a five-point Likert scale. Result : The average length of stay was significantly shorter in the study group compared to the control group (2.3 days vs. 3.8 days, P<0.05). The execution rate of the hospital discharge notice system was higher in the study group (100% vs. 72%) than in the control group. Daily hospital revenues were higher by 264,178 Korean won in the study group when compared to the control group. The study group showed greater satisfaction of patients compared to the control group based on a four-point Likert scale (P<0.05). The study group showed greater satisfaction in medical team compared to the control group based on a five-point Likert scale (P<0.05). Conclusion : The development and implementation of a critical pathway protocol for hospital admission the day after gamma knife radiosurgery is an effective care process that improves the clinical quality.

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Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care (신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석)

  • Park, Jung-Han;Kim, Soo-Yong;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.531-548
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    • 1991
  • To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

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Design of Remote Early Dementia Diagnosis Systems (원격 치매 조기 진단 시스템 설계)

  • Choi, Jongmyung;Jeon, Gyeong-Suk;Kim, Sunkyung;Choi, Jungmin;Rhyu, Dong Young;Yoon, Sook
    • Journal of Internet of Things and Convergence
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    • v.6 no.4
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    • pp.27-32
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    • 2020
  • Along with the aging of the population, the number of dementia patients is increasing, and the social and economic burden is also increasing. Currently, the effective way to manage dementia patients is to identify patients with dementia early. However, in rural and island areas where medical staff are scarce, there is a problem that it is difficult to visit a hospital and get an early examination. Therefore, we propose a remote early detection system for dementia to solve the problems. The remote dementia early diagnosis system is a system that allows a patient to receive examination and treatment from a remote dementia expert using remote medical technology based on real-time image communication. The remote early diagnosis system for dementia consists of a local client system used by medical staff at health centers in the island, an image server that transmits, stores and manages images, and an expert client used by remote dementia experts. The local client subsystem satisfies the current medical law's remote collaboration by allowing the patient to use it with the health center's medical staff. In addition, expert clients are used by dementia experts, and can store/manage patient information, analyze patient history information, and predict the degree of dementia progression in the future.