• Korean Journal of Clinical Laboratory Science
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• v.48 no.2
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• pp.130-136
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• 2016

The aim of this study was to examine and analyze the infection management status of Jeju-area general hospitals, and in order to convey the importance of infection management, and to determine role plans of medical technologists as infection management staff, the infection management status was examined through surveys targeting 7 general hospitals located in Jeju Special Self-Governing Province. The infection management of Jeju-area medical institutions showed excellence in that all institutions operated an infection management room, there was dedicated manpower, and hospital infection management guidelines were established and executed. However most institutions were operating their infection management room with only 1 nurse, reporting many difficulties in securing dedicated manpower, microbe-related culture deciphering, frequency of multiple-resistance bacteria, infection statistics, and details on microbe testing. Accordingly, it is believed that the medical technologist who can perform the practical tasks of infection management has sufficient qualification and experience in infection management as per the medical law enforcement regulations, and in operation of an infection management room. If medical technologists (infection control microbiological technologist) with expert knowledge on microbes and infection control nurses can execute the tasks as dedicated personnel, the operation of the infection management room will be more advanced. In addition, for proper infection management in the future, the introduction of a medical system specialized in infection management and full support for infection management of vulnerable small/medium hospitals in addition to general hospitals across the country is considered important.

• Journal of the Korea Convergence Society
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• v.9 no.9
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• pp.431-440
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• 2018

In this study, authors predicted probability of resignation of newly employed nurses using TensorFlow, an open source software library for numerical computation and machine learning developed by Google, and suggested strategic human resources management plan. Data of 1,018 nurses who resigned between 2010 and 2017 in single university hospital were collected. After the order of data were randomly shuffled, 80% of total data were used for machine leaning and the remaining data were used for testing purpose. We utilized multiple neural network with one input layer, one output layer and 3 hidden layers. The machine-learning algorithm correctly predicted for 88.7% of resignation of nursing staff with in one year of employment and 79.8% of that within 3 years of employment. Most of resigned nurses were in their late 20s and 30s. Leading causes of resignation were marriage, childbirth, childcare and personal affairs. However, the most common cause of resignation of nursing staff with in one year of employment were maladaptation to the work and problems in interpersonal relationship.

• Journal of Korean Academy of Nursing
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• v.23 no.3
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• pp.397-416
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• 1993

This study identified the relationships between the hospital’s organizational pattern for nursing, the organizational characteristics perceived by nurses and their job satisfaction. The study subjects were a convenience sample of 383 staff nurses working at 10 general hospitals with more than 300 beds in Seoul. Hospitals included in the study were classified Into five organizational patterns, where nursing was organized as an independent but lower level, attached to the medical department, attached to a department supporting medicine, and various other organizational pattern. The data were collected from July 10 to August 15, 1992. The organizational characteristics as perceived by the staff nurses were measured by Park & Yoon’s Scale (1986) and job satisfaction was measured by Slavitt’s Scale (1978). The data were analyzed by percentage distribution, Pearson’s correlation, x$^2$-test, t-test, ANOVA, and ANCOVA The summarized results are as follows : 1. The proportion of independent and attached nursing organizational patterns was 35.1％ and 54.9％ respectively. 2. There were differences between four general characteristics of the nurses, age, experience, position and education level, and the five structural types of nursing organization(p〈.05). 3. 1) There were no relationship between the perceived organizational characteristics and general characteristics of the nurses but there was a differ once in job satisfaction according to education level of nurses in hopitals where nursing was an independent department(T=-2.24, p〈.05). 2) There were differences in the perceived organizational characteristics according to age group and experience of nurses (F=3.26, 5.41, p〈 , 05)and in job satisfaction according to the position of nurses in the independent but lower level organizational pattern (T=2.26, p〈.05). 3) There was a difference in the perceived organizational characteristics according to age group (F=3.19, p〈 .05) and in job satisfaction according to the experience of nurses where nursing was attached to the medical department (F=3.49, p〈.05). 4) There was a difference in the perceived organizational characteristics according to nursing unit (F=3.19, p〈 .05), but none between job satis-faction and general characteristics of nurses where nursing was attached to a departiment supporting medicine. 5) There were no relationships between the perceived organizational characteristics and job sat isfaction and general characteristics of nurses in the various other organizational patterns. 4. Nurses in hospitals where nursing is organizationed as an independent department perceived their organizatianal pattern more positively and had higher job satisfaction than nurses working in hospitals where nursing is part of another department. 5. There were differences between perceived organizational characteristics and job satisfaction according to the organizational patterns for nursing (F=13.52, 8.76, p=.0000). 6. There were correlations between the perceived organizational characteristics and job satisfaction of nurses working in two independent nursing departments (r=0.2180, 2351, p〈.05). In conclusion, the relationship between perceived organizational characteristics and job satisfaction was significantly correlated in the hospitals where the nursing department is independent. Perceived organizational characteristics and job satisfaction depended on whether the nursing department is independent from or attached to other departments in the hospital. For nurses job satisfaction the nursing department should be independent from other departments and at the highest level of organization in the hospital.

• Quality Improvement in Health Care
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• v.1 no.1
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• pp.32-43
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• 1994

The 'Pharmacy and Therapeutic Committee' decided to restrict the use of vancomycin which was categorized into restricted antimicrobials, among general, reserved and restricted antimicrobials. The committee also established prescribing guidelines of vancomycin in Seoul National University Hospital, May, 1991. Especially, the restricted antimicrobials should be used after approval by infectious disease specialist physician. A retrospective drug use evaluation (DUE) on vancomycin has been conducted to compare with the previous vancomycin DUE study in 1990. 'Criteria for DUE on vancomycin' was modified from Am J Hosp Pharm. Total 65 charts of patients were retrospectively reviewed from July 1991 to June 1992 in Seoul National University Children's Hospital. The justification of use was improved from 56% to 75% comparing with the previous study. In analyzing process indicators, several criteria including body temperature monitoring, WBC monitoring and use of concomitant antibiotics were well documented, but serum creatinine monitoring, culture and sensitivity test and level monitoring were infrequently performed, while the accepted level has been improved. Accepted level for appropriate initial dosage and duration of therapy were decreased. In outcome analysis, blood culture after discontinuing the drug was relatively well documented compared with the previous study. As the results, the approval vancomycin use was shown to be effective and rational in antibiotic therapy. And it is suggested that the above findings should be communicated to the medical staff, and a active intervention, such as feedback control, also be necessary for rational drug use.

• Quality Improvement in Health Care
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• v.28 no.1
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• pp.2-13
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• 2022

Purpose: This study assessed the status of the Development and Utilization of critical pathways (CP) in South Korea. Methods: We surveyed 195 hospitals obtained on the Korean Hospital Association website. Data were collected using structured questionnaires for staff members in charge of CP management personnel in these hospitals. The questionnaire included CP developed by the institutions, the coverage rates and completion rates of CP in the current year, and management indicators related to CP. The questionnaire also included CP support systems and content within the institutions and questions regarding the advantages of CP utilization and obstacles associated with the CP development process. Results: Analysis of the responses from 70 hospitals (35.9% response rate) showed that a total of 1,370 CP sets were developed. The number of CP related to surgery departments was 365 (26.6%), and CP related to surgery and procedure was 1,093 (79.8%), respectively. The CP coverage rate was the most frequently used indicator to monitor the effect of CP (97.1%), followed by the completion rate (90.0%) and the length of stay in hospital (61.4%). CP managers reported that CP were highly useful for communication (3.39±0.493) and accurate information provision (3.39±0.491). The perception that CP violated doctors' autonomy in treatment was relatively low (2.87±0.645). Conclusion: It is necessary to establish an infrastructure in hospitals for CP. CP can facilitate communication and provide accurate information.

• Korea Journal of Hospital Management
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• v.6 no.3
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• pp.130-147
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• 2001

This study is about major symptoms of elderly and medical services for elderly in long-tenn care facilities. The subject of this study was 298 patients over 00 years old staying in two geriatric hospitals and two nursing homes. The symptoms and medical services were level of patient classification from RUG(Resource Utilization Group)-III which is applied for both Medicare and Medicaid for skilled nursing facilities reimbursement system in US and designed for measuring patient characteristics and medical staff time. This classification is explained by each patient resource(staff time) utilization level which is called CMI(Case-Mix Index). In this study, the symptoms and services were compared by facility type and they were categorized by level and compared by CMI. Major findings are as follows; 1. There were more elderly who have cognitive function problems in nursing homes than patients in geriatric hospitals. There were more patients with behavioral problems in geriatric hospitals than residents in nursing homes. These results were both statistically significant. 2. The patients in geriatric hospitals received significantly more nursing rehabilitation services, rehabilitation services and extensive services than residents in nursing homes. Other hands, special care services were provided significantly more to residents in nursing homes than elderly in geriatric hospitals. 3. ADL and depression variables had higher CMI when the symptoms were heavier condition. The CMI were not matched with levels of cognitive function problems and behavioral problems. 4. The CMI matched well significantly with levels of nursing rehabilitation services, special care services, and clinically complex services provided for the patient in geriatric hospitals and only nursing rehabilitation services in nursing homes. The CMI for rehabilitation services level and extensive services had regular trends. From the result of this study, the resource utilization level and services provided for elderly in each long-term care facilities were figured out. For the further study, it needs to have more concern about RUG-ill which classification variables were just analyzed.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.3 no.1
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• pp.37-49
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• 1996

The Purposes of this study were to understand the types of appellations used by nurses and doctors for patients in a hospital and to analyze satisfaction and reason about appellation for patient. This would enable us to provide basic data on culturally suitable appellations for admitted patients. 454 patients at K University hospital in Seoul were subjects for this study. Subjects were interviewed individually using a questionnair and frequency $X^2-test$. Results are as follows. 1. The most frequently used type of appellations in hospitals was '-ssi ; -sir' used by 88.1% of the nurses and 83.9% of the doctors. About 3 quaters of the medical staff used '-ssi' while none used job position. 2. 93.2% of the patients were satisfied with the appellations used by nurses and 93.0% of the patients were satisfied with the appellations used by the doctors 43.7% didn't think appellations were important and 44.3% thought it natural to use the appellation. The most satisfactory form of appellation used by nurses was '-ssi' to 93.3% of patients. All were satisfied with '-nim ; -sir', '-teacher' and there was no statistically significance. On the other hand, the level of satisfaction and the appellation used by doctors showed a relationship($X^2=19.72$, p=.000). Every patient was satisfied with '-nim' and '-teacher' but 19.9% were dissatisfied with the others of appellations. 3. Most patients preferred to be called '-ssi' by nurses(77.3%) and doctors(78.7%) respectively. The dominant reason being accuracy(45.8%), naturalness(33.9%) for nurses and 43.8% and 45.4% respectively for doctors. 4. The relationship between the type of appellations requested of nurses and general characteristics showed that age($X^2=83.91%$ p=.000), level of education($X^2=33.35$ p=.000), and occupation($X^2=38.22$ p=.033) were related to the type of appellation. The type of appellation requested of doctors was related to the age($X^2=72.56$ p=.000), level of education($X^2=30.01$ p=.000), and occupation($X^2$=42.90 p=.010). Generally, '-ssi' was requested of doctors and nurses, but lower age group or higher age group(over 61), those in elementary schools or elementary school graduates snd students preferred being called by their first names or grandfather, grandmother. From the results above, we can see that the most general type of appellation used for patients by the medical staff is '-ssi' and most patients were satisfied with the appellation but, the reason being that such appellations were accepted without concern. This shows that most are not adequately satisfied with the appellation. Only a small number of people use '-nim' and '-teacher' but is the preferred and frequently used types of appellation. Therfore, a continuous research of appellations used for patients with patients using '-nim' and an investigation with nurses' opinions of appellations for patients as the subject are required.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.38
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• pp.32.1-32.6
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• 2016

Background: This study aimed to analyze and describe the morbidity and mortality associated with tracheostomy in patients with oral cancer and to identify the risk factors associated with tracheostomy complications. Methods: We performed a retrospective chart review of patients who underwent tracheostomy during a major oral cancer resection between March 2001 and January 2016 at the National Cancer Center, Korea. Overall, we included 51 patients who underwent tracheostomy after oral cancer surgery. We assessed the morbidity and mortality of tracheostomy and determined the risks associated with tracheostomy complications. Results: Twenty-two tracheostomy-related complications occurred in 51 patients. The morbidity and mortality rates were 35.2 % (n = 18) and 0 % (n = 0), respectively. Tracheostomy-related complications were tracheitis (n = 4), obstructed tracheostomy (n = 9), displaced tracheostomy (n = 5), air leakage (n = 1), stomal dehiscence (n = 1), and decannulation failure (n = 2). Most complications (19/22) occurred during the early postoperative period. Considering the risk factors for tracheostomy complications, the type of tube used was associated with the occurrence of tracheitis (p < 0.05). Additionally, body mass index and smoking status were associated with tube displacement (p < 0.05). However, no risk factors were significantly associated with obstructed tracheostomy. Conclusions: Patients with risk factors for tracheostomy complications should be carefully observed during the early postoperative period by well-trained medical staff.

• YAKHAK HOEJI
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• v.52 no.4
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• pp.283-287
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• 2008

Drug identification service and other drug-related query service are becoming increasingly important in hospital pharmacy. The goal of this research was to investigate current situation of the service in hospital pharmacy, which recently implemented the services as part of provision of advanced hospital pharmacy service in order to assure national health improvement. We investigated the report performed from November 2006 through April 2007 in a university hospital located in Daegu, Korea. Number of drug identification service performed was 81 cases during the first three months period (period I), but it increased to 222 cases during the second three months period (period II), which suggested that the service was welcomed by medical staff in the hospital. Time to process each case was about 30 minutes in the period I while it was only 16 minutes in the period II. Proportion of the unidentifiable cases remained at about 25% during the entire period, which suggests that the system for the identification task appears to have some limitations such as unsatisfactory support from the Korea Pharmaceutical Association, laws, and regulations. A vast majority of drug-related queries were mostly from physicians (60.5%) followed by nurses and pharmacists. Time to process each drug-related query was 10.6 minutes in the period I while it was 6.9 minutes in the period II. Queries answered immediately were about 70% of all queries in the period I, but increased to about 85% in the period II.

• Journal of Korean Critical Care Nursing
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• v.9 no.2
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• pp.1-12
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• 2016

Purpose: This study aimed to develop a nursing handoff protocol for intensive care units and test its relevance. Methods: This is a methodological research to develop a protocol. A preliminary protocol was developed by composing items and testing content validity through literature review and experts' review. We revised and complemented the preliminary protocol following practical relevance assessment of 38 intensive care unit nurses at a university hospital to test content validity and to assess practical relevance of the final protocol. Results: On the basis of the content validity test for the final protocol, 40 items were adopted. The scores for the practical relevance of the final protocol increased significantly for items such as accuracy of handoff, reduction of handoff-related errors, convenience in using the protocol, reduction in handoff time, and simplification of handoff. Conclusions: The nursing handoff protocol for intensive care units in this study is expected to improve nursing performance with a standardized handoff in intensive care units, promote patient safety, and improve communication among the medical staff.