• Journal of Trauma and Injury
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• v.37 no.3
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• pp.192-200
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• 2024

Purpose: Traumatic peripheral nerve injury (PNI), which occurs in up to 3% of trauma patients, is a devastating condition that often leads to permanent disability. However, knowledge of traumatic PNI is limited. We describe epidemiology and clinical characteristics of traumatic PNI in Korea and identify the predictors of traumatic complete PNI. Methods: A list of enlisted soldier patients who were discharged from military service due to PNI over a 10-year period (2012-2021) was obtained, and their medical records were reviewed. Patients were classified according to the causative events (traumatic vs. nontraumatic) and injury severity (complete vs. incomplete). Of traumatic PNIs, we compared the clinical variables between the incomplete and complete PNI groups and identified predictors of complete PNI. Results: Of the 119 young male patients who were discharged from military service due to PNI, 85 (71.4%) were injured by a traumatic event; among them, 22 (25.9%) were assessed as having a complete injury. The most common PNI mechanism (n=49, 57.6%), was adjacent fractures or dislocations. Several injury-related characteristics were significantly associated with complete PNI: laceration or gunshot wound, PNI involving the median nerve, PNI involving multiple individual nerves (multiple PNI), and concomitant muscular or vascular injuries. After adjusting for other possible predictors, multiple PNI was identified as a significant predictor of a complete PNI (odds ratio, 3.583; P=0.017). Conclusions: In this study, we analyzed the characteristics of enlisted Korean soldiers discharged due to traumatic PNI and found that the most common injury mechanism was adjacent fracture or dislocation (57.6%). Patients with multiple PNI had a significantly increased risk of complete injury. The results of this study contribute to a better understanding of traumatic PNI, which directly leads to a decline in functioning in patients with trauma.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.1
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• pp.147-211
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• 1995

Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.2
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• pp.237-251
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• 1999

The purpose of this study is to suggest successful strategies through which the effect of the information system of a hospital can be forecasted at the nursing department. In order to set up successful strategies, in the first place, both the methods of CSF(Critical Success Factor: Rockart, 1979) and ULD(User-Led Development) method and the method suggested by the Korea Productivity Center were applied. In order to measure the improvement of nursing productivity, the Dissonance theory was used. The data were collected from 100 employees serving at the clinic department of Kwangju Patriots' and Veterans' Hospital from July 4 to July 25, 1998 with reference to all 222 cases, for sampling work; then the part of the efficiency of the treatment or management of hospital business - simplification of the process of the treatment of hospital business and reduction of the time of the treatment of hospital business were measured; and in order to forecast organizational behavior, 100 cases of organization behavior were analysed, based on the well structured, questionnaires. In order to forecast the user's organizational behavior, a tool(Ronald. 1988; Stephen, 1982: Senn, 1992: Olsen, 1980: Anderson, 1988: Kim. 1992: Cho. 1994) to measure the extent or degree of the user's recognition or understanding whose reliability coefficient is 0.63 was used: and regarding the items expected by the users concerning the convenience of the system, a tool created by Bernadett, Szajna and Richard W. Scamell(1993) whose reliability coefficient is 0.88 was used. And finally, those data were analysed, utilizing the statistical package of SPSS/PC 6.0. successful strategies are suggested as follows: 1. In order that the Kwangju Patriots' and Veterans' Hospital's purpose can be successful through its strategic, information system, the quality of its services should be elevated. and for elevating the quality of medical services, elevation of the quality of medical expertism or specialty is an important factor in determining such quality. 2. In order to make the hospital information system to be successful, the hospital's top manager should participate in the effort making it successful with helping hands of the members or personnel of the hospital. 3. In order to make users participate in the hospital information system, it is prerequisite that all nurses in a hospital should voluntarily participate in the system 4. In order to reduce the expense, the time in coping with business per duty should be reduced by 10${\sim}$33.23%. The time of the direct nursing care which added value is relatively high should be elongated in order to elevate the quality of hospital services. 5. Since the introduction and spread of the hospital information system are influenced by the duration in the experience of computer use, the user of the hospital information system should have a plan to receive well-planned computer education. Finally it is suggested that the forecast of long-term productivity through a review of the user's expectation of the system should be inspected and tested through continuous studies of its effectiveness.

• Korea Journal of Hospital Management
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• v.10 no.1
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• pp.71-92
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• 2005

The purpose of this study is to analyze the efficiency in management of general hospitals and investigate the major factors on efficiency. Specifically, the management of each general hospital is evaluated by using Data Envelopment Analysis(DEA) technique which is a nonparametric statistical method for measurement of efficiency. Then, the influencing factors are investigated through analyses of Decision-Tree Model and Tobit Regression. The target hospitals were general hospitals in which bed sizes are between 200 and 500 among a total of 276 general hospitals. The main data of financial indicators were collected from 48 hospitals, and it was analyzed by using two statistical models. For Model I, three input and two output variables were used for efficiency evaluation. In particular, three input variables were the number of medical doctors, the number of paramedical personnel, and the bed size. And, two output variables were the numbers of inpatients and outpatients per year, adjusted by bed-size. The results of DEA analysis showed that only seven out of 48 hospitals(15%) turned out to be efficient. The decision-tree analysis also showed that there were six significant influencing factors for Model I. Six factors for Model I were Bed Occupancy Rate, Cost per Adjusted Inpatient, New Visit Ratio of Outpatients, Retired Ratio, Net Profit to Gross Revenues, Net Profit to Total Assets. In addition, the management efficiency of hospital is proved to increase as profit and patient-induced indicators increase and cost-related indicators decrease, by the Tobit regression model of independent variables derived from the decision-tree analysis. This study may be contributable to the development of analytic methodology regarding the efficiency of hospital management in that it suggests the synthetic measures by utilizing DEA model instead of suggesting simple ratio-analyzing results.

• Quality Improvement in Health Care
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• v.4 no.1
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• pp.116-124
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• 1997

Background : As parking problem caused by increasing owner-driver and patients concentrating to a general hospital is becoming one of the dissatisfactions in medical care. It is time that a general hospital should solve the parking problem in a desirable way. The purpose of this survey is to let the clients understand the basic motivation of the pay parking and develop the better parking system. Methods : Clients of a tertiary care hospital in Chon-ju were surveyed by means of a questionnaire. All in all, 193 subjects answered the questionnaire. Results : In relation to previous experiences, 39.6% of the subjects experienced inconvenience with confused parking lot and the shortage of parking space. Under the current parking system, the subjects who felt the available parking space was enough were more than those who didn't 62.7% of the subjects answered that they could find the parking lot easily. 33.2% of the subjects mentioned that it was not easy to drive in the parking area ; The reasons were pointed out the shortage of space, disordered parking, and insufficient guide. 12.8% of the subjects satisfied with the current administering system of parking lot. The outpatients were more affirmative than the admitted patients about the charging system. As for the parking fee, 64% of the subjects answered that it is expensive, and 89.5% of the subjects thought imposing of parking fee is irrational. Conclusion : To say as a whole, the basic purpose of the charging system are more or less accepted. However, the management details like parking facilities and payment method are dissatisfactory, so it is necessary to improve the management system. It is also noted that the inpatients showed more negative attitude than the outpatients with the charging system. To secure a more convenient parking, the parking system should be considered in relation to the information service, kind guidance, improve facilities, personnel cooperation, fix outpatient scheduling system, etc.

• Journal of Korean Academy of Nursing
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• v.25 no.4
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• pp.641-652
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• 1995

Working as nurses, authors found that some patients were not content with their hospital life. Some patients wanted to move to another ward, and others complained about their ward atmosphere. In spite of patients' discomfort, nurses didn't know what made some patients complain about their ward. So, authors tried to find factors that influence atmosphere of hospital wards of the neurosurgery patients. To know the atmosphere of wards, authors selected five neurosurgery ward of a university hospital in Seoul. Observation took a month. An author observed using molar approach, in the morning, in the day time, and in evening time. Authors used concealment /no intervention technique. An author checked condition of people in the wards, and observed their verbal and nonverbal communication behavior their activities and environmental characteristics, and interpreted their meaning through ethnographic research methodology by Spradly. Authors found there was an important factors that influence the atmosphere of ward. It was a human and his attitude. At least one person who was willing to help others made ward atmosphere better. Helping others physically whenever needed, sup-porting the depressed emotionally, offering foods, or talking to others friendly brought good atmosphere. On the contrary, if everyone was indiffernt to others, the atmosphere became cold. Self-centered or selfish behaviors such as occupying too much area, using the toilet too long, covering other's suction bottle without permission and seeing others delicate or urinate were hurtful. In addition to the attitude of patients and their families, unkindness of medical teams including nurses and doctors and tasteless meal caused bad ward atmosphere. Based on this research finding, authors suggest the followings. A For the better atmosphere of ward 1. Nurses should try to make the ward atmosphere better by introducing new patient to older ones. 2. Every ward should have dividing curtains to keep patient's privacy. 3. All hospital personnel should be kind enough to make patients feel that they are repected. 4. Hospital should serve high quality meals to patients. 5. Patients had better stay with those in the similar condition. B. For the future studies 1. Repeated researches are necessary to check reliability of this results. 2. Researches for patients in different area such as ICU, or hemodialysis unit are necessary.

• The Korean Journal of Health Service Management
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• v.4 no.1
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• pp.145-156
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• 2010

The purpose of this study is one of high price medical equipment wished to grasp propriety factor about the MRI introduction, analyzing payability through cost accounting into compensation. It was investigated from January 1 to December 31, 2007 about the MRI of a General Hospital. Expectation availability was 23.2 cases, but actual availability did achievement more than 196.1% with 45.5 items. It is estimated that there are a lot of occurrence cases because great reasons that actual availability increases more than expectation availability is excellent resolving power than a CT, and is device that prefer to reason back that radiation damage is less in person body. The followings show the main results of this study. 1. The MRI was construed in order of cost accounting, wave and personnel expenses 45.4%, administrative expenses 53.0%, and material costs 1.6%. 2. According to CVP (Cost-volume-profit) analysis, BEP (Break Even Point) profit is 173,931,428 won for 11 months, and break even usage number of items are 37.5 cases, and separation usage number of items were confirmed by 1.4 cases. Therefore, was construed that can achieve BEP within 11 months though usage number of items keeps 1.4 items day to create the MRI's hospital operation profit. 3. Estimated limit profitability appears high by 96.7%, exceed fixed charges even if when is non-benefit and when it is benefit consider variable, is judged that the MRI's addition induction helps in hospital management enhancing earning rates.

• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.4
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• pp.81-91
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• 2019

Purpose: Since infectious disease hospitals are premised on emergency operations, the operational efficiency of secured personnel, equipment, facilities, etc. is relatively low. In order to increase such normal operational efficiency, it is necessary to flexibly operate facilities and operations during normal and emergency times. The purpose of this study is to suggest the architectural planning method focusing on the space composition and circulation of the regional infectious disease hospital which can increase the operational efficiency in the private hospitals. Methods: Through literature review, functional requirements of infectious disease hospitals were identified, and related personnels inter-views and field surveys were conducted to understand the spatial composition and circulation requirements of infectious disease hospitals. Results: Through the complete separation between the negative pressure zone and the general zone, even when the negative pressure zone is completely closed, the general zone should be operated separately to achieve operational efficiency. In addition, the separation of the negative pressure zone and the general zone should simultaneously consider the optimal space configuration and movement for each function while the zone settings match in the floor plan of each department and the overall cross-sectional configuration of the hospital. Implications: Infectious disease hospitals intended to be installed in private hospitals should not apply excessive space just for safety reasons and should plan to ensure their operational efficiency.

• Tuberculosis and Respiratory Diseases
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• v.81 no.4
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• pp.261-273
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• 2018

Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients nationally and globally. The Korean clinical practice guideline for COPD was revised in 2018. The guideline was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Health Insurance Review and Assessment Service, Korean Physicians' Association, and Korea Respiration Trouble Association. The revised guideline encompasses a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea. We performed systematic reviews assisted by an expert in meta-analysis to draft a guideline on COPD management. We expect this guideline to facilitate the treatment of patients with respiratory conditions by physicians as well other health care professionals and government personnel in South Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.165-170
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• 2016

Background: Nurses are the most visible, frontline personnel providing health education to patients. In particular, nurse experience with Pap examinations have the potential to influence women's attitudes toward screening for cervical cancer. However, nurses in Taiwan have lower rates of Pap testing than the general population. Understanding the factors predicting nurse intent to have a Pap exam and Pap exam status would inform interventions and policies to increase their Pap exam uptake. Therefore, the present study was undertaken. Materials and Methods: Data were collected by questionnaire from a convenient sample of 504 nurses at a regional hospital in central Taiwan between August and October 2011 and analyzed by descriptive statistics, confirmatory factor analysis, and logistic regression. Results: Nurse intention to have a Pap exam was predicted by younger age, less negative attitudes toward Pap exams, and greater influence of others recommendations. However, nurses were more likely to actually have had a Pap exam if they were older, married, had sexual experience, and had a high intention to have a Pap exam. Conclusions: Nurses who are younger than 34 years old, unmarried, sexually inexperienced, and with low intention to have a Pap exam should be targeted with interventions to educate them not only about the importance of Pap exams in detecting cervical cancer, but also about strategies to decrease pain and embarrassment during exams. Nurses with less negative attitudes and experiences related to Pap exams would serve as role models to persuade women to have Pap exams, thus increasing the uptake rate of Pap exams in Taiwan.