• Health Policy and Management
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• v.16 no.2
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• pp.49-76
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• 2006

The aim of this study was to explore the effects of a computerized review program which was introduced in August 1, 2003, using claims data for acute respiratory infection related diseases. National Health Insurance (NHI) claims data on respiratory infection related diseases before and after the introduction, with six month intervals respectively, were used for the analysis. Clinic was the unit of observation, and clinics with only one physician whose specialty was internal medicine, pediatrics, otorhinolaryngology and family medicine and clinics with a general practitioner were selected. The final sample had 7,637 clinics in total. Indices used to measure practice pattern was prescription rates of antibiotics, prescription rates of injection drug per visit, treatment costs per claim, and total costs per claim. Changes in the number of claims for major disease categories and upcoding index for disease categories were used to measure claiming behavior. Data were analysed using descriptive analysis, t-test for indices changes before and after the introduction, analysis of variance (ANOVA) for practice pattern change for major disease categories, and multiple regression analysis to identify whether new system influenced on provider' practice patterns or not. Prescription of antibiotics, prescription rates of injection drug, treatment costs per claim, and total costs per claim decreased significantly. Results from multiple regression analysis showed that a computerized review system had effects on all the indices measuring behavior. Introduction of the new system had the spillover effects on the provider's behavior in the related disease categories in addition to the effects in the target diseases, but the magnitude of the effects were bigger among the target diseases. Rates of claims for computerized review over total claims for respiratory diseases significantly decreased after the introduction of a computerized review system and rates of claims for non target diseases increased, which was also statistically significant. Distribution of the number of claims by disease categories after the introduction of a computerized review system changed so as to increase the costs per claims. Analysis of upcoding index showed index for 'other acute lower respiratory infection (J20-22)', which was included in the review target, decreased and 'otitis media (H65, H66)', which was not included in the review target, increase. Factors affecting provider's practice patterns should be taken into consideration when policies on claims review method and behavior changes. It is critical to include strategies to decrease the variations among providers.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.25 no.1
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• pp.46-57
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• 2018

Purpose: The purposes of the study were to examine the knowledge and practice about Middle East Respiratory Syndrome (MERS) isolation precaution, and to explore influencing factors of the isolation practice among hospital nurses. Methods: A total of 182 nurses were recruited from four general hospitals where MERS patients had been treated. The knowledge and practice of MERS isolation precaution were measured by the scales developed based on the CDC guidelines. The collected data were analyzed by SPSS/WIN 22 with descriptive statistics, T-test, One-way ANOVA, Pearson correlation coefficients, and hierachical multiple regression analysis. Results: The nurses were 30 years old in average, and half of them had less than 5 years of clinical experience. and knowledge on droplet precautions (${\beta}=.171$, p=.019) were the significant predictors, explaining 19.6% of variance in the MERS isolation guideline practice. Clinical experience (${\beta}=.225$, p=.002), working at infection unit (${\beta}=-.203$, p=.011). Conclusion: The knowledge on droplet precaution and general knowledge on MERS were the important modifiable factor to improve the MERS isolation guideline practice among hospital nurses, even after adjusting clinical experience and demographic variables. It is necessary to develop an efficient education program on specific guidelines for prevention and management of infection by improving the knowledge on infectious disease such as MERS as well as droplet precaution which are modifiable factors.

• Journal of Korean Academy of Nursing
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• v.42 no.6
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• pp.771-782
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• 2012

Purpose: This study was conducted to develop and implement a case-based small group learning program on the care of children with infectious disease, and to examine its effects on knowledge, attitude and preventive practice behaviors of daycare center teachers compared to a control group. Methods: Based on the need assessment, the case-based learning program for the management of infectious children was developed. For this quasi-experimental study, 69 teachers were recruited from 14 child daycare centers in a city located in J province. Thirty four teachers were assigned to experimental group and participated in the case-based small group learning once a week for 5 weeks. Data were analyzed using the SPSS 18.0 program to perform ${\chi}^2$-test and t-tests. Analysis of covariance was used to treat the covariate of the number of assigned children between experimental and control groups. Results: The experimental group showed significantly higher posttest scores in knowledge, attitude and preventive practice behaviors than those of control group (p<.001). Conclusion: These findings indicate that case-based small group learning is an effective educational strategy for daycare center teachers to learn infection management through the emphasis of self-reflection and discussion.

• Journal of Preventive Medicine and Public Health
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• v.47 no.5
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• pp.273-280
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• 2014

Objectives: To evaluate the occurrence of patient adverse events in Korean hospitals as perceived by nurses and examine the correlation between patient adverse events with the nurse practice environment at nurse and hospital level. Methods: In total, 3096 nurses working in 60 general inpatient hospital units were included. A two-level logistic regression analysis was performed. Results: At the hospital level, patient adverse events included patient falls (60.5%), nosocomial infections (51.7%), pressure sores (42.6%) and medication errors (33.3%). Among the hospital-level explanatory variables associated with the nursing practice environment, 'physician-nurse relationship' correlated with medication errors while 'education for improving quality of care' affected patient falls. Conclusions: The doctor-nurse relationship and access to education that can improve the quality of care at the hospital level may help decrease the occurrence of patient adverse events.

• Journal of Korean society of Dental Hygiene
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• v.16 no.4
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• pp.507-516
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• 2016

Objectives: The purpose of the study is to investigate the awareness and practice of dental unit waterline management in dental hygienist. Methods: A self-reported questionnaire was completed by 377 dental hygienists in Seoul and Gyeonggido from March 2 to April 30, 2015. The data were collected by direct visit and informed consent was received after explanation of the study. The questionnaire consisted of general characteristics of the subjects, awareness of dental waterline, practice of dental waterline, and implementation of dental waterline disinfection. Data were analyzed using SPSS 12.0 program. Results: There was a significant correlation between the dental unit waterline disinfection and the appropriateness of the water used for dental treatment(p<0.01, p<0.001). The handpiece was the most commonly used device before treatment and the majority of the subjects answered that they didn't take water out of ultrasonic scaler and air-water syringe on a daily basis. Conclusions: The majority of the dental hygienists did not know the right understanding and proper practice of dental unit waterline management. To reduce the dental device contamination, the continuing education of waterline management should be done for the dental hygienists.

• Journal of dental hygiene science
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• v.15 no.4
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• pp.399-406
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• 2015

The purpose of this study was to investigate the performance of dental infection control. This survey was performed on 158 of the dental hygienist in certain areas. The research was performed using a self-reported questionnaire and interview method from June to July, 2014. The collected data was analyzed by PASW Statistics ver. 18.0. Guideline of infection management, infection controller, regular infection control training, Sterilization of the handpiece/per head resulted 57~74% for dental hospital. It was higher than 13~20% for dental clinics (p<0.05). Infection control guidelines and vaccination recognition of dental were more performed in dental hospital. Patient's hand hygiene performed, tooth brushing before treatment, cross infection educational experience was less than 20%, research cooperation of medical history was over 90% (p<0.05). Performing rate of the dental hospital workers were investigated higher in protective personal devices, infection control of treatment room. A correlation analysis about institutional support, infection control of dental hygienists, patients with infection control cooperation showed a positive correlation statistically significant. Infection control can be enhanced when the medical staff, the patient, the organization combined cognitive and practice. Dental hygienist is required to recognize and practice the infection control guidelines through continuing education.

• Journal of Korean society of Dental Hygiene
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• v.9 no.3
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• pp.282-293
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• 2009

The purpose of this study was to examine the degree of infection control implemented at dental offices and factors affecting it in an attempt to help promote the health of dental health care workers. The subjects in this study were 180 medical personnels who worked at dental offices in the region of South Jeolla Province. A self-administered survey was conducted from April 1 to May 30, 2008, and the collected data were analyzed. The findings of the study were as follows: 1. As for the implementation of infection control at the dental offices, what the health care workers investigated did the most was post-treatment hand washing(95.0), a constant separation of infectious wastes(94.4), wearing rubber gloves all the time during medical instrument cleansing(92.8) and pre-treatment hand washing(91.7). 2. In regard to the implementation of infection control at the dental offices, what the dental personnels did the least was drying their hands with air(5.0), wearing goggles in times of treatment(23.3), receiving regular education on infection control(26.7) and putting sterilizers to a performance test on a regular basis(43.9). 3. The dental health care workers were significantly different according to age in the management of contagious diseases(p=0.005). Their career made a significant difference to the management of contagious diseases(p=0.000) and instrument cleansing/sterilization(p=0.043). The service area made a significant difference to wearing and managing personal protective clothes (p=0.040) and waste management(p=0.040). 4. Concerning the relationship between the acquisition of dental hygienist certificate and the practice of infection control, whether the dental health care workers were certified or not made no significant difference to that. 5. As to the correlation among the factors affecting the prevention and management of contagious diseases, there was a positive correlation among hand washing(r=0.379), wearing and managing personal protective clothes(r=0.349), instrument cleansing/sterilization(r=0.323) and waste management(r=0.388). All the factors made a statistically significant difference to the prevention and management of contagious diseases(p<0.01).

• Journal of the Korean Society of Radiology
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• v.10 no.5
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• pp.351-358
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• 2016

This study surveyed the health professionals in Busan with regard to their awareness of nosocomial infection control. According to the conclusion of this study, first, the level of awareness and performance of personal hygiene management, equipment sanitation management, and cleaning and environmental management increased as the level of education decreased. Also, when it comes to personal hand-washing, the level of awareness was higher among workers in primary, secondary and other medical institutions, where as the level of performance was higher among the group of medical practitioners. The differences were statistically significant at a significance level of .001. Medical practitioners also showed a higher level of awareness and performance of hospital sanitation management, which was statistically significant. Overall, as the level of awareness was lower than the level of performance, it seems that individuals need to thoroughly practice infection control, and realistic improvement measures need to be devised.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.22 no.6
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• pp.90-99
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• 2021

This study was conducted to provide basic data for improving nursing management practice by comparing and analyzing the perceptions of nursing students and clinical instructors about the importance of the learning contents of nursing management and their practical experience. The final 343 copies were analyzed using the Mann-Whitney test and cross-analysis, targeting 4th-grade students and clinical instructors at three universities. Both nursing students and clinical instructors recognized 'communication', 'interpersonal relationship', 'responsibility', 'trust', and 'morality' as important factors in the evaluation items of practice. Among the top 10 most importantly recognized items among nursing-management practice learning content, six items ('infection control', 'nursing record management', 'patient nursing management', 'drug management', 'patient safety', and 'nursing malpractice') were matched in the two groups. Moreover, clinical instructors recognized that interpersonal relationships and relationship ethics were important, while nursing students chose legal responsibility. As a result of the practical experience analysis between the two groups, nursing students had high experience of indirect participation, but the clinical instructors had a high experience of direct instruction. A plan is needed to reduce the difference by establishing an organic partnership relationship between the university and practice institutions and increase the experience of direct practice of nursing students.

• Childhood Kidney Diseases
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• v.27 no.2
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• pp.55-63
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• 2023

In 2021, a new chapter on the general management of glomerulonephritis (GN) was added to the Kidney Disease: Improving Global Outcomes (KDIGO). It emphasizes the importance of early general management of GN for improving long-term kidney outcomes and prognosis. The chapter introduces the management of glomerular diseases in 18 subchapters. Here, kidney biopsy for the diagnosis and evaluation of kidney function and the management of complications, such as hypertension, infection, and thrombosis, are presented. Moreover, the adverse effects of glucocorticoids and immunosuppressive therapy, which are commonly used drugs for glomerular disease, are mentioned, and a guideline for drug selection is presented. Each subtheme focused on items reflecting the interpretation of the "practice points" of the expert working group are introduced. In this review of the general treatment for GN in the KDIGO guidelines, excluding pregnancy and reproductive health, we focused on and compared various references pertaining to pediatric GN management.