Purpose: This study aims to analyze design guidelines for hospice facilities in the US, UK, and Canada focused on design considerations and space requirements, and utilizes them as baseline data for establishing standards for Korean hospice facilities. Methods: Comparative review was carried out to investigate hospice care models, design consideration, and room sizes and requirements for design guideline of hospice facilities in United States, UK and Canada identified on electronic database and review articles, and to examine major characteristics and tendencies of hospice facilities. Results: The hospice care models characteristics in design guidelines is generally largely divided into hospital-based hospice facility, Nursing home-based hospice facility, and daycare hospice. The design considerations in hospice facilities focused on medical efficiency, flexibility, barrier-free environment, person-centered care, and stability. There is also a need for single resident room, rooms for the patient's family, and isolation room for infection control. Implications: it is recommended to establish standards for the installation and operation of required and recommended rooms and considerations when establishing the standards of hospice facilities in Korea. This Study is limited to a simple comparative analysis of the framework of guideline.
Purpose: In this study, we investigated the better application of the law which is about the AED installation and more effective ways of emergency medical care system, to understand the law and to research the current condition of public facilities which belong to local governments, and to seize the aspect of safety guards who currently work in order to provide the installation of AED in the public facilities and to provide more efficient emergency medical service with the effectuation of the immunity law of the good intention of first-aid treatment. Methods: In Gwang-ju, 234 public facilities have been identified by 31 December, 2008. With the exception of the duplication, we researched 158 facilities and received the answers from 95 of them. Results: In the research, 53% of them have had internal emergency first-aid education, and 55% of them didn't have this education and a CPR education manual, and 30% of the facilities even didn't know how to connect with the manager of the company for the first-aid department. On the other hand, most of them were highly interested in CPR and AED education on the ratio of 91% and 93%. 88% of them have been trained about first-aid, 51% of them haven't been retrained, 17% have never been trained. so, the reality of emergency system at public facilities is serious. 78% of them knew they are working at public facilities, though 49% of them didn't know about AED installation. 57% of them didn't know the fact there is the immunity law related with good intentions for first-aid treatment. 63% of the facilities have security guards, and 30% of them didn't answer the questions. Also, many of them agreed to the opinion that all employees should have first-aid training. At representative survey report of participator of public-facility, emergency treatment is 61%, 16% of patients calling. Accordingly they importantly think better doing an on-site first-aid than evacuating the patient. And the rates show that 57% of them answerers tend to call Fire-Office(119) for evacuating the patients, and 28% of them EMIC(1339) for the first-aid. Conclusions: In this study, we are suggest to improve the details of the efficient operations and management after the grasp of the uninstallation, indifference, and unreliable conditions of AED. 1) Need a publicity of AED install cognition which is an emergency medical instrument at public facilities. 2) Arrangement of safety agents at facilities and concerns about them for good management from the parties concerned. 3) Need a designation of legal details according to the decision of the AED installation and the standard of the AED installation. 4) Training about first-aid of safety guards and the persons concerned in the facilities should be practiced participation with the positive and through this, first-aid treatment could be done by anyone who knows the immunity law related to medical emergency. 5) The brochures for the potential users and the results form practicing the instructions need to be improved in many ways through recording the emergency cases that have happened.
Purpose: Major trauma patients should be transferred to a definitive care facility as early as possible because prompt management will prevent death. This study was designed to discover the obstacles leading to delayed transfers under the current emergency medical system in Korea and whether there are any negative outcomes associated with conducting procedures at primary care hospitals prior to transferring patients to higher levels of care. Methods: The medical records of major trauma patients with an Injury Severity Score above 15 within the past year were reviewed. Patients were divided three groups as follows: (A) came directly to our emergency center, (B) were transferred without CT or MRI scan at the primary care hospital and (C) transferred with CT or MRI scans. The transfer time of each group were compared and analyzed statistically. Additionally, the number and type of imaging performed at the primary care hospital were analyzed. Results: All qualified patients (n=276) were enrolled in this study: 121 patients in group A; 104 in group B; 51 in group C. There was a statistically significant difference in the transfer time between the three groups (p-value<0.001), and 79 (28.6%) were transferred to an emergency medical center within one hour. In group C, CT or MRI scans were performed an average of 1.86 times at the primary care hospital, and the median transfer time was 4 hours 5 minutes. Conclusion: Only 28.6% of the cases in the study arrived within the golden hour at a definitive care facility. Such delays are in part the result of prolonged times at the primary care hospital for radiologic examinations, such as CT or MRI scans. Major multiple trauma patients should be transferred to a definitive care facility directly or as soon as the primary survey and the resuscitation of Advanced Trauma Life Support guideline are completed at the primary care hospital.
Purpose: There are an insignificant number of studies done on the demographics of intoxication patients and on the characteristics of toxic exposure on a long term basis in Korea. The objective of our survey is to investigate the epidemiologic characteristics of intoxication in a metropolitan emergency department in order to more efficiently manage intoxication patients. Methods: We retrospectively reviewed the medical records of intoxication patients who visited the emergency department of a high end medical facility between January, 1998 and June, 2009. We investigated the trend of the substances people became intoxicated with during the study period and we analyzed the age, gender, year and distribution of patients and the outcome of the patients. Results: There were 1544 cases of intoxication during the study period, and the cases made up 0.37% of the total visitors to our emergency department, which is a high end medical facility located in the city. Most of the patients were female (70%) in their twenties and thirties. The most commonly ingested intoxication substances were sedatives, analgesics and pesticides. Unlike in the province, antidepressant abuse is on the rise while pesticide abuse is falling. The overall admission rate was 24.8% and the mortality rate was 1.6%. Pesticides intoxication was the most common cause of death (76%). Pesticides intoxication, a male gender and old age were the most significant fatality-related factors. Conclusion: We think that there is a need to investigate the actual conditions of drug intoxication in the city and prepare measures to prevent drug intoxication.
Background & Objectives: International radiation protection committee recognized the importance of radiation protection from medical practices because the exposure to the radiation in medical practice is higher than any other exposure. The factors on knowledge, attitude and practice of radiation safety of the medical workers engaged in radiation were analyzed in order to improve radiation safety technology. Method: Questionnaires were used for 1200 radiation workers in medical institution from July 23 through September 4 and collected for analysis. Results: Different level of safety measures were practiced by age, marital status, career, and medical facility. The difference was statistically significant. Higher levels of safety measures were practiced in the age group of 50s and married persons. The workers who have more than 20 years experience have higher level of safety measures. The workers of health centers have higher level of safety measures to compare with other workers. The factors which give more concerns on safety practice were self efficacy, practice and knowledge in order. Conclusion: Safety conscious operators should get additional education program to maintain higher level of safety. The operators who do not have much safety concern should be intensive training program for self efficacy and safety.
This study was conducted to understand the influences or satisfaction of mental disease patient's carer about medical service on utilizing hospital, for 202 mental disease patients who are in 19 hospitals from March 2, to 31, 2000 with questionnaire. Factor for understanding satisfaction of patient's carer includes ability of medical professional, view of facility, kindness of steps, convenience of medical procedure, cleanness of environment and convenience of traffic. The data collected were analyzed by SPSS program and the results of this study are summarized as follows; 1. There are not significantly difference bet wren general character and whole satisfaction of patient's carer. 2. Each factor has the positive relation with whole satisfaction of patient's carer about medical service. 3. Whole satisfaction of patient's carer have the significant positive relation with utilizing hospital($\beta$=.527, p=.000), this means that the higher whole satisfaction of patient's carer, the higher their tendance of utilizing hospital. 4. Knowledge for mental disease of patient's carer appear the positive results in view of medical care. In conclusion, the policy has to be developed in order to prevent the stop of utilizing hospital of patient and their carer. But there is a limit to except mental disease patients in this study.
The present study is aimed at assessing medical service quality as perceived by in-patients of geriatric hospitals and at analyzing the excitement factors by using revised IPA Applying the Kano's model for users' satisfaction. The data was collected from Nov. 5 to Dec. 7, 2012. Among a total of 503 cases of questionaries, only 419 cases were used. To data were analyzed by PASW statistics 18.0 and revised IPA applying Kano's model. The paired t-test results reveal that satisfaction was higher than the expectation level at a statistically significant level across all the medical service quality factors. The revised IPA results categorized facility convenience, hospitalization and care, and kindness as basic factors and medical reliability and access as excitement factors. In conclusion, medical reliability and access, which were identified as excitement factors of medical service quality, are essential opportunity factors for users and should accordingly be used as strategic factors to increase satisfaction with a geriatric hospital and induce customer surprise.
High Dose Rate Remote Afterloading system was installed at Wonkwang University Hospital in January 1994. In this report, the calibration of a Gammamed 12-i High Dose Rate Remote Afterloading system and the radiation survey around the facility after design and construct a shieding room are discussed. The radiation survey of the facility indicates that the use of ordinary concrete shielding of existing room will provide adequate shielding. Also, the methodologies for performing source calibration are presented.
Along with the heightening development of modern medical technology in the world, the economy and quality of lifestyle has contributed to the increase in the average lifespan. Therefore the issue to deal with the aging population is becoming an important social issue. As aging population becomes a serious social problem, the issue of supporting the senior citizens is confronted with a more difficult situation. From the perspective of senior citizen's physical and social and economic situations, there are great difficulties to deal with, like lowered physical ability compared to the rest of population. Therefore the supply of senior welfare facility that is based on senior citizen's physical characteristics yet provides the opportunity to be independent needs to provided rather than just planning a simple facility that provides living accommodations. This research examines thereinto welfare center's usage of residential circulation system from the senior welfare facilities' type classification to understand the actual usage problem and presents a circulation plan that will resolve the problem.
With the development of medical technology, economic growth and increased interests In health in our society nowadays, the male and female average length of life has continued to increase. In response to the rapid aging phenomenon, diverse paid residential facilities for the elder have geometrically emerged in a short period, but compared to their quantitative increase, the kinds of facilities are not diverse and the quality of the facility environment also is not at the desirable level in comparison with the economic and intellectual level. Accordingly, the purpose of this study was to analyze the residential space from a perspective of marketing and establish the residential environment for the elder in response to the expansion of the market of the paid residential facilities for the elder in the future.
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