• 제목/요약/키워드: Medical Recorders

검색결과 13건 처리시간 0.018초

의료 질 관리 활동에 대한 병원종사자들의 태도와 인식 (Quality Improvement Activity in Hospitals and Its Acceptance among Hospital Personnels)

  • 황정해;조성현;김창엽;서정돈;한만청;이정예
    • 한국의료질향상학회지
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    • 제3권2호
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    • pp.86-97
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    • 1997
  • Background : It is a primary goal for hospital personnel to improve the quality of patient care. In Korea the concept of quality assurance has been spread over the last five years. Many hospitals have implemented quality assurance programs that fit their own philosophy and needs. As a result, they are supposed to have different experiences and attitudes toward quality assurance. To investigate their diversity will be helpful to have a direction to the future and to enhance the quality assurance activities in Korean hospitals. Objectives : The aim of this study is to obtain information about hospital personnel's attitude and opinion toward quality assurance in hospitals. Methods : A questionnaire was developed which consisted of five parts; the general characteristics of respondent, the concepts of quality assurance, need for quality assurance program, current status of quality improvement activities, and participation in programs. Using the registry of Korean hospitals, 102 hospitals with more than 400 beds were selected. Questionnaires were mailed to hospital staffs of each hospital; top managers, clinical department heads, registered nurses, medical recorders, and administrators. Results : Of 2038 questionnaires sent, 877 were returned, giving response rate of 44%. Most respondents(70%) regarded quality assurance as efforts to provide patient with care in highest quality and to improve effectiveness or resource utilization. Ninety-nine percent of respondents agreed to need for quality assurance in their hospitals. There were current quality improvement programs implemented in the department of 553 respondents(62%), and most of the(85%) have participated in at least one program. Lack of motivation was pointed out as a barrier to implement the programs. Conclusion : Although most respondents have known of the concept and need for quality assurance, this study suggests that education and motivation of hospital personnel be needed to activate the quality assurance programs in hospitals.

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종합 건강검진 과정에서 나타난 일부 중년기 여성의 건강문제 (Health Problem of the Middle-Aged Women)

  • 성미혜
    • 대한간호학회지
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    • 제29권2호
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    • pp.258-270
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    • 1999
  • This study was carried out to offer the basic data for more qualitative lives of the middle-aged women through their health maintenance and control. So, the researcher reviewed and analyzed the health problems of the middle-aged women, the differences of main symptoms in each subject, positive ratcs in screening tests, the difference of screening tests with age and the correlation of obesity and blood pressure with screening tests. All subjects were 218 women(40-59years) who had a check-up at a comprehensive health check-up center in K University Hospital in Seoul from July 1, 1998 to August 31. 1998. Questionaires were developed to get subjects, general characteristics. main symptoms, medical examination and diagnosed disease by the researcher referring through the questionaires of comprehensive health check-up center and the medical recorders were used as a tool of study. The researcher analyzed the data with SPSS PC+ ; the distribution of the subjects, general characteristics and main symptoms with percentage : the difference between main symptoms and screening tests with X$^2$-test, ANOVA. The results are as follows. 1) Among the age distribution, most were 40-45 years old and unemployed. 2) The most common complaints were indigestion in digestive system, cough in respiratory system, heart beat in cardiovascular system, general sweat in endocrine system. edema in urinary system, easy bruise in hematologic system, backache in musculoskeletal system, headache in psychoneurologic system, lochia in gynecology, itch in dermatology system, eye ball pain in visual system and tinnitus in auditory system. 3) In main symptoms according to age, the 40-45 age group had a higher rate of complaints in digestive system and gynecology than other age group ; the 46-49 age group in endocrine system. 4) The main symptoms according to diagnosis had no difference statistically. 5) The screening tests which showed high rates of abnormality were mammography(the highest), abdominal ultrasonography, upper gastrointestinal series/gastrofiberscopy, PFT. In all age group the highest rate of abnormality was seen in mammography. 6) In screening tests according to age. the 46-49 age group showed higher positive rates of pap smear, blood sugar test, urine test than any other age group ; the 50-55 age group showerd higher positive rates of obesity, BP, chest X-ray, abdominal ultrasonography, ESR, SGOT, CRP and urine micro. 7) In correlation of obesity with screening test, the obesity group showed higher positive rates of blood pressure, chest X-ray, abdominal ultrasonography, HCT and CRP than the normal weight group. 8) In correlation of blood pressure with screening test, the hypertension group showed higher positive rate of obesity, chest X-ray, abdominal ultrasonography, pap smear and blood sugar than the normal blood pressure group. In conculusion, the middle-aged women have various physical symptoms and affected by age. The obesity and BP have an important effect on the health of the middle aged women. Therefore, this study is considered significant as data for qualitative lives of the middle-aged women playing an important part of family health care by catching of their health problem complaints for prevention of disease and promotion of health.

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말기 암 환자의 마지막 24시간 동안 진통제 사용의 분석 : 내과의사와 외과의사의 비교 (The Use of Analgesics in the Last 24 hours of Life of Patients with Advanced Cancer : A Comparison of Medical Physicians and Surgeons)

  • 최윤선;김종민;이영미;임종국;이태호;홍명호
    • Journal of Hospice and Palliative Care
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    • 제1권1호
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    • pp.47-55
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    • 1998
  • 목적 : 암은 우리나라 사망원인의 첫째이며 말기암환자에서 보이는 신체증상 중 통증은 의료인이 반드시 조절을 해주어야 한다. 암환자의 90%이상에서 통증조절이 가능하며, 말기 암환자의 임종 24시간 전 $33{\sim}60%$에서는 의식이 명료하여 진통제의 경고, 투여가 가능하다. 마지막 24시간 동안의 진통제 사용실태와 내과계와 외과계 의사에따른 통증조절 방법의 차이를 조사함으로서 보다 계획적이고 적극적인 통증 조절 중요성의 중요성을 강조하고자 본 연구를 시행하였다. 방법 : 1994년 7월 1일부터 1995년 6월 30일까지 모대학병원에 입원하여 암으로 사망한 환자 160명을 대상으로 의무기록지, 간호기록지를 조사하는 후향적 코호트 방법을 시행하여 인구통계학적 자료와 사망 24시간전의 의식상태, 통증여부, 암의 종류 등을 조사하였다. 대상자를 내과의사와 외과의사에 의해 치료받은 군으로 나누어 임종전 24시간 동안 투여한 진통제의 용량, 투여방법, 투여종류, 필요시 마타 투여된 진통제의 평균 횟수를 비교 분석하였다. 진통제의 용량은 경구몰핀 등가량으로 환산해서 계산하였다. 결과 : 1) 전체 160명 중 남자가 102명(63.8%)명, 여자는 58명(36.2%) 이었고 평균연령은 56.4세였다. 2) 평균입원 27.8일이었으며 원발부위에 따른 암의 종류는 위암 42명(26.3%), 폐암 29명(18.1%), 간암 29명(18.1%), 췌장암 10명(6.2%), 대장암 9명(5.6%), 자궁경부암 6명(3.7%), 유방암 5명(3.1%)의 순이었다. 3) 160명 중 125명(78.13%)이 통증을 호소했고 진통제를 투여받은 환자는 내과계 103명중 66명(64.08%), 외과계 57명 중 31명(54.39%)이었다. 97명 중 50명(51.55%)에서 경고, 투여가 가능했다. 4) 임종 24시간 전에 86명(53.75%)에서 의식이 명료했다. 5) 규칙적으로 투여된 진통제의 종류는 경구용 모핀이 34명(내과계 24명, 외과계 10명)으로 제일 많았고, 주사용 모르핀이 26명(내과계 20명, 외과계 6명), 경구용 코데인이 8명 (내과 5명, 외과 3명)의 순이었다. 비정기적으로 통증조절을 위해 투여된 약물로는 주사용 모르핀이 16회, 데메롤 근주가 12회, nubain 근주가 9회의 순이었다. 6) 규칙적으로 투여된 진통제의 평균량은 내과계에서 115.41 OME에서 외과계 52.7 OME 보다 많았으나(P<0.05), 환자 요구시마다 투여된(p.r.n.) 진통제의 양은 외과계가 66.64 OME 로서 내과계 23.49 OME 보다 유의하게 많았다(P<0.01). 7) 통증호소시에 투여한 진통제의 횟수에 있어서도 내과계 평균은 0.62회, 외과계는 1.88로 유의한 차이가 있었다(P<0.001). 8) 보조진통제의 사용은 내과계에서 57명(55.34%), 외과계에서 25명(43.86%)이 사용했다. 결론 : 임종 24시간 전에 과반수 이상이 의식이 명료했으며 내과의사가 외과의사보다 적극적으로 통증조절을 하고 있으나 많은 의사들이 규칙적인 통증조절보다는 비정기적인 투약과 진통제의 비경구투여를 선호하였다.

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