• 제목/요약/키워드: Medical practice management

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노래를 이용한 심폐소생술의 교육 효과 (The effect of teaching cardiopulmonary resuscitation using a song)

  • 이원주;이창섭
    • 한국응급구조학회지
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    • 제20권1호
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    • pp.31-39
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    • 2016
  • Purpose: This study proposed an improved method of teaching cardiopulmonary resuscitation (CPR). Methods: A teaching method for CPR using a song was evaluated. To validate the effect of this teaching method, we performed a comparative reference test against a traditional CPR lecture-oriented education method. A total of 202 study participants were enrolled in this project. Half were taught by the traditional CPR education method, and the other half were taught by the alternative educational method using a song. Results: The results for those educated by the traditional lecture-oriented method showed scores of 4.84 / 6.00 (Mean of knowledge) and 70.22 / 100 (Mean of practice ability for CPR). The results for those educated by the alternative method showed scores of 5.26 / 6.00 (Mean of knowledge) and 74.13 / 100 (Mean of practice ability for CPR). The alternative educational method utilizing a song improved the results on written and practical examinations. This improvement could be attributed to the effect of music on memory circuits in the brain. Conclusion: We believe that the results of this study will help to improve the success rates of CPR.

보건진료원 직무교육 교과과정개선을 위한 연구 (A Study on Curriculum Development for CHPs)

  • 권명순
    • 한국보건간호학회지
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    • 제13권2호
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    • pp.26-44
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    • 1999
  • The study was done to improve the job training course for Community Health Practioners (CHPs) by evaluating the level of help that the training provided to the CHPs in carrying out their work and to analyze the management activities of the CHPs in order to develop a more effective CHP training program. The methodologies used in the study were a questionnaire survey. The survey results were analyzed using SPSS Windows. The study results are as follows. 1. The total average level of help from the job training(Theory. Practice and Field Practice) for carrying out the CHP work was found to be $3.04\pm.53$ (of a possible 4), which indicates a high level of help. The average for clinical practices was $3.16\pm.60$. for theory. $3.11\pm.40$ and for field practice. $2.84\pm.60$. 2. For the theory content of the job training courses. the help level was low in the area of mother and child health management/family planning with an average of $2.65\pm.62$ and in the area of health information system development with an average of $2.62\pm.83$. The reason for these deficiencies were. in order of frequency. few opportunities to apply learning. training content that was inadequate. training methodologies which were incongruent with content. improper training items and insufficient class hours. For the practice. the clinical work in rehabilitation/orthopedics departments and in ENT/Opthalmology departments had averages of $2.96\pm.86$ and $2.97\pm.80$ respectively. This low level resulted from the lack of direct experience. lack of sincerity during the practice time. lack of practice guidance. insufficient time and lack of practice equipment. in that order. For the field practice. the delivery management averaged $2.06\pm.90$ as the lowest help level. In this case 68% of respondents replied that there were no relevant reasons for this deficiency. 21% responsed that there was a lack of direct experience, 7%, a lack of practice guidance and 4.8%, insufficient time. 3. There were significant differences for several demographic variables when comparing the help level of the clinical courses (practice and Field Practice). A higher help level was reported by older nurses as compared to younger ones, experienced nurses as compared to scholarship nurses, and married over single. Also for nurses who had finished more other programs and were qualified or licensed in several areas the level was high. Although it was not statistically significant the level was higher if the work area was in a rural county, not a city, and if one had more recently completed the job training(P<,05). 4. Of the respondents 58.6% replies stated the period of job training for the CHP was adequate, but 51.7% reported that the period for theory courses was too short while an other 48.3% responded that it was sufficient. For practice locations, 50% responsed that it was good to practice in medical institutions(primary, secondary and tertiary) at the same time. While 48.3% agreed that doing theory and practice simultaneously was good, and 56.9% agreed that field practice should be done after completing theory and practice training. Hence, the development of new field practice guidelines suitable for changing environments of health management are required in place of the existing ones which were considered low in help level to the practical work of the CHPs.

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의사의 직무 스트레스와 건강증진행태에 영향을 미치는 요인 (Factors Influencing Job Stress and Health Promotion Behavior among Medical Doctors)

  • 김경호;한삼성;유왕근
    • 한국산업보건학회지
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    • 제29권1호
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    • pp.98-107
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    • 2019
  • Objective: This study was carried out to examine factors influencing job stress and health promotion behavior of medical doctors, who play the important role for improving people's health. The data were collected from 340 medical doctors working in clinic and hospitals in Daegu using self-administered questionnaires over the period from July 1 to August 15, 2018. Methods: A multiple regression model was used to study the factors influencing job stress and health promotion behavior of medical doctors. Results: This study showed that average job stress level of the subjects was 3.06 out of 5 point. The medical doctors with carrying out surgery and longer working time tend to have higher job stress level compared to other groups without surgery and having short working time. And medical doctors generally do not have good health promotion behavior and average level of practice of health promotion behavior of the subjects was 2.30 out of 5. The groups with high rate of quitting job and working in hospital tend to have lower practice level of health promotion behavior compared to other groups. And it also showed that the groups with higher the job satisfaction rate and vocational aptitude tended to have the higher level of practice of health promotion behavior compared with other groups. Conclusions: Medical doctors tend to have higher job stress level, whereas they have relatively lower health promotion behavior compared with people with other jobs. Thus, strengthening of health education and counselling for medical doctors and improvement of work environment considering job's characteristics is needed. In particular, the education for job stress management and health promotion in regular continuing education program organized by medical doctors's association should be strengthened.

근거기반 중심정맥 주입요법 간호실무지침 개정 (Updates of Evidence-Based Nursing Practice Guidelines for Central Venous Infusion Therapy)

  • 임경춘;정재심;김경숙;김현림;김현정;김동연;이미정;이주현
    • 임상간호연구
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    • 제29권1호
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    • pp.42-55
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    • 2023
  • Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

의사 특성에 따른 외래 진료내용의 변이 (A Study on the Practice Variations According to Physician Characteristics)

  • 정은경;문옥륜;김창엽
    • Journal of Preventive Medicine and Public Health
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    • 제26권4호
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    • pp.614-627
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    • 1993
  • It is well known that a physician's personal characteristic affects his practice pattern. Furthermore, a physician's specialty has powerful influences on his practice pattern. However, despite the fact that specialization has received the most attention for its influence on physician's service behavior, few studies have been conducted on the variations of contents and volume of physician's services. This study has intended to identify factors influencing the practice variations according to various physician characteristics. There are some other evidences that medical care providers are different in using of health services and resources in Korea. Four physician characteristics were selected for the analysis, two demographical factors, age and sex, and two practice factors, place of practice and medical specialty. Also, three indicators of service amount (total amount of insurance claim bill, number of visits per case, number of prescriptions per case) were selected. From the pool of insurance claims for ambulatory care received by the Korean National Federation of Medical Insurance(NFMI), 84,898 cases were randomly sampled. In the meantime using physician database of NFMI, 613 general practitioners (GP), 107 regular family physicians (FP), 483 'grandfather' family physicians(GFP), and 1,157 specialist practitioners(SP) were randomly sampled. Their different practice contents were compared concerning the specialty, age groups, sex, and practice sites (urban-rural) Specialist physicians tend to provide more costly care than do generalists. General practitioners and family physicians usually make fewer following visits and prescriptions. Age is also the important factor in determining the amount of services, which is highest at the physician's age group of 40's. Female doctors and urban practitioners use much more resources than their counterparts respectively. Research findings suggest that physician's characteristics particularly the specialty can affect practice patterns and resource utilizations. Other characteristics such as age and sex are not controllable but physician's specialty is relatively easily controllable during the entire phases of policy implementation. This is all the more true in the individual's initial decision of his specialty. Specialization therefore should receive policymaker's attention for its potential influence on medical care utilization and health care expenditure.

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간호학 임상실습교육의 현황과 발전방안 (Current Status and Future Direction of Nursing Education for Clinical Practice)

  • 신수진;양은배;황은희;김건희;김윤주;정덕유
    • 의학교육논단
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    • 제19권2호
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    • pp.76-82
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    • 2017
  • The quantitative expansion of nursing schools has necessitated the qualitative improvement of nursing education, which requires the development of nursing education for clinical practice. To identify strategies for strengthening the educational capacity of clinical fields and nursing schools, this study first examined the current status of nursing education for clinical practice, and then proposed several prospective directions for education. Nursing clinical practice-related studies from several Korean and international electronic databases were reviewed. Insufficient training hospitals and lack of qualified clinical training instructors were the main problems found within nursing educational resources for clinical practice, while the simple practice contents based on observation and inadequate evaluations were the main problems found in nursing educational management for clinical practice. This study suggests better standards and educational accountability for training hospitals and programs to nurture human resources for clinical practice, as well as a variety of training methods to integrate practical training courses and the expansion of formation evaluation. Based on these results, it is necessary to establish governance for nursing education for clinical practice and clarify the role and standards of each practitioner, strengthen the educational role of the hospital, and improve the system. In addition, introducing various types of education methods and strengthening evaluation standards are needed in order to enhance nursing education for clinical practice.

제왕절개 분만율 공표 후 요양기관의 분만행태 변화 (Provider's Behavior Change after the Public Release of the Information on the Cesarean Section Rate)

  • 고수경;신순애;김기영;김창엽
    • 보건행정학회지
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    • 제11권3호
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    • pp.121-150
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    • 2001
  • This study was conducted to investigate provider's behavior change after releasing the information on the Cesarean section rate. Claims data filed at the National Health Insurance Corporation was used for this analysis and the focus of this study was the change of cesarean rate after the public disclosure of information. Average rates of the year 1999 and 2000 were compared, on the institutional basis, and range and coefficient of variation were estimated. For the last decade, Cesarean section rate has been increased dramatically. Clinical or demographic factors could not adequately explain the increase. Instead, nonclinical factors, such as financial incentive, physician's convenience, practice characteristics, etc., were more significant in explaining the increasing rate. Providers' behavior was significantly affected by the public release of information: after the release, average rate was decreased by 10.2%, and variations were also decreased. In particular, the extent of decrease was explained mainly by nonclinical factor rather than clinical ones. The results suggest that disseminating practice information to providers and consumers could contribute to reducing unnecessary medical service.

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Good manufacturing practice of radiopharmaceuticals in Korea

  • Oh, Seung Jun
    • 대한방사성의약품학회지
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    • 제1권2호
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    • pp.98-103
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    • 2015
  • Good manufacturing Practice (GMP) regulation for diagnostic and therapeutic radiopharmaceuticals was prepared at 2014. The mandatory GMP regulation becomes effective on $1^{st}$, July 2015,with two years of grace periods. Korean radiopharmaceuticals GMP regulation was consisted of quality management, personnel, premise and facility, documentation, production, quality control and self-audit and they have a very similar structure to European Union and PIC/S GMP regulation. Here, we describe detailed description of GMP regulation each part and application to radiopharmaceuticals production. And we also compare Korea, Japan and USA radiopharmaceuticals GMP regulation. GMP is a method to maintain quality of radiopharmaceuticals in daily production and it must be embedded on the manufacturing operation and management.

의사들의 의료정보추구행태에 관한 탐구 (Exploring Medical Doctors' Medical Information Seeking Behaviors)

  • 김나원;박지홍
    • 정보관리학회지
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    • 제26권3호
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    • pp.435-449
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    • 2009
  • 새로운 기술의 발달과 병행하는 정보이용환경의 급격한 변화는 정보원의 이용 및 정보서비스에 대한 새로운 고찰을 요구한다. 이용자 정보추구의 올바른 이해는 정보서비스의 향상에 핵심적인 역할을 하고 있으므로 변화하는 정보이용환경에 따라 이용자의 정보추구를 시기적절하게 새롭게 고찰할 필요가 있다. 많은 이전 연구들이 이용자 정보추구에 초점을 맞추고 있으나 의사들의 정보추구, 특히 진료정보 및 의학지식 추구를 동시에 대상으로 한 연구는 거의 없다. 이에 따라 본 연구는 진료와 의학연구를 동시에 수행하는 대학병원의 강사인 의사들의 정보추구행태를 탐구하는 것을 목적으로 하고 있다. 본 연구는 연세의료원 강사 12명을 대상으로 개방형 반구조화 형식의 심층 면접을 통하여 수집하였다. 면접 내용은 크게 연구 환경, 진료와 관련된 정보 추구 행태, 선호하는 정보원과 자료 유형, 검색과정과 만족도의 4가지 주제로 구성하였다. 응답 결과 연구 목적의 정보추구에 있어서는 PubMed를 통한 전자학술지 대한 신뢰도가 더 높았으나 진료 목적인 경우에는 인쇄형태의 교과서를 더 선호하는 것으로 나타났다. 이는 정보원에 대한 권위와 근거를 매우 중요시하는 의사들의 태도에서 그 원인을 찾을 수 있다.

인공수정체 보험급여 전.후 진료양상의 변화 (Changes in Medical Practice Pattern before and after Covering Intraocular Lens in the Health Insurance)

  • 최노아;유승흠;민혜영;정은욱
    • Journal of Preventive Medicine and Public Health
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    • 제27권4호
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    • pp.807-814
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    • 1994
  • This study is to find out changes in medical practice at a university hospital before and after covering intraocular lens (IOL) from the health insurance benefit. The coverage started on March 1, 1993 and a total of 596 cases who were discharged from July 1 to December 31, 1992 and 580 cases who were discharged from July 1 to December 31, 1993 were analyzed. Since the standard reimbursement scheme was changed from March 1, 1993, the charges for 1992 were transformed into 1993 scheme. Major findings are as follows: Average length of stay was statistically significantly decreased from 8.24 days in 1992 to 6.86 days in 1993. Charges except IOL has been statistically significantly decreased from 501,000 Won in 1992 to 444,000 Won in 1993. Charges for drugs and injection have been reduced. However, charge per day for them was not much different. This is due to decrease in length of stay. Charges for laboratory tests and radiologic examination were quite the same. Charges which are not covered by the insurance remained the same. The revenue of the hospital was reduced as expected. However, the hospital reduced the length of stay and increase the turnover rate In order to compensate the potential loss of revenue due to the difference of reimbursement between the out-of-pocket expense and the insurance coverage. By introducing the IOL benefit in the insurance, the insured pays less, hospital generates more revenue through shortening the hospital stay, and the total medical care cost becomes less nationwidely.

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