• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권4호
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• pp.29-39
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• 2021

Purpose: As the need for a hospital specializing in infectious diseases has increased, construction is being promoted. Hospitals specializing in infectious diseases receive some state subsidies, but in the case of private hospitals, hospital operation efficiency should be considered to prevent cost loss. Therefore, we aim to derive a building plan for a general ward in a hospital specializing in infectious diseases that can be used not only in normal times but also in times of crisis. Methods: In this study, relevant literature review and field interviews were conducted with medical staff working in facilities designated as infectious disease hospitals. Results: The general ward building plan of the hospital specializing in infectious diseases was classified into three categories and presented. 'Spatial composition' for nursing unit and ward zoning, 'Spatial plan' for ward space conversion in normal times and crises, 'Bedroom plan' for effective dimensions and area of the ward. Implications: It can be used as a guideline when designing an infection-facility ward. And it can be a basis for inducing improvements to prevent infection in the ward of existing medical facilities.

• Journal of Hospice and Palliative Care
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• 제7권2호
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• pp.232-237
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• 2004

배경: 보편적으로 호스피스 병동에서 말기 암 환자에 있어서, DNR 동의가 흔하게 취득되고 있다. 그러나 말기 암 환자에 대한 현황과 실태 분석에 관한 국내 연구는 아직 드문 현실이다. 최근 저자 등은 보호자가 DNR 동의를 거부하여 심폐소생술 후 인공호흡기 치료를 시행하여 2개월 간 중환자실에서 치료 후 사망한 환자를 경험하면서 지금 까지 진행된 DNR 동의의 현 실태와 앞으로 시행될 DNR 동의의 보완점을 마련하기 위해 본 연구를 시작하였다. 방법: 2003년 1월부터 6월까지 6개월 동안 성빈센트병원 호스피스 병동에 입원한 말기 암 환자 60명을 대상으로 후향적으로 의무기록과 DNR 동의서를 조사하였다. 대상 환자들의 나이, 성별,진단명, DNR 동의 시간, 사망까지의 시간, DNR 동의에 참여한 보호자, DNR 결정 당시 환자 상태, 사망장소, DNR 결정 당시의 치료와 DNR 결정 전후 치료의 변화 등을 조사하였다. 치료 단계는 3단계로 분류하였다. 결과: 중앙 연령은 66세($31{\sim}93$세) 였고 남자가 31명, 여자가 29명이었다. 폐암 12명, 위암 12명, 담낭암 및 담도암 7명, 대장암 6명, 췌장암 4명, 기타 19명이었다. DNR 동의서에 서명한 사람은 아들이 22명, 배우자가 19명, 딸이 16명, 기타가 3명이었다. 이 중 환자가 DNR 동의서에 동의한 경우는 한 명도 없었다. 60명 중 30명이 입원 시에, 30명은 입원 기간 중에 DNR 동의서에 서명하였다. 입원 기간 중에는 증상의 악화 19명, 활력 증후 변화 4명, 다기관 기능부전 3명, 기타 상태 4명 등으로 DNR이 결정 되었다. DNR 동의 후 사망까지의 시간은 13명이 5일 이내에 사망하였다. 사망 장소는 60명 중 한 명을 제외하고는 모두 본원이었다. DNR이 시행되었을 당시 치료 단계는 2명을 제외하고 1단계였고 2단계와 3단계가 각각 1명씩이었다. 결론: 환자의 존엄성과 권리라는 측면에서 DNR 동의의 환자 참여가 국내에서도 신중하게 고려되어야 하겠다. 또 이를 위해 DNR 동의의 의미, 경과, 동의 철회 등의 사항이 포함된 문서화된 동의서에 의해서 환자와 보호자에게 설명되어야 하겠다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권3호
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• pp.39-49
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• 2021

Purpose: The negative pressure isolation ward is a key facility in preparedness and response to infectious diseases. For the sustainable operation of the facility, appropriate facility improvement is required. The experience of medical staff responding to infectious diseases in the COVID-19 pandemic provides effective informations for facility planning. Methods: The post occupancy evaluation (POE) was conducted by interviewing medical staff who is working on Nationally designated negative pressure isolation ward in general hospital. Floor plan analysis was conducted before field surveys for identifying facility characteristic and spatial composition. After that, field surveys were conducted at 3 hospitals, and interviews and fieldwork were conducted together. Results: It is necessary to increase the standard size of ward area from 15m² to 20m². The size of the doffing room has to be planned for accommodation of two or more people. Equipment storage, clean storage and waste storage also should be properly planned. There were almost no problems with the circulation in the ward. There was not enough space for medical staff. Implications: For a sustainable and safe negative pressure isolation ward planning, it is necessary to exploit learning from the medical staffs who have many experiences of coping with infectious diseases.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제3권5호
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• pp.97-105
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• 1997

According as the medical demands have been high, ward dept, in general Hospital become more specifying. One thing of its sample is Children ward in general Hospitals and Children's medical demand become increasing. Therefore, this study aims to represent the standard for the architectural planning of the children ward in general Hospital. For it, the present conditions and space programs of 4 general Hospitals were investigated, analyzed. And to present children ward's functional programs, plans of the 2 domestic children hospitals and foreign children hospitals were analyzed. Then one children ward in general hospital was selected, architectural remodeing process was performed by the whole those sources.

• 대한간호학회지
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• 제1권1호
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• pp.111-132
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• 1970

An analysis of nursing activities in a in-patient ward and its management was observed in order to assess necessary number of nursing hands and find out reasonable work management with them. The study was performed with two wards of St. Mary′s Hospital, Catholic Medical Center, for the period from July to December 1970. The results and conclusions were as the following 1. The role of the nurses are determined by doctor′s order in 57.7% in kind, 80.0% in amount. and by nurses decision 20.0% in amount. 2. Works related to patient care are found to be 20.6% in the internal medicine ward and 20.4% in the surgical ward while works related to treatment are 4.7% in the former and 27.2% in the letter. Medication occupies 40.0% in the internal medical ward while 26.6% in the surgery ward, and observation occupies 34.7% in the former while 25.8% in the letter. These can be said to reflect characteristic differences bet ween the two wards. 3. When nursing functions were evaluated by importance "A" level in the amount of works to be done occupied 67.6% in the surgical ward and 62.8% in the internal medical ward. In the kind of the important works, "B"level is found to be most frequent with 50% while "A"level 43%. When evaluated by difficulty, "B"level was found to be most frequent in amount in both internal medicine and surgical wards (52.6%, 38.2%). 4. Works needing professional knowledge and skills occupied 92% in the both wards while unprofessional works 2.8% and 4.2% respectively. There are indications, however, that unprofessional works have an increasing tendency. 5. When evaluated by the amount of works, the surgical ward has 11 nurses less and the internal medicine ward 3 nurses less then the necessary number of nursing staffs. There are shortage of 12 and 6 nurses respectively when evaluated by the number of patients and 18 nurses in the both wards when evaluated by the medical regulations of the Government. 6. The ratio of the nursing staff to patient was found to be 1:11.5, 1:23.0 and 1:34.5 in the morning, evening and night turn in the surgical ward. In the medical word the ratio was 1:9.4, 1:22.0 and 1:33.0. 7. The deficiency of necessary equipment and tension accompanying management of those equipment were found to lower the effective functioning of the head nurse who is a junior manager of the ward. They also consume much of the time and energy of the nurses at work who are over burdened in most of the cases. 8. The high rate of the number of nurses who leave the job impairs the functioning of team work which is considered to be most important in the effective performance of nursing activities and thus contributes to lower the efficiency of nursing functions.

• Asian Pacific Journal of Cancer Prevention
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• 제16권1호
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• pp.239-244
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• 2015

Background: One of the causes of acute leukemia can be exposure to certain chemicals such as pesticides. This study determined the relationship between exposure to pesticides and the occurrence of acute leukemia in Fars province, south of Iran. Materials and Methods: Between April 2011 and April 2013 in a case-control study conducted in Nemazee Hospital in Shiraz, Southern Iran; 314 subjects diagnosed with acute leukemia (94 pediatric cases and 220 adults) were enrolled to determine any correlation between exposure to pesticides and the occurrence. Controls (n=314) were matched by sex and age. Results: There was a history of exposure to pesticides among 85% of pediatric cases and 69% of their controls and 83% of adult cases and 75% of their controls while 87.5% of pediatric cases and 90% of adult cases reported exposure to intermediate and high doses of pesticides and among the controls, the exposure to low doses of pesticides was 70.5% and 65%, respectively. Exposure to indoor pesticides was seen among most of cases and controls. Being a farmer was at a significantly more increased risk of developing acute leukemia in comparison to other jobs, especially for their children. Conclusions: Exposure to pesticides was shown to be one of the most important causes of acute leukemia. It seems that there is a need to educate the people on public health importance of exposure to pesticides especially during school time to reduce the risk of malignancies during childhood.

• 간호행정학회지
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• 제20권3호
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• pp.313-321
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• 2014

Purpose: The purpose was to compare operating room (OR) nurses and general ward nurses on their communication competence and interpersonal relationship ability within the medical team. Methods: Participants were 276 nurses (OR 122, ward 154) working in one of 4 university hospitals located in I and K areas. Data were collected using a questionnaire and data collection was done in June, 2013. Comparisons between OR nurses and general ward nurses on communication competence and interpersonal relationship ability were analyzed using ANCOVA. Results: There were statistically significant differences between the two groups in communication competence (F=11.96, p=.001) with average score for OR nurses at 3.37 points and ward nurses at 3.53 points. There were statistically significant differences between the two groups in interpersonal relationship ability (F=15.51, p<.001) with the average score for OR nurses at 3.30 points and ward nurses at 3.50 points. Conclusion: The results indicate a need to develop a variety of programs to promote communication competence in OR nurses and to enhance the openness of interpersonal relationship ability in human resource management.

• 정신신체의학
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• 제1권1호
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• pp.75-80
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• 1993

To understand and evaluate the patients who were referred for psychiatric consultation from medical departments, the authors reviewed the concept of disease, psychological reaction to disease, problems on psychiatric diagnosis and evaluation which were encountered at the medical ward. In addition, we reviewed what psychiatrists should do during consultation.

• Journal of Korean Biological Nursing Science
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• 제16권4호
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• pp.259-266
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• 2014

Purpose: The purpose of this study was to analyze risk factors in predicting medical patients transferred to Intensive Care Unit (ICU) on the general ward. Methods: We reviewed retrospectively clinical data of 120 medical patients on the general ward and a Modified Early Warning Score (MEWS) between ICU group and general ward group. Data were analyzed with multivariate logistic regression and the area under the receiver operating characteristic curves using SPSS/WIN 18.0 program. Results: Fifty-two ICU patients and 68 general ward patients were included. In multivariate logistic regression, the MEWSs (Odds Ratio [OR], 1.91; 95% confidence interval [CI], 1.32-2.76), sequential organ failure assessment score (OR, 1.28; 95% CI, 1.10-1.72), $PaO_2/FiO_2$ ratio (OR, 0.98; 95% CI, 0.98-0.99), and saturation (OR, 0.93; 95% CI, 0.88-0.99) were predictive of ICU transfer. The sensitivity and the specificity of the MEWSs used with a cut-off value of six were 80.8% and 70.6% respectively for ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.

• 대한간호학회지
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• 제38권1호
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• pp.161-171
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• 2008

Purpose: The aim of this study was to analysize net income of a surgical nursing ward in a general hospital. Method: Data collection and analysis was conducted using a performance-based costing and activity-based costing method. Result: Direct nursing activities in the surgical ward were 68, indirect nursing activities were 10. The total cost volume of the surgical ward was calculated at \119,913,334.5. The cost volume of the allocated medical department was \91,588,200.3, and the ward consumed cost was \28,325,134.2. The revenue of the surgical nursing ward was \33,269,925.0. The expense of a surgical nursing ward was \28,325,134.2. Therefore, the net income of a surgical nursing ward was \4,944,790.8. Conclusion: We suggest that to develop a more refined nursing cost calculation model, a standard nursing cost calculation system needs to be developed.