• Title/Summary/Keyword: Medical ward

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A study on the Planning of a general ward in infectious diseases hospital considering the efficiency of hospital operation (운영 효율성을 고려한 감염병 전문병원의 일반병동 건축계획에 관한 연구)

  • Han, Eunbee;Kwon, Soonjung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.27 no.4
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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.

DNR (Do-Not-Resuscitate) Order for Terminal Cancer Patients at Hospice Ward (호스피스 병동에서 시행되는 말기 암 환자의 DNR (Do-Not-Resuscitate) 동의)

  • Shim, Byoung-Yong;Hong, Seok-In;Park, Jin-Min;Cho, Hong-Joo;Ok, Jong-Sun;Kim, Seon-Young;Han, Sun-Ae;Lee, Ok-Kyung;Kim, Hoon-Kyo
    • Journal of Hospice and Palliative Care
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    • v.7 no.2
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    • pp.232-237
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    • 2004
  • Purpose: DNR order is generally accepted for cancer patients near the end of life at Hospice Ward. It means not only no CPR when cardiopulmonary arrest develops but no aggressive meaningless medical interventions. Usually on admission, we discuss with the patients' family about DNR order at the Hospice Ward. Recently, we experienced a terminal lung cancer patient who had been on the ventilator for two months after pulmonary arrest. CPR and artificial ventilation were performed because patient's family refused DNR order. There is no consensus when, who, and how DNR order could be written for terminal cancer patients in Korea, yet. Methods: Hospice charts of 60 patients who admitted between Jan and Jun 2003 to Hospice Ward were reviewed retrospectively. Results: The median age was 66(range $31{\sim}93$) and there were 31 males and 29 females. Their underlying cancers were lung (12), stomach (12), biliary tract (7), colon (6), pancreas (4) and others (19). The persons who signed DNR order were son (22), spouse(19), daughter (16) and others (3). But, there was no patients who signed DNR order by oneself. Thirty families of 60 patients signed on day of admission and 30 signed during hospitalization when there were symptom aggravation (19), vital sign change (4), organ failure (3) and others (4). There were 13 patients who died within 5 days after DNR order. Most of patients died at our hospice ward, except in 1 patient. The level of care was mostly 1, except in 2 patients. (We set level of care as 3 categories. Level 1 is general medical care: 2 is general nursing care: 3 is terminal care.) Conclusion: We have to consider carefully discussing DNR order with terminal cancer patients in the future & values on withholding futile intervention.

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A Study on the direction for Facility Improvement of Nationally Designated Negative Pressure Isolation Ward through Post Occupancy Evaluation (거주 후 평가를 통한 국가지정 입원치료병상 시설 개선 방향 도출에 관한 연구)

  • Jeong, Dawoon;Kwon, Soonjung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.27 no.3
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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.

A Study on the Architectural Planning for the Children's Ward in General Hospital (종합병원 소아병동부에 관한 건축계획적 연구)

  • Song, Young-Suk;Kim, Kwang-Moon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.3 no.5
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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.

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간호 업무 실태 분석 및 합리적인 병실 관리 개선 방향

  • 방용자;강흥순
    • Journal of Korean Academy of Nursing
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    • v.1 no.1
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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.

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Relationship between Exposure to Pesticides and Occurrence of Acute Leukemia in Iran

  • Maryam, Zakerinia;Sajad, Amirghofran;Maral, Namdari;Zahra, Lesan;Sima, Pooralimohamad;Zeinab, Attabac;Zahra, Mehravar;Fariba, Ebrahimi;Sezaneh, Haghpanah;Davood, Mehrabani
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.1
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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.

Comparison of Operating Room Nurses and General Ward Nurses on Communicative Competence and Interpersonal Relationship Ability within the Medical Team (수술실간호사와 병동간호사의 의료진과의 의사소통 능력 및 대인관계 능력 비교)

  • Lim, Eun-Ju;Yi, Yeo-Jin
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.3
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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.

Therapeutic Approaches to the Patients Who Were Referred for Psychiatric Consultation from Medical Departments - Focused on Evaluation and Understanding - (정신과에 의뢰된 내과계 환자들에 대한 치료적 접근 -환자에 대한 평가와 이해 -)

  • Lee, Jung-Ho;Lee, Gi-Chul
    • Korean Journal of Psychosomatic Medicine
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    • v.1 no.1
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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.

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Analysis of Risk Factors to Predict Intensive Care Unit Transfer in Medical in-Patients (내과 환자의 중환자실 전동에 대한 위험요인 분석)

  • Lee, Ju Ry;Choi, Hye Ran
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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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.

An Analysis of Cost and Profit of a Nursing Unit using Performance-Based Costing: Case of a General Surgical Ward in a General Hospital (시행기준 원가계산을 적용한 간호단위 원가 및 수익 인식에 관한 연구: 1개 종합병원 일반외과병동 사례를 중심으로)

  • Lim, Ji-Young
    • Journal of Korean Academy of Nursing
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    • v.38 no.1
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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.