• Korea Journal of Hospital Management
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• v.22 no.3
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• pp.144-156
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• 2017

Purpose: Crisis is inevitable to every organization and therefore, successful crisis management is critical to the organizations' survival and prosperity. With the understanding, this study aims to draw propositions for successful crisis management of hospitals when facing infectious disease outbreak. For the purpose, a case of a small and medium sized hospital's experience of crisis management during 2015 Middle East Respiratory Syndrome outbreak was analyzed. Methodology/Approach: The detailed internal circumstances and experiences of the hospital during the MERS outbreak were identified by in-depth interview as well as the extensive material review, and analyzed under the view of the theories of accident, error, and crisis in relation of organization management Findings: Overall, nine propositions are drawn by the phase of crisis. In pre-crisis phase, for example, 'the hospital preparedness has positive influence on the effective responding to the crisis'. In detection phase, 'the mindfulness of the hospital organizations' as well as the individuals' has positive influence on detecting the crisis signals'. In crisis phase, for example, 'improvising naturally occurs in crisis by the unknown disease, therefore, a component site supervisor coordinating such improvision is important'. Lastly, in post-crisis phase, 'successful crisis responding experience facilitates the positive hospital culture'. Practical implication: From the experience of a small and medium size hospital, it is suggested that proactive system approach oriented by safety is beneficial for effective crisis management.

• Journal of Korean Orthopaedic Sports Medicine
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• v.3 no.1
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• pp.73-80
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• 2004

Purpose: To compare the results of a miniopen repair with those of complete arthroscopic repair in medium and large sized full thickness rotator cuff tears. Materials and Methods: The thirty four(34) patients with medium and large sized complete rotator cuff tear were observed, Group I (complete arthroscopic repair) were 13 cases and group II (miniopen repair) were 21 cases. The tear sizes are from 1cm to 5cm. The average follow up periods are 24(range;12$\~$36) and 28(range; 12$\~$36) months. Subjective pain was evaluated with VAS (visual analogue scale) in rest state. ADL (Activity of Daily Living) and UCLA scoring system were used to evaluate clinical results. Results: At last follow-up periods, pain and functional scores were improved but they had not been shown statistical significance (p>0.05). In the group I and group II, there are no significant difference in VAS, ADL; UCLA score, satisfaction (p>0.05). Conclusions: In medium and large sized full thickness rotator cuff tears, there are no significant clinical results between the arthroscopic and miniopen group.

• Quality Improvement in Health Care
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• v.15 no.1
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• pp.123-133
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• 2009

Background : The principal diagnosis has been used in many different fields such as hospital statistics, medical research, insurance claim, national health statistics and so on. Some principal diagnoses have a relatively low level of reliability in the medium-sized hospitals. The purpose of this study is to identify the reliability level of principal diagnoses and to suggest ways to improve reliability of the principal diagnosis. Method : Data were collected from a medium-sized hospital located in Pusan. The discharge summaries on 323 patients who were discharged in January, 2008 and the outpatient summaries on 251 patients who visited the hospital on March 28, 2008 were collected, and descriptive analysis was performed using SPSS version 12.0K. Result : The findings are the followings: (1) the diagnostic consistency rate between medical records and doctors' was 92.0%; (2) the diagnostic consistency rate between medical records and insurance claims was 86.1%; (3) the diagnostic consistency rate between doctors' diagnoses and insurance claims was 80.2%. The evidence seems to indicate that some principal diagnoses have reliability problems in the medium-sized hospitals. Conclusion : The results of this study suggest the followings: (1) employees should be trained and supervision of hospital activities are needed; (2) network systems should be constructed for each department; (3) professions need to be fostered (4) doctors' awareness of medical records should be changed.

• Journal of Korean Academy of Nursing
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• v.50 no.4
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• pp.621-630
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• 2020

Purpose: This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital. Methods: This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness. Results: The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those of CREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: - 0.16~0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63~.78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors' cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively. Conclusion: The CREP-model's discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points.

• Journal of Korean Biological Nursing Science
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• v.23 no.4
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• pp.318-329
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• 2021

Purpose: This study was conducted to identify factors affecting COVID-19 vaccination and associated side effects among health care workers in a small and medium-sized hospital. Methods: In May 2021, 301 workers out of a total of 670 working in a small and medium-sized hospital in Gyeonggi-do, were surveyed. The small and medium-sized hospital treats patients with COVID-19. Health care workers across different medical institutions responded with self-reported internet questionnaires. Factors influencing COVID-19 vaccination were analyzed via logistic regression. Results: Out of 301 subjects, 89.0% showed an intention to inoculate, and 85.7% were vaccinated against COVID-19. The most frequent reason for vaccination was responsibility as a medical worker. The fear of adverse reactions was the most frequent reason for non-vaccination. Adverse reactions after inoculation occurred in 70.9% of cases, and 30.6% were referred for treatment of adverse reactions. The factors ultimately influencing COVID-19 vaccination were vaccination intention, previous side effects from other vaccinations, occupation, and age. Conclusion: In order to improve the effectiveness of COVID-19 vaccination, a systematic approach is required to determine the risk factors associated with the young age of the administrative staff/personnel, subjects with a history of side effects associated with other vaccines, and health care workers who do not intend to be vaccinated. It is important to develop strategies to improve immunization. In addition, accurate and essential information regarding the side effects of vaccination is needed, along with appropriate education and publicity.

• Journal of the Korean Applied Science and Technology
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• v.39 no.6
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• pp.839-852
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• 2022

This study is a descriptive research study to identify work stress, resilience, nursing performance and influencing factors so that nurses in small and medium-sized hospitals can flexibly cope with rapidly changing medical environments. The subjects of the study were 219 nurses working at four small and medium-sized hospitals located in S region, and the survey was conducted using a structured questionnaire. The collected data were analyzed by using descriptive statistics, t-test, ANOVA, Pearson's correlation analysis and multiple regression analysis. There was a negative correlation between work stress and nursing performance in small and medium-sized hospital nurses (r=-0.150, p<.05), and a positive correlation between work stress and resilience (r=0.160, p<.05). Nursing performance showed a positive correlation with resilience (r=0.351, p<.01). The variable affecting nursing performance was resilience (𝛽=.231, p<.01), and its explanatory power was 17.4% (Adj.R2=0.174, p<.001). Therefore, in order to improve the nursing performance of nurses, it is necessary to increase resilience.

• Journal of Korean Academy of Nursing
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• v.34 no.7
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• pp.1243-1254
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• 2004

Purpose: This study was performed to give direction to quality improvement strategies of nursing services by comparing the differences in quality perceptions and satisfaction for nursing services between patients and nurses in small-medium sized general hospitals with 200 beds. Method: The subjects, who were 150 inpatients and 162 nurses of 4 general hospitals in a community, answered a self-report questionnaire with a SERVQUAL scale. Result: There were differences between patients' and nurses' expectations and perceptions of nursing service and satisfaction. In the service expectation, the highest factor was 'the responsiveness', and in the perceived performance, the highest was the 'assurance'. In addition, overall patients' perceptions on nursing services showed higher than nurses'. There were positive correlations among the expectations and perceptions on nursing service, and satisfaction. The correlation between perception and satisfaction was higher than the correlation between expectations and satisfaction. Conclusion: To improve the nursing service quality at small-medium hospitals, strengthening the 'assurance' factor and improving the nursing service support system is needed. Also, this study on nurses' perceived nursing service at small-medium sized hospitals should be duplicated.

• Journal of muscle and joint health
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• v.24 no.3
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• pp.159-170
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• 2017

Purpose: The purposes of this study were to identify musculoskeletal symptoms and to investigate factors associated with musculoskeletal symptoms in small and medium sized hospital nurses. Methods: The data were collected from 206 nurses working in Jeonnam. We used self administration questionnaires of KOSHA GUIDE H-9-2012 for musculoskeletal symptoms, PWI-SF for psychosocial stress, KOSS for job stress, and HPLP-II for health behaviors. The collected data were analyzed using the $x^2$, t-test, and logistic regression analysis in SPSS Ver. 23.0. Results: Sixty-six percent of the subjects had musculoskeletal symptoms. The shoulder had the highest symptom at 38.3%, followed by lower back at 32.5%, and neck at 29.1%. The mean and standard deviation score of psychosocial stress were $24.06{\pm}6.01$, those of job stress were $2.38{\pm}0.23$, and those of health behaviors were $2.14{\pm}0.39$. The items that were significantly different according to musculoskeletal symptoms were career ($x^2=6.67$, p<.036), one week overtime ($x^2=7.27$, p<.026), subjective health status ($x^2=4.29$, p<.038), and psychosocial stress ($x^2=7.99$, p<.010). In logistic regression analysis, career, and psychosocial stress were found to affect musculoskeltal symptoms. Conclusion: It is necessary to conduct preventive intervention to reduce musculoskeletal symptoms according to career and psychosocial stress for small and medium sized hospital nurses.

• Journal of Korean Living Environment System
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• v.25 no.1
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• pp.90-97
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• 2018

The purpose of this study is to compare and analyze the air infections in middle and small hospitals with the facilities of large national hospitals that have air-borne infection isolation (AII) wards through actual condition investigation and airflow analysis simulation (CFD) and to provide basic data for prevention. The method and scope of the study are as follows. First, through literature review, data related to prevention of infection spread in domestic medical institutions were investigated. Second, we conducted a survey on the status of isolation facilities to prevent the spread of infectious diseases in large hospitals and small and medium - sized clinics in Korea. Third, airflow analysis simulation (CFD) was carried out using the isolation ward of the nationally designated inpatient ward and the data of the plane and facility system of the small clinic. As a result of the study, it is found that regulations applicable to small and medium-sized clinics are insufficient. In addition, the simulation results show that the infectious disease virus is likely to spread to other patients in the hospital.

• Journal of Convergence for Information Technology
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• v.7 no.4
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• pp.61-67
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• 2017

The objective of this study is to understand the effects of service-orientation perceived by customers(patients) on relationship commitment and prosocial behavior, in order to suggest the direction necessary to establish the management strategies of small & medium-sized hospitals. The elements of service-orientation were composed of customer treatment, service failure recovery, and service standard suitable for the characteristics of small & medium-sized hospitals. In order to verify if the effects of three sub-factors of service-orientation on relationship commitment would cause prosocial behavior, the path analysis through AMOS was conducted. In the results of study, all the sub-factors of service orientation showed significant results, and also the relationship commitment and prosocial behavior showed significant effects. Based on such results, the implications and future research were suggested.