• KSII Transactions on Internet and Information Systems (TIIS)
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• v.15 no.12
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• pp.4400-4419
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• 2021

In the 4th Industrial Revolution, the healthcare industry is undergoing a paradigm shift from post-care and management systems based on diagnosis and treatment to disease prevention and management based on personal precision medicine. To optimize medical services for individual patients, an open ecosystem for the healthcare industry that allows the exchange and utilization of personal health records (PHRs) is required. However, under the current system of hospital-centered data management, it is difficult to implement the linking and sharing of PHRs in practice. To address this problem, in this study, we present the design and implementation of a patient-centered PHR platform using blockchain technology. This platform achieved transparency and reliability in information management by eliminating the risk of leakage and tampering/altering personal information, which could occur when using a PHR. In addition, the patient-consent system was applied to a PHR; thus, the patient acted as the user with ownership. The proposed blockchain-based PHR platform enables the integration of personal medical information with scattered distribution across multiple hospitals, and allows patients to freely use their health records in their daily lives and emergencies. The proposed platform is expected to serve as a stepping stone for patient-centered healthcare data management and utilization.

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.48-79
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• 1999

Background : The clothing is considered as second skin. The patient clothing needs basic clothing demands which are comfortable, functional and aesthetical and special demeands which are associated with medical examination, treatment and management of daily-life inconveniences. The patient is weak and labile to psychic trauma and has limitation of movement. So the help of others is needed. But recent patient clothing does not satisfy above demands. So the design, making and management of patient clothing to satisfy those demands are very important. The purpose of this study' is to develop multipurpose clothing which is comfortable, functional, aesthetical and satisfying patients and medical personnels. Method : The questionnaires of existing patient clothing were tested by patients, medical doctors, and nurses. After analyzing two types of questionnaires, eight types of experimental patient clothing were made. After preference test, shortcomings were removed and merits were adapted. One type of multipurpose patient clothing mixing eight above experimental clothing was made. The state of wearing and moving were videotaped. The videotape-recoding was watched by patient, caregivers(medical doctors, nurses) and clothing specialists. Result : The general reaction for experimental clothing were positive by the group of patients, medical personnels and clothing specialist, there were significant differences among three groups. Conclusion : It was thought that to develop one type of multipurpose clothing is possible. If the studys for patient clothing which are free-size and economic matters that are type of clothes and method of washing are made in depth, the desirable patient clothing will appear.

• Health Policy and Management
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• v.16 no.1
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• pp.17-40
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• 2006

With the prospect of rapidly growing health insurance expenditures, particularly spending for ambulatory care, the introduction of a case-based payment method is discussed as an alternative to the current fee-for-service based method. A system to measure case mixes of providers is a core component of such payment systems. The objective of this study were to develop a classification system for ambulatory care, Korean Ambulatory Patient Group (KAPG) based on the U.S. APG version 2.0 and to evaluate the classification accuracy of the system. A database of 64,258,386 records was constructed from insurance claims submitted to the Health Insurance Review Agency (HIRA) during three months from August 2002. A total of 41,347,307 records with a single visit was used for the development and 7% random sample of the database was used for the evaluation. Additional groups were defined to include both physician and hospital fees in the classification, age splits were added to classify the entire population as well as the population older than 65, and the definition of medical groups used by the HIRA was adopted. The variance reduction in charges achieved by KAPGs was computed to evaluate the accuracy of classification. A total of 474 KAPGs was defined compare to 290 groups in the U.S. APG. The variance reduction for charges of all visits ranged from 20% to 37% depending on the type of provider, and ranged from 22% to 42% for non-outliers, that were better than those achieved by the system currently used by the .HIRA for its internal review purpose. Although further study is required to improve the classification for complicated care in larger hospitals, the results indicated that KAPGs could be used for better management of costs for ambulatory care.

• Journal of Korean Clinical Nursing Research
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• v.27 no.1
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• pp.12-22
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• 2021

Purpose: The purpose of this study is to identify the effects of organizational commitment (OC) and perceived patient safety culture (PPSC) on patient safety nursing activities (PSNA) among nurses in comprehensive nursing care units. Methods: Participants were 173 nurses working at five general hospitals in Chungcheong area. Data were analyzed using descriptive statistics, 𝑥² test, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis with SPSS/WIN 23.0 programs. Results: The mean scores of the OC and PPSC were 3.28±0.50 and 3.85±0.35, respectively. The mean score of PSNA was 4.55±0.41, and PSNA was significantly different by the experience of participating in hospital's safety culture campaigns (t=2.70, p=.008). The results of the multiple regression analysis showed that 'patient safety knowledge and attitudes' (β=.27, p=.006) and 'unpunished environment to error' (β=.22, p=.004) as the sub-categories of PPSC were affecting factors on PSNA with an explanatory power of 26.0% (F=6.40, p<.001). Conclusion: The results of this study suggest that in order to promote PSNA among nurses in comprehensive nursing care units, it is necessary to develop a program to enhance patient safety-related knowledge and attitudes. In addition, the hospital's organizational efforts such as operating safety campaigns and creating an unpunished environment to error should be needed.

• Journal of Korean Academy of Rural Health Nursing
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• v.15 no.1
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• pp.30-40
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• 2020

Purpose: This study was done to describe a community health practitioner's nursing case management for a terminal cancer patient registered in the public health post. Methods: For this purpose, data were collected through the patient and family through home visits, health clinic offices, and phone calls. The nursing process was carried out from August to November 2019. Results: The patient suffered the most from anorexia and lack of energy. Also he expressed psychologically uncertainty about disease and death anxiety caused by long-term treatment. In order to reduce the death anxiety, Community Health Practitioner (CHP) asked him to express his life stories and listened to him. CHP provided information of appropriate medications and alternative foods for symptoms such as gastrointestinal disorders and anorexia to the patient and family. Observing the situation of the patient and family, CHP guided the patient and family to prepare for death and has confirmed to them that the process was not with the patient alone. Conclusion: CHP's this experience has shown the possibility for CHP to help the terminal cancer patient and family to prepare peaceful death in their communities.

• The Journal of Korean Academic Society of Nursing Education
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• v.26 no.1
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• pp.56-66
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• 2020

Purpose: The purpose of this study was to explore nursing students' experiences with patient deaths during clinical practice. Methods: The participants were ten nursing students who had experienced patient deaths during clinical nursing practice at a university hospital in Korea. Individual in-depth interviews were conducted, and the data were analyzed using the content analysis method suggested by Graneheim and Lundman (2004). Results: The participants' experience was structured into six categories: experiencing various emotions in facing patient deaths, viewing oneself as a nursing student at the scene of a patient's death, thinking about death again, finding a pathway of understanding and support for patient death experiences, impressions and regret felt while actually observing terminal care, and picturing oneself as a future nurse dealing with a patient's death. Conclusion: Based on this study, stress management and self-reflection programs are suggested for nursing students who have experienced patient deaths. Practical nursing education for patient death and end of life care is also needed.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.44-54
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• 2024

Purpose: This study aimed to identify tasks performed by patient safety personnel using importance-performance analysis. Methods: An online survey was conducted during a mandatory educational course. The questionnaire consisted of 43 items categorized into four subscales: management of patient safety accidents, education of healthcare personnel, education of patients and guardians, and patient safety activities. Importance-performance analysis was employed to ascertain the relationship between the importance and performance of tasks conducted by patient safety personnel. Results: A total of 145 patient safety personnel participated in the survey. The perceived importance of tasks by participants averaged 3.67 out of four, while the average performance was 3.40 out of four, indicating a significant difference (t=8.04, p<.001). Activities such as collecting patient safety reports, conducting root-cause analyses, and educating new employees were identified as low-performance tasks compared to their perceived importance. Conclusion: Tasks recognized as having low importance but high performance among patient safety personnel should be addressed through increased awareness and education. Analyzing the causes of tasks with low importance and performance is crucial for recognizing their importance and implementing improvement measures.

• Journal of Technologic Dentistry
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• v.41 no.4
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• pp.305-317
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• 2019

Purpose: The purpose of this study is to provide basic data for the improvement of dental care service for patient care. Methods: The survey period was from December 10, 2018 to June 10, 2019. The subjects were 180 patients who were treated with dental implant in 20 dental hospitals and clinics in Daejeon and Gyeonggi province. A total of 145 questionnaires were analyzed except for 35 copies which were unreliable or difficult to analyze. Results: The most important care method for prolonging the life time of dental implant prosthesis was the highest rate of correct brushing (39.4%), and a majority in the subjects used oral hygiene products (91.0%). With regard to discomfort after dental implant prosthesis, food particles between the teeth showed the highest response (49.7%), and discomfort with gum infections and bleeding and reduced mastication increased significantly with age (p<0.05), whereas feeling of irritation decreased significantly with age (p<0.05). Conclusion: This study is meaningful in that it approached the perception and discomfort of prosthesis from the patients' point of view. It needs to establish the basic data to improve dental treatment service for patient care.

• Safety and Health at Work
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• v.9 no.4
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• pp.372-380
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• 2018

The manual handling of people (MHP) is known to be associated with high incidence of musculoskeletal disorders for aged care staff. Environment-related MHP interventions, such as appropriate seated heights to aid sit-to-stand transfers, can reduce staff injury while improving the patient's mobility. Promoting patient mobility within the manual handling interaction is an endorsed MHP risk control intervention strategy. This article provides a narrative review of the types of MHP environmental controls that can improve mobility, as well as the extent to which these environmental controls are considered in MHP risk management and assessment tools. Although a range of possible environmental interventions exist, current tools only consider these in a limited manner. Development of an assessment tool that more comprehensively covers environmental strategies in MHP risk management could help reduce staff injury and improve resident mobility through auditing existing practices and guiding the design of new and refurbished aged care facilities.

• Journal of Digital Convergence
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• v.15 no.2
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• pp.273-283
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• 2017

This study aims to develop a convergence optimized LOS(Length of Stay) management system that can provide efficient by predicting LOS on outpatient information for inducing the LOS to manage their own activities. web program has been implemented to comput in real-time predicting LOS by using the predicted LOS model of outpatient information. The predict model was derived management targets of long term predicted patient group and intensive care patient group. The optimized LOS(Length of Stay) management system was confirmed efficient for optimizing management of LOS that can provide by the long-term predicting alarm and over LOS alarm service for long term predicted patient group and intensive care patient group. Therefore the trial operating policy alternative on extension of predicted LOS is needed to utilized convergence optimizing system on LOS.