• Quality Improvement in Health Care
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• v.9 no.1
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• pp.66-73
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• 2002

The current health care system demands provisions for patient care in perspectives of a cost-effectiveness and patient satisfaction. Critical pathway implementation facilitates optimal sequencing and intervention timing of patient care, and makes medical team and patients participate in a treatment actively. In this study, a critical pathway was developed and implemented to patients with osmidrosis who undertake operation. Sixty patients were included in the study. The critical pathway was implemented for care of 26 patients while the traditional care was implemented for 34 patients. In the critical pathway implemented group, time needed for charting and unessential working was reduced. Mean time amount of time for patient nursing was increased. The critical pathway implementation is an effective method to utilize time of medical team. Also it increases the satisfaction index of patients and medical team simultaneously.

• Journal of the Korean Dietetic Association
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• v.2 no.2
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• pp.199-215
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• 1996

In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.

• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.92-106
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• 1999

Background : In many university hospitals, intravenous(IV) therapies and samplings had been one of the most important works of doctors who are in training. However, recently as patient oriented care is becoming more weighted for qualified health service IV therapies should be the works of specialized personnels. This study was conducted to investigate the medical staff's perception on IV team, to survey patient or parent's expectation on IV team, and to assess the frequency of IV therapy related complications and the characteristics of phlebitis among the hospitalized children. Methods : We collected data prospectively before the start of IV team from February 22 to February 29. 1999 and from September 27 to October 3, 1999, 6 months after beginning of IV team at Seoul National University Children's Hospital. IV team started their activities from March 1, 1999. General pediatric wards were not included for the IV and sampling team and oncology ward and surgical units were all included for the IV and sampling team's work. IV specialist was the well trained nurse who had been working in the field of pediatrics especially for the oncology patients. The subjects of this study were medical staffs who were working in children's hospital as doctors in training and patients who were treated with IV therapies in children's hospital during the same period. Results : Doctors responded that IV team need to be organized for IV care and expected IV team could reduce their work load. Parents of patients also responded IV team was very improtant to perform high quality IV care. They had willingness to pay extra charge for IV team care. In the wards where IV team did not work, they used various kinds and sizes of catheters, but in the wards where IV team worked, they needed just one or two types of catheters. As the exact role of IV team is not still established, job description is needed between the IV team and medical doctors. In the aspects of medical costs. it could save the materials for the IV also. Conclusion : This study showed that IV team could increase patient's satisfaction with decrease of medical doctors work load and concomitantly could save the costs of IV materials. And for the expansion of the IV team, job description is needed and for the total care of the children IV specialist and sampling team should expand their roles.

• Journal of Hospice and Palliative Care
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• v.27 no.2
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• pp.77-81
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• 2024

This case report explores the challenges and complexities associated with opioid management of cancer pain, emphasizing the importance of early involvement of a hospice consultation team and the adoption of a multidisciplinary approach to care. A 56-year-old man with advanced pancreatic cancer experienced escalating pain and inappropriate opioid prescriptions, highlighting the shortcomings of traditional pain management approaches. Despite procedural intervention by the attending physician and increased opioid dosages, the patient's condition deteriorated. Subsequently, the involvement of a hospice consultation team, in conjunction with collaborative psychiatric care, led to an overall improvement. The case underscores the necessity of early hospice engagement, psychosocial assessments, and collaborative approaches in the optimization of patient-centered palliative care.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.6
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• pp.2933-2934
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• 2014

Involvement of a multidisciplinary team in cancer care may have added benefits over the existing system of patient management. A paradigm shift in the current patient management would allow more focus on nutritional support, in addition to clinical care. Malnutrition, a common problem in cancer patients, needs special attention from the early days of cancer care to improve quality of life and treatment outcomes. Patient management teams with trained oncology dietitians may provide quality personalized nutritional care to cancer patients.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.32-45
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• 1996

Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.

• Korean Medical Education Review
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• v.19 no.3
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• pp.152-157
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• 2017

Interprofessional education (IPE) fosters effective team-based collaborative practice among members of different health care professions to advance high-quality and safe patient care. Although the importance of IPE has been recognized and IPE initiatives have expanded rapidly in the past decades, substantial difficulties in IPE assessment still exist. At present, a lack of consensus on the optimal approach to IPE assessment contributes to uncertainty about the level of attainment of collaborative team performance. This paper aims to provide an overview of the benefits and current challenges associated with IPE assessment. Furthermore, a multifactor model with an assessment matrix and assessment blueprints from a recent study is briefly discussed. We also provide examples of assessment blueprints for the team management of stroke patient discharge covering a competency examination at the levels of individuals, the team, and the task.

• Journal of Hospice and Palliative Care
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• v.25 no.3
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• pp.133-137
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• 2022

A 72-year-old woman with metastatic lung cancer to bone and brain and with left external iliac vein thrombosis was under the care of a community palliative care provider. She experienced an acute pain crisis due to acute limb ischemia of the left lower limb. Goals-of-care discussions were held with the patient and her family; she prioritized symptom control and end-of-life care at home. The family and patient were aware of her short prognosis. Her complex pain was managed by the community palliative team, and her family was empowered to give subcutaneous injections. We illustrate a case showing the importance of community health services with palliative care support in providing symptom management and support to patient and family caregivers throughout the course of a life-limiting illness. It also highlights family caregivers' potential psychological distress in delivering subcutaneous injections in terminal care for a patient at home.

• Journal of Korean Academy of Nursing
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• v.13 no.3
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• pp.86-94
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• 1983

The purpose of this study were to find out the perceived importance of psychological care, to investigate the nurses perception on the quantity of psychological care activities, and the correlation between the structual variables. 206 registered nurses from general wards of 3 university hospitals in Seoul were randommly sampled. Data were gathered by check-list on the perceived importance and perceived quantity and were analysed by the frequency, percentile scores, ANOVA and Correlation-coefficient. Results are as follows 1. Majority of subjects(96.6%) responded to the psychological care for hospitalized patients being very, and most important nursing care activity Two-third(66%) revealed to be give more or less satisfactory amount of psychological care-to the hospitalized patients. 2. Heavy work-load(79%), personal factors of(33.0%) nurses and the health team and factors of nurse-patient relationship (20.9%) revealed to be the major causes hindering psychological care. 3. To improve quality and the quantity of psychological care, personal and professional development of nurses and the health team(56.8%), improvement of nurse-patient relationships (49.03) and improvement of nurse patient ratio(45%) were suggested. 4. The perceived quantity of psychological care and the educational status revealed significant correlation(p<.005). The perceived quantity and position in nursing revealed significant correlation (p<.01). 5. No significant correlation was revealed between the perceived importance and the perceived quantity of the psychological care.

• The Journal of Korean Physical Therapy
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• v.12 no.1
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• pp.113-118
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• 2000

The purpose of this study was to review the Japanese home care service and analyse the necessity for the home care service and the team approaching. The subjects of this study were 23 Korean students who visited on the Japanese home n due to the curriculum of university. The data were collected from sep. 1 to nov. 30, 1999. The main results of this study were as follows : 1. There was consisted of some nurses, physical therapists, medical doctors, occupational therapists as a team of home care service. They visited patients as multidisciplinary team. 2. The qualities of service was good, and the attitude of patient was positive. 3. There was necessity for rehabilitation home care service in Korea. 4. There was necessity for team work through the rehabilitation home care service in Korea.