• Title/Summary/Keyword: Patient Management Protocol

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Patient Safety Culture, Perception of Importance on Patient Safety Management, and Patient Safety Management Activities of Care Workers in Nursing Homes: Mixed-method Approach (노인요양시설 요양보호사의 환자안전문화, 환자안전관리 중요성 인식 및 환자안전관리활동: 혼합연구방법 적용)

  • Kim, Soon Ock;Kim, Jeong Ah
    • Journal of Korean Public Health Nursing
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    • v.34 no.3
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    • pp.473-489
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    • 2020
  • Purpose: This study investigated the patient safety culture (PSC), the perception of importance on patient safety management (PIPSM) and the patient safety management activities (PSMA) of care workers in nursing homes. This was a descriptive study that attempted to provide basic data for the patient safety education program of care workers. Methods: Data were collected using questionnaires and interviews from July 1 to 31 in 2020. One hundred and seventy-four care workers participated in quantitative research. The collected data were analyzed by the SPSS/WIN 25.0 program using descriptive statistics, t-test, ANOVA, Bonferroni, and Pearson's correlation. The qualitative data were collected through semi-structured, audio-recorded interviews with six representatives and six care workers from six nursing homes. Content analysis was performed to analyze the data. Results: Positive correlations were observed between PSC and PIPSM, and between PIPSM and PIPSM. Care workers' experience in patient safety management was in the following six categories: "Safety accident risk factors", "Type of safety accidents", "How to prevent safety accidents", "Effective safety management education", "Emphasis on occupational ethics of care workers", and "Needs for standard protocol" Conclusion: These findings indicate that considering the care workers' age and facility size, nurses should enhance patient safety education for care workers and establish a management activity system.

Privacy Model based on RBAC for U-Healthcare Service Environment (u-헬스케어 환경에서 환자의 무결성을 보장하는 RFID 보안 프로토콜)

  • Rhee, Bong-Keun;Jeong, Yoon-Su;Lee, Sang-Ho
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.16 no.3
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    • pp.605-614
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    • 2012
  • Nowadays u-healthcare which is very sensitive to the character of user's information among other ubiquitous computing field is popular in medical field. u-healthcare deals extremely personal information including personal health/medical information so it is exposed to various weaknees and threats in the part of security and privacy. In this paper, RFID based patient's information protecting protocol that prevents to damage the information using his or her mobile unit illegally by others is proposed. The protocol separates the authority of hospital(doctor, nurse, pharmacy) to access to patient's information by level of access authority of hospital which is registered to management server and makes the hospital do the minimum task. Specially, the management server which plays the role of gateway makes access permission key periodically not to be accessed by others about unauthorized information except authorized information and improves patient's certification and management.

A novel method for the management of proximal segment using computer assisted simulation surgery: correct condyle head positioning and better proximal segment placement

  • Lee, Yong-Chan;Sohn, Hong-Bum;Kim, Sung-Keun;Bae, On-Yu;Lee, Jang-Ha
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.21.1-21.8
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    • 2015
  • Computer Assisted Simulation Surgery (CASS) is a reliable method that permits oral and maxillofacial surgeons to visualize the position of the maxilla and the mandible as observed in the patient. The purpose of this report was to introduce a newly developed strategy for proximal segment management according to Balanced Orthognathic Surgery (BOS) protocol which is a type of CASS, and to establish the clinical feasibility of the BOS protocol in the treatment of complex maxillo-facial deformities. The BOS protocol consists of the following 4 phases: 1) Planning and simulation phase, 2) Modeling phase, 3) Surgical phase, and 4) Evaluation phase. The surgical interventions in 80 consecutive patients were planned and executed by the BOS protocol. The BOS protocol ensures accuracy during surgery, thereby facilitating the completion of procedures without any complications. The BOS protocol may be a complete solution that enables an orthognatic surgeon to perform accurate surgery based on a surgical plan, making real outcomes as close to pre-planned outcomes as possible.

Enhanced Secure Sensor Association and Key Management in Wireless Body Area Networks

  • Shen, Jian;Tan, Haowen;Moh, Sangman;Chung, Ilyong;Liu, Qi;Sun, Xingming
    • Journal of Communications and Networks
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    • v.17 no.5
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    • pp.453-462
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    • 2015
  • Body area networks (BANs) have emerged as an enabling technique for e-healthcare systems, which can be used to continuously and remotely monitor patients' health. In BANs, the data of a patient's vital body functions and movements can be collected by small wearable or implantable sensors and sent using shortrange wireless communication techniques. Due to the shared wireless medium between the sensors in BANs, it may be possible to have malicious attacks on e-healthcare systems. The security and privacy issues of BANs are becoming more and more important. To provide secure and correct association of a group of sensors with a patient and satisfy the requirements of data confidentiality and integrity in BANs, we propose a novel enhanced secure sensor association and key management protocol based on elliptic curve cryptography and hash chains. The authentication procedure and group key generation are very simple and efficient. Therefore, our protocol can be easily implemented in the power and resource constrained sensor nodes in BANs. From a comparison of results, furthermore, we can conclude that the proposed protocol dramatically reduces the computation and communication cost for the authentication and key derivation compared with previous protocols. We believe that our protocol is attractive in the application of BANs.

Development of a Patient Monitoring System Overall Architecture and Specifications (환자모니터링시스템의 개발 : 전체구조 및 기본사양)

  • 우응제;박승훈
    • Journal of Biomedical Engineering Research
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    • v.18 no.1
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    • pp.17-24
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    • 1997
  • We have developed a patient monitoring system including module-based bedside monitors, interbed network, central stations, clinical workstations, and DB servers. A bedside monitor with a color LCD can accommodate up to 3 module cases and 21 different modules. Six different physiological parameters of ECG, respiration, invasive blood pressure, noninvasive blood pressure, body temperature, and arterial pulse oximetry with plethysmoyaph are provided as parameter modules. In a single bedside monitor, modules and a module controller communicate with IMbps data rate through an intrabed network based on RS-485 and HDU protocol. At the same time, it communicates with other bedside monitors and central stations through interbed network based on 1 OMbps Ethernet and TCP/IP protocol. Central stations using 20" color CRT monitors can be connected with many bedside monitors and they display 18 channels of waveforms simultaneously. Clinical workstations are used mainly for the review of patient datE In order to accommodate more advanced data management capabilities such as 24-hour full disclosure, we have developed a relational database server dedicated to the patient monitoring system. Software for bedside monitor, central station, and clinical workstation fully utilizes graphical user interface techniques and all functions are controlled by a rotate/push button on the bedside monitor arid a mouse on the central station and clinical workstation. The entire system satisfies the requirements of AAMI and ANSI standards in terms of electrical safety and performances.nces.

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A Secure Health Data Transmission Protocol Using Identity-Based Proxy Re-Encryption in Remote Healthcare Monitoring System (원격건강정보 모니터링 시스템에서 신원기반 프록시 재암호화 기법을 이용한 건강정보 전송 보안 프로토콜)

  • Noh, Si-Wan;Park, Youngho;Rhee, Kyung-Hyune
    • KIPS Transactions on Computer and Communication Systems
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    • v.6 no.4
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    • pp.197-202
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    • 2017
  • The remote healthcare monitoring system enables a doctor to diagnose and monitor patient's health problem from a distance. Previous researches have focused on key establishment method between a patient and a particular doctor to solve personal health information disclosure problem in data transmission process. However, when considering a misdiagnosis of doctor, the result of a diagnosis by a many doctors is more reliable. In previous work, in order to select multiple doctors, patient should generate shared key for each chosen doctor and perform many times encryptions. Therefore, in this paper, we propose a secure data transmission protocol for receiving diagnosis from multiple doctors using identity-based proxy re-encryption scheme. In proposed protocol, a patient don't need key management work for session key. Also, monitoring server performs re-encryption process on behalf of patient. So, we can reduce computational burden of patient in previous work.

Development and Evaluation of an Evidence-based Nursing Protocol for Postoperative Nausea and Vomiting (근거기반의 수술 후 오심·구토 관리 프로토콜의 개발 및 임상적 평가)

  • Oh, In Ohg;Yoo, Jae Yong;Oh, Eui Geum
    • Journal of Korean Biological Nursing Science
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    • v.19 no.2
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    • pp.86-97
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    • 2017
  • Purpose: Postoperative nausea and vomiting (PONV) is very common among postoperative orthopedic surgical patients with patient-controlled analgesia (PCA), especially for narcotics. Therefore, the purpose of this study was to investigate the effects of an evidence-based PONV management protocol on nursing and patient outcomes. Methods: A methodological study was conducted to develop PONV protocol and a quasi-experimental study to evaluate the effectiveness of protocol. The preliminary PONV protocol was drawn by conducting a systematic review and by reviewing clinical guidelines and best practice recommendations. Validation of the content was done by expert clinicians, and the clinical applicability was evaluated by staff nurses and patients. The effect was evaluated in clinical outcomes associated with PONV and nursing outcomes. Results: In the experimental group, the occurrence of vomiting (z= 2.147) was significantly decreased, the maintenance PCA (${\chi}^2=4.212$) and the satisfaction of patients (z= 5.007) were significantly higher. In the outcomes of nurses, the PONV knowledge of nursing care (z = 3.791), awareness (z = 2.982) and self-efficacy (z= 2.745) were higher in the experimental group. The attitude towards evidence-based nursing practice (z= 2.446) was significantly positive. Conclusion: The results show that an evidence-based approach to the implementation of PONV care is effective in improving patient clinical outcomes and quality of care.

Factors influencing the appropriateness of hospital stays (재원 적절성에 영향을 미치는 요인)

  • Hwang, Jee In
    • Health Policy and Management
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    • v.15 no.3
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    • pp.94-113
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    • 2005
  • The purpose of this study was to determine the level of appropriateness in hospital stays and factors influencing inappropriate hospital stays. The study was conducted at fifteen general care units in a tertiary university hospital. Appropriateness of hospital stay was assessed using Appropriateness Evaluation Protocol by trained head nurses. The total of 447 patient records were reviewed. Among them, 352 patient data were included in the final data set. A unit of observation was patient day. A rate of appropriate hospital stay was calculated per patient as a unit of analysis. Multiple regression analysis was performed to determine the factors affecting inappropriate hospital stay. The eighty-three percent (2030/2651) of hospital stays were evaluated as appropriate. There were significant differences in appropriateness of hospital stay according to patient's age, type of health insurance, medical specialty, and length of stay(p<0.05). In the multiple regression analysis, medical speciality was the most significant factor to predict the inappropriate hospital stay. The study showed a substantial proportion of hospital stay was found to inappropriate. Level of appropriateness was significantly different from medical specialty. Interdepartmental approach should be required to coordinate and improve appropriate resource utilization.

Implementation of Medical Device Integration Module for Integrated Patient Monitoring System

  • Park, Myeong-Chul;Jung, Hyon-Chel;Choi, Duk-Kyu
    • Journal of the Korea Society of Computer and Information
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    • v.22 no.6
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    • pp.79-86
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    • 2017
  • In this paper, we implement a common module that can integrate multiple biometric information for integrated patient monitoring system. Conventional biomedical instruments have many devices attached to each patient, making it difficult to monitor abnormality signs of many patients in real time. In this paper, we propose a module for an integrated monitoring system that can perform centralized monitoring using a common module that integrates multiple measurement devices. A protocol for sending and receiving packets between the measuring device and the common module is designed, and the packets transmitted through the network are stored and managed through the integrated monitoring system and provide information to various users such as medical staff. The results of this study are expected to contribute to the management of patients and efficient medical services in hospitals.

Evaluation of Clinical Alarms and Alarm Management in Intensive Care Units (중환자실에서 사용되는 의료장비의 경보음 발생과 관리 현황)

  • Jeong, Yu Jin;Kim, Hyunjung
    • Journal of Korean Biological Nursing Science
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    • v.20 no.4
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    • pp.228-235
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    • 2018
  • Purpose: This study aimed to investigate the clinical alarm occurrence and management of nurses toward clinical alarms in the intensive care unit (ICU). Methods: This observational study was conducted with 40 patients and nurses cases in two ICUs of a university hospital. This study divided 24 hours into the unit of an hour and conducted two times of direct observation per unit hour for 48 hours targeting the medical devices applied to 40 patients. Data were analyzed using IBM SPSS Statistics 23. Results: On average, 3.8 units of medical devices were applied for each patient and the ranges of alarm settings were wide. During 48 hours, 184 cases of clinical alarm were occurred by four types of medical devices including physiological monitors, mechanical ventilators, infusion pumps, and continuous renal replacement therapy. Among them, false alarm was 110 cases (59.8%). As for the alarm management by ICU nurses, two-minute alarm mute took up most at 38.0% (70 cases), and no response was second most at 32.6% (60 cases). When valid alarm sounded, nurses showed no response at 43.2%. Conclusion: The findings suggest that a standard protocol for alarm management should be developed for Korean ICU settings. Based on the protocol, continuous training and education should be provided to nurses for appropriate alarm management.