• 한국보건간호학회지
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• 제34권3호
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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.

• 한국정보통신학회논문지
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• 제16권3호
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• pp.605-614
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• 2012

최근 유비쿼터스 컴퓨팅 기술 분야 중 사용자의 정보 속성이 매우 민감한 u-헬스케어가 의료분야에서 각광을 받고 있다. u-헬스케어는 개인 건강/의료 정보를 포함한 극히 개인적인 정보를 다루고 있기 때문에 보안 및 프라이버시 측면에서 다양한 취약점 존재 및 위협에 노출되어 있다. 본 논문에서는 환자가 소유하고 있는 휴대장치(PDAs나 휴대용 컴퓨터)를 제 3자가 불법적으로 악용하여 환자의 정보를 훼손하는 것을 예방하기 위한 RFID 기반의 환자정보 보호 프로토콜을 제안한다. 제안 프로토콜은 사전에 관리 서버에 등록된 병원(의사, 간호사, 약국 등)의 권한 정보에 따라 환자의 개인정보에 접근할 수 있도록 병원(의사, 간호사, 약국 등)의 권한을 계층적으로 분리하여 병원이 최소한의 업무를 수행하도록 한다. 특히, 게이트웨이 역할하는 관리 서버는 접근 허가가 승인된 환자 정보 이외에 허가받지 않은 정보에 대해서 제 3자가 쉽게 접근하지 못하도록 주기적으로 접근 허용 키를 생성하여 환자의 인증 및 관리의 효율성을 향상시키고 있다.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제37권
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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.

• Journal of Communications and Networks
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• 제17권5호
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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.

• 대한의용생체공학회:의공학회지
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• 제18권1호
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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.

• 정보처리학회논문지:컴퓨터 및 통신 시스템
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• 제6권4호
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• pp.197-202
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• 2017

원격 건강정보 모니터링 시스템에서 의사는 원격지에서 환자의 건강상태를 진단하거나 모니터링하여 적절한 의료서비스를 제공한다. 기존의 연구들은 공개된 네트워크를 통한 전송과정에서 환자의 민감한 건강정보의 노출로 인한 문제를 해결하기 위해 환자와 의사 사이에 비밀 공유키를 생성하여 메시지를 암호화하는 방법에 중점을 두고 있었다. 하지만 의사의 오진을 고려할 때 다수의 의사에게 진단을 받는 것이 좀 더 신뢰할 수 있는 진단결과를 얻을 수 있다. 하지만 기존 프로토콜에서는 환자가 여러 의사에게 메시지를 전달하기 위해서는 모든 의사와 각각 공유하는 키의 생성이 필요하고 전송과정에서 선택한 모든 의사들을 위해 여러 번의 암호문 생성과정을 필요로 하였다. 이에 본 논문에서는 신원기반 프록시 재암호화 기법을 사용한 원격건강정보 모니터링 시스템의 전송 보안 프로토콜을 제안한다. 제안 프로토콜에서 환자는 별도의 세션키 관리가 필요하지 않고 전송과정에서 환자가 비밀키로 생성한 암호문을 모니터링 서버에서 재암호화하여 선택한 의사에게 전달하므로 기존 프로토콜을 적용했을 때 환자에게 필요한 과도한 연산부담을 개선할 수 있다.

• Journal of Korean Biological Nursing Science
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• 제19권2호
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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.

• 보건행정학회지
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• 제15권3호
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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.

• 한국컴퓨터정보학회논문지
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• 제22권6호
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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.

• Journal of Korean Biological Nursing Science
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• 제20권4호
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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.