• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• Journal of Korea Society of Digital Industry and Information Management
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• v.8 no.2
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• pp.59-65
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• 2012

Emergency medical information center performs role of medical direction about disease consult and pre-hospital emergency handling scheme work to people. Emergency medical information system plays a major role to be decreased mortality and disability of emergency patient by providing information of medical institution especially when emergency patient has appeared. But, various attacks as a hacking have been happened in Emergency medical information system recently. In this paper, we proposed security structure which can protect the system securely by detecting attacks from outside effectively. Intrusion detection was performed using rule based detection technique according to protocol for every packet to detect attack and intrusion was reported to control center if intrusion was detected also. Intrusion detection was performed again using decision tree for packet which intrusion detection was not done. We experimented effectiveness using attacks as TCP-SYN, UDP flooding and ICMP flooding for proposed security structure in this paper.

• The Journal of the Korean dental association
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• v.43 no.1 s.428
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• pp.41-52
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• 2005

Information Technology has extended its scope to the medical field as well as dental field. Like medical field, network ststem for dental field requires acquisition, storage, and display of images. However, unlike the medical field, the system to integrate several information including medical images has not been developed according to industrial standard for management of digital image for medical use, so called DICOM conformance. which makes the digital environment in dental field more and more difficult and expensive for this standardization and comfortable communication in LAN and WAN. To solve this problem, the DICOM encoder and server has to be developed because the DICOM file can be easily retrieved with patient's information from the DICOM server in the system as DICOM file has the standard specification to integrate the patient's information. The information including image and other discrete data can be easily integrated in DICOM file and can be used without any difficulty for precise diagnosis and for contribution to the decision making for each treatment protocol. Therefore, the system composed of DICOM encoder and server in dental practive for DICOM file must be developed with prudent consideration of the several strategic factors: I) Enhanced diagnostic capability through the integrated information of image and clinical data. ii) Clinician-friendly interface to simulate the systemic treatment procedure in clinical practice iii) Implementation of multidisciplinary treatment protocol The development of DICOM encoder and server based on these strategic considerations will provide paperless and filmless hospital environments by the seamless integration and management of patient's history, several clinical data and clinical images through image processing for quantitative analysis. The system also allows clinicians to provide more predictable dental care for the patients.

• The Journal of Korea Institute of Information, Electronics, and Communication Technology
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• v.1 no.3
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• pp.33-40
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• 2008

The TMO may contain two types of methods, time-triggered methods(also called the spontaneous methods of SpMs) which are clearly separated from the conventional service methods (SvMs). The SpM executions are triggered upon design time whereas the SvM executions are triggered by service request message from clients. In this paper, we describes the application environment as the patient monitor telemedicine system with TMO structure. Vital sign information web viewer systems is also the standard protocol for medical image and transfer. In order to embrace new technologies as telemedicine service, it is important to develope the standard protocol between different systems in the hospital, as well as the communication with external hospital systems. It is able to apply to remote medical examination and treatment. Through the proper data exchange and management of patient vital sign information, real time vital sign information management will offer better workflow to all hospital employee.

• Journal of Chest Surgery
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• v.53 no.2
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• pp.41-48
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• 2020

Background: Chylothorax after congenital heart surgery is not an uncommon complication, and it is associated with significant morbidity. However, consensus treatment guidelines are lacking. To improve the treatment outcomes of patients with postoperative chylothorax, we implemented a standardized management protocol at Severance Hospital in September 2014. Methods: A retrospective review of patients treated at a single center was done. All corrective and palliative operations for congenital heart disease performed at our institution between January 2008 and April 2018 were reviewed. The incidence and treatment outcomes of postoperative chylothorax were analyzed. Results: The incidence of chylothorax was 1.9%. Sixty-one percent of the patients could be managed with a low-fat diet, while 28% of the patients required complete restriction of enteral feeding. Thoracic duct embolization was performed in 2 patients and chest tube drainage decreased immediately after the procedure. No patient required thoracic duct ligation or pleurodesis. After implementation of the institutional management protocol, the number of chest tube drainage days decreased (median, 24 vs. 14 days; p=0.45). Conclusion: Implementing a strategy to reduce postoperative chylothorax resulted in an acceptable incidence of postoperative chylothorax. Instituting a clinical practice protocol helped to curtail the treatment duration and to decrease the requirement for surgical treatment. Image-guided embolization of the thoracic duct is an effective treatment for postoperative chylothorax.

• Journal of Digital Convergence
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• v.10 no.2
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• pp.153-159
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• 2012

Now a days, U-healthcare comes into the spotlight as a new business model which combines RFID technology with medical service in the well-being era and IT popularization. U-healthcare service needs a method that can deals with hand-writing, overlap data, forgery and falsification of data, difference between information version that happen in medical process because of graft between RFID technology and u-healthcare. This paper proposes RFID based user certification protocol to protect user's privacy who gets medical service through U-healthcare. In the protocol, secret information of patient does the XOR with the secret key that is created in the hospital to reconsider the stability of security system of U-healthcare and user's data forgery and falsification and privacy and then saves it in the secret key field of patient in DB table. Also, it informs the case of illegal access to certification server and make it approved the access of u-healthcare service by differentiating whether u-healthcare is illegal or not.

• Journal of dental hygiene science
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• v.12 no.6
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• pp.545-557
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• 2012

Dental caries is biofilm induced disease throughout life and is recognized significant oral health problem. This article reviewed new trends in dental caries management by risk assessment, including history, protocol/guideline, and collaborated model. Dental caries prevention and treatment according to caries management by risk assessment (CAMBRA) model is patient-centered, risk-based, evidence-based practice. Team approach is necessary and clinician need to integrate science, practice and product. Dental hygienist take a important role in implementing CAMBRA. CAMBRA model could be incorporated into clinical dental hygiene education based on dental hygiene process of care as standard of dental hygiene practice and education. Dentist and dental hygienist able to provide scientific and ethical care managing dental caries by risk assessment.

• Journal of Trauma and Injury
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• v.36 no.1
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• pp.49-52
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• 2023

Blunt carotid artery injury can lead to impaired brain perfusion due to ischemic stroke and thromboembolic events. To reduce the risk of potential neurological complications, it is critical to determine the diagnosis and management protocol as quickly as possible after a detailed clinical examination. This report presents successful surgical treatment of a young male patient who developed a traumatic left common carotid artery thrombosis after a motor vehicle accident.

• The Journal of Korean Academic Society of Nursing Education
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• v.29 no.4
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• pp.381-394
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• 2023

Purpose: This study aimed to develop an intentional rounding protocol to enhance the clinical competence of nursing students. Methods: An intentional rounding protocol for nursing students' clinical practice was developed following the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A convenient sampling method was used to select 23 junior year university nursing students during their clinical practice in adult nursing. The program evaluation included a quantitative assessment (communication and relationship efficacy, empathy, and patient safety competency) and focus group interviews. Results: The intentional rounding protocol focused on the 4Ps (pain, position, potty, and possessions) and encompassed aspects such as level of consciousness, pain management, personal care needs, intravenous injection, oxygen administration, nasogastric/nasoenteric tube care, maintenance of urine collection bags, and the identification of environmental fall risks. Nursing students performed intentional rounding at least twice a day. Following the implementation of this protocol, nursing students demonstrated a significant improvement in communication and interpersonal efficacy. The focus group interviews revealed four main themes: growth of human relationships, acquiring knowledge in and about the clinical field, becoming a nurse, and barriers in reality. Conclusion: The intentional rounding protocol has the potential to enhance nursing students' communication and interpersonal skills during clinical practice and to provide them with positive experiences in nursing clinical education. Therefore, it is recommended that this protocol be incorporated into nursing clinical practice education.

• The Korean Journal of Emergency Medical Services
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• v.16 no.3
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• pp.29-43
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• 2012

Purpose : The goal of the present study is to provide the basic information to medical control which is the most important improving factor of pre-hospital medical treatment. Method : A total of 749 records of direct medical control were collected from 119 EMTs in emergency medical information center of Daejeon, Chungcheongnam-do and Chungcheongbuk-do from March 1, 2010 to February 28, 2011. Results : The 119 EMTs should record the level of qualification of EMT and general patient history taking precisely when they receive direct medical controls. The doctors should take medical controls within the task range of qualification of EMTs. Conclusion : It is necessary to establish the guideline of medical direction and protocol of prehospital emergency care. The quality improvement of pre-hospital emergency services will be possible by the guideline and protocol.