• 제목/요약/키워드: Patient Related Management

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선천성 무통 무한증 환자의 치과적 관리 증례보고 (Dental Management in a Patient with Congenital Insensitivity to Pain with Anhidrosis : A Case Report)

  • 배철현;이대우;김재곤;양연미
    • 대한소아치과학회지
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    • 제46권4호
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    • pp.416-421
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    • 2019
  • 선천성 무통무한증(Congenital insensitivity to pain with anhidrosis, CIPA)은 NTRK1 유전자의 돌연변이에 의해 발생하는 드문 유전질환으로 통증에 대한 무감각 및 땀을 흘리지 못하는 것이 특징이다. 지적장애를 동반하는 경우가 많으며, 구강내 임상검사에서는 자해로 인한 병소를 제외하고 특징적인 병소가 발견되지 않으므로 초기 감별진단이 중요하다. 소아치과의사는 이 질환과 동반되는 조절되지 않는 체온, 지각 과민, 통증 반사의 부재와 같은 다양한 임상증상 등을 인지하고 있어야 하며 이를 치과 치료에서 고려해야만 한다. 이 연구는 본원에 첫 내원 이후 6년여간 경과 관찰 중인 선천성 무통무한증 환아의 치험례를 통하여 이 질환의 감별진단 및 치과치료에서의 주의사항 등을 알아보고자 하였다.

Prognostic Factor Analysis for Management of Chronic Neck Pain : Can We Predict the Severity of Neck Pain with Lateral Cervical Curvature?

  • Seong, Han Yu;Lee, Moon Kyu;Jeon, Sang Ryong;Roh, Sung Woo;Rhim, Seung Chul;Park, Jin Hoon
    • Journal of Korean Neurosurgical Society
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    • 제60권4호
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    • pp.456-464
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    • 2017
  • Objective : Although little is known about its origins, neck pain may be related to several associated anatomical pathologies. We aimed to characterize the incidence and features of chronic neck pain and analyze the relationship between neck pain severity and its affecting factors. Methods : Between March 2012 and July 2013, we studied 216 patients with chronic neck pain. Initially, combined tramadol (37.5 mg) plus acetaminophen (325 mg) was administered orally twice daily (b.i.d.) to all patients over a 2-week period. After two weeks, patients were evaluated for neck pain during an outpatient clinic visit. If the numeric rating scale of the patient had not decreased to 5 or lower, a cervical medial branch block (MBB) was recommended after double-dosed previous medication trial. We classified all patients into two groups (mild vs. severe neck pain group), based on medication efficacy. Logistic regression tests were used to evaluate the factors associated with neck pain severity. Results : A total of 198 patients were included in the analyses, due to follow-up loss in 18 patients. While medication was successful in reducing pain in 68.2% patients with chronic neck pain, the remaining patients required cervical MBB. Lateral cervical curvature, such as a straight or sigmoid type curve, was found to be significantly associated with the severity of neck pain. Conclusion : We managed chronic neck pain with a simple pharmacological management protocol followed by MBB. We should keep in mind that it may be difficult to manage the patient with straight or sigmoid lateral curvature only with oral medication.

종합병원 진단검사의학과 검사실의 시설 현황 조사 - 300 병상 미만 병원을 중심으로 (A Study on the Facility and Equipment of Laboratory Medicine in General Hospital - Focused on less than three hundred bed hospitals)

  • 김영애
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제25권3호
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    • pp.15-23
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    • 2019
  • Purpose: As the medical laboratories in general hospitals have made an efforts on quality management and employee health, they recognized the need of design guideline for clinical laboratory. As laboratories are prohibited to patients, their environments are becoming more congested and deteriorated as time goes by. So, this study investigates the current status of facility and equipment of laboratory medicine focusing on less than three hundred patient bed hospitals, and searches the improving matters. Methods: Questionnaires to technologist captains and field surveys to medical laboratories in korean hospitals have been conducted for the data collection. 18 answers have been analysed statistically by MS Excel program. Results: The result of this study can be summarized into followings. Clinical laboratory functions are all hematology, clinical chemistry, immunology, transfusion and urine microscopy, and except for three including microbiology for infection and bio safety level. Average man power of lab are 12.3 man including lab director and captain. Patient bed number, space area and total specimen numbers are not correlated with each other, but specimen numbers and employee number are correlated with. Work space distances are usually good, but exit distances are not adequate for escape owing to obstacles. Specimen delivery system by courier, test method by automatic analyzer, access floor for exposed plumbing and electricities are more practical. Open lab layed out in the center and lab support layed peripheral in space diagram. Lab space configuration by SD method showed that lab support area and employee support area are dissatisfied. Implications: Specialized hospital and yearly total specimen numbers are related to the space area and organization for laboratory planning and design.

Epidemiology of Facial Bone Fractures During the Coronavirus Disease 2019 Pandemic: A Single Korean Level I Trauma Center Study

  • Kim, Min Ji;Yang, Kyung Min;Lim, Hyoseob
    • Journal of Trauma and Injury
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    • 제34권4호
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    • pp.233-241
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    • 2021
  • Purpose: The medical community has been heavily impacted by the coronavirus disease 2019 pandemic. The management of facial trauma patients has been affected by the patient capacity of emergency rooms. In this study, we share our experiences of facial trauma management during the social lockdown period and investigate the epidemiological changes in facial bone fractures. Methods: A total of 997 patients who presented to Ajou University Hospital Emergency Center and were evaluated by plastic or maxillofacial surgeons for facial trauma were included in this retrospective study. Our study design was a comparative study of two groups: the 2019 group (control) and the 2020 group (the experimental group that experienced social lockdown). Results: The total number of emergency room inpatients reflected the national pandemic trends with three peaks in patient numbers. According to these trends, facial bone fractures had two different low points in August 2020 and December 2020. A comparison of the 2019 and 2020 facial bone fractures did not show a statistically significant difference in the total number of patients. An analysis of the causes of trauma showed that domestic accidents increased in 2020 (30.92%; p<0.001). Among the anatomical sites of facial injury in surgical patients, the frontozygomatic complex fracture increased the most in 2020 (p=0.018). Facial injuries with two separate sites of injury or with three or more involved sites also showed a significant increase in 2020 (p<0.001). Conclusions: We demonstrated that the incidence of facial trauma patients correlated with the incidence of patients presenting to the emergency department and that facial trauma is inextricably related to multi-trauma cases. Domestic accidents and facial trauma with multiple anatomically involved sites are increasing trends that need more attention.

의료 질 향상을 위한 서비스디자인: 환자경험 증진을 위한 실행 접근법 (Service Design for Healthcare Quality Improvement: An Implementation Approach for Enhancing Patient Experience)

  • 구정하;유운형;권영대
    • 한국의료질향상학회지
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    • 제29권2호
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    • pp.47-63
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    • 2023
  • Purpose:This study aims to suggest the future direction for applying service design to improve the quality of healthcare as part of hospital service innovation and present implementation plans in Korea, based on a review of quality improvement activities and the current status of service design applications. Methods: Through a literature review, we examined the status of service design introduction and application in the healthcare field, focusing on cases in the US and Europe. The possibility and limitations of service design in the healthcare field were examined through a comparison of oversea and domestic cases. Results: Recently, service design has begun to be applied to the healthcare field worldwide. Service design shows the possibility of an alternative that alleviates and complements the limitations of existing quality improvement activities. It also offers the possibility of creating new organizational improvement and innovation approaches through integration and convergence with existing quality improvement activities and management innovation. Conclusion: To effectively apply service design to hospitals, it is necessary to integrate internal organizations related to service improvement, combine methods, and objectively measure and evaluate performance. To this end, we propose the operation of a nationwide education and training center for quality improvement and service design led by academic society. Service design will provide an opportunity to change the management innovation and organizational culture of hospitals beyond the scope of the current quality improvement, which deals only with micro-subjects of individual hospitals.

손상 및 외상환자 발생에 영향을 미치는 일반적 특성, 입원 특성에 미치는 요인에 관한 연구 (Research on Factors Affecting General Characteristics, Hospitalization Characteristics that Affect the Occurrence of Injuries and Trauma Patients)

  • 백재성;김광환
    • 디지털융복합연구
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    • 제22권1호
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    • pp.23-32
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    • 2024
  • 본 연구는 퇴원손상심층조사 자료를 선정하여 2016년 1월부터 2018년 12월까지 입원 치료 후 퇴원한 환자 중 주진단이 한국표준질병·사인분류(KCD-7th) 기준 S00-T98(손상, 중독 및 외인에 의한 특정 기타 결과)인 환자 92,364명을 최종 대상으로 분석하였다. 연구결과 손상 및 외상환자의 일반적 특성을 분석한 결과 성별은 남자가 발생률이 높았으며 연도가 증가할수록 여성의 발생비율이 증가하였다. 손상 및 외상환자의 손상 외인 특성을 분석한 결과 손상 의도는 비의도성 손상 비율이 높았고, 손상장소는 길/도로에서 가장 높았으며 연도가 증가할수록 감소 추세를 보이며 주거지에서 증가 추세를 보였다. 이상의 결과 손상 예방을 위한 관련 시스템의 구축의 기초 자료로 활용될 수 있을 것이다.

Effectiveness of Electroacupuncture for Managing Urinary Retention Post Lumbar Spine Surgery: a retrospective single-cohort study

  • Phuong Dong Tran;Quoc Dung Nguyen;Thanh Duc Ngo
    • 대한약침학회지
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    • 제27권2호
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    • pp.123-130
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    • 2024
  • Objectives: Post-operative urinary retention (POUR) is a frequent complication following surgical procedures, characterized by an acute inability to void, leading to additional complications and extended hospitalization. Acupuncture has been shown to be effective in facilitating spontaneous urination and alleviating anxiety in patients experiencing poor urination. The present study aims to evaluate the effectiveness of electroacupuncture in the management of POUR in patients who have undergone lumbar spine surgery. Methods: This retrospective study conducted at the National Hospital of Acupuncture in Vietnam and reviewed the medical records of patients over 18 years old who underwent lumbar spine surgery and were diagnosed with POUR between January to December 2019. Electroacupuncture was administered at five specific acupuncture points: Qugu (CV2), Zhongji (CV3), Zhibian (BL54), Pangguanshu (BL28), and Kunlun (BL60). This study monitored key parameters related to the effectiveness of the acupuncture treatment, including the number of acupuncture treatment sessions required until a patient was successfully treated was recorded, with a maximum of three acupuncture treatment sessions per patient, the time elapsed until urination following the treatment (minutes), and urinary bladder volume before and after treatment (mL). Results: The study demonstrated a 93.3% success rate in treating POUR with electroacupuncture. A significant reduction in post-void residual volume was noted, and patients could void within 30 minutes post-treatment. No significant differences in treatment effectiveness were observed across difference genders and age groups. Conclusion: Electroacupuncture proved to be a highly effective treatment for POUR in patients post-lumbar spine surgery, with a rapid response time and substantial reduction in PVR. However, the retrospective nature of the study and single-center focus limit its generalizability. Future research incorporating randomized controlled trials or multi-center observational studies are recommended to validate these findings and explore the potential of acupuncture in POUR management on a broader scale.

인공호흡기 중앙감시시스템 소프트웨어의 사용적합성 총괄평가 (Summative Usability Assessment of Software for Ventilator Central Monitoring System)

  • 정지용;김유림;장원석
    • 대한의용생체공학회:의공학회지
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    • 제44권6호
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    • pp.363-376
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    • 2023
  • According to the COVID-19, development of various medical software based on IoT(Internet of Things) was accelerated. Especially, interest in a central software system that can remotely monitor and control ventilators is increasing to solve problems related to the continuous increase in severe COVID-19 patients. Since medical device software is closely related to human life, this study aims to develop central monitoring system that can remotely monitor and control multiple ventilators in compliance with medical device software development standards and to verify performance of system. In addition, to ensure the safety and reliability of this central monitoring system, this study also specifies risk management requirements that can identify hazardous situations and evaluate potential hazards and confirms the implementation of cybersecurity to protect against potential cyber threats, which can have serious consequences for patient safety. As a result, we obtained medical device software manufacturing certificates from MFDS(Ministry of Food and Drug Safety) through technical documents about performance verification, risk management and cybersecurity application.The purpose of this study is to conduct a usability assessment to ensure that ergonomic design has been applied so that the ventilator central monitoring system can improve user satisfaction, efficiency, and safety. The rapid spread of COVID-19, which began in 2019, caused significant damage global medical system. In this situation, the need for a system to monitor multiple patients with ventilators was highlighted as a solution for various problems. Since medical device software is closely related to human life, ensuring their safety and satisfaction is important before their actual deployment in the field. In this study, a total of 21 participants consisting of respiratory staffs conducted usability test according to the use scenarios in the simulated use environment. Nine use scenarios were conducted to derive an average task success rate and opinions on user interface were collected through five-point Likert scale satisfaction evaluation and questionnaire. Participants conducted a total of nine use scenario tasks with an average success rate of 93% and five-point Likert scale satisfaction survey showed a high satisfaction result of 4.7 points on average. Users evaluated that the device would be useful for effectively managing multiple patients with ventilators. However, improvements are required for interfaces associated with task that do not exceed the threshold for task success rate. In addition, even medical devices with sufficient safety and efficiency cannot guarantee absolute safety, so it is suggested to continuously evaluate user feedback even after introducing them to the actual site.

병원종사자의 직업성 스트레스에 관한 연구 - 서울시내 500병상 이상 병원종사자를 중심으로 - (Occupational Stress of Hospital Workers)

  • 이우천
    • 한국병원경영학회지
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    • 제3권1호
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    • pp.1-33
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    • 1998
  • The purpose of this thesis is to study theoretical access to the methods that have been used for the research of occupational stress, thereby providing management methods of occupational stress of hospital workers. With a stress model of hospital workers set up from the viewpoint of organization management, 929 sets of questionnaires were collected from intern doctors, resident doctors, nurses, nursing aides, pharmacists, medical technicians, workers in patient affairs(reception and medical insurance workers), administrators and clerks from the 8 hospitals in Seoul with more than 500 beds. Upon variance analysis, correlation analysis and regression analysis of the collected questionnaires, this work examined how differences in stress caused by specific occupations and formulated a method of stress management for the hospital workers. The results are as follows. 1) If some duties of the nurses suffering from role-overloaded stress are transferred to the nursing aides dissatisfied with insufficient role, the two grunting groups can be satisfied at the same time. It is also necessary to transfer some jobs of the overloaded workers in patient affairs to the administrators, or the other way around. To reduce stress of conflict and ambiguity of role caused by the obscure division of roles between the workers, the role of each occupation should be delineated and the clear division of roles should be translated into action strictly according to that delineated. 2) Stress of inefficiency of organization from which the student doctors suffer can be relieved by management of participation. If they have access to the process of decision-making in general hospital affairs and consequently their understanding and the autonomy of job performance are promoted, such stress will be reduced. 3) To cope with stress of career development from which nurses, medical technicians, administrators, workers in patient affairs suffer, it is necessary to establish whether they have a chance to revive their careers, whether there are any ways of remotivation for less contributive workers, and whether they encourage each other to develope their careers. If they are given a chance to develope their careers, such stress will be relieved. 4) Pharmacists, suffering from stresses of living and personal relations, have strong cohesive power among themselves and organize a well-integrated team; thereby reducing the stress of personal relations and increasing productivity. 5) For administrators and student doctors confined to lesser social supports and for nurses and workers in patient affairs whose recognition of stress and job satisfaction are affected by social supports, emotional and informational supports for job performance help alleviate an individual's mental, and physical stress. 6) In addition to the above-mentioned stress-management methods, if an organizational coping strategy is provided according to the types of stress from the general viewpoint of the whole group of hospital workers, it would be of great help to managing stress. For example, the redesign of jobs, the management of objective, the improvement of working environment, the formation of an autonomous working group and various working plans can be set up for those who suffer from stress related to inappropriate role, while career counseling and development of career process can be provided for those dissatisfied with career development. Participation in the process of decision-making and the restructuring of the organization are needed for those who suffer from stress of malfunctioning organization, whereas creation of a supportive organizational atmosphere is desired for those who feel stressed due to personal relations. As well, such organizational coping strategies. as the increase of welfare facilities, seminars and educational programs and provision of health-promotion facilities can be provided.

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병원의 홈페이지 관리운영 실태와 병원경영에 미치는 효과 (Realities of a Hospital's web-site' Management and It's Effect on Hospital Management)

  • 황병덕;임복희;이영환
    • 한국콘텐츠학회논문지
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    • 제10권3호
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    • pp.241-249
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    • 2010
  • 본 연구의 목적은 부산광역시 소재 병원급 이상 의료기관에 근무하는 병원 홈페이지관련 담당 관리자를 대상으로 병원홈페이지 관리 운영 실태와 홈페이지가 병원경영에 미치는 효과를 분석하여 홈페이지를 활용한 마케팅 전략의 기초자료를 제공함에 있다. 이를 위하여 부산광역시 소재 병원급 이상 53개의 병원급 이상의 의료기관 홈페이지 관리자들을 대상으로 2008년 5월 1일부터 5월 25일까지 25일간 연구자가 직접 방문하여 인터뷰와 설문조사를 실시하였다. 병원홈페이지 관리자들의 설문내용은 일반적인 특성, 홈페이지 제작, 관리 운영, 영향, 부가기능, 정보교류 항목으로 구성 하였으며 분석한 결과는 다음과 같다. 첫째, 병원홈페이지 제작관리 및 운영에 있어서는 제작시기는 2001-2005년이며, 외부업체가 주로 관리하고, 제작 목적은 병원소개이며, 1년 기준으로 홈페이지를 개편하고, 100-300만원 미만의 운영예산과 병원소개, 고객만족센터 그리고 온라인 답변 게시가 가장 높은 것으로 나타났다. 둘째, 병원홈페이지 운영에 영향을 미치는 것은 병원소개, 진료예약, 이용안내, 의료정보제공, 고객상담, 진료안내이고 이들은 대부분 병원경영에 영향을 미치고 있다고 인식하고 있었다. 따라서 내부고객만족을 위해 병원홈페이지에 의료정보제공과 메뉴개선은 직원들의 지속적인 관심을 통하여 향상시키도록 노력하여야 할 것이다.