• Journal of Periodontal and Implant Science
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• 제40권2호
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• pp.90-95
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• 2010

Purpose: The aim of this study is to report a case of oral bisphosphonate-related osteonecrosis of the jaw (BRONJ) resulting in implant failure. Methods: A patient suspected of having BRONJ was referred to the Department of Periodontology, Kyung Hee University School of Dentistry for the evaluation and treatment of exposed bone around implants. Results: The patient, who had been taking oral bisphosphonates (BPs) for about a year, was successfully treated with systemic antibiotics, chlorhexidine mouth rinse, explantation, and surgical debridement of necrotic bone. Conclusions: The results of this case suggest that a patient taking BPs orally should be treated cautiously. Appropriate management including cessation of BPs and respective dental treatment may reduce the development of BRONJ.

• 한국보건간호학회지
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• 제34권3호
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• pp.490-502
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• 2020

Purpose: This study aimed to identify the factors influencing competency for Multi-Drug Resistant Organisms (MDRO) infection control in nursing students with clinical practice experience. Methods: This cross-sectional descriptive study was conducted from May 2020 to August 2020 by including 175 nursing students in two nursing schools located in Daegu. The data were collected using self-report questionnaires. The data were analyzed using the SPSS/WIN 25.0 program with descriptive statistics, independent t-test, ANOVA, correlation, and multiple regression. Results: The competency of MDRO infection control was 3.41.±0.38. The attitude to patient safety management and - knowledge of MDRO infection control were 3.81±0.47 and 16.98±3.02, respectively. Factors influencing the competency of MDRO infection control were perceived benefit(β=.38, p<.001), knowledge toward MDRO infection control(β=.21, p=.001), attitude in patient safety management(β=.17, p=.028), and perceived barrier(β=-.15, p=.029) with an explanatory power of 34.2%. Conclusion: A systemic education program regarding MDRO infection control is needed for nursing students to provide knowledge related to MDRO infection control and help establish positive beliefs toward MDRO infection control and attitudes in patient safety management.

• 한국간호교육학회지
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• 제13권1호
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• pp.41-51
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• 2007

Purpose: This research studied the nurses' knowledge and attitude about pain management. Method: The research subjects were 465 nurses working at three university hospitals in Seoul and at one university hospital in Kyunggi-do. The survey results were collected between October 13 and 21 in 2004. Result: The overall mean score of correct answers on knowledge about pain management was 73.34, general knowledge 71.08, and cancer pain control was 93.93. Similarly, the mean score of correct answers on knowledge about the classification of analgesics was 75.89, while the knowledge of their use was only 52.48. The overall characteristics related to the degree of the nurses' knowledge about pain management were their educational background and their experiences of pain education. In a similar view, the overall characteristics related to the knowledge about the classification of analgesics were age and religion. Likewise, the use of analgesics was related to field of service and the experience of pain education. Finally, the overall characteristics related to the nurse's attitude toward pain management were their field of service and their position. Conclusion: The results of this study could be useful to institutions involved in the education and application of patient pain management.

• 대한간호학회지
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• 제25권4호
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• pp.709-728
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• 1995

The job related activities of sixty nine nurses, working in the emergency rooms of three university hospitals, were analyzed for six days according to preestablished checklist of nursing activities ; the frequency of these activities and the amount of time spent in each specific nursing activity. The established checklist was monitored every five minutes for the duration of the duty autu, thus producing 414 items of data. The data were not gathered on consecutive days but over the period of one month from May 6, 1994 to June 5, 1994. The following conclusions are derived from analysis of the data : 1. Twelve categories of nursing activities were obtained : The primary activity was communication related to the patient and all information pertaining to the patient. Other activities included maintaining the patient's record, observation and assessment of the patient, cooperation with other medical personnel, management of equipment and drugs, procedure and treatment, specimen collection, consultation and education for the patient, including drug management and personal hygiene and any other relevant education to the patient's condition. 2. The average frequency of categorized nursing activity can be classified as follows : communication related to patient was the highest at 17.6 times. The next was maintaining the patient's record at 17.3 times. The observation and assessment occurred 16.9 times. Consultation and education for patients and family, 8 times, medication, 5.7 times, and procedures and treatments, 6 times. 3. The average time required for each activity was as follows : 230.1 minutes (or maintaining the patient's record, 204.9 minutes for communication related to the patient, 199.2 minutes for observation and assessment, 71.2 minutes for medication, 66 minutes for consultation and education of the patient and family, and 51.8 minutes for procedures and treatment. 4. The most demanding nursing activity in the emergency room for the nurse was answering questions from the patient's family, maintaining communication between the medical staff, maintaining and reviewing the patient's charts, writing prescriptions and monitoring 1. V. infusion rates. 5. The most time consuming nursing activities for the emergency room nurse include maintaining and following the patient's charts, communication between the medical staff, answering questions from the patient's family, observation of the patient and relaying all of the appropriate patient information to the incoming nurses during a shift change. 6. The F-test was administered to measure the required time for the categorized nursing activities according to day, evening, and night-shift nurses. There were significant differences (p<.05) in specimen collection, observation and assessment, cooperation between medical staffs, personal hygiene, communication related to patient, education and re-search. Posterior multiple comparison test showed that specimen collection, cooperation between medical staffs and personal hygiene were mostly done by the evening-shift nurses. Also most observations and assessments were done by the night-shift nurses. Education and communication to patients were done by day-shift nurses. Thus there were significant difference between shifts for the main nursing activities. So there should considev a reallocation of the duty of nurses on each shift. 7. The F-test also indicated that there wes a similarity in time duration for procedures and treatments and for cooperation between medical staff and nurses in all three hospitals. However, the remaining categories of nursing activities also showed a significant difference between the three hospitals. This indicated that there were differences in each emergency room that influence time for each categorized nursing activities and this should be given more consideration. Recommendations : 1. A seasonal difference should be considered in the activities of nurses in the emergency room and a comparative analysis should be carried out to deter-mine seasonal differentiation. 2. A study on more objectively measurable nursing activities should be administered as well as one determining the subjective responds towards nursing activities in the emergency room.

• Journal of Chest Surgery
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• 제11권3호
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• pp.303-315
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• 1978

During the full 10-year period from June 1968 through June 1978, 112 consecutive patients underwent isolated or double valve replacement. A total of 130 valves were used in aortic, mitral or tricuspid positions: 63 prosthetic valves in 56 and 67 glutaraldehyde-preserved porcine aortic valves in 56 patients. There were 31 early and 9 late deaths with a cumulative mortality rate of 35.7 percent. Eighty-five patients survived longer than 10 days postoperatively were studied for the occurrence of thromboembolism and complications related to anticoagulant therapy. At the end of follow-up period, 68 patients were on Coumadin; 74 were on Persantin with or without Coumadin; 11 were off any antithrombotic drugs with 6 of them being off electively after 6 months of tissue valve replacement. Thromboembolism occurred in 7 [8.2%] of 85 patients or 10.9%/patient-year. Embolic rates were as follows: one of 18 patients anticoagulated [5.6%] or 6.1%/patient-year and 4 of 16 patients not anticoagulated [25.0%] or 17.8%/patient-year for the prosthetic valve replacement; and one of 40 patients anticoagulated [2.5%] or 7.9%/patient-year and one of 11 patients not anticoagulated [9.1%] or 7.9%/patient-year for tissue valve replacement. Three complications of major bleeding were experienced by 3 patients during the follow-up period, being related to Coumadin therapy. The importance of proper anticoagulation were stressed for the successful management of patients after cardiac valve replacement, both prosthetic and tissue valves.

• 한국병원경영학회지
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• 제7권4호
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• pp.57-101
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• 2002

These days, the environment of hospital marketing is changing rapidly. The level of expectation and demand of patients have become greater and more diversified, and patients have more alternatives in selecting hospitals. The standard of hospital selection and the type of using hospital have been changed, and competition among hospitals has been accelerated due to the opening of the medical market through globalization. Accordingly, differentiation strategies are critical in hospital marketing. The quality of medical service oriented toward patient satisfaction becomes a strong strategic weapon to secure a hospital's competitive advantage. Therefore, marketing and communication strategies should be focused on patient-oriented, rather than hospital-oriented. Considering the changes in the hospital environment and the increase in the patients' expectation level, this study categorizes doctors' communication styles into four different ones: trust-type, professional-type, cooperation-type, and control-type. The effects of these communication styles on patient satisfaction were empirically examined. The moderating roles of the patient's characteristics and clinical characteristics between the doctors' communication styles and patient satisfaction were also investigated to find out managerial implications for hospital management. To achieve such goals, data were collected from patients of 12 general hospitals in Busan. The data were analyzed to test research hypotheses that examine 1) the relationships between doctors' communication styles and patient satisfaction, 2) the moderating roles of the patient characteristics and clinical characteristics in the research model, and 3) the impact of patient satisfaction on positive word-of-mouth and repurchase. The following summarizes the major results of this research. First, the data showed that patient satisfaction varied across doctors' communication styles. Trust-type style had the strongest impact on patient satisfaction while control-type style had the weakest influence on patient satisfaction. Professional-type style and cooperation-type style also had positive effects on patient satisfaction but the impact of the two are not statistically different. Second, significant differences in terms of patient satisfaction were found depending upon demographic variables such as gender, marital status, age, occupation, and education. Patient satisfaction, however, was consistent across varying income groups. Third, patients' medical insurance types were also related to patient satisfaction. It implies that a doctor may need to use different communication styles depending on a patient's medical insurance type. Fourth, out-patient and in-patient showed a different level of satisfaction with varying communication styles. Fifth, highly professional knowledge and strong control can influence patient satisfaction depending on the characteristics of the patient treatment field. Sixth, patient satisfaction were proved to have significantly positive effects on word-of-mouth and repurchase. The implications drawn from this study must be tempered by its limitations. First of all, the subjects used in this study were patients in Busan and small- and medium-size hospitals were excluded from the research. Therefore, future research should examine the research model by using a variety of hospitals and clinics throughout Korea. Another research agenda has to do with finding more determinant and moderating variables which will increase an explanatory power of the model. In short, this study may be the first empirical research that investigates the effects of doctors' communication styles on patient satisfaction. Interestingly enough, the results showed that each communication style had a unique impact on patient satisfaction. The findings from this research can be very useful in developing hospital marketing strategies.

• 한국의료질향상학회지
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• 제26권1호
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• pp.46-54
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• 2020

Purpose: The purpose of this study was to, present basic data on the necessity of introducing assistant staff to support administrative tasks related to patient safety. Methods: This was a cross-sectional study. The participants (n=103) of this study were nurses, working at general and long-term care hospitals in Korea. Data were collected using structured questionnaires on August 29, 2019 and analyzed with SPSS 25.0. Specifically, data analysis was conducted using frequencies, mean and standard deviation, independent t-test, and X²-test. Results: Assistant staff was needed to support patient safety tasks, but this required nurses who could fully perform patient safety tasks by supplementing their work experience rather than employees who only support administrative tasks. This is because the hospital's patient safety management activities are difficult to distinguish between administrative tasks and patient safety tasks, and even nurses with five years of work experience, must be aware of the basic concepts and should have knowledge of patient safety and have gained experience in managing the patient safety activities. Conclusion: Hospitals are calling for an improvement in the system that increases the number of workers in charge of patient safety affairs and lowers their work experience, rather than the introduction of assistant staff who help with patient safety work.

• 한국병원경영학회지
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• 제2권1호
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• pp.183-202
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• 1997

Health care organizations have been faced with financial difficulties under turbulent health care environment. This situation led hospitals to concentrate their efforts to improve their managerial efficiency in various ways. This study aims to evaluate technical efficiency of 31 tertiary hospitals in Korea and find determinants which are closely related with hospital efficiency. Data envelopment analysis(DEA) and Tobit Model were adopted for study. For the analysis, human resource factors such as number of physicians, nurses, and administrative staffs are used as input variables and the number of inpatients and outpatients) are used as output variables. Among 31 hospitals, in CCR model, 8 hositals showed efficiency score 1 which means they have been operated in very efficient ways and BCC model showed 13 of 31 hospitals as efficient organizations. Next, we analyzed determinants which are closely related with hospital efficiency. By using Tobit model, the study showed hospital size, Quality of care, value added per capita, and revenue per patient were closely related with hospital efficiency, However, it appeared that financial status of hospitals(i.e : making profit or not) was not related with hospital efficiency.

• 보건행정학회지
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• 제9권2호
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• pp.21-39
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• 1999

An increasing number of hospitals are seeking for new or mixed compensation strategies to improve the productivity of their medical staff in the struggle to provide high quality medical services at low costs amid the economic hardship. To motivate physicians toward the right direction, it is necessary to effectively evaluate their performance that provides a basis for compensation. However, productivity has been historically difficult to measure, particularly for physicians in academic medical centers who are expected to engage in research, education, and patient care simultaneously. The objectives of this study were to define performance measures of physicians and clinical departments in academic medical centers. to examine correlations between the measures. and to investigate factors affecting the measures. The performance data of 212 faculty physicians in 17 clinical departments in two university teaching hospitals affiliated to one medical school during the fiscal year 1994 was used for analyses. Patient care revenue, net profit. and adjusted number of patients were defined to measure the performance in patient care. and number of articles published in academic journals and research grant were defined for research activities. Both individual physicians' performance measures and per physician measures of clinical departments were analyzed. All measures defined to evaluate individual physicians' performance were positively related to each other. Clinical department and rank of faculty position were statistically significant predictors of revenue. and hospital. clinical department. and rank were significant predictors of net profit. journal publication. and research grant. Patient care measures defined to evaluate clinical departments were related to each other. so were research measures. and no significant correlations were found between patient care measures and research measures. Also found were large differences in department. ranks when clinical departments were evaluated by absolute per physician performance measures and evaluated by annual rate of changes in performance measures. These findings suggest that departmental performance measures opposed to individual performance measures are relatively free from problems of factors affecting the performance measures that are not in control of clinical departments or individual physicians. Results from the correlation analysis of departmental performance measures indicates that measures of research performance should be included in the evaluation to promote research activities in academic medical centers.

• Industrial Engineering and Management Systems
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• 제13권2호
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• pp.193-202
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• 2014

Patients' satisfaction while receiving medical service is affected by whether or not their preferences can be met, including time and physician preference. Due to scarcity of medical resource in China, efficient use of available resources is urgently required. To guarantee the utilization ratio, the scheduling decisions are made after all booking information is received. Two integer models with different objectives are formulated separately, maximizing the degree of satisfaction and revenue. The optimal value of the two models can be considered as the bound of corresponding objectives. However, it is improper to implement any of the extreme policies. Because revenue is a key element to keep the hospital running and satisfaction degree is related to the hospital's reputation, neither the revenue nor the satisfaction can be missed. Therefore, hospitals should make a balance. An integrated model is developed to find out the tradeoff between the two objectives. The whole degree of mismatching that is related to patient satisfaction and other separate mismatching degree are considered. Through a computational study, it is concluded that based on the proposed model hospitals can make their decisions according to service requirement.