• 한국병원경영학회지
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• 제18권4호
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• pp.97-112
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• 2013

This study is a proposal of quality scale and measurement for the Mobile Hospital Information System Usability used to the Chungnam National University Hospital in Daejeon Korea. This study is to provide decision- making guideline for hospital managers and to provide feedback for the users' information needs in Mobile Hospital Information System. The target people of the study were medical doctors in Chungnam National University Hospital. The service contexts of usability were request of medical Care, Vital sign check of Patient, Care Agreement of Patient, Blood management, Check of care state, Sign of choice doctors, Query of doctor order and patient measurement result. The Usability factors were the efficiency, effectiveness and satisfaction of quality model ISO9241-11. This study shows that the Mobile HIS is used for the communication and education between doctor and patients. Especially, The Care Agreement of Patient is a part of the most utilized in the Mobile HIS.

• 한국산학기술학회논문지
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• 제17권3호
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• pp.509-517
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• 2016

본 연구는 종합병원 간호사를 대상으로 환자안전문화에 대한 인식과 안전간호활동에 미치는 영향을 파악하고 변인을 규명하기 위함이다. D시와 G시에 위치한 종합병원의 간호사 178명을 대상으로 하였다. 자료는2015년 6월 20일부터 7월 30일까지 수집하였으며, Kim 등이 수정 보완 한 환자안전문화에 대한 인식과 Lee가 개발한 안전간호활동을 연구도구로 사용하였다. 수집된 자료는 t-test, One-way ANOVA, Pearson correlation coefficients와 단계적 중다회귀분석하였다. 환자안전문화에 대한 인식은 환자안전간호활동과 양의 상관관계가 있었다(r=.407, p<.001) 본 연구 결과 대상자의 병원 근무 환경은 안전간호활동에 43.3%의 영향력이 있는 것으로 나타났으며, 병원간호사의 안전간호활동에 병원근무환경이 가장 중요한 변인으로 볼수 있다. 안전간호의 질 향상을 위하여 환자안전문화에 대한 인식을 높일 수 있는 구체적인 방안과 안전간호 지침이 필요하다.

• 한국임상약학회지
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• 제9권2호
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• pp.109-118
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• 1999

The need for and components of a contemporary community pharmacy externship for pharmacy students have not been clearly identified in Korea. Mail survey was performed among 20 college of pharmacy deans and 800 community pharmacists to analyze the current status and develop a consensus regarding major focus area and criteria of community pharmacy externship to be implemented under the separation of dispensary from medical practice in year 2000. Mail survey yielded $80\%\;and\;23.5\%$ response rate for pharmacy school deans and community pharmacists, respectively. Of the 16 pharmacy schools that responded 14 said they have externship program in hospital pharmacy, and only 8 pharmacy schools responded of having externship program for community pharmacy. However, these community pharmacy programs lacked criteria and standard guideline for the externship. The results of survey revealed that community pharmacy externship program for students should be organized and directed toward developing expert knowledge and skills in pharmacy practice activities, clinical services, communications, pharmacy management, and professionalism. Pharmacy practice components should include competencies and skills in computer application, prescription processing, dispensing, pharmaceutical compounding, Narcotics Control Law application, maintenance and provision of drug information, and laws and regulations. Clinical service components should include the ability to identify patient's drug-related problems, provide long-term patient care and appreciate drug therapy services. Communication skills should be taught to effectively express his/her professional opinion, deduce the needs of others, utilize appropriate techniques and media to communicate ideas and conduct a patient interview and to obtain patient drug history. Pharmacy management skills should be taught to be efficient in medical insurance and drug control process. It was found that professionalism, morality, pharmacy practice experience, ability to provide clinical services, collect and provide drug information and regality are important criteria of preceptors. Externship sites should possess the ability to stock various drugs, access and provide diverse pharmacy services and should have private patient counseling area. Most pharmacists agreed that top 200 drugs' generic and brand name, indications, dosage, side effects, and contraindication should be instructed during the externship. It was also found that student and preceptor should be evaluated for their performances during the externship. This information will be incorporated into teaming objectives for students and to develop Academic Extemship Program Guidelines.

• 대한한의학방제학회지
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• 제23권1호
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• pp.161-169
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• 2015

Objectives : This study is aimed to report the outcomes of the treatment of a patient with chronic anal fissure during a 8-year period. Methods : Basic patient’s data was analyzed as a CARE guideline. And related psychological state was measured with BAI, STAI-X-II test. Results : The treatment is based on Shanghanlun and the patient reported better outcomes. The main symptoms of the patient were chronic constipation, blood in the stool. The main clinical findings were that the patient’s symptoms got worse during the examination period because of the anxiety of the exam. And loss of appetite and digestive disorders are due to Jue-Yin-Bing(厥陰病) and the clue of bleeding can be found in article 375 in Shanghanlun. The main diagnoses was chronic anal fissure and main interventions were Chijasi-tang according to article 375 in Shanghanlun and counseling on anxiety. As a results bleeding has stopped after taking herbal medicine and constipation has been treated at the same time. After 6 months, the patient performed BAI, STAI-X-II test and scores got lowered indicating decreasing anxiety level. Conclusion : Chijasi-tang with counseling achieved valid positive results to the patient with chronic anal fissure.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제27권3호
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• pp.27-37
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• 2021

Purpose: The purpose of this study is to compare the changes in hospital accreditation evaluations, the changes in hospital building design guidelines, and the development of design indicators for reducing medical accidents in the state-of-the-art healthcare providers. Methods: The changes and tools were carefully investigated and compared that had been taken place and used in the building certification standards, design guidelines, and patient safety design standards to reduce accidents in the United States and the United Kingdom. Results: First, medical accidents are recognized as multiple defense layers rather than personal ones, and a public reporting and learning system is created, reporting the accidents in question publicly and suggesting ways to improve them based on the data at a time. Second, for the accreditation institute that secures the service quality of medical institutions, detailed standards for patient safety are continuously updated with focus on clinical trials. The United States is in charge of the private sector, but on the other hand the United Kingdom is in charge of the public sector. Third, the design guidelines are provided as web-based tools that complement various guidelines for patient safety, and are improved and developed as well. Fourth, detailed approaches are continuously developed and provided to secure patient safety and reduce medical accidents through appropriate research, evidence-based design and strict evaluations. Implications: When medical institutions make efforts to strength patient safety methods through valid design standards, accidents are expected to decrease, whereby hospital finances are also to be improved. A higher level of medical quality service will sure be secured through comprehensive certification evaluation.

• 생물정신의학
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• 제19권4호
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• pp.153-158
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• 2012

Understanding of a clinical trial is essential in developing clinical guideline and adopting evidence based practice. In designing and executing clinical trials, following ethical requirements should be considered : social value, scientific validity, fair subject selection, informed consent, favorable risk-benefit ratio, institutional review board, and respect for human subjects. According to the stage of drug development, purpose of trials, accumulated scientific data, clinical trials for drug development are classified as phase 1, 2, 3, and 4. Phases of clinical trials can be overlapped and the judgment of entering into the next phase should be considered highly strategically. In reading, evaluating and interpreting clinical trial reports, various skills and challenges exist. Patient sample composition, trial duration, selection of endpoints, responders and non-responders, placebo effect, patient recruitment, and extrapolation to the real world are the examples of those challenges. Treatment success will come from the well balanced approach of evidence based decision making and consideration of specific single case.

• 한국의료질향상학회지
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• 제23권1호
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• pp.25-38
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• 2017

Root cause analysis (RCA) is systematic process for identifying contributing factors and root causes. It detects system-level vulnerabilities and prevents them from occurring in the future. In many countries, RCA guidelines have been developed and used for these purposes, and various practical tools are suggested according to stages of RCA implementation. In Korea, adverse events occur in 7.2-8.3 percent of inpatients according to studies conducted in hospitals. However, frontline staffs are suffering from lack of knowledge about RCA implementation. This study introduces RCA guidelines that may be used in hospitals to improve the quality of medical care and patient safety.

• Radiation Oncology Journal
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• 제34권2호
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• pp.81-87
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• 2016

Hypofractionated whole breast irradiation (HF-WBI) has been proved effective and safe and even better for late or acute radiation toxicity for early breast cancer. Moreover, it improves patient convenience, quality of life and is expected to be advantageous in the medical care system by reducing overall cost. In this review, we examined key randomized trials of HF-WBI, focusing on adequate patient selection as suggested by the American Society of Therapeutic Radiology and Oncology (ASTRO) guideline and the radiobiologic aspects of HF-WBI in relation to its adoption into clinical settings. Further investigation to identify the current practice pattern or cost effectiveness is warranted under the national health insurance service system in Korea.

• Tuberculosis and Respiratory Diseases
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• 제47권4호
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• pp.460-470
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• 1999

연구배경 : 지역사회획득 폐렴의 치료는 질환의 중증도로 인해 원인균주의 증명없이 바로 경험적 항생제를 투여하는데, 미국흉부학회에서는 초기 경험적 항생제에 관한 지침을 1993년 제시한 바 있다. 그러나 한국의 경우 미국과 의료제도, 원인균, 항생제 내성 면에서 다르므로 미국흉부학회 지침이 한국의 지역사회획득 폐렴환자에서도 유용한지 알아보고자 했다. 방 법 : 1997년 4월 부터 1998년 3월 까지 삼성서울병원에 입원한 환자들 중 지역사회획득 폐렴으로 진단된 64명올 대상으로 후향적 연구를 시행하였다. 환자군은 항생제 초가선택에 따라 1) ATS군 ; ATS의 지침에 맞게 초기 항생제를 사용한 군, 2) Non-ATS overuse군 ; ATS의 지침보다 과하게 항생제를 사용한 군, 3) Non-ATS underuse군 ; ATS 지침보다 불충분한 항생제를 사용한 군으로 나누고 각 군간의 치료 반응, 실패 원인, 그리고 원인균올 조사하였다. 결 과 : ATS군 36명중 33명, Non-ATS overuse군 10명 중 9명, Non-ATS underuse군 18명중 14명에서 치료효과를 나타내었고 각 군간 치료 효과에서는 차이가 없었다(p>0.05). 원인균은 S. pneumoniae (12.5%), K. pneumoniae (9.4%), P. aeruginosa (4.7%), Mycoplasma (3.1%)의 순으로 나타났고 중증폐렴의 경우 Pseudomonas가 원인균인 경우는 1 례에 불과했고 Legionella 폐렴은 없었다. 결 론 : 미국흉부학회의 치료지침에 따른 항생제 선택은 우리나라의 지역사회획득폐렴의 치료에서 높은 효과를 보여 유용할 것으로 생각된다. 그러나 중증폐렴에서의 원인균주와 초기 항생제 선택에 있어 전향적인 연구가 필요할 것으로 생각된다.

• Journal of Trauma and Injury
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• 제33권3호
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• pp.195-203
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• 2020

The following key questions and recommendations are presented herein: when is airway intubation initiated in severe trauma? Airway intubation must be initiated in severe trauma patients with a GCS of 8 or lower (1B). Should rapid sequence intubation (RSI) be performed in trauma patients? RSI should be performed in trauma patients to secure the airway unless it is determined that securing the airway will be problematic (1B). What should be used as an induction drug for airway intubation? Ketamine or etomidate can be used as a sedative induction drug when RSI is being performed in a trauma patient (2B). If cervical spine damage is suspected, how is cervical protection achieved during airway intubation? When intubating a patient with a cervical spine injury, the extraction collar can be temporarily removed while the neck is fixed and protected manually (1C). What alternative method should be used if securing the airway fails more than three times? If three or more attempts to intubate the airway fail, other methods should be considered to secure the airway (1B). Should trauma patients maintain normal ventilation after intubation? It is recommended that trauma patients who have undergone airway intubation maintain normal ventilation rather than hyperventilation or hypoventilation (1C). When should resuscitative thoracotomy be considered for trauma patients? Resuscitative thoracotomy is recommended for trauma patients with penetrating injuries undergoing cardiac arrest or shock in the emergency room (1B).