• 성인간호학회지
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• 제27권2호
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• pp.146-155
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• 2015

Purpose: The aim of this descriptive study was to explore the relationship between non-technical skills (NTSs) and cardiopulmonary resuscitation (CPR) performance of nurses' teams in simulated cardiac arrest in the hospital. Methods: The sample was 28 teams of nurses in one university hospital located in Seoul. A high fidelity simulator was used to enact simulated cardiac arrest. The nurse teams were scored by raters using both the CPR performance checklist and the NTSs checklist. Specifically the CPR performance checklist included critical actions; time elapsed to initiation of critical actions, and quality of cardiac compression. The NTSs checklist was comprised of leadership, communication, mutual performance monitoring, maintenance of guideline, and task management. Data were collected directly from manikin and video recordings. Results: There was a significant difference between the medians of the NTSs and CPR performance (Mann Whitney U=43.5, p=.014). In five subcategories, communication (p=.026), mutual performance monitoring (p=.005), and maintenance of guideline (p=.003) differed significantly with CPR performance in medians. Leadership (p=.053) and task management (p=.080) were not significantly different with CPR performance. Conclusion: The findings indicate that NTSs of teams in addition to technical skills of individual rescuers affect the outcome of CPR. NTSs development and assessment should be considered an integral part of resuscitation training.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권3호
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• pp.7-15
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• 2016

Purpose: As medicare services have gotten spreaded, clinical laboratory has been dominant position. So, it has been acted for quality control and clinical pathology accreditation. But there has been quite deficient information to evaluate working space and technical standards of medical laboratory for accreditation. This study goals to figure out accreditation standard and design guideline for clinical laboratory, and to give safe and efficient design information. Methods: This study has been searched by literature for accreditation standards and design guidelines of clinical pathology in USA, UK, and Germany. Results: Three countries have accredited based on working lab space, staff space, storage space, patient space and health and safety equipment. Design guidelines of three countries commonly have focused on worktable layout, worktable distance and module, and specific laboratory biosafety level. And USA guidelines stress on the architectural design such as design process and passage distance for escape, UK stress on the efficiency as functional work flow and construction cost, lastly Germany design guidelines stress on the operator's safety distance and workstation. Three countries have not only accreditation standards but also design guidelines for more specific quality management, separating from accrediting institute. Implications: In korea, it has been needed to make clinical laboratory design guideline for the safe and efficient environment and reliable and competitive medical service.

• 한국콘텐츠학회논문지
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• 제16권12호
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• pp.468-479
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• 2016

본 연구는 중환자 첫 발열 평가 가이드라인에 대한 간호사의 지식과 수행 정도를 확인하고자 수행된 연구이다. 대상자는 2개 병원 내 외과병동 및 중환자실에서 근무하는 총 145명의 간호사를 대상으로 하였다. 자료 분석은 SPSS 19.0 프로그램을 활용하여 분석하였고, 중환자 첫 발열 평가 가이드라인의 지식과 수행의 평균 평점은 각각 0.70점과 3.08점이다. 가이드라인의 근거수준 1영역은 지식과 수행 상위군에서 하위군보다 유의하게 높은 수행 점수를 나타냈고, 근거수준 3영역은 지식 상위군보다 지식 하위군이 더 높은 수행 점수를 나타냈다. 대상자의 가이드라인에 대한 지식과 수행은 유의한 상관관계를 나타냈다. 결론적으로 본 연구는 중환자 첫 발열 평가 가이드라인에 대한 간호사의 지식과 수행력을 향상시키고 근거기반실무를 개선시킬 필요가 있음을 제시하였다.

• 대한간호학회지
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• 제28권1호
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• pp.26-36
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• 1998

This primary study was done to develop an ethical guideline for organ transplantation, a life-saving treatment which helps improve the quality of life. This study tried to identify the current situation in Korea, in terms of ethical considerations in organ transplantations. This study collected basic data in organ transplantations, in the hope that procedure of organ transplantations could be developed that would be fair to both organ donors and recipients. The immediate goals of this study were : 1)to identify staff in charge of organ transplantations and their jobs in the hospital, 2)to survey whether there exists a Hospital Ethics Committee(HEC), 3)to research what consideration are formally taken in selecting recipients, and 4)to accumulate data on how consent from donors are currently obtained. The study used a survey questionnaire and received responses from 31 hospitals out of 45 hospitals where organ transplantation are being done. Organ transplantation coordinators were found in 16 hospitals, but the job description varied among hospitals. The survey showed that all 16 hospitals with an HEC that health care personnel unnecessarily dominate the committee. The study notes that HECs should be vitalized by recruiting, as members, ethicists, theologians, patients, guardians, as well as the general public outside of the hospital. The study revealed that in selecting recipients the hospital take into account ABO blood type, histocompatibility, age, waiting time. and level of patient compliance. Finally, it was shown that in the cases of living donors the transplanting hospitals seek a formal consent, whereas there are no common consenting practice established for cadaveric donors. The study concludes with three proposals. First, a nationwide institution responsible exclusively for procurement and distribution of cadaveric organs for transplantation should be established. Second. we should rebuild the national health insurance system so that have costly organ transplantation expenses are substantially covered. Last, but certainly not least. there is a need to emphasize the HEC's committment to prepare a proper ethical guideline for organ transplantation in general.

• Journal of Trauma and Injury
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• 제27권3호
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• pp.63-70
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• 2014

Purpose: In children, mild traumatic brain injuries (TBI) account for 70~90% of head injuries. Without guidelines, many of these children may be exposed to excess radiation due to unnecessary imaging. The purpose of this study was to evaluate the impact of a mild TBI guideline in imaging of pediatric patients. Methods: The medical records of all children who had head computed tomography and were admitted to our hospital with a TBI with Pediatric Glasgow Coma Scale and Glasgow Coma Scale of 14 to 15 were retrospectively reviewed and compared with PECARN Rule. Results: A total of 1260 children were included and all children checked with head computed tomography. 61 pediatrics had CT positive and presented skull fracture 40, hemorrhage 8, hemorrhagic contusion 7, and diffuse axonal injury 1. Also, 4 patients diagnosed both skull fracture and brain haemorrhage and 1 patient diagnosed both haemorrhage and haemorrhagic contusion. Conclusion: There are many pediatric traumatic patients who exposed to radiation due to CT. But, the most of results were negative. So, consider to follow the CT guideline for children and many do not require brain CT.

• Nuclear Medicine and Molecular Imaging
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• 제42권4호
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• pp.261-266
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• 2008

We established a model to calculate radioactive waste from sewage disposal tank of hospitals to optimize the number of patients receiving inpatient radioiodine therapy within the safety guideline in our country. According to this model and calculation of radioactivity concentration using the number of patients per week, the treatment dose of radioiodine, the capacity and the number of sewage tanks and the daily amount of water waste per patient, estimated concentration of radioactivity in sewage waste upon disposal from disposal tanks after longterm retention were within the safety guideline (30 Bq/L) in all the hospitals examined. In addition to the fact that we could increase the number of patients in two thirds of hospitals, we found that the daily amount of waste water was the most important variable to allow the increase of the number of patients within the safety margin of disposed radioactivity. We propose that saving the water amount be led to increase the number of patients and they allow two patients in an already furnished hospital inpatient room to meet the increasing need of inpatient radioiodine treatment for thyroid cancer.

• 대한간호학회지
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• 제50권6호
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• pp.863-875
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• 2020

Purpose: This study was conducted to develop and test the effects of a program for practice application of intravenous infusion evidence based nursing practice (EBP) guidelines in small and medium-sized hospitals. Methods: A mixed method research design was used, combining non-equivalent control group pre-post test design with qualitative study analysis. The subjects consisted of 55 nurses. The practice application program was developed based on the Advancing Research and Clinical practice through close Collaboration (ARCC) model. Data were collected for analysis in the following areas: nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, importance about intravenous infusion, and performance about intravenous infusion, with data assessed using valid and reliable instruments. Patient outcomes were collected from the hospital's medical records. Data were analyzed using t-test, χ2-test, and Shapiro-Wilk test, with qualitative content analysis used for interview data. Results: Following the intervention, nurses' EBP organizational culture and readiness, EBP beliefs, EBP implementation, and performance of intravenous infusion and perceptions of its importance showed significant improvement in the experimental group. Phlebitis rates decreased in the experimental group compared to the control group. Conclusion: This program is effective to improve nurse's perception and practice of evidence based nursing. Therefore we recommend to use this program at same levels of hospitals.

• 대한통합의학회지
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• 제8권4호
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• pp.79-92
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• 2020

Purpose : The purpose of this study was to evaluate the prescription pattern of NSAIDs and GPAs in the arthritis patients over 65 years old to prevent the GI adverse events. Nonsteroidal anti-inflammatory drugs (NSAIDs) are the most commonly used agents to treat arthritis, can cause gastrointestinal (GI) adverse effects. Recent guidelines recommend that moderate risk patients who have one or two risk factors, should be prescribed either combination of non-selective NSAID (nsNSAIDs) and gastroprotective agent (GPAs) or selective NSAID alone. Methods : Study population was National Patient Sample of 2011. Number of drugs used were 138 for NSAIDs and 21 for GPAs. Chi-square test was used to compare prescribing patterns. Results : The appropriate prescription rate follows the guideline was 11.2%: co-prescription with nsNSAID and proton pump inhibitor (PPI) or misoprostol was 1.6% and selective NSAID alone was 9.6%. Inappropriate prescription rates were as follows: co-prescription with nsNSAID and Histamine-2 receptor antagonist (H2RA) or antiacid was 53.8% and nsNSAID alone was 35.0%. The appropriate prescription rate among the types of medical institute was 54.4% in tertiary hospital, 31.2% in secondary hospital, and 6.0% in primary hospital. The appropriate prescription rate among the regions was 19.4%, highest in Seoul and 4.2%, lowest in Jeju. The appropriate prescription rate among the medical departments was as follow: 12.2% in orthopaedic surgery, 11.0% in internal medicine, and 7.7% in other departments. Conclusion : This finding suggests the needs to revise the national medical insurance imbursement policy, provide continuing medical education about the guideline of medical doctors.

• Korean Journal of Acupuncture
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• 제41권1호
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• pp.1-6
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• 2024

Objectives : The aim of this study is to set out case series study protocol to complete clinical pathway (CP) of hip and finger degenerative arthritis by applying CP, based on Korean medicine clinical practice guideline developed by clinical experts, to clinical field. Methods : The treatments included Manual acupuncture, acupoint injection, electroacupuncture, laser acupuncture, cupping, moxibustion, chuna, and physiotherapy. They were conducted in the 2nd week of admission and 4th week of out patient department (OPD) days. We carried out 10-point Likert scale questionnaires on the clinical usefulness and the satisfaction of patients and staff after applying CP. Appropriateness and improvement on patients were conducted using a 10-point Likert scale. An open-ended questionnaire was also conducted to ask if there was any requirement to be added. Results : In past research studies, there were no related studies about Korean medicine CP on hip and finger degenerative arthritis. Final version of CP is going to be completed based on the questionnaire. Conclusions : This evidence-based case series study protocol is expected to contribute development of hip and finger degenerative arthritis.

• 대한임상독성학회지
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• 제3권1호
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• pp.22-26
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• 2005

The majority of acute toxic poisoning occur via oral route. The most important emergency treatment of acute poisoning are gastric lavage. Gastric lavage should be considered a patient has ingested a potentially life-threatening amount of a poison and the procedure can be undertaken within 60 mins of ingestion. But, gastric lavage does not consist properly in the cases of emergency situation or an inexperienced doctors treat. The purpose of this study was to determine whether gastric lavage is performed properly. Eighty patients were enrolled in the study in 12-month period from January to December 2002. A retrospective chart review was performed on patients identified as drug overdose who admitted to ER. To assess whether there was a subgroup of patients who may have been candidates for the initiation of gastric lavage in the ER, the patients divided in two groups by time interval from toxin ingestion to ER arrival. The group 1 that admit within 60 minutes after drug ingestion was 38 cases ($47.5\%$), and the group 2 patient who admitted after 60 minutes was 42 cases ($52.5\%$). The average age was $44\pm19$ years in group 1, and $48\pm24$ years in group 2. There were no differences in sexual distribution of two groups. The mean time interval was $49\pm20$ minutes in the group $1,258\pm190$ minutes in the group 2. Only thirty ($37.5\%$) of the patients had an overdose for which the treatment of gastric lavage was potentially feasible according to guideline. The correctly performed gastric lavage was 18 ($47.4\%$) in group 1, 12 ($28.6\%$) in group 2. We must enforce education about the gastric lavage, and do so that may treat according to guideline.