• 한국의료질향상학회지
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• 제5권2호
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• pp.202-215
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• 1998

Purpose : To shorten processing time for variety of medical affairs of the patient at the outpatient clinic of a big hospital is very important to qualify medical care of the patient. Therefore, patient's waiting time for drug delivery after doctor's prescription is often utilized as a strong tool to evaluate patient satisfaction with a medical care provided. We performed this study to investigate factors influencing patient satisfaction related with waiting time for drug delivery. Methods : The data were collected from July 21 to August 12, 1998. A total 535 patients or their families who visited outpatient clinics of Inha University Hospital were subjected to evaluate the drug delivery time and the level of their satisfaction related, which were compared with those objectively evaluated by Quality Improvement Team. The reliability of the scale was tested with Cronbach's alpha, and the data were analyzed using frequency, t-test, ANOVA, correlation analysis and multiple regression. Results : The mean drug delivery time subjectively evaluated by the patient (16.1 13.0 min) was longer than that objectively evaluated (10.9 7.6 min) by 5.2 min. Drug delivery time objectively evaluated was influenced by the prescription contents, total amount or type of drug dispensed, etc, as expected. The time discrepancy between two evaluations was influenced by several causative factors. One of those proved to be a patient's late response to the information from the pharmacy which the drug is ready to deliver. Interestingly, this discrepancy was found to be more prominent especially when waiting place for drug delivery was not less crowded. Other factors, pharmaceutical counseling at the pharmacy, emotional status or behavior of a patient while he waits for the medicine, were also found to influence the time subjectively evaluated. Regarding the degree of patient satisfaction with the drug delivery, majority of patients accepted drug delivery time with less than 10 min. It was also found to be influenced by emotional status of the patient as well as kindness or activity of pharmaceutical counselor. Conclusion : The results show that, besides prescription contents, behavior pattern or emotional status of a patient, environment of the waiting place, and quality of pharmaceutical counseling at the pharmacy, may influence the patient's subjective evaluation of waiting time for drug delivery and his satisfaction related with the service in the big hospital. In order to improve patient satisfaction related with waiting time for drug delivery, it will be cost effective to qualify pharmaceutical counseling and information system at the drug delivery site or waiting place rather than to shorten the real processing time within the pharmacy.

• 성인간호학회지
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• 제22권1호
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• pp.90-102
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• 2010

Purpose: The purpose of this study was to identity factors affecting patient adherence and to develop an explanatory model for patient adherence in patients with spinal cord injury. 8 Variables that were based on the previous research and a review of literature were used to construct hypothetical model. Social support, economic status, perceived barrier, patient provider relationship and rehabilitation related knowledge were the exogenous variables, depression, self-efficacy and patient adherence were the endogenous variables. Methods: Data form 117 patients with SCI were analysed to test the hypothetical model, using SAS and LISREL 8.53 program. Results: The overall fitness of the model was good (GFI=.991, AGFI=.915, NNFI=1.299, NFI=.953, p=.632) Depression, powerlessness, economic status were the strong factors influencing patient adherence. Powerlessness was significant factors for self-efficacy. Conclusion: To improve of patient adherence should focus on nursing intervention for depression, powerlessness and economic status.

• Clinical Endoscopy
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• 제56권4호
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• pp.433-445
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• 2023

Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient's clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.

• Journal of Korean Biological Nursing Science
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• 제25권2호
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• pp.95-104
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• 2023

Purpose: The purpose of this study was to analyze the trends and characteristics of infection-related patient safety incident reporting before and during the coronavirus disease 2019 (COVID-19) pandemic in Korea, and to provide basic data for preventing infection-related patient safety incidents and improving their management. Methods: A cross-sectional analysis of secondary national data (Patient Safety Reporting Data) was conducted. In total, 517 infection-related patient safety incidents reported from 2018 to 2021 were analyzed. Changes in the number of reports before and during the COVID-19 pandemic and differences in variables related to infection-related patient safety incidents were analyzed using the chi-square test and independent t-test in SPSS 29.0. Results: This study found that infection-related patient safety incidents decreased during the COVID-19 pandemic compared to before the pandemic. Furthermore, incident-related characteristics, such as the type of healthcare organization, severity of harm, and post-incident actions, changed during the COVID-19 pandemic. Conclusion: The many changes in the infection control system and practices during the COVID-19 pandemic may have contributed to a decrease in the reporting of infection-related patient safety incidents. It is hoped that longitudinal studies on patient safety incidents related to the pandemic and analytical studies on factors influencing patient safety incidents will continue to be conducted to prevent and improve patient safety incidents.

• 한국전문물리치료학회지
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• 제9권1호
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• pp.97-110
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• 2002

The purposes of this study were to investigate the patient satisfaction with physical therapy services and find the related factors to patient satisfaction. In this study, three hospitals were selected at large, middle, small city. Ninety subjects (53 males, 37 females) who had received physical therapy service were participated in this survey. Survey data were collected by a written questionnaire. The patient satisfaction scale had a good reliability (Cronbachs alpha=.9134). The collected data were analyzed by t-test, ANOVA, and Kruskal-Wallis. The scores of patient satisfaction with physical therapy services at large, middle, and small city were 79.67, 76.23, and 86.33 respectively. The score of patient satisfaction at small city was significantly higher than middle and large city (p<.01). There was no significant difference in patient satisfaction with physical therapy services according to gender, age, education years, occupation, marital status, religion and average monthly income. Further studies are needed to identify which specific factors are related to patient satisfaction with physical services. This information will be useful in improving the patient satisfaction.

• Journal of Korean Biological Nursing Science
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• 제23권1호
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• pp.43-54
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• 2021

Purpose: This study aimed to identify the factors influencing infection-related characteristics and patient safety culture on awareness of blood-borne infection prevention between operating room nurses and general ward nurses. Methods: Participants were 198 nurses(operating room nurses 98 and general ward nurses: 100) working at three general hospitals and three university hospitals in three cities. Data were collected using a structured questionnaire from September 11 to October 14, 2020. Data were analyzed using descriptive statistics, t-tests, ANOVA, Pearson's correlation coefficient, and multiple regression with IBM SPSS/WIN 26.0 program. Results: Typically, 39.8% of nurses in the operating room and 24.0% of ward nurses experienced injuries such as needles and sharp instruments used by the patient. The awareness of patient safety culture was identified to be higher for the ward nurses. Factors influencing the awareness of blood-borne infection prevention in operating room nurses were patient safety culture and wearing protective equipment for infection prevention while nursing infected patients. Moreover, the explanatory power of these variables was 19.4%. In general ward nurses, the patient safety culture was identified as a significant predictor, which accounted for 16.5% of awareness of blood-borne infection prevention. Conclusion: To prevent hospital infection, a strategy is needed to improve the level of awareness of blood-borne infection prevention and patient safety culture of operating room nurses. To this end, the difference in infection-related characteristics and influencing factors between the operating room nurses and the general ward nurses should be considered and planned.

• 임상간호연구
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• 제29권3호
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• pp.296-311
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• 2023

Purpose: This study aimed to identify factors related to the workload of intensive care unit nurses through a systematic literature review and meta-analysis to provide basic data to explore the direction of development of nursing staffing standards. Methods: This study involved quantitative studies about nurses working in intensive care units related to nursing workload published in English or Korean since 2000. Search terms included 'intensive care unit', 'nursing workload', and their variations. Databases such as RISS, DBpia, MEDLINE(PubMed), CINAHL, PsycINFO, and Web of Science were utilized. Quality assessment was conducted using the Joanna Briggs Institute's Critical Appraisal Checklist for Analytical Cross-Sectional Studies. JAMOVI software facilitated the analysis of effect sizes, employing a meta-analysis approach for 7 studies with correlational or regression data. Results: From 16 studies on the workload of intensive care unit nurses, a total of 20 patient and nurse-related factors were identified. Patient-related factors included severity of illness, length of stay, and age. Meta-analysis was conducted for three patient-related factors: age, severity of illness measured by SAPS 3, and length of stay. Only severity of illness measured by SAPS 3 was significantly associated with nurse workload (Zr=0.16, p<.001, 95% CI=0.09-0.24). Conclusion: In previous studies, the characteristics of intensive care units and patients varied across studies, and a variety of scales for measuring workload and severity of illness were also used. Sustained research reflecting domestic intensive care unit work environments and assessing the workload of intensive care unit nurses should be imperative.

• 한국병원경영학회지
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• 제10권2호
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• pp.64-80
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• 2005

The objectives of this study were to identify factors associated with unexpected revisit to an emergency medical center (EMC) located in Seoul and to examine reasons for revisit. During March, June, September and December, 2002, a total of 168 patients had unexpected revisits to the EMC within 48 hours of a previous discharge. As a 1:1 matched control, we included 136 patients who: discharged from the EMC during the same time period: did not return to the EMC; had the same diagnosis and age(${\pm}5$) with the case. In this study, factors associated with unexpected revisits were defined as characteristics of a previous discharge, which were classified into three: sociodemographic, EMC visit-related, and discharge management factors. Reasons for revisit were categorized into disease, physician, patients, and system-related factors. Data were collected by medical chart review with assistance from clinicians of the EMC. Logistic regression results showed that patients who headed home after discharge without follow-up schedule had a 27.6 times higher risk of revisiting EMC than those who were hospitalized following EMC visit. Patients discharged on his own will had a 5.9 times higher risk of revisiting than those discharged following physician's advice. Patients requiring continual observation at the time of discharge were more likely to revisit by 8.7 times than those discharged with improved condition. About 69.13% of the revisits were due to disease-related factors, followed by 13.90% due to patient-related factors, 8.64% due to system-related factors, and 8.34% due to physician-related factors. It appears that the most significant factors influencing revisits are discharge management factors such as patient's condition at discharge, whether the discharge was accorded with physician's advice, and whether returning home without follow-up schedule. Therefore, appropriate discharge management is necessary to prevent EMC revisit.

• Journal of Information Technology Applications and Management
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• 제21권2호
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• pp.31-48
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• 2014

The concept of Health Related Quality of Life and its determinants have evolved since the 1980s. Although many researchers have published articles of technology usage in hospitals and the installation of technology based healthcare system, the research about applying the information technology to improve the patients' perceived quality of healthcare services is still limited. In general, services are deeds, processes and performances that are essentially concerns of the consumer. The healthcare service quality depends on tangible factors, such as equipments, facilities, and the quality of hospital staff and also the intangible ones. The main purpose of this work is to establish new model and find out the contribution of information technology to enhance the patients' perceived quality of healthcare service. We attempted to examine the main information technology related factors in 3 aspects, namely quality of information, the technology accessibility and the community that can improve patients' perceived quality of healthcare services. Offline and online questionnaires were used to measure the patients' perceived quality and were distributed to 384 people in 2 countries, Laos and South Korea. A principle component analysis and multiple regressions were used to verify our model. Results show that the use of information technology has partial positive effect on patient-physician interaction in both countries. However, patient knowledge and patient autonomy which are the 2 dimensions of patient-physician interaction has significant positive effect on patients' perceived quality of healthcare service.

• 한국임상약학회지
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• 제22권3호
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• pp.211-219
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• 2012

Nonsteroidal antiinflammatory drugs (NSAIDs) are used in the treatment of extensive diseases related to various symptoms; inflammation, pain and fever. NSAIDs work by blocking prostaglandin synthesis, but adverse drug events (ADEs) have been increasing dramatically such as gastrointestinal bleeding, perforation and stenosis, a kind of serious ADEs. Therefore, NSAID-related ulcer complication guidelines have been announced containing various risk factors and symptoms. Thus, this study aims to evaluate of NSAID usage and appropriateness for prevention of NSAID-related ulcer complication based on American journal of gastroenterology (AJG) guideline 2009. Further, the study suggests Korean guideline for prevention of NSAID-related ulcer compared to AJG guideline. For this study, data was collected through electronic medical record (EMR) at Seoul national university of Bundang hospital. The primary end point was a composite of NSAID-related ulcer risk factor, types of NSAIDs, co-prescribed NSAID ulcer prevention drugs and NSAID-related ulcer after taking NSAID. The risk factors include over 65 years, high dose NSAID, previous ulcer history and taking drugs (e.g. aspirin, anticoagulant and steroid) causing ulcer. If a patient has 3 or 4 factors, that patient was classified high risk group. And if 1 or 2 factors that patient was classified moderate risk group. The patient who has no risk factor was in low risk group. I studied 8,120 patients who received NSAID from 1 January 2009 to 31 December 2009. High risk group was 16(0.2%), moderate risk group was 4,364(53.7%), and low risk group was 3,740(46.1%). The results show that high risk group should be prescribed COX-2 inhibitors with ulcer prevention drugs, and moderate or low risk group need traditional NSAIDs with ulcer prevention drugs. This may be different with 2009 AJG guideline because AJG guideline suggested taking COX-2 inhibitor alone in moderate group or taking traditional NSAID alone in low risk group could get higher ulcer complication. The results indicated that choosing preventive drug is important in case that how many risk factors the patients have. The proper drugs would be helpful for safe and effective NSAID usage in each patient group.