• Title/Summary/Keyword: Percent improvement

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CQI Action Team Approach to Prevent Pressure Sores in Intensive Care Unit of an Acute Hospital Korea (중환자의 욕창 예방 연구 : 욕창 예방 QI팀을 중심으로)

  • Kang, So Young;Choi, Eun-Kyung;Kim, Jin-Ju;Ju, Mi-Jung
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.50-63
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    • 1997
  • Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

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A Study on the Improvement of Technology Balance of Payments to Enhance Global Technology Competitiveness in Korea: Based on the Surveys regarding Perception and Current State of Industry (우리나라의 글로벌 기술경쟁력 제고를 위한 기술무역수지 개선방안 연구: 산업계 인식 및 실태조사를 중심으로)

  • Lee, Jongmin;Noh, Meansun
    • Journal of Technology Innovation
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    • v.23 no.4
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    • pp.1-31
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    • 2015
  • Korea has continuously increased investment on R&D to improve global technology competitiveness through technology innovation. Korea's R&D expenditure as a percent of GDP is world's No. 1 as 4.15 and it accomplished 1 trillion won trade volume for 4 consecutive years. However, despite these efforts, technology balance of payment, which is an important factor that can measure nation's technology competitiveness is in a state of chronic deficit and the lowest level among OECD countries. In this paper, we studied methods to improve Korea's technology balance of payment We figured out concept and current state of technology trade and examined the importance of technology trade through making a comparison between commodity trade and technology trade. There have been studies regarding technology trade, but there was no study which tried to figure out cognition on technology trade from the point of view of companies which plays an important role in technology trade. For this, this study distinguished companies with experience in technology trade and which have not and conducted a survey to figure out cognition and current state of companies. The survey result showed noticeable difference on cognition of top decision makers between companies with experience in technology trade and which have not and there are serious shortage in department and staff which is exclusively responsible for technology trade. Also, despite their needs for education regarding technology trade, the ratio of employees who received education is below 10 % of the total respondents. This study suggested improvement methods such as reforming survey methods of technology trade statistics, enhancing social cognition, supporting to vitalize technology export, building infrastructure regarding technology trade, and opening education programs for cultivating experts based on preceding research and industry survey.

The Effect of Nutrition Education on Visceral Fat Reduction and Diet Quality in Postmenopausal Women (폐경 여성의 내장지방 및 식사의 질에 미치는 영양 교육의 효과)

  • Baek, Young-Ah;Kim, Ki-Nam;Lee, Yo-A;Chang, Nam-Soo
    • Journal of Nutrition and Health
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    • v.41 no.7
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    • pp.634-664
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    • 2008
  • This study investigated the effects of the nutrition education on body weight, visceral fat and diet quality in the postmenopausal women. The subjects (n = 101) were randomly divided into two groups: Nutrition education + Exercise (NEE) group (n = 51) and Exercise only (EO) group (n = 50). Nutrition education was consisted of counseling in portion control, food selection for low carbohydrate, high fiber food items and for the improvement in micronutrient intakes and diet quality. After 6 months, the reduction in the body weight and visceral fat area was significantly greater in the NEE than in the EO group. The NEE subjects were further divided into two groups according to the amount of visceral fat area reduction; high visceral fat area loss (HVL) group with a visceral fat area reduction 2.35% or greater and low visceral fat area loss (LVL) group with a reduction less than 2.35%. In the HVL group, the reduction in body weight, BMI, percent body fat, waist to hip ratio and visceral fat area was significantly greater than that in the LVL group. We observed a significant increase in the serum HDL-cholesterol level and a decrease in systolic blood pressure, fasting blood sucrose, total and LDL-cholesterol levels in the HVL group compared to the LVL group. The energyadjusted protein, fiber, calcium, vitamin $B_6$, vitamin C, vitamin E intakes were significantly increased in the HVL compared to LVL group. The index of nutritional quality (INQ) and mean adequacy ratio (MAR) were also increased in the HVL group compared to the LVL group. These results show that our nutrition education program was an effective intervention measure for the reduction of body weight and visceral fat, blood pressure, glucose and lipid levels in the blood and also for the improvement of nutrient intake and diet quality in postmenopausal women who are overweight.

The Effect of Aerobic Exercise on Body Composition, Cardiopulmonary Function, Serum Lipid and Antioxidants of Obese College Female Students (에어로빅운동이 비만여대생의 신체조성, 심폐기능, 혈청지질 및 항산화물질에 미치는 영향)

  • Jung Eun-Sook;Park Hyeong-Sook
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.5 no.1
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    • pp.125-141
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    • 1998
  • The purpose of this research is to analyze the effects of aerobic exercise on body composition, cardiopulmonary function, serum lipid level and antioxidants of obese and normal college female students. The subject group was made up of 13 normal students (below 30% body fat ratio) and 12 obese students (above 30% body fat ratio). After a pretest, the subjects were given an 8-week aerobic program. Then the subjects were given a posttest and analyzed of body composition, serum lipid level, antioxidants and cardiopulmonary function after the 6th and the 8th week of the program. The program schedule was made up of 4 days per week, 60 minutes per day. Test includes B.W., subscapular and triceps subcutaneous fat thickness, change of respiratory gas, and two blood sampling before treadmill exercise and post all out state, which analyzed serum lipid and antioxidants. The subjects performed treadmill exercise starting with 4km/hr of walking and then gradually increase the speed of 1km/hr per minute until all out state. The obtained data were analyzed using SAS program. The statistical methods employed here were one-way ANOVA with repeated measure, Duncan Multiple range test, paired-t test and t-test. The test results and conclusion of this research were as follows. 1. The effects of aerobic exercise on body composition were as follows ; Percent body fat was significantly reduced 6 weeks after the program and lean body mass was significantly increased 8 weeks after the program in both groups(obese group: F=3.44 P=.044, normal group: F=3.30 P=.048). subscapular skinfold of the obese group showed a remarkable decrease after the 6th week(F=4.33 P=.021) triceps skinfold of the normal group showed a remarkable decrease after the 6th and the 8th week(F=4.55 P=.017) compared with readings before the aerobic program, the aerobic program made a bigger difference concerning body fat, lean body mass, subscapular skinfold in the obese group than in the normal group(t=2.41 P=.024, t=2.40 p=.025, t=2.43 p=.028). 2. The effects of aerobic exercise on cardiopulmonary function were as follows ; Maximal $O_2$ uptake/kg was significantly increased 6 weeks after the program in the obese group(F=3.20 P=.054), but not much difference was observed in the normal group. Maximal pulse rate was significantly reduced in both groups after 6 weeks of the program(obese group: F=2.77 P=.087, normal group: F=7.17 P=.001). 3. The effects of aerobic exercise on serum lipid level were as follows ; In a resting period, total cholesterol, Triglyceride, and LDL-cholesterol were slightly higher in the obese group than in the normal group, but HDL-cholesterol was higher in the normal group. But, with the aerobic program, total-cholesterol, Triglyceride, LDL-cholesterol were reduced gradually and HDL-choleterol got increased in both groups, but not much change was noticed in the normal group. However, in the obese group, serum HDL-cholesterol level got increased significantly(F=5.12 P=.012). 4. The effects of aerobic exercise in serum antioxidants were as follows ; In a resting period, the obese group's serum Free Radical and GSSG content were higher than the normal group's and the normal group's serum GSH content was higher than the obese group's. After 6 weeks of the aerobic program, Free Radical was reduced significantly in both groups(obese group: F=13.87 P=.000, normal group: F=18.60 P=.000) In the obese group, 8 weeks after the program, GSH was increased significantly(F=13.78, P=.000). In the normal group, 6 weeks after the program, GSH was reduced but increased again after 8 weeks(F=6.07 P=.005). Plasma GSSG was significantly increased after 8 weeks of exercise in both groups(obese group: F=19.75 P=.000, normal group: F=22.42 P=.000,) Compared with readings before the aerobic program, the aerobic program made a bigger difference serum GSH in the normal group than in the obese group(t=3.37 p=.003). As this result shows, it is known that the regular aerobic exercise improves cardiopulmonary function, body composition, serum lipid effectively and through the serum Free Radical reduction and antioxidant system activation, oxidant stress was suppressed. This effect was higher in the obese group than in the normal one. At least 6weeks exercise period need for improvement of body composition, cardiopulmonary function and activation of antioxidant system. This result suggest that improvement of serum lipid profile was needed longer than 8weeks exercise period.

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A Clinical study on the Treatment of Pruritus (피부소양증(皮膚瘙痒症) 치료(治療)에 관(關)한 임상적(臨床的) 연구(硏究))

  • Park, Seong-sik
    • Journal of Sasang Constitutional Medicine
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    • v.11 no.2
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    • pp.361-376
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    • 1999
  • 1. Backgrounds and Purpose : Pruritus, one of the most common dermatological symptoms, was clinically examined with a view to a better understanding of its characteristics for more accurate treatment. 2. Method : For 22 months from November in 1997 to September in 1999 we selected outpatients who had consulted for itchiness more than twice in the department of Sasang Constitution of the Pundang Oriental medical hospital, Dongkook University, and 59 of those (35 males and 24 females) were confirmed of their course of treatment. From their medical records and history, we learned the general characteristics and patterns of pruritus, and the qualities and effects of its various treatments. 3. Result and Conclusion : Pruritus was more complained by men than by women and the largest age groups were 20's and 30's. For its suffering period, the duration of 1 month to less than 1 year was the greatest, and most patients had already experienced western medical care. Itchiness affected them almost day and night. In addition, many patients had abnormal bowel habits as a general symptom. According to Sasang Constitution, the Soeumin gave sleep disturbance and indigestion; the Soyangin showed a different pattern in their tongue coatings and bowel habits; the Taeumin had different tongue coatings and sweating pattern. The commonly prescribed herbal formula for pruritus was Gakhangjungisan, Yangkyuksanhwatang, Chungsimyonjatang. As for their efficiency, 61.0 % of patients improved, whereas 39.0 percent did not. Patients aged over 30 showed a more significant improvement than those of 20 years or under, and the duration of less than 1 year was more significantly improved than that of 1 year or more. Those who had no experience in western medical care or had been continuously treated showed a more significant improvement than those with intermittent treatments, and severe pruritus was more significantly improved than mild pruritus.

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A Survey on Utilization of Health Center and Health Service Demand of Residents in a Urban and Rural Unified Community (일개 도시·농촌 통합지역 주민의 보건기관 이용경험과 보건서비스 요구도 조사)

  • Lim, Bu-Doll;Lee, Ju-Young
    • Journal of agricultural medicine and community health
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    • v.25 no.1
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    • pp.99-112
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    • 2000
  • This survey was conducted to assess the utilization of health center including health sub-center and community health post and the health service demand of residents in a urban and rural unified community. Officials in Up·Myun·Dong offices visited randomly sampled 4,027 households(4.6% of total households in unified City) which included 3,337 households in urban area(4.9% of total households) and 690 households in rural area(3.7% of total households) and interviewed with heads or housewives of the households in September, 1995. There were significant differences in health-related demographic characteristics including age-sex distribution, educational level, period of residence in the community and medical insurance status of the interviewees between urban and rural areas. Of the respondents, 64.8% in urban area and 55.6% in rural replied that they had utilized the health center in the past. The most common purpose for visiting the health center was to get vaccination in urban area and to get outpatient care in rural area. The top priority health center activity that needs to be reinforced was communicable disease control and over 90% of the respondents preferred to have mobile clinic and home health care service in were also highly demanded. Eighty-six percent of the urban respondents replied that a health sub-center must be established in urban area. In the rural area, 90.3% of the respondents replied that they wanted to maintain the health sub-center and 88.3% wanted to maintain the community health post. Along with the improvement of facilities and equipments of the health center by Rural Health Service Improvement Project, new health service programs must be developed to meet the demand of the community.

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A Prospective Study on Attitude of Professional Student toward Population Related Issues in Korea (대학전공별(大學專攻別) 전문직학생(專門職學生)들의 인구관련문제(人口關聯問題)에 대한 연차적(年次的) 변화(變化) 연구(硏究))

  • Lee, Kyung-Sik;Kim, Hwa-Joong
    • Journal of Preventive Medicine and Public Health
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    • v.9 no.1
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    • pp.11-24
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    • 1976
  • This study was a part of large scale of a prospective study on attitudes of professional students in medicine, nursing and teaching toward population related issues in Korea. The study was first conducted in May 1974 and then in May 1975 for the 1974 class cohot using a questionaire consisted of attitude scales and other items developed by Lee. The purpose of stuay was twohold, namely, to determine the difference in students among specializations on one hand and between the first and second years in the 1974 class cohot regarding tile subject matter. A one-way analysis of variance was used for attitude scale, and absolute and relative frequency were computed for the analysis of non-attitude scale items by employing Fishers' Ratio and Duncan's multiple range test at 5% level and chi square test at 5% level as significance tests. The hypothesis 'students in health profession are more likely to have positive attitudes toward population related issues progressively as class year advances than students in teaching profession' was tested and the following results were obtained: 1) Nursing students were more likely to display favarable attitudes toward family planning than medical or teaching students although the class cohot showed slightly negative improvement in the second year. Medical and teaching students apperaed to have slightly improved attitudes in the second year. 2) Respondents in general perceived national family planning program as a means of population control and this tendency was more true among nursing students as the class year advances than two other professional groups of students. Students in teaching profession appeared to perceive it more as a means to improve individual family welfare while health students were likely to see as to improve maternal and child health. This tendency was progressively improved as the class year advanced. 3) The majority of students regardless of their respective specializations believed that family planning program should be directed toward the improvement of individual family welfare. No progressive changes in the class cohot were observed. 4) About the plan to use contraceptives in future, no singnificant differences were observes among different specializations nor in different class years. However, the majority was confirmed to have a plan to use contracepives in future. An increasing proportion of the undecided category was observed, as class year advanced among health students. 5) Students in health profession were found to be more favorable about 'more leisure opportunities' as motive for limiting number of children whereas education students indicated the reasons as 'facilitate ambitions' and 'economic base' The progressive changes toward positive direction in both groups were observed as the class years advanced. 6) Attitudes toward induced abortions of the health students were observed to be positively related to class years while an inverse relationship was found in teaching students who showed much less favor in the subject matter than health students. This phenomenon may be due to the different exposure to learning environments unique to respective specializations. 7) Health students were found to have more favorable attitudes toward population education in general than the teaching students. The teaching students appeared to have changed more to the negative direction when they became the second year while no such development was observed in health students. The teaching students seemed to hold a very conservative position with regard to sex education in schools. 8) About the equality of sexes, the nursing group was found to be most favorable while the reverse was true in the teaching group. A change in the negative direction as the class year advanced was found in the teaching group. 9) About questions related to fertility values-the 10 percent of respondents regardless of specialization indicated that they would maintain their single status in future, however no change was observed in the second year. The desired number of children was found to be two by the majority of students in nursing, medicine and teaching in order of high proportion. No changes in a different class year were observed. The childless marriage was seen by nursing students as a problem more than other students, but a slight change in positive direction was found when the nursing students became the second year. In summing, as data supported in the above, students in health profession demonstrated more favorable attitudes toward population related issues than the teaching students and this tendency became more apparent in the second year. It was noticed that health students were more conscious about the health aspect of population and family planning program while the teaching students gave more attention to the socioeconomic aspect. The sex variable seemed to have operated in the item related to the equality of sexes. In conclusion, as data presented in the above, the hypothesis of this study was accepted except in the few items. It should be noted that the limitation of this study is the short duration of the observation in measuring the possible attitude changes. It should include curriculum analysis for the respective specializations in order to indentify the area of curriculum impact on students in future study.

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Comparison between REML and Bayesian via Gibbs Sampling Algorithm with a Mixed Animal Model to Estimate Genetic Parameters for Carcass Traits in Hanwoo(Korean Native Cattle) (한우의 도체형질 유전모수 추정을 위한 REML과 Bayesian via Gibbs Sampling 방법의 비교 연구)

  • Roh, S.H.;Kim, B.W.;Kim, H.S.;Min, H.S.;Yoon, H.B.;Lee, D.H.;Jeon, J.T.;Lee, J.G.
    • Journal of Animal Science and Technology
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    • v.46 no.5
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    • pp.719-728
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    • 2004
  • The aims of this study were to estimate genetic parameters for carcass traits on Hanwoo(Korean Native Cattle) and to compare two different statistical algorithms for estimating genetic parameters. Data obtained from 1526 steers at Hanwoo Improvement Center and Hanwoo Improvement Complex Area from 1996 to 2001 were used for the analyses. The carcass traits considered in these studies were carcass weight, dressing percent, eye muscle area, backfat thickness, and marbling score. Estimated genetic parameters using EM-REML algorithm were compared to those by Bayesian inference via Gibbs Sampling to find out statistical properties. The estimated heritabilities of carcass traits by REML method were 0.28, 0.25, 0.35, 0.39 and 0.51, respectively and those by Gibbs Sampling method were 0.29, 0.25, 0.40, 0.42 and 0.54, respectively. This estimates were not significantly different, even though the estimated heritabilities by Gibbs Sampling method were higher than ones by REML method. Since the estimated statistics by REML method and Gibbs Sampling method were not significantly different in this study, it is inferred that both mothods could be efficiently applied for the analysis of carcass traits of cattle. However, further studies are demanded to define an optimal statistical method for handling large scale performance data.

Estimation of Genetic Parameters for Economic Traits and Profit by Milk Production of Holstein Dairy Cattle in Korea (국내 Holstein종 젖소의 경제형질과 착유량에 따른 소득의 유전모수 추정)

  • Noh, Jae-Kwang;Choi, Yun-Ho;Cho, Kwang-Hyun;Choi, Tae-Jeong;Na, Seung-Hwan;Cho, Ju-Hyun;Kim, Jin-Hyung;Shin, Ji-Sub;Do, Chang-Hee
    • Journal of Animal Science and Technology
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    • v.54 no.4
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    • pp.275-282
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    • 2012
  • The data including milk yields, fat and protein percent for 628,395 heads collected by National Agricultural Cooperative Federation, 15 type traits and final score for 62,262 heads collected by Korea Animal Improvement Association, which were born in 1998 to 2004, and net profits calculated from milk price and raising expenses of individuals were used to estimate genetic parameters. The highest positive genetic correlation, 0.81, was shown between body depth (BD) and loin strength (SR). Genetic correlations between body depth (BD) and udder depth (UD), front teat placement (TP) and front teat length (TL) were -0.23, which were lowest among the linear type traits. Furthermore, medium level of negative genetic correlations were shown the milk yield with milk contents rate traits. Mostly low level of positive genetic correlations were shown between the milk traits and linear score traits except milk yield and stature. Most of the genetic correlations of between the linear score traits and net profit were low level of positive or negative genetic correlations. Among the genetic correlations, body depth (BD), angularity (DF) and rear attachment width (UW), and final score (FS) with net profit were high as 0.17, 0.17, 0.18 and 0.18, respectively. Finally all of the genetic correlations between net profit and milk traits were positive and higher than the linear traits with positive genetic correlations. The results of this study suggest that net profit has been related with the linear traits, such as body depth (BD), angularity (DF) and rear attachment width (UW) traits, and furthermore, milk traits including yield and contents rates influence positively and greatly on net profit.

A Study on Improvement of Laws regarding Welfare for the Aged (노인복지 관련법제의 발전방향)

  • Park, Ji-Soon
    • Journal of Legislation Research
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    • no.41
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    • pp.87-123
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    • 2011
  • Korea is expected to become an 'aged society' with more than 14 percent of the public aged 65 years or more by 2018. The rapid aging is giving rise to various problems within the society along with falling birthrate in a short period of time. In this context, the role and function of laws on welfare for the aged must be particularly emphasized. Also the Senior Citizens Welfare Act is of great importance as it provides social welfare service on the basis of functional connection with social insurance and public assistance. First, this paper looks into the history of laws related to welfare for the elderly such as the Senior Welfare Act, the Act on Long-term Care Insurance for Senior Citizens and the Basic Old Age Pension Act as well as the findings of earlier studies. In the second place, it will break down such laws by main components aiming to examine details of the laws and questions raised regarding them and to seek ways to achieve improvement with an emphasis on health care, old age income security, housing welfare(assisted living facilities), job security for the aged. The Senior Welfare Act offers substance of social welfare service for the elderly. Income security, health and medical care, welfare measures through long-term care and assisted living facilities, social participation by working are the key elements and all of them should be closely associated to ensure citizens get sufficient public support in their old age. For this purpose, the Senior Welfare Act is under a normative network with laws such as Act on Long-term Care Insurance for Senior Citizens and Basic Old Age Pension Act. Current laws on welfare for the aged including Senior Welfare Act are not sufficiently responsive to the aged society of the 21st century. Income security combined with decent social participation, health and medical care closely connected with long-term care system, efficient expense sharing between government and local government, enhancement of effectiveness of welfare measures can be considered as means to improve current welfare system so that the elderly can enjoy their old age with dignity and respect.