• Quality Improvement in Health Care
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• v.5 no.2
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• pp.258-276
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• 1998

This study was conducted to justify the "prescribed shelf life" currently used in Samsung Medical Center and give recommendations based on scientific data to adopt for safe and cost-effective storage times for sterile goods Since the early 1970's, predetermined expiration dating policy has been used in Korea on all in-house sterilized products like any other countries; six months for the supplies wrapped in polyethylene peel pouches and two weeks for the rest. Recently, however, the studies suggest that current standards for preserving the sterility can be changing. It looks like we unnecessarily have too-short expiration date of sterilized supplies, that is far from being cost effective. Certainly, this research is an exciting project, especially in Korea, and will be leading and contributing to the paradigm shift of the conservative concept of shelf life for sterile supplies in Korean healthcare facilities. The major goal of this study was placed on the measurement of the recontamination time in packs wrapped in all kinds of wrapping materials used in S.M.C and stored in various conditions for periods ranging from three months to six months, and then develop a practical standard of "shelf life" based on the analyzed data. Objectives: To measure and compare the recontamination time of sterile packs among wrapppers and storage conditions, and develop a practical standard for the shelf life and storage conditions of sterile products. Samples and Method: The sterile integrity was investigated of the total 1,440 sterile sample packs containing gauze strip($1.5cm{\times}0.5cm$) we prepared and wrapped in nine wrapping materials (randomized reprocessed linens, linens reprocessed 99 times, linens reprocessed 120 times, new kraft paper, used kraft paper, new nonwoven fabrics, 6-time reprocessed nonwoven fabrics, new polyethylene peel pouches, used polyethylene peel pouches), and stored in four locations(closed cabinet of one of the typical wards, open shelf of one of ICUs, open shelf of separate storage room in ER, open shelf in OR), for three to six months, respectively in 1998. Each type of packs were opened weekly and the gauze strips inoculated into Brewer's thioglycollate broth at $35^{\circ}C$ for seven days. Results: There was no growth found for any types of the pack and storage conditions studied. Discussion: This study was conducted in an attempt to identify the possibility of extending the current shelf life for sterile goods we use in a sense of cost effectiveness. The findings suggest that we could extend our expiration dates, that means we can save a lot of materials and personnel time meeded for resterilizing, outdating, recleaning, wrapping, and reshelving. Then it will initiate a great reform in the field of healthcare in Korea, and now we are looking forward to this valuable revolution. We are going to continue this study and take all steps need to apply this new concept to our practice, and then trying to extend to other hospitals.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.22
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• pp.9679-9685
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• 2014

Background: When evaluating health-economics for cervical cancer prevention policies in Japan, it is important to use Japanese value settings. This study aimed to obtain preference-based measures (preference measures) for hypothesized health states among healthy Japanese women, and to examine differences between the EuroQol-5D (EQ-5D) and standard gamble (SG) instruments. Materials and Methods: The investigation was performed among female students at a nursing university. We used written hypothetical scenarios describing three grades of cervical intraepithelial neoplasia (CIN) and eight stages of cervical cancer, both at diagnosis and after medical intervention. Preference measures were evaluated using both EQ-5D and SG. Results: We received responses from 136 women. The mean number of respondents per stage was 24.6 (SD: 2.7). At diagnosis, average EQ-5D scores for CIN1, CIN2, CIN3, IA1, IA2, IB1, IB2, IIA, IIB, III, and IV stages were 0.84 (0.14), 0.78 (0.12), 0.73 (0.10), 0.78 (0.12), 0.72 (0.12), 0.63 (0.13), 0.64 (0.12), 0.68 (0.08), 0.62 (0.13), 0.55 (0.21), and 0.18 (0.24), respectively. Using one-way analysis of variance with the Tukey-Kramer method for multiple comparisons (each stage vs. CIN1), we found significant differences for IB1 and more advanced stages (p<0.05). After medical intervention, corresponding EQ-5D scores were 0.84 (0.12), 0.81 (0.12), 0.84 (0.12), 0.80 (0.15), 0.78 (0.11), 0.64 (0.15), 0.63 (0.15), 0.71 (0.15), 0.50 (0.17), 0.52 (0.17), 0.21 (0.28). The multiple comparisons identified significant differences for IB1 and more advanced stages, excepting IIA (p<0.05). SG evaluations were more variable and relatively higher than EQ-5D evaluations. Conclusions: We obtained preference measures for three grades of CIN1-3 and eight stages of cervical cancer. In combination with appropriate sensitivity analyses, these preference measures will provide a basis for an economic evaluation of cervical cancer prevention in Japan. We suggest that EQ-5D is appropriate for cost-utility analysis of this topic.

• Journal of Hospice and Palliative Care
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• v.14 no.4
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• pp.204-211
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• 2011

Purpose: This study used a nonequivalent control group pre-post test design to analyze how a death preparation education program helps middle-aged adults deal with life and death anxiety. Methods: We studied 83 adults at the age of 40 to 65 years. An experimental group of 38 people participated in the death preparation education, and a control group of 45 people did not. The death preparation program comprising four sections was given for four hours per week, and the program ran for 11 weeks. Data were analyzed by descriptive statistics, t-test, ${\chi}^2$ test, Fisher's exact test, and ANCOVA using SPSS version 17.0. Results: The death anxiety score of the experimental group was significantly lower than that of the control group (P<0.000). The quality of life did not show significant difference between the experimental and control groups (P=0.188). Conclusion: It was confirmed that the death preparation education program is effective in alleviating death anxiety. Although the program was confirmed as a necessity for the middle-aged adults, repeated observations with a wider range of experimental group is needed to collect objective and solid data. Death preparation education for middle-aged adults is expected to be more widely provided, starting from local health facilities.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.57-72
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• 2021

Purpose: At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS). Methods: This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm). Results: Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable. Conclusion: This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.

• 한국노년학
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• v.28 no.4
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• pp.1069-1087
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• 2008

The purpose of this study was to closely examine the effects of aromatherapy on Behavioral and Psychological Symptoms of Dementia(BPSD) to the elderly in a nursing home, and to help the application of aromatherapy is expected to be conducive to managing the quality life in the dementia and the care-giver, and to provide a base of the aromatherapy application as an elderly program in geriatric institutions. This is an one group pre-post test design and the research subjects were the dementia in a nursing home those were totally 15 available for communication or intention observation. Aromatherapy was offered for 3 weeks totally 15 times by once a day in each with aroma hand massage and inhalation, by blending essential oils, Lavender, Chamomile Roman and Grapefruit. The results are as follows. Given examining a change in the whole about whether there are effects of aromatherapy on BPSD, there was significant difference in a change depending on the experimental period with 1.47 for the pre-measurement value, 1.09 for the post 1-measurement value, 1.01 for the post 2-measurement value and 0.71 for the post 3-measurement value. And, even the difference in experimental period was indicated to have significant difference(F=11.501, p<0.001). As an itemized results, the effect of aromatherapy were indicated to have significant difference on easing the anxiety, anguish, fear, dreadful feeling, depressed feeling, and outstandingly bustling movement, and outstandingly inactive behavior, and sleep disturbance and behavior of wandering about at night. On the basis of the result in this study, the application of aromatherapy is expected to lead the quality life in the dementia, and to contribute to health of mind and body in the dementia as an program in geriatric institutions.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.5
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• pp.47-58
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• 2017

This study examined the effects of elderly people's frail prevention program performed in a senior center located in J-si. The most interesting were the effects on the subjective health status, depression, physical fitness, and quality of life for the senior center participation of the elderly. The nonequivalent control group pre-post-test design was employed. A total of 43 people living in J-si were assigned to either the experimental group (n=22) or control group (n=21). The experimental group was provided with the 8-weeks frail elderly prevention program from September 1 to October 16 in 2015. The data were analyzed with SPSS/WIN 21.0 using descriptive statistics, $x^2-test$, Fisher's exact test, and t-test. The results indicated a significant difference between the experimental group and control group with respect to the scores of the subjective health status (t=-0.35, p=.024), depression (t=2.76, p=.035), physical fitness, including right grip strength (t=-3.10, p=.004) and flexibility of the waist (t=-2.13, p=.039), and the quality of life (t=4.36, p<.001). In conclusion, an elderly people's frail prevention program has a significant effect on the change in subjective health status, depression physical fitness, quality of life, and self-care behavior for senior center participation.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.3
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• pp.520-534
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• 2018

This study was conducted to understand the conceptual definition and characteristics of health inequality. To accomplish this, we analyzed data collected from 14 participants as well as from available literature regarding health inequality using the hybrid model introduced by Schwartz-Barcott and Kim. We categorized health inequality into nine attributes in three dimensions. These dimensions included "target", "precede", and "result," corresponding to the target, cause and consequence of health inequality, respectively. Specifically, we define health inequality as individuals, families, communities, socio-economic, or geographically distinct demographic groups that are treated unfairly and result in several problems such as loss of quality of life, reduction of survival rate, or aggravation of a disease due to (i) poor treatment by a hospital (ii) irregular meals, (iii) desperate need for work (for money), (iv) expensive medical care costs, (v) qualitative differences in medical care by regional groups (vi) the lack of knowledge regarding disease (vii) and inadequate health care because of lack of time. As a result of this unfair treatment, human rights violation occurs. The major contribution from this paper is that we provide a guideline for establishing strategies to reduce health inequality by identifying the concept of health inequality. Based on this study, we recommend development of an educational program to reduce health inequalities.

• Korean Journal of Hospice Care
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• v.2 no.1
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• pp.87-111
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• 2002

The hospice activities in Korea have still stood in the premature stage, although the contemporary hospice program, which professionally accommodates terminally ill patients, appeared in the history 35 years ago. Especially, the availability of the facility hospice is not only poor in number, but also lack of a guideline for the conduct of the facility. Saemmul Hospice has keenly felt the necessity of more facility hospices and has interchanged experiences and informations with people interested in hospice. However, the number of facilities has fallen short of one's expectations, and many problems have been revealed in order to maintain the operation. This paper was written in order to improve these atmospheres and to help more terminally ill cancer patients properly. This paper clarifies in detail the principle of management, the method of practice in each departments of Saemmul Hospice, expected effects and supplemental items. We try to provide concrete and practical informations and to help extensively for all peoples who are to begin or currently working. 1.Facility: It secures, maintain, and manage the hospice environment for all around care of patients effectively. 2.Education and Volunteer: It trains and manages hospice volunteers devoted to hospice. 3.Financial: It manages donation by healthy soul with an effective method. 4.Administration and Organization: It executes the administration efficiently and constitutes the organization to operate. 5.Medical and Nursing: It offers the maximum professional supports to a hospital. 6.Medicine and alternative medicine: It improves the quality of life of patients by medical and pharmaceutical approach and by other possible methods available. 7.Nutrition: It helps patients to have diets in accord with the order of the creation. 8.Belief: It offers spiritual care which allows the profound relationship with God. 9. Funeral ceremonies: Funeral ceremonies may heal grieves of families faced with their deaths. 10. Bereaved families: It supports the families after the deaths of patients. 11.Reception and consultation: It seeks to help the patients who meet the purposes for which Saemmul Hospice is established. 12.Publication: It allows publicity activities for Saemmul Hospice. Facility hospice programs are able to overcome the disadvantages that the other type of the hospice possess, like as the economic burdens of the families, and the patients' losses of comforts of home after being transferred to a hospital. Facility hospice can provide home atmosphere with professional manpower and facilities like hospital to the patients. Therefore, it can also improve patients' qualities of life and make them comfortable death. We anticipate that the hospice program in Korea would be more active to let more people be indebted to maintain the nobel human dignity and to cross beautifully in the most painful process of dying in the journey of their lives.

• Korean Journal of Social Welfare
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• v.69 no.2
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• pp.191-218
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• 2017

The purpose of this study was to examine the effect of the possibility of job-related risk, emotional labor, and emotional leadership on the job turnover intention of caregivers working at the long-term care facilities in Korea. For the study, survey data of 434 caregivers at senior nursing homes were collected and analyzed using hierarchical multiple regression method. The results showed that high level of caregivers'perception of both the possibility of management risk and employee risk led to increased turnover intention. On the other hand, perception of the possibility of social-disaster risk did not give significant impact on turnover intention. Although the perception of the possibility of service user risk gave statistically significant effect on the turnover intention, the direction was the opposite to the one set at the research hypothesis. Frequent camouflage behavior("surface acting") of caregivers, which is the kind of emotional labor led to increased turnover intention. However, caregivers'behavior consistent with their inner warm heart("deep acting") did not lead to a statistically significant result. Lastly, the more caregivers perceive their superiors'emotionally supportive leadership, the lower possibility of turnover intention. Based on the above result, the researchers suggested several intervention methods in order to prevent turnover of caregivers and improve service quality of long-term care institutions.

• Research in Community and Public Health Nursing
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• v.10 no.2
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• pp.494-507
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• 1999

This study has developed the sex education contents including new natural family plan, concept and principle by receiving the opinions and advices from professionals and professors on sex education, by amending and supplementing existing teaching materials on sex, and examining the books related with sex education contents that reflect the request of teachers and students, and the lack of sex education teaching materials which have been the reason that needs of school sex education has been highly recognized but not vitalized. The developed sex education contents are 8 areas such as knowing my body right, caring my body, observing the ability of being pregnant, marriage, sexual intercourse, process of pregnancy, miscarriage, and sexual violence, 30 lower areas, and 105 detailed contents in their composition, and here are the results of analyses of the degree of request of nurse teachers and the students on them. The teachers showed highest request in the area of sexual violence(M =4.67), the next was my body care(M=4.44), knowing my body right(M =4.38), process of pregnancy(M=4.13), marriage(M=4.11) and sexual intercoursen (M=3.98), ways of judging the ability of being pregnant(M=3.88), and miscarriage(M=3.72) showed comparative higher request than normal. Not like the teachers, the students showed that they requested Marriage area as the highest need(M=3.04) and next was sexual violence(M=3.02), caring my body(M=3.00) to have been higher than normal. Process of pregnancy(M=2.99), Sexual intercourse(M=2.81), miscarriage(M = 2.77), observation of the ability of being pregnant(M=2.74), and knowing my body right(M=2.70) have been the requests lower than normal. This study showed that sexual violence, marriage, caring my body, were the items most requested by both the leacgers and students and in elementary school the development of sex education teaching materials on natural family plan suitable to the level of development of the children has been requested as it has had no inclusion of the concept of natural family plan, and the students in elementary school are concerned on indirect sexual contents related with physical health like regular exercise rather than direct sexual education contents including sexual intercourse. All these show that they are still so naive on sex. The sense of the teachers on sex has been connected with the level of achievement of sex education of the children as it has been the important cause of deciding the contents of sex education. Therefore the materials developed onesidedly by leaders without reflecting the needs or the preference of the students might be worries of bringing shameful. low quality and negative opinions on sex, and on the other hand the children might lose the concerns and interest on sex education, So the materials should be developed to have the contents of sex education coinciding with the request of the children.