• Title/Summary/Keyword: Quality of medical service

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Working Conditions that Impact the Workload of Cytotechnologists: A Study Calculating the Actual Man Power Required (세포병리사의 업무량에 따른 적정인력 산정을 위한 업무실태 조사 연구)

  • Jee, Soo Il;Ahn, Yong Ho;Ha, Hwa-Jeong;Kang, Jeong Eun;Won, Jun Ho
    • Korean Journal of Clinical Laboratory Science
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    • v.53 no.2
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    • pp.174-187
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    • 2021
  • Cytotechnologists evaluate and analyze disorders of cells that constitute the human body, and are involved in the primary assessment of diverse diseases, including cancer. However, the employment conditions and workload of cytotechnologists are poorly understood. This study was undertaken to provide basic data for establishing the criteria for quality control certification factors based on the scope of effective task performance of cytotechnologists, and to provide results of their workload analysis according to the type of medical institution. The study was conducted by enrolling certified cytotechnologists working at various nationwide medical institutions. Our analysis revealed that 178 personnel (72.7%) were involved in primary screening of samples. On an average, the daily number of primary screening of samples performed per cytotechnologist (76 respondents) was determined to be 75.4 chapters (16.8 chapters/hours) at the university hospital level, 72.4 chapters (18.6 chapters/hours) at the general hospital level, and 231 chapters (32.6 chapters/hours) at professional trust institutions. Our results indicate the necessity to establish a consultant with the Korean Cell Pathology Association, to enable finding solutions to solve existing issues by establishing accurate standard guidelines for assessing cell screening.

Study on the Difference of Urine Sediment Preparation for Microscopic Examination (현미경검사를 위한 요침사 표본제작에 따른 차이 연구)

  • Lee, Hyeok-Jae;Park, Chul;Seo, Min-Young
    • Korean Journal of Clinical Laboratory Science
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    • v.49 no.4
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    • pp.366-373
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    • 2017
  • Urinalysis is considered to be easier and simpler than other tests. It has been known to cause no burden to patients, while offering important information on diagnosing, treating, and determining the prognoses of kidney and urinary tract diseases. Urinary sediments are usually performed by microscopic examination of centrifuged urine by technologist. The guidelines proposed by the Korean Association of External Quality Assessment Service are actually different from those actually practiced by medical institutions and taught to biomedical students in textbooks. Therefore, we verified whether different sediment preparation methods lead different test results. Specimens that tested positive from the occult blood and leukocyte esterase in the urine dipstick test were randomly selected for a microscopic examination. The differences in the urine sediment preparation affected the sediment concentrations, which influenced the cell grade and cell number per HPF. The first factor in determining the sediment concentration is the centrifugal force. Many medical institutions use 1,500 rpm as the centrifugal speed without considering the radius of the centrifuge; such a value may not be accurate for 400 G. Consequently, there were differences in urine concentrations, which influenced the results. The second factor is the amount of sediment in urine. Different amounts of the remaining supernatant led to different sediment concentration factors, again, causing different results. Furthermore, not only by using a pipette to obtain an accurate amount as stipulated, but also by roughly obtaining a drop, the microscopic examination using such a volume of sediment examined affected the results. Therefore, this study highlights the importance of standardization of urine sediment preparation procedures to promote consistency and accuracy across institutions.

A Study on Home Visiting Hospice Care of the Terminally Ill Patients (가정 호스피스케어환자 방문간호 조사분석)

  • Lee, So-Woo;Lee, Eun-Ok;Park, Hyun-Ae;Oh, Hyo-Sook;Ahn, Hyo-Seop;Huh, Dae-Suk;Yun, Young-Ho;Kim, Dal-Sook;Rho, Yoo-Ja
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.39-46
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    • 1998
  • Purpose : Hospice Care is considered as one of the most perfect solutions for the problems brought up as the number of chronically ill patients are increasing rapidly and most of social welfare oriented countries are seeking the quality of life. Our former studies(1996, 1997) were to find out the current status of the hospice care in Korea by surveying terminally ill patients and their family members as well as medical professionals. The former study was also to conduct the operation research by developing an information service system for training of hospice care teams and volunteers, and hospice patients management. The purpose of this study was that hospice information service system was tested by home visiting hospice care through visiting nurses. Methods : From October 1, 1997 to March 31, 1998, Twenty six terminal cancer patients were included in this study from Seoul National University Hospital and other hospital. Databases and homepage, hospice information service system were designed and developed for the information needed for the hospice care before this study by our research team and this services were available through the internet. Visiting nurses were trained about this system and they visited the patients with PC notebook and provided them hospice care with hospice information system. They collected physical, psychiatric, social data of the subjects at the first visit and during hospice care at home. Results : Sixteen subjects(61.5%) died during the study and the mean survival was 20.7 days. Anorexia(96.2%), immobility(88.5%) and pain(84.6%) were the major symptom in the 26 subjects, Altered nutrition(26.1%) and pain(12.4%) were the most frequent diagnoses in 226 nursing diagnoses of the subjects. Families understood and demanded the hospice care more than patients. And most patients and families didn't demand spiritual or social care. Conclusion : Through this demonstration study, it was found that we have to provide the information of pain management and nutritional support for patients by the nurses and visiting hospice nurse. The information service system needs to be upgraded with information and manpower of spiritual and social care according to the findings.

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Development of Curriculum for the Emergency Clinical Nurse Specialist (응급전문간호사의 교육과정안 개발)

  • 김광주;이향련;김귀분
    • Journal of Korean Academy of Nursing
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    • v.26 no.1
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    • pp.194-222
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    • 1996
  • Various accidents and injuries are currently occurring in Korea at increasingly high rates. Good quality emergency care service is urgently needed to cope with these various forms of accidents and injuries. In order to develop a sound emergency care system, there need to be a plan to educate and train professionals specifically in emergency care. One solution for the on going problem would be to educate and train emergency clinical nurse specialists. This study on a strategy for curriculum development for emergency clinical nurse specialist was based on the following five content areas, developed from literature related to the curriculum of emergency nursing and emergency care situation : 1. Nurses working in the emergency rooms of three university hospitals were analyzed for six days to identify categories of nursing activities. 2. Two hundreds and eleven nurses working in the emergency rooms of 12 university hospitals were surveyed to identify needs for educational content that should be included in a curriculum for the clinical nurse specialist. 3. Examination of the environment in which emergency management was provided. 4. Identification of characteristics of patients in the emergency room. 5. The role of emergency clinical nurse specialist was identified through literature, recent data, and research materials. The following curriculum was formulated using the above mentioned process. 1. The philosophy of education for emergency clinical nurse specialist was established through a realistic philosophical framework. In this frame, client, environment, health, nursing, and learning have been defined. 2. The purpose of education is framed on individual development, social structure, nursing process and responsibility along with the role and function of the emergency clinical nurse specialist. 3. The central theme was based on human, environment, health and nursing. 4. The elements of structure in the curriculum content were divided to include two major threads, I, e., vertical and horizontal : The vertical thread to consist of the client, life cycle, education, research, leadership and consultation, and the horizontal thread to consist of level of nursing (prevention to rehabilitation), and health to illness based on the health care system developed by Betty Neuman system model. 5. Behavioral objectives for education were structured according to the emergency clinical nurse specialist role and function as a master degree prepared in various emergency settings. 6. The content of the curriculum consisted of three core courses(9 credits), five major courses(15 credits), six elective courses(12 credits) and six prerequisite courses (12 credits). Thus 48 credits are required. Recommendations : 1. To promote tile quality of the emergency care system, the number of emergency professionals, has to be expanded. Further the role and function of the emergency clinical nurse specialist needs to be specified in both the medical law and the Nursing Practice Act. 2. In order to upgrade the qualification of emergency clinical nurse specialists, the course should be given as part of the graduate Program. 3. Certification should be issued through the Korean Nurses Association.

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Respite Care와 영적케어의 고찰

  • Sin, Min-Seon
    • Korean Journal of Hospice Care
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    • v.5 no.1
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    • pp.50-62
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    • 2005
  • The elderly people was over 8.3% in 2003. This seament is projected to grow to 14.4% by 2019(Aged society) and over 20% by 2026(Super aged society). As the elderly population is increasing and young population is declined social issues around elderly care are emerged in Korea. As a result of that, they are in the condition of poor system of the welfare of the old and it is the worst one in Korea. And because of the worst financial independence and difficulty in Korea, welfare facilities and medical instruments are so insufficient and deteriorated, so the quality of service is getting low. Furthermore the mortality of cancer is rapidely increased in recent years. So it is expected that the number of families who are caring for terminal cancer patient will be increased. We can not solve those problems only with government's policy such as to secure ample budget and to enlarge the aged welfare institutions. Definitely, to acheve the suggetions persistence concern about old people is most important, and family, community and national government should be linked to accomplish to goal. Accordingly, for this study attempts to provide conceptual framework of the respite care, spiritual care and home hospice, nursing home for the elderly. And this study is to discuss the necessity and effect about the construction of housing welfare infrastructure and to make a cooperation and linkage system among the aged welfare institutions, government and the aged welfare programs. As is well known, the issue of the increasing aged people is neither a matter of individuals nor of the family, but rather a complex matter of whol society. Therefore it can be resolved by the active participation of government. Conclusively this study tries to provide an direction of the improvement with regard to the welfare policy for the elderly. The study is as follwos: Chapters 1: The theological base, conception, essentiality, respite care, spiritual care and home hospice, nursing home for the elderly. Chapters 2: Definitions of respite care, spiritual care, hospice, patient of termina cancer and quality of life. And relations between respite care and nursing home. Chapters 3: The necessity of long-term care insurance and the perspectives of spiritual care. Chapters 4: Conclusions and summarizing(The directions of improvement of welfare policy for the elderly). To sum up, the problems of the aged people has not effects only to the aged people. This means that the problems of aged is the problems of the young generation today. Because young generation will be the old generation in the near future.

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A Performance Evaluation of Diagnostic X-ray Unit Depends on the Hospitals Size (병원 규모별 진단용 X선 발생장치의 성능 평가)

  • Park, Ju-Hun;Im, In-Chul;Dong, Kyung-Rae;Kang, Se-Sik
    • Journal of Radiation Protection and Research
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    • v.34 no.1
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    • pp.31-36
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    • 2009
  • The purpose of this study is to measure the tube voltage, the tube current/volume, exposure time and exposure dose of diagnostic X-ray unit in each doctor offices, hospitals and general hospitals for evaluating the performance of such device, to learn the method and technology of its measurement and to suggest its importance. Research subjects were total 30 X-ray units and divided into groups of 10 X-ray units each. The tube voltage, the tube current/volume, exposure time and exposure dose were measured using percentage average error, and then reproducibility of exposure dose was measured through calculating coefficient of variation. The results are like followings; The tube voltage correctness examination showed that incongruent devices among total 30 X-ray units were 5 devices (16.7%). The tube current correctness examination showed that incongruent X-ray units were 3 devices (10.0%). The tube current volume correctness examination showed that incongruent X-ray units were 4 devices (13.3%). Finally, according to exposure time correctness examination, incongruent X-ray units were 5 devices (16.7%) and according to reproducibility examination of exposure dose, incongruent X-ray units were 7 devices (23.3%). Above results showed serious problem in performance management based on management regulation of diagnostic X-ray unit; it means that regular checkout and safety management are required, and as doing so, patients will be able to receive good quality of medical service by the reduction of radiation exposure time, image quality administration, unnecessary retake and etc. Therefore, this study suggests that the performance of diagnostic X-ray units should be checked regularly.

A Study on the Experience of Non-face-to-face Lecture by College Freshmen Using Focus Group Interview (포커스 그룹 인터뷰를 활용한 대학 신입생들의 비대면 강의 경험에 대한 연구)

  • Kang, Jin-Ho;Son, Sung-Min;Han, Sueng-Tae
    • Journal of Korea Entertainment Industry Association
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    • v.14 no.7
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    • pp.397-408
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    • 2020
  • This study conducted a focus group interview with 15 college freshman from J college to find out their experiences in non-face-to-face lectures with COVID-19. The contents of the interview were recorded and conducted, and the meaning was analyzed according to the focus group interview procedure through repeated listening. Components were 'Operation of non-face-to-face lectures in unprepared situations', 'Loss of orientation in lectures and departure from learning', 'One way listening', 'The convenience of taking a lectures'. The experience of 'Operating non-face-to-face lectures in unprepared situations' included the start of mixed non-face-to-face lectures, cumbersome and inconvenient online systems, and the demand for tuition refunds. The experience of 'Loss of orientation in lectures and departure from learning' has experienced difficulty in concentrating on lectures, Deficiency in the degree of recognition of learning content, and burden of assignments and exams. The experience of 'One way listening' has experienced lack of interaction between professors and learners and non reflection of liveliness in the field. Finally, participants experienced satisfaction with being able to lectures and repeat lectures at anytime and anywhere they wanted with the convenience of taking lectures. Based on this study, participants called for improvements in the quality lecture contents and interaction between professors and learners, and it is thought that universities will need administrative and financial support and education design and system construction to construct high-quality lecture contents.

Development of Linking & Management System for High-Resolution Raw Geo-spatial Data based on the Point Cloud DB (Point Cloud 기반의 고해상도 원시데이터 연계 및 관리시스템 개발)

  • KIM, Jae-Hak;LEE, Dong-Ha
    • Journal of the Korean Association of Geographic Information Studies
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    • v.21 no.4
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    • pp.132-144
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    • 2018
  • 3D Geo-spatial information models have been widely used in the field of Civil Engineering, Medical, Computer Graphics, Urban Management and many other. Especially, in surveying and geo-spatial field, the demand for high quality 3D geospatial information and indoor spatial information is so highly increasing. However, it is so difficult to provide a low-cost and high efficiency service to the field which demand the highest quality of 3D model, because pre-constructed spatial data are composed of different formats and storage structures according to the application purpose of each institutes. In fact, the techniques to construct a high applicable 3D geo-spatial model is very expensive to collect and analyze geo-spatial data, but most demanders of 3D geo-spatial model never want to pay the high-cost to that. This study, therefore, suggest the effective way to construct 3D geo-spatial model with low-cost of construction. In general, the effective way to reduce the cost of constructing 3D geo-spatial model as presented in previous studies is to combine the raw data obtained from point cloud observatory and UAV imagery, however this method has some limitation of usage from difficulties to approve the use of raw data because of those have been managed separately by various institutes. To solve this problem, we developed the linking & management system for unifying a high-Resolution raw geo-spatial data based on the point cloud DB and apply this system to extract the basic database from 3D geo-spatial mode for the road database registration. As a result of this study, it can be provided six contents of main entries for road registration by applying the developed system based on the point cloud DB.

The Effects of Standardized Suction and Ventilator Management Protocol on Ventilator Associated Pneumonia in the Intensive Care Unit (중환자실 흡인간호 및 인공호흡기관리 표준화를 통한 인공호흡기 관련 폐렴발생 감소효과에 관한 연구)

  • Song, Kyung Ja;Yoo, Cheong Suk;Kwon, Eun Ok;Jung, Eun Ja;Shin, Hyeon Ju;Park, Ock Hyang;Ok, Sun Ok;Yu, Mi;Yun, Sun Hee;Lee, Bok Nam;Choi, Jin Ah;Hwang, Jeong Hae;Oh, Hyang Soon
    • Quality Improvement in Health Care
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    • v.8 no.1
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    • pp.44-55
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    • 2001
  • Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.

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Prioritizing Themes Using a Delphi Survey on Patient Safety Theme Reports (환자안전 주제별 보고서의 주제 우선순위 설정: 델파이 조사를 통한 분석)

  • Park, Jeong Yun;Shin, Eun-Jung;Kim, Rhieun;Kim, Sukyeong;Park, Choon-Seon;Park, Taezoon;Choi, Yun-Kyoung;Heo, Young-Hee
    • Quality Improvement in Health Care
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    • v.28 no.1
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    • pp.45-54
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    • 2022
  • Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.