Objective : Due to the implementation of vaccinations and the development of therapeutic agents, the coronavirus disease 2019 (COVID-19) pandemic that started at the end of 2019 has entered a new phase. As a result, neurosurgeons should reconsider the way they treat their patients. As the COVID-19 situation prolongs, the change in neurosurgical emergency patients according to the number of confirmed cases is no longer clear. Outpatient treatment by telephone was permitted according to government policy. In addition, visits to caregivers in the intensive care unit were limited. Methods : The electronic medical records of patients who had been treated over the phone for a month (during April 2020, while the hospital was closing) were reviewed. Meanwhile, according to the limited visits to the intensive care unit, a video meeting was held with the caregivers. After the video meeting, satisfaction was evaluated using a questionnaire. Results : During April 2020, 1021 patients received non-face-to-face care over the telephone. Among the patients, no critical medical problem occurred due to non-face-to-face care. From July 2021 to December 2021, 321 patients were admitted to the neurosurgical intensive care unit and 107 patients (33.3%) including their caregivers agreed to video visits. Twice a week, advance notice was given that access would be made through a mobile device and the nurse explained to caregivers how to use the mobile device. The time for the video meeting was approximately 20 minutes per patient. Based on the questionnaire, 81 respondents (75.7%) answered that they agreed, and 26 respondents (24.3%) answered that they strongly agreed that was easy to communicate through video meetings. Fifty-two (48.6%) agreed and 55 (51.4%) strongly agreed that they were easy to understand the doctor's explanation. For overall satisfaction with this video meeting, three respondents (2.8%) gave 4/5 points and 95 respondents (88.8%) gave 5/5 points, and nine (8.4%) gave 3/5 points. Their reason was that there was not enough time. Conclusion : In situations where patient visits are limited, video meetings through a mobile device can provide sufficient satisfaction to caregivers. Telemedicine will likely become common in the near future. Health care professionals should prepare and respond to these needs and changes. Therefore, establishing a system with institutional support is necessary.
Purpose: The purpose of this study is to understand the effect of the unique product recommendation system on customer satisfaction. Research design, data and methodology: The survey method used the self-recording way in which the respondents selected for the study and distributed 300 questionnaires, and with due personal care, researchers collected all the distributed questionnaires. Results: The result implies that the characteristics of the product recommendation system should be more secure and developed. Conclusions: The aspects of the product recommendation system were selected as factors of price fairness, accuracy, and quality through previous studies, and the empirical analysis of the effect of the characteristics of the product recommendation system on customer satisfaction was summarized as follows. Among the attributes of the product recommendation system, the attributes of price fairness, accuracy, and quality affect customer satisfaction. Among them, the beta value of quality was the highest, and the effect of quality was the largest among the three factors. Based on the results of the study, the implications for the characteristics of the product recommendation system are summarized as follows. The aspects of the product recommendation system have a positive effect on customer satisfaction, so it is necessary to fill the needs of consumers based on the survey focused on quality
The purpose of this study were to find out the practical way to enlarged child-raising knowledge and to enhance their satisfaction with out-patient care by evaluating how effectively the education is done by nurses for mothers with ill-child and how their satisfaction with out-patient care changed. This study was designed as a Nonequivalent Control Group study. The subjects studied were consisted of the experimental and control group. Each consisted of 50 mothers with ill-child in pediatric department at one university hospital in Seoul. The period of this study is from May 20, 1996 to J one 28, 1996. The first data were collected from both of experimental and control groups in which mothers with ill-child come to the hospital for the first time. After this being done, the experimental group had been educated by the planned program and then the second data were collected from them. On the contrary, as for the control group, there had been no education and the second data were col looted on the same method. The data analysis was done by SPSS program. The results of this study are as follow, 1 The child-raising knowledge level of mothers with education was higher than that of with no education. (t=18.84, df=49, p=0.000) 2. The satisfaction with out-patient care level of mothers with education was higher than that of no education. (t=10.51, df=49, p=0.000) Based on these results, I suggest as follow, 1. The research on the patients and their family should be made not only in pediatric department, but in every out-patient department. 2. For more effective education, it is required for all out-patient nurses to research the education demand of patients and their family. 3. To increase the effect of education, there must be the consultation room in out-patient department. 4. The meetings with the mothers with ill-child of the same illness have to be established and periodical education must be executed. 5. Audio-visual education programs like video tapes are needed to make use of waiting time for the medical treatment. 6. On-line consulting programs are needed.
Recognition of the usefulness and the importance of the nursing diagnosis is increasing. There is a prevailing opinion that nursing diagnosis should be used to improve the quality of nursing care. Developing standardized nursing care palns based on nursing diagnoses is therefore considered one of the most essential projects for professional growth and improvement in the nursing world of Korea. Consequently, in the first stage of this research project, the ten nursing diagnses used most frequently with patients on medical and surgical wards were determined and related nursing care plans were developed, implemented and evaluated. The application of the standardized nursing care plans raised the nurses' confidence and proved to be effective in enhancing the quality of nursing care. This study was initiated as the next stage, to develop, test, and determine the validity of nursing care plans for the remaining nursing diagnoses. Nineteen medical and surgical wards were selected for the study ; the 176 staff nurses working on those wards and 1211 patients hospitalized there (603 patients during the nursing care plan use) took part in the project. The following summarizes the results of the study : 1. After listing all the nursing diagnoses up to the 20th in frequency from each ward except the ten used in the first study, 22 nursing diagnoses were selected. Two related to ‘self care deficit’, were combined into one. Standardized nursing care plans were established for these 21 nursing diagnoses. 2. The first page of each nursing care plan lists the related factors and defining characteristics as supporting data. The application rate distribution revealed that the majority were recorded less than 50% of the time. For each nursing diagnosis, only one to three related factors were recorded more than 50% of the time regardless of the number of suggested related factors, and similarly, only one to five defining characteristics were recorded more than 50% of the time regardless of the number of suggested defining characteristics. Therefore, these factors and defining characteristics were proposed as the common related factors and the typical signs and symptoms for each nursing diagnosis. 3. The application rate distribution for the expected outcomes, and the nursing orders that were the main data of each nursing care plan occurred more than 50% of the time, unlike the related factors and the characteristics that occurred less frequently. These findings supported the clinical validity. 4. In an effort to evaluate indirectly the effect of the use of the standardized nursing care plans, nurses' job satisfaction and perceptions of their ability in the use of the nursing process were measured and compared. Scores after the use of the plans were significantly higher than those before. The experience in actually using the standardized nursing care plans with patients increased the nurses' professional and emotional satisfaction and their confidence in using the nursing process. Also when the nurses who actually used the nursing care plans were asked to rate their effectiveness, the highest score was given to ‘the ease of establishing the nursing goal’, followed by ‘improved professional advice and care for patients’, ‘the efficiency and systemization of charting’, ‘the definite recognition of the nursing problem’, and ‘the selection of effective and appropriate nursing interventions’ in descending order. The results indicate the nurses were very positive about the effect of the real clinical application of standardized nursing care plans, and that the objective of this study to utilize the nursing diagnosis to strengthen the nursing process was attained.
Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.
Journal of Korean Academy of Nursing Administration
/
v.6
no.2
/
pp.211-225
/
2000
With the drastically changing healthcare market, the adoption of DRG system and the use of Critical Pathway will be increased gradually in order to care hospitalized patients qualitatively and manage cost-effectively in Korea. The purpose of this quasi-experimental research is to apply and analyze the developed critical pathway to the patients with Cesarean section. 35 eligible subjects for the control group were chosen from postpartum patients who has delivered at H-hospital in Kwang-ju, and were questioned after appling previous care plan from May to December, 1998. For the experimental group, 37 subjects were chosen and questioned after applying Critical Pathway service from January to June, 1999. The instruments are a critical pathway for the patients with Cesarean section developed by chung(1998) and a questionnaire that evaluate patients and family members' satisfaction level. Also, educational materials were used to inform them in the process of Critical Pathway application. As a result of chi-square test on general characteristics, there is significant difference between control group and experimental group only in terms of room size(p= .010). There are no significant differences in the average length of stay in the hospital between control group and experimental group(t=.078). Also, the average medical consult fee has no difference significantly between two groups(t= .105). The findings showed that the experimental group with critical pathway service scored significantly higher than control group on the satisfaction level toward care services(p=.000). The items are post-operative care, postpartum exercise technique, breast feeding and breast manage through educational materials. In conclusion, the research indicates that the application of planned Critical Pathway can have a positive impact on satisfaction level of inpatients with Cesarian section.
The purpose of this research is to identify causalities among service quality, service value, customer satisfaction and customer loyalty. A Structural Equation Model is used to test the hypothesis of conceptual model. To test the model, we collect data by conducting a survey with 508 patients. Empirical result indicates that three factors such as tangibles, assurance, and empathy have direct impact on service value and customer satisfaction. Especially, customer loyalty is positively related not with service value but with customer satisfaction.
This study is on understanding the reality of disabled seniors and investigation of factors that affect overall life satisfaction, making a proposal to improve their life quality. Situation data for the disabled, gathered by Korea Institute for Health and Social Affairs (KIHASA) in 2014, was used to perform the study, and the target group is 3,181 people with disability, above the age of 65. Descriptive statistics was presented for data analysis and logistic regression analysis was performed to investigate factors that affect life satisfaction. It was concluded from the analysis that gender, age, presence of spouse (demographic factors), house income, possession of house, presence of pensioner, registration to public pension plan, social discrimination (social-economical factors), level of disability, subjective health status, level of help needed for daily living, presence of care-giver, sufficiency of help, ability to go out by oneself, difficulty of using public transportations, and presence of medical checkups (disability and health factors.) make meaningful effects to life satisfaction of disabled seniors. Based on the derived results, this study suggests intensive interests and care-giving service for disabled seniors that live alone, institutional complementations to guarantee income security, including public or private pensions, improvements to social recognition and environments for discrimination of the disabled, organization of health and medical treatment service and health care system, comprehensive service provision to social welfare for both the disabled and seniors, and comprehensive service provision to both health care and social welfare.
This study was conducted to identify the factors that affect the output of health conters. An analystical model employed in this study was developed by modifying 'input-output model' and 'organizational behavior model'. Data were collected form two source; the 1995 report of thealth center which was submitted to the Ministry of Health and Welfare and a mail survey questionary of officers at health center, including 66 directors and 1,768 staffs of the health centers in southern region. The major findings are as follows: That analysis has identified the factors associated with dependent variables: medical services provided by the health center and health program performance(HPP). The number of primary medical facilities was negatively associated with health center performance while the number of staffs, job satisfaction, and professional background of health center directors were positively associated. These independent variables accounted for 40.1% of the variance of dependent variables. The variance of HPP was significantly explained by the number of health subcenter and primary health post, priority level of public health program by hief executive officers(CEOs) and legislator. A significant relationship was found between leadership types of health center directors and the performance of maternal and child health program. Considering these results, the authors suggested that the role in medical care service of health center in the should be rearranged at local level because medical care service of the health center is competing with primary medical facilities in the same region. It is also suggested that educational efforts be made to improve leadership of the health center directors and concern with public health program by the CEOs and legislators of local governments.
This study divided 409 local residents in G city of Gyeongsangbuk-do into urban area and rural area, and analyzed the satisfaction with using public health center. The subjects of this study were 284 people who had experience using public health centers among 409 people. In rural areas, satisfaction with general care, oriental care, dental care, physical therapy, examination, and vaccination was low. To improve this, it is necessary to expand and improve facilities so that smooth public health services can be provided to local residents. It is necessary to implement health care policies to resolve medical inequality between urban areas and rural areas.
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