• Journal of Korean Society for Quality Management
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• v.43 no.1
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• pp.11-30
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• 2015

Purpose: The purpose of this study is to lay groundwork for future research on the outcomes of national quality awards for secondary-care healthcare organizations. Methods: For this study, a secondary-care hospital was selected through a convenience sampling method and all of its organizational members participated in complete enumeration survey using 109 survey questions derived from the MBNQA criteria for healthcare through structural equation modeling (SEM) Results: As a result, Leadership was shown to drive Foundation and Direction, which affect System that creates Results with 12 hypotheses supported out of 18 hypotheses established. Conclusion: The findings of this study will provide valuable implications to the top management of secondary-care hospitals for self-examining quality management and promoting sustainable competitiveness.

• Journal of Preventive Medicine and Public Health
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• v.27 no.3 s.47
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• pp.437-445
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• 1994

The objective of this study was to evaluate outcome for the patients of the intensive care unit, using APACHE III prognostic system. We prospectively collected the information of 429 patients in intensive care units at 2 tertiary care hospitals and 4 secondary care hospitals in PUSAN who had been admitted from December 1, 1993 to February 28, 1994. The results were as follows. 1. APACHE III scores were various from 0 to 173. But the distribution of the scores were similar between tertiary care hospitals and secondary care hospitals. 2. The mortality rate significantly increased as APACHE III score rised (p<0.001). Within the interval of same score, generally, the mortality of operative patients was higher in secondary care hospitals but in the case of nonoperative patients higher in tertiary care hospitals. 3. When the tertiary care hospitals compared with secondary for ratio of the predicted mortality rate to the actual mortality rate, there was little difference. 4. When we compared the 6 hospitals, one hospital had significantly better results and another hospital was significantly inferior (p<0.05).

• Journal of Hospice and Palliative Care
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• v.21 no.3
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• pp.84-91
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• 2018

Purpose: This study aims to investigate treatment of cancer patients at a secondary hospital. Methods: A retrospective analysis was performed with electronic medical records of cancer patients admitted to a secondary hospital from January 1, 2009 through September 31, 2017. Results: A total of 223 patients were studied. Sixty-nine patients were hospitalized for supportive care after receiving a surgery, chemotherapy, and radiotherapy at a tertiary hospital, 58 patients for other supportive care, 53 patients for symptom control, 16 patients with a decision not to take active cancer treatment, and 27 patients for treatment of cancer that was diagnosed during their hospital stay. Among 75 patients who were discharged to other institutions, 50 were transferred to tertiary hospitals, 10 to long-term care hospitals, eight to hospice hospitals, four to nursing homes and two to secondary hospitals. Comorbidities were found in 120 patients (53.8%). For patients who consulted with more than one department, more consultations were for non-cancer diseases than cancer. Seventy-three patients had a do-not-resuscitate order. Conclusion: For treatment of cancer patients, it is needed to establish a cooperation system among medical institutions and provide comprehensive management including treatment of comorbidities.

• Korean Journal of Adult Nursing
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• v.29 no.3
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• pp.290-301
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• 2017

Purpose: This study was aimed to identify the level of emotional labor, job stress and professional quality of life and to identify the factors affecting on professional quality of life among nurses in long-term care hospitals. Methods: 136 nurses working at eight different long-term care hospitals were recruited from May 1 to June 30, 2016. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson correlation, and stepwise multiple regression using SPSS/WIN 22.0. Results: Professional quality of life is consisted of three subcategories as compassion satisfaction, secondary traumatic stress and burn-out. As for the factors affecting on compassion satisfaction, age, satisfaction on working ward and shift pattern of duties were significant factors. The three variables' explanation power on compassion satisfaction was 25.0%. As for factors affecting on secondary traumatic stress, emotional labor was a significant factor. The emotional labor's explanation power on secondary traumatic stress was 13.0%. Factors affecting on burn-out, emotional labor, age, and health condition were significant factors. The three variables' explanation power on burnout is 31.0%. Conclusion: On the basis of results, program development are required to relieve emotional labor and job stress for nurses at long-term care hospitals and to improve their professional quality of life.

• Journal of Korean Biological Nursing Science
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• v.18 no.2
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• pp.69-77
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• 2016

Purpose: This study aimed to investigate the effects of a secondary stroke prevention education program on the health risk indicators and self-care compliance of stroke patients. Methods: A non-equivalent control group pretest-posttest design was used to select the participants. Subjects were 54 stroke patients (27 in the experimental group and 27 in the control group) hospitalized in a K university hospital in D city, Korea. Health risk indicators and self-care compliance were measured both for a baseline, as well as after intervention. The data was analyzed using a chi-square test, paired t-test and ANCOVA. Results: There were significant differences in systolic blood pressure, diastolic blood pressure, fasting blood sugar, weight and self-care compliance. Conclusion: The results of the study indicate that an educational secondary stroke prevention program is effective for health risk indicators and self-care compliance of patients. Therefore it can be used as an effective nursing intervention in clinical practice.

• Korean Circulation Journal
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• v.53 no.9
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• Journal of Korean Critical Care Nursing
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• v.5 no.1
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• pp.44-55
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• 2012

Purpose: The purpose of this study was to investigate perception of patient safety culture and safety care activity among hospital nurses and to identify factors associated with the safety care activity. Methods: A total of 399 nurses working at secondary or tertiary hospitals in B city were participated in. Data were collected using 'Questionnaire on Patient Safety' and 'Safety Care Activity Questionnaire'. Results: The mean score of patient safety culture was 3.41 out of possible 5. The mean score of safety care activity was 4.40 out of possible 5. There was a positive relation between the perception of patient safety culture and the safety care activity. Through stepwise regression analysis with 22.4% of accountability, it was found that the perception of the safety care activity was associated with communication process, a sub-domain of safety culture, marital status, experience of incidence reporting, and level of patient safety. Conclusion: The findings show the importance of communication among nurses to improve the safety care activity. To provide high quality of care for patients, it is necessary to educate nurses on fire safety, patient education, and medication safety and improve their communication skills.

• Journal of Yeungnam Medical Science
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• v.32 no.2
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• pp.143-145
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• 2015

Page kidney refers to the phenomenon of hypertension secondary to long-standing compression of renal parenchyma caused by renal subcapsular collection. The most common cause of renal subcapsular collection is a hematoma which usually occurs after a history of blunt trauma. A 42-year-old female patient who received botulinum toxin injection in her back during chiropractic care was admitted to the emergency room with sudden bilateral flank pain and hypertension. The computed tomography (CT) images demonstrated the presence of bilateral subcapsular renal hematoma. The patient was treated conservatively and recovered well. The follow up CT images showed markedly resolved bilateral hematoma.

• Research in Community and Public Health Nursing
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• v.12 no.1
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• pp.22-31
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• 2001

Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

• The Korean Journal of Pain
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• v.33 no.2
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• pp.166-175
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• 2020

Background: The effect of dexmedetomidine as an adjuvant in the adductor canal block (ACB) and sciatic popliteal block (SPB) on the postoperative tramadol-sparing effect following spinal anesthesia has not been evaluated. Methods: In this randomized, placebo-controlled study, ninety patients undergoing below knee trauma surgery were randomized to either the control group, using ropivacaine in the ACB + SPB; the block Dex group, using dexmedetomidine + ropivacaine in the ACB + SPB; or the systemic Dex group, using ropivacaine in the ACB + SPB + intravenous dexmedetomidine. The primary outcome was a comparison of postoperative cumulative tramadol patient-controlled analgesia (PCA) consumption at 48 hours. Secondary outcomes included time to first PCA bolus, pain score, neurological assessment, sedation score, and adverse effects at 0, 5, 10, 15, and 60 minutes, as well as 4, 6, 12, 18, 24, 30, 36, 42, and 48 hours after the block. Results: The mean ± standard deviation of cumulative tramadol consumption at 48 hours was 64.83 ± 51.17 mg in the control group and 41.33 ± 38.57 mg in the block Dex group (P = 0.008), using Mann-Whitney U-test. Time to first tramadol PCA bolus was earlier in the control group versus the block Dex group (P = 0.04). Other secondary outcomes were comparable. Conclusions: Postoperative tramadol consumption was reduced at 48 hours in patients receiving perineural or systemic dexmedetomidine with ACB and SPB in below knee trauma surgery.