• 기록학연구
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• 제31호
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• pp.43-93
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• 2012

인적자원의 질은 사회 운용의 효율을 높이는 핵심 요소이다. 세계 각국은 국가 직무능력표준을 개발하고 이를 인적자원관리에 활용하고 있다. 이러한 추세에 발맞춰 기록관리분야 역시 직무능력표준을 개발하고 이를 중심에 두는 인적자원개발체제를 구축해갈 필요가 있다. 각급기관에 기록물관리전문요원이 배치되고 기록관 조직이 운용되고는 있으나 직무상 성장 발전이 요구되고 있음은 주지의 사실이다. 이러한 상황에서 기록관리 직무를 수행하는데 필요한 직무능력을 규명하고 이를 활용하는 것은 전문요원의 전문성 강화의 측면에서나 기록관 업무의 정상화의 측면에서나 의미 있는 일이다. 본 연구에서는 공공영역과 민간영역의 기록관리 전 분야에 활용가능한 직무능력표준을 개발하는 절차와 방법론을 제시하였다. 그리고 표준의 설계과정에 대한 예시를 보여줌으로써 기록관리분야의 직무능력표준 개발의 가능성과 타당성, 활용성 등을 확인하고자 하였다. 또한 기록관리분야의 직무능력모형과 각 능력 단위별 요소들을 제시하였다. 최근 이슈로 부각된 기록관리의 전문성을 입증하기 위한 방법론을 마련하고 기록관리분야의 인적자원개발시스템을 도입하는데 본 연구가 도움이 될 수 있기를 기대해 본다.

• Advances in pediatric surgery
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• 제17권2호
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• pp.139-144
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• 2011

Hypertrophic pyloric stenosis (HPS) is the most common infantile surgical condition and the standard treatment is open pyloromyotomy. Recently, laparoscopic techniques have rapidly advanced, and the laparoscopic approach has become widely adopted by pediatric surgeons. The aim of this study was to compare the clinical outcomes between open and laparoscopic pyloromyotomy. We retrospectively evaluated outcomes of pyloromyotomy for HPS by the open (OP) and the laparoscopic (LP) method. The procedures were performed at the Samsung Medical Center between September 2001 and March 2009. We analyzed patient age, sex, birth weight, length of hospital stay, postoperative length of stay (LOS), operating time, time to feeding commencement, postoperative vomiting frequency, the time to full feeding without vomiting, and surgical complications. A total of 54 patients were included in the study. There were 26 OP and 28 LP patients. There was no statistically significant difference in age, sex, birth weight, operating time, postoperative emesis. In contrast, postoperative LOS in the LP group was statistically significantly shorter than that in the OP group (2.0 vs. 3.3 days, p=0.0003) and time to full feeding was significantly shorter following LP. (p=0.018) There were no wound complications. Laparoscopic pyloromyotomy significantly reduced postoperative LOS and time to full feeding compared to open pyloromyotomy.

• 한국의료질향상학회지
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• 제19권2호
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• Archives of Plastic Surgery
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• 제40권2호
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• pp.104-108
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• 2013

Background Microsurgical techniques are considered standard procedures in reconstructive surgery. Although microsurgery by itself is defined as surgery aided by optical magnification, there are no guidelines for determining in which clinical situations a microscope or loupe should be used. Therefore, we conducted standardized experiments to objectively assess the impact of optical magnification in microsurgery. Methods Sixteen participants of microsurgical training courses had to complete 2 sets of experiments. Each set had to be performed with an unaided eye, surgical loupes, and a regular operating microscope. The first set of experiments included coaptation of a chicken femoral nerve, and the second set consisted of anastomosing porcine coronary arteries. Evaluation of the sutured nerves and vessels were performed by 2 experienced microsurgeons using an operating microscope. Results The 16 participants of the study completed all of the experiments. The nerve coaptation and vascular anastomoses exercises showed a direct relationship of error frequency and lower optical magnification, meaning that the highest number of microsurgical errors occurred with the unaided eye. For nerve coaptation, there was a strong relationship (P<0.05) between the number of mistakes and magnification, and this relationship was very strong (P<0.01) for vascular anastomoses. Conclusions We were able to prove that microsurgical success is directly related to optical magnification. The human eye's ability to discriminate potentially important anatomical structures is limited, which might be detrimental for clinical results. Although not legally mandatory, surgeries such as reparative surgery after hand trauma should be conducted with magnifying devices for achieving optimal patient outcomes.

• Industrial Engineering and Management Systems
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• 제15권3호
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• pp.231-238
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• 2016

Traditional acceptance sampling plans have focused on the proportion of nonconforming items as an attribute criterion for quality. In today's modern quality management under high quality production environments, the reduction of the deviation from a target value in a quality characteristic has become the most important purpose. In consequence, various inspection plans for the purpose of reducing the deviation from the target value in the quality characteristic have been investigated. In this case, a concept of the quality loss evaluated by the deviation from the target value has been accepted as the variable evaluation criterion of quality. Further, some quality measures based on the quality loss have been devised; e.g. the process loss and the process capability index. Then, as one of inspection plans based on the quality loss, the rigorous design procedure for the variable sampling plan having desired operating characteristics (VS-OC plan) indexed by the quality loss has been proposed by Yen and Chang in 2009. By the way, since the estimator of the quality loss obeys the non-central chi-square distribution, the rigorous design procedure for the VS-OC plan indexed by the quality loss is complicated. In particular, the rigorous design procedure for the VS-OC plan requires a large number of the repetitive and complicated numerical calculation about the non-central chi-square distribution. On the other hand, an approximate design procedure for the VS-OC plan has been proposed before the proposal of the above rigorous design procedure. The approximate design procedure for the VS-OC plan has been constructed by combining Patnaik approximation relating the non-central chi-square distribution to the central chi-square distribution and Wilson-Hilferty approximation relating the central chi-square distribution to the standard normal distribution. Then, the approximate design procedure has been devised as a convenient procedure without complicated and repetitive numerical calculations. In this study, through some comparisons between the rigorous and approximate design procedures, the applicability of the approximate design procedure has been confirmed.

• 해양환경안전학회지
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• 제17권4호
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• pp.391-398
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• 2011

최근 해상교통안전진단제도가 국내에 도입되면서 선박의 안전여부를 판별하는 중요한 핵심 기술 요소로 다양한 항행 환경을 인위적으로 재현하는 선박조종시뮬레이션이 활용되고 있다. 그러나 현행 시행지침에 명시된 진단기술은 국내 시뮬레이터 보유 기관에서 공통적으로 활용하고 있는 수행 절차 및 평가 방법 등을 일반화한 것으로 이에 대한 적절한 보완 또는 개선이 필요하다. 본 연구는 현행 선박조종시뮬레이션 진단기술의 기술력 분석과 함께 한계점 및 문제점 등의 적정성 평가를 수행하였다. 또한 선박조종시뮬레이션 선박모델의 표준화, 표준조선법, 평가 방법 등의 고도화 방안을 제시하였다. 이러한 연구 결과는 선박조종시뮬레이터 시스템 개선은 물론 해상교통안전진단제도에 활용되고 있는 진단 기술의 정량화 및 신뢰성 향상에 기여할 것으로 사료된다.

• Journal of Nutrition and Health
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• 제37권8호
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• pp.712-721
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• 2004

The objective of this study was to evaluate the microbiological quality of heating and after-heating processed foods for implementation of a HACCP system in day-care center foodservice operations. The evaluating points were microbial assessment and temperature of foods during receiving, cooking, and serving in heating process. In non-heating process, in addition to monitoring microbial assessment of food during preparation, cooking, and serving steps, the microbial populations of employees' hands and utensils and serving temperature were also evaluated. Microbiological quality was assessed using 3M Petrifilm$^{TM}$ to measure total plate count and coliforms for foods and utensils and Staphylococcus aureus for hands in five Gumi day-care centers. Microbiological quality assessment for foods and utensils is summarized as follows. Microbiological quality of the heating processed foods was satisfactory for cooking and serving steps. The internal temperature of food was above 74$^{\circ}C$. However, temperature control before the serving step was not achieved due to inappropriate time management between the cooking and serving steps. In the after-heating process, the total plate counts of boiled mungbean sprouts salad, blanched spinach salad, com vegetable salad were below the standard at the serving step. The majority of samples showed that coliforms exceeded the norm, which is thought to be the result of the cross-contamination from utensils. These results suggest that it is essential to educate employees on the importance of hand washing and of avoiding cross-contamination by using clean, sanitized equipment to serve food in the after-heating process. Establishing Sanitation Standard Operating Procedures (SSOPs) is an essential part of any HACCP system in day-care center foodservice operations.

• Journal of Chest Surgery
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• 제45권2호
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• pp.95-100
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• 2012

Background: The purpose of this report is to describe the perioperative outcomes of standard carotid endarterectomy (CEA) with general anesthesia, routine shunting, and tissue patching in symptomatic carotid stenoses. Materials and Methods: Between October 2007 and July 2011, 22 patients with symptomatic carotid stenosis (male/female, 19/3; mean age, $67.2{\pm}9.4$ years) underwent a combined total of 23 CEAs using a standardized technique. The strict surgical protocol included general anesthesia and standard carotid bifurcation endarterectomy with routine shunting. The 8-French Pruitt-Inahara shunt was used in all the patients. Results: During the ischemic time, the shunts were inserted within 2.5 minutes, and 5 patients (22.7%) revealed ischemic cerebral signals (flat wave) in electroencephalographic monitoring but recovered soon after insertion of the shunt. The mean shunting time for CEA was $59.1{\pm}10.3$ minutes. There was no perioperative mortality or even minor stroke. All patients woke up in the operating room or the operative care room before being moved to the ward. One patient had difficulty swallowing due to hypoglossal nerve palsy, but had completely recovered by 1 month postsurgery. Conclusion: Routine shunting is suggested to be a safe and reliable method of brain perfusion and protection during CEA in symptomatic carotid stenoses.

• Safety and Health at Work
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• 제4권2호
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• pp.100-104
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• 2013

Background: The aim of this study was to assess public and private medical diagnostic laboratories in Nigeria for the presence of biosafety equipment, devices, and measures. Methods: A total of 80 diagnostic laboratories in biosafety level 3 were assessed for the presence of biosafety equipment, devices, and compliance rate with biosafety practices. A detailed questionnaire and checklist was used to obtain the relevant information from enlisted laboratories. Results: The results showed the presence of an isolated unit for microbiological work, leak-proof working benches, self-closing doors, emergency exits, fire extinguisher(s), autoclaves, and hand washing sinks in 21.3%, 71.3%, 15.0%, 1.3%, 11.3%, 82.5%, and 67.5%, respectively, of all laboratories surveyed. It was observed that public diagnostic laboratories were significantly more likely to have an isolated unit for microbiological work (p = 0.001), hand washing sink (p = 0.003), and an autoclave ($p{\leq}0.001$) than private ones. Routine use of hand gloves, biosafety cabinet, and a first aid box was observed in 35.0%, 20.0%, and 2.5%, respectively, of all laboratories examined. Written standard operating procedures, biosafety manuals, and biohazard signs on door entrances were observed in 6.3%, 1.3%, and 3.8%, respectively, of all audited laboratories. No biosafety officer(s) or records of previous spills, or injuries and accidents, were observed in all diagnostic laboratories studied. Conclusion: In all laboratories (public and private) surveyed, marked deficiencies were observed in the area of administrative control responsible for implementing biosafety. Increased emphasis on provision of biosafety devices and compliance with standard codes of practices issued by relevant authorities is strongly advocated.

• 대한안전경영과학회지
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• 제18권4호
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• pp.81-90
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• 2016

Research and development activities have been actively conducted at universities, research institutions and research laboratories which belong to corporations. Because of blooming research and development activities in various fields, safety accidents in the laboratories happen consistently. The government office established Act on the establishment of safe laboratory environment to decrease safety accident rates and make environment of laboratories better, and it is effective slowly. However, in the case of laboratory safety management of the laboratory where various research and development activities are carried out. So it is difficult to closely monitor them. Even though safety inspections and periodic inspections is regularly conducted, these are focused on facilities and environment. According to a study of Dea-deok science town safety council, accidents in laboratories of 73% have arisen out of careless actions. Therefore, it is important for researchers to know to potential harmful factors in research. there is necessary to make a system to prevent laboratory accidents. The purpose of this study is that the researchers discovered potential hazard factors in laboratories. For that, foreign laboratory safety management systems has applied to domestic laboratories. Four laboratories in targeted institution has been selected to apply the appropriate personal protection equipments, job safety assessment and standard operating procedures. And I found the limitations of the process according to the excavations harmful factors in the research process. To overcome these limitations, Suggest a laboratory safety management system. This study discovered current laboratory safety system limitations and provides alternatives so that effective safety management can be achieved.