• Journal of Korean Clinical Nursing Research
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• v.21 no.3
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• pp.277-292
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• 2015

Purpose: The purpose of this study was to develop a Clinical Ladder System (CLS) model for staff nurses working in inpatient units of tertiary care hospitals in Korea. Methods: The study was carried out in 2 steps. First, a nursing competence evaluation scale was developed. Second, evaluation of the nursing competences, qualifications, and professional activities of 230 nurses from five tertiary care hospitals was done by 49 head nurses between Feb. and Dec., 2014. Nurses were selected by head nurses according to their clinical experience and expected behavioral characteristics at each level of the ladder. Results: A nursing competence scale was developed consisting of 5 subcategories (clinical practice, ethical practice, education, leadership, and professional development) and 11 elements, and 5 levels of behavioral indicators for each element. Cronbach's alphas for the entire tool and subcategories were over .853 and stability of the scale was confirmed. There were significant differences in nursing competence according to the 5 levels of the ladder. Conclusion: The findings indicate that the proposed CLS model with a standard score for nursing competence, recommended or obligatory criteria for qualifications and professional activities provides a good tool for developing nurses' competences and retaining excellent nurses in clinical practice.

• Journal of Yeungnam Medical Science
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• v.40 no.2
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• pp.156-163
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• 2023

Background: Interest in digital medical information has increased because it allows doctors to easily access a patient's medical records and provide appropriate medical care. Blockchain technology ensures data safety, reliability, integrity, and transparency by distributing medical data to all users over a peer-to-peer network. This study attempted to assess pediatricians' thoughts and attitudes toward introducing blockchain technology into the medical field. Methods: This study used a questionnaire survey to examine the thoughts and attitudes of 30- to 60-year-old pediatricians regarding the introduction of blockchain technology into the medical field. Responses to each item were recorded on a scale ranging from 1 (never agree) to 7 (completely agree). Results: The scores for the intentions and expectations of using blockchain technology were 4.0 to 4.6. Pediatricians from tertiary hospitals responded more positively (4.5-4.9) to the idea of using blockchain technology for hospital work relative to the general population (4.3-4.7). However, pediatricians working in primary and secondary hospitals had a slightly negative view of the application of blockchain technology to hospital work (p=0.018). Conclusion: When introducing the medical records of related pediatric and adolescent patients using blockchain technology in the future, it would be better to conduct a pilot project that prioritizes pediatricians in tertiary hospitals. The cost, policy, and market participants' perceptions are essential factors to consider when introducing technology in the medical field.

• Journal of Korean Clinical Nursing Research
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• v.29 no.3
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• pp.238-248
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• 2023

Purpose: This study aimed to examine the relationships between positive nursing organizational culture, organizational communication satisfaction, and the level of work engagement among nurses working in tertiary hospitals, as well as to identify influencing factors on work engagement. Methods: This study used a descriptive research design. Data were collected from 184 general nurses working in four tertiary hospitals in Seoul using self-report questionnaires from March 13 to 30, 2023. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson correlation, and hierarchical regression. Results: In the hierarchical regression analysis, the variables that significantly influenced work engagement in Model 1 were marital status (β=.26, p=.002), graduate or higher degree (β=.41, p<.001), more than 1 year and less than 3 years (β=.18, p=.030) and 3 years or more but less than 5 years of clinical experience in present hospital (β=.17, p=.023), and satisfaction (β=.27, p=.002) and moderate satisfaction with pay (β=.18, p=.033). In model 2, adding the subdomains of positive nursing organizational culture and organizational communication satisfaction to the Model 1, the variables that had a significant effect on work engagement were trust-based organizational relationships (β=.50, p<.001) and organizational communication satisfaction (β=.25, p=.005). Conclusion: The results suggest that education level, clinical experience, and satisfaction with pay should be considered to improve nurses' work engagement. In addition, it was identified that organizational relationship based on trust and organizational communication satisfaction are the main influencing factors for improving work engagement.

• Clinical and Experimental Vaccine Research
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• v.12 no.4
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• pp.313-318
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• 2023

Purpose: Globally, 25 million children were either unvaccinated or under-vaccinated in year 2021. Among them, India had the highest number of children unvaccinated. Studies have shown impact of coronavirus disease 2019 (COVID-19) pandemic on routine health-care services. Present study aimed to estimate the impact of COVID-19 on utilization of routine immunization services during years 2020 and 2021 in tertiary-care facility. Materials and Methods: Record based descriptive analytic study was conducted at pediatric tertiary-care hospital, Jaipur. Data of children vaccinated as per the National Immunization Schedule for the period January 2019 to December 2021 were retrieved from the immunization records. Doses administered were assessed as a proxy measure of vaccine coverage. The vaccination trends of 2020 and 2021 were compared assuming base year 2019. Unpaired t-test of significance and Pearson correlation was used for correlation analysis. Results: There was significant drop in the vaccine counts after emergence of COVID-19 pandemic. In year 2020 and 2021, mean monthly vaccine count was 2,190±715.1 and 2,305±393.2, respectively, in which maximum drop was in April 2020 (-79.12%) and May 2021 (-57.16%) when it was compared with matched month of base year. There was negative correlation between percent change in vaccine count and COVID-19 cases in 2020 (r=-0.057, p=0.861) and 2021 (r=-0.827, p=0.001) as compared to year 2019. Conclusion: Study concludes that there was a significant gap in utilization of routine immunization services during the COVID-19 pandemic. This necessitates planning and management of routine immunization services in-case of future pandemics to avoid resurgence of vaccine-preventable diseases in the Rajasthan.

• Journal of muscle and joint health
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• v.31 no.2
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• pp.86-94
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• 2024

Purpose: The goal of this study aimed to understand the factors influencing the empathy competence and moral sensitivity of nurses working in tertiary general hospitals who offered end-of-life care. Methods: Descriptive data were collected from self-reported questionnaires completed by 164 nurses with direct nursing care experience with end-of-life patients at two tertiary general hospitals located in Busan, Korea. The variables examined were empathy competence, moral sensitivity, and end-of-life care performance. Data were analyzed using SPSS version 27.0 software. Results: Participants scored 3.73±0.40 on empathy competence, 4.97±0.51 on moral sensitivity and 2.91±0.37 on end-of-life care performance. There was a significant positive correlation between empathy competence and end-of-life care performance, and between moral sensitivity and end-of-life care performance. The factors affecting nurses' end-of-life care performance, empathy competence and moral sensitivity, exhibited with an explanatory power of 31%. Conclusion: Programs to increase empathy competence and moral sensitivity should be developed to improve nurses' end-of-life care performance.

• Journal of Hospice and Palliative Care
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• v.20 no.4
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• pp.253-263
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• 2017

Purpose: To develop end-of-life care training programs for nurses who provide in a tertiary hospital, we examined the mediating effects of empathy and resilience on the relationship between their stress and job performance. Methods: This study was conducted with 218 participants at a hospital in B city in South Korea from August 15 through August 30, 2017. Data collected from the participants were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using the IBM SPSS/WIN 21.0 software. Results: Terminal care stress was found to be negatively correlated with empathy competence (r=-0.345, P<0.001), resilience (r=-0.223, P=0.001) and terminal care performance (r=-0.260, P<0.001), whereas empathy (r=0.467, P<0.001) and resilience (r=0.358, P<0.001) were positively correlated with terminal care performance. Empathy had a complete mediating effect (${\beta}=0.409$, P<0.001) on the relationship between terminal care stress and performance, and resilience a partial mediating effect (${\beta}=0.294$, P<0.001). Conclusion: Based on the findings of this study, development of training programs with a focus on empathy and resilience are highly recommended to improve job performance of nurses who provide terminal care in a tertiary hospital.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.88-104
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• 2002

According to the change of mandatory referral system in July 1, 2000, the effect to the medical utilization of outpatient clinic and medical income in ophthalmology of tertiary care medical institute, S Hospital in Seoul was evaluated for 6 months before(1999. 12$\sim$2000. 5) and after(2000. 12$\sim$2001. 5). The results were as follows: 1. The number of outpatients was reduced by 16.6%. The number of patient with blindness low vision, retina, glaucoma increased and that of patient with accommodation refractive error, cataract decreased. 2. The number of cataract patients was reduced by 36.6%. The major location of patient's address was changed to nearer to the hospital. The number of cataract surgery reduced in 4.1%, the waiting time reduced in 42.2%, however surgery time increased in 20.2% and number of postoperative complications increased in 11.4%. 3. The income of outpatient clinic and cataract surgery reduced. Among items of outpatient clinic income, the most increased was ocular examination and the most reduced was injection and drugs. Among items of cataract surgery income, the most increased was operation fee and the most decreased was doctor's fee. In conclusion, for the patient, due to the lowered density of outpatient population more space was provided to the patients with more severe disease entity such as blindness' low vision, retina and glaucoma. For the hospital, the need for the expansion of ophthalmology was not found, however that for creation of the special clinics dealing with more severe disease entity was found. Due to reduced income and increased need of financial investment for the equipment and manpower for the more severe disease entity, the ophthalmology of tertiary care medical institute is faced with financial disaster. It is strongly suggested that the cost of medical practice of more severe disease entity be raised to achieve the success after change of mandatory referral system in ophthalmology.

• Journal of Trauma and Injury
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• v.19 no.2
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• pp.159-163
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• 2006

Purpose: The number of patients transported by the Helicopter Emergency Medical Service (HEMS) has increased recently. In our review of the Korean HEMS, there was no established helicopter utilization criteria or triage tool on the scene, so many patients with minor injuries were transported to tertiary care centers. The aim of this study is to evaluate the percentage of patients with minor injuries and to propose a more appropriate triage tool for predicting the need for transport to a tertiary care center. Methods: The subjects of this study were 59 trauma patients transported to Asan Medical Center (AMC) from the scene by Seoul HEMS from January 2004 to December 2005. The Triage score (TS), Injury Severity Score (ISS), and modified Canadian Triage and Acuity Scale (mCTAS) were calculated as severity scales. Patients with minor injuries were defined as those with TS=9, ISS${\leq}15$, and mCTAS${\geq}3$. We evaluated the association of TS, ISS, and mCTAS with the appropriateness of transport. Results: Many of the patients transported to tertiary medical centers were classified as having a minor injury: TS=9 group 35 cases (72.9%), ISS${\leq}15$ group 30 cases (62.5%) and mCTAS${\geq}3$ group 27 cases (56.2%). However, 56.2% (27/59) of the patients were appropriately transported according to need for admission or an operation. The more severely injured patients classified by TS, ISS, and mCTAS were more appropriately transported to a tertiary center (p<0.05). Conclusion: Many patients with minor injuries were transported to a tertiary center from the scene directly. The TS can be easily calculated by an emergency medical technician at the scene. Thus, we propose the TS as a useful triage tool for determining the necessity of transport to a tertiary center by helicopter.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.6
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• pp.2801-2804
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• 2016

It is conventionally accepted that renal cell carcinoma (RCC) occurs in older patients and the clear cell type is the most common histology. However, ethnic variations exist and this study was carried out to determine the epidemiological pattern of RCC in Oman. Ninety RCC patients who presented to a tertiary care center in the Sultanate of Oman from 2010 to 2014 were studied. The main findings were that the median age of presentation was low, more patients presented with localized stage, and there was a higher incidence of non-clear (especially papillary) histology. Data from other Gulf countries and possible reasons for the different profile are discussed.

• Korea Journal of Hospital Management
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• v.23 no.2
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• pp.18-27
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• 2018

Purposes: This study aims to investigate the policy effect of mandatory application of DRG for 7 disease groups in general and tertiary hospitals. Methodology: As DRG was fully implemented in July 2013, this study compares two periods before and after the change(from July 2012 to June 2013, and from July 2013 to June 2014). The benefit claim data of the National Health Insurance Service was used for the comparison. Target patients were those who visited general or tertiary hospitals between July 2012 to June 2014. For pharmaceutical consumption, Interrupted Time Series (ITS) analysis was used to see the effect of DRG mandatory application. Findings: The number of drugs prescribed per patient and pharmaceutical expenditure both showed significant reduction compared to before the DRG implementation. Practical Implications: This study used 2 sets of 1 year period data from before and after the full implementation of DRG to analyze pharmaceutical consumption. When the comparison data accumulates further, it would be possible to conduct more diverse analysis to assess policy effect and to provide way forward for the future.