• Journal of Yeungnam Medical Science
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• 제40권2호
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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.

• 임상간호연구
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• 제29권3호
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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.

• 대한예방한의학회지
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• 제10권2호
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• pp.147-158
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• 2006

The purpose of this paper is to review the empirical study results of conversion factors(unit prices) for relative values of health care services in the national health insurance system and establish optimal classification of health care institutions for feasible contract of conversion factors between National Health Insurance Corporation(NHIC) and provider groups, based on legal backgrounds and types of health care service delivery system. some empirical research evidences shows the validity of applying multiple conversion factors to annual contract for reimbursement in the national health insurance. Policy recommendations suggest that clinic, hospital, general hospital, tertiary hospital, dental clinic, oriental medical clinic, pharmacy, and public health centers would be a basic category of provider groups for a meaningful price contract between the NHIC and providers.

• 한국의료질향상학회지
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• 제26권1호
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• pp.11-22
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• 2020

Purpose: The objective of this study was to compare and analyze the work environment, role conflict, and job embeddedness between comprehensive nursing care service (CNCS) ward nurses and general ward nurses. Methods: This descriptive research study involved 70 CNCS ward nurses and 69 general ward nurses working at an advanced general hospital in Seoul. Data were collected using the structured questionnaire from March 27 to April 14, 2019 and analyzed with the SPSS 24.0 program. Results: The work environment of the CNCS ward nurse was higher than that of the general ward nurse (t=4.38, p<.001), and the role conflict of the CNCS ward nurse was lower than that of the general ward nurse (t=-2.09, p=.038). However, job embeddedness did not show any statistically significant difference (t=0.22, p=.824). Conclusion: The results of this study show that the introduction of CNCS ward has shown improvement in the work environment and strengthened the establishment of the roles in their team, while maintaining the job embeddedness of nurses. These results indicate that improvements in the work environment, such as nurse staffing and material support, would contribute to the qualitative enhancement of nursing and that it would need to extend the introduction of CNCS wards.

• 한국병원경영학회지
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• 제3권1호
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• pp.62-82
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• 1998

The purpose of this study is to assess the cause and level of conflict arising within and between departments among administration office workers who work in a recently established tertiary hospitals of a major cooperation or related non-profit cooperation: The study also aimed to find methods for resolution of such conflicts by comparing with other existing university hospitals. The subject population included 299 business administration office workers randomly selected from two cooperate related tertiary hospitals of less than 3 years in its existence and two university hospitals over 700 beds in Seoul and Kyong In area. Data were collected through a survey questionnaire. To define related factors for the level of conflict among departments in each hospitals multivariate regression analysis was conducted. Independent factors were characteristics of subjects, conflicting factors within and between the departments. The results are as follows: 1. Those in the 30-39 rears of age group demonstrated significantly higher level of conflict between departments. Those working in the new hospitals, who were older and had long-term tenure, and those with short-term job experience at current working hospital had higher level of conflict between the departments with statistical significance. 2. Concerning the involvement of conflicting factors and the level of conflict in the administration there was statistically significant positive correlation between reliability and job-related intra- and interdepartmental level of conflict in existing hospitals. There was a significant positive correlation between intradepartmental conflicting factors of mutual dependence, difference in goal/orientation and intra- and interdepartmental level of conflict. 3. In multivariate regression analysis, women more than men, and those who had worked for many years in hospitals had statistically significant influence on factors involved in interdepartmental level of conflict, explaining 51.0% of the model. 4. In existing hospitals, gender was a significant factor with women showing a higher level of interdepartmental conflict compared to men. Among the interdepartmental factors, mutual dependence had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the new hospitals, job position was a significant factor which showed that those in high position such as section chief or above, compared to those in managerial or general position had higher level of conflict. Among the interdepartmental characteristics, factors of mutual dependence and goal/orientation had statistically significant influence and showed a positive relationship with interdepartmental level of conflict. In the new hospital setting efforts to reduce conflict in areas among workers with high position, old age, and long tenure and those in Purchasing, Material and Computer Department should be made and prudent management and planning for improved manpower and increased budget or efficient allocation and clear definition of job description are necessary to adequately assess and make improved efforts for rapid stabilization of the premature hospital system from its inception, In the existing hospitals a lack of conflict within and between departments may give rise to stagnation or inefficiency of the organization. Future study are needed with respect to the relationship between interdepartmental level of conflict and the effectiveness of the hospital organization for improved resolution of conflict in the organization and hospital management.

• 한국의료질향상학회지
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• 제9권2호
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• pp.176-197
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• 2002

Backgound : This study is to suggest the standardized format of the clinical sheets and the standardized items of every clinical sheet. The standardization of the medical records will increase the faithfullnes of the contents in them and it will contribute to construct the good health information system. Method : From Jan. 1st. 2001 to March 31st 2001, we gathered as many paper clinical sheets as possible by every class of institutions to review the faithfulness of the clinical contents in them. Clinical sheets of 9 tertiary care hospitals, 6 general hospitals and 56 clinics were gathered. Two experienced medical record administrators reviewed them. The review focus was to check whether the items recommend by the hospital standardization review criteria and hospital service evaluation organization were appeared in the clinical sheets and whether the contents of every item were written. Results : Tertiary care hospitals; In case of administrative data, the contents were filled well if the items were fixed. The clinical data like C.C, history,physical examiniation were filled well, but if the items were not fixed, some items were omitted. The result is that more items are to be filled if they are fixed. General hospitals Administrative data were filled more than 50%. Final diagnosis was filled about 66.7%.But other clinical data were not filled well and not many clinical related items were appeared in the sheets.In the legal point of view, the reason for visiting hosptals or the right diagnosis, patient condition at discharge could not be confirmed well.In surgery cases, surgical procedures could not be confirmed well as many surgical related information(surgery time, fluids and blood, number of sponges, biopsy, etc) were omitted. Clinics More than 70% administrative data were filled and fixed as items. Among the clinical related data, laboratory result was the most credible data. But without the right diagnosis, drug orders were given and doctors' written signatures were not appeared over 96.4%. So the clinical sheets cannot be used as a legal document. Conculusion : There was a tendency that the contents were filled well if the items were fixed in the documents, We also suggest a clinical check list to review the completeness and faithfulness of the clinical sheets. If many hospitals use the suggested clincal check list and if they make the necessary items fixed in the clinical sheets, the quality of the medical record will increase dramatically.

• 간호행정학회지
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• 제19권5호
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• pp.613-621
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• 2013

Purpose: To identify the extents of nursing professionalism, clinical decision making abilities and job performance of advanced practice nurses and investigate the relationship among the variables Methods: Participants, selected by a convenience sampling method, were 135 advanced practice nurses working in 4 tertiary care general hospitals in 'B' Metropolitan City and in 1 tertiary care general hospital in 'J' city. Data collection was done from January 15 to February 28, 2013 using self-reporting questionnaires. Results: The average score for nursing professionalism of study participants was $81.19{\pm}7.56$. for clinical decision making abilities, $140.42{\pm}9.62$ and for job performance, $102.54{\pm}10.30$. These averages are relatively high. The relationship between the extent of nursing professionalism and the extent of clinical decision making abilities showed an intermediate level positive correlation (r=.45, p<.001). The relationship between the extent of nursing professionalism and the extent of job performance was also an intermediate level positive correlation (r=.42, p<.001). The extent of clinical decision making abilities and the extent of job performance was an intermediate level positive correlation (r=.41, p<.001). Conclusion: Developing a program, which can improve nursing professionalism and clinical decision making abilities of nurse, is required to enhance their job performance.

• 한국의료질향상학회지
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• 제22권2호
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• pp.15-25
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• 2016

Objectives: In this study, we examined the validity of Clostridium difficile culture results as a proxy measure of Clostridium difficile infection, and inferred the epidemiologic characteristics of Clostridium difficile infection by tracking the trends of Clostridium difficile culture results. Methods: We reviewed the medical records to figure out the actual possibilities of Clostridium difficile infection of those with positive or negative results of Clostridium difficile culture during the time span from January 2012 to March 2012. We calculated the positive and negative predictive value of Clostridium difficile culture results for Clostridium difficile infection. Furthermore, epidemiologic characteristics of Clostridium difficile infection in a tertiary general hospital in 2012 were analyzed. Result: The estimated positive predictive value of Clostridium difficile culture tests for Clostridium difficile infection was 100%, and the estimated negative predictive value was around 94.4~99.3% depending on the cutoff value of possibility of Clostridium difficile infection. A total of 622 cases were identified as Clostridium difficile infection in a tertiary general hospital in 2012 and there were 4.9 patients with Clostridium difficile infection per 1,000 inpatients. Conclusion: In conclusion, we identified that Clostridium difficile culture results can be used as a proxy measure of Clostridium difficile infection.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제23권4호
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• pp.37-53
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• 2017

Purpose: As the structure of the disease has been changed and the infectious disease has been increased, the demand for diagnostic examination has been increasing. So, the department of laboratory medicine in hospital has playing the important role accounting for about nineteen percent of total medical expenses in korea. This study is to investigate the laboratory function and spatial composition of the department and figure out the space area and space organization. Methods: Explore the literature review to identify the laboratory function. Limit to five cases of tertiary level general hospital having about a thousand bed and analyze the space layout and floor area to confirm the spatial composition. Classify the exam function and check the spatial composition and spatial organization. Results: This study allows 5 conclusions to be summarized. Laboratory medicine divided into nine part in regulation, but in space allocated into core lab, emergency lab and six part lab. Total laboratory area is $2,036m^2$ in average, and is composited with 60% for lab, 17% for office and 20% for public. Lab area per a bed presents $1.88m^2$. Microbiolgy and molecular lab area are getting large. Laboratory space organized into the four zone, like an entrance zone, core zone, rear zone and peripheral zone. Emergency and transfusion lab are allocated in entrance zone, hematology chemistry and immunology in core lab, microbiology and molecular lab in rear, support offices in peripheral zone. The most important point was to check the spatial composition of the Laboratory Medicine according to the inspection function. Implications: This study can be used as a useful data in planning and designing a Laboratory Medicine Department.

• 중환자간호학회지
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• 제14권2호
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• pp.1-11
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• 2021

Purpose : The aim of this study was to propose appropriate nurse staffing of adult intensive care units considering patients' nursing care needs according to the Workload Management System for Critical Care Nurses (WMSCN). Methods : In a cross-sectional survey conducted in September 2017, 1,786 patients' WMSCN scores, surveys from 2,145 nurses, and administrative data from 118 units in 41 hospitals were analyzed. The means (standard deviations) of the aforementioned scores and nursing hours per patient day were presented. Nurse-to-patient ratios and nurse-to bed ratios for staffing to meet patients' nursing care needs were calculated. Results : The mean WMSCN scores were 109.50±17.17 in tertiary hospitals and 96.38±19.26 in general hospitals. Nursing hours per patient day were 12.47±2.80 in tertiary hospitals and 11.01±2.45 in general hospitals. Nursing hours per patient day correlated with WMSCN scores. Nurse-to-bed ratios required for the provision of ICU nursing care ranged from 1: 0.36 to 1: 0.48. Conclusion : Our findings provide evidence that current ICU nurse staffing is insufficient for meeting patients' nursing care needs. We suggest adjusting the legal standards for adequate nurse staffing considering these needs.