• Journal of The Korea Institute of Healthcare Architecture
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• v.30 no.3
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• pp.35-44
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• 2024

Purpose: The purpose of this study is to present basic data on installation location, functional connection, and arrangement to be considered when planning a neonatal intensive care unit in a certified tertiary general hospital. Method: Review the facility standards related to the neonatal intensive care unit, such as laws and guidelines, and select a Certified Tertiary General Hospital as a case hospital among the Neonatal Intensive Care Regional Centers designated by the Ministry of Health and Welfare to analyze the placement characteristics of major NICU components such as the location of the NICU installation, the connection of movement between adjacent facilities and functions, and the treatment room and accessory room. Results and Implications: NICU is a facility for critically ill babies among newborns and needs to consider more about infection and patient management compared to adult intensive care units, which not only install close to delivery-related facilities to enable immediate action after childbirth, but also divide the treatment room into open rooms and allow access to the attached rooms through dedicated corridors to minimize movement in the treatment room.

• Korea Journal of Hospital Management
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• v.19 no.2
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• pp.66-72
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• 2014

Although stress has been implicated to be a risk factor that can threaten physical and mental health, there have been no sufficient studies that analyze the different levels of stress among employees working in the different levels of the hospitals. We aim to identify the general characteristics of hospitals at different levels, to compare the stress levels among customer service representatives working in the tertiary care hospitals as well as acute general hospitals. In addition, we also wanted to analyze the relationship between the types of hospitals and the stress level. The work stress was measured using the Korean Occupational Stress scale. Study subjects' demographic characteristics and lifestyle factors were analyzed using analysis of frequency and multiple regression analysis. Our study revealed that the levels of medical facility were significantly associated with the levels of job stress(P=0.043), and the stress levels of employees working in the acute general hospital's medical facilities were higher than those who were working in tertiary care facilities. We also found that those with higher depression level tended to have higher job stress (P<0.001). Therefore, it is urgent to implement some kind of job stress interventions, especially in the acute general hospital's medical facilities. Moreover, further studies including social and policy research are necessary in order to analyze the overall impact of stress on physical and mental health and to reduce health inequalities among healthcare workers.

• Nutrition Research and Practice
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• v.12 no.3
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• pp.215-221
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• 2018

BACKGROUND/OBJECTIVES: The prevalence of malnutrition among hospitalized children ranges between 12% and 24%. Although the consequences of hospital malnutrition are enormous, it is often unrecognized and untreated. The aim of this study was to identify the current status of in-hospital nutrition support for children in South Korea by carrying out a nationwide hospital-based survey. SUBJECTS/METHODS: Out of 345 general and tertiary hospitals in South Korea, a total of 53 institutes with pediatric gastroenterologists and more than 10 pediatric inpatients were selected. A questionnaire was developed by the nutrition committee of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition. The questionnaires were sent to pediatric gastroenterologists in each hospital. Survey was performed by e-mails. RESULTS: Forty hospitals (75.5%) responded to the survey; 23 of them were tertiary hospitals, and 17 of them were general hospitals. Only 21 hospitals (52.5%) had all the required nutritional support personnel (including pediatrician, nutritionist, pharmacist, and nurse) assigned to pediatric patients. Routine nutritional screening was performed in 22 (55.0%) hospitals on admission, which was lower than that in adult patients (65.8%). Nutritional screening tools varied among hospitals; 33 of 40 (82.5%) hospitals used their own screening tools. The most frequently used nutritional assessment parameters were weight, height, hemoglobin, and serum albumin levels. In our nationwide hospital-based survey, the most frequently reported main barriers of nutritional support in hospitals were lack of manpower and excessive workload, followed by insufficient knowledge and experience. CONCLUSIONS: Although this nationwide hospital-based survey targeted general and tertiary hospitals with pediatric gastroenterologists, manpower and medical resources for nutritional support were still insufficient for hospitalized children, and nutritional screening was not routinely performed in many hospitals. More attention to hospital malnutrition and additional national policies for nutritional support in hospitals are required to ensure appropriate nutritional management of hospitalized pediatric patients.

• Korea Journal of Hospital Management
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• v.7 no.1
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• pp.19-40
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• 2002

The purpose of this study is to find out if there has been any change in the outpatient visit to tertiary care hospitals after the introduction of the new healthcare program that divides the roles of doctors and pharmacists and the reason for the change if there is any. Two tertiary care hospitals with the largest capacity of 1200 beds and two tertiary care hospitals with the lowest capacity of 600-700 beds were randomly selected. Data of the outpatient visits from March-May 2(xx), before the new healthcare system was adopted, were compared with the data from March-May 2001, after the new policy was adopted. Outpatient visits have decreased 5.8% after the new system. There has been a dramatic decrease, especially, in the department of OB-GYN and Pediatrics of tertiary hospitals. Decrease in re-visits is much higher than the first visits. Female patients decreased more than the male patients. Outpatient visits by economically active patients group aged 25-44 declined much. Tertiary hospitals in Seoul and Kyonggi Province, as well. Outpatient income of tertiary hospitals has dropped up to 14.7% due to the decline in outpatient visits and pharmaceutical income, and resell price system which in turn has caused the hospital financial deficits. While the new program has succeeded in lowering the use of antibiotics and injections, it has the pitfall of prescribing long days and expensive drugs. A full-fledged review of the system should be conducted for the establishment of the new system and I believe this study may be a useful references. Furthermore, more profound and overall studies on the chance in the patients use of hospitals are needed.

• Journal of the Korean Dietetic Association
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• v.20 no.4
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• pp.257-274
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• 2014

The objective of this study was to examine job satisfaction status and its related factors among dietitians working in hospitals. A survey questionnaire was sent to dietitians working in tertiary, general, and convalescent hospitals in Korea. The study sample hospitals included all tertiary hospitals (n=43), and the sample of general hospitals (n=114) and convalescent hospitals (n=240) was randomly selected using a stratified sampling method. A total of 665 dietitians completed the survey questionnaire. The questionnaire included 27 job satisfaction questions on task, stability vision, working conditions, and relationship areas, and the questions on task improvement need. The job satisfaction scores in all four areas ranged from 2.53/5.00 to 3.89/5.00, implying generally low job satisfaction level in hospital dietitians. The job satisfaction levels in the convalescent hospital group were significantly lower compared to those in the tertiary and general hospital groups. Whereas job satisfaction levels of tertiary and convalescent hospital groups did not differ by number of beds, those of the general hospital group increased significantly with the number of beds for all four areas. Multivariate regression analysis results showed that hospital type was a significant predictor of job satisfaction level for all four areas. Job satisfaction of relationship area was also significantly affected by the number of beds, whereas that of working conditions was influenced by annual income and working experience. The study findings provide useful information in planning clinical dietitians' optimal supply outlook for the improvement of clinical nutrition services.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.44.1-44.11
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• 2023

Background: A series of breast cancer cases were recently reported in a tertiary university hospital in South Korea. Nurses are generally exposed to risk factors for breast cancer such as night shift work, antineoplastic agents, and job strain. However, the epidemiological evidence of excess incidence among nurses remains lacking. This study aims to investigate the excess incidence of breast cancer among nurses in a tertiary university hospital and provide epidemiological evidence of occupational risk factors. Methods: A retrospective cohort was developed using personnel records of female workers in the nursing department who worked from January 2011 to June 2021 in a tertiary university hospital in South Korea. Sick leave records were used to identify cases of breast cancer. The standardized incidence ratio of breast cancer among nurses was compared to the general population. Results: A total of 5,509 nurses were followed up for 30,404 person-years, and 26 breast cancer cases were identified. This study revealed a significantly increased breast cancer incidence among all included nurses, with a standardized incidence ratio of 1.65 (95% confidence interval [CI]: 1.08-2.41), compared to the general population. Workers, who handle antineoplastic agents in their representative department and current and/or former department, had significantly elevated breast cancer standardized incidence ratios of 2.73 (95% CI: 1.008-5.94) and 3.39 (95% CI: 1.46-6.68), respectively. Conclusions: This study provides significant evidence of increased breast cancer risk among nursing staff in a hospital setting, particularly those who handle antineoplastic drugs. Measures that reduce exposure to risk factors should be implemented, especially anticancer drugs, to protect healthcare professionals. Further research at a national level that focuses on healthcare workers is necessary to validate breast cancer incidence and its contributing factors.

• Journal of Preventive Medicine and Public Health
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• v.57 no.3
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• pp.252-259
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• 2024

Objectives: This study investigated factors associated with the retention of people living with human immunodeficiency virus (HIV) on antiretroviral therapy (ART) during the first 3 years of treatment. Methods: A retrospective study using electronic health records was conducted at a tertiary hospital in Jakarta, Indonesia. Adult HIV-positive patients who started ART from 2010 until 2020 were included. A binary logistic regression model was used to identify factors associated with ART retention in the first 3 years. Results: In total, 535 respondents were included in the analysis. The ART retention rates for the first, second, and third years were 83.7%, 79.1%, and 77.2%, respectively. The multivariate analysis revealed a negative association between CD4 count when starting ART and retention. Patients with CD4 counts >200 cells/mL were 0.65 times less likely to have good retention than those with CD4 counts ≤200 cells/mL. The year of starting ART was also significantly associated with retention. Patients who started ART in 2010-2013 or 2014-2016 were less likely to have good retention than those who started ART in 2017-2020, with adjusted odds ratios of 0.52 and 0.40, respectively. Patients who received efavirenz-based therapy were 1.69 times more likely to have good retention than those who received nevirapine (95% confidence interval, 1.05 to 2.72). Conclusions: Our study revealed a decline in ART retention in the third year. The CD4 count, year of enrollment, and an efavirenz-based regimen were significantly associated with retention. Patient engagement has long been a priority in HIV programs, with interventions being implemented to address this issue.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.7
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• pp.2685-2691
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• 2015

To evaluate the clinical impact of preoperative serum CEA and CA19-9 on resectable gastric cancer (GC), a total of 1,075 consecutive cases with gastric adenocarcinoma were obtained retrospectively from January 2012 and December 2013 in a single tertiary hospital, and the relationships between serum CEA, CA19-9 and clinicopathologic features were investigated. Positive preoperative serum rates of CEA and CA19-9 were 22.4% and 12.3% respectively, levels significantly correlating with each other and depth of invasion, lymph node involvement, pTNM and stage. The CEA level also presented a remarkable association with lymphovascular invasion. Both CEA and CA19-9 positivity significantly and positively correlated with depth of invasion, nodal involvement, pTNM stage, lymphovascular invasion, tumor size and tumor location. Stratified analyses according to gender or tumor location showed preoperative CEA or CA19-9 had different associations with clinicopathologic features in different gender subgroups or location subgroups. Preoperative serum CA19-9 positivity may be more meaningful for tumor size rather than CEA. In conclusion, preoperative serum CEA and CA19-9 correlate with disease progression of GC, and may have applications in aiding more accurate estimation of tumor stage, decision of treatment choice and prognosis evaluation.

• Journal of Korean Clinical Nursing Research
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• v.29 no.3
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• pp.312-326
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• 2023

Purpose: This study attempted to analyze the staffing level and critical care nursing fees of intensive care units at tertiary and general hospitals and to provide a professional judgment-based recommendation on staffing level and critical care nursing fee schedules. Methods: Staffing grades and critical care nursing fee schedules for the first quarter of 2017~2020 and the fourth quarter of 2020~2022 were analyzed. A survey was conducted on nursing managers and nurses about the current and appropriate staffing levels. A total of 77 nurse managers and 708 nurses working in Intensive Care Unit(ICU)s at tertiary and general hospitals participated in the study. Results: Grade 1 staffing increased from 25.6% in 2017 to 92.1% in 2022 at tertiary hospitals and from 0.8% in 2017 to 28.4% in 2022 at general hospitals. The current staffing ratios of tertiary and general hospitals were 1:2.21 and 1:2.77, respectively. The appropriate staffing ratio according to nurse managers and nurses was 1:1.00 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in tertiary hospitals, and it was 1:1.25 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in general hospitals, respectively. Conclusion: The appropriate staffing level was suggested from 1:1.0 to 1:2.0. The new nursing fee schedules were suggested from 1:1.0 (Grade 1) to 1:3.0 (Grade 5) and recommended to be paid based on the staffing grade, minimum number of nurses, and standard annual working days. It is expected to increase staffing levels and provide a better nursing work environment.

• Journal of Korean Clinical Nursing Research
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• v.29 no.3
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• pp.327-336
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• 2023

Purpose: This study aimed to identify the factors affecting the practice of medical waste management of nurses in tertiary general hospitals after the coronavirus disease 2019 (COVID-19). Methods: The participants were 154 nurses working in two tertiary general hospitals. Data were collected using structured questionnaires and analyzed using an Independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis using the SPSS/WIN 27.0 program. Results: Factors significantly influencing the subject's practice of medical waste management include medical waste education(β=.18, p=.013), recognition of infection control organizational culture (β=.26, p=.007), and attitudes toward medical waste management (β=.23, p=.011). The explanatory power of these variables for medical waste management practice was 29.0% (F=7.34, p<.001). Conclusion: To improve the practice of medical waste management, a strategy to provide positive attitudes toward medical waste management should be needed when developing medical waste management training programs, and various measures are necessary to make the organizational culture positive for the implementation of infection control guidelines at the organizational level.