• Title/Summary/Keyword: Tertiary general hospital

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Factors Affecting Nurse's Health Promoting Behavior: Focusing on Self-efficacy and Emotional Labor (간호사의 건강증진행위에 영향을 주는 요인: 자기효능, 감정노동을 중심으로)

  • Hong, Eunyoung
    • Korean Journal of Occupational Health Nursing
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    • v.23 no.3
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    • pp.154-162
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    • 2014
  • Purpose: This study examined self-efficacy, emotional labor, and health promoting behaviors. It also investigated factors affecting health promoting behaviors of nurses working for tertiary and general hospital. Methods: Between June and July 2013, a convenience sample of 233 subjects was collected from 2 tertiary hospitals and 4 general hospitals. The data analysis was done with ANOVA, t-test and stepwise multiple regression. Results: Emotional labor of the subjects was slightly lower than that of other nurses and the average level of health promoting behaviors was lower than the median. Health promoting behaviors were differentiated by education, hospital type, and monthly income. Self-efficacy showed positive correlation with HPLP-II, but emotional labor showed negative correlation with self-efficacy and HPLP-II. The most significant factor affecting health promoting behaviors was self regulation(16.3%). The combination of self regulation, attentiveness to required display rules, BSN, preference to task difficulty, and monthly income(${\geq}300$) accounted for 25.4% of health promoting behavior. Attentiveness to required display rules was a negative factor of HPLP-II. Conclusion: When developing health promotion programs for nurses, self-efficacy should be considered and further research is needed to identify mediating variables between emotional labor and health promoting behaviors.

The Effects of Temperament and Character, Emotional Intelligence on Self-leadership of Clinical Nurses (임상간호사의 기질·성격, 감성지능이 셀프 리더십에 미치는 영향)

  • Bak, Won-Sook;Oh, Kyung Mi;Yu, Jae Sun
    • Journal of muscle and joint health
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    • v.28 no.3
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    • pp.263-274
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    • 2021
  • Purpose: This descriptive research study investigated the effects of temperament and character, emotional intelligence on self-leadership of clinical nurses. Methods: This study recruited clinical nurses at a tertiary general hospital located in S city through convenience sampling. A survey was conducted from April 10 to May 5, 2020, using offline questionnaires. A total of 343 answers were analyzed using descriptive statistics and a three-step hierarchical regression analysis with the SPSS 22.0 program. Results: Factors influencing self-leadership of clinical nurses at a tertiary general hospital in S city were persistent among temperament (β=.331, p<.001), personal maturity (β=.408, p<.001), and total emotional intelligence (β=1.062, p<.001). These factors contributed 58% of self-leadership (F=29.20, p<.001). Conclusion: It was confirmed that persistent among temperament and personal maturity among character, emotional intelligence were factors affecting self-leadership of clinical nurses. Therefore, it is necessary to develop and provide programs to control the factors affecting self-leadership of clinical nurses to increase self-leadership.

Incidence of Peripheral Cyanosis in Patients with Therapeutic Hypothermia after Cardiac Arrest in the Acute Care Unit of a Tertiary General Hospital (일개 상급종합병원 응급중환자실 내 심정지 후 저체온요법을 적용한 환자의 말초 청색증 발생 현황)

  • Bang, Soo Youn;Yi, Young Hee
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.128-140
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    • 2021
  • Purpose : This study aimed to identify the incidence of peripheral cyanosis and the characteristics and clinical results of patients with therapeutic hypothermia after a cardiac arrest. Methods : Data were collected from April to June 2021 via the electrical medical records of 95 patients with therapeutic hypothermia for 72 hours after a cardiac arrest admitted to an acute care unit at a tertiary hospital between January 1, 2016, and December 31, 2019. The data were analyzed using descriptive statistics and a t-test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, and logistic regression using SPSS/WIN. Results : The incidence of peripheral cyanosis was 20%. In the peripheral cyanosis group, peripheral vascular disease, fibrinogen, vasopressor, infection, disseminated intravascular coagulation, acute physiology, chronic health evaluation II score on the second hospital day, nursing intervention, and mortality on the seventh hospital day were higher. The level of fibrinogen and use of vasopressors affected the occurrence of peripheral cyanosis. Conclusion : Considering the influencing variables, careful observation is necessary for patients with high fibrinogen levels and vasopressor use. These results provide basic data to recognize the need for nursing intervention for peripheral cyanosis and encourage nurses to deliver them during therapeutic hypothermia.

Role of interventional endoscopic ultrasound in a developing country

  • Hasan Maulahela;Nagita Gianty Annisa;Achmad Fauzi;Kaka Renaldi;Murdani Abdullah;Marcellus Simadibrata;Dadang Makmun;Ari Fahrial Syam
    • Clinical Endoscopy
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    • v.56 no.1
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    • pp.100-106
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    • 2023
  • Background/Aims: Endoscopic ultrasound (EUS) has become an essential diagnostic and therapeutic tool. EUS was introduced in 2013 in Indonesia and is considered relatively new. This study aimed to describe the current role of interventional EUS at our hospital as a part of the Indonesian tertiary health center experience. Methods: This retrospective study included all patients who underwent interventional EUS (n=94) at our center between January 2015 and December 2020. Patient characteristics, technical success, clinical success, and adverse events associated with each type of interventional EUS procedure were evaluated. Results: Altogether, 94 interventional EUS procedures were performed at our center between 2015 and 2020 including 75 cases of EUS-guided biliary drainage (EUS-BD), 14 cases of EUS-guided pancreatic fluid drainage, and 5 cases of EUS-guided celiac plexus neurolysis. The technical and clinical success rates of EUS-BD were 98.6% and 52%, respectively. The technical success rate was 100% for both EUS-guided pancreatic fluid drainage and EUS-guided celiac plexus neurolysis. The adverse event rates were 10.6% and 7.1% for EUS-BD and EUS-guided pancreatic fluid drainage, respectively. Conclusions: EUS is an effective and safe tool for the treatment of gastrointestinal and biliary diseases. It has a low rate of adverse events, even in developing countries.

Analysis of Factors Affecting Profitability of General Hospital in Kyung-in Region (경인지역 종합병원의 수익성 관련요인 분석)

  • Kim, Young-Hoon
    • Korea Journal of Hospital Management
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    • v.4 no.1
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    • pp.41-65
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    • 1999
  • This study was attempted to identify the factors affecting profitability of general hospital in Kyung-In Region. Operating profit to gross revenues and net profit to gross revenues were used as a proxy indicator for profitability of hospitals. The unit of analysis was hospital, and the data were collected 5 years data from 20 hospitals. The major findings are as follows; (1) The average operating profit rate was 1.03% and the net profit rate was -5.00% in twenty hospitals in the Kyung-In Region for the last five years. In terms of maximum surplus, the operating profit rate was 14% and net profit rate was 3.40%. In terms of maximum loss revenue, the operating profit rate was -16.56% and the net profit rate was -22.83%. (2) Since the year 1993, which was the starting year of this study, the operating profits and the net profits consistently decreased. (3) Analyzing the difference in profits among various hospital groups, the tertiary hospital group and the 501-1000 beds group exhibited the highest in operating profit rate. Also, among the higher grade number of beds in hospital group, per 100 beds group, the 41-50 beds group exhibited the highest in operating profit rate. There is a statistically significant difference in those groups(p<0.05, p<0.01). (4) In the health care delivery system, the profit gain in the secondary hospital was 51.5% and in the tertiary hospital was 72.4%. Based on the number of beds in each hospital group, the highest profit gain was 75.0% in the over 1001 beds group, and 71.4% in the 501-1000 beds group. Also, among the higher grade number of beds in hospital group, per 100 beds group, the 41-50 beds group exhibited 88.6% surplus. (5) According to the surplus difference based on the analysis of health care utilization, a group with over 31 patients in bed turnover rate, a group with over 96% in bed occupancy rate and group with over 9% in emergency cases to outpatient visits exhibited the highest profit gains. In addition, a group with over 301 patients in daily outpatient visits per 100 beds and group with 11-12 days average length of stay exhibited the highest profit gains. These results are statistically significant(p<0.05, p<0.01). (6) According to a stepwise regression analysis, the variables measuring the bed turnover rate, number of licensed beds, and number of outpatient visits per specialist explain 34.1% of the variation in operating profits. In terms of net profits, the new outpatient visits, the bed turnover rates and the number of general bed variables explain 30.6%. These results are statistically significant(p<0.01).

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An Importance-Performance Analysis of the Healthcare Reform on a Doctor-Designation System - Focused on the Perception of Medical Providers' at Tertiary Hospital in Seoul - (선택진료제도 개편에 대한 중요도-성취도 분석(IPA) - 서울시내 상급종합병원 의료종사자 인식을 중심으로 -)

  • Park, Hye Jin;Kim, Hyo Jeong;Kim, Young Hoon
    • Korea Journal of Hospital Management
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    • v.23 no.1
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    • pp.28-40
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    • 2018
  • Purpose: The purpose is to understand the perception of medical providers at tertiary hospitals in Seoul on the importance-performance of the reform on a doctor-designation system, and to provide the policy suggestion of the perception on such a system. Methodology: To achieve the purpose, this study utilized structured survey tools to conduct a questionnaire survey of nursing, administrative and medical technology professionals at six tertiary hospitals in Seoul. An importance-performance analysis was utilized for an analysis that showed the perception of the reform on a doctor-designation system. Findings: First, it was identified that those medical providers had the highest perception of the importance about the performance of the reform on a doctor-designation system. Second, according to the result of action grid of an importance-performance analysis (IPA), it can be identified that in the 2nd stage of 'Concentrate here' included are the items as to design and effect of medical care quality and subsidies & patient infection and safety and control fees, effect of income security of the method for compensating for loss established by the government and offering sufficient information on general medical services and doctor-designation medical services. In the 1st stage of 'Keep up the Good Work', and the 2nd stage of 'Concentrate here' included is the item as to the performance of patients of the reform on a doctor designation system. Practical Implications: There could be identified the effect of the reform bill on the perception of medical providers. It is expected that a better environment would be provided for patients to use a hospital and for medical providers to offer medical services, if the goverment makes efforts to improve methods for compensating for loss and continuous monitoring of the performance of patients.

The Prevalence and Risk Factors of Latent Tuberculosis Infection among Health Care Workers Working in a Tertiary Hospital in South Korea

  • Park, Jae Seuk
    • Tuberculosis and Respiratory Diseases
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    • v.81 no.4
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    • pp.274-280
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    • 2018
  • Background: The risk of tuberculosis (TB) infection among health care workers (HCWs) is higher than as noted among workers in the general population. The prevalence and risk factors of TB infection among HCWs were assessed in a tertiary hospital in South Korea, resulting in a conclusion of an intermediate TB burden within the country. Methods: This cross-sectional study enrolled HCWs who underwent a QuantiFERON-TB Gold In-Tube (QFT-GIT) test to detect the presence of a latent TB infection (LTBI), in patients admitted to a tertiary hospital in South Korea in 2017. The departments of the hospital were divided into TB-related and TB-unrelated departments, which were based on the risk of exposure to TB patients. In this sense, the risk factors for LTBI, including current working in the TB-related departments, were analyzed. Results: In this case, a total of 499 HCWs (54 doctors, 365 nurses and 80 paramedical personnel) were enrolled in this study. The median age of the subjects was 31 years (range, 20-67 years), 428 (85.8%) were female, and 208 (41.7%) were working in the TB-related departments. The prevalence of LTBI was 15.8% based on the QFT-GIT. Additionally, the prevalence of experience of exposure to pre-treatment TB patents was higher among HCWs working in the TB-related departments, than among HCWs working in the TB-unrelated departments (78.8% vs. 61.9%, p<0.001). However, there was no significant difference in the prevalence of LTBI between the two groups (17.3% vs. 14.8%, p=0.458). On a review of the multivariate analysis, only the factor of age was independently associated with an increased risk of LTBI (p=0.006). Conclusion: Broadly speaking, the factor of age was associated with an increased risk of LTBI among the HCWs in South Korea. However, those workers current working in the TB-related departments was not associated with an increased risk of LTBI.

Clinico-Morphological Profile and Receptor Status in Breast Cancer Patients in a South Indian Institution

  • Ghosh, Saptarshi;Sarkar, Shreyasee;Simhareddy, Samara;Kotne, Sivasankar;Rao, Pammidimukkala Bramh Ananda;Turlapati, Satya Prakash Venkatachalam
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.18
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    • pp.7839-7842
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    • 2014
  • Background: Breast cancer is the most common malignancy in women worldwide and the second most common cancer in females in India. Receptor status may be important for survival. Objective: To analyse and correlate the clinical and morphological parameters with receptor status in breast carcinoma patients in a tertiary care institution in Southern India. Materials and Methods: This retrospective study involved 320 patients of breast cancer diagnosed in an oncology hospital over a period of $3^{1/2}$ years. Data was analysed using SPSS Version 21. Results: Some 60.6% patients with breast carcinomas belonged to the age group of 40 to 60 years. The most common histological type was infiltrating ductal carcinoma, not otherwise specified, accounting for 84.4% of patients. On immunohistochemistry, estrogen receptor (ER) and progesterone receptor (PR) were expressed in 56.3% and 53.1% of cases, respectively. Conclusions: Breast cancers in India, a developing country, occur in younger women and tend to be more aggressive with lower rates of ER and PR expression and higher histological tumor grades. Both ER and PR status of the tumors had significant associations with the patient age, pathological TNM stage and histological tumor grade.

The Students' Evaluation of Practice Sites and Preceptors in Pharmacy Experiential Education (일개 약학대학 실무실습교육 후 학생의 실무교육기관 및 프리셉터 평가)

  • Yoon, Jeong-Hyun;Suh, Hae Sun;Je, Nam Kyung
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.2
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    • pp.69-76
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    • 2017
  • Objective: This study was conducted to assess the current status of experiential education, by analyzing pharmacy students' satisfaction and evaluation for practice sites and preceptors for 3 years from 2014 through 2016. Methods: Students evaluated the practice sites and preceptors using a 5-point and a 4-point Likert scale, respectively. Analysis was performed based on the types of curriculums and practice sites. In addition, sub-analysis was conducted based on the types of health-system pharmacy and the community pharmacy. Results: Total 203 students responded to the survey questionnaires. The 3-year average score of students' satisfaction with practice sites was 4.25. In the sub-analysis conducted based on the types of health-system pharmacy, the score was higher in the tertiary hospital pharmacies than that of the general hospital pharmacies (4.49 vs. 4.06, P<0.001). For community pharmacy, the difference in the score of the 3-year analysis was not significant, depending on the types (4.51 vs. 4.33, P=0.054). The average score of students' evaluation on the preceptors was 3.37 in the 3-year analysis. The score was significantly higher for the preceptors of tertiary hospital pharmacies than those of general hospital pharmacies (3.61 vs. 3.25, P<0.001). For community pharmacy, no significant differences were found, depending on the types of pharmacy (3.53 vs. 3.43, P=0.309). Conclusion: The students' satisfaction with practice sites and preceptors in pharmacy experiential education was high. However, it varied greatly depending on the types of educational institutions. Mutual effort between university and educational institutions is required, to narrow the gap in the degree of students' satisfaction.

Efficiency Analysis of Specialists by Medical Specialty using Activity-Based Costing Data: Using the DEA-CCR model and SBM model (활동기준 원가 자료를 활용한 과별 전문의의 효율성 분석 : DEA-CCR 모형과 SBM 모형을 이용)

  • Do Won Kim;Tae Hyun Kim
    • Korea Journal of Hospital Management
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    • v.28 no.2
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    • pp.44-65
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    • 2023
  • Purposes: As super-aging population and low fertility rates are threatening the sustainability of the National Health Insurance funds, enhancing the efficiency of hospital management is paramount. In the past, studies analyzing the efficiencies of hospitals primarily made inter-hospital comparisons, but it is important to assess hospitals' internal efficiency and develop improvement measures in order to attain practical improvements in hospital efficiencies. The purpose of this study is to analyze the efficiencies of specialists by medical specialty in a hospital in order to provide foundational data for efficient hospital management. Methodology/Approach: We used the activity-based costing (ABC) data and hospital statistical data from one tertiary hospital in Seoul to analyze the efficiency of specialists by medical specialty. Efficiency was analyzed and compared among specialists using the data envelopment analysis developed by Charnes, Cooper, and Rhodes (DEA-CCR) model and the slacks-based measure (SBM) models. The input variables were labor cost, material cost, and operational expenses, and the output variables were the number of outpatients, number of inpatients, outpatient revenue, and inpatient revenue. Findings: First, there was a marked deviation in efficiency across specialists. Second, there was a marked deviation in efficiency across medical specialties. Third, there was little difference in efficiency according to the specialist's sex, age, and job position. Fourth, the SBM model produced more conservative results and better explained efficiency parameters than the CCR model. Practical Implications: The efficiency of a specialist was more influenced by their medical specialty than their personal characteristics, namely sex, age, and job position. Therefore, Further research is needed to analyze the efficiencies of each subspecialty and identify factors that contribute to the variations in efficiencies across medical specialties, such as clinical practices and fee structures.

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