• The Korean Journal of Air & Space Law and Policy
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• v.9
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• pp.85-143
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• 1997

The main purpose of the investigation of an accident caused by aircraft is to be prevented the sudden and casual accidents caused by wilful misconduct and fault from pilots, air traffic controllers, hijack, trouble of engine and machinery of aircraft, turbulence during the bad weather, collision between birds and aircraft, near miss flight by aircrafts etc. It is not the purpose of this activity to apportion blame or liability for offender of aircraft accidents. Accidents to aircraft, especially those involving the general public and their property, are a matter of great concern to the aviation community. The system of international regulation exists to improve safety and minimize, as far as possible, the risk of accidents but when they do occur there is a web of systems and procedures to investigate and respond to them. I would like to trace the general line of regulation from an international source in the Chicago Convention of 1944. Article 26 of the Convention lays down the basic principle for the investigation of the aircraft accident. Where there has been an accident to an aircraft of a contracting state which occurs in the territory of another contracting state and which involves death or serious injury or indicates serious technical defect in the aircraft or air navigation facilities, the state in which the accident occurs must institute an inquiry into the circumstances of the accident. That inquiry will be in accordance, in so far as its law permits, with the procedure which may be recommended from time to time by the International Civil Aviation Organization ICAO). There are very general provisions but they state two essential principles: first, in certain circumstances there must be an investigation, and second, who is to be responsible for undertaking that investigation. The latter is an important point to establish otherwise there could be at least two states claiming jurisdiction on the inquiry. The Chicago Convention also provides that the state where the aircraft is registered is to be given the opportunity to appoint observers to be present at the inquiry and the state holding the inquiry must communicate the report and findings in the matter to that other state. It is worth noting that the Chicago Convention (Article 25) also makes provision for assisting aircraft in distress. Each contracting state undertakes to provide such measures of assistance to aircraft in distress in its territory as it may find practicable and to permit (subject to control by its own authorities) the owner of the aircraft or authorities of the state in which the aircraft is registered, to provide such measures of assistance as may be necessitated by circumstances. Significantly, the undertaking can only be given by contracting state but the duty to provide assistance is not limited to aircraft registered in another contracting state, but presumably any aircraft in distress in the territory of the contracting state. Finally, the Convention envisages further regulations (normally to be produced under the auspices of ICAO). In this case the Convention provides that each contracting state, when undertaking a search for missing aircraft, will collaborate in co-ordinated measures which may be recommended from time to time pursuant to the Convention. Since 1944 further international regulations relating to safety and investigation of accidents have been made, both pursuant to Chicago Convention and, in particular, through the vehicle of the ICAO which has, for example, set up an accident and reporting system. By requiring the reporting of certain accidents and incidents it is building up an information service for the benefit of member states. However, Chicago Convention provides that each contracting state undertakes collaborate in securing the highest practicable degree of uniformity in regulations, standards, procedures and organization in relation to aircraft, personnel, airways and auxiliary services in all matters in which such uniformity will facilitate and improve air navigation. To this end, ICAO is to adopt and amend from time to time, as may be necessary, international standards and recommended practices and procedures dealing with, among other things, aircraft in distress and investigation of accidents. Standards and Recommended Practices for Aircraft Accident Injuries were first adopted by the ICAO Council on 11 April 1951 pursuant to Article 37 of the Chicago Convention on International Civil Aviation and were designated as Annex 13 to the Convention. The Standards Recommended Practices were based on Recommendations of the Accident Investigation Division at its first Session in February 1946 which were further developed at the Second Session of the Division in February 1947. The 2nd Edition (1966), 3rd Edition, (1973), 4th Edition (1976), 5th Edition (1979), 6th Edition (1981), 7th Edition (1988), 8th Edition (1992) of the Annex 13 (Aircraft Accident and Incident Investigation) of the Chicago Convention was amended eight times by the ICAO Council since 1966. Annex 13 sets out in detail the international standards and recommended practices to be adopted by contracting states in dealing with a serious accident to an aircraft of a contracting state occurring in the territory of another contracting state, known as the state of occurrence. It provides, principally, that the state in which the aircraft is registered is to be given the opportunity to appoint an accredited representative to be present at the inquiry conducted by the state in which the serious aircraft accident occurs. Article 26 of the Chicago Convention does not indicate what the accredited representative is to do but Annex 13 amplifies his rights and duties. In particular, the accredited representative participates in the inquiry by visiting the scene of the accident, examining the wreckage, questioning witnesses, having full access to all relevant evidence, receiving copies of all pertinent documents and making submissions in respect of the various elements of the inquiry. The main shortcomings of the present system for aircraft accident investigation are that some contracting sates are not applying Annex 13 within its express terms, although they are contracting states. Further, and much more important in practice, there are many countries which apply the letter of Annex 13 in such a way as to sterilise its spirit. This appears to be due to a number of causes often found in combination. Firstly, the requirements of the local law and of the local procedures are interpreted and applied so as preclude a more efficient investigation under Annex 13 in favour of a legalistic and sterile interpretation of its terms. Sometimes this results from a distrust of the motives of persons and bodies wishing to participate or from commercial or related to matters of liability and bodies. These may be political, commercial or related to matters of liability and insurance. Secondly, there is said to be a conscious desire to conduct the investigation in some contracting states in such a way as to absolve from any possibility of blame the authorities or nationals, whether manufacturers, operators or air traffic controllers, of the country in which the inquiry is held. The EEC has also had an input into accidents and investigations. In particular, a directive was issued in December 1980 encouraging the uniformity of standards within the EEC by means of joint co-operation of accident investigation. The sharing of and assisting with technical facilities and information was considered an important means of achieving these goals. It has since been proposed that a European accident investigation committee should be set up by the EEC (Council Directive 80/1266 of 1 December 1980). After I would like to introduce the summary of the legislation examples and system for aircraft accidents investigation of the United States, the United Kingdom, Canada, Germany, The Netherlands, Sweden, Swiss, New Zealand and Japan, and I am going to mention the present system, regulations and aviation act for the aircraft accident investigation in Korea. Furthermore I would like to point out the shortcomings of the present system and regulations and aviation act for the aircraft accident investigation and then I will suggest my personal opinion on the new and dramatic innovation on the system for aircraft accident investigation in Korea. I propose that it is necessary and desirable for us to make a new legislation or to revise the existing aviation act in order to establish the standing and independent Committee of Aircraft Accident Investigation under the Korean Government.

• Journal of the Korean Society of Marine Environment & Safety
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• v.12 no.4 s.27
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• pp.293-300
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• 2006

Domestic laws such as Korea Marine Pollution Prevention Law (KMPPL) which has been mae and amended according to the conclusions and amendments of various international conventions for the prevention a marine pollution such as MARPOL 73/78 were reviewed and compared with the major contents of the relevant international conventions. Alternative measures for legislating new laws or amending existing laws such as KMPPL for the acceptance of major contents of existing international conventions were proposed. Annex VI of MARPOL 73/78 into which the regulations for the prevention of air pollution from ship have been adopted has been recently accepted in KMPPL which should be applied to ships which are the moving sources of air pollution at sea rather tlnn in Korea Air Environment Conservation Law which should be applied to automobiles and industrial installations in land. The major contents of LC 72/95 have been accepted in KMPPL However, a few of substances requiring special care in Annex II of 72LC, a few of items in characteristics and composition for the matter in relation to criteria governing the issue of permits for the dumping of matter at sea in Annex III of 72LC, and a few of items in wastes or other matter that may be considered for dumping in Annex I of 96 Protocol have not been accepted in KMPPL yet. The major contents of OPRC 90 have been accepted in KMPPL. However, oil pollution emergency plans for sea ports and oil handling facilities, and national contingency plan for preparedness and response have not been accepted in KMPPL yet. The waste oil related articles if Basel Convention, which shall regulate and prohibit transboundary movement of hazardous waste, should be accepted in KMPPL in order to prevent the transfer if scrap-purpose tanker ships containing oil/water mixtures and chemicals remained on beard from advanced countries to developing and/or underdeveloped countries. International Convention for the Control if Harmful Anti-Fouling Systems on the Ships should be accepted in KMPPL rather tlnn in Korea Noxious Chemicals Management Law. International Convention for Ship's Ballast Water/Sediment Management should be accepted in KMPPL or by a new law in order to prevent domestic marine ecosystem and costal environment from the invasion of harmful exotic species through the discharge of ship's ballast water.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.1
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• pp.35-56
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• 1996

Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.132-151
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• 1988

This study was conducted to establish the control program for preventing unfavorable health effects of nitrogen dioxide($NO_2$) exposure in homes by preparing the fundamental data for evaluation of relation-ships between $NO_2$ levels and influencing factors through measurements of indoor-outdoor $NO_2$ levels and personal $NO_2$ exposures for housewives with questionnaire survey on 172 homes in Pusan area from April to June, 1987 $NO_2$ measurements were made by using diffusion tube samplers(Palmes tube $NO_2$ sampler) for one week at 4 sites in homes ; kitchen(KIT), bedroom(BED), living room(LIV), outdoor(OUT) and near the collar of housewives(personal exposure livel, PNO). The details of questionnaire were number of household members(FAM), number of regular smokers (SMOKER), daily number of meals eaten(MEAL), type of housing units(HOUSE), location of house with distance from the heavy traffic roads as walking time(DIST), and of kitchen(KAREA), kind of cooking fuels(FUEL), cooking time of each meal(CTIME), usage of kitchen fan for cooking(FAN), type of heating facilities(HEAT) and so on of subject homes. The Obtained results were as fellows : 1) The mean $NO_2$ level was significantly higher at indoors than outdoors(p<0.01) and the kitchen $NO_2$ level was the highest with $33.7{\pm}13.6ppb$(9.5-81.5ppb). The mean personal exposure level of $NO_2$ for housewives was $20.6{\pm}8.8ppb$(3.1-46.9ppb). 2) The mean indoor $NO_2$ level was significantly higher in the group of household members above 5 than below 4(p<0.05), in detached dwellings than apartments(p<0.001), within 5 minutes of distance than over 5 minutes(p<0.001), in the group of unusing fan(p<0.001), in the group of longer cooking time(p<0.001), and it was in order of coal briquette, gas, electricity and oil by kind of cooking fuels(p<0.05). 3) Variables showing significant correlation(p<0.001) with indoor $NO_2$ level were kitchen $NO_2$ level(r=0.8677), cooking time(r=0.5921), outdoor $NO_2$ level(r=0.5192), personal $NO_2$ exposure level(r=0.4615), usage of kitchen fan(r=0.3573) and location of house(r=-0.2988) 4) As a result of multiple regression analysis, the most significant influencing variable to the kitchen $NO_2$ level was cooking time[KIT=$-0.378{\pm}11.772$(CTIME)+0.298(OUT)+3.102(FAN)], it was kitchen $NO_2$ level to the indoor $NO_2$ level[IND=6.996+0.458(KIT)+0.230(OUT)-1.127(KAREA)], and it was indoor $NO_2$ level to the personal $NO_2$ exposure level[PNO=15.562+0.729(IND)-4.542(DIST)-0.200(KIT)] 5) It was recognized that aritificial ventilation in the kitchen, suppression of unnecessary combustion and replacement of cooking fuel, as much as possible, were effective means for decreasing indoor $NO_2$ levels in homes.

• Korean Security Journal
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• no.24
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• pp.91-123
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• 2010

The threat factors available for occurrence given G20 Summit Meeting are expected leader terrorism, hostage terrorism, bomb terrorism, public facilities terrorism, and aircraft terrorism. As for the threat groups, which are expected in Korea, the North Korea, Islam extremist group, and the group such as NGO organization of being opposed to international meeting are regarded as having possibility of causing hazard. Thus, the purpose of this study is to suggest VIP Security-measure plans in the main site in preparation for G20 Summit Meeting. Accordingly, each country in the world is adopting 'the principle of Triple Ring' in common. Thus, it elicited a coping plan by 1st line(inner ring) 2nd line(middle ring) 3rd line(outer ring) based on this principle, and proposed even an opinion together that will need to be reflected in light of policy for the VIP security measures. In conclusion, as for the VIP Security-measure plans in the main site in preparation for G20 Summit Meeting, In the inner ring(safety sector), first, an intercepting measure needs to be devised for a spot of getting into and out of vehicles given the Straight Street. Second, the Walking Formation needs to be reinforced boldly in the exposed area. In the middle ring(security sector), first, the control plan needs to be devised by considering particularity of the main site. Second, there is necessity for adopting the efficient security badge operation plan that is included RFID function within security badge. In the outer ring(aid protective sector), first, there is necessity of preparing for several VIP terrorisms, of collecting information and intelligence, and of reinforcing the information collection system against terrorism under the cooperation with the overseas information agency. Second, the urgent measure training in time of emergency needs to be carried out toward security agent event manpower. Third, to maintain the certain pace in VIP motorcade, the efficient traffic control system needs to be operated. Finally, as for what will need to be reflected in light of policy for VIP security measures, first, there is necessity for allowing VIP residence to be efficiently dispersed to be distributed and controlled. Second, there is necessity for allowing impure element to misjudge or attack to be failed by utilizing diverse deception operations. Third, according to the reorganization in North Korea's Organization of the South Directed Operations, the powerful 'military-support measure' needs to be driven from this G20 Summit Meeting. For this, the necessity was proposed for further reinforcing the front back defense posture under the supervision of the Ministry of National Defense and for positively coping even with detecting and removing poison in preparation for CBR (chemical, biological, and radio-logical) terrorism.

• Korean Journal of Health Education and Promotion
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• v.18 no.3
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• pp.133-162
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• 2001

Unexpected accidents in school has been gradually increased every year, and student's mistaken was the first reason of the accident. To preventing the students from Unexpected accidents in school, safety education is more important than having strong facilities to have much more strong protecting forces for the accidents. Therefore, systematic education of safety is needed most of all, and especially, strengthening safety education in school is needed. Hereby, this study is aimed at investigating and analysing the actual condition and demand of safety education. It also conducted a survey with the target of 1,255 students in the second grade of high school in Seoul from April 20 to May 19, and the result of this study is as follows. 1. In the general features of the subject of the survey, boy students and girl students occupied 50.8％ and 49.2％ each, and boys' high school (34.3％), girls' high school(32.2％) and co-ed(33.5％) participated in balance. In the location, north from Han river occupied 54.6％, south were 45.2％. 2. According to the status of experiencing an accident, boys were more experienced then girls(p〈0.05). From the section, home accident(56.8％) occupied most followed by school accident, traffic accident, sports accident and poisoning. The accident happening most often in detailed category is sports accident such as basket ball, foot ball and dodge ball. The actual condition of the subject's using a school health facility shows that boys students use it more often than girl students(p〈0.01) 3. In attitude toward safety, the subject showed lower interest in safety issues than other social issues. But attitude in seriality of safety problems were high. Also, they responded ‘individual citizen’(63.1％) as the one who should make efforts for safety. Regarding knowledge of preventing safety accidents in attitude toward individual safety, 42.2％ answered ‘they know a little’ and 32.6％ of respondents say ‘they do not know’. To a question of the degree of the subject's following safety rules, 36.4％ were answered ‘keeping’ and the group using a school health facility shows more ‘keeping’ the others(p〈0.05). 4. To a question of asking if they have experienced safety education, 51.2％ answered ‘yes’. Teachers who mainly take care of safety education are answered as training teacher(48.7％). As for education time, training class(51.3％) is said to have safety education most followed by health-related event and PE(Physical Education). Frequency of education shows once or twice a session (62.8％) most often, but in case of co-ed school, 5-7times a session or more(20.1％) are being practiced. Looking at education time, 1-2 hour(s)(22.1％) or for a short time(22.1％) during class are being practiced. As an education method, instruction(43.8％) and video education(32.5％) are being practiced, and when it comes to education evaluation method, ‘not practiced’(70.0％) answered. To the question if they are satisfied with school safety education, they answered more ‘no(43.1％)’ than ‘yes(6.7％)’, and the reason is that safety education class is just for formality's sake, and the fact they already know is being repeated. The contents of safety education is composed of school safety, home safety, and first aid. 5. It is turned out that 56.5％ of the total boy students and 61.1％ of the total girl students recognize the necessity of safety education. To the question if safety education is needed in an elementary and middle education course, 46.4％ of the subject answer answered' it's necessary'. The most reason for their answers are ‘safety education is directly related to life’. 6. Regarding the requested time of safety education is ‘one hour a week’ by 55.9％. For safety education, safety education teachers(38.7％) are answered to be the most proper. As a request for safety education, video education is answered to be the most appropriate(30.6％), followed by practical skills, lecture and discussion(p〈0.05). Demand of educational evaluation, practical skills, interview and observation are answered to be needed. To the question if they want to participate in the way of demanded safety education, 41.9％ of respondents answer ‘have a mind to participate in’ (41.9％). To benefits followed by completing safety education, 72.0％ of respondents answer ‘agree’, and 24.7％ ‘do not agree’, which means lout 4 disagrees with completing safety education. 7. Looking at demand of safety education according to the features of the subject, ‘our position for the person who has handicapped’ was answer to the most.

• KSCE Journal of Civil and Environmental Engineering Research
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• v.36 no.5
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• pp.867-879
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• 2016

Since the 1970s, the region of its own pedestrian center and environmental pollution caused by exhaust gases have been reduced gradually in a continuous increase of the vehicle, school route the central business district, around the school, the sidewalk where the vehicle do not pass, facilities of minimum for the safety of pedestrians and systematic management of an area where an unspecified number and alleys impassable is insufficient. Recently, in response to the "Law for convenience enhancing safety and walking" is enforced in Korea, research on Pedestrian only Street has been actively about the government, the standard for calculating the weights of evaluation associated with it. it is a actuality, however, there are insufficient, evaluation for business promotion is being conducted evaluation polite manner by using, for example, scale residence time and purpose of the passengers as there is no car that has been carried out on a voluntary basis through the municipality have. In this study, by suggesting a method for the selection of the street without a car, make a survey by placing a purpose in the selection method presentation of the street with no car to be construction future, was researching. F.G.I (Focus Group Interview) survey, professors, staff in urban, traffic field of experts in order to present the weights for the evaluation of the Pedestrian only Street by using the evaluation index by type of Pedestrian only Street, was interviewed about the evaluation index for the conducted for professionals engaged in the engineering company, and randomly selected 200 peoples, weighted evaluation of the street with Pedestrian only Street was proposed. By classifying the items purpose and goals of the evaluation type by this by applying the weight, and present the weight of the detailed indicators each corresponding to each item, and scored on the basis of the result, in this paper it can be so that one methodology for the selection standard for the construction as Pedestrian only Street, and the weight of the evaluation of the type that has been derived, the selection and evaluation methods and then added to these criteria to settle careful study of the reference should be performed further.

• Journal of Korean Academy of Nursing
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• v.24 no.4
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• pp.545-556
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• 1994

Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. ［P=0.009］ By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

• Journal of Home Health Care Nursing
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• v.6
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• pp.33-45
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• 1999

The purpose of this study was to develop a basic framework and criteria for evaluation of quality care provided to patients with the attributes of disease in the home care nursing field, and to provide measurement tools for home health care in the future. The study design was a developmental study for evaluation of hospital-based HCN(home care nursing) in Korea. The study process was as follows: a home care nursing study team of College of Nursing. Yonsei University reviewed the nursing records of 47 patients who were enrolled at Yonsei University Medical Center Home Care Center in March, 1995. Twenty-five patients were insured at that time, were selected from 47 patients receiving home care service for study feasibility with six disease groups; Caesarean Section (C/S), simple nephrectomy, Liver cirrhosis(LC), chronic obstructive pulmonary disease(COPD), Lung cancer or cerebrovascular accident(CVA). In this study, the following items were selected : First step : Preliminary study 1. Criteria and items were selected on the basis of related literature on each disease area. 2. Items were identified by home care nurses. 3. A physician in charge reviewed the criteria and content of selected items. 4. Items were revised through preliminary study offered to both HCN patients and discharged patients from the home care center. Second step : Pretest 1. To verify the content of the items, a pretest was conducted with 18 patients of which there were three patients in each of the six selected disease groups. Third step : Test of reliability and validity of tools 1. Using the collected data from 25 patients with either cis, Simple nephrectomy, LC, COPD, Lung cancer, or CVA. the final items were revised through a panel discussion among experts in medical care who were researchers, doctors, or nurses. 2. Reliability and validity of the completed tool were verified with both inpatients and HCN patients in each of field for researches. The study results are as follows: 1. Standard for discharge with HCN referral The referral standard for home care, which included criteria for discharge with HCN referral and criteria leaving the hospital were established. These were developed through content analysis from the results of an open-ended questionnaire to related doctors concerning characteristic for discharge with HCN referral for each of the disease groups. The final criteria was decided by discussion among the researchers. 2. Instrument for measurement of health statusPatient health status was measured pre and post home care by direct observation and interview with an open-ended questionnaire which consisted of 61 items based on Gorden's nursing diagnosis classification. These included seven items on health knowledge and health management, eight items on nutrition and metabolism, three items on elimination, five items on activity and exercise, seven items on perception and cognition, three items on sleep and rest, three items on self-perception, three items on role and interpersonal relations, five items on sexuality and reproduction, five items on coping and stress, four items on value and religion, three items on family. and three items on facilities and environment. 3. Instrument for measurement of self-care The instrument for self-care measurement was classified with scales according to the attributes of the disease. Each scale measured understanding level and practice level by a Yes or No scale. Understanding level was measured by interview but practice level was measured by both observation and interview. Items for self-care measurement included 14 for patients with a CVA, five for women who had a cis, ten for patients with lung cancer, 12 for patients with COPD, five for patients with a simple nephrectomy, and 11 for patients with LC. 4. Record for follow-up management This included (1) OPD visit sheet, (2) ER visit form, (3) complications problem form, (4) readmission sheet. and (5) visit note for others medical centers which included visit date, reason for visit, patient name, caregivers, sex, age, time and cost required for visit, and traffic expenses, that is, there were open-end items that investigated OPD visits, emergency room visits, the problem and solution of complications, readmissions and visits to other medical institution to measure health problems and expenditures during the follow up period. 5. Instrument to measure patients satisfaction The satisfaction measurement instrument by Reisseer(1975) was referred to for the development of a tool to measure patient home care satisfaction. The instrument was an open-ended questionnaire which consisted of 11 domains; treatment, nursing care, information, time consumption, accessibility, rapidity, treatment skill, service relevance, attitude, satisfaction factors, dissatisfaction factors, overall satisfaction about nursing care, and others. In conclusion, Five evaluation instruments were developed for home care nursing. These were (1)standard for discharge with HCN referral. (2)instrument for measurement of health status, (3)instrument for measurement of self-care. (4)record for follow-up management, and (5)instrument to measure patient satisfaction. Also, the five instruments can be used to evaluate the effectiveness of the service to assure quality. Further research is needed to increase the reliability and validity of instrument through a community-based HCN evaluation.

• Journal of Preventive Medicine and Public Health
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• v.21 no.2 s.24
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• pp.224-237
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• 1988

To determine the causes of and related factors to childhood injuries, the emergency room records and inpatient medical records were reviewed for 4,849 injured children out of 15,790 pediatric patients(<15 years old) who visited the emergency rooms of 3 university hospitals and 2 general hospitals in Taegu from 1 January to 31 December 1987. Out of total injured children, 54.675 were 3-8 years old and the male to female ratio of the total injured children was about 2:1. The leading causes of injury were falls and slips (29.1%) and traffic accident(28.2%). The frequency of injury was higher in May-October than the rest of months and 51.6% of the injuries occurred between 15 and 20 o'clock. Falls and slips took place most frequently at the stairway(25.7%). The most common interpersonal violence was inflicted injuries(85.6%) and there were 11 child rapes. Dog bites accounted for 67.6% of all biting injuries and it occured 2.9 times more in male than in female. CO intoxication was the most common cause of poisoning (45.3%) and scalding accounted for 85.2% of all burns. Common places of drownings were river (32.2%), swimming pool (22.6%) and construction site(19.3%). To prevent childhood injuries, it is recommended to eliminate the hazardous environmental factors, to provide safe playgrounds, to educate the children for safety from kindergarten and the general public through mass communication, to establish a strict safety standard for houses, public buildings and facilities, and playgrounds.