Some of the important and vital roles performed by the Health Care Center of Pohang Iron & Steel Co., Ltd.(POSCO) are the periodic monitoring of the work sites as well as regular medical check-ups for each workers to ensure both pleasant and safe working conditions and to protect employees' health. Pohang Steel Works, which has 42 plants, 26 facilities and 12,000 employees, has an annual crude steel production capacity of 9,670,000 using 24,500,000 ton of raw materials. We have measured lots of areal and personal working environment according to Occupational Safety and Health Law semiannually. All data collected on industrial hygiene is stored and managed by personal computer. The developed of a computerized industrial hygiene control system linked to the company's main computer system will provide efficient evaluation of the working environment as well as critical informations on employees' health. Development of this system had begun in May, 1992 and was completed in March, 1994. The computerized industrial hygiene control system can; 1. store industrial hygiene data, providing key pertinent to the diagnosis of occupational related illnesses, and if necessary, the basis for improving the working environment, 2. decide type and time of medical examination of each work for exposure to specific agents, and supply proper protection periodically, 3. prevent occupational related illnesses through evaluation of environmental and biological monitoring, and performance of epidemiological surveillance, 4. facilitate proper job placement through linking of industrial hygiene control and personnel information systems, 5. monitor job processes. levels of chemical agents used, and new agents introduced, 6. and increase productivity by saving time resulting from the implementation of the computerized sysyte,
내부회계통제는 자산을 보호하고 회계자료의 정확성과 신뢰성을 검증하고, 운영의 효율성을 촉진하며 미리 정한 경영정책의 실행을 촉진하기 위하여 경영조직의 계획과 기업이 채택한 조정방법과 조치를 포함한다. 내부회계통제는 다음과 같이 분류된다. l. 일반통제 : $\circled1$ 조직과 운영통제 $\circled2$ 시스템개발과 문서통제 $\circled3$ 하드웨어 통제 $\circled4$ 소프트웨어와 하드웨어의 접근 가능성에 대한 통제 $\circled5$ 일반적인 시스템의 보안 2.응용통제 : $\circled1$입력통제 $\circled2$처리과정 통제 $\circled3$출력통제 내부회계통제는 기업의 경영통제와 연계시킴으로서 총체적인 경영정보시스템을 구축할 수 있으며 의사결정자로 하여금 의사결정지원시스템을 구축할 수 있게 한다.
This study was done in order La provide basic data to a Fee System for hospital based Home Health Care services in Korea in the future. It was done by investigating activities provided to possible Home Health Care clients who could be discharged early from genera] hospitals and then estimating the nursing care fee according to each nursing activity based upon the time used for activity. The subjects of the study were selected by convenience sampling and consisted of 35 clients who might be clients for Home Nursing Care and were presently admitted to a medical- surgical ward of Y University Medical Center located in Seoul, Korea. The data collection period was from September 1, 1991 to September 30, 1991. The research in strum nets utilized for the study were a client selection criterial for Home Health Care developed by Choo(l991) and a check-list of nursing activity developed by researcher. The results of the study were as follows : 1. There were 44 different nursing activities provided in the seven days but the time was calculated for only 25 of the nursing activities. 2. Fees for the 25 different nursing activities were calculated by multipling the median of the average wage of a staff nurse having five years experience in an A grade general hospital to the Lime of the nursing activity. The results were compared with the insurance fee which the government recognized as an appropriate fee for that activity. The nursing activities with a lower calculated fee than the insurance fee were suction, catheterization, exercise education and dressing change. The nursing activities with a higher calculated fee than the government recognized fee were 1M injection and vital sign check. 3. There was a range of 1-15 nursing activities provided daily to the client. For the average number of nursing activities per day of 6.26 events the nursing care fee was calaulated at W 6136 per day. 4. Based upon the results of the study, a recommentdation for a Home Health Care fee per visit based on the nursing activities provided could be formulated for a Home Health Care fee system. It could be formulated as following: 1) Home health Care fee per visit $=[(direct{\;} nursing{\;}fee(direct{\;}nursing{\;}care{\;}time{\;}per{\;}activity{\;}{\times}{\;}average{\;}nursing{\;}wage)+indirect fee]{\times}average$ nursing activity per visit]+management fee+ materials fee+a travel fee In this way a nursing fee could be calculated based upon the result of the study of the nursing fees per visit. 2) Nursing activity fees per visit. = $([direct nursing{\;}care{\;}fee+indirect{\;}nursing{\;}fee]{\times}average$ number of nursing activities provided per visit] (W 6, 136) + travel fee(\ 5, 542) +management fee material $fee({\alpha})\{\;}16, 436+{\alpha}$ The nursing fee per visit as calculated in this research of $\{\;}15, 0000+{\alpha}$ could be adjusted according to the patient's condition or the use of high technology nursing care or according to the amount of time spent for travel. The nursing care fee per visit presented in this study can be validated through a Home Health Care demonstration project.
우리나라에서 흔히 채택하고 있는 배수형 터널은 배수시스템 열화 혹은 수압작용에 따라 누수가 발생하는 문제점을 내포하고 있다. 누수는 소량일 경우 외관으로 드러나지 않아, 육안으로 확인할 단계가 되면 이미 라이닝 손상 혹은 설비에 영향을 미치는 상황이 되어 초기에 인지하고 대책을 마련하는 것이 매우 중요하다. 그러나 운영 중인 배수터널의 누수거동을 확인하기 위해서는 터널을 훼손하여 배면을 조사하여야 하는데, 이는 터널 유지관리상 허용되기 어렵다. 본 연구에서는 비파괴 물리탐사법인 전기비저항 탐사법을 이용하여 터널의 방수막을 훼손하지 않고, 누수여부를 파악하는 새로운 시도를 하였다. 모형 라이닝을 제작하여 습윤정도, 혹은 열화에 따른 누수거동을 탐사한 결과 전기비저항 탐사법이 라이팅 배수기능모니터링 혹은 누수조사에 유용하게 활용될 수 있음을 확인하였다. 또한 이 방법은 라이닝 누수 보수공사 후, 추가 누수여부의 조사 및 보수공사 점검에도 유용하게 활용될 수 있음을 보였다.
The purpose of pilot clinical trial is to evaluate the efiicacy and safety of Needle-Embedding acupuncture therapy on TEWL(Transepidermal Water Loss) and Skin hydration. A total of 24 human who visited Dongshin Oriental Medical Center from December 1st, 2016 to July 31st, 2017 were included in the pilot clinical trial. Needle-Embedding acupuncture therapy performed at Gokji(LI11). We observed change of TEWL(Transepidermal Water Loss), Skin hydration before and after Needle-Embedding acupuncture therapy. In the primary endpoint, index of TEWL showed a statistically insignificant decline ($8.5{\pm}2.12{\rightarrow}7.8{\pm}1.53g/h/m^2$). Index of skin hydration showed a statistically significant result ($38.2{\pm}6.77{\rightarrow}36.8{\pm}6.64$). To evaluate the safety, Adverse events and Vital sign check were conducted and there were no problem. And when the physical response, self-awareness, skin system, musculoskeletal pain, and other abnormal responses were assessed 60 minutes and 24 hours and 7 days after Needle-Embedding acupuncture therapy at Gokji(LI11) for stability assessment, Adverse events disappeared during a pilot clinical trial. According to the above pilot clinical trial, it is suggested Needle-Embedding acupuncture therapy were effective for Skin moisturizing and safe.
Medication is a kind of medical service and a therapeutic nursing function which takes large portion of nursing service and requires complicated procedures. So many different medical personnel should be involved and cooporate each other in order to accomplish medication. Medication is also a vital nursing service, So nurse feels heavy responsibi lity in that she gives medication to the patient finally, so she has much responsibility if medication error is happened. Therefore it seems very important to clarify the problem of medication system and method, and find the subculture of medication situation because it may promote nursing productivity. The study was conducted to 1. Describe and interpret medication situation. 2. Find out the problem of medication system and method and on alternatives. 3. Compare the medication system and method of hospitals which are located in Seoul with object hospital Ethnographic methodology was used to study medication situation by doing participant observation and interview of health care personnel. Ten nurses and three nurse aids were interviewed. Two residents and internists, two phamacists and two accountants were also interviewed. Data was obtained and analized according to Developmental Research Sequence introduced by Spradly. On the basis of this data the results were as follows. 1. The overall flow of medication system was devided into six stage : first, checking doctor's order : second writing doctor's order, : third, transfering slip into the related departments such as account department, pharmacy : fourth, distribution of medication from pharmacy to unit : fifth, identifing medication by nurses : and finally, medicating to the patient. Behaviorors have been under a lot of stress in that they have to do much works, especially paperworks, So too much time were needed. They also have been suffered interpersonal conflicts among health care personnel and role conflicts in the process of doing medication service. 2. In the process of checking order, the problem was that too much time was required for checking order and paperwork. The more the order changes the more the paperwork is. Nurses have been suffering difficulties in calling internist in order to get bill. Even if writing down slip for medication order is doctor's job, Sometimes nurse has been expected to write slip by doctors or nurse would write slip beacuse of two much complexities and efforts for calling doctors. If the slip were incorrect, much time complicated procedures were more required for correcting it. So delay of administering drug would be resulted consequently. Drugs were delivered from pharmacy to units by delivery agent and phamacist. But because drugs were delivered without arranging room number of patient. Nurse should rearrange drugs in order of the room number So it had made waste time and effort, and Even when emergency drugs were needed, Prompt delivery of drug was not easy because of many reasons. For nurses, it took too long in the identification of the right drug. Actually nurses have heavy burden when medication error happens because nurse is the final actor who gives medication to the patient, So every three shift nurse ought to check drugs as soon as every shift begins. That's why it took too much time due to repeated confirming procedure. When nurses had to go patient room in order to give medications, there were difficulties in watching patient until the patient take medicine correctly. So it was impossible to check every patient wheather he took medicine or not especially in hectic situation. 3. There were many hospitals in Seoul which have similar medication system and method as object hospital according to the results of questionaire. This means that many hospitals have been suffering srimilar problems which were identified in object hospital. 4. Recommendations for promoting simplification of medication system and method were the following : Redesigning of slip from two pieces of paper into one : early discharge announcement system, and slip confirming through computer and controlling of period of prescreption from one day to two or three days : designing personal drug storage box for each patient and using it. If nurses follow the recommendations, they will make medication short & simple, and also have enough time of direct nursing care 5. Even though there were many difficulties in medicating patients. Medication itself has been considered as a caring among nurses because it makes rapport between nurse and patient. So nurses had better accept medication as a portion of nusing service not a original portion of phamacist. There are some limits in this research in terms of confining to only one unit of one hospital, and treating it especially in view of nurses' aspects, So further researchs should be continnued from various kmds of viewpoints of doctors, phamacists and so on. ${\cdot\cdot\cdot}$. Especially esthnographic study of computerized medication system and method seems to be followed.
1990년대 후반 이후 스마트 의류는 인간과 컴퓨터의 상호작용, 사용자 중심의 디자인 등 다각적으로 연구, 개발되고 있다. 최근에는 보다 기능화, 감성화된 스마트 의류가 개발되기 시작하였으며, 이는 다양한 어플리케이션으로 연구, 개발되어 제시되고 있다. 그 중 센서를 기반으로 한 건강관리용 스마트 의류는 스마트 의류의 여러유형 중 가장 예상 수요가 높은 유형으로 예측되며, 이러한 전망으로 인해 연구, 개발이 가속화되고 있는 분야이다. 이에 따라 본 연구에서는 스마트 의류에 적합한 생체 신호 센서를 도출하고, 그를 기반으로 기본적인 생체신호, 심장질환, 호흡기 질환을 측정할 수 있는 스마트 의류 디자인을 개발하였다. 즉, 본 연구에서 개발된 스마트의류는 기존의 의류의 외관 형태는 그대로 유지하면서, 직물 신호선을 제작, 와이어의 이물감을 없애 착용성을 높였으며, 착장 시 생체신호가 컴퓨터로 무선 전송되어 이를 실시간으로 모니터링 할 수 있도록 고안되었다. 이 스마트 의류는 생체 신호 센서를 이용하여 심장질환, 호흡기 질환과 다양한 질병 예방을 보조할 수 있는 건강관리용 의류로서 센서기반 스마트 의류의 한 모형을 제시하였다.
This study was done to determine direct and in-direct nursing time in nursing units in hospital to ap-plied computer system and expect that those results contribute to measure efficiency of nursing practice and planning of nursing manpower. The design for study was a descriptive study. The study results are as follows. 1. Patients admitted to the Internal Medicine and General Surgery units were grouped into four. Group Ⅰ, 32.9% of the total patients, consisted patients whose condition was considered minor Group Ⅱ, 26.1%, was of those whose condition was considered moderate, Group Ⅲ, 41. 8%, moderate severe and Group Ⅳ, 29.2% the most severe. 2. Nursing intervention times by care type were as follows four minutes spent for suction eight minutes, for simple position change, ten minutes, for sheet change, seven minutes for a hot or cool compress, six minutes for dressing change, four minutes for Ⅰ.M. injection, six minutes for patient health education and five minutes for body temperature check. 3. Direct care time by patient group revealed the following : Group Ⅰ rquired 191.4 minutes, Group Ⅱ required 331.1 minutes, Group Ⅲ rquired 499.4 minutes, and Group Ⅳ rquired 1328.0 minutes. 4. The ratio of time for adequate nursing care and direct care time in the Internal Medicine and Goneral Surgery units was 67.4%-83.4% and 94.7%-99.3% in the Intensie Care Unit. 5. Average daily direct care time per patient was 5.5 hours in the Internal Medicine unit and 11.5 hours in the Intensive Care Unit. 6. Time spent in indirect care was 48.3 minutes for computer recording,34.8 minutes for giving and receiving patient information for shift duty, 28.0 minutes for eating and resting time, 26.6 minutes for transfering and identifying patients, 25.6 minutes for identifying Doctor's order, 23.9 minutes for recording vital signs. 7. Time spent in indirect care was 282.2 minutes by head nurses (charge nurses), 258.7 minutes by nurses and 261.6 minutes by nurse aids. 8. The average nurse's workload was 9.3 hours and daily indirect nursing time required 46.3%-50. 5% of above mentioned workload time. .9. The average daily indirect care time per patient was expected to be 57.7 minutes in the Internal Medicine unit and 3.3 hours in the Intensive Care Unit.
The purpose of the present study is to confirm the interacting behavior between nurses and patients and other things concerned herewith. Subjects of investigation were : 42 nurses selected out of the average nurses who serve in hospital as nurses assigned to medical and surgical wards : and 42 male and female adult patients selected out of the average patients who were under the care of the nurse individuals and can make themselves understood verbally. A nurse and her patient were paired off for questioning. Materials for statistics were gathered by means of observaing interactions- - verbal and nonverbal - -of the chosen subjects for four hours every day from 7 : 30 a.m. through 7 : 30 p.m. between on July 15, 1988 and on Aug. 16, 1988. Classified by patterns, the materials observed and gathered were preliminarily analyzed by this researcher, and then reexamined in a full-fledged way by one professor, three nurses and three non - nurses. The researcher depended chiefly on Frequency, ANOVA, Pearson's Correlation Coefficient attached to SPSS Computer System for the process of gathered materials. The results of this investigations are follows 1) A total of 98 times' interactions between nurses and patients were provided during observation of 168 hours. 2) It took them the averaged 264.8 seconds(around 4.4 minutes) per a couple of subjects to interact between nurses and patients during observation of four hours. 3) The aim of interactions between nurses and patients appear that 29 times of injection amounted to 29.6% the most, 27 times of PO around to 27.6% the next most, 25 times of vital check to 25.5% the next most, 17 times of independent nursing works and round to 17.3% the least most. 4) As a result of qualitative analyzing the interactions between nurses and patients by the distinctive method of words were positively recognized in 19 cases with 45.2% and negatively in 23 cases with 54.8%. 5) A total of 2, 193 times. interaction behaviours between nurses and patients were provided. The frequency of these interaction behaviours took place l, 364 times with 62.2% to nurse, and 829 times with 37.8% to patients. 6) The classification of verbal and nonverbal interaction behaviour between nurses and patients indicated that it is amounted to 64.9% for verbal behaviour numbered 1, 423 and 35.1% for nonverbal one numbered 770. 7) The frequency of verbal behaviour between nurses and patients numbered 1, 423 in total. They took place 924 times to nurses and 499 times to patients, it can be also amounted to 64.9% and 35.1% respectively in percentagewise. 8) In interactions between nurses and patients, it turned out that the frequency of nurses' turns, which the present research discovered averaged 16.8 times for four hours, and the verbal behaviours by numbered 9.7 on an average. 9) Nonverbal behaviours between nurses and patients numbered 770 in total, it is assigned 440 times to nurse with 57.1% and 330 times to patients with 42.9%. 10) The investigation releases in formation that the frequency of verbal behaviours between nurses and patients was very much concerned with the age of patients(r=0.422, p<.01) and the number of patients one nurse has under her care(r=-0.356, p<.01). 11) It was found that were deep relationship of the number of a nurses turn with the patients age(r=0.377, p<.01) and the nurses burden of caring patients(r=-0.372, p<.01).
The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.
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