• 제목/요약/키워드: clinical management

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급성 중이염과 삼출성 중이염의 진단과 치료 (Diagnosis and Management of Acute Otitis Media and Otitis Media With Effusion)

  • 장성희
    • Clinical and Experimental Pediatrics
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    • 제48권12호
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    • pp.1283-1294
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    • 2005
  • The American Academy of Pediatrics and American Academy of Family Physicians developed the clinical practice guideline on the management of acute otitis media. The American Academy of Pediatrics, American Academy of Family Physicians, and American Academy of Otolaryngology-Head and Neck Surgery developed the clinical practice guideline on the diagnosis and management of otitis media with effusion. These two guidelines provide evidence-based recommendations.

진료과별 재무성과 측정모형 구축 연구 -병원의 의료이익에 영향을 미치는 요소를 중심으로 - (A Study on Establishing Finance Performance Evaluation Model in Each Clinical Department - Factors Influencing Operating Profit of Hospitals -)

  • 이윤태;유기현
    • 한국병원경영학회지
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    • 제4권2호
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    • pp.162-191
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    • 1999
  • This study was conducted to establish finance performance evaluation model for physicians in each clinical department, by using factors which determines financial outcome(performance) in each clinical department The ultimate aim of study is to develop effective performance-based pay system for physicians. The system, by motivating physicians, should increase their productivity. To do so, it is critical to establish finance performance evaluation model to achieve final goal of this study. 232 private hospitals were chosen from 693 hospitals which were subject to hospital survey by the Korea Institute of Health Services Management and their revenue and expense-related data during 1997 were collected. By adopting multiple regression method, the study shows that the evaluation model for each clinical department was statistically significant. The study suggest the effective performance-based pay system based on financial performance of each clinical department. The pay system includes the level of compensation, the way of how to allocate profits to each department, and criteria whether the compensation should provide or not. In conclusion, the study has following implications. First, the study suggest finance performance evaluation model for each clinical department Second, the study suggest guidelines and plans to establish qualitative measure of financial performance in each clinical department. Third, the study suggest that adopting performance-based pay for physicians could be impetus to achieve organizational goal by motivating them with fair compensation.

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임상실습 경험이 있는 간호대학생의 환자안전 관리 활동 구조모형 (Model Patient Safety Management Activities for Nursing Students with Clinical Experience)

  • 오재우
    • 산업융합연구
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    • 제22권3호
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    • pp.121-135
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    • 2024
  • 본 연구는 임상실습 경험이 있는 간호대학생을 대상으로 환자안전사고관리 활동을 설명하고 Ajzen의 계획된 행위이론 및 안전문화 풍토-안전행동모형을 개념적 기틀로 하고, 문헌고찰을 토대로 간호대학생의 환자안전사고관리활동의 가설적 모형을 제시하고, 수집된 자료를 통해 모형의 적합도와 가설을 검증하는 구조방정식 모형 구축연구이다. 연구 대상은 임상실습 경험이 있는 간호대학생 251명을 대상으로 구조화된 설문지를 이용하여 자료수집을 시행하였다. 본 연구결과 모형은 적합한 것으로 확인되었으며 간호대학생의 환자안전관리 활동에 영향을 미치는 예측변수로 환자안전관리 태도, 환자안전문화 및 안전동기임이 확인되었다. 따라서 환자안전관리활동을 향상을 위해서는 임상 실습 현장에서부터 졸업 후 임상에 나가기 전까지 간호대학생이 올바른 환자안전 관리행위를 올바르게 수행할 수 있도록 간호대학생 대상 효과적인 환자안전 사고관리 교육프로그램이 필요하며 이러한 교육 프로그램이 실무현장까지 연속성있게 이어지는 방안을 모색할 필요가 있겠다.

임상영양팀의 업무생산성 및 효과분석 (Productivity and effectiveness of the clinical nutrition team)

  • 김영혜;신은수;강은희;김주현;김미경;김계진;홍희선
    • 대한영양사협회학술지
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    • 제2권2호
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    • pp.199-215
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    • 1996
  • In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.

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임상실습 스트레스와 실습 만족도의 관계에 미치는 적극적 스트레스 대처의 매개효과 (Mediation Effect of a Positive Stress Coping Strategy in the Relationship between Clinical Practice Stress and Clinical Practice Satisfaction)

  • 이선영;전선영;김윤영
    • 보건의료산업학회지
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    • 제10권2호
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    • pp.193-204
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    • 2016
  • Objectives : The purpose of this study was to identify the mediation effect of a positive stress coping strategy between clinical practice stress and clinical practice satisfaction in nursing students. Methods : In this study, data was collected from 248 nursing students at K University in South Korea from October of 2015 to November of 2015. The collected data was analyzed using the SPSS 22.0 Statistics Program. Results : Clinical practice stress and a positive stress coping strategy were significant predictors of clinical practice satisfaction (${\beta}$=.442, p<.001). The explanatory power of the measure of clinical practice satisfaction was increased to 29.3% (p<.001) with solely clinical practice stress, and it reached 44.2% (p<.001) when a positive stress coping strategy was reflected. The results of this study confirmed that a positive stress coping strategy has a mediation effect on clinical practice stress and clinical practice satisfaction levels. Conclusions : It is necessary to develop a program to take advantage of positive stress coping skills so that nursing college students can smoothly overcome stress during their clinical training and thus improve their clinical practice experience.

임상간호사의 통증관리에 대한 지식과 태도 (Clinical Nurses' Knowledge and Attitudes on Pain Management)

  • 현주;박경숙
    • 성인간호학회지
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    • 제12권3호
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    • pp.369-383
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    • 2000
  • The purpose of this study was to understand clinical nurses' knowledge and attitudes on pain management. The subject of the study were 254 nurses working at two hospitals affiliated with a university in Seoul. The questionnaires included four areas: general knowledge on pain, knowledge on the use of analgesia, knowledge and implementation on the pain assessment scales and pain interventions and nurses' general characteristics. The data were analyzed with descriptive statistics, analysis of variance, LSD test and t-test using SPSS statistical package. The results were as follows. 1. The mean score of the general pain knowledge was 61.46 and that of knowledge on the use of analgesia was 52.19. 2. Most nurses(74%) answered with hesitation about injecting narcotic analgesia to patients. 3. The pain assessment scale which nurses knew (57.5%) and used(48.0%) extremely was a simple descriptive scale. 4. The pain intervention which nurses knew (94.5%) and implemented(92.1%) extremely was to inject analgesia. 5. The number of nurses who had learned about pain management was 49 of 254(19.3%). 6. Nurses' knowledge on the use of analgesia was of relevance to having learned pain management, but general pain knowledge was not so relevant. According to this research, I suggest the following. 1. It is necessary to develop an education program with actual practice and intervention which nurses can perform for themselves. 2. It is necessary to continuously educate about pain management in clinical wards.

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중소병원 간호사의 근거기반 통증 관리 지식과 수행 및 근거기반 실무에 대한 태도 (Nurses' Evidence-Based Pain Management Knowledge, Performance and EBP Attitude in Small-medium Sized Hospitals)

  • 홍인화;은영
    • 한국임상보건과학회지
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    • 제3권4호
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    • pp.476-489
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    • 2015
  • Purpose. The purpose of this study was to investigate the evidence-based pain management knowledge, performance and Evidence-Based Practice(EBP) attitude of nurses at small-medium sized hospitals. Methods. The sample of this study were 214 nurses. Data were analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation and stepwise multiple regression using SPSS/Win 21.0 Results. Evidence-based pain management knowledge score averaged $3.95{\pm}0.43$, with significant differences depending on clinical experiences. Performance score averaged $3.77{\pm}0.51$. EBP attitude score averaged $3.21{\pm}0.57$, and significant differences were evident depending on hospital division and clinical setting. Evidence-based pain management knowledge and EBP attitude were significant predictors of evidence-based pain management performance. Conclusions. This result indicates that education and training programs to facilitate evidence-based pain management knowledge, performance, and EBP attitude are needed among nurses.

병원 영양부서의 급식 및 임상영양 서비스의 중점관리 요인 (Task Analysis on Foodservice , Clinical Nutrition Service in Hospital Dietetic Departments)

  • 홍완수;김혜진;장은재
    • 대한영양사협회학술지
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    • 제6권2호
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    • pp.148-160
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    • 2000
  • The purpose of this research was to analyze the tasks on foodservice ․ clinical nutrition service in hospital dietetic departments. A survey of 30 hospital food and nutrition service departments was undertaken and detailed informations were collected from each, including surveys of 176 dietitians and 30 foodservice managers. Statistical data analysis was completed using the SAS/win 6.11 package for descriptive analysis and t-test. The results of this study can be summarized as follows : Regarding dietitian's training period, 38.6% dietitians answered that they spent 1~2 years in mastering food service management. 28.4% dietitians replied that they needed 2~3 years in learning clinical nutrition management. It was shown that 48.9% dietitians were engaged in food service management, while 26.7% were engaged in clinical nutrition and 26.7% were engaged in both. The 13 elements of food service management showed low performance level. These elements were food temperature, food intake, menu selection, contaminated substances and serving mistake and reliance on hospital food. These should be controlled with caution. The average score of dietitian's life satisfaction within the work place was 3.42 out of 5. The most dissatisfactory element was physical environment of the workplace. 5 elements for improving nutrition service activities showed low performance level with high importance score. Problem analysis showed low difference score between importance and performance level. Hospitals under contract foodservice management received higher points on clinical nutrition performance(P<.05) than hospitals under self-operated foodservice management.

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IPA 분석을 활용한 임상영양관리업무의 수행도와 중요도 연구 (A Study on The Performance and Importance of Clinical Nutrition Management Using IPA Analysis)

  • 김송희;정용주
    • 한국콘텐츠학회논문지
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    • 제20권6호
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    • pp.156-166
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    • 2020
  • 본 연구는 IPA를 활용하여 의료기관에 근무하는 임상영양사의 임상영양관리업무의 수행도와 중요도의 인식차이를 조사하고자 하였다. 이를 위해 의료기관에 근무하는 100명의 영양사를 대상으로 분석하였다. 임상영양관리업무 17개 항목 모두에서 수행도와 중요도 인식에 유의한 차이가 나타났다. 중요도와 수행도 인식의 차이가 가장 큰 항목은 영양사의 임상영양 교육 참여 및 관련 직무 개발 활동(1.38), 가장 낮은 항목은 치료식 식사제공(0.69)으로 나타났다. IPA분석 결과 중요도와 수행도 모두 낮은 임상영양교육 참여 및 관련 직무 개발 활동은 우선적으로 개선해야 할 항목으로 분석되었다. 이를 위해 영양사에 대한 내외부 교육이 필요하다. 마지막으로 임상영양사를 의료인 범주에 포함시키는 정책과 효과적인 치료를 위해 의료진과 영양서비스관리에서의 협진이 무엇보다도 필요하다.

혈액 은행 전산 처리 프로그램의 개발 (The Development of Blood Bank Management Program)

  • 김종원;이승국;한규섭;김진규;조한익;김상인
    • 대한의용생체공학회:학술대회논문집
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    • 대한의용생체공학회 1989년도 춘계학술대회
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    • pp.75-76
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    • 1989
  • The blood bank is a field of clinical pathology which requires the most accuratemaintenanceofrecording. Because the mistake in it is directly related to a patient's life. So, the computerization of the blood bank is urgent to maintain a log blook arid to compare the patient's current data with past result. We developed the blood bank management program using 32 bit minicomputer. This is composed of 4 parts; a management of routine test result, special test result, the blood issue and statistics. The management of routine test result handles the patient's information and blood typing and compares above results with the past one of same patient. The management of special test result are for special immunohematologic tests like an irregular antibody, Coombs' test, and etc. Blood issue part records the type of the blood bag, component, and the name of issuer. Statistic part are made to get statistics of each day and each month by the blood type, and the type the blood component. The program is secured by the maintenance of operator's operation history and thu provision of the security code to each operator, without which no one can enter the system and after the content. So the stability and reliability of the data is obtained. This program will be upgraded for bar-code using system in the near future.

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