• Journal of Korean Society of Occupational and Environmental Hygiene
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• v.24 no.3
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• pp.310-320
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• 2014

Backgrounds: Endotoxin, which found in the outer membrane of the gram-negative bacteria cell wall, makes up almost all of the lipopolysaccharide(LPS). When people are exposed to endotoxin,it can result in diverse health effects such as an airway irritation and inflammation, fever, malaise, bronchitis, allergic asthma, toxic pneumonitis, hypersensitivity lung disease. Cases among the elderly, children or pregnant can occur more frequently than a healthy adult if they are repeatedly exposed to the existing endotoxin. Therefore, we investigated and assessed the environmental characteristics associated with the airborne endotoxin concentration level in six hospital lobbies. Method: Endotoxin from indoor air in six hospital lobbies was measured by an area sampling method and analyzed according to American Society for Testing and Materials International(ASTM international) E2144-01. Total suspended particulate(TSP), carbon dioxide($CO_2$), temperature and humidity were also measured by using direct reading measurements or airborne sampling equipment at the same time. Environmental characteristics were appropriately divided into two or three groups for a statistics analysis. One-way analysis variable(one-way ANOVA) was used to examine a difference of the endotoxin concentration, depending on the environmental characteristics. In addition, only variables with p-value(p<0.25) were eventually designed to the best model by using multiple regression analysis. Results: The correlation analysis result indicated that TSP(p=0.003) and $CO_2$(p<0.0001) levels were significantly associated with endotoxin concentration levels. In contrast, temperature(p<0.068) and humidity(p<0.365) were not associated with endotoxin concentration. Levels of endotoxin concentration were statistically different among the environmental characteristics of Service time(p=0.01), Establishment of hospital(p<0.001), Scale of hospital(p=0.01), Day average people using hospital(p=0.03), Cleaning time of lobby(p=0.05), Season(p<0.001), and Cleaning of ventilation system(p<0.001) according to ANOVA. Finally, the best model(Adjusted R-square=72%) that we designed through a multiple regression test included environmental characteristics related to Service time, Area of lobby, Season, Cleaning of ventilation system, and Temperature. Conclusions: According to this study, our result showed a normal level of endotoxin concentration in the hospital lobbies and found environmental management methods to reduce the level of endotoxin concentration to a minimum. Consequently, this study recognized to be requirement for the management of ventilation systems and an indoor temperature in order to reduce the level of endotoxin concentration in the hospital lobbies.

• Journal of Trauma and Injury
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• v.32 no.1
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• pp.1-7
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• 2019

Purpose: The present study aimed to evaluate the influence of how the trauma care system applied on the management of trauma patient within the region. Methods: We divided the patients in a pre-trauma system group and a post-trauma system group according to the time when we began to apply the trauma care system in the Halla Hospital after designation of a trauma center. We compared annual general characteristics, injury severity score, the average numbers of the major trauma patients, clinical outcomes of the emergency department, and mortality rates between the two groups. Results: No significant differences were found in the annual patients' average age ($54.1{\pm}20.0$ vs. $52.8{\pm}18.2$, p=0.201), transportation pathways (p=0.462), injury mechanism (p=0.486), injury severity score (22.93 vs. 23.96, p=0.877), emergency room (ER) stay in minutes (199.17 vs. 194.29, p=0.935), time to operation or procedure in minutes (154.07 vs. 142.1, p=0.767), time interval to intensive care unit (ICU) in minutes (219.54 vs. 237.13, p=0.662). The W score and Z score indicated better outcomes in post-trauma system group than in pre-trauma system group (W scores, 2.186 vs. 2.027; Z scores, 2.189 vs. 1.928). However, when analyzing survival rates for each department, in the neurosurgery department, in comparison with W score and Z score, both W score were positive and Z core was higher than +1.96. (pre-trauma group: 3.426, 2.335 vs. post-trauma group: 4.17, 1.967). In other than the neurosurgery department, W score was positive after selection, but Z score was less than +1.96, which is not a meaningful outcome of treatment (pre-trauma group: -0.358, -0.271 vs. post-trauma group: 1.071, 0.958). Conclusions: There were significant increases in patient numbers and improvement in survival rate after the introduction of the trauma system. However, there were no remarkable change in ER stay, time to ICU admission, time interval to emergent procedure or operation, and survival rates except neurosurgery. To achieve meaningful survival rates and the result of the rise of the trauma index, we will need to secure sufficient manpower, including specialists in various surgical area as well as rapid establishment of the trauma center.

• Investigative Magnetic Resonance Imaging
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• v.16 no.1
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• pp.1-5
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• 2012

Breast MRI is the most accurate adjunctive to the mammography for the screening of breast cancer. Despite lack of randomized controlled trials on the effectiveness of MRI screening, it is now recommended for the women at high risk for breast cancer by the American Cancer Society and the National Comprehensive Cancer Network based on several prospective observational studies. In Korea, a retrospective study reported that preoperative MRI screening of the contralateral breast in women with unilateral breast cancer was associated with reduced metachronous cancer incidence. To introduce breast MRI as a supplemental modality to screening mammography in Korea, standardization and education of interpretation, establishment of MR-guided biopsy and adequate indication, and evaluation of cost-effectiveness and should be preceded.

• Journal of Korean Academy of Nursing
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• v.42 no.1
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• pp.76-84
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• 2012

Purpose: The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: A cross-sectional study design was used. Data were collected from a convenience sample of 202 critically ill patients admitted to a university hospital. Upon establishment of content and translation equivalence between the English and Korean version of CPOT, psychometric properties were evaluated. Results: The interrater reliability was found to be acceptable with the weighted kappa coefficients of .81-.88. Significant high correlations between the CPOT and the Checklist of Nonverbal Pain Indicators were found indicating good concurrent validity (r=.72-.83, p<.001). Data showed the area under the ROC curve of 0.86 with a cut-off point of 1, which resulted in 76.9% sensitivity and 88.6% specificity. The mean score of CPOT during suctioning was significantly different from that of before (t= -14.16, p<.001) or 20 minutes after suctioning (t=16.31, p<.001). Conclusion: Results of this study suggest that the CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal patients.

• Journal of Korean Academy of Nursing Administration
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• v.8 no.4
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• pp.655-667
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• 2002

Purpose : This study analysis of nursing interventions and core nursing interventions performed orthopedic surgery care unit. Method : The data were collected from 55 nurses of 4 general hospital from July. 10, 2002 to Aug. 30, 2002. The instrument for this study was the Korean translation of 486 nursing intervention classifications developed by McColskey & Bulechek in 2000. In the 486 nursing interventions 350 nursing interventions were selected 8 among the 10 more than 5 years working group in orthopedic surgery care unit. Self frequency checking performed by 350 nursing interventions were used secondary questionnaire In the orthopedic surgery care unit nurses. Results : 1. The most frequently used nursing interventions domains were "Physiological : basic" and then "Physiological: complex", "Health system" "Behavior", "Family", "Safety". 2. Orthopedic surgery care unit core nursing interventions were performed several times a day by 50% or more of orthopedic surgery care unit and this result were 4 of domain, 11 of class, 26 core nursing interventions. This core nursing interventions were 5 of "Physiological : basic", 17 of "Physiological: complex", 1 of "Safety", 3 of "Health system" and have no "Behavior", "Family". Conclusion : This study analyzed nursing intervention of orthopedics and reestablished nursing intervention concept and I hope this study will be helpful for the nurse to be a professional by applying this to actual clinic, for development in qualified nursing and for establishment nursing information system.

• Journal of Korean Clinical Nursing Research
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• v.24 no.1
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• pp.23-33
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• 2018

Purpose: The purpose of this study was to investigate the effect of SBAR communication program on nurse's perception about communication and attitudes toward patient safety. Methods: A single-group pre-post experimental study was conducted. A SBAR education program was provided to 167 nurses working in 9 general wards of a hospital in Seoul. A total of 153 questionnaires were included for the final analysis. Statistical analysis included analysis of variance, paired sample t-test, and Cochran-Mantel-Haenzel test. Results: After applying SBAR communication education, nurses perceived significant improvement in three of the five categories of communication between nurses and doctors; satisfaction (p=.001), accuracy (p=.001), and understanding (p=.002). The indicators of communication between nurses were also improved significantly in the order of accuracy (p=.001), satisfaction (p=.001), shift communication (p=.001), and openness (p=.016). The scores of nurse's attitudes toward patient safety demonstrated a significant increase in the five categories out of the six; perception of management (p=.001), working condition (p=.001), safety climate (p=.001), teamwork climate (p=.001), job satisfaction (p=.012). Conclusion: It is recommended that nurses and doctors use SBAR communication in their practice. Developing education programs and utilization methods is required for the effective establishment of SBAR communication.

• The Korean Journal of Health Service Management
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• v.9 no.1
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• pp.17-29
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• 2015

This study, an examination of the plan for effective resource management for national university hospitals, was performed to determine the relationship between the effectiveness of patient output by considering input personnel using the DEA model and Management Performance, in which 4 years of data from 12 national university hospitals were analyzed. Among the components of the effectiveness, utilizing properly imput components from the application of VRS(Variable Returns to Scale), the Management Performance of national university hospitals was found to be affirmatively influenced by PTE(Pure Technical Efficiency). Regarding the Management Performance of national university hospitals in their attempts to establish a plan for effective human resource management, the management of patient numbers on the basis of calculation level with input is more recommendable than the controlling of personnel input using patient numbers. Thus, the establishment of a strategy plan for the proper allocation of administrative staff and sickbeds, considering the variation of patient numbers, is suggested.

• Journal of The Korean Society of Clinical Toxicology
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• v.4 no.2
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• pp.122-127
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• 2006

Purpose: It is not easy to detect carbon monoxide (CO) leakage, and CO-intoxicated patients do not show a specific set of symptoms. The aims of this study are to clinically evaluate patients with CO gas intoxication from a CO leak at an underground shopping center, and to discuss the establishment of a disaster prevention plan. Methods: A total of 51 patients intoxicated by CO gas exposure in a gas disaster at a underground shopping center in Seoul on September 8, 2006 were enrolled in this study, and the patients' medical records were retrospectively reviewed. Results: The mean patient age was $29.4{\pm}6.3$. The initial mean COHb level was $14.98{\pm}6.97%$. The number of patients with COHb greater than 25% was three, and six patients experienced a syncopal attack. Only one patient-was treated with hyperbaric oxygen therapy. However, none of the patients complained of severe neurologic or cardiovascular symptoms. Conclusion: The symptoms of CO intoxication are non-specific and difficult to define, and the detection of CO leak-age is difficult. Thus, workplaces should be equipped with leakage sensors and automatic alarm systems and should have develop disaster prevention plans.

• Korea Journal of Hospital Management
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• v.18 no.2
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• pp.81-103
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• 2013

This study is to research cost accounting practice and to analyze propriety of patients' medical payment in artificiality kidney center. The researched cost datum of the year 2012 are as follows. - Hemodialysis medical treatment was reimbursed as much as 158,001 won in case of health insured patients, but payed-off as much as 135,810 won. - The average figure of the total hospitals and clinic center is 1,603,303 won, and one time cost of hemodialysis treatment is 154,487 won. Optimal treatment pay are suggested as follows. First, Regardless of the notified classification from MOHW(Ministry of Health and Welfare), 136,000 won of fixed price payment classification needs to be reclassified by patients, severity and tobe rearranged by fixed price payment system of hospitals. Second, Fixed payment code notified by the Ministry of Health and Welfare is recommended to be simplifies and to reflect according to contents of the medical treatment rendered to patients. Third, Establishment of artificial kidney center has to be risk managed because of its huge investment. Fourth, Cost analysis model has to be maintained as basis together with appropriate application of conversion index model mixed with SGR model.

• Journal of Korean Academy of Nursing Administration
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• v.12 no.4
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• pp.532-540
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• 2006

Purpose: To identify the degree of users' satisfaction with Nursing Information System. Methods: The study is a survey of users' satisfaction with Nursing Information System. The subjects of the study are 300 nurses who use the Nursing Information System at least for 6 months or longer; data was collected from August 26th to September 1st, 2005. The collected data was analyzed on SPSS 12.0. Results: The results showed that there are noticeable differences in the degree of satisfaction among the users using the Nursing Information System depended on the subjects' marital status, working department, job title, types of computer training and other facts, such as individual's ability of using the system finding necessary references. Nursing records (including administration and prescription of medicine) was chosen to be the priority for the recognition of the Nursing Information System; for motivation on establishment of Nursing Information System was the efficiency of work; and for any problems or troubles with the Nursing Information System was the delayed work due to the system-suspension. Conclusion: The study implied that Nursing Information System have improved and effective Nursing practice.