• 임상간호연구
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• 제22권1호
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• pp.78-87
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• 2016

Purpose: This study was conducted to investigate the factors that influence the psychosocial adjustment of organ transplant recipients. Methods: Participants were 132 organ transplant recipients who received follow-up more than 3 months after the organ transplantation at one general hospital in Seoul. A questionnaire survey was done from November 3 to December 3, 2015. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficient, and hierarchical multiple regression. Results: Family support, medical staff support and hope were significantly correlated with psychosocial adjustment. In the hierarchical multiple regression analysis, hope appeared to be the most important factor influencing psychosocial adjustment (${\beta}=.39$, p<.001). Conclusion: The findings show that hope had an influence on the psychosocial adjustment of organ transplant recipients. Thus, to improve psychosocial adjustment it is important for nurses to develop interventions to increase hope in organ transplant recipients.

• 성인간호학회지
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• 제22권1호
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• pp.70-79
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• 2010

Purpose: This study was conducted to develop a Web-based learning program on cardiopulmonary emergency care for clinical nurses and to evaluate learners' responses. Methods: Based on the assessment of learning needs of clinical nurses, a total of three self-directed learning modules were developed according to the procedure of the ADDIE (assessment, design, development, implementation, & evaluation) model. Results: Each learning module included the emergency treatments and drugs used in the real patients' situations with cardiopulmonary crisis, which had been adopted from the emergency department of a C University hospital located in G-city. Real video clips for endotracheal intubation and ACLS (advanced cardiac life support) were developed with the help of the staff of the department of emergency medicine using a human simulator, $SimMan^{(R)}$. The program published on the Web was evaluated by 20 clinical nurses who are working in the emergency department and wards of a C-University hospital. About 80% of the respondents were satisfied with the program contents, design, and learning strategy. Conclusions: Web-based learning programs on cardiopulmonary emergency care are needed for clinical nurses as educational material for staff education to increase their knowledge for making immediate clinical decisions and in giving skilled care in emergency situations.

• 산업경영시스템학회지
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• 제32권4호
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• pp.17-24
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• 2009

The purpose of this research is to find the reasons of overcrowding in the emergency department of an hospital, then to shorten the total stay time of patients. The fact that main causes of the overcrowding exist in the process of the emergency department was discovered by analysis of the data. In order to improve these process, simulation model was developed by ARENA 7.0. Staff's service time, staff's organization, process ratio, and patient's waiting time were estimated in the simulation model in consideration of the decision of the patient's course of action. Several scenarios such as the simplification of the process, the setup of dedicated pathology lab, and mixed method were suggested and evaluated. Total stay time of the patients would be reduced up to 28.45%.

• 한국의료질향상학회지
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• 제27권1호
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• pp.26-42
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• 2021

Purpose: This study aimed to explore frontline nurses' experience of patient-centered care and understand the factors affecting its implementation in hospitals. Methods: Four focus group interviews were conducted with 30 nurses in two university hospitals. The following theoretical framework of patient-centered care was used: 1) Respect for patients' values, preferences, and expressed needs, 2) Care coordination and integration, 3) Information, communication, and education, 4) Physical comfort, 5) Emotional support and alleviation of fear and anxiety, 6) Involvement of family and friends, 7) Care transition and continuity, and 8) System issues. We performed a directed content analysis. Results: The most frequent patient-centered nursing practices of the hospital nurses were "promoting physical comfort" in inpatient settings and "providing information and communicating" in outpatient settings. The factors influencing patient-centered nursing included the health professionals' mindfulness, work overload and staff shortage, and unreasonable social demands and regulations. Conclusion: A more comprehensive patient-centered nursing practice should be implemented by improving "care transition and continuity," "family/caregiver involvement," and "system building." Health professionals' mindfulness is significant, and organizational supports addressing work overload and staff shortage are needed alongside change in social awareness.

• 동의신경정신과학회지
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• 제34권4호
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• pp.463-471
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• 2023

Objectives: Medical personnel are professionals subject to stressful situations and psychological distress. This case series reports the results of a mindfulness meditation program combined with digital health for medical personnel at a Korean medicine (KM) hospital. Methods: An online mindfulness program was implemented in 2022 to improve the mental health of nursing staff in a KM clinic. The online mindfulness program, which was supplemented based on previous results and limitations, was applied to KM doctors and nurses working at a KM hospital in this case series. An important difference from the existing case series was the introduction of a smartphone application that promoted the daily routine of meditation. A total of 7 medical personnel, including 4 doctors and 3 nurses, participated in the program. Results: After participating in the program, an increase in deep acting and a decrease in surface acting, which are aspects of emotional labor, were consistent with the results of a previous case series. However, the patterns of change in burnout and hwa-byung symptoms differed depending on the occupation of the participants. Participants' satisfaction with this program and the smartphone application and willingness to recommend it to colleagues were high. Conclusions: As this study was only a small case series, the author plans to continue to expand and improve the program based on the findings.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제30권2호
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• pp.23-34
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• 2024

Purpose: The Hybrid care environment, combining interventional procedures and surgeries in one space, is crucial for managing complex diseases, responding to emergencies, and reducing recovery times and pain. This study provides foundational data for creating architectural guidelines for a Hybrid Operating Unit in a general hospital's surgical department, focusing on cardiovascular care. Methods: The study analyzed the spatial and configuration types of the Vascular Angiography Unit and the Cardiac Operating Unit, which are the basic components of the Hybrid Operating Unit, through a literature review. Based on the initial research findings, interviews with experts were conducted. Results: In the Hybrid Operating Process, the study proposed spatial configuration alternatives that consider the positioning of medical staff and the types and arrangement changes of equipment, including Angiography, Heart-lung machines, and other surgical tools and instruments. Implications: The integration of the two units leads to increased diversity and demand for medical staff, equipment, and supplies during surgical and interventional procedures. Therefore, strategic spatial configurations and equipment placement are necessary to effectively respond to these needs.

• 서비스연구
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• 제13권4호
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• pp.113-130
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• 2023

본 연구는 환자와 의료진의 경험을 중심으로 상급종합병원 권역응급의료센터의 서비스디자인을 적용한 단일 사례 연구이다. 서비스디자인 기법을 활용하여 의료 서비스 경험을 측정 및 개선하고, 그 효과를 검증하는 것을 목표로 한다. 환자와 의료진으로부터 심층적인 경험 데이터를 수집하기 위해 민족지학(ethnography)과 디자인 워크숍을 중심으로 한 질적 사례 연구를 진행했다. 이 연구는 응급 의료 서비스에서 직면한 문제에 특히 중점을 두고 환자와 의료진 간의 주요 경험 차이를 확인하였으며, 권역응급의료센터 환경의 복잡한 역학을 이해하기 위해 환자와 의료진 인터뷰, 디자인씽킹 워크숍을 통해 수집된 정성 데이터를 대해 종합적으로 분석하고 디자인에 반영했다.연구 결과, 환자와 의료진의 요구를 반영한 디자인 현황을 3가지 주요 측면인 소통 개선, 환자 흐름 관리, 환경 개선의 필요성이 강조되었으며, 환자와 의료진 두 그룹의 특정 요구 사항의 차이점을 분석하여 권역응급의료센터의 서비스 개선을 위해 디자인 주도의 실행 과정을 적용 할 수 있었다. 이 연구는 의료 분야에서 디자인의 역할과 중요성을 강조하며, 이론적인 연구와 실제 디자인 실행 간의 효율적인 방법을 제시하고 있다. 이를 통해 더욱 빠르고 효과적이며 만족도가 높은 의료 서비스 환경을 만드는 데 기여할 수 것이다. 그리고 서비스디자인이 환자와 의료진 모두의 만족을 위한 새로운 혁신 과정의 핵심으로 보는 새로운 계기가 되기를 기대한다.

• 간호행정학회지
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• 제2권1호
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• pp.17-33
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• 1996

The primary purpose this descriptive study was to identify, describe, and compare the patterns of shared governance and nursing unit culture in the hospital settings. The secondary purpose of the research was to identify, describe whether the participation style or responsibility style of nursing management activities shared through nurses in a consistent way. Methodology included survey and in-depth interviews with a total 145 members of 15 nursing units in 3 hospitals. One was a national hospital, another was a corporation hospital and the other was a teaching hospitals. Conclusions from this research included the following: 1. The degree of shared governance in nursing management activities was the highest in the corporation hospital. 2. In the participation style of nursing management activities, 'all participation' was the highest in the corporation hospital. 'Nursing administration only' was the highest in the national hospital. 3. Distribution of responsibility style differed from that of participation style. Three hospitals showed high in nursing management activities such as 'nursing administration only' and 'head nurse only' style. 4. Five experts surveyed showed that the ideal level of nurses' participation in nursing management activities was a traditional nursing governance pattern. 5. There was a distinct difference in the nursing unit culture throughout the institutions in the professional growth. 6. There was no significant difference in the same nursing units of three hospitals in nursing unit culture. According to these results, the following implications can be made; 1. In nursing administration, there should be an emphasis on preparing staff nurses' potential decision-making ability through continuing education so that staff nurses' autonomy and responsibility will be developed and increased. 2. It is necessary to develop a strategic nursing unit for improving nursing quality in hospital setting. 3. The relationship of shared governance, nursing unit culture and nursing outcome should be researched further.

• 한국의료질향상학회지
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• 제19권2호
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• pp.80-88
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• 2013

Objectives: With the increase in the number of people who are marginalized in receiving medical services, the role of Seoul National University Hospital as a public hospital is being emphasized. However, many patients are either experiencing delays in receiving medical services or simply being left out as a result of the inaccessibility to the department of social work on part of both the patients and the medical staff. Methods: In order to increase consultation from other departments and the accessibility to the department of social work for the socially marginalized group through early consultation from other departments, the following steps were taken. First, an orientation program for novice medical residents led by clinical social worker was introduced/implemented. Second, posters and brochures on various financial aids programs were produced and distributed. Third, a system of early screening was built/constructed, and once a week rounds and early screening meeting were executed/carried out. Result: The department of social work's rate of consultation from other departments increased by 4.4% compared to last year, while it showed 61% increase for those wards that had an early screening meeting. In addition, the average time of consultation from other departments was reduced by 3.1 days, securing sufficient amount of time for clinical social work services, both in terms of quality and quantity. Conclusion: It is believed that the various promotional activities, along with the strengthening of accessibility to clinical social work services and early consultation on part of social disadvantaged/marginalized group, would undoubtedly help provide quality services to patients and increase their level of satisfaction. In this way, the wards can effectively reduce the number of unnecessary hospital stay days while the hospital can prevent the accumulation of outstanding bills/fees as well as contribute to the publicness of hospitals. The promotion of clinical social work programs in various ways are crucial to ensuring the satisfaction of patients and hospital staff.

• 한국병원경영학회지
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• 제5권1호
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• pp.1-23
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• 2000

This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.