• Title/Summary/Keyword: hospitals of Korean Medicine

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Calculation of the Quality Additional Rate of Clinical Laboratory Test and Review of Application Criteria (임상병리검사 질 가산율 산출 및 적용기준의 검토)

  • Yang, Byoung Seon;Park, Sang Muk;Bae, Hyung Joon;Kim, Won Shik;Park, Hun Hee;Lim, Yong;Kim, Yoon Sik;Choi, Se Mook;Bae, Do Hee;Park, Ji Ae
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.261-270
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    • 2020
  • This study reviewed the quality addition rate, calculation, and application criteria needed to identify the possibility of additional medical technologists in the field for new certification and professional manpower to provide a superior laboratory. The six institutions that participated in the study were the size of large hospitals with more than 1,000 beds, with an average of five full-time laboratory physicians (also called clinical pathologists) and an average of 53 medical technologists, with 10.6 per laboratory physician. An analysis of the time required for each activity category of medical technologists revealed decreasing behavior during the analysis. In contrast, the ratio of the comprehensive pre-analysis activities was high due to the strengthening of laboratory operations and quality control. During the analysis, the proportion of biochemistry tests was high, and post-analysis of most of the results was performed. Hence, improving the quality of sample testing requires significant time, and appropriate personnel are required. In conclusion, the recruitment of medical technologists is also a key component to improving the sample quality, and corresponding personnel regulations are necessary.

A Comparative Study on the Perception of the Impediment Factors between Mothers and Nurses in Nursery (모유수유 저해요인에 대한 산모와 신생아실 간호사간의 인식정도 비교 연구)

  • Lee, Mi-Ja
    • Women's Health Nursing
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    • v.1 no.1
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    • pp.138-152
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    • 1995
  • The condition of nutrition during infancy will greatly affect infants' physical, emotional growth, especially breast feeding is important in their growth and development, and emotional stability, too. Despite such advantages of breast-feeding, its rate has continued to fall year after year in Korea : the 95% rate in 1960's has fallen to 25.4% in 1990. It is known that such a downfall of breast-feeding rate is associated with various factors. The purpose of the study is to examine mother's and nurses' in nursery perception of the impediment factors of breast-feeding : to compare those between of breast-feeding : to compare those between two groups : to provide fundamental data for developing strategies for increasing breast-feeding. The subjects were 45 new mothers from one hospital and the same number of nurses sampled from 3 university hospitals, in Seoul. The data were collected for 11 days from April 12 to April 23, 1994 and a questionnaire was developed based on the interview with 14 nurses and 10 mothers and the literature reviews. Liker's Five-Point Scale was used as measurement. The Data were analyzed using SPSS / PC and descriptive statistics, t-test, ANOVA. The results of study are as follows : 1) Most new mothers get the information about breast-feeding from their mothers, books or newspaper, and relatives in rank than professionals(nurses or doctors). 2) The impediment factors the breast-feeding are categorized as mothers, hospital system, medical personnels and social factors. The most frequently mentioned impediment factors from mothers are 'Difficulty by operational wounds'(3.13), 'Lack of will for breast-feeding'(3.47), 'Insufficient rest and sleep'(3.52) and 'Opposition from husband or his family members'(4.77)in rank. On the other hand those factors from nurses are 'Inadequate nipple condition'(2.37), 'Decreasing milk secretion given medicine after operation'(2.63), 'Mothers knowledge deficit by poorly prepared education'(2.79) and 'Mothers abhorance of breast-feeing'(3.87) in rank. 3) As for the hospital system, the highly perceived impediment factors by mothers are 'Seperation of baby from mother after birth'(2.78), 'Lack of space for breast-feeding in the hospital'(2.93), 'Lack of facility for informing the time for breast-feeding'(3.18) and 'Because of babys' preference artificial nipple by being accustomed to it in hospital(3.97), in rank. Meanwhile, those from nurses are "Seperation of baby from mother after birth",(1.92), "Inconsistency between hospital's nursing time and mother's breast secretion time" scretion time(2.97), "Lack of space for breast-feeding in the hospital"(3.39), and "Lack of facility for informing the time for breast-feeding"(3.74) 4) As for the medical personnels, the highestly perceived Impediment factor from mothers in "Lack of professional nurses for breast-feeding"(2.96), and the lowestly perceived one is "Doctors' reluctance"(4.75). Nurses perceived same as mothers, too. 5) As for the social factors, the highestly perceived impediment factor by mothers and nurses is "Inconvience of social activities"(2.83) and the lowestly ones are "The sense of self-sacrifice"(4.22) by mothers, and "The sense of old fashioned"(4.13) by nurses. 6) The difference of the perception of impediment factors between mothers and nurses is statistically significant only in mother factor.

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Factors related to Use of Physical Restraints for Older Adults with Dementia in Long-term Care Settings (장기요양시설 및 요양병원 입소 치매대상자의 억제대 적용 관련 요인)

  • Lee, Haejung;Park, Myonghwa;Lee, Sung-Hwa;Lee, Mihyun;Go, Younghye;Kim, Chun-Gill;Kim, Jeong Sun;Kim, Kyung Sook;Lee, Young Whee;Lim, Young Mi;Song, Jun-Ah;Park, Young Sun;Youn, Jong Chul;Kim, Ki Woong;Hong, Gwi-Ryung Son
    • Journal of Korean Gerontological Nursing
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    • v.21 no.2
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    • pp.125-134
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    • 2019
  • Purpose: The purpose of this study was to investigate factors related to use of restraints for older adults with dementia in long-term care settings. Methods: This study analyzed secondary data from the Nationwide Survey on Dementia Care in Korea (NaSDeCK). Demographic characteristics, disease characteristics, and functional characteristics were analyzed. Data were analyzed with χ2 test, t-test, ANOVA, and logistic regression analysis. Results: Among participants, 8.2% experienced use of restraints. 'Strap' (78.3%) was the most commonly used restraint and 'Behavioral problem' (51.3%) was a major reason for the restraint. Persons who have low levels of daily activity and cognition deficits, higher levels of dependence, histories of falls within the past 3 months, and living in long-term hospitals have greater probability of restraint experience. Conclusion: Developing interventions for older adults who have a high risk of being restrained is essential to minimize unnecessary restraint use among older adults with dementia in long-term care settings. Further study exploring the interacting roles of organizational and staff factors related to use of physical restraints would provide more comprehensive perspectives in understanding this phenomenon.

Survey for Alternative Therapy Used by Cancer Patients Receiving Radiation Therapy (방사선치료 암 환자의 대체요법 경험실태 조사연구)

  • Park Cheol Woo;Park Tae-Jin
    • The Journal of Korean Society for Radiation Therapy
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    • v.13 no.1
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    • pp.75-90
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    • 2001
  • Although it is presumed that cancer patients take various alternative therapies, the present status is not well recognized. The purpose of this study is to survey alternative therapies used by cancer patients receiving radiation therapy and then, find associated factors of taking alternative therapies. The study subjects were composed of those who receiving radiation therapy in the department of radiation oncology in 5 hospitals located at Extended Busan city and who were on follow-up after medical cure. They were 394 male and female patients over 20 years old. The mean age of the subjects was 53.2 years old and the age ranged from 23 to 83 years old. 188 patients($47.7\%$) used alternative therapies. Total 68 different kinds of alterative therapies were used, average 7.3 kinds per patient were experienced, and average total cost expenditure was 2,830,000 won. Among the alternative therapies, black bean($38.8\%$) was the most commonly used and brown rice($38.3\%$), ganoderm lucidum($37.8\%$), elm tree($33.5\%$), and phellinus linteus($30.8\%$) were followed in order of frequency. However in considering the time, cost and effort spent, phellinus linteus was the first. In terms of cost, phellinus linteus was the highest with average expenditure of 2,740,000 won. Among the motivation of using alternative therapies, expecting auxiliary help for the hospital therapy was the highest ($31.4\%$). About half of users($56.9\%$) of alternative therapies were recommended by their relatives to use alternative therapies. In comparing the characteristics of experienced and unexperienced groups, alternative therapy was experienced significantly more in patients of younger age(p=0.001), in patient of higher educational level(p=0.001), and in patients of higher income(p=0.030) The proportion of using alternative therapies was significantly higher in the group treated with chemotherapy(p=0.005), and in the patients who did not satisfy with radiation therapy(p=0.001). The frequency of drinking was significantly higher tendency in the inexperienced group(p=0.046), There was no significant difference in marital status, job, religion, other disease, surgical operation of the cancer and smoking staus between the two groups. Among the unexperienced group, $34.0\%$ of the patients did not take the alternative therapies because they did not have know]edge for the alternatives, and $22.3\%$ worried about negative effects on hospital-based therapy $58.7\%$ of them were willing to take the alternative therapies if the effects and safety were proven by the government or research institutes. $21.9\%$ of the patients wanted to take the alternatives if they were affordable. $72.3\%$ of the patients was willing to take them if their families recommend, but $27.2\%$ responded they would not take them in any situation. Conclusively, various kinds of alternative therapies which were not proved medically were exposed to patients, In these circumstances, it is required to investigate, study and evaluate the medical effects and safety of the alternative therapies.

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A Study on the Job-Santisfacion and Its Depressive Facors in Human Relation Among Operation Room Nurses (수술실 간호사의 인간관계 만족도와 저해요인에 관한 연구)

  • Cho, Mi-Ja
    • The Korean Nurse
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    • v.32 no.4
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    • pp.48-62
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    • 1993
  • This study was done for the purpose of analyzing the job-satisfaction and its depressive factors in human relation of operating room nurses of university hospital. Therfore, it makes an offer the basic data to help the resolution and prevention of the problems in operating room nurses. Furthermore, this study was conducted in order to find out some kinds of scientific data for the better control of depressive factors of job-satisfaction expressed by the operating room nurses. The structred questionaire reports of 246 operating room nurses who were employed in 5 different university hospitals which have over 1, 000 beds located in Seoul, Korea were used, which wer collected from August 24th to August 30th of 1992. The author visited supervisors of operating room in each university hospital and explained the aim of this study. The most of them(90.0%) answered to the questionaires. Analysis of the collected data were done by mean, standard deviation, percentage, t-test, F-test, Q-test, correlation analysis, one-way ANOVA.and stepwise multiple regression analysis. Major findings of this study were as follows: 1. The job of the operating room nurses were remarkably related with the satisfaction in human relation, which was defined as the behavioral job with thoughtful action rather than with mechanical action. However, the degree of satisfaction in human relation with personnel in other departments was found to be the lowest and its the main depressive factors were appeared due to the absence of interaction and uncooperative attitudes. Therefore, it was required that the members of other job need more cooperative attitude to the actual works in the operating room nurses. 2. The depressive factors in the satisfaction degree of human relation with offical seniors wer significantly related with their irresponsibility and partialness. Moreover, the job attitude of the operating room nurses is abundantly required to be improved, 3. The depressive factors in the satisfaction of human relation with medical doctors were significantly related with their insincerity and the class-consciousness. It is clearly suggested that the medical doctors do more cooperative behaviors for the jobs of the operating room without the suggested that the medical doctors do more cooperative behaviors for the jobs of the operating room without the superiority feeling of class-consciousness. 4. There was a significantly positive association between the satisfaction degree of human relation of the nurses with the following charateristics. (1) The registered nurses which had a tendency to be satisfied about the registered nurses' job. (2) The registered nurses which had a tendency to be a technique-aptitued in the motivation of the registered nurses'job. (3) The registered nurses which had a tendency to be satisfied about the total hospital working carrier and the aspects of old ages. Finally, these findings indicated that the operating room nurses should require the professional education courses associated with a high-development techniques and setisfaction in their jobs.

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Clinical experience in managing temporomandibular joint ankylosis: five-year appraisal in a Nigerian subpopulation

  • Braimah, Ramat;Taiwo, Abdurrazaq;Ibikunle, Adebayo;Oladejo, Taoreed;Adeyemi, Mike;Adejobi, Francis;Abubakar, Siddiq
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.44 no.3
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    • pp.112-119
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    • 2018
  • Objectives: Temporomandibular joint ankylosis (TMJA) is a joint pathology caused by bony and/or fibrous adhesion of the joint apparatus, resulting in partial or total loss of function. Materials and Methods: This is a retrospective study conducted between 2012 and 2016 in the northwest region of Nigeria. The data retrieved includes gender, age, etiology of ankylosis, duration of ankylosis, laterality of ankylosis, type of imaging technique, type of airway management, types of incision, surgical procedure, mouth opening, interpositional materials used, and complications. Results were presented as simple frequencies and descriptive statistics. Results: Thirty-six patients with TMJA were evaluated during the study period. There were 21 males (58.3%) and 15 females (41.7%), yielding a male:female ratio of 1.4:1. The patients' age ranged from 5 to 33 years with $mean{\pm}standard$ deviation ($13.8{\pm}6.6years$). Thirty-five cases (97.2%) were determined to be true/bony ankylosis, while only 1 case (2.8%) was false/fibrous ankylosis. Most of the TMJA cases (16 cases, 44.4%) were secondary to a fall. In our series, the most commonly utilized incision was the Bramley-Al-Kayat (15 cases, 41.7%). The mostly commonly performed procedures were condylectomies and upper ramus ostectomies (12 cases each, 33.3%), while the most commonly used interpositional material was temporalis fascia (14 cases, 38.9%). The complications that developed included 4 cases (11.1%) of severe hemorrhage, 1 case (2.8%) of facial nerve palsy, and 1 case (2.8%) of re-ankylosis. Conclusion: Plain radiographs, with their shortcomings, still have significant roles in investigating TMJA. Aggressive postoperative physiotherapy for a minimum of 6 months is paramount for successful treatment.

Comparison of Split versus Subunit Seasonal Influenza Vaccine in Korean Children over 3 to under 18 Years of Age

  • Kang, Seah;Kim, Dong Ho;Eun, Byung Wook;Kim, Nam Hee;Kang, Eun Kyeong;Lee, Byong Sop;Kim, Yun-Kyung
    • Pediatric Infection and Vaccine
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    • v.26 no.3
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    • pp.161-169
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    • 2019
  • Purpose: This study was conducted to compare immunogenicities and reactogenicities of the trivalent inactivated subunit influenza vaccine and split influenza vaccine in Korean children and adolescents. Methods: In total, 202 healthy children aged 36 months to <18 years were enrolled at six hospitals in Korea from October to December 2008. The subjects were vaccinated with either the split or subunit influenza vaccine. The hemagglutinin inhibition antibody titers against the H1N1, H3N2, and B virus strains were measured, and the seroconversion rates, seroprotection rates, and geometric mean titers were calculated. All subjects were observed for local and systemic reactions. Results: Both the split and subunit vaccine groups had similar seroprotection rates against all strains (95.9%, 94.9%, 96.9% vs. 96.0%, 90.9%, and 87.9%). In children aged 36 to <72 months, the seroprotection rates were similar between the two vaccine groups. In children aged 72 months to <18 years, both vaccines showed high seroprotection rates against the H1N1, H3N2, and B strain (98.4%, 98.4%, 98.4% vs. 97.0%, 95.5%, and 91.0%), but showed relatively low seroconversion rates (39.1%, 73.4%, 35.9% vs. 34.3%, 55.2%, and 38.8%). There were more local and systemic reactions in the split vaccine group than in the subunit vaccine group; however, no serious adverse reactions were observed in both groups. Conclusions: Both the split and subunit vaccines showed acceptable immunogenicity in all age groups. There were no serious adverse events with both vaccines.

The Evaluation of Therapeutic Control with Warfarin in Patients with Mechanical Heart Valve Prostheses (인공심장판막 환자를 대상으로 한 Warfarin 치료의 적정성 평가)

  • Im, Young Sun;Chang, Byung Chul;Suh, Ok Kyung;Lee, Suk Hyang;Shin, Hyun Taek
    • Korean Journal of Clinical Pharmacy
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    • v.9 no.1
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    • pp.27-34
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    • 1999
  • The goal of oral anticoagulation therapy with warfarin is to maintain INR values within the therapeutic range in order to prevent complications such as bleeding and thrombosis. The purposes of this study were to investigate the current level of anticoagulation control using INR values, to investigate the incidences of thromboembolism and bleeding complications, and to compare the effect of low intensity INR regimen with therapeutic range recommended by ACCP (American College of Chest Physician). Two hundred three patients with mechanical heart valve replacement done at Yonsei University Cardiovascular Center between January 1994 and December 1996 were selected and reviewed retrospectively. The target INR ranges of $2.5\sim3.5$ (ACCP standard) and low intensity INR of $2.0\sim3.5$ were used for evaluation. According to ACCP standard, $51.2\%$ of patients and $31.1\%$ of INR values were within the therapeutic range when average INR and cumulative INR were used, respectively. Applying low intensity INR values of $2.0\sim3.5$, the therapeutic control was achieved in $57.4\%\;and\;90.1\%$, using average INR and total INR, respectively. The incidences of major and minor bleedings were $0.5\%\;and\;26.6\%$, respectively. The incidence of thromboembolism was $0.5\%$. There was no significant difference in terms of complication incidences between INR $2.0\sim2.5\;and\;INR\;2.5\sim3.5$ groups. However, INR values at the time of bleeding were generally high. In conclusion, the evaluation of patients with mechanical heart valve replacement showed low level of therapeutic control with warfarin therapy. This is partially explained by the fact that the physicians at Yonsei University Cardiovascular Center were using lower intensity INR values as a goal than recommended INR. Also, in the near future, systematic anticoagulation service should be implemented at various hospitals in Korea so that patients on anticoagulant therapy can be more closely monitored to be within the recommended INR by ACCP.

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Respiratory Hospital Infections of Patients with a Tracheostomy (기관절개술 환자의 호흡기계 병원감염양상에 관한 연구)

  • 양숙자;최영희;김문실
    • Journal of Korean Academy of Nursing
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    • v.19 no.3
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    • pp.240-248
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    • 1989
  • The increase in size and numbers of general hospitals in the process of conspicuous development of modem medicine has been accompanied by a serious increase in hospital acquired infections. Hospital aquired infections cause pain and discomfort, may threaten life, adds an economic burden, and delays recovery and return to society. Even though respiratory hospital infection rates resulting for tracheostomy and respiratory inhalation therapy, may be low, they are serious because of their bad prognosis and high mortality rates. This study was designed to assess certain aspects of respiratory infections of patients with a tracheostomy and thus provide baseline data for further research related to preventive or therapeutic nursing interventions. The specific objectives were to determine the incidence of colonization in the trachea, clinical signs, type of colonized bacteria and sensitivity to antibiotics. Data were collected from July 1 to December 10, 1989 at two university Hospital in Seoul. Subjects were 20 patients with a tracheostomy admitted to the Intensive Care Unit or Cerebral Vascular Accident Center. Clinical signs related to respiratory infection were observed using a checklist based on previous study outcomes. Bacterial culture, sensitivity test to antibiotics, WBC counts and chest X-ray were also performed. Cultures were done on the day of tracheostomy, and on the third, fifth and seventh day. Cultures were then done on seventh days after the first colonization. The results were as follows : 1. The incidence of bacteria colonization in a week was 90%(18 patients) 50% (10/20 patients) on the day of tracheostomy, 70%(7/10 patients) on the third day, and 0% on the fifth day, and 33%(1/3 patient) on the seventh day. 3 of 18 patients (16.7%) were colonies of mixed growth isolated. 2. The observed clinical signs related to respiratory infection were high fever 38.9%(7 patients), prulent secretion 16.7%(12 patients) and infiltration seen on chest X-ray 33.3%(6 patients). 3. The total number of types of bacteria isolated among the 18 subjects was 21 ; gram negative 71.4%, gram postive 28.6%. The dominant bacteria type was Staphylococcus aureus(5 cases) for gram(equation omitted) and Pseudomonas aeruginosa(3 cases), Klebsiella (4 cases), Enterobacter(3 cases) for gram (equation omitted). The results of culture on 7th day after the first colonization, 6 cases showed same type of bacteria, 3cases showed different type of bacteria and 1 cases showed no growth. 4. The sensitivity tests to antibiotics showed that Pseudomonas aeruginosa and Staphylococcus were strongly resistant to most kinds of antibiotics, but Klebsiella and the rest of gram negative bacteria were moderately sensitive to antibiotics.

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Nurse Practitioner Roles and Curriculums in the United States (미국 전문간호사(NP)의 역할과 교육과정에 관한 고찰)

  • Lee Sun-Ock
    • The Journal of Korean Academic Society of Nursing Education
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    • v.5 no.1
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    • pp.97-105
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    • 1999
  • Based on literature, status and role of the NP in America was reviewed. The process of developing NP program in America suggests us many things. In America, nurse practitioners have sustained a mutually beneficial status with their patients for over thirty years. Excel fence in academic education and clinical training will enable nurse practitioners to continue to provide quality health care. The magnitude changes in the health care system of the United States, the challange of providing real access of health care continues. Lack of access to adequate primary care was the driving force in the initial 1965 Federal Involvement in developing the NP role. In 1993 President Bill Clinton's health care reform initiative provided policy support for NPs as primary care providers. The Institute of Medicine explicitly recognized NPs as an integral part of the primary care team. In addition, several national reports recognized NPs as affordable, accessible, high-quality care providers. The recent passage of direct Medicare reimbursement for NPs reflected public policy statements coincided with and likely contributed to a growth spurt in the NP workforce. From 1965 to 1977 NP programs offered traditional primary care clinical tracks(adult, family, woman's health, and pediatrics) for relatively small clusters of students in a variety of institutional settings. From 1978 to 1990 these educational programs were incorporated into graduate schools of nursing. By 1990 the majority of NPs received educational preparation in master's-level nursing programs. A new emphases was placed on postmaster's NP programs designed for master's prepared clinical nurse specialists and nurse managers. he the health care system shifted hospital nursing resources toward community-based care, these master's -level nurses sought additional NP preparation. NP educational programs are defined as the educational structure in which one or more NP clinical tracks are offered. NP clinical tracks, in turn, offer curriculum and supervised clinical experiences that match standards in specific practice areas such as family(FNP), adult(AUP), geriatrics(GNP), pediatrics(PNP), women's health (WHNP), neonatal (NNP), and acute care(ACNP). There were indications that NP practice was expanding into new clinical areas as evidenced by new types of tracks, particularly in acute care and psychiatry. The increase in acute care NP students likely reflects the increased demand from hospitals and other acute care settings. In Korea, change of nurse's role into nurse practitioner's role may have many difficulties. The need of health consumer, policy support of government, approval of medical care team are all essential component. Every nursing personnel make effort to planning the new health care delivery system.

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