• 한국치위생학회지
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• 제11권4호
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• pp.557-569
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• 2011

Objectives : Based on the system and control activity for the monitoring system made of components for infection control at dental hospitals and infection rate reporting, and the role of trained infection control staff, this study tried to understand approaches to the effective infection control program by surveying infection control at dental hospitals in Korea. Methods : The survey was conducted from December 14,2010 to January 31,2011 for 121 dental hospitals in Korea. For statistical analysis, PASW Statistic 18 was used. Results : And following conclusions were reached. 1. As for the infection control system at dental hospitals, 54.7% has an infection control committee, 58.7% infection control staff, 78.5% infection control rules, and 39.7% annual infection control plan and record. 2. As for surveillance indexes to report infection rates, 50.4% has the reporting system for staff's exposure to infectious disease and needle pricking. The average number of exposures to infectious disease was $0.28{\pm}2.23$ and that of needle pricking was $1.83{\pm}5.39$. 3. As for infection control indexes, it was reviewed whether infection control rules were implemented according to operation agents, general hospitals were more active in staff infection control, and hospitals annexed to a dental university or special legal entity were more active in microorganism control. As for use of personal protection gear, there was no significant difference among operation agents. More than 71% of operators and their assistants said they did not replace their masks between patients. 4. As for personnel indexes for effective infection control staff, most hospitals designated dental hygienists, which was followed by dental doctors (or doctors). Where their workload was reviewed, the ratio of other work such as treatment was relatively higher than that of infection control (n=71). Conclusions : These results show dental hospitals in Korea have a certain level of infection control system. As infection indexes are managed mainly for staff members, patient monitoring is needed, and trained and effective infection control staff should be designated. This study reviewed surveillance, infection control and personnel indexes. And further studies are needed in the future.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제22권4호
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• pp.97-104
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• 2016

Purpose: Facilities for infection prevention according to the characteristics of the patients, caregivers and medical personnel are needed in the patient triage room of the emergency department as a space for the first medical examination and classification of the patients. This study focus on the patient tirage room with the highest frequency of use in the emergency department to prevent the hospital acquired infection of the emergency department. Methods:: This study analyzed the facilities standard needed for the infection prevention through interviews with the medical personnel and analyses on the facilities standard/cases of foreign hospitals and facilities standard at home and abroad Results: And based on this, it attempted to present improvement measures by analyzing the line of circulation and space used by infected patients in a hospital designated in the regional emergency medical center among hospitals whose emergency department overcrowding index is high. Implications: The facilities standard for the infection prevention among the courses for patient classification of the emergency medical centers could be identified and implemented to prevent infection.

• 임상간호연구
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• 제16권3호
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• pp.63-71
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• 2010

Purpose: This study was conducted to evaluate the incidence and risk factors for surgical glove perforation during operation. Methods: During the month of december 2008, a total of 1,400 pairs of surgical gloves used in major operations was collected in a tertiary hospital. All gloves were examined immediately after operation using the standardized water-leak method to detect any perforation. Incidence of the glove perforation was counted according to the type of operation, operation time, the number of involved personnel, perforation sites, and the manufacturing companies. Results: Out of 2,800 gloves examined, 312 perforations were detected comprising 11.1% of samples. In terms of the type of operation, the perforation incidence varied from 5% to 20%, and the perforation rates in CS (20%) and NS (18%) (p<.001) were significantly higher than those in other departments. The 1st assistant or scrub nurse got glove perforation more frequently than the 2nd assistant or operator (p<.001). Longer operation time was associated with higher incidence of perforation evidently (p<.001). In terms of the sites, the thumb and index finger were more frequently perforated than other sites (4.1% and 3.4% respectively) without any differences between left and right side. Conclusion: Risk factors for glove perforation including the department of operation, operation time, participating personnel, and location of perforation should be taken into account to improve surgical safety.

• 치위생과학회지
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• 제13권3호
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• pp.254-263
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• 2013

본 연구는 국내 치과의료기관 감염관리 평가지표를 도출하고 타당성을 검증하고자 하는 연구로서 평가지표의 구성단계, 개발단계, 검증단계로 설계되었으며, 평가지표 구성단계에서 이론적 고찰과 모형의 적용, 평가지표의 개발단계에서 국내 치과병원 감염관리담당자를 대상으로 양적, 질적방법의 예비조사와 관련 전문가를 대상으로 설문조사와 면접조사가 실시되었으며 신뢰도, 안면타당도와 내용타당도검증을 실시하였고 전국의 치과병원 감염관리담당자 121명을 대상으로 감염관리 평가지표 항목에 대한 가중치 조사 및 현장 적용의 문제점을 확인하였다. 평가지표 검증 단계에서는 탐색적 요인분석과 경로분석을 통해 구성타당도를 확인하였다. 이상의 모든 통계적 처리는 PASW Statistics 18.0 프로그램과 AMOS 5.0 프로그램을 이용하였다. 연구의 결과로 국내 치과병원 감염관리 평가지표는 구조, 과정, 결과 영역이 수립되었으며 구조 영역에서 5개 평가요인에서 21개의 세부 평가지표가 도출되었고, 과정 영역에서 8개 평가요인에서 32개의 세부 평가지표가 도출되었으며, 결과 영역에서 1개 평가요인에서 5개의 세부 평가지표가 도출되어, 각 영역에서 총 14개의 평가요인과 58개의 세부 평가지표가 도출되었다. 또한 상관성이 성립되는 8개 평가요인에 대한 경로분석 결과 '표준주의지침($x_1$)', '감염관리지원체계($x_2$)', '내외부적 특성($x_3$)'은 다른 변수들에 영향을 주는 외생관측변수이고 '표준감염관리($y_1$)', '기구 장비관리, 손씻기($y_2$)', '환경감염관리($y_3$)', '개인보호장구($y_4$)', '세탁물 및 폐기물관리($y_5$)' 등은 다른 변수들로부터 영향을 받는 내생관측변수로 작용함을 알 수 있었다. 본 연구에서는 우리나라 치과의료기관 실정에 맞는 감염관리 표준을 위해 평가지표를 개발하고자 하였으며 개발된 치과의료기관 감염관리 평가지표를 통해 국내 치과의료기관 감염관리 체계 활성화 및 감염관리 우선순위 결정에 기여하고자 한다. 향후 치과의료기관 감염관리의 질적 제고를 위하여 감염관리 평가제도 및 인증제도 활성화를 제안하며 향후 지속적인 연구와 관심이 필요하다.

• Journal of Korean Neurosurgical Society
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• 제55권1호
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• pp.48-50
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• 2014

Brucellosis is caused by gram-negative, aerobic, non-motile, facultative, intracellular coccobacilli belonging to the genus Brucella. A 50-year-old man working as an employee was admitted to neurosurgery clinic with severe low back, radicular right leg pain and hypoesthesia in right L4-5 dermatomes for 2 months. Brucella tube agglutination (Wright) test was positive in serum sample of the patient with a titer of 1/640. Brucella melitensis was isolated from blood culture. X-ray and MRI of the lomber spine showed massive collapse of L4 vertebral body. Neural tissue was decompressed and then posterior L3-5 short segment transpedicular screw fixation and stabilization was performed. Brucella melitensis was isolated from microbiologic culture of pathologic specimen. Antibiotic therapy was given as doxycycline 200 mg/day and rifampicin 600 mg/day for 6 months. Brucellosis is a systemic zoonotic infection and still an important public health problem in many geographical parts of the world. Vertebral body collapse caused by brucellosis occurs very rarely but represents a neurosurgical emergency because of its potential for causing rapidly progressive spinal cord compression and permanent paralysis. Neurosurgeons, emergency department personnel as well as infectious disease specialists should always keep a high index of suspicion and include brucellosis in the differential diagnosis of vertebral body collapse.

• Tuberculosis and Respiratory Diseases
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• 제82권4호
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• pp.298-305
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• 2019

Background: Tuberculosis (TB) causes substantial health burden to the Korean military. This study aims to assess the impact of infectious TB cases on close and casual contacts in the Korean Army settings based on contact investigation data. Methods: Six Army units with infectious TB cases from September 2012 to May 2013 were enrolled in the study. We analyzed the clinical data from close and casual contacts screened using the tuberculin skin test (TST) and QuantiFERON-TB Gold In-Tube to identify latent tuberculosis infection (LTBI) cases. For the control group, 286 military conscripts with no reported TB exposure were tested by TST only. Results: Of the 667 contacts of index cases, LTBI cases identified were as follows: 21.8% of close contacts of smearpositive cases (71/326), 8.5% of casual contacts of smear-positive cases (26/305), and 2.8% of close contacts of smearnegative cases (1/36). In the control group, 16.8% showed positivity in TST. In a multivariate analysis, having stayed in the same room or next room with TB patients was identified as a risk factor of LTBI. Conclusion: Using the data from TB contact investigations in the Korean Army units, we found an overall LTBI rate of 14.7% among the contacts screened. This study demonstrates that contacts living in the same building, especially the same room or next room, with TB patients are at a high risk of acquiring LTBI, serving as additional evidence for defining close and casual contacts of a TB patient with regard to Army barrack settings.