Journal of Korean Academy of Nursing Administration
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v.7
no.2
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pp.265-284
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2001
The case management has been applied to improve the quality of care and the cost-effectiveness in the most health care institutions. In a way of case management, the critical pathway(CP) has been executed in many acute care settings, focused on the diagnoses with high cost, high volume, and high risk. This study was conducted to develop a case management program using CP as an intervention of patients with lumbar spinal stenosis for the surgery of posterolateral fusion, and to find out the effects of the critical pathway on the quality of nursing care, patient satisfaction as an outcome of care, length of stay and medical charge, and nurses' job satisfaction. At the same time, patients' functional states were checked with the Oswestry Low Back Pain Index, to show that the CP would not decrease the patients' function compared to the control group. The subjects were 25 control patients with a usual operation of lumbar fusion and 25 experimental patients with CP. They were all female, aged $50s{\sim}70s$, admitted in the Orthopedic surgery ward of a university hospital. Also nurses on the floor using CP were asked to respond to measurement tool of job satisfaction before and after the application of CP, and compared with other nurses on the different wards. Data were analyzed with t-test for continuous variables and chi-square for non-parametric variables in addition to the reliability test of the measurement tools. The results of this study were as followings: 1. Patients' functional states The differences in Oswestry scores of the experimental and control groups assessed at preoperation and at discharge were not statistically significant. The change in scores of the experimental group measured at preoperation and at discharge was larger than that of the control group, however the difference was not statistically significant. The results indicate that the CP did not decrease the patients' functional status. 2. The quality of nursing care The total of quality of nursing care given to the experimental group was better than that of the control group(P=.000). In addition, the experimental group showed better scores of quality of every item of care than the control group(P=.000 -.004). 3. Patient satisfaction Patients of the experimental group were not more satisfied with general care than the control group. But they were more satisfied with discharge care of 'explanation about medication, body posture, and brace application' and 'explanation about the adjustment of daily living and exercise during recovery'(P= .047, P=.028). 4. Nurses' job satisfaction Nurses working with the CP showed more job satisfaction than before the CP introduction(P=.048). But the control group of nurses on a different floor showed no change in job satisfaction at the same period of time. 5. Length of stay and medical charge The mean length of stay of the experimental group was shorter than that of the control group without statistical significance. The charge of medication and treatment of the experimental group were smaller than that of the control group(P=.011, P=.000). The results of the study support that the case management using critical pathway enables to improve the quality of care and job satisfaction, to reduce the medical charge, and consequently to increase satisfaction with care. However, the case management should be instituted focusing on the quality improvement of nursing and the client satisfaction, not just for the purpose of cost-effectiveness of health care facilities.
HACCP is a preventative food safety management system whose application is highly encouraged worldwide. In this study, the workers' demands for the application of HACCP system at the meat retail shops were surveyed. According to a factor analysis on the demands of the application of HACCP system, the results could be classified into three factors: HACCP support, HACCP promotion and education, and generic livestock product safety management. Items on demands showed higher results for HACCP support (3.91 point) than for HACCP promotion and education (3.83 point) or generic livestock product safety management (3.72 point). The application of HACCP system was more demanded by HACCPcertified retailors with 4.11 point than the non-HACCP-certified ones (3.57 point). From the analysis of items on demands, 'governmental promotion of the general public livestock HACCP; (p<0.001) was the highest demand item by the HACCPcertified retailors and 'HACCP certification support for the government's investment' by the non-HACCP-certified ones (p<0.05). The strengthening of governmental support for the application of HACCP at meat retail shops as well as active HACCP promotion and education aiming at general public was demanded. With this, the establishment of HACCP system and the improvement of safety management level at the area of meat retail shops could be achieved, contributing to the increase of consumers' satisfaction.
The purpose of this study was to identify the sanitation management items of school foodservice suppliers that require improvement, by assessing their sanitation practices with food commodities. Our field assessment was performed using a total of 20 vendors supplying agricultural products, meat products, seafoods and processed products; all were located in the Seoul and Gyeonggi areas. The assessment tool for sanitation management was composed of 93 checklist items and was used to evaluate seven different categories; the facility and environment, management of the facility and equipment, food materials management, process control, water management, personal hygiene management, and laboratory instrument management. A score of two was given for "satisfactory", one for "fair", and zero for "unsatisfactory". The overall average supplier score was 1.7/2.0 (85.8%). The score of the seafood vendors was highest at 1.9 (95.4%), while the lowest score of 1.3 (65.7%) occurred with the processed product suppliers. Among the sanitation management categories, water management was scored at 2.0, while inspection management was lowest at 1.4. The subcategories indicating needed improvements for the processed product suppliers were raw materials, storage, transport and recall. For the agricultural product suppliers it was preparation management. furthermore, one item within the laboratory instrument management category was unsatisfactory for both the agricultural and processed product suppliers. In conclusion, these results can be used to develop sanitation management procedures for suppliers, as well as by administration agencies to evaluate and guide those suppliers.
The purpose of this study is to evaluate and standardize the four scales of Questionnaire for the Sasang Constitution ClassificationII (QSCCII). QSCCII is newly prepared by statistical item analysis and is designed to examine its diagnostic discriminability. QSCCII is administered to 1366 random informants. From the survey, we could get the data for the standardization. The criteria of standardization are based on the data from 265 informants who are examined by professionals. Collected data are analyzed by internal consistency, variation analysis(ANOVA), Duncan test and discrimination analysis of SPSS PC+ V4.0 program. The results are as follows 1) The reliability of four scales for QSCCII is relatively valid. The internal consistency of Tae-yang(太陽) scale is Cronbach's ${\alpha}=0.5708$. That of So-yang(少陽) scale is ${\alpha}=0.5708$. That of Tae-eum(太陰) scale is ${\alpha}=0.5922$. That of So-eum(少陰) scale is ${\alpha}=0.6319$. 2) There is a significant difference between each group through variation analysis of four scales. 3) The process of standardization is based on the average value and standard deviation with respect to age and sex difference of each criteria. 4) This study suggests a source of standardization of Sasang Constitution Classification by providing norms in which the differences of age, sex, and number of items are taken into deep consideration. QSCCII, therefore, can be applied to every age(the 10's to the 60's) and sex groups. 5) The recalculation of the raw-score to standard value (T-score) shows that the diagnostic discriminability (Hit-ratio : 70.08%) of QSCCII brings about 37% improvement than proportional chance criteria(33.33%). Especially, Hit-ratios of Tae-eum In(74.5%) and So-eum In(70.8%) are higher than that of So-yang In(60.0%). 6) QSCC has discriminability only to male informants. Compared with QSCC, however, QSCCII has relatively efficient discriminability both to male and female informants. 7) These results would be a demonstration of the fact that the QSCCII could be used as a tool for sasang constitution classification.
Park Won;Huh Seung Jae;Kim Dae Yong;Shin Seong Soo;Ahn Yong Chan;Lim Do Hoon;Kim Seonwoo
Radiation Oncology Journal
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v.22
no.1
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pp.33-39
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2004
Purpose : A tumor registry system for the patients treated by radiotherapy at Samsung Medical Center since the opening of a hospital at 1994 was employed. In this study, the tumor registry system was introduced and the validity of the tumor registration was analyzed. Materials and Methods: The tumor registry system was composed of three parts: patient demographic, diagnostic, and treatment Information. All data were input in a screen using a mouse only. Among the 10,000 registered cases in the tumor registry system until Aug, 2002, 199 were randomly selected and their registration data were compared with the patients' medical records. Results : Total input errors were detected on 15 cases (7.5%). There were 8 error items In the part relating to diagnostic Information: tumor site 3, pathology 2, AJCC staging 2 and performance status 1. In the part relating to treatment information there were 9 mistaken items: combination treatment 4, the date of initial treatment 3 and radiation completeness 2. According to the assignment doctor, the error ratio was consequently variable. The doctors who 010 no double-checks showed higher errors than those that 010 (15.6%:3.7%). Conclusion: Our tumor registry had errors within 2% for each Item. Although the overall data qualify was high, further improvement might be achieved through promoting sincerity, continuing training, periodic validity tests and keeping double-checks. Also, some items associated with the hospital Information system will be input automatically In the next step.
This study was performed for developing upscaling Environmental Conservation Value Assessment Map(ECVAM) of National Land in South Korea and presenting the application method of ECVAM. This ECVAM adopted the least indicator method and uses a Geographic Information System(GIS). This map is made through evaluation of 67 items. As a result, the construction of ECVAM was defined as a process of identifying land use to scientifically assess the physical and environmental value of land and classify conservation value into several grades for the sustainable management of environmental resources. After applying ECVAM criteria of five degrees to the whole of study area, Grade I, showing the highest conservation value, accounted for 29.3% by land area of ECVAM. Grades II, III, IV and V likewise accounted for, respectively, 21.7%, 17.2%, 7.1% and the lowest conservation value of 24.7%. other result, ECVAM and land suitability assessment agreement rate is Grade I 33.05%, Grades II, III, IV and V likewise accounted for 12.92%, 15.05%, 36.93% and last value of 53.28% This study set up "the realization of the improvement ECVAM" as the vision of the advancing strategy. In order to accomplish the vision, this study established the purpose as follow; constructing strategic assessment value relation to ECVAM based on knowledge, arranging the foundation to upscaling assessment value And this study devised preparatory plans to achieve the vision and the purpose as next; construction on base theme map by 1:5,000 scalie, base on land register theme map and precision land cover map. Therefore, for applying the result of this study to the upscaling Environmental Conservation Value Assessment Map(ECVAM), it considers regularly the systematic categorization of preceding item, consideration issue of national environmental geographic information using the ECVAM.
While in the early stages of space activities only a few states engaged in the use of outer space, as is well known, commercial space activities have grown dramatically in recent years. Both states, state institutions, and international governmental organizations as well as many private enterprises are engaged in such commercial use of outer space by now. This development is not reflected in the present state of space law. The existing international instruments of space law were developed and finalized before this development and thus only provide very few and sometimes unfitting provisions for the commercial use of outer space and particularly the use by private enterprises. Law formulated in an era when the word "privatization" had not even been coined cannot contain potential problems caused by the increasing commercialization of outer space. For the promotion and further development of such commercial use of outer space it is necessary to clarify and establish the legal framework for such use, because participants will need this information for their future investments in this field. The purpose of this paper is to research and make an analysis of the contents and international regulation of international space commerce, which is rapidly proliferating and to review the process of improvement on national legislations relating to the commercialization of outer space in a few main space advanced countries to make the sustainable progress of commercial space activities project in international society. The legal implications of matters such as international commercial launch services, the liability aspects of such services, intellectual property rights, insurance, product liability insurance and materials processing could one day will be subject to regulated by international space law as well as domestic law. In fact, the question of commercialization is linked to the question of sharing benefits of space activities, and this currently is an agenda item in the Legal Subcommittee of UN COPUOS. Most of developed countries have enacted the national legislation for commercial space activities relating to the development of our space as follows : The National Aeronautic and Space Act of 1958 and the Commercial Space Act of 1998 in the United States, Outer Space Act of 1986 in England, Establishment Act of National Space Center of 1961 in France, Canadian Space Agency Act of 1990 in Canada, Space Basic Act of 2008 in Japan, and Law on Space Activity of 1993 in Russia. Becides there are currently three national legislations relating to space development and commercial space activities in Korea as follows : Aerospace Industry Development Promotion Act of 1987, Outer Space Development Promotion Act of 2005, Outer Space Damage Compensation Act of 2008. Commercial space great promise for the utilization and expansion of human outer space activities but aspring commercial actors must recognize that foreign policy, as well as obligations to the international community as a whole, ensure that commercial space activities will not operate in a legal and regulatory vacuum. As commercial space matures the law and accompanying regulation will most certainly evolve and choose to become participants in the inevitable evolution of law and regulation.
Journal of the Korean Society of Food Science and Nutrition
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v.40
no.8
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pp.1164-1171
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2011
The purpose of this study was to compare service quality between local and global coffee brand shops and to investigate improvement. Of 350 questionnaires distributed to customers of six brand coffee shops (three local brands, three global brands) located in Daejeon, 330 complete questionnaires (94.3%) were analyzed. The questionnaire included a seven-point multiple-item scale for measuring service quality. The 21 items measuring service quality were grouped into four factors, and the mean scores for the levels of "representativeness", "coffee sensory and beverage features", "employee attitude" and "physical environment" were 5.42, 4.77, 4.74, and 4.13, respectively. The levels of "coffee sensory and beverage features" and "employee attitude" of the high income customers were significantly lower than those of the low income customers. The results showed that the levels of "employee attitude" of local coffee brand shops was significantly higher (p=0.050) than that of global coffee brand shops. Whereas, the levels of "representativeness" of global coffee brand shops was significantly higher (p=0.003) than that of local coffee brand shops. Based on the results, the global coffee brand shops should pay attention to internal marketing and the local coffee brand shops must strive to improve service quality through strategies such as improving brand awareness and developing representative beverages and foods.
Background: Initial symptoms for esophageal perforation have not been clarified, but when there is no early diagnosis and proper treatment to follow immediately after the diagnosis, it is fatal for the patients. Therefore, this study attempted to discover the factors that influence the prognosis of esophageal perforation to contribute to the improvement of the treatment result. Material and Method: The subjects of this study are 32 patients who came to the hospital with esophageal perforation from October, 1984 to June, 2000. This study examined the items for clinical observation such as patients' sex, age, cause of the perforation, perforation site, the time spent until the beginning of the treatment, symptoms caused by the perforation and its complication, and treatment methods. This study tried to find out the relationship between the survival of patients and each item. Result: There were 24 male and 8 female patients and their mean age was 49.7+16.4. For the causes of perforation, there were 14 cases(43%) of iatrogenic perforation, which ranked first, caused by the medical instrument operation and surgical damage. As for the perforation sites, thoracic esophagus was the most common site(26 cases of 81.2%) and chest pain was the most frequent symptom. The complication caused by esophageal perforation showed the highest cases in the order of mediastinitis, empyema, sepsis and peritonitis. After the treatment, there were 23 cases of survival and 9 cases of mortality. The total mortality rate was 28.1% and the main causes of mortality were sepsis and acute respiratory distress syndrome(ARDS). As for the treatment, 8 cases(25.0%) treated the perforation successfully using conservative treatment only. As for the surgical treatment, there were 5 cases(15.6%) of cervical drainage, 7 cases (21.8%) of primary repair and 12 cases(37.5%) of esophageal reconstruction after performing an exclusion-diversion. There were 18 cases(56.2%) of complete treatment of esophageal perforation at its initial treatment and in 14 cases(43.8%) of treatment failure at its initial treatment, patients were completely cured in the next treatment stage or died during the treatment. The cases of perforation in thoracic esophagus, complication into severe mediastinitis or sepsis and the cases of failure at initial treatment showed a statistically significant mortality rate (p<0.05).
In the event of an air accident, the media and members of the general public pay attention to the victim of the accident and are deeply concerned about their actions and rewards. However, through the accident of Air China(CCA) Flight 129, which occurred in 2002, we were able to confirm that it is a real problem that the victims of the air accident as well as the victims suffer much suffering and serious aftermath. Nevertheless, Korea's system for assistance the families of victims of air accident is very poor. On the other hand, when Trans-World Airlines(TWA) Flight 800 exploded and crashed over the Atlantic Ocean in 1996, the United States enacted a law to assistance the families of the victims of the accident. According to this law, systematic assistance and management of not only the victims of the accident but also their families, minimize the additional damage of victims and victims' families and help them to get rid of the accident after the accident. In particular, the measures taken by the US authorities in response to an accident in which an Asiana Airlines flight(AAR) 214 crashed during a landing at San Francisco International Airport in 2013, made a lot of suggestions for us to assistance the victims and their families in an air accident. The purpose of this paper is to suggest the necessity of improving the system for victims and victim's family assistance in air accident. In this paper, we analyze the domestic and foreign legal systems and related cases in past accidents, identify the deficiencies of the Korean system, and derive the necessity to improve the related system. It is also important to make sure that victims' families are relieved from early psychological and economic shocks and that the results of accident investigations are reliable. Relevant ministries, airlines, and related agencies should recognize that prompt and systematic assistance and cooperation is needed to ensure that victims and families are relieved of the impact and confidence in the investigation, as is the case in the United States. In addition, efforts should be made to supplement the related laws for the assistance of aircraft victims and victims' families, to establish manuals for implementation, to plan and to implement them promptly in the event of an accident. To achieve this, it is necessary to establish regulations for the legal institutionalization of the roles and responsibilities of national and state agencies on victims of aviation accidents and family assistance. And the victim and family assistance plan that the airline has to submit to it, as specified in the current law, need to specify that item. In addition, new and supplemented contents should be integrated into a single clause or proposed as a separate special law for the purpose of applying a clear law.
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