• Title/Summary/Keyword: large hospitals

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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.

Cervical Cancer Screening and Analysis of Potential Risk Factors in 43,567 Women in Zhongshan, China

  • Wang, Ying;Yu, Yan-Hong;Shen, Keng;Xiao, Lin;Luan, Feng;Mi, Xian-Jun;Zhang, Xiao-Min;Fu, Li-Hua;Chen, Ang;Huang, Xiang
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.2
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    • pp.671-676
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    • 2014
  • Objective: The objective of this study was to establish a program model for use in wide-spread cervical cancer screening. :Methods: Cervical cancer screening was conducted in Zhongshan city in Guangdong province, China through a coordinated network of multiple institutes and hospitals. A total of 43,567 women, 35 to 59 years of age, were screened during regular gynecological examinations using the liquid-based ThinPrep cytology test (TCT). Patients who tested positive were recalled for further treatment. Results: The TCT-positive rate was 3.17%, and 63.4% of these patients returned for follow-up. Pathology results were positive for 30.5% of the recalled women. Women who were younger than 50 years of age, urban dwelling, low-income, had a history of cervical disease, began having sex before 20 years of age, or had sex during menstruation, were at elevated risk for a positive TCT test. The recall rate was lower in women older than 50 years of age, urban dwelling, poorly educated, and who began having sex early. Ahigher recall rate was found in women 35 years of age and younger, urban dwelling, women who first had sex after 24 years of age, and women who had sex during menstruation. The positive pathology rate was higher in urban women 50 years of age and younger and women who tested positive for human papillomavirus. Conclusion: An effective model for large-scale cervical cancer screening was successfully established. These results suggest that improvements are needed in basic education regarding cervical cancer screening for young and poorly educated women. Improved outreach for follow-up is also necessary to effectively control cervical cancer.

Application of Critical Pathway in Trauma Patients (외상 환자 관리에서 Critical Pathway의 적용)

  • Shim, Hongjin;Jang, Ji Yong;Lee, Jae Gil;Kim, Seonghwan;Kim, Min Joung;Park, You Seok;Park, Inchel;Kim, Seung Ho
    • Journal of Trauma and Injury
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    • v.25 no.4
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    • pp.159-165
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    • 2012
  • Purpose: For trauma patients, an early-transport and an organized process which are not delayed in hospital stage are necessary. Our hospital developed a procedure, the trauma Critical Pathway (CP), through which a traumatic patient has the priority over other patients, which makes the diagnostic and the therapeutic processes faster than they are for other patients. Methods: The records of patients to whom Trauma CP were applied from January 1, 2011 through April 15. 2012. were reviewed. We checked several time intervals from ER visiting to decision of admission-department, to performing first CT, to applying angio-embolization, to starting emergency operation and to discharging from ER. In addition, outcomes such as duration of ICU stay, hospital stay and mortality were checked and analyzed. Results: The trauma CP was applied to a total of 143 patients, of whom, 48 patients were excluded due to pre-hospital death, ER death, transferring to other hospital and not severe injury. Thus 95 patients (male 64, 67.3%) were enrolled in this study. Fifty-nine patients(62.1%) were injured by the traffic accident. The mortality rate was 10.5% and the mean Revised Trauma Score (RTS) of the patients was $6.4{\pm}2.0$. After visiting ER, decision making for admission was completed, on average, in 3 hours 10 seconds. The mean time intervals for the first CT, angio-embolization, surgery and discharge were 1 hour 20 minutes, 5 hours 16 minutes, 7 hours 26 minutes and 6 hours 13 minutes, respectively. Conclusion: The trauma CP did not show the improvement of time interval outcome, as well as mortality rate. However, this test did show that the trauma CP might be able to reduce delays in procedures for managing trauma patients at the university-based hospitals. To find out the benefit of CP protocol, a large scaled data is required.

Impact of antimicrobial resistance in the $21^{st}$ century

  • Song, Jae-Hoon
    • Proceedings of the Korean Society for Applied Microbiology Conference
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    • 2000.04a
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    • pp.3-6
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    • 2000
  • Antimicrobial resistance has been a well-recognized problem ever since the introduction of penicillin into clinical use. History of antimicrobial development can be categorized based on the major antibiotics that had been developed against emerging resistant $pathogens^1$. In the first period from 1940 to 1960, penicillin was a dominating antibiotic called as a "magic bullet", although S.aureus armed with penicillinase led antimicrobial era to the second period in 1960s and 1970s. The second stage was characterized by broad-spectrum penicillins and early generation cephalosporins. During this period, nosocomial infections due to gram-negative bacilli became more prevalent, while those caused by S.aureus declined. A variety of new antimicrobial agents with distinct mechanism of action including new generation cephalosporins, monobactams, carbapenems, ${\beta}$-lactamase inhibitors, and quinolones characterized the third period from 1980s to 1990s. However, extensive use of wide variety of antibiotics in the community and hospitals has fueled the crisis in emerging antimicrobial resistance. Newly appeared drug-resistant Streptococcus pneumoniae (DRSP), vancomycin-resistant enterococci (VRE), extended-spectrum ${\beta}$-lactamase-producing Klebsiella, and VRSA have posed a serious threat in many parts of the world. Given the recent epidemiology of antimicrobial resistance and its clinical impact, there is no greater challenge related to emerging infections than the emergence of antibiotic resistance. Problems of antimicrobial resistance can be amplified by the fact that resistant clones or genes can spread within or between the species as well as to geographically distant areas which leads to a global concern$^2$. Antimicrobial resistance is primarily generated and promoted by increased use of antimicrobial agents. Unfortunately, as many as 50 % of prescriptions for antibiotics are reported to be inappropriate$^3$. Injudicious use of antibiotics even for viral upper respiratory infections is a universal phenomenon in every part of the world. The use of large quantities of antibiotics in the animal health industry and farming is another major factor contributing to selection of antibiotic resistance. In addition to these background factors, the tremendous increase in the immunocompromised hosts, popular use of invasive medical interventions, and increase in travel and mixing of human populations are contributing to the resurgence and spread of antimicrobial resistance$^4$. Antimicrobial resistance has critical impact on modem medicine both in clinical and economic aspect. Patients with previously treatable infections may have fatal outcome due to therapeutic failure that is unusual event no more. The potential economic impact of antimicrobial resistance is actually uncountable. With the increase in the problems of resistant organisms in the 21st century, however, additional health care costs for this problem must be enormously increasing.

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Factors that Impact on Safety Activities of Personnels in Oriental Medicine Hospital of University (대학부속 한방병원 교직원의 안전활동에 영향을 미치는 요인)

  • Lee, Jung-Woo
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.61-73
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    • 2017
  • Purposes : The purpose of this study is to identify factors that have effects on safety activities of hospital personnels by investigating causality between patient safety culture, job stress, safety system and safety activities of faculty and staff member who are working for oriental medicine hospital of university. Methodology : The subjects were 246 employees working in 4 oriental medicine hospitals of university in Daejeon and Chungcheongnam-do. The data were collected from January 16 to January 25, 2017 using a structured questionnaire. For data analysis, descriptive statistics, Pearson correlation coefficient, t-test, ANOVA and Duncan test with SPSS 22.0 were used. Findings : The activity score for patient safety of faculty and staff member, who were experienced at job training program after joining a company and regular training course for qualification or license, was meaningfully higher than that of group who had no job training experience. The result indicated that the higher there is level of safety culture and safety system and the lower there is work stress, the more the activity has positive effect on patient safety. The level score of awareness for safety culture of faculty and staff member in C hospital, which is facing financial crisis in business circumstances recently, showed average value of 3.29. It was significantly lower than that of the other three hospital. Also, The activity score for patient safety was markedly lower than that of the other three hospital. This result become interested in the process of linking non-financial performance and financial performance. The level score of safety activity in A hospital which obtained healthcare accreditation was remarkably higher than that of the other three hospital which didn't certify healthcare accreditation. Pratical Implications : Subjects about Q.I or patient's experience management must be included in curriculum of Oriental medicine. It is necessary to get the effect of job training program for faculty and staff member through the process of preparation for obtaining healthcare accreditation. When the hospital director is appointed, it must be considered that he/she has the ability to attach importance to analysis and management of the factors creating safety accident, and has business mindset for healthcare delivery of customer- centricity. This research showed that financial performance of hospital, which of business environment is favorable; located in metropolitan city and having large scale of hospital and quality of residence rating but low-level of safety culture and safety activity, was lower than that of general hospital situated in small and medium-sized cities. More research needs to be done for answering this result.

A Study on the Dental Hygienists' Image Perceived by Health Allied College Students (보건계열학생이 인식하는 치과위생사의 이미지 조사연구)

  • Kim, Mi-Jeong;Lee, Hye-Kyung;Kim, Young-Im
    • Journal of dental hygiene science
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    • v.11 no.6
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    • pp.481-487
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    • 2011
  • The purpose of this study was to examine the perception of health-related majors in their third year of college about the image of a dental hygienist as prospective dental personnels. The findings of the study were as follows: 1. Concerning perception of the image of a dental hygienist by geographic region, the college students from large cities gave 89.07 to that, and the college students from small and mid-sized urban areas gave 85.03. The former gave higher marks to the image of a dental hygienist, and the gap between the two was statistically significant. By department, the students who majored in physical therapy gave the highest score of 88.93, dental technology and radiology gave the second highest score of 86.91. The clinical pathology gave the third highest score of 83.28, and the gaps among them were significant. 2. As for their perception of the four subfactors(qualifications, roles, social participation and interpersonal relationship) of the image of a dental hygienist by geographic region, there were statistically significant gaps in their way of looking at the qualifications, roles and interpersonal relationship of a dental hygienist. By department, the physical therapy majors gave the highest marks to all the four subfactors. 3. When they were asked to give one or more answers to the question what affected their image building about a dental hygienist, the largest number of the students that accounted for 67.9 percent replied that the looks of dental hygienists whom they saw in dental clinics or hospitals impacted on their image of a dental hygienist.

Study on Staffing of Medical Physicist in the Field of Radiation Therapy (방사선치료분야에서 의학물리사의 적정인력 분석)

  • Hwang, Ui-Jung;Lim, Young Gyung;Kim, Dong Wook;Shin, Dong Oh;Kim, Sung Kyu;Jung, Haijo;Ji, Young Hoon
    • Progress in Medical Physics
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    • v.23 no.4
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    • pp.209-218
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    • 2012
  • Recently, an adequate number of qualified medical physicist is needed for achieving effective treatment and securing safety to the patient, staff and the public on the course of radiation therapy, since the equipment and the technique of radiation therapy are being developed fast and becoming complex. The studies on medical physics staffing level in United State and European countries were investigated. These results were applied to the domestic situation in order to anticipate indirectly the adequate number of medical physicist in Korea. The current number of medical physicists of 6 (middle to large sized) hospitals in Korea was less than 50% of number recommended in the study. Further detailed research specified on the domestic situation is needed in order to expect adequate number of medical physicist more accurately, and particle beam therapy has to be also considered in the research since the facility site is increasing gradually.

A Comparative Study on the Clinical Features and Complications of Snake Bite Patients in Urban and Rural Areas (도시와 농촌에서 발생한 독사 교상 환자의 임상적 양상과 합병증 비교 연구)

  • Hong, Seong-Jun;Lee, Joo-Hwan;Choi, Woo-Ik;Jin, Sang-Chan;Jeon, Jae-Cheon
    • Journal of agricultural medicine and community health
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    • v.45 no.3
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    • pp.154-161
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    • 2020
  • Purpose: The purpose of this study is to compare the clinical features and complications of snake bite patients in urban and rural areas. Methods: A retrospective study was conducted on patients over 18 years of age who were hospitalized for snake bites from January 2013 to December 2019. Patients were categorized into urban and rural groups according to their respective locations at the time of the snake bite and the clinical characteristics and complications of the two patient groups were researched and compared. Results: Of the 77 snake bite patients, 44 patients were categorized into the rural group (57.1%). The rura1 group showed significant differences in old age (p=0.011), delayed hospital visits (p=0.010), far hospital distance (p<0.001), high local effect score (p<0.001), high traditional snake-bite severity grading scale (p=0.008) and use of large amounts of antivenins (p=0.026). There was a significantly higher incidence of acute kidney injury (p=0.030), rhabdomyolysis (p=0.026), and coagulopathy (p=0.033) in the rural group as well as a longer hospitalization period (p<0.011). Conclusion: Snake bites that occurred in rural areas resulted in patients with more complications compared to urban areas due to farther distances from hospitals, causing a delay in antivenom treatment.

Current Status and Direction for Future Development of Evidence-based Nursing in Korea (국내 근거기반간호의 현황과 발전 방향)

  • Choe, Myoung-Ae;Bang, Kyung-Sook;Park, Yeon-Hwan;Kang, Hyun-Ju
    • Perspectives in Nursing Science
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    • v.8 no.2
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    • pp.129-138
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    • 2011
  • Purpose: The purpose of this study was to identify the current status of evidence-based research, education, and practice, and to suggest a directions for the future development of evidence-based nursing. Methods: To examine the current status of evidence-based nursing research, experimental research among studies published in the Journal of Korean Academy of Nursing from 2008 to 2010 were analyzed. We suggested a direction for the future development of evidence-based research based on the analysis and literature reviews. We also suggested a direction for the future development of evidence-based education and practice based on literature reviews. Results: The results showed that designs and methods of studies were insufficient to use evidences derived from the studies in terms of evidence-based research, and experimental studies consistent with themes were found to be deficient. In the future, the methods and rationale for the design of experimental studies need to be clearer In addition, a test for intervention effects through repetitive studies and a connection between the intervention effects and a protocol for clinical practice will be required. In terms of evidence-based education, curriculum revision and development of teaching methods including contents related to evidence-based practice and research methodology in undergraduate and graduate programs will be required. Evidence-based practice in Korea was less actively done than with that of foreign countries. Some large hospitals have recently attempted systemic activities to promote evidence-based nursing practice in clinical settings. To activate evidence-based practice, the perception of nurses for evidence-based practice needs to be changed and support for education and administration of the program is required. Also, evidence-based practice guidelines, protocols, and assessment tools need to be developed. Conclusion: Evidence-based nursing in Korea is in the process of evolving. To realize evidence-based nursing, we need to develop nursing science based on evidences of closer communication and cooperation in terms of nursing research, education, and practice.

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The Results of Gastric Cancer Surgery during the Early Stage of a Training Hospital (설립 초기의 수련 병원에서의 위암 수술 성적)

  • Kim, Kun-Young;Yoo, Moon-Won;Han, Hye-Seung;Yun, Ik-Jin;Lee, Kyung-Yung
    • Journal of Gastric Cancer
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    • v.8 no.4
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    • pp.244-249
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    • 2008
  • Konkuk University Hospital (KUH), which opened in September 2005, is currently categorized as a secondary hospital. Early on after its establishment, the surgical residents and nurses were relatively inexperienced in the treatment of stomach cancer. Therefore, the quality of surgery for stomach cancer at KUH may be different from that of the existing large-scale tertiary hospitals. The purpose of this study is first to investigate the clinicopathological characteristics of the gastric cancer patients at the KUH, and second to compare our morbidity & mortality rates with those of previous studies, and we also analyzed the risk factors of morbidity at the early stage of a training hospital. Materials and Methods: This study retrospectively collected the clinicopathological characteristics and the post-operative morbidity rates and mortality rates with using the electronic medical records of all the patients who went under a gastric cancer operation at KUH from September 2005 to April 2008. Results: The total number of gastric cancer patients who underwent operation was 201. The morbidity rate and death rate at KUH were 10.4% and 0.5%, respectively. The morbidity has increased with an older age. The other variables had no influence on morbidity. Conclusion: The morbidity rate, death rate and the clinicopathological characteristics of gastric cancer patients at KUH were similar to those of the previous reports. We found that age is the main factor affecting the morbidity rate after stomach cancer surgery. For further surgical qualification of stomach cancer surgery at KUH, it is necessary to collect the survival data of patients who undergo stomach cancer surgery.

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