• 제목/요약/키워드: managed care

검색결과 304건 처리시간 0.028초

급성 호흡부전 임산부에서의 폐병변 (Unusual Roentgenographic Presentation of Lung Cancer in a Pregnant Woman with Acute Respiratory Failure)

  • 박태병;황성철;이이형;박경주;주희재
    • Tuberculosis and Respiratory Diseases
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    • 제42권6호
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    • pp.951-954
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    • 1995
  • Diagnostic procedures in pregnant wowen is limited and is usually delayed, especially so if she is on mechanical ventilation. A 28-year-old pregnant woman with severe dyspnea was referred to our hospital under the impression of miliary tuberculosis. The respiratory failure was so severe that patient had to be managed with mechanical ventilator under clinical impression of overwhelming pneumonia or pulmonary tuberculosis. But the patient's conditions deteriorated. Bronchoscopy and blind transbronchial lung biopsy performed to determine the nature of the etiology, and to our surprise, revealed squamous cell carcinoma of the lung.

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간호장교의 복지정책을 위한 조사연구 - 여성복지와 군복지 일반을 중심으로 - (A Study On The Welfare Policies For Nurse Officers)

  • 최청숙
    • 한국보건간호학회지
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    • 제10권2호
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    • pp.15-36
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    • 1996
  • It is clear that the women's participation in social activity is dramatically increased in civilian field as well as military profession. Because of the characteristics of military nursing service, there are many difficulties. Frequent move, medical insurance, baby care. and the education are typical forms of difficulties for nurse officers in the military. The purpose of this research is to contribute to the perfect execution of nursing service. guarantee the active attitude for research and improve the combat strength by solving those private and economic problems. The method of research was analysis of question survey and the review of related literatures. The subject of research was 300 active nurse officers who work at the Army Hospitals. The survey was conducted 14 days from Oct 15 to Oct 28. The collected data was processed by computer using SPSS(Statistical Package of Social Science). Frequencies and percentages were used to examine the demographic characteristics of subject, and T-test was also used in the case of necessity. The result showed as follows; As the general characteristics of subject group; 28.7 years of average age, 73.6 months of service period, 63.4% of married. In regard of specialty; General 57.7%. Intensive Care 12.7% and Psychiatries 8.8%. The dissatisfactory factors about military welfare system were the difficulties in children education (36.9%). disadvantages on the civil medical insurance system (27.3%), and little chance of self education and development (21.5%). The problems in performing their duties were shown as dwelling instability due to frequent move (67.7%), and bring up children (14.2%). The reasons for resigning their job were shown as the instability of living status (64.2%), bring up children (18.8%) and dissatisfaction to the service (11.2%). The residential status was shown that military offered houses (45.2%), rental houses (29.3%) and own houses(14.64). The average numbers of moving residencies were; 3-4 time(34.6%), less than 2 times(33.1%), and 5-7 times(21.5%). Higher than 94.7% of the subject group spent more than 50.000 Won. In regard of education, they wanted to attend graduate school with their own expense(26.2%), computer science(20%) and Office Job Training(20%). The ways of taking care of children were mother-in-low(49.6%), mother(14.6%), and others(25%). The average expenditure per month for children were 20-30 hundred Won(44.2%), 10-20 hundred Won(25%) and 30-40 hundred Won(22.3%). The places of children care selected were public or occupational care center(56.2%), religious organization(20.8%), and other center managed by social organizations(10.4%). The result of survey for general welfare of nurse officers are as follows; By and large they seem to be satisfied with their job. however. there are some dissatisfactory factors. They are children care facilties, promotion. income. welfare facilities. disadvantage in medical insurance and civil hospitals. house purchase. unfair chances in specialty training. influence on promotion by educational status. and insufficient role for their children and husbands. As conclusion. the recommendations for improving nursing service are as follows; 1. Children care center managed by occupation 2. Dormitory system for children by military personnel 3. Equal opportunities in education according to ability 4. Reasonable moving price according to the distance and scope of family and extra allowance

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산후조리원 내 신생아실의 실내 환경 특성 - 목재가구류에 따른 실내공기질과 조명배치에 따른 조도 특성을 중심으로 - (Indoor Environment of Infant Units in Postnatal Care Center - Focus on Indoor Air Quality by Types of Wooden Furniture and Intensity of Illumination by Arrangement of Lights -)

  • 정소담;김태욱;장슬애;김석환;이상진
    • 한국가구학회지
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    • 제24권1호
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    • pp.33-41
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    • 2013
  • As professional postnatal care systems have been rapidly supplied, there is sharp increase of postnatal care centers without legal regulations for a mother and a infant. For the quick recovery of mothers, newborn infants that have weaker immune systems are being managed in group in the postnatal care centers. Recently, the attention of the postnatal care centers has been growing because the problem of pneumonia which led to result in a casuality in a infant unit was happen. So, this research analyzed the indoor environment of infant unit through measuring formaldehyde, carbon dioxide, intensity of illumination. As a result of the data, infant units showed higher concentration of formaldehyde and carbon dioxide than Indoor Air Quality Control Law. Moreover, infant units was measured higher intensity of illumination than the range of optimum illumination for infants.

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장루 관리를 위한 Web 기반 간호교육 프로그램 개발 (Development of Web-based Nursing Education Program for Ostomy Care)

  • 홍해숙
    • 가정∙방문간호학회지
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    • 제10권2호
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    • pp.141-147
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    • 2003
  • The purpose of this study was to develop and apply a Web-based Nursing Education & Instruction Program to help the clinical nurses improving their knowledge and skills of ostomy care. This program was developed in three different steps: analysis. design. and development. The results of the study were as follows: The analysis step was designed to select the study contents for effective and easy educationthrough the analyses of specialized books. This surveyed and analyzed study contents were categorized into five different sections. Introduction. ostomy classification. ostomy management. elimination management. and life style. After that each section describes necessary information of each category. In the design step. the image files used in this program were created using Adobe Photoshop 6.0. and HTML files were designed and developed using Namo Editor 5.0. In the development step. the developed program was published into Web using FTP (File Transfer Protocol) and then finalized after trial operation for testing of real users. In addition. this Web-based Nursing Education & Instruction Program will be used as excellentand effective tool for continuous and lifelong education in nursingfield. In this study. computer-aided education program was developed for ostomy management and managed at the Web-Server (http://hshong.knu.ac.kr/ostomy) in order to help nurses real-time education in clinical field by this program.

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보육교사의 특성에 따른 심폐소생술의 차이 (The Differences Verification of Cardiopulmonary Resuscitation According to Characteristics of Child Care Teachers)

  • 배성주;이병주
    • 한국임상보건과학회지
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    • 제6권2호
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    • pp.1189-1198
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    • 2018
  • Purpose. The study was basic materials are provided to identify differences in the knowledge, attitude and performance of cardiopulmonary resuscitation(CPR) depending on the characteristics of child care teachers, and to develop an education program that will enable you to improve your future CPR performance. Methods. This study was conducted on 147 child care teachers. The questionnaire of the previous study was corrected and 48 total questions were used. Using spss 22.0 frequency analysis, T-test, ANOVA and Duncan-test were performed. Results. The knowledge level of 50s was higher those in their 20s. The higher the satisfaction level with education, the more positive was about CPR(p<.001). The more CPR training, the higher the performance(p<.01). The was a positive correlation between CPR attitude and performance ability(r=.355, p<.001). Conclusion. In order to have a positive influence on the CPR of child care teachers, the number of education should be increased and the level of education satisfaction should be managed to increase.

An unstable patient with a large sucking chest wound managed with gauze packing for preventing tension and bleeding control before surgery in Korea: a case report

  • Chang-Sin Lee;Min-Jeong Cho;Tae-Wook Noh;Nak-Jun Choi;Jun-Min Cho
    • Journal of Trauma and Injury
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    • 제37권2호
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    • pp.147-150
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    • 2024
  • This case report describes the management of a 51-year-old female patient who arrived at the emergency room with a stab wound to the upper right chest. Immediate medical interventions were undertaken, including blood transfusions and endotracheal intubation. To prevent tension and control bleeding, gauze packing was applied directly through the large open wound. Further surgical exploration identified a laceration in the lung, necessitating a right upper lobe resection. Postoperatively, the patient's vital signs stabilized, and she was subsequently discharged without complications. This case highlights the decision-making process in selecting between an emergency department thoracotomy and an operating room thoracotomy for patients with penetrating chest trauma. It also illustrates the role of gauze packing in managing tension and hemorrhage. In summary, gauze packing can be an effective interim measure for stabilizing patients with traumatic injuries, unstable vital signs, and large open chest wounds, particularly when a chest tube is already in place, to prevent tension and facilitate bleeding control prior to surgical intervention.

농촌지역 일차건강관리 기관의 고혈압환자 관리실태 -전남지역을 중심으로- (The control of the hypertension in rural primary health care settings in Korea)

  • 정영해;강혜영;정미영
    • 지역사회간호학회지
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    • 제5권2호
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    • pp.162-180
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    • 1994
  • The control of the chronic degenerative diseases becomes a challenge in Korea as the aging of the population progresses. Accordingly, the importance of the control of the hypertension, one of the major chronic degenerative diseases, in the primary health care settings increases. However, such control activities are still minimal. This study gives brief description of how the rural residents who are currently registered for the control of the hypertension feel about the activities of the health centers, subcenters and the CHP posts, in relation to the control of the hypertension. We also describe the knowledge and practice of the registered hypertensive. In general, the knowledge, the acceptance and the satisfaction of the respondents about the hypertension control activities were not very high. Respondents being managed by the health center showed the highest knowledge, acceptance and satisfaction, and those being managed by the subcenters ranked lowest. The knowledge about the hypertension was not satisfactory. There were great variations among the items in terms of the proportion answered correctly. As many as 60% of the respondents take medication regularly but only 4.5% were practicing weight control regularly. Despite some limitations of the study, the results can be very useful for those planning hypertension control programs. The educational materials and the dietary protocols need to be developed in accordance with the regional social and food pattern, so that they can be utilized with minimal modification for each beneficiary. We also suggest to minimize the area a health personnel covers. In other word, running several small health posts at village level would be more effective than running a subcenter at the township level, in terms of the hypertension control.

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의료이용심사에 대한 소고 (Introduction to Utilization Review)

  • 신의철
    • 한국의료질향상학회지
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    • 제12권2호
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    • pp.75-83
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    • 2006
  • Background : Utilization review has been adopted as a vehicle for cost and utilization control of health care services. Its role was further stressed and expanded through the establishment of Health Insurance Review Agency in 2001. This article is to introduce concept, activities, and effect of utilization review based on the experiences of U.S. and to suggest important characteristics for ideal utilization review activities at the national level in Korea. Method : Twenty-five articles related with utilization review were reviewed after being selected through web site search through Med Line and Richis. Result : Utilization review was introduced mainly for health care expenditure control either by insurer, provider or the third parties under the pressure of increasing health care cost. It's activities can be categorized to prospective, concurrent and retrospective review according to the time of service provision. Based on most of studies, utilization review has been effective in controling rising health care cost and utilization. However it's effectiveness assumes a reimbursement structure of managed care like capitation payment. More worse, it is still unknown it's effectiveness on quality of care. Conclusion : Utilization review should be employed to increase the cost effectiveness of medical care by optimizing quality and patient's outcomes while also attempting to reduce the use of resources. So, it should consider outcomes before expenditures, check for both under and over-use, and construct an structure in which consumption is reduced equitably. Aggressive adoption of utilization review in Korean health care setting with fee-for-service reimbursement structure might not be a cost-effective approach before adoption of prospective payment system such as D.R.G. and capitation.

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보건진료소 영유아 예방접종사업(1980년~2009년) (Vaccination for Infants and Children in the Primary Health Care Posts from 1980 to 2009)

  • 손계순
    • 한국농촌간호학회지
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    • 제3권2호
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    • pp.96-103
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    • 2008
  • Purpose: The Study of vaccination for infants and children business in Primary Health Care Posts from 1980 to 2009. Method: look for national essential vaccination look for the change of vaccination by the times in Primary Health Care Posts and the rate of vaccination for infants and children by a administrative report statistics survey of a vaccine delivery system of Public health care institutions investigation about assistance details of vaccination cost in order to raise the rate of vaccination for infants and children. Results: In 1980s, there are many infants and children management object, but now there are rapidly decreasing infants and children management subject of a Primary Health Care Post because of rural exodus phenomenon of 1990's and a low birthrate of 2000's. Currently, the infants and children that registed, and managed to a Primary Health Care Post is most multi-cultural families. A multi-cultural family assistance program is provided these infants and children to the objects. Conclusions: Infant vaccination execution in Primary Health Care Posts showed to high vaccination rate because the prevention of vaccination delay or omission of the interior child who raised geographical accessibility to object sons nowadays it difficult to management of transportation of vaccine and storage management for a little shroud objects limited and management of inoculation business in quality. A main problem is as follows. There are a little vaccine transportation, trouble of proper temperature maintenance of a storage process, and having a lot of vaccine abolition as a little objects, educational training shortage of health care practitioner regarding to execute an inoculation. Therefore, vaccination business needs measures for management in quality in Primary Health Care Posts.

보육교사의 반응성 상호작용 전략 적용을 통한 영아의 중심축 행동 발달 (Development of infants' pivotal behaviors using the responsive interaction strategy of child care teachers)

  • 이경진;이유진
    • 한국보육학회지
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    • 제17권1호
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    • pp.1-28
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    • 2017
  • 본 연구는 보육교사들이 반응성 상호작용 전략을 적용을 한 후 영아의 중심축 행동의 발달이 어떠한지 살펴본 사례연구이다. 연구 참여자는 H재단에서 수탁 운영하는 직장어린이집 5곳의 만1세 영아 5명과 그들의 담임교사 5명이다. 이 연구에서는 교사-영아 상호작용을 녹화한 동영상, 일화기록, 교사의 반성적 저널, 교사와의 심층면담 자료를 통해 연구대상 영아의 중심축 행동 변화를 분석하였다. 연구결과를 살펴보면 보육교사의 반응성 상호작용 전략 적용은 영아의 중심축 행동(주의집중, 문제해결, 흥미, 협력, 주도성, 공동주의, 애정)을 긍정적으로 변화시켰다. 이러한 연구결과는 영아를 담당하고 있는 보육교사들이 영아의 중심축 행동 발달을 돕기 위해 반응성 상호작용의 중요성을 인식하고 실천해야 함을 시사한다.