• 제목/요약/키워드: managed care

검색결과 303건 처리시간 0.026초

효율적인 지역사회 건강관리를 위한 데이터베이스 시스템 구현- 보건소의 가족단위 방문간호사업을 중심으로- (Development of a Database System for Efficient Community Health Management - Focus on the Home Visiting Care of Family as a Unit by the Health Centers-)

  • 최인희
    • 지역사회간호학회지
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    • 제11권1호
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    • pp.67-79
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    • 2000
  • In recent years, the recipients of the services of the health centers in Korea have been shifted from individual sick persons to families as a unit. As a result, the home visiting care records which are all filled out manually, will be increased. Since there is virtually no increase in the number of community health nurses, the CHNs are required to work more efficiently. One of the ways to make the CHNs' work more efficient is to reduce recording time by using a computer. However, a computer system that can manage the families as a unit has not yet been developed. In response to this need, we developed a database system that can be utilized in home visiting care service. The family assessment data is collected. diagnosed. and evaluated according to the family diagnosis classification. The system for family diagnosis consists of seven areas. Those areas are family structure. maintenance of the family system, interaction and interchange. support. coping and adaptation, health management. and housing environment. The areas of the family diagnosis consists of 99 items in all. We expect the following from this system. First. the CHNs will be able to identify family problems more easily. Second. the community's health level can be confirmed by the statistics the system produces. Thirdly, the CHNs' nursing services will be cost effective via reduced recording time. Finally, the family problems of the sick individuals which have been neglected under the health system oriented on individual persons can be effectively managed.

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간호실무에서의 결과평가 (Evaluation of outcome in nursing practice)

  • 이병숙;권영숙
    • 간호행정학회지
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    • 제2권2호
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    • pp.59-71
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    • 1996
  • Today, quality management is appearing as a critical issue in the field of health care service, partly because of increasing cost of health care. And qualified health care is also accepted as the right of clients, and the responsibility of health professions. So nursing profession can survive and develop only through the quality management of nursing practice like other health professions. Recently, Consumers of nursing service require the effectiveness and the efficiency of nursing practice. Effectiveness and efficiency of nursing practice can be accomplished by outcome evaluation. The focus of outcome evaluation in nurisng practice is on the change which occures in patient's health status with nurisng intervention. Evaluation of outcome is difficult because of some related problems which should be solved, or managed. These problems could be classified as problems of measurement, and attribution. To solve the problems and to evaluate the outcome in nursing practice more accurately, following tasks were suggested. 1) Outcome indicators, and outcome measurement tools should be developed. For these purpose, outcome variables that nursing interventions can contribute primarily should be found out. Also, outcome variables which are driven from nursing theories should be developed. 2) Outcome researches which can explain the effect of nursing care to patient outcomes should be performed. The outcome researches are the methods which can increase the power of nursing profession. 3) Models which can be used for the systematic and scientific quality management in nursing practice should be developed. The models should include outcome variables, and be able to explain the relationship between structure, process, and outcome aspects of quality management. 4) The method which can make patients participate in the evaluation process of quality of nursing practice should be devised. Because outcome evaluation is client-focused evaluation, the perspectives of patients should be emphasized, and reflected in the process of evaluation.

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가시성에 기반한 노인요양시설의 공간계획에 관한 분석 - 공간구문론을 활용한 가시성 분석과 에이전트 시뮬레이션을 중심으로 - (Spatial Configuration Analysis of the Elderly Care Facilities Based on Visibility - Visibility Analysis and Agent-Based Simulation Using Space Syntax -)

  • 이지선;이현수
    • 한국실내디자인학회논문집
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    • 제27권3호
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    • pp.14-23
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    • 2018
  • The spatial planning of the elderly care facility plans is analyzed using space syntax in terms of encouraging the social interaction of the residents in this study. First, through the visibility graph analysis, openness and accessibility of space is analysed. Second, the walking behavior of residents through agent analysis model is simulated. Third, the space planning methods for the elderly care facilities are proposed based on the results. The results are as follows. According to the visibility graph analysis, the main corridor has high visual openness and high accessibility. The visual openness and accessibility of the unit living room, where social interaction among residents is possible in each unit, is low. Space planning is needed to increase direct protection and observation of employees to the unit living room. The location of the nurse station that manages the entire floor needs to be located where the openness and accessibility is most high. The nursing station should have a high degree of connectivity to the entire space, so that any accidents can be managed and contact is accessible. Through the agent simulation the flow from the center to each unit space is highest in the corridor space and the inflow to the private rooms and the living room are similar. Therefore, it is necessary to plan the accessibility of the unit living room more for the natural inflow of residents.

종합병원의 비용절감과 업무개선을 위한 중앙공급실의 활동 (Case Report on the Activities for Cost Reduction and Performance Improvement in the Central Supply Room in A University Hospital)

  • 송규남;송선옥;황운순;구본업;최혜숙;이상윤
    • 한국의료질향상학회지
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    • 제6권1_2호
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    • pp.150-160
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    • 1999
  • Background : Because hospitals had to faced with financial hardship, we have to have more effective hospital management. In this study, we tried to improve job performance and to reduce cost maintaining safety in fields of patients care. Methods : Central Supply Room(CSR) staffs taught strategy of material cost reduction to middle level managers and staffs 14 times. All staffs and voluntary service workers, working in 33 nursing units, participated in this activity. We developed questionnaire to check the degree of participate in cost reduction activity and job performance in CSR, and quality improvement in the wards. Two hundred questionnaires were distributed and 197 returned. Results : Because CSR staffs developed new items and every item was managed at each department, stocks of each department were reduced. Overall, by comparing before and after cost reduction activity, almost 1.2 billion won reduced for one year. Staffs' loyalty and spirits of cost reduction were improved by changing clothes and duty environment. Furthermore, these activity improved patients' satisfaction. Conclusion : We suggest that CSR activity in a university hospital contributes to improve job performance and to reduce cost without any problem in patient care.

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재난관리스템을 이용한 어린이집 안전관리에 관한 연구 (A Study on Safety Management of Day Care Center using disaster management system)

  • 정창식;권미란
    • 한국인터넷방송통신학회논문지
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    • 제18권1호
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    • pp.29-35
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    • 2018
  • 최근 어린이집에서 안전사고가 빈번하게 발생하고 있다. 유형별로는 부딪힘, 넘어짐, 끼임, 화상, 떨어짐, 통학버스 교통사고, 이물질 삽입... 등이 있으며, 이러한 안전사고 즉, 재난으로 인해 사망까지 이르는 영유아들이 매년 꾸준히 증가하는 추세이다. 이에 따라 안전사고, 즉 재난에 대한 예방이 시급한 실정이다. IoT(Internet of Things)는 위험을 예방하기 위해서 다양한 센서와 관련제품들이 생활공간에서 인터넷으로 연결해 관리되고 있다. 특허 IoT 제품은 언제 어디서든 스마트폰이나 센서 등으로 자동 제어하기 때문에 에너지와 시간을 아끼고, 편리하고 신속 정확하게 지킬 수 있다. 이 논문은 학습현장 즉, 학교나 유치원 및 어린이집과 같은 곳에서 건물재난관리를 위한 사물인터넷 전용망인 SK LoRa 통신망과 아두이노를 이용하여 재난에 대응하고 예방할 수 있는 연구 모델을 제안하고자 한다. 그리고 건물재난관리에 필요한 다양한 센서로 건물 내 다양한 안전 상태를 표현하고 데이터는 스마트폰으로 송수신하여 주거환경을 제어할 수 있는 시스템 모델을 제안한다.

영유아 보육시설의 급식 운영 실태 조사 - 충남 아산 지역 중심으로 - (A Survey on the Foodservice Management System of the Child Care Centers in Chungnam Asan Area)

  • 송은승;김은경
    • 대한지역사회영양학회지
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    • 제14권6호
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    • pp.846-860
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    • 2009
  • We investigated the foodservice management practices in various operation types of childcare centers in Asan, Chungnam Province, with the intention of improving the quality of foodservice and providing the basic information for establishing more effective and efficient foodservice model system. Self-completed questionnaires were collected from the directors of 174 child care centers. The statistical analysis was completed using SPSS Ver. 12.0 program. The followings are about the results of this study. Approximately 94.8% of the directors were women with the average age of 40.3. All of the investigated facilities executed foodservice; the facilities of 96.2% had been self-operated, 1.9% was contract-managed and the remaining 1.9% served delivered meal from outside. Only 20.0% of the investigated centers employed a dietitian. In most of the centers, meals were prepared in a conventional manner and approximately 85.3% of the centers are serving only snacks twice a day as a supplementary due to financial difficulties. Menu planner of the facilities, which have no dietitian was the director (35.8%) or the cook (25.7%). In most centers, the directors purchased the food materials (67.5%). Material inspection was done by the director (54.9%) or the cook (40.5%). However, home care centers did not inspect the food material. These results indicate that food service management guidelines need to be established by the facility type with the government control and financial support. Especially, dietitian employment and the efficient foodservice model system establishment are questions that confront us.

중첩된 이기종 무선망에서의 다중 무선 서비스 프레임워크 (A Framework for Multiple Wireless Services in Heterogeneous Wireless Networks)

  • 신충용;조진성
    • 한국컴퓨터정보학회논문지
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    • 제13권5호
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    • pp.85-94
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    • 2008
  • WLAN, WiBro, cdma2000, HSDPA와 같은 여러 이기종 무선 네트워크 서비스가 늘어나고 무선 서비스를 사용하기 위한 사용자의 선택의 폭도 점점 커짐에 따라 다양한 이기종 무선인터페이스를 동시에 사용하고자 하는 Multiple Care-of Address 방안이 IETF MONAMI6 WG에서 제안되었다. 이 방안을 통해 단말은 다중 인터페이스를 사용하여 동시에 여러 네트워크로의 접속이 가능하다 이처럼 다양한 무선 접속 기술은 All-IP 기반 핵심망에 연결되어 통합되는 형태로 발전하고 있으며 무선 접속 기술의 커버리지에 따라 이기종 무선망이 중첩되어 운영되고 있어, 이에 대한 고려가 요구되고 있다. 이에 따라 4G를 위한 차세대 네트워크와 현존하는 이기종 인터페이스를 지원하는 서비스 프레임워크가 요구되는 실정이다. 본 논문에서는 현재 서비스되고 있는 환경을 고려한 이기종 무선 서비스 프레임워크를 제안하고 여러 인터페이스 특성과 사용자 정의를 고려하여 효율적인 네트워크를 선택하는 수정된 MCoA (Multiple Care-of Address) 방안과 다중 인터페이스 핸드오버 상황에 따른 패킷 손실을 최소화하는 방안을 제안한다.

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일개 종합병원 간호사의 임종간호 스트레스에 영향을 미치는 융합적인 요인 (Convergence Factors Influencing Terminal Care Stress in General Hospital Nurses)

  • 박미선;김혜영;김지영
    • 융합정보논문지
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    • 제9권4호
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    • pp.28-38
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    • 2019
  • 연구의 목적은 종합병원 간호사의 임종간호 스트레스에 영향을 미치는 요인을 파악하는 것이다. 연구의 대상자는 J시 소재의 일개 종합병원에서 근무하는 간호사 197명이다. 자료수집 기간은 2017년 12월 25일부터 31일까지이며, 구조화된 설문지를 사용하여 자료를 수집하였다. 수집된 자료는 SPSS/WIN 25.0 Program을 이용하여 기술통계, independent t-test, one-way ANOVA, Pearson's correlation coefficient와 hierarchial multiple regression으로 분석하였다. 임종간호 스트레스 예측요인은 품위 있는 죽음에 대한 태도, 이직의도, 존엄사에 대한 태도 및 영성이 임종간호 스트레스를 설명하는 유의한 변수로 나타났으며, 이들 변인들은 임종간호 스트레스를 39.6% 설명하였다. 본 연구결과에 비추어 볼 때 임종간호 스트레스를 감소시키기 위해 임종간호 스트레스에 영향을 미치는 변인들을 체계적으로 사정하고 이들 변인을 모두 고려한 구체적인 중재를 개발하여 이에 대한 효과를 검증하는 연구가 필요할 것이다.

Clinical outcome of perioperative airway and ventilatory management in patients undergoing surgery for oral cavity cancer: a prospective observational study

  • Souvik Mukherjee;Anuj Jain;Seema S;Vaishali Waindeskar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제50권3호
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    • pp.146-152
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    • 2024
  • Objectives: This prospective observational study aimed to assess the clinical outcomes of perioperative airway and ventilatory management in patients undergoing surgery for oral cavity cancer. The study described the frequencies and types of procedures for securing the airway and the duration and types of postoperative ventilatory support. We compared the findings with those of the TRACHY study. Patients and Methods: One hundred patients undergoing oral cavity oncological surgeries were included. Airway assessment included inter-incisor gap, Mallampati class, neck movements, and radiological features. Surgical parameters, postoperative ventilatory support, and complications were documented. Results: The buccal mucosa was the most common cancer site (48.0%), and direct laryngoscopy was deemed difficult in 58.0% of patients. Awake fibreoptic intubation or elective tracheostomy was required in 43.0% of cases. Thirty-three patients were extubated on the table, and 34 patients were successfully managed with a delayed extubation strategy. In comparison with the TRACHY study, variations were observed in demographic parameters, tumour characteristics, and surgical interventions. Our mean TRACHY score was 1.38, and only five patients had a score ≥4. Prophylactic tracheostomy was performed in 2.0% of cases, in contrast to the TRACHY study in which 42.0% of patients underwent the procedure. Conclusion: The study emphasizes the challenges in airway management for oral cavity cancer surgery. While prophylactic tracheostomy may be necessary in specific cases, individualized approaches, including delayed extubation, are preferrable to maximize safety. Our findings contribute to better understanding and managing perioperative challenges in oral cancer patients and highlight the need for personalized strategies. Scoring systems like TRACHY should not be accepted as universally applicable.

보건 진료원 제도 운영 평가에 관한 연구 -우리나라 1차 보건의료 제도 방향 재설정을 위하여 - (A Review of the Operation Community Health Practitioner System as a Reorientation of Primary Health Care)

  • 홍여신;이인숙
    • 대한간호학회지
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    • 제24권4호
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    • pp.568-583
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    • 1994
  • In the changing social and economic conditions, reorientation of the health care system is a process of rearranging health care resources keeping in mind the appropriativeness, relevancy, and efficacy of health care programs. Also it has been recognized recently that the CHP program is in need of review for the same reasons, that is to say, the ease in which health care facilities are available, the high rate of coverage with insurance and the development of an effective transportation system. Therefore there is a social inclination to think that there are no remote areas and to question the roles of public health facilities, health centers, health sub centers and CHP posts. This paper was done to review problems and to propose new directions for the CHP system. The findings of this study are as follows ; 1) It is necessary that primary health care should be simplified into three parts, medical treatment, preventive care services and the organization of administration and logistics. Also each department should be supplemented with the appropriate professional personnel in order to develop a task oriented system. The reorientation of the CHP system should be managed in keeping with that of other public health care systems. Therefore it is necessary to look at the CHP system problems as one aspect of the reorientation process of public health care systems, and to work to find new ways to address these problems. 2) The location of the CHP post should be decided by the needs of the community in both the medical and preventive areas. If the people have a minimum need, the location of the CHP post should be altered and the existing roles of the CHP should be modified to allow for flexibility according to the community needs. 3) Use of the problem solving method in regular team meetings will prove to be as efficient as continuing education programs in improving job competancy. 4) The supervision of CHP's activities should be made by the same type professional personnel, that is, senior CHPs or charge nurses in the public health center at the county level. 5) The operational expensies of CHP post should be supported by the administrative department of the public health center and should create working conditions that will allow the CHP to concentrate on community health service programs. 6) The organizations for community participation, working committees, community health workers and a number of the local assembly, should be activated to provide for participation in finding solutions to health related problems in the com-munity.

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