• 제목/요약/키워드: out patient

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환자 만족도 조사를 통한 QI활동의 효과 평가 - 일개 병원을 중심으로 - (QI Activities for Promotion of Patient's Satisfaction)

  • 박연옥;김미숙;고은정;김연정;홍창호
    • 한국의료질향상학회지
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    • 제5권2호
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    • pp.312-323
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    • 1998
  • Background : Evaluation of patient's satisfaction is one of the most important aspects of quality improvement. If the patient highly satisfies with the medical service provided in the hospital, he/she will be likely to visit the same hospital again. Patient's satisfaction of a particular hospital is directly correlated with hospital profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the patient's satisfaction. This study is to find the effect of hospital QI activities on the patent's satisfaction level. Methods: After questionnares were developed, survey of measuring satisfaction level was performed in August, 1998. On the basis of survey results, QI activities were carried out to attain the target point of 4.0 and subsequent survey was done in November, 1998. Results: With three main principles of "problem solving approach with kindness". "helping patient to participate in medical procedure with sufficient information", and "putting employees into practice of attitude with human respect", the average level of satisfaction was enhanced from 3.45 to 3.55 level. Also kindness level of employees was increased from 3.71 to 3.82. Level of dissatisfaction about insufficient explanation and unkind attitude was dropped from 69% to 48% and from 82% to 46% respectively. Conclusion: With the result of this study overall satisfaction level was enhanced. In order to keep these advantages a operation of Quality Improvement Task Force Team in each subject will be required.

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환자안전사건 분석을 위한 한글 근본원인분석 소프트웨어 개발 (Development of Korean Root Cause Analysis Software for Analyzing Patient Safety Incidents)

  • 최은영;이현정;옥민수;이상일
    • 한국의료질향상학회지
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    • 제24권1호
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    • pp.9-22
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    • 2018
  • Purpose: The purpose of this study is to develop the Korean root cause analysis (RCA) software that can be used to systematically investigate underlying causes for preventing or reducing recurrence of patient safety incidents. Methods: We reviewed the existing guidelines and literatures on the RCA in order to figure out the RCA process. Also we examined the existing RCA softwares for investigating patient safety incidents to design the contents and interface of the RCA software. Based on the results of reviewing literatures and softwares, we developed a draft version of the Korean RCA software that can be easily used in Korean hospital settings by RCA teams. Results: The Korean RCA software consisted of several modules, which are modules for identifying patient safety incidents, organizing RCA team, collecting and analysing data, determining contributory factors and root causes, developing the action plans, and guiding evaluation. Conclusion: The Korean RCA software included optimized RCA process and structured logic for cause analysis. Thus even beginners in RCA are expected to easily use this software for investigating patient safety incidents. As software has been developed with the public financial support, it will be distributed free of charge. We hope that it will contribute to facilitating patient safety improvement activities in Korea.

치과 환자의 진료 만족도 증진을 위한 비약물적 접근으로서 최면 요법의 분석 (Use of hypnosis in dentistry for improving patient satisfaction: as a means of non-phamaceutical approach)

  • 옹승환;이성조;조인우;박정철
    • 구강회복응용과학지
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    • 제33권3호
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    • pp.169-177
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    • 2017
  • 본 연구의 목적은 치과 치료를 받는 환자들의 불안, 통증, 공포, 스트레스를 줄이기 위해 최면의 효과를 알아보고 환자의 만족도를 높이기 위해 어떤 방법으로 도입하는 것이 바람직할지 알아보기 위함 이었다. Medline을 이용하여 치과 및 의학 영역의 최면과 관련된 연구를 검색하여 분석하였다. 치과 영역에서 최면 요법의 이용은 환자의 불안, 공포, 통증, 스트레스 등을 줄여주어 편안한 치료를 받을 수 있도록 도움을 주는 것으로 나타났다. 또한 면역 체계에 영향을 끼쳐 치유에 도움을 주고, 약물의 사용을 줄여 부작용을 감소시킬 수 있는 효과도 나타났다. 따라서, 최면 요법을 활용한 치과 진료 시 환자는 정신적, 육체적으로 편안한 진료가 가능하며, 이로써 환자의 진료의 만족도가 높아질 것으로 예상된다.

한방병원에 내원한 만성 피로환자와 건강인의 심박변이도 측정을 통한 피로 진단 지표 연구 (Fatigue Diagnostic Measure Research Through The Heart Rate Variability of Chronic Fatigue Patients and Healthy Students in Korean Medical Hospital)

  • 신선미;김기태;고흥
    • 동의생리병리학회지
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    • 제29권5호
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    • pp.409-415
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    • 2015
  • This study compared the heart rate variability tests of healthy college students and chronic fatigue patients for 2 years. Study subjects were idiopathic chronic fatigue patients who carried out the HRV tests and students conducted HRV test when health screening test. Study subjects were 250 people, 104 people and men (41.6%), women were 146 patients (58.4%). In patient group, the autonomic nervous system activity was decreased, the activity of the sympathetic nerve and the parasympathetic nerve were significantly reduced compared to the control group(Patient:84.17±16.27, Control:98.33±17.28). Regardless of gender, patient group's autonomic nervous system activity was decreased, the activity of the sympathetic nerve and the parasympathetic nerve were significantly reduced, compared to the control group(Patient Female:84.17±16.27, Patient Male:84.07±14.96/Control Female:98.33±17.28, Control Male:96.45±16.92). Even though same ages, patient group's autonomic nervous activity was reduced compared to control group(Patient:89.36±12.43, Control:97.39±16.91). Fatigue patients' activity of the sympathetic nerve and the parasympathetic nerve were significantly reduced, regardless of the fact that activity of the sympathetic nerve is increased and the parasympathetic nerve is decreased in stress state like an impassioned injury(七情傷). Therefore HRV test is useful to diagnose Fatigue from this study.

"소문(素問).조경론(調經論)"의 유여(有餘).불족증(不足證)에 대(對)한 연구(硏究) (Interpretation of Excess and Deficiency Syndromes(有餘不足證) Described in "Somun . Jogyongron(素問.調經論)")

  • 방정균
    • 대한한의학원전학회지
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    • 제20권3호
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    • pp.49-56
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    • 2007
  • The "Somun Jogyongron(素問 調經論)" describes excess and deficiency syndromes. The study suggests that excess syndrome(實證) is caused by vigorous pathogenic fire(火邪)(the spirit(神)), pathogenic dryness(燥邪)(Gi(氣)), pathogenic wind(風邪)(blood(血)), pathogenic dampness(濕邪)(physique(形)) or pathogenic coldness(寒邪)(will(志)). When pathogenic fire is dominant within the body, Gi and blood becomes excessive and come out of the body, but the body cannot take them back, leading to the symptom in which the patient cannot stop laughing. When pathogenic dryness prevails, the lung(肺) cannot function properly. This means that the convergence(收斂) function of the clearing the lung and descending Gi(肅降) is deteriorated, and the patient shows symptoms of dyspnea and cough. Strong pathogenic wind increases the ascencling Gi in the liver(肝氣) and fuel angry emotion when the patient becomes upset. When pathogenic dampness is dominant, spleen(脾) function drops due to lumping effects, and the patient will experience abdominal distention(腹脹), which will disturb urination and defecation. When pathogenic coldness prevails, abdominal distention occurs due to condensating effects, and Yang Gj(陽氣) in the kidney(腎) is disturbed, leading to digestion disorders and eventually water-grain dysentery. Deficiency syndrome is caused by the lack of essential Gi(精氣) in the five viscera(五藏). Deficiency of sprit means the lack of Gi in the heart(心氣), so the patient becomes vulnerable to sadness. Deficiency of Gi means the lack of Gi in the lung(肺氣), so the patient may have breathing disorders. Deficiency of blood means the lack of Gi in the Liver(肝氣), so the patient can be easily scared. Deficiency of physique means the lack of Gi in the spleen(脾氣), making it difficult to use arms and legs. Deficiency of will means the lack of Gi in the kidney(腎氣), so Gowl syndrome(厥證) can ensue.

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IoT-based Architecture and Implementation for Automatic Shock Treatment

  • Lee, Namhwa;Jeong, Minsu;Kim, Youngjae;Shin, Jisoo;Joe, Inwhee;Jeon, Sanghoon;Ko, Byuk Sung
    • KSII Transactions on Internet and Information Systems (TIIS)
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    • 제16권7호
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    • pp.2209-2224
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    • 2022
  • The Internet of Things (IoT) is being used in a wide variety of fields due to the recent 4th industrial revolution. In particular, research is being conducted that combines IoT with the medical field such as telemedicine. Among them, the field of shock detection is a big issue in the medical field because the causes of shock are diverse, treatments are very complex, and require a high level of medical knowledge and experience. The transmission of infectious diseases is common when treating critically ill patients, especially patients with shock. Thus, to effectively care for shock patients, we propose an architecture that continuously monitors the patient's condition, and automatically recommends a drug injection treatment according to the patient's shock condition. The patient's hemodynamic information is continuously monitored, and the patient's shock generation information is recorded periodically. With the recorded patient information, the patient's condition is determined and automatically injected with necessary medication. The medical team can find out whether the patient's condition has improved by checking the recorded information through web applications. The study can help relieve the shortage of medical personnel and help prevent transmission of infectious disease in medical staff. We look forward to playing a role in helping medical staff by making recommendations for the diagnosis and treatment of complex and difficult shocks.

류마티스 관절염 환자 배우자의 부담감 (A Study on Burden of Middle Aged Spouses of Rheumatoid Arthritic Patients)

  • 최경숙;은영;함미영
    • 근관절건강학회지
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    • 제7권2호
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    • pp.241-257
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    • 2000
  • Rheumatoid arthritis as one of the chronic illness requiring management in long period of time puts great burden to patients, their family and society. For patients with chronic illnesses, providing a social support is important and the most important source comes from spouses. Therefore we assessed burden of husbands of female rheumatoid arthritic patients and also found out the factors affecting burden. The sample of study was 107 female rheumatoid arthritic patients and their spouses. The tool of assessing spouses' burden was the revised version of subjective and objective parameters developed by Montgomery et al.(1985). The results are as follows: 1. General characteristics of patients and spouses: The mean age of the patients was 48 years. Educational level of patients was high school 41.1%. The mean age of the spouses was 51years. Educational level of spouses was mostly high school(40.2%) and college(29.9%) graduate. The mean marital period was 23.4years. Average income per month was 1,609,000 won. The average duration since diagnosis was 9.4years. As a therapy, 67.3% chose standard drug therapy. Average rating of discomfort by patient was 3.05(range 1-5) and that of severity was 3.48 and that of dependency was 2.58. The husband's rating of their spouses disease severity was 3.68. 2. Husbands' burden: The average burden in subjective items was 21.61(range 6-36) and objective items was 35.24(range 10-60). The average of total burden was 56.59(range 16-96). 3. Husband's total burden correlated with patient's age, educational level of patients, therapy method, patient's level of discomfort, patient's severity, patient's level of dependence, husband's recognition of level of severity in statistical level. Husband's objective burden correlated with patient's age, educational level of patient, patient's level of discomfort, husband's recognition of level of severity. Husband's subjective burden correlated with patient's age, educational level of patients, therapy method, patient's severity, patient's level of dependence, husband's recognition of level of severity. 4. Linear correlation analysis on burden: The husbands' total burden is explained in 37 7% by husband's recognition of level of severity and husband's age. The husbands' objective burden is explained in 31.2% by patient's level of dependence, husband's age, husband's recognition of level of severity. The husbands' subjective burden is explained in 26.7% by husband's recognition of level of severity and patient's age. In conclusion, husbands' level of burden is affected by many factors and therefore nursing strategy for relieving burden of middle aged husbands should be individualized taking these factors into consideration.

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응급환자의 방사선영상검사 분포 및 Patient Care (The Distribution and Patient Care in Radiography for Emergency Outpatients)

  • 이환형;강원한
    • 대한방사선기술학회지:방사선기술과학
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    • 제19권1호
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    • pp.55-74
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    • 1996
  • This study was carried out to improve service efficiency and to cope with a emergency situation in emergency radiography, through analysis of the radiographic distribution and literature cited about emergency care. Data collection of radiographic distribution was surveyed for 761 emergency outpatients who visit during JAN, 1994 at ER of the general hospital in Pusan city. The results is as follows: Emergency radiography rate of simple radiography was 61.1 %, special radiography 2.5 %, CT 12.6 %, and ultrasonography 6.7 %. In simple radiography rate, a high rate was distributed on male(63.6 %), thoracicsurgery part(90.0%), admission patient(74.9 %), and long stayed patient at ER. In special raiography rate, a high rate was observed in urologic part(28.6%), and in CT rate, observed neurosurgery part(49.2 %) and neurologic part(36.7%). Ultrasonography rate was high for female(8.8 %) and internal medicine part(15.9 %). There are distributed regional radiography rate in radiographic type that chest(55.3 %) is high in the simple radiography, urinary system(1.2%) in the special study, and brain(40.0 %) in the CT. Regional radiography rate according to diagnostic department also was showed highly for head(64.6%) in neurosurgery, chest(90.0%) in thoracic-surgery, abdomen(58.0%) in general-surgery, spine (40.0% ) in neuro-surgery, and pelvis(15.9%), upper extrimity(20.5%), and lower extrimity(31.8%) in orthopedic-surgery each. Mean radiographic case number per patient of simple radiography was sinificant on sex, age, transfer relation in both total and radiographic patients(p<0.05). Mean radiographic case number was highly distributed on male(2.2 case number) in sex, on thirties(2.7) in age, transfered patient(2.7) in patient type, and on neurosurgery(3.4) in diagnostic charged part. Total radiographic case number in regional part was highly distributed on chest(499 case number). Considering the above results, emergency radiographer should take care of the elder patient in emergency radiography and get hold of injury mechanism to decrease possible secondary injury during radiography. Because of high radiography rate of urinary system in special study, radiographer should know well about dealing with contrastmedia administration and related instrument. All radiographer who take charge emergency patient should cope with a emergency situation during radiography, Because head trauma patients is very important in patient care, especilly in CT at night, charged doctor should be always silted with CT room and monitoring-patient. Radiography was reqested by many diagnostic department in ER. Considering that rate of simple radiography is high, special room for emergency radiography should be established in ER area, and the radiographer of this room should be stationed radiologic technician who is career and can implement emergency patient care.

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임종태도와 HOSPICE에 관한 연구 (A study on the attitude toward dying and hospice)

  • 김영욱;이중훈;이종범;박병탁;정성덕;김명세;김후자
    • Journal of Yeungnam Medical Science
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    • 제7권2호
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    • pp.55-66
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    • 1990
  • 1. 임종통고에 대한 반대는 노인군과 환자가족군이 40.2%, 40.9%로 환자군과 의료인군의 23.%, 13.3%보다 유의하게 높았다(p<0.001). 2. 임종환자에 대한 의료인의 회피적 태도에서는 의료인군의 44%가 반대하여 전체평균 28.5%보다 유의하게 높았다(p<0.001). 3. 불치병 환자의 생명 연장에 대한 태도에서는 환자군과 보호자군의 반대율이 33.3%, 22.5%로 노인군과 의료인군의 54.5%, 56.0%보다 유의하게 낮았다(p<0.001). 4. 임종환자를 위한 특수시설 및 교육문제에 있어서는 의료인군의 찬성율이 81.3%로 가장 높았고 환자군이 56.8%로 가장 낮았다. 5. 임종환자에 대한 가족의 회피적 태도에 대해서는 노인군의 찬성율이 81.3%로 가장 높았고 가족군이 34%로 가장 낮았다. 6. 임종에 대한 지각문제에 있어서는 의료인군의 찬성율이 77.3%로 전체평균 58.8%보다 높았다.

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수술실 간호사의 환자안전관리활동 영향 요인 (Factors Influencing on Patient Safety Management Activities in Operating Room Nurses)

  • 강희;최수경;김인숙
    • 한국산학기술학회논문지
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    • 제17권9호
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    • pp.329-339
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    • 2016
  • 본 연구는 수술실 간호사의 직무 스트레스와 조직몰입, 환자안전관리활동 정도를 파악하고, 환자안전관리활동 정도에 영향을 미치는 요인을 확인하기 위한 서술적 조사연구이다. 대상자는 G광역시 소재 1개의 대학병원과 9개 종합병원 수술실에 근무하는 간호사로 대상자 선정기준에 적합한 총 136명이었으며 자료수집기간은 2014년 7월 25일부터 8월 7일까지이었다. 수집된 자료는 SPSS/WIN 21.0 program을 이용하여 기술통계, Independent t-test, one- way ANOVA, Pearson's correlation, multiple regression으로 분석하였다. 연구결과는 다음과 같다. 대상자의 직무 스트레스 정도는 5점 만점에 3.76점, 조직몰입 정도는 5점 만점에 3.09점, 환자안전관리활동 정도는 5점 만점에 4.15점이었다. 수술실 간호사의 환자안전관리활동 정도는 대상자의 근무경력, 적성, 근무만족도와 환자안전교육 횟수에 따라서 통계적으로 유의한 차이가 있었다. 환자안전관리활동은 조직몰입과 유의한 양의 상관관계가 있었고, 수술실 간호사의 환자안전관리활동에 영향을 미치는 요인은 조직몰입과 환자안전교육 횟수로, 이들 변수의 설명력은 23%이었다. 이상의 연구결과를 통해 조직몰입과 환자안전교육이 수술실 간호사의 환자안전관리활동을 증진시키는 주요 영향요인으로 확인되었다. 따라서, 수술실의 환자안전관리를 위해서 수술실 간호사의 조직몰입을 향상시키는 다양한 중재프로그램 개발과 환자안전관리활동을 위한 지속적이고 체계적인 환자안전교육의 강화가 필요하다고 사료된다.