• 제목/요약/키워드: patient focused

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투약간호 중심의 환자안전 프로그램 개발 및 평가 (Patient Safety Program and Safety Culture)

  • 김영미;김세영;김민영;김주희;이숙경;장미경
    • 간호행정학회지
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    • 제16권4호
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    • pp.455-465
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    • 2010
  • Purpose: To determine the impact of the Patient Safety Program on the safety culture of nursing department. Methods: Patient Safety Program focused on medication safety was launched by QI team and patient safety committee. Patient Safety Program was composed of the establishment of improved reporting system as s way to learn from error, 'Patient Safety Guard' movement, and continuous education for medication safety. With one group pretest-posttest design, nurses' perception of the safety culture were measured with self-administered questionnaire. Subjects were all nurses and managers in nursing department of a tertiary teaching hospital in Seoul. Collected data from survey was statistically analyzed using t-test. Results: Patient Safety Program had been continued for 20 months in participation of all nurses and managers. Safety culture was improved (pretest=2.84, posttest=2.90, p<.001; 4 point scale). Conclusions: This study indicates that there has been a statistically significant increase in the nurses' perception of safety culture. These findings suggest that Patient Safety Program had made great contribution toward system wide safety culture in the hospital. To improve safety culture, leadership supports and flexibility to apply tailored interventions to the hospital were required necessarily.

만성 수부 습진을 호소하는 소음인 환자 치험 1례 (A Clinical Case Report of Soeumin Patient with Chronic Hand Eczema)

  • 이지연;이민정;황민우
    • 사상체질의학회지
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    • 제33권3호
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    • pp.161-170
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    • 2021
  • Introduction Hand eczema is dermatitis that occurs on the hand and fingers. In this case, the patient had chronic hand eczema that had relapsed for 3 years, worsened for 6 months, and did not improve even with standard dermatological treatment. We report significant improvement of the patient with chronic hand eczema, diagnosed with Soeunmin Greater Yin Symptomatology based on Sasang Constitutional Medicine. Methods We prescribed herbal medicine, Sibimigwanjung-tang(十二味寬中湯), and the western medications were continued throughout the treatment period. To evaluate the treatment progression, we observed objective and subjective symptoms and took pictures of the patient's hands. Results At the first time of the outpatient visit, the patient complained of pain, oozing, scaling and severe itching even though she had taken dermatological medication for over 6 months. After 8 weeks of Korean medicine treatment, most symptoms showed improvement, and after about 47 weeks of treatment, the symptoms maintained 90% improvement even after stopping western medications and herbal medications. Conclusion The patient in this case showed a significant improvement of chronic hand eczema and the improvements have been maintained even stopping western medications and herbal medications during follow-up for 15 weeks. In addition, the patient showed improvement and maintenance of general conditions as well as skin-related symptoms. In this case, we can concern the effect of the Sasang Constitutional Medicine focused on treating the patient's general pathology as well as the patient's chief complaint at chronic hand eczema not responding to standard dermatological treatment.

상급종합병원 간호사의 환자중심간호 예측모형 (A Predictive Model on Patient-Centered Care of Hospital Nurses in Korea)

  • 정현;박명화
    • 대한간호학회지
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    • 제49권2호
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    • pp.191-202
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    • 2019
  • Purpose: Patient-centered care is a widely utilized concept in nursing and health care. However, the key components of patient-centered nursing have not yet been reported. Moreover, previous studies on patient-centered care have mostly focused on components of nursing rather than organizational factors. Therefore, a comprehensive understanding of influential factors of patient-centered care is required. Methods: The purpose of this study was to develop a theoretical model based on person-centered care theory, and the relevant literature and to test the developed model with covariance structure analysis in order to determine the causal paths among the variables. Results: The model fit indices for the hypothetical model were suitable for the recommended level (goodness of fit index=.87, standardized root mean residual=.01, root mean square error of approximation=.06, Tucker-Lewis index=.90, comparative fit index=.92, parsimonious normed fit index=.75). In this study, five of the six paths established in the initial hypothetical model were supported. The variables of teamwork, self-leadership, and empathy accounted for 56.4% of hospital nurses' patient-centered care. Among these, empathy was the strongest predictor of patient-centered care. Conclusion: These results suggest that it is necessary to use strategies to improve self-leadership and empathy. In addition to enhancing the personal factors of nurses, nursing organizations should strive for effective multidisciplinary cooperation with active support for patient-centered care and openness to change.

The Relationship between Hospital Service Quality and Customer Satisfaction: An Empirical Study from Vietnam

  • NGUYEN, Ngoc Mai;DUONG, Thi Thu Ly
    • The Journal of Asian Finance, Economics and Business
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    • 제8권12호
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    • pp.553-561
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    • 2021
  • Health services in developing countries are increasingly focused on satisfying the needs of customers. During the COVID-19 pandemic, many patients have anxiety when going to hospitals for medical treatment. The pressures brought by the pandemic have overwhelmed the hospital system in Vietnam. This has caused the quality of service at these hospitals to decrease because they have focused on the goal of preventing the spread of the virus. Therefore, hospitals, especially private hospitals, need many solutions to improve the quality of their services. This study evaluated the impact of these factors on hospital service quality, as well as the influence of customer service quality on patient satisfaction. The survey was conducted from January 2021 to September 2021 and data was collected directly from 539 patients at Van Phuc Hospital 1. The results show that 4 factors affect the service quality of the hospital, as well as the service quality affecting patient satisfaction, in which, the strongest impact on the service quality of the hospital is the service attitude and professional capacity of the medical team. In the context of the COVID-19 epidemic, this study implies that if the hospital service is good, the customers' peace of mind and satisfaction will be enhanced.

간호사의 가정간호를 위한 교육요구 분석 (A study on educational need of nurses for home care)

  • 문정순
    • 한국보건간호학회지
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    • 제5권2호
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    • pp.5-25
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    • 1991
  • This study was conducted from July to December 1990, in order to diagnose nurses' educational need for home care. The study subjects consisted of 145 nursing educators, and the 3 groups of nurses, namely 250 senior nursing students of diploma and collegiate program, 235 health center nurses, 521 university' hospital nurses in Seoul. Four types of questionaires were formulated by Delphi method. Two questionaires for the nursing educators were designed to measure their expectations of nurses' knowledge and of their skill for home care, and another two questionaires for the nurses to measure their actual home care knowledge and skill. The results of the study were as follows : 1) The mean scores of educators' expectation for home care knowledge were 17.68 for the care of dependence on medical equipment, 17.44 for the care of mobility impairment patient, 16.56 for the care of cardiopulmonary impairment patient, 16.40 for the care of nutrition and elimination impairment patient, '1.20 for the care of psychiatric disorder patient and 9.03 for the care of cancer and terminally ill patient,. 2) The mean scores of nurses' home care knowledge tested by 20 items were 14.36 for the care of mobility impairment patient, 13.28 for the c8;re of dependence on medical equipment, 13.78 for the care of cardiopulmonary impairment patient, 12.92 for the care of nutrition and elimination impairment patient, and those of tested by 10 items were 7.08 for the care of psychologic disorder patient, 7.80 for the care of cancer and terminally ill patient. The sum of means marked 69.23. As for the nurses' home care knowledge categorized by tasks in terms of the group, significant difference were shown in the care of mobility impairment(P=0.00), cancer and terminally ill(P=0.03), nutrition and elimination impairment(P=0.00) and psychologic disorder patient(P=0.00). No significant difference were shown in the care of dependence on medical equipment and cardiopulmonary impairment patient. 3) Regard to educational need of nurses' home care knowledge categorized by task according to the group it was found that all sampled nurses had educational need in the care of mobility impairment, dependence on medical equipment, cardiopulmonary impairment, cancer and terminally ill patient. It was found that health center nurses had educational need in the care of psychologic disorder. No educational need were found in the health center nurses whose career less than 2 years, in the care of mobility impairment, cardiopulmonary impairment and psychologic disorder patient, and in those of career with 2-5 year in the care of psychologic disorder patient. No educational need were found in the hospital nurses whose career more than 15 years, in the care of cardiopulmonary impairment patient and in those of career with 11-15 year, in the care of cancer and terminally ill patient. 4) The mean scores of educators' expectation for home care skill measured by Likert 5 points scale were 4. 21 for assessing, 4.49 for planning, 4.29 for basic care, 4.42 for curative care, 4.40 for rehabilitative care, 4.36 for emergency care, 4.53 for medication, 4.31 for nutritional care, 4.32 for other means for care, and 4.38 for evaluation. 5) Regard to nurses' home care skill measured by Likert 5 points scale of self evaluation, there was a significant difference between the nurses' home care skill and group(P=0.00l). The higher scores reported by students were vital sign checking and basic care while the scores of below medium were curative care and emergency care. The higher scores reported by health center nurses were vital sign checking, other means for care and care of specimen while the scores below medium were curative, emergency and nutritional care. The higher scores reported by hospital nurses were vital sign checking, care of specimen and basic care, while the score below medium was emergency care. 6) Regard to educational need of nurses' home care skill by nursing process activity according to the group it was found that health center nurses had educational need in all nursing skills including vital sign checking, care of specimen, health assessment, socioeconomic assessment, nursing diagnosis, care plan, basic care, curative care, rehabiitative care, psychological care, emergency care, medication, nutritional care, other means for care and evaluation. And students had educational need in all nursing skills except vital sign checking, and hospital nurses had educational need in all nursing skills except vital sign checking, care of specimen and basic care. 7) In short, the result of this study suggests that the curriculum should be organized in accordence with nurses' educational background and their career for the education of nurses for home care. It should be considered to develop the short term educational program focused on curative and rehabilitative care for health center nurse or community health nurse practitioner and which was focused on family care for hospital nurse. Concerning about this field practice for home care nurse, they are required not only community practice but also . clinical practice including emergency, curative and rehabilitative care.

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중소병원 환자가 인지하는 의료서비스 품질이 서비스 가치, 고객만족, 재이용 의도에 미치는 영향 (A Study on Medical Service Quality affecting percieved value, Satisfaction and Intention of Revisit in Middle Hospitals)

  • 지경자
    • 한국병원경영학회지
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    • 제18권4호
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    • pp.18-38
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    • 2013
  • This study aims to analyze the effect of quality of health care on perceived value, patient satisfaction and revisit intention. Especially, it was focused on outdoor environment, indoor environment, admission procedure, hospital image, service quality of physicians nurses medical technicians medical staff that patients perceived. Inpatients and outpatients were selected from three hospital in D city Questionnaire survey was employed to collect data from the subjects. For inpatients, indoor environment, admission procedure, hospital image and service quality of physicians have an effect on perceived value. Admission procedure, hospital image and service quality of physicians nurses medical technicians has an effect on the patient satisfaction. Hospital image and service quality of physicians nurses medical technicians have an effect on revisit intention. Perceived value have an effect on the patient satisfaction. Perceived value have an effect on revisit intention. Patient satisfaction have an effect on revisit intention. For outpatients, Admission procedure, hospital image and service quality of physicians medical technicians have an effect on perceived value. Indoor environment, hospital image and service quality of physicians medical technicians medical staff has an effect on the patient satisfaction. Indoor environment, hospital image and service quality of physicians medical technicians have an effect on revisit intention. Perceived value have an effect on the patient satisfaction. Perceived value have an effect on revisit intention. Patient satisfaction have an effect on revisit intention. They should evaluate customer satisfaction on their services and analyze various factors that affect on it to improve middle hospitals.

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Brachial Plexus Palsy whilst on Crutches Treated with Korean Medicine Focused on Bee-Venom Pharmacopunture

  • Lim, Jae Eun;Song, Mi Sa;Do, Hyun Jeong;Kim, Gyu Hui;Park, Jung Hyeon;Yoon, Hyun Min;Jang, Sun Hee;Seo, Jong Cheol;Song, Choon Ho;Kim, Cheol Hong
    • Journal of Acupuncture Research
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    • 제37권4호
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    • pp.270-274
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    • 2020
  • This study aimed to show the effects of Korean medicine treatment (particularly bee-venom pharmacopunture) on a patient with brachial plexus palsy. A 64-year-old woman was diagnosed with brachial plexus palsy on the right upper extremity and was treated with Korean and Western medicine from September 30th to November 6th, 2019. Improvement of the patient's symptoms was evaluated using the Manual Muscle Test, Range of Motion and visual analogue scale. After treatment, the patient's Manual Muscle Test grade and Range of Motion were improved, and the Visual Analogue Scale score indicated the intensity of her right hand numbness had decreased. These results suggested that improper use of crutches can result in brachial plexus palsy and a Korean-Western medicine treatment regimen primarily focused on bee-venom pharmacopunture, may be effective in reducing the symptoms of brachial plexus palsy.

시뮬레이션에서의 간호대학생의 임상적 판단 기술 분석: Tanner의 Clinical Judgment Model을 적용하여 (Nursing Students' Clinical Judgment Skills in Simulation: Using Tanner's Clinical Judgment Model)

  • 김은정
    • 한국간호교육학회지
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    • 제20권2호
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    • pp.212-222
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    • 2014
  • Purpose: The purpose of this study was to evaluate the nursing students' clinical judgment skills in simulation using Tanner's Clinical Judgment Model. Method: Forty-five teams of a total 93 nursing students participated in a post-operative patient care scenario using human patient simulator. Data were collected from students' responses in scenario and guided reflective journaling according to the framework of Tanner's model which comprised noticing, interpreting, responding, and reflecting on response. Data were analyzed using descriptive statistics. Results: The students' responses of the situation were in accordance with the goals of scenario, i.e. relieving patient' pain and preventing pulmonary complications. However, most of students needed clinical cues and focused on a given clue to solve the issues. They were lack of ability to collect additional information as well as connect the relevant clues in simulated clinical situation. Conclusion: The nursing students have difficulty in what they notice, how they interpret finding, and respond appropriately to the situation. The simulation training using Tanner's model could provide faculty and nursing students with an effective teaching and learning strategy to develop the clinical judgment skills.

Cerebellar vermis atrophy로 인한 Spinocerebellar Ataxia환자(患者) 치험(治驗) 1례(1例) 보고(報告) (Case report on Spinpcerebellar Ataxia(SCA) with cerebellar vermis artophy)

  • 조현열;배은정;이경민;서정철;한상원
    • Korean Journal of Acupuncture
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    • 제19권2호
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    • pp.79-85
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    • 2002
  • Objective : In 1983 Autosomal dominent spinocerebellar ataxia(ADCA) has been classified to four types by a useful clinical features according to Harding. Since 1993 ADCA referred to as SCA by molecular genetic characteristics. We focused on the improvement of clinical symptoms in SCA patient through oriental medical treatment. Methods & Results : The assessment included neurophysiological examination and clinical symptoms. For example slow saccade, gaze limitation, upward and lateral, nystagmus, truncal and gait ataxia. The patient(M/30) was clinically charaterized by ocular abnormalities, trunkal and gait ataxia and the MRI showed atrophy of cerebellar vermis. The patient was taken both common acupuncture and Dong-Si venepuncture on Hwasan with herbal medicine. Before the treatment Rt. ocular movement were slowed and a significant eye fixation was observed always in abduction and intermittently presented trunkal and gait ataxia. During the treatment trunkal and gait ataxia has not been presented and ocular obnomalities changed to normal state. This case suggests the possibility of oriental medical treatment on SCA but further observation is needed on this patient.

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피부 질환 증례 연구를 통한 백호탕(白虎湯)과 백호가인삼탕(白虎加人參湯)의 비교 (Clinical Differences between Baekho-tang and Baekhogainsam-tang through Skin Disease Case)

  • 박승구;조은희;최한결;홍지은;박민철
    • 대한한의학방제학회지
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    • 제27권2호
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    • pp.179-187
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    • 2019
  • Objective : The purpose of this paper is to analyze the difference between Baekho-tang(白虎湯) and Baekhogainsam-tang (白虎加人蔘湯). Methods : We compared the effect of Baekho-tang on atopic dermatitis and the effect of Baekhogainsam-tang on allergic contact dermatitis. We focused on the level of thirst. Results : After the Baekho-tang treatment, the SCORAD of atopic dermatitis patient decreased $63.8{\rightarrow}4.3$ and VAS of pruritus on atopic dermatitis patient were improved $8{\rightarrow}2$ respectively. Meanwhile, after the Baekhogainsam-tang treatment, the VAS of pruritus on allergic contact dermatitis patient was improved $7{\rightarrow}2$ and the thirst of the patient improved. Conclusions : There is a difference between Baekho-tang and Baekhogainsam-tang at the level of thirst. Baekhogainsam-tang continues to thirst hard enough to find water.