• 임상간호연구
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• 제28권3호
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• pp.223-232
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• 2022

Purpose: The purpose of this study was to apply patient-engaged bedside handoffs in comprehensive care units, and to evaluate the effects of bedsides to nurses and patients. Methods: This study employed a cluster randomized cross-over design.Electrical Medical Record (EMR)-based handoffs and patient-engaged bedside handoffs were alternatively applied to 104 patients, who were assigned to a total of 30 clusters (nursing handoff teams) in 4 comprehensive care units at the S medical center in Seoul, and the patients evaluated each type of handoffs. A total of 139 nurses were also participated in the same units and evaluated each type of handoffs. Data were analyzed using t-test, Wilcoxon rank sum test, ANOVA, and Kruskal-Walls test. Results: The patient's satisfaction of the patient-engaged bedside handoffs was higher than that of the EMR-based handoffs (Z=-5.16, p<.001). On the other hand, the nurse's satisfaction of the patient-engaged bedside handoffs was significantly lower than that of the EMR-based handoffs (t=13.21, p<.001). There were no differences in length of the reporting time between two types of handoffs (t=-0.48, p=.634). Conclusion: Patient satisfaction with the patient-engaged bedside handoffs was higher than that of EMR-based handoffs, and nurses' satisfaction with the patient-engaged bedside handoffs was significantly lower than that of EMR-based handoffs. Future studies are needed regarding the impacts of patient-engaged bedside handoffs on the quality of healthcare by identifying the benefits of the handoffs.

• 한국임상약학회지
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• 제32권2호
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• pp.74-83
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• 2022

Objective: There is a growing movement to introduce Patient-Reported Outcome (PRO) to clinical settings. This study aimed to investigate the routine use of PRO in tertiary hospital clinical settings. Methods: From January 2016 to December 2018, the usage status of Patient-Reported Outcome Measures (PROMs) submitted to the electronic medical record of a tertiary hospital clinical setting was investigated. Descriptive analysis was conducted to investigate the usage status of PROMs by 42 departments. Also, the most frequently used PROMs by departments, the purpose of measurement, the use rate of verified PROMs were investigated. Results: The PROMs accounted for 66% (98) of the 148 Instruments. Of the 98 PROMs, 64% (63) were using a validation Korean version of PROMs. Only about 1% of total outpatient visits applied PROMs, and among them, it was frequently used in urology (13%), orthopedics (8%), and otolaryngology (5%). The use rate of the validated PROMs was found to be 64%. Conclusions: The use of PROMs in domestic clinical settings was found to be very limited and frequently used only in specific departments. It is essential to use a PROMs that has been validated according to guidelines, as the use of validated PROMs will provide beneficial information to health professionals and also for the patient health improvement by objectively measuring the patient's health status.

• 대한방사선기술학회지:방사선기술과학
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• 제45권3호
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• pp.255-262
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• 2022

In this study, by analyzing the examination time for each procedure, the appropriate workload of radiologic technologist is analyzed based on the actual examination time in the current clinical setting by comparing with the examination time in the radiology field setting of the health insurance review and assessment service. In addition, this result is introduced into the calculation of relate value units; it was attempted to provide accurate and objective evidence in the field of radiology. From May 2020 to December 2021, the study retrospectively investigated the examination times recorded in the electronic medical record and picture archiving and communication system at 5 tertiary general hospitals and 1 general hospital. The total of 16 examination parts are applied in this study, including the head, sinuses, chest, ribs, abdomen, pelvis, cervical, thoracic, lumbar, shoulder, elbow, wrist, hip, femur, knee, and ankle. The minimum number of images that could be obtained per radiation generator was 3.6 images for one hour, and the maximum was 6.4 images. When 50% median of procedure time is calculated, the minimum number of images that could be obtained was 16.7 images and maximum was 35.3 images; in addition, minimum examination time is 1.7 minutes, and maximum time is 3.6 minutes. In conclusion, it is judged that there will be insufficient explanation time for basic infection instructions such as hand hygiene during the examinations in current clinical practice. It is believed that radiologic technologists will contribute to providing higher-quality of radiation examination services to the public by complying with guidelines for work and setting appropriate workload on their own.

• 한국컴퓨터정보학회논문지
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• 제17권3호
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• pp.33-40
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• 2012

최근 병원정보 시스템은 의료서비스의 질과 효율성을 제고하기 위해 스마트폰 및 태블릿 PC를 활용한 스마트 진료서비스가 대형병원을 중심으로 도입되고 있으며 개인의 진료정보를 PC, 스마트폰 등을 통해 관리하는 개인건강기록(PHR) 서비스에 대한 관심 및 기술개발이 활발히 진행 중에 있다. 이러한 차세대 병원정보 시스템을 구축하기 위해서는 상이한 병원정보 시스템 간의 데이터 연동과 다양한 사용자 기기 간의 UX 일관성이 보장되어야 한다. 따라서 본 논문에서는 이러한 멀티플랫폼 환경 하에서 의료정보를 통합하여 연동할 수 있는 게이트웨이 시스템을 설계하기 위해 개인의 진료정보 표준과 성능 향상을 위한 연구를 수행하였다. 본 연구를 통해 게이트웨이 시스템의 핵심 기능인 데이터 간의 매핑 방법에 있어서 CCR 표준을 적용하고 다중 테이블 기반 매핑 방법을 사용하여 시스템 설계를 하였다. 이에 대한 성능 평가를 위해 실험을 한 결과 응답속도가 약 20% 향상된 결과를 얻을 수 있었다.

• 디지털융복합연구
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• 제13권2호
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• pp.267-277
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• 2015

본 연구의 목적은 중년기 남성 만성 간 질환자의 삶의 질에 대한 관련요인을 알아보고자 시도되었다. 연구 방법은 병원에서 외래치료를 받는 110명의 환자를 대상으로 설문조사와 전자의무기록지를 활용하였다. 자료분석은 PASW (SPSS) 19.0 프로그램을 이용하여, one-way ANOVA, Pearson 상관관계와 다중회귀분석하였다. 연구결과는 중년기 남성 만성 간 질환자의 삶의 질은 48.16점/100점이었으며, 불안과 우울, 증상경험, 건강지각, 질병상태와 배우자가 있는 경우에서 유의하게 나타났으며, 이들 요인은 삶의 질을 68.6% 설명하였다. 결론은 중년기 남성 만성 간 질환자의 삶의 질은 불안과 우울의 정서적 요인이 주요 요인이므로, 불안과 우울을 감소시킬 수 있는 간호중재전략의 개발을 제안한다.

• Tuberculosis and Respiratory Diseases
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• 제80권1호
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• pp.69-76
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• 2017

Background: Much of the attention of tuberculosis (TB) programs is focused on outcomes of microbiological cure and mortality, and health related quality of life (HRQL) is undervalued. Also, TB patients have a significantly higher risk of developing depression and anxiety compared with those in the general population. We intend to evaluate the HRQL and the prevalence of symptoms of depression and anxiety in hospitalized patients with TB. Methods: Cross-sectional study in a tertiary care hospital in Brazil. Adult patients with pulmonary TB that were hospitalized during the study period were identified and invited to participate. HRQL was measured using the Medical Outcomes Study Short Form-36 (SF-36) version 2. Hospital Anxiety and Depression Scale (HADS) was used to record symptoms of anxiety and depression. Results: Eighty-six patients were included in the analysis. The mean age of all patients was $44.6{\pm}15.4$ years, 69.8% were male, and 53.5% were white. Thirty-two patients (37.2%) were human immunodeficiency virus positive. Twenty-seven patients (31.4%) met study criteria for depression (HADS depression score ${\geq}11$) and 33 (38.4%) had anxiety (HADS anxiety score ${\geq}11$). Scores on all domains of SF-36 were significantly lower than the Brazilian norm scores (p<0.001). Conclusion: The present study shows that TB patients may have a poor HRQL. Additionally, we found a possible high prevalence of depression and anxiety in this population. Health care workers should be aware of these psychological disorders to enable a better management of these patients. The treatment of these comorbidities may be associated with better TB outcomes.

• Journal of Preventive Medicine and Public Health
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• 제26권3호
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• pp.430-441
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• 1993

The objectives of this study are two-fold : to identify geographic variations in the rate of tonsillectomy and adenoidectomy (T&A) and appendectomy and analyze the socioeconomic variables and health resources which affect geographic variation in the rate. The nationwide three month's cases of the two surgical procedures in 1991 are obtained from the record of the National Federation of Medical Insurance. The analysis shows two to ten-fold variations in the regional rates for the performance of two common procedures such as T&A and appendectomy. T&A shows a bigger regional variations than appendectomy. As a result of multiple regression, the factor of bed supply has been found significant for the dependent variable of the rate of T&A. The finding of large variations in the rate of surgical procedures throughout the country would have important implications for allocating scarce resources and managing quality of care. Further analysis is needed for the elaboration of the above implications.

• Journal of Preventive Medicine and Public Health
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• 제26권3호
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• pp.400-411
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• 1993

The aim of this study is to analyze the variations among hospitals and hospital groups in resource use and procedures of diagnostic and therapeutic process, such as laboratory tests, radiologic examinations, tissue diagnosis, timing of surgery after admission, the time required for operation. The study was performed for five procedures including cesarean section (C/S), appendectomy, cholecystectomy, cataract extraction, and pediatric pneumonia. The 2,316 subjects were selected from medical insurance claims list, and from this list 413 cases were sampled for medical record review. The patterns of resource utilization and process of treatment were described according to hospitals and characteristics of hospital groups. The major results were as follows : 1. The numbers of laboratory and radiologic tests showed significant difference among hospitals and hospital groups. In case of hospital groups, we could find tendencies of more tests with increasing hospital bed size. 2. In general, the proportion of operative cases evaluated by tissue diagnosis postoperatively among all operations ranged from 28.3% to 100%. The proportion varied among hospital groups, of which general hospital A group(more than 15 specialty) showed the highest proportion. 3. Post-admission delay until operation and the time required for operative procedure were not invariable among hospitals and hospital groups. The duration of operation in tertiary hospitals was slightly shorter than general hospitals, with varying statistical significance. We could find that probably there were differences of quality among hospitals in some components of procedures, which suggested that the implementation of quality assurance activities would be mandatory. In this study, we simply described the patterns of resource utilization and some features of clinical process, with institution of the need for advanced studies with in-depth analyses for each component of diagnosis and treatment procedures.

• 대한한방종양학회지
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• 제7권1호
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• pp.131-139
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• 2001

Objectives: This study was designed to evaluate the effects of symptom differentiated treatment on cancer patient. Methods: We retrospectively analyzed the medical record of a case of hepatoma patient with lungs and brain metastasis who had been treated with oriental medicines from 16 august 2001 through 5 september 2001. Results: For the 21 hospital days, he was treated with oriental medicines. Not only all most symptoms were disappeared but also hematological and radiological examinations were improved. According to the results, it could be suggested that symptom differentiated treatment has significant effects on improving symptoms and quality of life as a supportive or palliative therapy for cancer patients.

• 대한의용생체공학회:학술대회논문집
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• 대한의용생체공학회 1996년도 추계학술대회
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• pp.304-306
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• 1996

Endoscopy has become a crucial diagnostic and theraputic procedure in clinical areas. Over the past three years, we have developed a computerized system to record and store clinical data pertaining to endoscopic surgery of laparascopic cholesystectomy, peviscopic endometriosis, and surgical arthroscopy. In this study, we are developed computer system, which is composed of frame grabber, sound board, VCR control board, LAN card and EDMS(endoscopic data management software). Also, computer system has controled over peripheral instruments as a color video printer, video cassette recorder, and endoscopic input/output signals(image and doctor's speech). Also, we are developed one body system of camels control unit including an endoscopic miniature camera and light source. Our system offer unsurpassed image quality in terms of resolution and color fidelity. Digital endoscopic data management system is based on open architecture and a set of widely available industry standards, namely: windows 3.1 as a operating system, TCP/IP as a network protocol and a time sequence based database that handles both an image and drctor's speech synchronized with endoscopic image.