• 기본간호학회지
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• 제2권2호
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• pp.139-154
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• 1995

The purpose of this study was presented basic data for management of living kidney donor to make bioethical decision. The research subjects were the documents and progress notes of Doctor's and Nurses in medical records related to kidney donation and nephrectomy of 20 kidney donors who received nephretomy at 4 general hospitals in Pusan. The result of this study, a desirable documents to help the living kidney donor might include following : 1st, identification of the donor and the guardian. 2nd, confirmation of the intension of kidney donor which is based on humanity or not and 3rd, a written oath about Nephrectomy. Especially it is more desirable to participate of paramedical personnels such as the religious, the social workers, the counsellors, and etc when assess the motivation of kidney donor and to use of a formulated visual educational materials about renal angiography and nephrectomy which required written consent of kidney donor. Further more, the donor should be educated sufficiently about the kidney itself and procedure for nephrectomy-the anatomical position of kidney, the function of the kidney, the operative maneaver, pre and post operative complication, the prevention of the complication, the possiblity of rejection phenomenon and loss of the transplanted kidney etc. In conclusion, medical team members for kidney transplantation must suggest not only physical problem but also psychological problem And the educated donor ought to have enough time before a making decision and all these process should be recorded in medical records

• 기록학연구
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• 제60호
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• pp.283-315
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• 2019

소프트웨어 산업은 새로운 비즈니스 모델의 등장으로 빠르고 유연하게 대처할 수 있는 기술로의 변화가 요구되고 있다. 이와 관련하여 차세대 기록관리시스템의 아키텍처로 거론되고 있는 마이크로서비스는 민첩성과 편리성을 지니는 아키텍처로 급부상했다. 마이크로서비스를 적용한 기록관리시스템을 개발한다면 혁신의 기반과 함께 민첩성과 확장성을 확보할 수 있다. 본 연구의 목적은 마이크로서비스를 적용한 기록관리시스템 구축 시 효율적인 방안을 제시하는 데 있다. 이를 위해 먼저 전통적 방식의 아키텍처를 살펴보고, 마이크로서비스의 주요 특징을 설명하였다. 또한 마이크로서비스 아키텍처를 적용한 시스템 구축 시 '마이크로서비스의 짧은 역사', '기술의 성숙도', '프로젝트팀의 기술 수준' 등 세 가지 측면을 검토해야 함을 정리하였다. 그리고 국내 환경에 맞춰 마이크로서비스를 적용한 기록관리시스템 구축 시 고려사항을 제시하였다.

• 임상간호연구
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• 제15권1호
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• pp.107-122
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• 2009

Purpose: The purpose of this study was to identify nursing interventions frequently used with cancer patients. Nursing records from 5 general hospitals for patients with stomach, liver, lung or colon cancer were analyzed. Method: A descriptive study methodology was used and nursing records for 15 patients in each disease category at each hospital, who were admitted and discharged during June 2007 were analyzed. Results: Five domains of NIC were found and the physiological(basic) domain was most frequent (31.52%). Twenty two classes of NIC were identified with risk management for safety being most frequent (22.49%). For the 119 nursing interventions identified, the most frequent was pain management with 7,827 (12.31%), followed by prevention of falls (11.76%), surveillance (6.79%) and wound care (5.12%). Nursing activities of pain management and prevention of falls were comparable to activities listed in literature on guidelines for evidence based and best practices in nursing care. Eight of the 17 nursing activities for pain management, and 9 of 14 for fall prevention were consistent with these guidelines. Conclusion: In this study, nursing interventions were found to be focused on physical care, monitoring patients' condition and education. We have to develop diverse nursing interventions and a convenient recording process.

• 한국의료질향상학회지
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• 제6권1_2호
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• pp.136-149
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• 1999

Background : Although a number of studies are related to QA improvement, there are few studies applied various method of QA tools. This study reviewed the availability of general quality assurance(QA) tools according to ten steps in performing quality improvement activities at emergency room of a tertiary teaching hospital which has more than 1,000 beds. Methods : All patients in emergency room from 15th Oct. 1997 to 5th Sep. 1998 were surveyed. The survey data based on the patient's records of emergency room were evaluated according to length of stay, and we tried to identify problems with management of emergency room. To solve the problems, our team applied general QA tools(brainstorming, flow chart, nominal group technique, benchmarking, cause-and-effect diagram, run chart, control chart) to quality improvement activities and discussed the availability of the tools. Results : After the activities such as changes of staffing, the establishment of local area network and chest pain clinic, application of triage and so on, the percentage of patient who had stayed more than six hours was reduced from 56.0% to 46.8%. The mean number of patients per day in emergency room was increased from 49 to 62. But the reporting time for laboratory test was not changed after these activities. Conclusion : Each QA tool has unique benefit and limitation, but we can implement and evaluate the quality improvement activities more scientifically and systematically by applying these tools to practice according to QA ten steps.

• 한국직업건강간호학회지
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• 제10권1호
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• pp.74-92
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• 2001

This study was carried out to investigate the types of health documents for nurses, the content of informations in the documents, and writing behaviors of occupational health nurses. Health documents were collected from 7 nurses who were working in 7 group occupational health agencies (GOHA) located at Seoul and Inchon area in Korea. The collected health documents written in January to June 1999 were analyzed, and revealed the following results. 1) The occupational health nurses were using 9 to 18 different types of health documents. The contents of the documents were considered quite similar to each other with slightly different headings and items to record. Among different types of health documents. Health Management Card for Workplace', Nursing performance sheet and Workplace environmental checklist were in common among nurses and were used for content analysis. 2) The 'Health Management Card for Workplace' was the only formal sheet of small-scale-enterprises (SSE) for health management, in which health and safety related information was recorded. The information on nursing services were recorded on the Nursing performance sheet, which has slightly different names on each type with similar contents. The Workplace environment checklist was for the information on general work environment management and mainly status of workplace hygiene. This checklist is to be used by or with nurses among the 3 types health professional team such as doctor, hygienist, and nurse, but it seemed not being used frequently by nurses. 3) Analysis on recording tendencies of nurses revealed that the writing styles of occupational health nurses were associated with 'memo' using a few number of words and short sentences. The amount of information by this kind of recording style was considered not enough for health management situation. The possible reasons for nurses to use this writing style might be insufficient time for recording and improper designed format of health documents. Because nurses working in SSE spend more time on the roads to visit workplaces, nurses may not found enough time for recording properly within their working time. In addition, the health records were designed to focus on the frequency of nurse's performance in certain types of work rather than on the method they used to deal with health problems. In conclusion, this study suggests that some steps are necessary to develop health documents and recording system which is appropriate to occupational health nurses. The educational need for nurses on appropriate recording behavior is also recommended.

• 대한간호학회지
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• 제40권1호
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• pp.69-77
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• 2010

This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. Methods: The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using $X^2$-test, factor analysis, and the Analytical Hierarchy Process. Results: Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. Conclusion: PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.

• 국제학술발표논문집
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• The 9th International Conference on Construction Engineering and Project Management
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• pp.375-381
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• 2022

Safety accidents are of concern during construction projects, even given the recent innovations in digital technologies. These projects remain focused on overcoming specific and limited applications on construction sites. For this reason, the development of an inclusive safety management system has become crucial. This study aims to build a Big Data platform to inform decisions on how to proactively eliminate worker hazards on construction sites. The platform consists of about 100,000 real records and a real-time monitored database featuring various safety indices, such as workers' altitudes, heart rates, and fatigability during construction, which are determined through various wearable devices. The data types are customized and integrated by a research team in accordance with the characteristics of a specific project using hypertext transfer protocol (HTTP). The results can be helpful as efficient tools to ensure successful safety management in complex construction situations. This study is expected to provide three significant contributions to the field, including real-time fatigability analysis and tracking of workers on-site; providing early GPS-based warnings to workers who might be accessing dangerous spaces or places; and monitoring the workers' health indices, based on details from 100,000 cases.

• 대한간호학회지
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• 제30권5호
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• pp.1156-1169
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• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.51-59
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• 2023

Purpose: We evaluated the status of patients enrolled in South Korea's pediatric palliative care pilot project based on the experience of a single center. This study examined factors related to end-of-life services and differences in medical costs. Methods: The medical records of 120 patients referred by a pediatric palliative care team were analyzed retrospectively. Data from July 1 to February 28, 2022 were collected and analyzed using the chi-square test and the Mann-Whitney U test. Results: Volunteer programs and psychological support (100%), family support and education (99.2%), and financial support through institutional linkage (62.5%) were provided to the participants. In the deceased group, there were no significant differences in general characteristics, which included age, gender, primary disease, religion, duration of hospitalization in an intensive care unit (ICU) and non-intensive care unit (non-ICU). However, the ICU group had fewer opportunities to access individual pain and physical symptom management than the non-ICU group and there were limitations in linking with external resources. Medical expenses were significantly different for the ICU group, with a 3-times higher average cost than the non-ICU group. Conclusion: Although an individualized approach is needed for each patient in pediatric palliative care, psychosocial care is essential. In addition, if early intervention for end-of-life pediatric patients is available from a palliative care team, the cost burden of medical care for patients and their families should be minimal.

• 한국의료질향상학회지
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• 제6권1_2호
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• pp.38-46
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• 1999

Background : To evaluate the frequency and cause of return to the emergency department within 48 hours and to identify the nature of the problem. Methods : We reviewed the medical records of 76 patients who returned to the emregency department within 48 hours from September 1998 to February 1999. Results : Overall revisit rate within 48hours was 2.6%. Of 76 patients, 5(6.6%) had planned return, 64(84.2%) had unplanned return and 7(9.2%) had incomplete documentation. The causes of unplanned return were inadequate medical management (11.8%), discharge against medical advice (27.6%), return after scheduled ambulatory care (22.4%), and unavoidable revisit due to symptom aggrevation or development of new symptom (22.4%). Conclusion : The study provided a basic information for us to improve the quality of emergency care by reducing unnecessary return to the emergency department. It is necessary to monitor continuously the quality of emergency care and to develop the standard of emergency return rate.