• Title/Summary/Keyword: tertiary care hospitals

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Comparison of the Trauma Outcome Between Secondary and Tertiary Hospitals (2차와 3차 병원에서 외상 치료의 적정성 비교)

  • Hong, Suk Hyun;Han, Gap Su;Jung, Sang Hun;Chun, Chung Min;Choi, Sung Hyuk;Lee, Sung Woo;Hong, Yun Sik
    • Journal of Trauma and Injury
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    • v.18 no.1
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    • pp.33-40
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    • 2005
  • Background: This study compared the performance of trauma care in an urban and a suburban hospital before and after the enhancement of emergency and intensive care. Method: The medical records of patients who were admitted to the intensive care unit following trauma from 1994 to 1995 and from 2002 to 2003 were examined. The standardized W (Ws), the 95% confidence interval (CI) of the Ws, and the predicted survival rate (Ps) were calculated. During each period, each hospital's actual survival rate was compared with the 95% CI of the Ps according to the revised trauma score (RTS) and injury severity score (ISS). Spell out RTS and ISS. Result: From 1994 to 1995, 225 and 121 records from the urban and the suburban hospitals were reviewed, respectively. The 95% CI's of the Ws were -2.30 to 2.73 and -11.40 to -5.90, respectively. The actual survival rate of the suburban hospital was significantly lower than the predicted survival rate at all RTS. From 2002 to 2003, 315 and 268 records from the urban and the suburban hospitals were reviewed, respectively. The 95% CI's of the Ws was -3.56 to 0.24 and -3.73 to 0.26, respectively. There was no difference between the actual survival rate and the predicted survival rate. Conclusion: An enlargement of the capacities of emergency and intensive care may improve the performance of trauma care at a small suburban hospital.

Influence of Death Perception, Attitude Toward Terminal Care, Mental Health on the Terminal Care Stress of Intensive Care Unit Nurses (중환자실 간호사의 죽음 인식, 임종간호 태도, 정신건강이 임종간호 스트레스에 미치는 영향)

  • Hwang, Jung Ok;Kim, Sang Hee
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.3
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    • pp.323-332
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    • 2019
  • Purpose: This study aimed to identify the factors affecting the terminal care stress of nurses in intensive care units in terms of their death perception, attitude toward terminal care, and mental health. Methods: This descriptive study collected data from 118 nurses in intensive care units in one tertiary referral hospital and three general hospitals. The instruments used in the study were the Terminal Care Stress Assessment Tool, the View of Life and Death Scale, the Frommelt Attitudes toward Nursing Care of the Dying Scale (FATCOD), and the Mental Health Assessment Tool. The data were analyzed by t-test, ANOVA, Pearson's correlation coefficient, and multiple regression. Results: There was a significant positive correlation between terminal care stress and death perception (r=.31, p<.001). The factors significantly influencing the terminal care stress of the participants included gender (β=.33, p<.001), religion (β=.24, p=.004), and death perception (β=.35, p<.001), and the overall explanatory power was 23.1% (F=12.73, p<.001). Conclusion: To decrease terminal care stress among nurses, establishing the death perception of nurses based on value clarification about death may be necessary. Furthermore, this study suggests an intervention study examining the effect of an education program on terminal care stress among ICU nurses.

A Study on the Research Trend of the End-of-Life Care in Korea (임종간호에 관한 국내 연구동향 분석)

  • Byun, Jinyee;Kwon, Sinyoung
    • The Journal of the Korea Contents Association
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    • v.22 no.10
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    • pp.374-382
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    • 2022
  • This study aims to explore the research trends of hospice that were published in KCI from July 2003 to 2022. Using Korea Citation Index, a total of 115 papers were selected for data analysis. According to the analysis, research on terminal care were conducted mostly from 2017 to 2019. A total of 26 papers were published on Journal of Hospice and Palliative Care. 115 papers were mostly conducted with nurses and nursing students. It was found that those nurses were working in tertiary hospitals, long-term care hospitasl, and general hospitals. The research topics of the published papers are mainly related to end-of-life care attitude, end-of-life care performance, experiences of end-of-life care, and end-of-life care stress. Among them, 78.3% of the papers adopted quantitative research method. Concerning the IRB, 64.3% of the papers got an approval. It is expected that the present study can shed some lights on hospice care field by analyzing the trends of terminal care studies.

Market share of specialty hospitals in the region and out of the region (전문 질환에 대한 전문병원의 권역내·외 시장점유율 비교)

  • Myung-II Hahm;Ji Eun Kim;YoonKung Kang;Hyewon Lee;Sun Jung Kim
    • Korea Journal of Hospital Management
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    • v.28 no.1
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    • pp.14-23
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    • 2023
  • Purposes: The Specialty hospital designation policy had launched in 2011 and 110 designated specialty hospitals have been operating nationwide in 2022. This study was to estimate the market share of specialty hospitals for the specific diseases compared to other types of hospitals. Methodology: Data were derived from the National Health Insurance Claim data from 2018 to 2019. Subjects were all the inpatients with MDC(Major Disease Category) that specialty hospitals specialized in. A total of 34,231,387 claims were analyzed to estimate the market share. Findings: 90 specialty hospitals were responsible for 2.4 percent of inpatient care with specific diseases for specialty hospitals. There were regional variations in the market share of the specialty hospitals as the number of specialty hospitals in regions. Specialty hospitals' market shares were relatively high in burn(31.3%), ophthalmology(16.4%), obstetrics and gynecology(7.1%), alcohol(6.0%), joint(3.7%), spine(2.7%). After adjusting the number of inpatients per hospital, hospitals specialized in burn, alcohol, ophthalmology, breast, joint, obstetrics and gynecology, and hand replantation had treated more patients than tertiary hospitals. Practical Implications: Although specialty hospitals' market share was small, some types of specialty hospitals had an impact on the regional market as well as the national level market. To improve patients' accessibility to a specialty hospital, it is necessary to government supports non-specialized hospitals to change into specialty hospitals in certain fields and regions where the number of specialty hospitals is insufficient.

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Adequacy of Reprocessing Gastrointestinal Endoscopes in Korea Hospitals (국내 병원 소화기내시경 재처리과정의 적절성)

  • Kim, YoungOk;Jeong, Jae Sim
    • Journal of Korean Biological Nursing Science
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    • v.18 no.4
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    • pp.288-295
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    • 2016
  • Background: This study was conducted in order to survey the current state of cleaning, disinfection, rinsing, drying, and storage of gastrointestinal endoscopes. Methods: Eighty hospitals were selected through convenient sampling. Self-reported questionnaire was distributed from September 14 to October 10 in 2015. Results: The response rate was 67.5% (54/80). In 88.9% of the hospitals, reprocessing was performed in a cleaning space separated from the laboratory and 88.9% used an enzymatic cleaner. Disinfectants used were ortho-phthalaldehyde in 63.0%, and paracetic acid in 33.3%. Eighty seven percent of the hospitals used test strips in order to test the effective concentration of disinfectant and in 61.1%, drying was done through passing air and over 70% alcohol. Microbial culture for the quality control of gastrointestinal endoscopes was performed in 77.8%. In the comparison of the adequacy of gastrointestinal endoscope reprocessing, it was observed that gastrointestinal endoscopes were reprocessed more adequately in larger and tertiary care hospitals. Conclusion: Gastrointestinal endoscopes were reprocessed in similar manners, but there were differences in the detailed process. It is still necessary to segment reprocessing into stages, to prepare standardized guidelines, and to monitor compliance with the guidelines.

A Study on Hospital Nurses' Perception of Patient Safety Culture and Safety Care Activity (병원간호사의 환자안전문화에 대한 인식과 안전간호활동에 관한 연구)

  • Park, So-Jeong;Kang, Ji-Yeon;Lee, Young-Ock
    • Journal of Korean Critical Care Nursing
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    • v.5 no.1
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    • pp.44-55
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    • 2012
  • Purpose: The purpose of this study was to investigate perception of patient safety culture and safety care activity among hospital nurses and to identify factors associated with the safety care activity. Methods: A total of 399 nurses working at secondary or tertiary hospitals in B city were participated in. Data were collected using 'Questionnaire on Patient Safety' and 'Safety Care Activity Questionnaire'. Results: The mean score of patient safety culture was 3.41 out of possible 5. The mean score of safety care activity was 4.40 out of possible 5. There was a positive relation between the perception of patient safety culture and the safety care activity. Through stepwise regression analysis with 22.4% of accountability, it was found that the perception of the safety care activity was associated with communication process, a sub-domain of safety culture, marital status, experience of incidence reporting, and level of patient safety. Conclusion: The findings show the importance of communication among nurses to improve the safety care activity. To provide high quality of care for patients, it is necessary to educate nurses on fire safety, patient education, and medication safety and improve their communication skills.

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The perceptions and performance of family-centered care among pediatric nurses at a children's hospital in South Korea: a descriptive study

  • Suk-Jin Lim;Kyung-Sook Bang
    • Child Health Nursing Research
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    • v.29 no.3
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    • pp.207-217
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    • 2023
  • Purpose: This study aimed to examine pediatric hospital nurses' perceptions and performance of family-centered care. Methods: A descriptive study design was used. This study surveyed 162 nurses who worked at a single tertiary children's hospital in South Korea. The modified Family-Centered Care Scale was used to assess nurses' perceptions and performance of family-centered care. Barriers to the implementation of family-centered care were described in an open-ended format. Results: Pediatric hospital nurses had a higher score for perceptions (mean score=4.07) than for performance (mean score=3.77). The collaboration subscale had the lowest scores for both perceptions and performance. The perceptions of family-centered care differed significantly according to the nurses' clinical career in the pediatric unit and familiarity with family-centered care, while performance differed according to clinical career only. Perceptions and performance were positively correlated (r=.594, p<.001). Barriers to implementation included a shortage of nursing personnel, a lack of time, and the absence of a family-centered care system. Conclusion: To improve the performance of family-centered care, nurses' perceptions of family-centered care should be improved by offering education programs and active support, including sufficient staffing, and establishing systems within hospitals.

Experiences of Critical Care Nurses Caring for Dying Patients (중환자실 간호사의 임종 환자 돌봄 경험)

  • Seol, Eun-Mi;Koh, Chin-Kang
    • Journal of Korean Critical Care Nursing
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    • v.11 no.2
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    • pp.1-10
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    • 2018
  • Purpose : This study aimed to develop an in-depth and comprehensive understanding of the experiences of critical care nurses caring for dying patients. Method : Eleven critical care nurses with experience in caring for dying patients were recruited from four tertiary hospitals. Semi-structured face-to-face interviews were conducted between November 2016 and March 2017. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of critical care nurses. Results : The following six themes, and twelve sub-themes, were identified: (1) the gap between expectation and reality, (2) a distorted meaning of death, (3) repeated emotional pain and stress, (4) finding a solution alone, (5) sublimation into mission and calling, and (6) integration into one's own life. Conclusion : This study found that critical care nurses experience various psychological difficulties while caring for dying patients, and they made efforts on their own to overcome them. These findings are expected to inform the development of specialized programs to support critical care nurses to tackle these challenges, create guidelines on caring for dying patients, and help promote death education.

Economic Effects of Subsidiary Services in Hospitals (병원급 의료기관 의료부대사업의 경제적 파급효과)

  • Lee, Ye Seol;Lee, Sang Gyu;Kwon, Sung Tak;Kim, Tae Hyun
    • Korea Journal of Hospital Management
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    • v.21 no.1
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    • pp.32-42
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    • 2016
  • This study is conducted to estimate economic ripple effects of subsidiary services of hospitals. Using the Input/Output Analysis, this study analyzes production inducement effect, added value inducement effect, and labor inducement effect. Also, it assesses potential economic effects of the subsidiary services of which the scope is expanded as the government's proposed in 2014. Data regarding hospital subsidiary services and economic effects are obtained from the hospitals' financial statements on the National Tax Services and the Bank of Korea. The major results of this study are summarized as follows; subsidiary service profits of hospitals are 466 billion won and rent profits of hospitals are 152 billion won. Of these, the rate of subsidiary service profits in tertiary hospitals is about 66% of total subsidiary service profits. Producement inducement effect of subsidiary services of hospitals is higher than that of total industry, service industry and medical service industry. Added value inducement effect of subsidiary services of hospitals is higher than that of total industry, manufacturing industry, service industry and medical service industry. Job position inducement effect of subsidiary service in hospitals is higher than that of total industry, service industry and medical service industry. Also, employment inducement effect of subsidiary service in hospitals is higher than that of total industry and medical service industry. The results may suggest that subsidiary services revenue in medical institutions contribute to improving operating profits. Facing with intense market competition and pressures to control health care costs, hospitals may need to determine whether subsidiary services help boost their profitability and improve customer satisfaction.

Nurses' Perception of the Performance and Necessity of Nursing Services for Patients Engagement (간호사의 환자참여 간호서비스 수행정도와 필요성 인식)

  • Lee, Tae Wha;Jang, Yeon Soo;Ji, Yoon Jung;Do, Hyun Ok;Oh, Kyoung Hwan;Kim, Chang Kyung;Chun, Ja Hye;Shin, Hae Kyung;Cho, Mee Young;Bae, Jung Im
    • Journal of Korean Clinical Nursing Research
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    • v.25 no.2
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    • pp.120-132
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    • 2019
  • Purpose: This study aimed to investigate the performance of patient engagement nursing services perceived by nurses and necessity in Korea. Methods: This study was a descriptive research. A total of 205 nurses participated in the study. The Smart Patient Engagement Assessment Checklist was developed by the investigators to assess patient engagement nursing services performance and necessity. The data were collected using online survey. Descriptive analysis and $x^2$ analysis were performed using SPSS 25.0 program. Results: The mean age of participants was $36.6{\pm}8.5years$ and the mean working experience was $12.92{\pm}9.23years$. Seventy eight percent of participants reported that patients and family participated in care as advisors through customer's suggestion or patient satisfaction assessment. The rate of patients' and family's engagement in care as advisors was significantly higher in tertiary hospitals ($x^2=28.54$, p<.001). About 89% of participants communicated with patients and family to make clinical decisions with a multidisciplinary approach. The rate of communication for multidisciplinary decision making was significantly higher in tertiary hospitals ($x^2=6.30$, p=.012). With regards to nurses' bedside patient handoff, 22.0% of participants reported that they were performing bedside patient handoff, and there was no significant difference between type of hospitals. About discharge planning, 72.2% of participants reported utilizing discharge checklist. Conclusion: Currently, patient engagement nursing services are applied partially in Korea. It seems that care protocols to be applied for patient engagement nursing services are insufficient. Therefore, patient engagement care protocols need to be developed to improve patient's health outcome and safety.