• Quality Improvement in Health Care
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• v.7 no.1
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• pp.118-131
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• 2000

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.1
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• pp.247-275
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• 1998

The purpose of this study was to offer the results of content analysis and qualitative study that explored the perceptions about quality nursing care of patients and families as consumers and to identify the implications of this study for quality nursing care management and research. The data was collected from 12 adult patients and 9 families who were admmitted at medical and surgical nursing unit of one university hospital in Seoul from October, 1996 to January, 1997. Research participants were asked to response "what do you think quality nursing care?" and similar questions during the interviews was performed. Data were analyzed using open coding and content analysis with frequencies and percents of attributes of quality nursing care. Attributes of quality nursing care and meaning of quality nursing care that patients and families perceived were explored. 1. The attributes of quality nursing care that patient and families perceived were categorized into 56 attributes. The highest response rate among the attributes was 'one's heart at ease' (76.2%), and the next high response rates were ranked in order 'consideration' , 'care about' (each 61.9% 'expert skill' (57.1%), 'deal with problem promptly' , 'information offer' (42.9%), 'intimate feeling' (38.1%), 'smile' 'service spirit' , 'do one's best' (each 33.3%), 'frequent visit' (23.8%), 'observe the time' (23.8%), 'direct nursing care' , 'speaking warmly' , give a hope' , 'address kindly' , 'a sense of duty' , 'good facilities' (each 19.0%), 'inquire after a patient health' , 'patient-centered nursing care' , 'showing an example' , 'professional knowledge' , 'careless moraly patient' , 'give encourage to patients' , 'good answer a question' (each 14.3%), 'do not imprudently' , 'do not disregard' , 'broad knowledge' , 'emergency treatment skill' , 'dependability' ,'consolation' giving a sense of security' , 'a self sacrificing spirit' , 'a sense of responsibility' 'hard - working', 'enough disposition of nursing staff (each 9.5%), 'improve patient's pride' and the rest attributes exhibited 4.7%, respectively. 2. The attributes that were identified in patients' data only were 8 categories, 'service sprit' (58.3 %) 'expert knowledge' , 'good answer a question' (each 25.0%), 'hard working' (16.7%), 'a warm character', 'professional attainments', 'do without reserve', 'satisfaction' (each 8.3%), 3. The attributes were identified to families' data only were 31 categories, 'speaking warmly' , 'direct nursing care', 'adress kindly', 'patientcentered nursing care', 'showing an example' (each 33.3%). 'do not imprudently' , 'do not disregard' , 'consolation', 'giving a sense of security', 'broad knowledge' , 'emergency treatment skill', 'dependability' ,'a self - sacrificing spirit', 'a sense of responsibility' (each 22.2%), 'improve patient's pride' , 'without discrimination' , 'show kindness' , 'individual nursing care', 'being with patient' , 'helping' , 'accuracy' , 'without any mistake' , 'love' , 'self - confidence', 'self possession', 'a self - denying spirit' , 'a sense of duty' , 'tighten discipline' , 'disposed room with similar patient to diagnosis', 'compensatory relationship between me dical team' , 'role of connection' (each 11.1 %). 4. The attributes of quality nursing care were integrated into 11 categories that they were 'patientcentered nursing care' (25.1%), 'expertise' (22.1%), 'caring'(18.1%), 'kindness'(11.1%L 'nurse attainments(10.1%), 'sincerity' (7.5%), 'good environment' (2.0%), 'effective organizational management', 'coordination', 'enough nursing staff' ( each 1.0%), 'satisfaction' (0.5%) were showed in the order of the highest rate. 5. The concept of quality nursing care were defined as 'give a satisfaction to patients by patientcentered care based on professional skill and caring with kindness and sincerity'. The description of the meaning of quality nursing care provided by this research participants, patients and families can provide important information for quality nursing care management, medical marketing, education and researches of this field. On the basis of the above findings the following recommendations are made: to suggest to utilize this results for patient care in practice setting, development of quality assessment tool in nursing care, repeat study by the same subjects and method, and to a comparative study by the same method to nurse.

• Pediatric Infection and Vaccine
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• v.26 no.3
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• pp.148-160
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• 2019

Purpose: This study aimed to investigate the molecular epidemiology of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak at a newborn nursery and neonatal intensive care unit (NICU). Methods: During the outbreak, from August to September 2017, MRSA isolates collected from neonates and medical staff underwent genotyping and screened for virulence factors. Antibiotic susceptibilities were tested. Results: During the study period, 41 neonates were admitted at the nursery (n=27) and NICU (n=14). Of these, 7 had MRSA infections (skin infection [n=6] and sepsis [n=1]) and 4 were colonized with MRSA. Associated medical staff (n=32) were screened; three were nasal MRSA carriers. Staphylococcal chromosomal cassette mec (SCCmec) type II, sequence type (ST) 89, spa type t375 was found to be the skin infection outbreak causing strain, with multi-drug resistance including low-level mupirocin resistance. SCCmec type IVa, ST 72, and a novel spa type designated t17879, was the cause of MRSA sepsis. Many different types of MRSA were colonized on the neonates; however, SCCmec type IVa, ST 72, spa type t664 was colonized in both neonates and a NICU nurse. All MRSA isolates from colonized infants were positive for the Panton-Valentine leukocidin (PVL) toxin gene. Conclusions: The strain causing an outbreak of skin infections had multi-drug resistance. Also, MRSA colonized in the neonates were found to carry the PVL toxin gene. Because different strains are present during an outbreak, molecular epidemiologic studies are important to identify the outbreak strain and colonized strains which aid in effective control and prevention of future MRSA outbreaks.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.9
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• pp.4209-4212
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• 2016

Purpose: To study clinical factors related to adequacy of transformation zone (TZ) components in cervical smears. Materials and Methods: Medical and Papanicolaou (Pap) smear reports from Thammasat University Hospital, Thailand during January to December 2015 were collected. Demographic data was reviewed by attending physicians and impact of clinical factors onTZ adequacy was primary outcome. A total of 3,251 smears were reviewed. Finally, 2,098 smears met The inclusion criteria and enrolled into this study. Results: Average age and bodyweight of participants in this study were 43.0 years and 60.0 kg, respectively. Ninety seven percent of smears were classified as satisfactory for evaluation according to the Bethesda system 2001. Adequacy (group A) and inadequacy (group B) of TZ were equal in percentage (50.9/46.0). Prevalence of abnormal cervical cytology was 4.4%. Percentages of abnormal Pap smears in group A and B were 7.3 and 1.4, respectively (p<0.001). Factors associated with increased adequacy of TZ were old-age (${\geq}50yr$), nulliparity, within 3-months postpartum, history of TZ inadequacy and abnormal smears. Sexually transmitted disease (STD), hormonal usage, previous cryotherapy and smears collected by staff were associated with inadequacy of TZ. Conclusions: Collection of cervical specimens should be carefully performed. STD history, hormonal usage and previous cryotherapy are risk factors for TZ inadequate specimens.

• The Korean Journal of Nuclear Medicine Technology
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• v.20 no.2
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• pp.32-35
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• 2016

Purpose The goal for this study is to figure out that medical staff except Nuclear Medicine Department could be exposed to radiation from the patients who take Nuclear Medicine examination. Materials and Methods Total 250 patients (Bone scan 100, Myocardial SPECT 100, PET/CT 50) were involved from July to October in 2015, and we measured patient dose rate two times for every patients. First, we checked radiation dose rate right after injecting an isotope (radiopharmaceutical). Secondly, we measured radiation dose rate after each examination. Results In the case of Bone scan, dose rate were $0.0278{\pm}0.0036mSv/h$ after injection and $0.0060{\pm}0.0018mSv/h$ after examination (3 hrs 52 minutes after injection on average). For Myocardial SPECT, dose rate were $0.0245{\pm}0.0027mSv/h$ after injection and $0.0123{\pm}0.0041mSv/h$ after examination (2 hrs 09 minutes after injection on average). Lastly, for PET/CT, dose rate were $0.0439{\pm}0.0087mSv/h$ after examination (68 minutes after injection on average). Conclusion Compared to Nuclear Safety Commission Act, there was no significant harmful effect of the exposure from patients who have been administered radiopharmaceuticals. However, we should strive to keep ALARA(as low as reasonably achievable) principle for radiation protection.

• Journal of agricultural medicine and community health
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• v.25 no.2
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• pp.427-440
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• 2000

A comparative study was made about health resources, medical care service statistics and public health service statistics by health subcenters at Jangdong and Jangpyung townships, Jangheung County, Chollanamdo before and after the unification of two health subcenter to improve their function. 1. While two general physicians, one dentist, 4 nurse aids arid one oral hygienist were working at two health subcenters with simple facility with examination room and public health office in 1997 prior to the unification, in 1999 after the unification of two health subcenters 14 staff including a specialist physician, a general physician, a dentist, a herb hygienist, a radiology technician and a physical therapist were working in the new health subcenters equipped with appropriate facilities in two storey building. 2. In 1997 before the unification the yearly total income of two health subcenters was 78,815 thousand won(about 14,000 won per capita) and the amount was 140,376 thousand won(about 25,000 won per capita) in 1999 after the unification. And the income was used for operation of health subcenters excluding personnel expense. 3. While 90.5% of visitors to the health subcenters came for general medical care, and 91.6% came for the revisit before the unification, after the unification 71.2% came for general medical care, 10.8% for dental care, 16.5% for oriental physician's care, 29.7% for the first visit and 70.3% for revisit. Most common problem cared for was musculoskeletal disorder like arthralgia. Average treatment cost per person per month was 9,363 won before the unification and 8,309 won after the unification. 4. Through the comparison of execution rate of public health services before and after the unification. the practice rate of most health service among target population including visiting service for chronic illness, maternal and child health service and immunization service increased after the unification. The practice rate of tuberculosis control service, hypertension control and diabetes management was a little decreased. In conclusion, continuous effort to satisfy all persons in two townships and evaluation are necessary to coincide with the spirit of unification of two health subcenters.

• Journal of Korean Academy of Nursing
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• v.21 no.3
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• pp.349-364
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• 1991

Recognition of the usefulness and the importance of the nursing diagnosis is increasing. There is a prevailing opinion that nursing diagnosis should be used to improve the quality of nursing care. Developing standardized nursing care palns based on nursing diagnoses is therefore considered one of the most essential projects for professional growth and improvement in the nursing world of Korea. Consequently, in the first stage of this research project, the ten nursing diagnses used most frequently with patients on medical and surgical wards were determined and related nursing care plans were developed, implemented and evaluated. The application of the standardized nursing care plans raised the nurses' confidence and proved to be effective in enhancing the quality of nursing care. This study was initiated as the next stage, to develop, test, and determine the validity of nursing care plans for the remaining nursing diagnoses. Nineteen medical and surgical wards were selected for the study ; the 176 staff nurses working on those wards and 1211 patients hospitalized there (603 patients during the nursing care plan use) took part in the project. The following summarizes the results of the study : 1. After listing all the nursing diagnoses up to the 20th in frequency from each ward except the ten used in the first study, 22 nursing diagnoses were selected. Two related to ‘self care deficit’, were combined into one. Standardized nursing care plans were established for these 21 nursing diagnoses. 2. The first page of each nursing care plan lists the related factors and defining characteristics as supporting data. The application rate distribution revealed that the majority were recorded less than 50% of the time. For each nursing diagnosis, only one to three related factors were recorded more than 50% of the time regardless of the number of suggested related factors, and similarly, only one to five defining characteristics were recorded more than 50% of the time regardless of the number of suggested defining characteristics. Therefore, these factors and defining characteristics were proposed as the common related factors and the typical signs and symptoms for each nursing diagnosis. 3. The application rate distribution for the expected outcomes, and the nursing orders that were the main data of each nursing care plan occurred more than 50% of the time, unlike the related factors and the characteristics that occurred less frequently. These findings supported the clinical validity. 4. In an effort to evaluate indirectly the effect of the use of the standardized nursing care plans, nurses' job satisfaction and perceptions of their ability in the use of the nursing process were measured and compared. Scores after the use of the plans were significantly higher than those before. The experience in actually using the standardized nursing care plans with patients increased the nurses' professional and emotional satisfaction and their confidence in using the nursing process. Also when the nurses who actually used the nursing care plans were asked to rate their effectiveness, the highest score was given to ‘the ease of establishing the nursing goal’, followed by ‘improved professional advice and care for patients’, ‘the efficiency and systemization of charting’, ‘the definite recognition of the nursing problem’, and ‘the selection of effective and appropriate nursing interventions’ in descending order. The results indicate the nurses were very positive about the effect of the real clinical application of standardized nursing care plans, and that the objective of this study to utilize the nursing diagnosis to strengthen the nursing process was attained.

• Journal of Korean Academy of Nursing Administration
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• v.1 no.2
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• pp.349-371
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• 1995

Professional nurse shall possess the firm nursing idea and ethical nursing philosophy based on the professional knowledge and technology but due to the rapid social situations has changed the value to man thus the nurse's sense of value in the nursing secenes has been confused and changed bringing the new ethical problems and discord due to the ethically difficult problems. This study is aimed to know about the discord between the ruling ethical sense of value and the ethical discord exeriencing in the clinical scenes of the nurse and to help them establish affirmative ethical sense of value and provide them with the materials which can effectively meet the ethical discord. The study research has been conducted by selecting 515 clinical nurses in 8 general hospitals as the subject from Mar. 13, 1995 to Apr. 3. The tool measuring the ethical sense of value disigned by Lee, Young Sook has been used and supplemented and the tool measuring the ethical discord was the question papers about the ethical dillemma of Han, Sung Sook. The collected materials have been analyzed by the statistical methods of arithmetical everage, t-test, ANOVA, Pearson's Correlation Coefficient and etc. The result of the study is as the below ; 1) The average point of the ethical sense of value of the nurse was 3.62(maximum point : 5) which showed that the ethical level was so high and the highest question item in the ethical level of the whole items of the ethical sense of value was "They conduct as directed by the doctor in case the disposition of the doctor looks mistaken"(4.56 point), "They keep the secret of the patients while serving them."(4.56) and the lowest item was "using placobo for the patients is not allowed" : (1.85 point). 2) Statistical variation which showed the significant difference in the relation with the ethical sense of value according to the general characters of the nurse has shown as scholarly years(F=3.47, p=.016), religion(F=1.66, p=.004), interest degree of ethical education(F=4.18, p=.006),attitude to the job of nursing(F=6.76, p=.006), ethical standard(F=3.28, p=.021), and recognition degree on ethical principles(F=4.53, p=.001). 3) The average point of the ethical discord of the nurse was 0.54(The maximum-1 point) point and the ethical discord in the clinical scenes : "the problems arising from the lack of manpower of the nurse"(0.86), "the discord from the uncooperative relation between them and the medical staff and"(0.75) and indifference of the doctor about the report of the nurse(0.73). 4) The variation which showed the significant difference statistically in the ethical discord according to the general characters of the nurse was that Age(F=19.88, p=.000), schooling(F=5.32, p=.001), Experience(F=15.77, p=.000), position(F=13.58, p=.000) and ethical standard(F=2.63, p=.049). 5) The results of the analysis of correlation between ethical sense of value and discord(r=0.519, p=.239) showed no significant correlation statistically.

• Research in Community and Public Health Nursing
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• v.14 no.3
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• pp.397-406
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• 2003

The purpose of this study is to provide the basic data in order to improve the quality of charged recuperation facilities which are specialized in the old. after finding out the satisfaction degree for the services which are provided in the current charged recuperation facilities specialized in the old and surveying the services which are demanded by users. As for the research method. the subjects were 88 family members of the users in the five charged recuperation facilities, which are specialized in the old and located in Seoul and Incheon. The survey research was executed from 27th July to 15th September, 2002. Then the collected data were analyzed by using the SPSS 10.0 for windows program. The research results are as follows. Firstly, in the satisfaction degree of the user's family about the daily service showed the highest satisfaction degree for the kind service of the staff to the users. In the satisfaction degree about the specialized service of the user's family, the satisfaction degree was high in bedsore prevention, periodical health care, proper medical treatment, family counsel, and adequate disease management. In the satisfaction degree about the facility and environmental service, the satisfaction degree about the surrounding environment of the facility or safety facility, and the comfort condition was high. In the satisfaction degree about the services related to the local society, it was high in the hospital and medical-related field. Secondly, in the demanded services, the demanding degree for worship, mental and spiritual nursing, hospice, funeral service, family meeting, and support for the special vehicle were not so high, but it was shown that they were generally demanded. Thirdly, it was shown that the provided services had an overall high satisfaction degree. In the service satisfaction degree according to the general characteristics of the user's family, it was recognized that there was a significant difference between the distinction of sex and local society related services. Also, there was a significant difference in the satisfaction degree between age and specialized service. Through the above research results, detailed rehabilitation programs such as linguistic treatment and working treatment should be more and more compensated in order to supplement the insufficient points of the services provided by the charged recuperation facility specialized in the old. Additionally, the correlation with the local society such as education and training for specialized human labor, close cooperation among the facilities, and positive participation in local society events are thought to be reinforced.

• The Journal of Korean Academy of Orthopedic Manual Physical Therapy
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• v.5 no.1
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• pp.75-80
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• 1999

The Taekwondo being a martial sports, there are higher chances for the injury to occur than the non martial sports. Therefore, this study analyze the frequency, the area, the type, and the condition of the injury which are prone to occur in the Taekwondo matches; it is to help the Taekwondo players in prevention of the injury and in treatment. The subjects of this study were the 48 players (male 24, female 24) who participated in the final selection contest of the national team player on March 9 to 12, 1993. The data of the injury were obtained from the medical recoder staff and were analyzed to the frequency of the injury per match, the vulnerable area of the injury, the type of injury, and the condition of the injury with a gender difference. There were 24 matches for the male and 24 matches for the female, total 48 matches. Therefore, the total participation number of the players are the double of the match number. 1. The frequency of the injury per match was 18.3%(11/60) for male and 23.1%(12/52) for women. 2. The areas of the injury were ankle 36.4%(4), foot 18.2%(2), knee 18.2%(2), lower leg 18.2%(2), wrist 9.1%(1) in male; foot 33.4%(4), ankle 16.7%(2), knee 16.7%(2), lower back 16.7%(2), lower leg 8.3%(1), face 8.3%(1) in female. 3. The types of the injury were contusion 45.5%(5), sprain 27.3%(3), abrasion 9.1%(1), laceration 9.1%(1), tendon rupture 9.1%(1) in male; contusion 33.3%(4), sprain 33.3%(4), abrasion 16.7%(2), subcutaneous hemorrhage 8.3%(1), dislocation 8.3%(1) in female. 4. The condition of the injury were the unblocked attack 36.4%(4), attacking kick 27.3%(3), blocking a kick 18.2%(2), attacking punch 9.1%, impact with surface 9.1%(1) in male; attacking kick 33.3%(4), unblocked attack 25%(3), blocking a kick 25%(3), attacking punch 8.3%(1), impact with surface 8.3%(1) in female. This study shows that the injury from the Taekwondo matches occurred most in the lower extremity joints and the foot, and shows that the most of the injury types were contusion and sprain. Therefore, it is believed to be helpful to wear the proper fitting ankle or the knee protector and using other protective equipment to prevent the sports injury in the Taekwondo matches.