• Title/Summary/Keyword: the medical staff

Search Result 920, Processing Time 0.026 seconds

Clinical Characteristics of Oncologic Patients with DNR Decision at a Tertiary Hospital (심폐소생술금지 결정 시점에서의 임상적 특성: 일개 종합병원 종양내과 사망한 암환자를 대상으로)

  • Kang, Na Young;Park, Jeong Yun
    • Journal of Hospice and Palliative Care
    • /
    • v.19 no.1
    • /
    • pp.26-33
    • /
    • 2016
  • Purpose: This study was conducted to identify clinical characteristics of oncologic patients at a point when they signed their do-not-resuscitate (DNR) orders. Methods: From January through December 2014, we retrospectively analyzed the records of 197 patients who passed away after agreeing to a DNR order in the hemato-oncology department of a tertiary hospital. Results: Of all, 121 patients (61.4%) were male and 76 (38.6%) were female, and their average age was 58.7 years. Ninety-four patients (47.7%) had gastrointestinal cancer. The ECOG performance status at admission was grade 3 in 76 patients (36.5%) and grade 4 in 11 (5.6%). The patients' mean hospital stay was 20 days. The mean duration from the admission to DNR decision was 13 days, and the mean duration from DNR decision to death was seven days. Conclusion: Study results indicate that a decision on signing or refusing a DNR order was made by medical staff mostly based on the opinions of patients' guardians rather than the patients themselves. This suggests that patients' own wishes are not well respected. Thus, it is urgent to establish institutional devices to enhance cancer patients' autonomy regarding DNR and to define an adequate timing for withdrawal of treatments.

Out-of-Hospital Resuscitation of Cardiac Arrest by 119 Emergency Medical Service System (119구급대에 의해 소생한 병원 전 심장정지 환자 1례)

  • Yun, Hyeong-Wan;Lee, Jae-Min;Jung, Ji-Yeon
    • Fire Science and Engineering
    • /
    • v.24 no.5
    • /
    • pp.142-149
    • /
    • 2010
  • The aim of this study was to report the out-of-hospital resuscitation of cardiac arrest along with literature consideration. CPR is technology of resuscitating patient by maintaining oxygen supply to organ, by preventing progression from clinical death to biological death, and by recovering heart beat and circulation, through circulatory support of mechanical ventilation. It is not what every patient with cardiac standstill is revived even if being implemented CPR. Patient's survival rate is decided by how quickly and correctly CPR was executed. A patient, who wasn't witnessed the cardiac arrest on the field, was performed 5-cycle CPR for 2 minutes on the field before being transferred to hospital, and was allowed to be used AED. A person, who was observed, is recommended to be used AED immediately, and then is said to be needed ACLS (advanced cardiac life support). In the Out-of-Hospital stage, it is rare in a case that 119 Emergency Medical Service System transfers by being ROSC and in a case of executing ACLS. Cardiac arrest was witnessed on the field, but CPR wasn't executed. First-aid staff executed CPR after arriving, and led to ROSC on the field with ACLS, there by having experienced 1 case of a patient's surviving to leave hospital by being ROSC on the field.

Suggestion of Japanese nursing staff supply and demand plan policy (일본 간호인력 수급방안정책의 시사점)

  • Kwon, Ju-Young
    • Journal of Convergence for Information Technology
    • /
    • v.11 no.3
    • /
    • pp.185-193
    • /
    • 2021
  • The purpose of this study is to seek out effective policy measures for improving the working environment and improving the supply and demand of nursing manpower in Korea, thereby improving the quality of nursing and creating a high-quality work environment to present a plan to secure adequate supply and demand for nursing manpower. To this end, we have looked at ways to secure effective nursing manpower through literature related to Japanese nursing manpower policy, which has similar health systems to Korea. Japan has established a nursing manpower supply policy since 1974, and is making efforts to improve the working environment and re-employment of idle nursing personnel due to frequent turnover and retirement. As a result of these efforts, the turnover rate of new nurses less than one year in Japan decreased to 7.5%, while the rate of new nurses in Korea was 33.9%. In addition, it is possible to consider ways to encourage medical institutions that have actively promoted and hired idle personnel through various incentives and financial support at the central and local levels.

A Survey of Doctors' Awareness of Weather Sensitive Diseases and Health-Related Weather Information (기상민감질환과 기상요소의 상관관계에 대한 의료진의 기초인식파악을 위한 설문조사기반 연구)

  • Kim, Hyunsu;Kim, Yoo-Keun;Jeong, Ju-Hee;An, Hye Yeon;Kim, Taehee;Yun, Jina;Won, Kyung-Mi;Lee, Jiho;Oh, Inbo;Lee, Young-Mi;Lim, Yeon-Ju;Kang, Min-Sung
    • Journal of Environmental Science International
    • /
    • v.26 no.5
    • /
    • pp.675-684
    • /
    • 2017
  • Provider-oriented weather information has been rapidly changing to become more customer-oriented and personalized. Given the increasing interest in wellness and health topics, the demand for health weather information, and biometeorology, also increased. However, research on changes in the human body according to weather conditions is still insufficient due to various constraints, and interdisciplinary research is also lacking. As part of an effort to change that, this study surveyed medical practitioners at an actual treatment site, using questionnaires, to investigate what kind of weather information they could utilize. Although there was a limit to the empirical awareness that medical staff had about weather information, most respondents noted that there is a correlation between disease and weather, with cardiovascular diseases (coronary artery disease (98.5%) and hypertension (95.9% ), skin diseases (atopic dermatitis (100%), sunburn (93.8%)) being the most common weather-sensitive ailments. Although there are subject-specific differences, most weather-sensitive diseases tend to be affected by temperature and humidity in general. Respiratory and skin diseases are affected by wind and solar radiation, respectively.

Convergence study of Comparison of prognosis between Adult and Elderly patients with Traumatic Acute Subdural Hematoma: Retrospective survey research (성인과 노인에서 외상성 급성 경막하 혈종의 예후 비교에 대한 융합적 연구: 후향적 조사 연구)

  • Lee, Seung-Woo;Woo, Sang-Jun;Kim, Eun-A
    • Journal of the Korea Convergence Society
    • /
    • v.11 no.6
    • /
    • pp.411-422
    • /
    • 2020
  • Purpose: The purpose of this study is to compare the prognosis of traumatic acute subdural hematoma between adults and the elderly to provide appropriate nursing according to age. Methods: A retrospective medical records research study was conducted on 239 patients(adults 104, elderly 135) at Gwangju C university hospital. For data analysis, χ2 test, independent sample t-test, one-way ANOVA were used. Results: There was no difference between GCS at discharge(t=-0.03, p=.978) and GOS at discharge(t=0.17, p=.863). But there were differences in gender(χ2=4.19, p=.041), history(χ2=20.78, p<.001), GCS at admission(t=-2.22, p=.028), pupil reflection at admission(t=8.04, p=.005), pH(t=-3.30, p=.001), serum blood glucose(t=-0.85, p=.040), complications(χ2=6.450, p=.011) between adults and elderly. Conculsion: When nursing patients with traumatic acute subdural hematoma, it is thought that patients assessment and nursing care considering the clinical characteristics according to age can be provided. Future research needs to develop educational materials for medical staff.

Factors Analysis Related to Health Administration Students' Satisfaction on Hospital Practice (보건행정 전공 대학생들의 병원실습 만족도에 영향을 미치는 요인분석)

  • Park, Eun-Young;Jang, Young-Jin;Hong, Jong-Pil
    • Journal of Korean Clinical Health Science
    • /
    • v.5 no.1
    • /
    • pp.825-833
    • /
    • 2017
  • Purpose .This study aims to assess the influence factors on the level of satisfaction with hospital training and to provide basic data for more efficient hospital practice of students' public health administration . Methods . We have conducted a survey on students satisfaction with their hands on practice against 200 students in Busan, Kyeongnam and Kyungbook area, who have completed their practice in public health administration. We have identified the general characteristics of the target respondents, the current training status of the department for the hospital practice and training venue; also analyzed the characteristics composed of the apprentice student's attitude before the practice, satisfaction with the department training program and hospital for practice, as well as their practice at hospital. The general characteristics of the target respondents and clinic practice status at the hospital were measured in percentage and frequency analysis; the average and standard deviations of hospital size were also measured; and the correlations between satisfaction with the department, attitude towards the practice and satisfaction with the hospital were analyzed. Results . Most public health administration students experienced their practice at the hospital after the first semester on the $2^{nd}$year and they have received the foundation training for the practice. The survey allowed multiple responses and the results are as follows: medical terminology 49.5%, medical coordinator 36.7%, Hospital administration 26.5%, Health insurance 17.3%, and medical recording and practice 13.8% respectively. In terms of each individual student's attitude towards the practice at the hospital, the respondents answered as follows: I have completed the obligatory subjects for the practice before the practice 89.5%; I have been fully informed on the hospital for my practice. 74.5%; I responsibly practiced and worked with professionalism and sense of belonging to the hospital as a member of staff 90%; I have actively learned and adopted 95%; My knowledge and skills from the practice was relevant to the theory and practice from my course 83.5%. The findings of satisfaction by size of hospital were in order of a small clinic($3.24{\pm}0.63$), medium sized clinic($3.27{\pm}0.65$), hospital ($3.20{\pm}0.61$), and large sized comprehensive hospital ($2.93{\pm}0.74$). Consequently the satisfaction rate shows no significant difference by size of hospital. In relations between practice attitude and satisfaction with subject, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.04), the matter of a sense of belonging and responsibility at hospital during practice(p=0.33). the matter of active adaptation attitude during practice (p=0.42), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. In relations between practice attitude and satisfaction with the hospital for practice, the matter of acquiring information and fully understanding of the hospital for practice before practice(p=0.01), the matter of a sense of belonging and responsibility at hospital during practice(p=0.04), and the matter of correlations with school curriculum during practice(p=0.00) showed significant results. Conclusion . The most essential subject for the practice in public health administration is medical terminology and there is no significance in satisfaction with the practice by size of hospital. Students were content with the hospital where they can experience as much as possible. Students content with their major show positive attitude towards the practice and so do those content with the hospital. Those with the positive attitude towards the practice show the high correlation of satisfaction with both the major and hospital. As a result, the satisfaction with the major is the significant attribute to the practice in the hospital.

Analysis of Nursing Care Activities of Nursing Students in Clinical Experience (간호학생의 임상실습 간호활동시간 분석)

  • Lee Chung-Hee;Sung Young-Hee;Jung Yoen-Yi;Kim Jung-Suk
    • The Journal of Korean Academic Society of Nursing Education
    • /
    • v.4 no.2
    • /
    • pp.249-263
    • /
    • 1998
  • The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

  • PDF

호스피스 전달체계 모형

  • Choe, Hwa-Suk
    • Korean Journal of Hospice Care
    • /
    • v.1 no.1
    • /
    • pp.46-69
    • /
    • 2001
  • Hospice Care is the best way to care for terminally ill patients and their family members. However most of them can not receive the appropriate hospice service because the Korean health delivery system is mainly be focussed on acutly ill patients. This study was carried out to clarify the situation of hospice in Korea and to develop a hospice care delivery system model which is appropriate in the Korean context. The theoretical framework of this study that hospice care delivery system is composed of hospice resources with personnel, facilities, etc., government and non-government hospice organization, hospice finances, hospice management and hospice delivery, was taken from the Health Delivery System of WHO(1984). Data was obtained through data analysis of litreature, interview, questionairs, visiting and Delphi Technique, from October 1998 to April 1999 involving 56 hospices, 1 hospice research center, 3 non-government hospice organizations, 20 experts who have had hospice experience for more than 3 years(mean is 9 years and 5 months) and officials or members of 3 non-government hospice organizations. There are 61 hospices in Korea. Even though hospice personnel have tried to study and to provide qualified hospice serices, there is nor any formal hospice linkage or network in Korea. This is the result of this survey made to clarify the situation of Korean hospice. Results of the study by Delphi Technique were as follows: 1.Hospice Resources: Key hospice personnel were found to be hospice coordinator, doctor, nurse, clergy, social worker, volunteers. Necessary qualifications for all personnel was that they conditions were resulted as have good health, receive hospice education and have communication skills. Education for hospice personnel is divided into (i)basic training and (ii)special education, e.g. palliative medicine course for hospice specialist or palliative care course in master degree for hospice nurse specialist. Hospice facilities could be developed by adding a living room, a space for family members, a prayer room, a church, an interview room, a kitchen, a dining room, a bath facility, a hall for music, art or work therapy, volunteers' room, garden, etc. to hospital facilities. 2.Hospice Organization: Whilst there are three non-government hospice organizations active at present, in the near future an hospice officer in the Health&Welfare Ministry plus a government Hospice body are necessary. However a non-government council to further integrate hospice development is also strongly recommended. 3.Hospice Finances: A New insurance standards, I.e. the charge for hospice care services, public information and tax reduction for donations were found suggested as methods to rise the hospice budget. 4.Hospice Management: Two divisions of hospice management/care were considered to be necessary in future. The role of the hospice officer in the Health & Welfare Ministry would be quality control of hospice teams and facilities involved/associated with hospice insurance standards. New non-government integrating councils role supporting the development of hospice care, not insurance covered. 5.Hospice delivery: Linkage&networking between hospice facilities and first, second, third level medical institutions are needed in order to provide varied and continous hospice care. Hospice Acts need to be established within the limits of medical law with regards to standards for professional staff members, educational programs, etc. The results of this study could be utilizes towards the development to two hospice care delivery system models, A and B. Model A is based on the hospital, especially the hospice unit, because in this setting is more easily available the new medical insurance for hospice care. Therefore a hospice team is organized in the hospital and may operate in the hospice unit and in the home hospice care service. After Model A is set up and operating, Model B will be the next stage, in which medical insurance cover will be extended to home hospice care service. This model(B) is also based on the hospital, but the focus of the hospital hospice unit will be moved to home hospice care which is connected by local physicians, national public health centers, community parties as like churches or volunteer groups. Model B will contribute to the care of terminally ill patients and their family members and also assist hospital administrators in cost-effectiveness.

  • PDF

The dose distribution and DVH change analysis wing to effect of the patient setup error (환자 SET-UP ERROR에 따른 선량분포와 DVH 변화 분석)

  • Kim KyoungTae;Ju SangGyu;Ahn JaeHong;Park YoungHwan
    • The Journal of Korean Society for Radiation Therapy
    • /
    • v.16 no.2
    • /
    • pp.81-89
    • /
    • 2004
  • Introduction : The setup error due to the patient and the staff from radiation treatment as the reason which is important the treatment record could be decided is a possibility of effect. The SET-UP ERROR of the patient analyzes the effect of dose distribution and DVH from radiation treatment of the patient. Material & Methode : This test uses human phantom and when C-T scan doing, It rotated the Left direction of the human phantom and it made SET-UP ERROR , Standard plan and 3mm, 5mm, 7mm, 10mm, 15mm, 20mm with to distinguish, it made the C-T scan error. With the result, The SET-UP ERROR got each C-T image Using RTP equipment It used the plan which is used generally from clinical - Box plan, 3Dimension plan( identical angle 5beam plan) Also, ( CTV+1cm margin, CTV+0.5cm margin, CTV+0.3,cm margin = PTV) it distinguished the standard plan and each set-up error plan and The plan used a dose distribution and the DVH and it analyzed Result : The Box4 the plan and 3Dimension plan which it bites it got similar an dose distribution and DVH in 3mm, 5mm From rotation error and Rectilinear movement( $0\%{\sim}2\%$ ). Rotation error and rectilinear error 7mm, 10mm, 15mm, 20mm appeared effect it will go mad to a enough change in treatment ( $2\%{\sim}^11\%$ ) Conclusion : The diminishes the effect of the SET-UP ERROR must reduce move with tension of the patient Also, we are important accessory development and the supply that it reducing of reproducibility and the move

  • PDF

Effect of Work Improvement for Promotion of Outpatient Satisfaction on CT scan (CT 외래환자의 만족도 향상을 위한 업무개선 연구)

  • Han, Man-Seok;Lee, Seung-Youl;Lee, Myeong-Goo;Jeon, Min-Cheol;Cho, Jae-Hwan;Kim, Tae-Hyung
    • Journal of radiological science and technology
    • /
    • v.35 no.1
    • /
    • pp.45-50
    • /
    • 2012
  • Nowadays, most of the hospital serves "one stop service" for CT scan. The patients could be taken the CT scan in the day they register for scan. On the contrary to the time convenience, patients are not satisfied with long waiting time and unkindness of staff. The objective of this study is to improve the patient's satisfaction for the CT scan, by analyzing inconvenience factors and improving the service qualities. From April 1 to August 30 in 2011, we investigated the satisfaction of patients who did examined abdomen CT scan with contrast media. We analyzed the 89 questionnaires before and after the service improvements from them. The worker's kindness, the environment of CT room and understanding about CT scan were answered by questionnaire and the waiting time of a day CT scan was drawn by medical information statistics. Also, the period before improvement was from April to June and the period after improvement was from July to September. And these questionnaire was analyzed through SPSS V. 15.0. In this study, kindness of staff, environment of CT room, intelligibility for CT scan and waiting time was explored and analyzed by SPSS V.15.0. The score of kindness was improved by 32%, satisfaction level of the environment was improved by 52.54%. The understanding level about CT scan was improved by 52.36% and the wating time of a day CT was shortened by 21% through our service enhancement programs. Consequentially, it is considered that these efforts would contribute to increase the revenue of hospital.