General Hospitals In Korea Research Articles

전자의무기록시스템의 수용요인

In this paper the factors are analyzed, which influenced on the of Electronic Medical System (EMR) of healthcare organization in Korea. The measured variables and factors were defined on the base of former research works. The questionnaires with Likert's 5 scale were administrated in the 102 general hospitals in Korea. This data was analyzed with SPSS v. 20. According to the result of factor analysis, the 4 influencing factors were grouped. They are, ICT-infrastructure of healthcare organization, Management strategy of healthcare organization, acceptance and EMR-performance. 5 hypotheses about the correlations between factors were formulated and analyzed with structural equation model(SEM). The result of this paper could be the good reference to the healthcare organizations on how they should implement and operate the EMR system.

Effects of Standardized Diabetes Education in Clinical Nurses

The purpose of this study was to exam effects of Standardized Diabetes Education for clinical nurses on the level of diabetes knowledge, the level of persuasion of knowledge and the level of practical application of knowledge for nursing care of patients with diabetes mellitus. This study was a one group quasi-experimental study. Study participants were 115 clinical nurses who 3 general hospitals in Korea from August 3 to September 30, 2013. Data were collected using structured questionnaires including the Knowledge on the DM and NPQ tool by Brett. The data were analyzed using Cronbach's α, means, standard deviations, and t-test with the SPSS windows 19.0 program. The result of implementing the standardized education of diabetes showed that the level of diabetes knowledge (t=2.19, p=.032) was significantly increased. And the level of practical application of diabetes knowledge (t=2.98, p=.004) based on the standardized education of diabetes showed a statistically significant difference between before education and after education

Unmet needs and quality of life of family caregivers of cancer patients in South Korea

Objective:The purpose of this study was to investigate the levels of unmet needs and quality of life (QOL) among family caregivers (FCs) of cancer patients and to characterize the relationship between unmet needs and QOL.Methods:A descriptive correlation design was used. Data were collected by convenience sampling during 2013 from 191 FCs of cancer patients who visited an outpatient cancer center in a general hospital in Korea. The comprehensive needs assessment tool for cancer-caregivers and the Korean version of the Caregiver QOL Index-Cancer were used to measure unmet needs and QOL, respectively.Results:FCs of cancer patients had a variety of unmet needs with prevalence ranged from 57.0% to 88.9%, depending on the domain. The domain with the highest prevalence of unmet needs was healthcare staff, followed by information/education. The mean QOL score was 74.62, with a possible range of 0-140. A negative correlation was found between unmet needs and QOL. Stepwise multiple regression analysis showed that unmet needs relating to health/psychological problems, practical support, family/social support, in addition to household income, cohabitation with the patient, and patient's age, explained 52.7% of the variance in QOL. The most influential factor was unmet needs relating to health/psychological problems, which accounted for 35.7% of the variance.Conclusions:The results of this study indicate that oncology professionals need to develop interventions to improve the QOL of FCs by focusing not only on information/educational needs of patient care but also on physical and psychological needs of FCs.

Influence of frailty on health-related quality of life in pre-dialysis patients with chronic kidney disease in Korea: a cross-sectional study.

BackgroundChronic kidney disease (CKD) is a progressive and lifelong condition with multiple medical comorbidities. Patients with CKD experience frailty more frequently and have lower health-related quality of life than do those with other chronic diseases. The purpose of this study was to examine the prevalence of frailty and investigate the contribution of frailty to quality of life in pre-dialysis CKD patients in Korea.MethodsUsing a cross-sectional survey design, data were collected at an outpatient CKD clinic in a general hospital in Korea. The frailty criterion was modified from previous studies. The Short Form-36 Health Survey version 2 was used to measure physical and mental component summary scores. Data were analyzed using chi-square, t-tests, and hierarchical linear regression.ResultsOf the 168 CKD patients, 63 (37.5 %) were frail. Frail patients were significantly older and had lower physical and mental quality of life than those who were non-frail. In hierarchical regression evaluating the influence of frailty on physical and mental quality of life, the initial model was significantly improved when frailty was included. Frail patients had lower physical and mental quality of life.ConclusionsFrailty affected both physical and mental quality of life in pre-dialysis patients with CKD. More attention should be paid to the potential role of early detection and prevention of frailty to improve patients’ quality of life.

The incidence and characteristics of adrenal insufficiency among patients with suspicious symptoms in general hospital in Korea

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Health-related Needs and Quality of Life in Childhood Cancer Survivors

Purpose: The purpose of this study was to identify the health-related needs and quality of life in childhood cancer survivors and to identify the relationship between health-related needs and quality of life. Methods: Data were collected from April 11 to May 30, 2014.The participants aged 18~35 years diagnosed with a childhood cancer had completed actual treatment (surgery, chemotherapy, or radiation therapy) at least two years earlier. They were randomly selected from among childhood cancer survivors under follow-up management after cancer treatment at three general hospitals in Korea. Descriptive statistics, t-tests, one-way ANOVA, the post-hoc Scheffe test, and Pearson’s correlation coefficients were used to analyze the data. Results: Among the 371 participants, 214 (57.7%) were male and the mean age was 22.5 years. The mean score for health-related needs was 2.72 out of 5. Positive self-motivation need had the highest mean score of domain. The mean score for quality of life was 5.92 out of 10. Health-related needs and quality of life were negatively correlated (r= - .70, p<.001). Conclusion: Health-related needs of childhood cancer survivors should be regularly assessed to meet their needs and improve the quality of life of childhood cancer survivors.

Characteristics of Metallo-β-Lactamase-Producing Pseudomonas aeruginosa in Korea.

BackgroundThe aim of this study was to investigate the molecular epidemiological characteristics of metallo-β-lactamase (MBL)-producing Pseudomonas aeruginosa clinical isolates in Korea.Materials and MethodsThree hundred and twenty nine P. aeruginosa clinical isolates were collected from 23 general hospitals in Korea from March to June 2014. Species were identified by matrix-assited laser desorption/ionization-time of flight and 16S rRNA sequencing. Antimicrobial susceptibility was determined by disk diffusion methods. Further, minimum inhibitory concentrations of carbapenems were determined by Etest. Polymerase chain reaction and sequencing were performed to identify genes encoding MBLs. Multi-locus sequence typing and pulsed-field gel electrophoresis were performed to determine epidemiological characteristics of MBL-producing P. aeruginosa isolates.ResultsOf the 329 isolates, 229 (69.6%) were susceptible to the carbapenems tested, including imipenem and meropenem; while 100 (30.4%) were non-susceptible to more than one of the carbapenems. Genes encoding imipenemase-6 (IMP-6) and Verona imipenemase-2 (VIM-2) MBLs were identified in 21 (6.4%) isolates (n = 17 and 4, respectively). All MBL-producing isolates showed multi-drug resistant phenotype, and a majority (n = 19) of the isolates were identified as sequence type 235 (ST235). The remaining isolates (n = 2) were identified as ST309 and ST463.ConclusionP. aeruginosa ST235 might play an important role in dissemination of MBL genes in Korea.

Validity and Reliability of the Korean Version of the Expanded Nursing Stress Scale

Purpose: This study was done to evaluate validity and reliability of the Korean version of the expanded nursing stress scale (ENSS). Methods: Forward-backward translation of ENSS from English to Korean was conducted. The translated instrument was pilot-tested and administrated to 285 nurses who worked in five general hospitals in Korea. Internal consistency reliability was assessed using Cronbach’s ⍺ and composite reliability. Validity was evaluated through construct validity with confirmatory factor analysis, convergent and discriminant validity. Results: The Korean version of ENSS showed a reliable internal consistency with Cronbach’s ⍺ .95 and composite reliability .99. Model fit indexes for 46 items were validated by confirmatory factor analysis(goodness of fit index .82, Tucker-Lewis index .92, root mean square error of approximation .04), indicating suitable construct validity. Factor loading of the 48 items (.47~.88) and average variance extracted out of nine factors (.52~.71.) indicated satisfactory convergent validity. Some values of square of the correlation coefficient between factors (.12~.89) were higher than average variance extracted values of each factor (.52~.71) so that it partly satisfied discriminant validity. Conclusion: Findings show that the Korean version ENSS has good reliability and suitable validity; therefore, can be used to assess and identify Korean nurses’ job stress.

Impact of coronary artery anatomy on clinical course and prognosis in apical hypertrophic cardiomyopathy: analysis of coronary angiography and computed tomography.

Background and ObjectivesApical hypertrophic cardiomyopathy (AHCM) is an uncommon variant of hypertrophic cardiomyopathy with a relatively benign course. However, the prognostic factors of AHCM-particularly those associated with coronary artery disease (CAD) and its anatomical subtypes-are not well known.Subjects and MethodsWe enrolled 98 consecutive patients with AHCM who underwent coronary angiography or coronary computed tomography scanning at two general hospitals in Korea from January 2002 to March 2012. Patient charts were reviewed for information regarding cardiovascular (CV) risk factors, symptoms, and occurrence of CV events and/or mortality. We also reviewed echocardiographic data and angiography records.ResultsThe mean age at the time of enrollment was 61.45±9.78 years, with female patients comprising 38.6%. The proportions of mixed and pure types of AHCM were 34.4% and 65.6%, respectively. CAD was found in 31 (31.6%) patients. The mean follow-up period was 53.1±60.7 months. CV events occurred in 22.4% of patients, and the mortality rate was 5.1%. The mixed-type was more frequent in CV event group although this difference was not statistically significant (50% vs. 30%, p=0.097). The presence of CAD emerged as an independent risk factor for CV events in univariate and multivariate Cox regression analysis after adjusting for other CV risk factors.ConclusionCoronary artery disease is an independent risk factor for CV events in AHCM patients. However, AHCM without CAD has a benign natural course, comparable with the general population.

Attitudes to and Diffusion of Intravenous Infusion Nursing Practice Guideline of Advanced General Hospital and General Hospital in Korea

Attitudes to and Diffusion of Intravenous Infusion Nursing Practice Guideline of Advanced General Hospital and General Hospital in Korea

Characteristics of inpatient care and rehabilitation for acute first-ever stroke patients.

PurposeThe purpose of this study was to analyze the status of inpatient care for acute first-ever stroke at three general hospitals in Korea to provide basic data and useful information on the development of comprehensive and systematic rehabilitation care for stroke patients.Materials and MethodsThis study conducted a retrospective complete enumeration survey of all acute first-ever stroke patients admitted to three distinct general hospitals for 2 years by reviewing medical records. Both ischemic and hemorrhagic strokes were included. Survey items included demographic data, risk factors, stroke type, state of rehabilitation treatment, discharge destination, and functional status at discharge.ResultsA total of 2159 patients were reviewed. The mean age was 61.5±14.4 years and the ratio of males to females was 1.23:1. Proportion of ischemic stroke comprised 54.9% and hemorrhagic stroke 45.1%. Early hospital mortality rate was 8.1%. Among these patients, 27.9% received rehabilitation consultation and 22.9% underwent inpatient rehabilitation treatment. The mean period from admission to rehabilitation consultation was 14.5 days. Only 12.9% of patients were transferred to a rehabilitation department and the mean period from onset to transfer was 23.4 days. Improvements in functional status were observed in the patients who had received inpatient rehabilitation treatment after acute stroke management.ConclusionOur analysis revealed that a relatively small portion of patients who suffered from an acute first-ever stroke received rehabilitation consultation and inpatient rehabilitation treatment. Thus, applying standardized clinical practice guidelines for post-acute rehabilitation care is needed to provide more effective and efficient rehabilitation services to patients with stroke.

국내 상급종합병원과 전국 분포 종합병원의 임상영양서비스 실태 조사 연구: 전국 규모 설문조사를 통하여

The purpose of this study was to investigate the status of clinical nutrition services provided at tertiary hospitals and general hospitals in Korea. In total, 157 questionnaires were distributed to the departments of nutrition at hospitals on September 2013. The results of this study are as follows. The median number of beds was 607 and average length of stay was 8 days. 63.1% of dietitians had over 5 years of career experience. Nutritional screening rate was 97% in tertiary hospitals but only 67.2% in general hospitals (P<0.001). The rate of equipment with computerized nutritional screening system was 100% in tertiary hospitals but 71.9% in general hospitals (P<0.001). Hospitals with the best regarding nutritional care were hospitals accredited by JCI (Joint Commission International). On the other hand, hospitals not accredited by the JCI but KOIHA (Korea Institute for Healthcare Accreditation) showed the lowest performance rate of nutritional care. Nutrition support teams (NSTs) were established in all tertiary hospitals but in only 73% of general hospitals (P<0.001). The rate of actively operating NSTs was 89% in tertiary hospitals but only 62% in general hospitals (P<0.001). There is a need to provide proper standardized clinical nutrition services as a primary treatment and we observed large variations in the quality of nutritional service between hospitals. Therefore, local solutions are needed to implement nutritional programs and policies for improved service and care.

종합병원의 전략 지향성이 성과에 미치는 영향

이 연구는 종합병원들이 마케팅 컨셉트를 적극적으로 도입하고 있는 상황에서 그 구성개념인 전략 지향성이 성과에 어떻게 영향을 미치는지, 또한 종합병원의 조직구조와 규모가 독립변수와 종속변수 사이에서 어떻게 조절효과를 보이는지를 분석했다. 전략 지향성과 성과 관련 선행연구들을 살펴보았으며, 전략 지향성 개념을 고객, 경쟁, 진료기술 지향성 등의 세 차원으로 세분화하고 이들이 각각 성과에 어떤 영향을 미치는지를 분석하고자 했다. 이러한 연구목적을 달성하기 위해 5개의 연구가설을 설정하였으며, 20313년 7월 1일부터 8월 13일까지 5개 종합병원에 근무하는 176명의 직원들을 대상으로 설문조사를 실시했다. 실증분석 결과 전략 지향성을 구성하는 세 차원 모두가 종합병원의 경영성과에 유의하게 정(+)의 영향을 미치는 것으로 나타났다. 또한 종합병원의 조직구조와 규모의 조절효과 분석에 있어서는 부분적으로 지지되는 것으로 조사되었다. 종합병원의 조직구조 및 규모 변수 모두 경쟁 지향성에 대한 조절효과는 유의하게 도출되었으나 고객 지향성과 진료기술 지향성에 대한 조절효과는 통계적으로 유의한 결과가 없는 것으로 나타났다. The main purpose of this study is to find out how strategy orientation influences to performance in general hospitals, and to analyze the effect of the general hospital structure and its size to the relationship between independence variables and performance variable. To achieve the goal we set 3 sub-dimension, customer orientation, competition orientation and care skill orientation based on comprehensive consideration of related studies, and established 5 hypothesis. Survey data for statistic analysis have been collected from 176 members of 5 general hospitals in Korea from 1July to 13 October, 2013. We found that three dimensions of strategy orientation influence to performance significantly. We also found that moderating effect of general hospital structure and its size is partially supported. General hospital structure and its size moderates only the relationship between competition orientation and performance.

The Factors Impacting Emergency Department Wait Times: A Case of a Local General Hospital in Korea

The Factors Impacting Emergency Department Wait Times: A Case of a Local General Hospital in Korea

의료종사자의 주사침 손상 사고 후 감염예방처치와 혈액매개바이러스 혈청양성전환

Purpose: Needlestick injuries (NSI) is the most frequent occupational hazard for healthcare personnel (HCP), and immediate report and adequate post-exposure prophylaxis (PEP) is essential in preventing occupational transmission of blood-borne pathogens. Methods: From June 2010 to October 2010, 544 NSI were reported through websites from 21 general hospitals in Korea. Among those, 499 cases of NSI were analyzed to identify the rate of follow-up treatment completion and for seroconversion. Results: 88.2% of the cases were completed with follow-up treatment, 8.8% of the NSI were not completed with follow-up treatment, and 5 cases were unavailable to trace. 4.2% cases of NSI required a hepatitis B vaccination concurrent with hepatitis B immunoglobulin. 41.1% of the cases and 31.1% of the cases needed to be tested for anti HCV and anti HIV, respectively. Prophylaxis medication for HIV was prescribed in 3 cases, and all cases completed required 1 month of medication. There was 1 case (0.2%) of seroconversion to HCV. Conclusion: The PEP completion rate was not satisfactory, and the importance of completion of PEP treatment should be emphasized through education and counseling. Also, a careful risk assessment is needed for HCP who are exposed to HCV or HIV.

Current Status of Evidence-Based Nursing in General Hospitals in Korea

Young Ae Cho · Mee Ock Gu · Jae Sim Jeong · Young Eun · Shin Mi Kim · Ihn Sook Jung · Myung Sook Park · Jeong Soon Kwon · Young Sun Jung · Kyeongsug Kim · Myong Hwa Park · Kyunghee Kim Clinical Professor, Research Institute of Clinical Nursing Science, Samsung Medical Center, Graduate School of Clinical Nursing Science, Sungkyunkwan University, Seoul; Professor, College of Nursing, Gerontological Health Research Center, Institute of Health Sciences, Gyeongsang National University, Jinju; Associate Professor, Graduate school of Industry,University of Ulsan, Ulsan; Associate Professor, Department of Nursing, Changwon National University, Changwon; Professor, College of Nursing, Pusan National University, Yangsan; Assistant Professor, Department of Nursing, Konkuk University, Chungju; Director, Department of Nursing, GangNeung Asan Hospital, Gangneung; Team Leader, Department of Nursing, Asan Medical Center, Seoul; Nurse Manager, Department of Nursing, Samsung Medical Center, Seoul; Associate Professor, College of Nursing, Chungnam National University, Daejeon; Professor, College of Nursing, Chung-Ang University, Seoul, Korea

Impacts of Job Stress and Cognitive Failure on Patient Safety Incidents among Hospital Nurses

BackgroundThis study aimed to identify the impacts of job stress and cognitive failure on patient safety incidents among hospital nurses in Korea.MethodsThe study included 279 nurses who worked for at least 6 months in five general hospitals in Korea. Data were collected with self-administered questionnaires designed to measure job stress, cognitive failure, and patient safety incidents.ResultsThis study showed that 27.9% of the participants had experienced patient safety incidents in the past 6 months. Factors affecting incidents were found to be shift work [odds ratio (OR) = 6.85], cognitive failure (OR = 2.92), lacking job autonomy (OR = 0.97), and job instability (OR = 1.02).ConclusionPatient safety incidents were affected by shift work, cognitive failure, and job stress. Many countermeasures to reduce the incidents caused by shift work, and plans to reduce job stress to reduce the workers' cognitive failure are required. In addition, there is a necessity to reduce job instability and clearly define the scope and authority for duties that are directly related to the patient's safety.

종합병원 구성원들의 의사소통 만족도가 조직유효성 인식에 미치는 영향

Abstract The purpose of this study is to verify the effects of hospital employees' communication satisfaction on their perceived organizational effectiveness. Four research hypothesis are established for the purpose of this study. The subject of this study were 473 employees who were working at 10 general hospitals in Korea. The survey was done with structured questionnaire from January 3 to February 8, 2013. The results of stepwise regression analysis show that hospital employees‘ communication satisfaction positively affected organizational effectiveness. Interaction effects between employees' communication satisfaction and work types had stronger effect on organizational growth than organizational stability. It can be pointed out as an important issue that communication satisfaction score of medical support occupation is the lowest level(3.11 points out of 5 points). If hospitals want an integration of organization, it is required to develop method or skill to increase communication satisfaction among employees.

Factors associated with suicide method among psychiatric patients in a general hospital in Korea

This study aims to highlight the factors associated with suicide method among psychiatric patients in a general hospital in Korea. In a sample of 467 suicides by patients who had received mental health care in a general hospital in Korea, the relationship between suicide method and time of death as well as clinical characteristics, including psychiatric adiagnosis, was examined using multinomial logistic regression analysis. Compared with the general population, psychiatric patients, regardless of disorder, committed suicide by jumping from heights more often than by hanging (OR=2.35–8.64). In particular, patients with psychotic disorders and female patients were more likely to use jumping from a height than hanging to kill themselves (OR=2.98 and 1.83, respectively). Patients were more likely to use suicide methods other than hanging (e.g., OR=6.7 for jumping, 5.3 for drowning, and 2.7 for self-poisoning) between midnight and dawn. Possible suicide-prevention strategies suggested by this study include limiting access to or fencing off tall structures in close proximity to psychiatric institutions and residential care homes. At night, limiting access to or instituting heightened supervision of tall structures is specifically indicated.

K대학병원 병동부 이중복도형의 개선을 위한 사용자 요구 조사연구

Purpose: General hospital in korea is getting large-scaled, specialized and upgraded. So, nursing unit of race track type has been advanced along with a spatial organization, building equipment and environmental approach. This study is to search the guidelines for renovation of nursing unit with race track type in the case of K university hospital in Daejeon. Methods: 9 cases of recently opened general hospital has been analyzed for spatial and environmental design solution. Questionnaires and interviews about user needs of nursing staff, patient and visitors, have been conducted for a nursing care system and facility of nursing units in K university hospital. Results: The user needs are represented as followings. Center core public zone in each floor plan and center core nursing station and supporting areas in nursing unit are good for an adjacency and separation of spatial organization. Toilet of group patient room is necessary to equip for easy, safe and infective aspects, and so toilet install will decrease the patient number and increase the nursing care service. Hall type of station front is good for visibility and observation. It is appropriate to renovate into south facing group patient room for privacy, enough space for nursing care facility and supporting area, enough width of door to move portable medical equipment, room for medical doctor and practical student, noise absorbing of day room. Implications: Upgrading the nursing care service and facility equipment is necessary to reflect the user needs and cooperate with hospital management.