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박연옥 ( Yon Ok Park ),문경선 ( Kyung Sun Moon ),정명숙 ( Myung Suk Chung ),김효심 ( Hyo Sim Kim ) 한국의료윤리학회 2006 한국의료윤리학회지 Vol.9 No.2
A study was designed to compare patients` and nurses` views on the expectations and performance related to ``respect for patients.`` The subjects of this study, which was approved by an Institutional Review Board, were 276 nurses working in general wards or intensive care units and 172 patients admitted to the general ward of a university hospital in South Korea.?The instrument used in the study was based on the concept of Respect for Patients developed by Yoo Myoung-Ran. The collected data was analyzed using SPSS WIN 12.0 with a paired t-test, independent t-test, and a one way ANOVA. The results were as follows. First, there was a statistically significant difference between nurses` views of the expectations and performance levels related to respect for patients (p=.000). Second, there was a statistically significant difference between patients` views of expectations and performance?levels related to respect for patients (p=.000). Third, the level of expectation concerning respect for patients as viewed by nurses and patients was 4.46 and 4.22 respectively. This was a statistically significant difference (p=.000). The level of performance related to respect for patients as viewed by nurses and patients was 3.48 and 3.82 respectively. This too was a statistically significant difference (p=.000). Fourth, there was a statistically significant difference in the level of expectations concerning respect for patients relative to the level of the nurses` education (p=.015) and a statistically significant difference in the level of performance related to respect for patients relative to the nurses` working place (p=.001). There was a statistically significant difference in the level of expectations concerning respect for patients relative to patients` income levels (p=.009) and a statistically significant difference in the level of performance concerning respect for patients relative to patients` income levels (p=.005) and religion (p=.037).
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표준 진료 지침서(Critical Paths) 개발에 관한 연구 - 충수절제술(Appendectomy) 환자용 -
김용순,박지원,박연옥,조은숙,김명욱,Kim, Yong-Soon,Park, Jee-Won,Park, Yon-Ok,Cho, Eun-Sook,Kim, Myung-Wook 한국의료질향상학회 1996 한국의료질향상학회지 Vol.2 No.2
Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.
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환자 만족도 조사를 통한 QI활동의 효과 평가 : 일개 병원을 중심으로
박연옥,김미숙,고은정,김연정,홍창호 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.2
Background : Evaluation of patient's satisfaction is one of the most important aspects of quality improvement. If the patient highly satisfies with the medical service provided in the hospital, he/she will be likely to visit the same hospital again. Patient's satisfaction of a particular hospital is directly correlated with hospital profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the patient's satisfaction. This study is to find the effect of hospital QI activities on the patient's satisfaction level. Methods : After questionnares were developed, survey of measuring satisfaction level was performed in August. 1998. On the basis of survey results. Ql activities were carried out to attain the target point of 4.0 and subsequent survey was done in November. 1998. Results : With three main principles of "problem solving approach with kindness". "helping patient to participate in medical procedure with sufficient information", and "putting employees into practice of attitude with human respect", the average level of satisfaction was enhanced from 3.45 to 3.55 level. Also kindness level of employees was increased from 3.71 to 3.82. Level of dissatisfaction about insufficient explanation and unkind attitude was dropped from 69% to 48% and from 82% to 46% respectively. Conclusion : With the result of this study overall satisfaction level was enhanced. In order to keep these advantages a operation of Quality Improvement Task Force Team in each subject will be required.
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고자경,박연옥 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.2
Background : There have been many studies and efforts about quality management in health services, but these were not focused on the thinking ability of the personnel. In this study. We planned to define the relationship between Quality Management(QM) and thinking skill, and analyzed critical thinking skill and problem solving ability of the nurses for QM in healthcare. Methods : We surveyed 260 nurses in 3 hospitals by using questionnaires about thinking skills and QM from November 18 to 28. 1998. The response rate was /6.9%. We described and analyzed the data by descriptive statistics, t-test. ANOVA, Pearson correlation, and non-parametric Friedman test using SPSS Win 7.5. Results : This study revealed that 1) understanding level of QM concepts was very low and insufficient, 2) willingness to practice QM in healthcare was relatively high and affirmative, but the positive attitude taking part in the program of QM is very low(4.5%). 3) even though the necessity of QM was recognized, actual application of critical thinking skills and problem solving abilities is lacking, 4) the production of idea for QM was the most insufficient, and so the next of the problem solving process(QA cycle) was the same. Conclusion : Based on the above results, we can conclude that understanding the concepts of QM is very important to solve problems about QM in healthcare. For development of thinking skill to promote critical problem solving ability for QM in healthcare, it is necessary to improve curriculum of nursing education and teaching-learning methods of QM strategy and technique.
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김용순,박지원,박연옥 한국의료QA학회 1997 한국의료질향상학회지 Vol.4 No.1
Background : An important issue in health care today is in trying to center service around the hospitalized patient. There is a "kindness Movement" developing now. Where in the focus of Health Care is being changed from simply treating the basic physical needs of the patient with sophisticated technology. to keeping emotional well being healthy with more humane and attentive treatment. In our attempt to reach the goal of a completely satisfied patient, we undertook a study of the common complaints of patients, and the subsequent nature of the interventions. Method : The study was carried out in two stages, first the patients made known their complaints by filling out questionnaires, then we collected data on the attempts to alleviate the complaints. The questionnaire provided 19 different complaints, which were then analysed for such variables as content, source of complaint, persons treating the complaint, and length of time and method used to solve the complaint. Result : 1. The Chief complaints made by patients(99.1%) were of physical discomfort, such as pain, nausea, vomiting, indigestion, diarrhea and constipation. 2. The complaints were vioced primarily by either a member of the patient's family, or by the patients themselves(78.4%). 3. The complaints were intervened by nurses alone(53.5%), physicians alone(25.5%), or by nurses and physicians together(19.25%). 4. The method by which the complaints were resolved included the utilization of prescriptions(55.7%), turther explanation and education (25.5%) and notification after treatment(13.2%). 5. Most complaints were voiced during the dayshift (42.6%, 7:00~15:00), followed by the evening shift(36.0%, 15:00~22:00) ;and then the nightshift(21.3%, 22:00~07:00). 6. The time required for successful resolution of the patient's problems varied from 10~88.9mi, according to the nature of the complaint. Conclusion : Hopefully by knowing beforehand the nature of both complaint and intervention, we can anticiapte problems and shorten reaction time, in order to provide for a more satisfied patient.
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