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      • KCI등재

        중증외상환자의 주 손상 부위별 특성과 간호활동

        김명희,김명희,박정하 기초간호학회 2013 Journal of korean biological nursing science Vol.15 No.4

        오늘날 산업화와 경제성장에 따라 교통사고, 재해, 산업 재해 등의 각종사고가 증가하면서(Kim, J. J. et al., 2011) 매년 12만 5천 명의 중증외상환자가 발생하고, 이 중 1만 1천 명이 사망하고 있지만, 적절하고 신속한 치료가 이루어진다면 살릴 수 있는 중증외상환자도 3천 5백 명에 달한다(Joo, 2010). 외상환자의 예방가능 사망률은 그 나라의 전체적인 외상체계를 평가할 수 있는 지표로(Mackenzie, 1999) 미국과 일본의 중증외상환자 예방가능 사망률은 10-15% (Esposito, Sanddal, Reynolds, & Sanddal, 2003; Kunihiro, 2005)인 데 비해 국내는 33%로(Kim, 2011) 2배가 넘는 실정이다. 외상진료체계를 구축하여 외상환자의 예방가능 사망률을 줄이고 있는 외국사례를 토대로(Stewart, Lane, & Stefanits, 1995) 국내에서는 2009년 중증외상 특성화 후보센터를 지정하였고, 향후 전문외상센터를 운영할 계획이다(Central Emergency Medical Center, 2009). 현재 중증외상환자들은 권역응급의료센터에서 치료를 전담하고 있으나 입원대기 환자들이 정체되고(Chun, 2008) 치료전담 의료 인력이 부족(Lee, 2011)하여 중증외상환자의 진단, 치료 및 처치가 지연되고 있다. 외상환자는 외상초기의 적절한 치료여부에 따라 예후에 많은 영향을 받으므로(Nguyen, Rivers, & Havastad, 2000), 진단 및 치료에 소요되는 시간을 단축시켜 빠른 시간 내에 처치가 이루어지는 것이 매우 중요하다(Kim et al., 2007). 외상환자의 대부분은 다발성 외상환자들로(Kim, T. Y. et al., 2011) 복합적인 문제들을 동반하는 경우가 많기 때문에 생명유지를 위한 기본적인 처치와 동시에 손상부위에 따른 사정, 처치 및 간호활동이 이루어져야 한다. 국군간호사관학교의 외상간호교육과정(Trauma Nursing Core Course, TNCC)에 신체의 해부학적 부위에 따른 간호가 있지만, 이는 사고현장에서부터 병원에 도착하기까지의 상황에 대한 것(Korean Nurses Association, 2013)이고, 응급환자 매뉴얼의 외상환자 간호처치는 이론적이므로 임상실무현장을 반영한 병원 도착 후의 중증외상환자의 간호활동에 대한 연구가 필요하다.

      • KCI등재

        중증외상환자의 치료경과 시간과 활력징후에 따른 응급처치 및 간호활동

        김명희,박정하,김명희,구지은 기초간호학회 2014 Journal of korean biological nursing science Vol.16 No.3

        Purpose: The aim of this study was to identify necessary emergency treatment and nursing activities for severe trauma patients according to elapsed time and vital signs. Methods: A survey was conducted with 121 patients over 15 points ISS on EMR from June 1, 2011 to May 31, 2012. Collected data were analyzed with descriptive statistics, applying McNemar’s test using SPSS 12.0. Results: Almost all of the subjects were men and the mean age was 46.9. Run-time for primary diagnosis, treatment decision, and leaving for the hospital room was 0.19, 4.36, and 4.21 hours, respectively, and stayover time was 9 hours. Regardless of vital signs, emergency treatments involving ambu-bagging, intubation, ventilator, and central vein catheterization insertion were offered within an hour. Central venous pressure, Foley catheter/Levin tube preparation and maintenance were performed in cases of unstable vital sign patients within an hour. Unrelated to vital signs, nursing activities for consciousness assessment, skin assesment and wound care, bed sore/fall down assesment and care, intravenous injection insertion and maintenance were conducted for all severe trauma patients within an hour. Foley catheter/Levin tube drainage care was performed for patients who had unstable vital signs within an hour. Conclusion: Emergency treatment and nursing activities for severe trauma patients were specific according to elapsed time and vital signs.

      • 뇌혈관 환자에 대한 간호진단 적용 분석

        김명희 대구보건대학 1996 대구보건대학 論文集 Vol.16 No.-

        간호진단의 실무적용을 증진시키고 간호의 질을 높이기 위해 대구시내에 소재한 Y의료원 신경계 변동에 입원한 환자 102명에게 적용된 간호진단수 총 109개를 NANDA회의에서 채택된 간호진단명 105개에 준하여 분석한 결과 환자 1인당 평균1개를 사용하였으며 총 사용 NANDA 간호진단명은 9개로 대상자 102명중 가장 많이 사용된 간호 진단은 안위의 변화 44.0%, 불안 19.3%, 부적절한 개인적 대응 12.8%로서 높게 나타났다. 본 연구의 결과 적용된 간호진단의 종류 및 빈도가 매우 낮았으며 간호진단에 대한 사정도구개발의 연구와 간호사들에게 지속적인 보수교육이 강화되어야 한다고 생각한다. This research was done for the improvement of practical appliance of Ng. diagnosis and for the elevation of nursing guality(level). I analized the Ng. diagnosis with 109 diagnosis used by NANDA conference from 102 patients who were admitted for Neuro Surgery Ward of Y medical Center which is in Taegu. Ther general characteristics of the patients are as follows ; by sex, men were 57 cases(55.9%) and women were 45 cases(45.1%). In age, 26~29 were I case(1.0%), 30~39 were 10 cases(9.8%), 40~49 were 30 cases(29.4%), 50~59 were 32 cases(31.4%), 60~69 were 26 cases(25.5%), and over 70 were 3 cases (2.9%). In diagnosis of the patients, Cerebral Infarction were 52 cases(50.9%), Intracerebral Hemorrhage were 20 cases(19.6%), Subarachnoid Hemorrhage were 12 cases(11.8%), Epidural Hemorrhage were 7 cases(6.9%), Subdural Hemorrhage were 5 cases(4.9%), Aneurysm were 4 cases(3.9%), Cerebrovascular Accident were 2 cases(2.0%). I used all 109 Ng. diagnoses which means one person used about 1.0 of NANDA'S diagnoses. All used NANDA'S was 9 diagnoses. The most popular diagnoses were alteration in Comfort(44.0%), Anxiety(19,3%), Ineffective individual Coping(12.8%) in 102 cases. Bae showed ineffective air way clearance(48.4%), impaired Physical mobility, ineffective Breathing pattern, Knowledge deficit, All of them were 41.9% in her diagnosis analysis research of Open Heart Surgery Patients. Kang showed self care deficit(27.7%), skin integrity(23.4%), tissue perfusion, alteration in cerebral area(16.4%), and high risk for infection(0.6%), in her diagnosis analysis research of brain disease patients. Park(1987) showed the representative diagnosis of high risk for injury, altered nutrition less than body reguirements, knowledge dificit, sleep pattern disturbance, and fluid volume excess, in her evaluations, of the original and revealational research rate of five diagnosis in patients with CAAH or CAVH. When we consider the specifics of each patient we can determine how the Ng assessment reveals that patients problems differ according to their disease. Signs and symptoms are one thing, and nursing requests are another. As the specific response-formal analysis of 9 Ng. Diagnoses in which the most popular diagnoses were Emotion(33.4%), Exchanging(22.2%), Moving(12.0%), choosing(11.1%) Knowing(11.1%) but Communicating and Relating, Valuing, Perceiving were not applied.

      • KCI등재

        시판 건 해산물 중 아황산염류 함량 조사

        김명희,최병현,함희진,김무상 한국식품위생안전성학회 1999 한국식품위생안전성학회지 Vol.14 No.4

        This study was performed to investigate the contents of sulfites in 2,770 dried marine products in Seoul Chung-Bu market from March to October in 1999. Sulfites of the samples were determined by Zn powder reduction method and Monnier-Williams's modified method. Eight samples of 2,770 (0.29%) were detected over 30ppm in S02 contents by Monnier-Williams's modified method. In samples detected over 30ppm, six dried filefishes(130.2-573.4ppm) were imported from Vietnam, same kind of other one(114.2ppm) was from China and the other one Alaska pollack(195.3ppm) was domestic. By Zn powder reduction method, 259 dried marine products (259/2,770=9.35%) were positive reaction (1-30ppm). These were 93 dried shrimps, 53 filefish meats, 34 dried squids, 33 slices of dried pollacks and 17 sea mussel meats. So sulfites must be use commonly to prevent black spot and preserve for many dried shrimps, filefishes meats, dried squids etc. According to results, the quality test for the imported dried marine products must be reinforced to supply safety food for the citizens.

      • KCI등재

        The Impact of Macroeconomic Variables on the Profitability of Korean Ocean-Going Shipping Companies

        김명희,이기환 한국항해항만학회 2019 한국항해항만학회지 Vol.43 No.2

        The objective of this study was to establish whether global macroeconomic indicators affect the profitability of Korean shipping companies by using panel regression analysis. OROA (operating return on assets) and ROA (ratio of net profit to assets) were selected as proxy variables for profitability. OROA and ROA were used as dependent variables. The world GDP growth rate, interest rate, exchange rate, stock index, bunker price, freight, demand and supply of the world shipping market were set as independent variables. The size of the firm was added to the control variable. For small-sized firms, OROA was not affect by macroeconomic indicators. However, ROA was affected by variables such as interest rates, bunker prices, and size of firms. For medium-sized firms, OROA was affected by demand, supply, GDP, freight, and asset variables. However, macroeconomic indicators did not affect ROA. For large-sized firms, freight, GDP, and stock index (SCI; Shanghai Composite Index) have an effect on OROA. ROA was analyzed to be influenced by bunker price and SCI.

      • KCI등재

        외부감사인의 용역업무 병행과 감사인의 독립성

        김명희,문재우 한국경영교육학회 2002 경영교육연구 Vol.26 No.-

        The core of the effective external audit function is built around the auditor independence. However, the recent financial fraud related to Enron has raised the great skepticism on the auditor independence and management advisory services (MAS) provided by the external auditor. This study attempts to examine the effect of MAS provided by the external auditor on the auditor independence based on public disclosures in the annual reports of the listed firms. Specifically, this study investigates whether there is any difference in audit fees and MAS fees between firms with MAS or qualified audit opinions by using the disclosures about audit fees, MAS fees, and audit opinions. Briefly, this study finds that the size controlled audit fee does not show any difference regardless of MAS provided by the external auditor. This finding is consistent with previous studies which did not report any audit fee discount under the presence of MAS. On addition, audit fee and MAS fee do not show any statistically significant difference regardless of audit opinions and opinion changes. However, these results do not imply that MAS are totally irrelevant to auditor independence since public disclosures exclude MAS provided by consulting firms which are affiliates of external auditors. Therefore, public disclosures on MAS should be strengthened to include those firms and further in-depth studies are required to resolve this issue.

      • KCI등재

        청소년의 자율 협력적 독서실행에 따른 독서유효성 효과 연구

        김명희,조현양,Kim, Myung-Hee,Cho, Hyun-Yang 한국도서관정보학회 2018 한국도서관정보학회지 Vol.49 No.2

        이 연구는 청소년의 자율 협력적 독서실행 모형을 제시하고 협력적 독서방식이 청소년의 독서유효성에 미치는 효과를 검증하였다. 이를 위하여 전국 8개 지역, 61개 중 고등학교에 68개 독서클럽을 조성하고 연구집단을 독서미흡집단, 독서양호집단, 독서혼합집단으로 구분하여 청소년의 자율 협력적 독서실행을 4개월 동안 실시하였다. 독서유효성의 설문지를 제작하여 사전과 사후검사를 실시하고 SPSS 통계 프로그램을 통해 분석하였다. 연구 결과, 청소년들의 독서유효성은 긍정적으로 향상되었으며 독서미흡집단이 가장 효과적인 것으로 나타났다. 또한, 청소년의 독서행동에도 긍정적인 변화가 나타났으며 독서유효성의 변화는 독서행동에 영향을 미치는 것으로 파악되었다. This study was to present a model of cooperative reading practice and verify reading effectiveness on youth. For this purpose, 68 reading clubs were established in 61 districts and 8 high schools. The research groups were classified as the poor reading group, the good reading group, and the mixed-skill reading group. The cooperative reading groups were carried out for four months. We developed a questionnaire on Reading effectiveness conducted it pre- and post-test, and analyzed the results through the SPSS statistical program. We found that there was a positive change in the reading effectiveness of youth and overall-the highest effectiveness was found in the poor reading group. In addition, there was a positive change in the reading behavior of youth. The change of reading effectiveness was found to affect reading behavior.

      • KCI등재

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