軍에서의 횡문근융해증 발생률 및 예방대책에 대한 연구 - 군 병원 진료통계를 중심으로 -

서청수 ( Cheong Soo Seo ),이용운 ( Yong Woon Lee ),김현태 ( Hyun Tae Kim ),이충용 ( Chung Yong Lee ) 국군의무사령부 2013 대한군진의학학술지 Vol.44 No.1

Objective : It is hardly deniable that due to the nature of the military, all personnel are subject to the same training systems regardless of their individual health status, and that such trend in general is prevalent throughout field units and education institutions. In 2012, a recruit in a division died from rhabdomyolysis despite emergency medical treatment at a military hospital, after his symptoms were recognized upon returning from night training. This study was motivated by the lack of research into this subject, where the dangerous circumstances of the current training system may even lead to death of trainees. Methods : The subjects of this study were limited to those who have been hospitalized in hospitals under Armed Forces Medical Command from 2011to 2012. We analyzed the cases of rhabdomyolysis to identify the potential causes and examined the medical records of patients who have been hospitalized for approximately two years to obtain the prevalence rate in the military. In this descriptive study, records of the patients were thoroughly reviewed in order to find any evidence that may reveal the potential cause, including personal or circumstantial factors. Results : Analyzing the general characteristics of the data regarding the prevalence rate of rhabdomyolysis, we found that the private second class (including the BCT trainees) comprised 51.21% out of 123 patients (considering the small size of the group, we only dealt with rates that seemed extraordinary). In terms of the age groups, 74.79% consisted of individuals below 21. In terms of the date of incidence, 84% of the patients were reported from April through September. In terms of the cause, 55.28% of the patients reported corporal punishment as the cause of their disease. In terms of the length of treatment, 97.56% of the patients were treated for less than a month and concluded as mild cases. We also confirmed that more than 55% of all the cases were caused from corporal punishment. Conclusions : Supervisors in the military should recognize the causes and cases of the disease, restrain from training that resemble corporal punishment, and require tailored training and prior exercises.

군 병원 환자경험 개선을 통한 의료혁신 성과에 대한 고찰

서청수 ( Seo Cheong-soo ),김광동 ( Kim Kwang-dong ),한광일 ( Han Kwang-il ),박진영 ( Park Jinyoung ),정연욱 ( Jeong Yeon-wook ),강재현 ( Kang Jae-hyun ) 국군의무사령부 2019 대한군진의학학술지 Vol.50 No.1

Objective; The purpose of this research is to find the right path of military medical innovation by comparing before and after the application of the polices and analyzing the effects of the polices. This research is progressed in accord with 'Project Today', which is for enhancing the outpatients` experience level. Project Today aims 'Providing quality treatment for all Patients who came to the hospital today` so is focused on reducing the number of untreated outpatients and improving patient experience. Method; Primary outcome is the score from patient experience questions of each area(medical officer service, nursing officer service, medical soldier service, process of prescription and treatment, hospital environment, overall evaluation), and was compared before and after the operation of the model project. The questionnaire contains total 8 areas 26 questions, including medical officer service, nursing officer service, medical soldier service, process of prescription and treatment, hospital environment, overall evaluation, individual trait. Results; As a result of patient experience evaluation, medical officer service from 3.12 to 3.33, nursing officer service from 3.17 to 3.19, medical soldier service from 2.67 to 3.11, process of prescription and treatment from 2.79 to 3.01, hospital environment from 3.29 to 3.42, overall evaluation from 5.95 to 6.85 has enhanced. Conclusion; After model implement of the Project Today, both quantitative and qualitative indicators have been enhanced and especially advancement of almost every area of patient experience has been verified. Yet, the whole military hospital scale result is not revealed, and it is to be analyzed in terms of cause and effect, and utilized for further policy development.

軍 국가감염병 전담병원에서의 이동형음압기 성능 기준 개선방안 연구

서청수 ( Cheong Soo Seo ),김영규 ( Young Kyu Kim ),최화영 ( Hwa Young Choi ),최정민 ( Jeong Min Choi ) 국군의무사령부 2021 대한군진의학학술지 Vol.52 No.1

Objective; Although efforts have been made to improve scarce health care resources due to the epidemic of infectious diseases such as MERS-CoV, the massive outbreak of COVID-19 has again recreated the lack of negative pressure isolation ward. The government tried to expand the insufficient negative pressure isolation ward by installing a portable negative pressure unit in the general ward. However, the current installation standards for portable negative pressure unit announced by the health authorities are ineffective due to the insufficient performance standards. Method; In order to improve performance standards of portable negative pressure unit, the official guidelines of government agencies and documents on the performance required by the national technical standards for similar devices such as vacuum cleaners were studied. In addition, a silencer test was conductde once on 112 portable negative pressure unit installed in the negative pressure isolation ward of an acutal infectious disease hospital. Result; As a performance standard improvement measure for portable negative pressure unit, the particle size of the HEPA filter satisfies the filtration efficiency of 99.97% or more at 0.3μm (0.1∼0.2μm recommended), the filter leakage standard is 0.005% or less, and the air volume accuracy is within ±10% needed to be improved. It is recommended that the noise be kept below 50dBA under the condition that the standard differential pressure is satisfied. Conclusion; For portable negative pressure unit used in medical institutions, filter and airflow performance standards are absolutely necessary to prevent secondary infection in hospitals, and noise standards need to be considered for stable patient healing.

의료기관평가가 군병원 의료의 질 향상에 미친 영향 및 성과 조사

박명화 ( Park Myung Hwa ),이선미 ( Lee Sun Mee ),서청수 ( Seo Cheong Soo ) 국군의무사령부 2010 대한군진의학학술지 Vol.41 No.1

Objectives: We aimed at investigating the effects and outcomes of the Hospital Evaluation Programme(HEP) on Military Hospital. Furthermore, we tried to get the basic data and various facts for Quality Improvement activities and Policy-Making. Method: The subject of our study was medical branch officers and military affair staff who were attending to military hospital. And, several consultants who have the experience of Hospital Evaluation Programme(HEP) were also included in this study as a study subjects. We used structured questionnaire which was revised from Han Woo-Seuk's. It was consist of several sub-part, such as 「Recognition/attitude for HEP」, 「Orientation for medical service」, 「Orientation for customer」, 「Satisfaction of hospital staff」, 「Outcomes/effects of operation」. The reliability(Cronbach’s Alpha) of questionnaire was 0.903. And we used SPSS 15.0 analysis programm in other to analyse study outcomes. Results: We got a study results as follows : Firstly, we awared that there was coexisted both positive and negative attitude for HEP. Secondly, there was no change of 'Orientation for medical service' and 'customer'. Thirdly, there was significant difference between the experienced and non-experienced of HEP. And there was co-relation among the all sub-part. Conclusions: We should adopt improvement measure as follows in near future. First of all, we should complement the weak-point of HEP results as soon as possible. And then, enough specialized-staff, facilities and equipment were supplemented. Thirdly, follow-up monitoring affairs should maintained. Fourthly, evaluation-related affairs was maintained in other to prevent single time evaluation effort. Lastly, commander's strong intention is an critical problem. Because the staff's will and HEP result depends on it.