Recently there is a growing interest in the airborne spread of virus. In particular, there is growing interest in secondary infection through the air in the hospital. The distribution of air-born virus depends on ventilation system installed in a hospital. In this study, simulations were carried out to predict the move of air-born virus by ventilation system at hospital. Simulation results showed that pressure distribution was –372.05Pa ∼ -3.45 Pa at 1st floor incase of only used mechanical exhaust at bathroom, shower stall , storage, kitchen etc.. if ventilation switch from used mechanical exhaust to mechanical exhaust & mechanical supply. Simulation results showed that pressure distribution was -336.44Pa at stair hall < -0.2Pa at bathroom < mean 1.19Pa at other room. So simulation results showed that using all of the mechanical supply and mechanical exhaust was more effective then the mechanical exhaust for maintain the pressure distribution in hospital. It was also showed that when using the mechanical supply and mechanical exhaust more effectively prevention of air born virus diffusion.

배경/목적: 병원내 감염증에 있어 항생제의 선택은 지역 사회 획득 질환과는 차별화되어야 한다. 급성 담낭염은 노인 에서 호발하는 질환으로서 초기 치료에 있어 항생제의 역할이 매우 중요한데, 일반적으로 노인 환자는 내성의 가능성이 높은 것으로 알려져 있다. 또한 동반 질환이 흔해 경우에 따라서는 선택적 치료인 담낭절제술의 시행이 쉽지 않을 수도 있다. 본 연구에서는 노인 환자에서 입원 중 발생한 급성 담낭염의 임상 경과에 대해 살펴보고, 일반적인 치료 원칙이 통용 될 수 있는지 살펴보고자 하였다. 방법: 2006년 3월부터 2015년 2월 사이에 급성 담낭염으로 진단된 환자들에 대해 후향적 의무기록 분석을 시행하였다. 여타 질환으로 입원 중 급성 담낭염이 발생한 경우를 병원군으로 정의하였고, 응급실로 내원한 환자를 대상으로 연령 및 성별에 대하여 1:2 대응한 대조군을 구성하였다. 결과: 40명의 병원군과 80명의 대조군 사이의 임상 경과를 비교하였다. 기초적 특성에 있어 병원군에서 만성 동반 질환 이 더 흔하였던 것 이외의 차이는 없었다. 병원군의 경우 상태의 악화로 인하여 초기 경험적 항생제를 교체해야 하였던 경우가 더 많았다(20.0% vs. 2.5%, p < 0.01). 회복까지의 기간도 병원군이 더 오래 소요되었다(23.3 ± 5.6 days vs. 10.1 ± 0.7 days, p = 0.02). 또한 병원군에서 조기 담낭절제술의 시행이 적었던 반면(7.5% vs. 40.0%, p < 0.01), 개복 전환은 흔하였다 (20.0% vs. 6.3%, p = 0.02). 결론: 노인 환자에서 입원 중 발생한 급성 담낭염의 경우에 는 항생제 치료 및 수술에 대한 일반적인 치료 원칙의 적용이 어려울 수 있으므로, 주의하여 접근하여야 한다.

Pigs have been extensively used as mediators of xenotransplantation research. Specifically, the Massachusetts General Hospital (MGH) miniature pig was developed to fix major histocompatibility antigens for use in xenotransplantation studies. We generated transgenic pigs for xenotransplantation using MGH pigs. However, it has not been studied yet whether these pigs show similarity of reproductive physiological characteristics to wild types of MGH miniature pig. In this study we analyzed the estrous cycles and pregnancy characteristics of wild type (WT) and transgenic MGH miniature pigs, which were α1,3-galactosyltransferase (GalT) heterozygous and homozygous knock-out, and membrane cofactor protein (MCP) inserted in its locus, GalT-MCP/+ and GalT-MCP/-MCP pigs. Estrous cycles of WT, GalT-MCP/+ and GalT-MCP/-MCP pigs were 20.9±0.74, 20.1±1.26, and 17.3±0.87 days, respectively, and periods of estrous were 3.2±0.10, 3.1±0.12, and 3.1±0.11 days. The periods of gestation of WT, GalT-MCP/+ and GalT-MCP/-MCP pigs were 114.2±0.37, 113.3±0.67, and 115.4±0.51 days, respectively. Litter sizes of WT, GalT-MCP/+ and GalT-MCP/-MCP pigs were 4.8±0.35, 4.8±1.11 and 3.0±0.32 respectively. There were no significant differences on estrous cycle, periods of estrous and gestation, and litter size among WT, GalT-MCP/+ and GalT-MCP/-MCP pigs, meaning that GalT knock-out and additional expression MCP of the MGH miniature pig did not effect on reproduction traits. These results provide relevant information to establish breeding system for MGH transgenic pig, and for propagation of GalT-MCP/-MCP pig to supply for xenotransplantation research.

The building which are essential for disaster recovery is classified as a special seismic use group. Especially, achievement of seismic performance is very important for the hospital, so the hospital should be able to maintain its function during and right after an earthquake without significant damage on both structural and non-structural elements. Therefore, this study aimed at checking the seismic performance of a hospital building, but which was limited to structural elements. For the goal, a plan with a configuration of general hospitals in Korea was selected and designed by two different seismic-force-resisting systems. In analytical modeling, the shear behavior of the wall was represented by three inelastic properties as well as elastic. Nonlinear dynamic analyses were conducted to evaluate the performance of structural members. The result showed that the performance of shear walls in the hospital buildings was not satisfied regardless of the seismic-force-resisting systems, while the demands on the beams and columns did not exceed the capacities. This is the result of only considering the shear of the wall as the force-controlled action. When the shear of the wall was modeled as inelastic, the walls were yielded in shear, and as the result, the demands for frames were increased. However, the increase did not exceed the capacities of the frames members. Consequently, since the performance of walls is significant to determine the seismic performance of a hospital building, it will be essential to establish a definite method of modeling shear behavior of walls and judging their performance.

Hospital costing has generally been using ABC costing method. However, based on increase of expensive equipment, the fixed cost is increased in the hospital industry. The most common equipment industry are using building block costing method for depreciation and equipment management costing elements. Additionally it presents three options that may be considered to be supported by the IT system to find the most appropriate alternative.

Secure operation of hospitals during and right after earthquake is essential. Past lessons from earthquake damages have shown that most of the injured and the death occurred within 30 minutes after earthquake and the portion of nonstructural damage has become significant. However, hospital buildings in Korea have not prepared fully to address such rising issues. This paper is to study what type of damage patterns are related to hospital buildings and how to develop a preparedness plan to keep hospitals operational at all earthquakes if possible. This paper first reviews on past earthquake damages reported as critical to hospital buildings while classifying them into four groups: (1) structural element; (2) architectural-nostructural element; (3) medical equipments and contents; and (4) utility facility. Upon such classification, some detailed concerns can be specified under each group explicitly. Then a hierarchy for hospital building is also developed for the classified groups, which enables us to identify required things for the enhancement of seismic performance of hospital building that consists of heterogeneous elements. To upgrade the level of seismic performance for existing hospital buildings, the concept of performance-based approach can be adopted to address the heterogeneous problems in a systematic and stepwise manner. Finally a conceptual framework for the seismic risk assessment for hospital building is proposed toward the seismic enhancement of hospital buildings using performance-based approach.

이 논문은 생태적 자아 개념에 비추어 루이자 메이 올코트의 『병원 스케치』 에 드러나는 생태적 삶의 양식을 고찰하기 위한 시도이다. 이 연구는 생태적 자 아의 특징으로 관계를 중시하는 자아, 공동체를 위해 자신을 끊임없이 재구성하 며 변화하는 자아, 그리고 타인과 공동체를 책임지는 자아를 상정한다. 엠마누 엘 레비나스는 우리의 자아가 고정불변의 주어진 실체가 아니라 관계 속에서 타인이 우리에게 요구하는 과제에 응답해가며 성숙해가는 과정의 산물이라고 본다. 레비나스의 자아에 대한 관점은 생태적 공동체로 이끄는 태도를 만들어낸 다. 올코트의 『병원 스케치』 에 등장하는 트립 간호사는 남성처럼 전쟁에 참여 하고자 간호사를 지망하지만 환자들과의 소통과정에서 성구분을 넘어 타인의 아픔에 응답하며 자신을 헌신하는 변화를 보인다. 환자들 역시 병원 공동체를 위해 관계에 집중하고 자신의 관점을 변화시키며 타인의 호소에 따르고자 한다. 작품 속에서 드러나는 간호사와 부상병의 상호작용은 서로의 생명을 책임지기 위해 관계망 속에서 부단히 타인에 집중하는 생태적 관계, 나아가 생태적 공동 체를 만들어 낸다.

Currently many geriatric hospitals have been built in Korea because younger people don’t want to care their parents and have been decreasing for labor. However, the increasing geriatric hospitals make the increasing fire safety accidents. Therefore, this study is conducted by survey and face-to-face talk for analyzing fire safety problem of twelve among 15 geriatric hospitals in the north of Chung-Buk area. The result of this study is that infection and fall accident are higher than others and fire safety implement rate of safety rule followed by CEO is 71%. Monthly safety training rate is 49% and initial fire safety training not conducted is 33%. Yearly outside fire safety training rate is 97% but workers who know how to use fire evacuation facility are 61%. Furthermore, safety instruction rate of fire safety manager is much higher than supervisor’s safety instruction. The cause of accident is facility (33%). In conclusion, the institution and rule improvement need for decreasing infection and falling, increasing implement level of fire safety rule and fire safety training, participation rate of supervisor for fire safety, quality of fire safety training, and investment of fire safety facility.

Floor slipperiness is a leading cause in slip and fall accidents which are a major source of occupational injuries in Korea. Researchers have estimated the slip and fall related accidents rank number one or two in number of the injured. The objectives of this study were to find the field contamination effect and improvement countermeasure. Slipping and falling are common accidents in large public facilities, especially facility which vulnerable adults generally use as like hospital. So, we measured the coefficient of friction of several floors on the floor in hospital, under dry and wet using BOT-3000. The results of the coefficient of friction measurements showed that floor type and surface conditions were all significant factors affecting the coefficient of friction. The most surprising finding of this study was that there were significant friction improvement when the floors were properly cleaned with cleaning equipments

As contemporary society has become more complicated, specialized, and segmented, people are experiencing more diverse types of stress. In particular, while several factors associated with job stress have been examined among nurses, who belong to a professional group, the existing research has made no quantitative assessments of stress that reflect temporal differences in individuals. Therefore, the aim of this study is to understand the effects of job stress on alpha-amylase with regard to the working hours of nurses, to assess the variations in jobs stress over time, and provide basic data to improve the quality of nursing services. Ninety nurses working in three shifts in general, emergency, and intensive care wards of a university hospital in D City participated in this study. Salivary alpha-amylase (SAA) was extracted and analyzed at two-hour intervals from 07:00 to 15:00 from nurses on the day shift and from 23:00 to 07:00 from those working the night shift. The SAA level was highest between 23:00 and 01:00 for nurses in general wards (mean±S.D. 39.00±14.88) and between 11:00 and 13:00 for those in both intensive care units and emergency wards (mean ± S.D. 67.50 ± 62.93 and mean ± S.D. 39.67±35.96, respectively). The characteristic variation in SAA was significant between 23:00 and 01:00 (p < 0.01) and for those in their fifties or older (p < 0.01). The activation ratio of alpha-amylase, a stress reactant, showed an increase when the sympathetic nervous system was activated by mental stress; in addition, job stress was manifested with the effect of awakening at different time segments and at different ages among the nurses. With the aim of raising the level of service based on the nurses maintaining their mental health, it is necessary to focus sharply on the time segment for critical control and to conduct repetitive studies to determine the divisions of eustress critical values as well as to expand the population.

Purpose: The purpose of this study was understanding of real experiences of the subjects taking anti-psychotics medication. Methods: The subjects of this study were 14 mentally ill patients hospitalized in C National Hospital. The interview data were analyzed with ethnography researchmethod. Results: 26 themes were drawn, and they were categorized into 5 categories. The 1st category was the stage not to acknowledge themselves as mentally ill patients, as mentally ill patients were forced to be hospitalized in the mental hospital by their family, when their mental illness developed. The second category was the stage to endure difficulties while taking medication. The third category was the stage to experience recurrence of disease. The fourth category is the stage to experience improvement of mental illness with medication. The fifth category is the stage to reflect thembecause of the improvement of mental illness, and to express confidence and will about medication after being discharged from the hospital. Conclusion:Nurses actually have to provide total care bymaking thementally ill patients feel comfortable not to have resistance about medication, when they are hospitalized, closely observing medication actions and side effects, and sharing difficulties felt by the patients.

The maxillofacial region is susceptible to damage because facial bone is prominent. The aim of this study is to evaluate the incidence, etiology, seasonal distribution, and patterns of maxillofacial injuries and investigate the percentage of bone fractures on CT scans by patient’s gender and age. Electronic medical records of 1,483 patients who had maxillofacial injuries and visited the Emergency Medical Center of Chonnam National Hospital were evaluated. Age, gender, etiology, seasonal occurrence, frequency of fracture, and the pattern of bone fracture were analyzed by using IBM SPSS Statistics 21 (SPSS Inc., Chicago, IL, USA). Male to female ratio was 2.82:1. The most common causes of injury were falls or collisions (male 40.09%, female 48.2%), followed by traffic accidents and violence. The number of injuries related to sporting accidents, assult, and industrial accidents was higher in male patients than that of female patients. With regard to the seasonal occurrence, 434 cases (29.26%) occurred in the summer, while 306 cases (20.63%) occurred in the winter. In this study, 946 patients (63.79%) were identified to have facture and 537 patients (36.21%) were found to be without fracture on CT scans. The orbital bone (41.38%) was the most commonly fractured in the mid facial structures. The most common fracture site in the mandible was the body of the mandible (23.13%). The patterns of maxillofacial injuries were various based on gender, age, cause of injury, and season.

The purpose of this study was to identify correlations among the continence function, cognitive function, and activities of daily living(ADL) in elderly male patients with dementia in geriatric hospitals. The subjects were 64 patients aged 65 or above who were diagnosed with dementia among the hospitalized male patients in a geriatric hospital. For the subjects' cognitive function, a questionnaire developed for the Korean Mini Mental Status Examination(K-MMSE) was used. For the continence function and ADL, data were collected using a patient evaluation table. As a result, a lower level of cognitive function resulted in corresponding higher levels of dependence in all items of ADL except bathing(p<.05), and a lower level of cognitive function led to corresponding declines in the continence function(bowel control, bladder control)(p<.01). In addition, a higher level of dependence in ADL resulted in corresponding higher levels of difficulty in bowel and bladder control(p<.01). This study showed correlations among the cognitive function, ADL, and continence function of elderly men with dementia. The results of this study may be used as basic data for the management and treatment of hospitalized elderly male patients with dementia in geriatric hospitals.

Main purpose of this study is to provide some basic data necessary to research, education, and policy to cultivate professional talents, by investigating what competencies needed to hospital administrative staffs and managers in performing their jobs in the global age. A survey was conducted through self-administered questionnaires for hospital administrative staffs and managers including first-line hands-on workers who were working in 77 hospitals located in Busan, Keongnam, Ulsan areas in South Korea. Major results are as follows: (a) The analysis for the competencies needed to hospital administrative staffs and managers in order to perform successfully their jobs revealed that interpersonal competency, knowledge of management skills in healthcare field, understanding ability for healthcare, in that order of importance, had significant influence on performing their jobs. (b) Regarding the analysis for the detailed competencies necessary to hospital administrative staffs and managers in order to perform successfully their jobs revealed that problem-solving ability, sense of responsibility, positive attitude, leadership, in that order of importance, had significant influence on performing them. This study suggests that universities opened courses related to health care management should newly open a subject 'problem-solving ability in health care' to link with health care field and their curriculums are necessary to change over to practice-oriented curriculum system.

Generally a patient who was injected radiopharmaceuticals for nuclear medicine examination is not an object of isolation. Therefore, when the patient uses toilet, we expect surface contamination of a toilet by radioisotope. The measured value is 25.69Bq/cm2(a restroom near admission and administration), 19.39Bq/cm2(a toilet near department of radiology). The study shows that 9 of 24 locations in controlled area exceed over surface contamination limit. From now on, we should find source of contamination through measurement radioactive nuclide to apply radiation safety management.

The health care markets are rapidly expanded due to population aging, increasing incomes, strengthening assurance of health insurance and so on, and the competition in the markets is getting serious. In the industry, hospitals have played more important role than any others, where doctors, nurses, medical technicians, administrative staff, etc cooperatively works hard. Among them, nurses capture 40 percents of specialized hospital workers and their role for patients as customers is essential. Therefore, it could be one of the most important keys to increase the productivity and wellbeing of nurses with respect to enhancing efficiency and competitiveness of operating hospitals. In this paper the impact of nurses' job satisfaction, job stress, burnout, and organizational citizenship behavior on their productivity is studied. The subjects were 576 nurses in 20 different hospitals in Seoul, Kyounggi, etc. We held hypotheses and statistically tested and analysed them, using SPSS 20.0 software. Thus, we found various significant results(p<0.05), and they will give useful suggestions for managing nurse manpower and enhancing their productivity.

◉ 목적 : 국내에 운영되고 있는 정신건강의학과 병원학교의 현황을 파악하고 정신건강의학과 병원학교를 다니는 건강장애학생의 학업 참여와 주관적 만족도 조사를 통해 정신건강의학과 병원학교에 대한 작업치료사의 인식을 높이고, 이들을 위해 작업치료사가 제공할 수 있는 서비스에 대해 생각해보고자 한다. ◉ 연구방법 : 국내 6개의 병원학교 중 연구에 동의한 2개의 정신건강의학과 병원학교의 교사 2명과 입교중인 정신건강장애학생 29명을 대상으로 2014년 4월 28일부터 동년 7월 10일까지 설문조사를 실시하였다. 연구대상자의 일반적인 특성 및 병원학교 현황을 빈도 분석하였고, 정신건강의학과 병원학교 학생의 수업참여와 병원학교 이용 만족도를 비교분석하였다. ◉ 결과 : 연구결과 정신건강의학과 병원학교 학생의 연령은 평균 15.41세(±2.16)이며 진단명은 지적장애(37.9%), 주요우울장애(24.1%), 품행장애(17.2%) 순이었다. 교사 평가에 의한 학생들의 전반적인 병원학교 생활에서 선생님과의 관계가 3.79점(±0.82)으로 가장 높은 점수를 보였고, 친구들과의 관계가 3.24점(±0.99)으로 가장 낮은 점수를 보였다. 학생이 평가한 병원학교의 전반적 만족도는 재량활동 4.24점(±0.83), 병원환경이 4.24점(±0.94)으로 높고 주요 교과목은 3.48점(±1.37)으로 가장 낮았다. 학생의 전반적인 병원학교 생활과 만족도는 시설물 배치편리에 대한 모든 하위항목과 선생님의 노력, 수업시간의 미래도움도, 선생님의 공평성, 수업시간 기대에 대한 대부분의 하위항목에서 유의한 정적상관을 보였다. ◉ 결론 : 본 연구를 통해 정신건강의학과 병원학교 학생들은 선생님과의 관계가 좋을수록 수업참여를 더 잘하고, 재량활동시간과 병원환경에 대해 가장 만족하고 있음을 확인하였다. 그러나 현재 국내에서 이러한 서비스를 받는 정신건강장애학생 수는 제한되어 있고 정신건강에 대한 폭넓은 이해에 기초한 커리큘럼이 정비되어 있지 않기 때문에 향후 다각적이고 체계적인 접근이 요구된다.

Purpose: The purpose of this study is to analyze the level of satisfaction and clinical competence on simulation-based practice in woman’s hospital and to figure out the factors that level of satisfaction affect to clinical competence. Method The subjects in the experimental group were 93 students who did simulation-based practice and subjects in the control group were 70 students who practiced in woman’s hospital. Data was analyzed using ex post factor experimentation during second semester in 2013. Results: There was statistically no significant difference between the two groups, but positive correlation between the main variables. The most significant affecting factors to clinical competence in experimental group were satisfaction of contents and duration(R2=.24). The most significant affecting factors to clinical competence in control group were satisfaction of evaluation and practice stressor (R2=.32). Conclusion Since there was no difference between the two groups, once the difficult part in clinical practice of maternity nursing is practiced repeatedly, student’s competence can be improved. Hence the continual study was required.

병원원가란 병원에서 진료, 수술, 교육 및 연구에 소비된 재화와 용역의 가치를 화 폐액으로 표시한 것으로 원가정보는 원가항목별로 표시되어 관리자와 경영자에게 제 공되어야 한다. 이러한 병원원가는 예산수립, 투자의사 결정 및 성과평가 등 내부 경 영관리를 위한 목적으로 유용한 정보를 제공해야 하고 외부적으로는 적절한 의료수가 결정의 기초자료로 활용될 수 있다. 그러나, 우리나라의 주요 병원에서 운영 중인 ABC 원가계산 방법은 병원원가 계산 의 거의 유일한 원가계산 방법 인정받고 있으며, 효과성이 우수함에도 불구하고 원가 계산 결과에 대한 신뢰성의 저하와 운영비용의 증가 등으로 인하여 활용도가 저조해 지고 경우에 따라서 폐기되는 사례도 발생하고 있다. 따라서 최근 병원에서 발생되는 비용의 구체적 특성과 병원의료 환경이 설비 의존형으로 변화됨에 따라 간접비가 증 가하고 있는 경영환경의 변화를 이해하여, 병원 원가계산 시스템의 발전적인 새로운 방식이 모색되어야 한다. 대안 중의 하나로 대표적인 장치산업의 하나인 통신업에서 사용되는 Building Block Costing 방식에 대한 적용 방식을 소개하고자 한다. Building Block Costing은 감가 상각비로 대표되는 자산관련 간접비와 설비와 시설 운영에 소요되는 인건비, 경비 등 의 비용을 ABC원가계산 방식과는 차별화된 원가계산 방식이다.