본 연구는 만성질환으로 외래서비스를 이용하는 환자를 대상으로 의 료기관 유형별 의료서비스 이용 경험을 조사하고, 만성질환자의 건강 결과를 실증적으로 비교 분석하여, 만성질환 관리의 효과적인 중재방안 마련에 기초자료를 제공하고자 시도되었다. 본 연구의 자료수집은 2023년 7월 1일부터 7월 31일까지 고혈압과 당뇨병 진단으로 보건소 와 의원, 종합병원의 외래서비스를 이용하고 있는 대상자 167명에게 면담을 통한 구조화된 설문지를 작성하여 자료를 수집하였고, 수집된 자료는 SPSS 통계프로그램을 이용하여 분석하였다. 연구 결과 고령의 취약계층은 의료기관 중 의원을 가장 많이 이용하고 있었고, 의료기관 유형별 이용경험의 결과는 의원이 가장 부정적이었다. 그러나 만성질환 관련 건강 결과는 의료기관 유형별로 유의한 차이가 없었다. 그러므로 보건소는 특히 취약계층 환자들의 보건의료 요구를 중시하고 공공보건 서비스를 효율적으로 제공해야 하며, 의원의 만성질환 관리 역량의 강 화를 위한 다양한 중재 방안 마련과 함께 국가 시범사업의 적극적 참 여를 유도할 수 있는 정책이 수립되어야 할 것이다.

Purpose: The purpose of this study is to explore the turnover experience of nurses who moved from a tertiary medical institution to a general hospital and to understand the meaning of the move for them. Methods: This is a phenomenological qualitative study using Colaizzi's (1978) method. Semi-structured, open-ended questions and in-depth interviews were conducted to 11 nurses within 3 years after turnover to a general hospital at a tertiary medical institution, between April, 2018 to September, 2018. Results: The four theme clusters and thirteen themes emerged. The core theme licited I was “the journey to find-balance and leave.” Four theme clusters were; “advance to a dream job”, including ‘expectation for my work’, ‘my confidence and family pride’, “unstable my dream job” including ‘stand alone in a desert’, ‘crushed by extra work’, ‘torn protection’, ‘invisible future’, “my job that I wish to keep” including ‘unconditional patience for growth’, “I can't be a loser” is desperate selfinspiration’, ‘leaning on comfort and support', and finally “my place I found again.” including ‘being prepared to be by my side’, ‘restoring work-life balance’, ‘revealed my existence’, and ‘unsatisfied with new work’. Conclusion: Participants choose of turnover for physical and psychological well-being, instead of the romance of the tertiary medical institution. This showed the characteristics of the millennial generation that values the comfort and relaxation in one's life prior to professional vision of nursing care as a nurse, and success. The result is meaningful as an understanding of effective job management for current-generation clinical nurses.

The effective use of disinfection and sterilization is important in preventing healthcare associated infections. Especially, multi-drug resistant organism and spore-forming bacteria are serious pathogens. Therefore, control of a nosocomial infection is emerging as a big problem. It is efficiently necessary to eliminate the pathogen. In this study, the components of sterilant were optimized. The optimized sterilant was applied for efficiency of sterilization using G. stearothermophilus E. coli, S. aureus as a standard microorganism. Our results were shown as follows : The decomposition or loss of potency of sterilant in small containers did not appeared for one month at ambient temperature. All of hydrogen peroxide 0.5%, peracetic acid 0.01%, and IPA 60% was effective for sterilization of E. coli, S. aureus using dilution method. Two kinds of sterilants(hydrogen peroxide 2%+peracetic acid 0.1%+IPA 0.5%, hydrogen peroxide 4%+peracetic acid 0.06%+IPA 1%) were bacteriocidal(> 6 log reduction). Microorganisms(E. coli, S. aureus) which treated with these sterilants for 2min were not grown in LB broth at 7 days culture. The gas plasma system for sterilization was applied. The sterilant solution(hydrogen peroxide 20%+IPA 5%) was vaporized in the sterilization chamber. The vaporized sterilant was bacteriocidal and sporocidal(> 6 log reduction) using G. stearothermophilus E. coli, S. aureus as biological indicators

The purpuse of this study is to find factors on the recognition by people involved in occupational safety and health of KOSHA 18001, the need of KOSHA 18001 certification, and the compliance by each medical institution with KOSHA 18001 review standards to help medical institutions introduce and use OSHMS. There was a survey of people involved in occupational safety and health at 300 local general hospitals with 100 or more beds that were registered with the Korean Hospital Association in 2012. The survey included the recognition of KOSHA 18001, the need of certification and the compliance by medical institutions of the occupational safety and health. A total of 132 people responded, of which an analysis of 126 cases was conducted except 6 cases poor in information.

환자가 받는 선량이 증가함에 의해 위해도가 증가한다. 이에 본 연구는 2009년 8월부터 2010년 9월까지 서울 및 경인지역의 영상의학과의원을 대상으로 환자피폭선량을 분석하였다. 두개골 전후방향검사에서 환자피폭선량은 영상의 학과의원 1.75mGy, 영국 3.00mGy, 일본 3.00mGy, 독일 5.00mGy로 영상의학과의원이 낮게 측정되었고. 두개골 측방 향검사에서 환자피폭선량은 영상의학과의원 1.49mGy, 3차 의료기관 1.50mGy로 영상의학과의원이 낮게 측정되었고 IAEA의 권고 선량인 3.00mGy 보다 낮게 측정되었다. 본 연구 결과를 바탕으로 환자의 의료피폭 저감화를 위해 국제 기구 권고안을 준수하고, 방사선의 효율적인 방호의 최적화와 의료방사선 피폭의 저감화가 필요할 것으로 사료된다.