• Quality Improvement in Health Care
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• v.18 no.1
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• pp.79-87
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• 2012

문제: 투약오류는 의료기관 전반에서 가장 많이 발생하는 오류의 하나이며, 환자에게 중대한 위해를 초래하기도 한다. 특히 고농축전해질은 문제발생의 가능성과 위험성이 높아 지속적인 관리 및 교육을 필요로 하고 있다. 목적: 발생한 투약오류 건에 대한 근본원인분석을 시행함으로써 유사사례가 발생하는 것을 예방하여 환자안전을 도모하고자 한다. 의료기관: 연세대학교 세브란스병원 질 향상 활동: 투약오류 건에 대해 근본원인분석 시행 후 고위험약물 관련 내규를 보완하였고, 고위험약물에 대한 Alert System 개발, 고위험약물 라벨 부착, 약 처방 관련 의료진 교육을 시행하였다. 개선효과: 고위험약물 투여와 관련된 시스템 개선 활동 이후 유사사례는 발생하지 않았고, 의료진 교육을 통하여 환자안전에 대한 인식과 중요성을 더욱 증가시켰다.

• The Journal of the Convergence on Culture Technology
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• v.10 no.3
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• pp.625-633
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• 2024

This study was attempted to identify the perception and experience of hospital nurses on medication errors of high-risk intravenous drugs, and to identify the causes of medication errors and ways to improve them. The subjects of the study were nurses with work experience related to high-risk intravenous administration working at a university hospital located in D City, and data were collected between May 16 ~ 30, 2021. As a result of the study, six key factors were identified as the key factors in the safety of high-risk intravenous injections: the lack of a protocol for the administration of major drugs in each ward, the lack of training in the operation of the injection machine, the lack of standardized procedures for administering high-risk intravenous injections, the lack of individualized medication training for nurses, the lack or lack of the hospital's own drug list, and the lack of identification of drugs packaged in similar containers. At the nursing practice level, it is proposed to apply a high-risk intravenous medication safety program and conduct a future study to identify safety outcome indicators.

• Journal of Korean Critical Care Nursing
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• v.8 no.1
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• pp.1-10
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• 2015

This study was conducted to examine the relationship among the error risk of high-alert medication, attitudes to single-person checking of medication, and medication safety activities. The participants were 60 nurses working in the intensive care unit. Data were analyzed using descriptive analysis, t-test, analysis of variance, and Pearson's correlation coefficient. The mean scores of the knowledge and certainty of high-alert medication were $0.71{\pm}0.11$ and $2.74{\pm}0.59$, respectively. The mean score of the error risk of high-alert medication was $1.63{\pm}0.24$ and that of attitudes to single checking medication was $3.32{\pm}0.49$. The error risk of high-alert medication had a positive correlation with nurses' attitudes to single checking medication (r = .258, p = .047), which is correlated with the scores for certainty of knowledge (r = .284, p = .028). Based on the results of this study, continuing education for high-alert medication and the development of an accurate protocol for single checking medication are needed to improve the stability of high-alert medication.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.15 no.3
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• pp.1650-1662
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• 2014

This study aimed to develop smartphone application contents for the medication reconciliation of high-alert medications and to evaluate the satisfaction for this application. The xcode 4.5 and ios 6.1 SDK(software development kit) were used for constructing screen of the system. After implementation during 4 weeks, thirty five ICU(Intensive Care Unit) nurses were asked function related, contents related, and usage related satisfaction using 12 items. And differences of satisfaction according to the number of daily use and the frequency of use were evaluated. Data were analyzed using descriptive analysis, ANOVA with the SPSS 18.0. We developed the formula for drug dosage calculation, the alarming procedure, and the information of the high alert medication. In the satisfaction items, the mean score of 'This application is helpful to perform drug dosage calculation' was 3.14. However, 'I satisfy this application' was relatively low as 2.94. There were no differences in satisfaction according to the daily use and frequency of use. Based on the results of this study, more advanced smartphone application for medication reconciliation of high-alert medications will provide an important platform for patient safety.

• Journal of Korean Critical Care Nursing
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• v.15 no.2
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• pp.1-13
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• 2022

Purpose : The study aimed to identify relationship among intensive care unit (ICU) nurses' critical thinking disposition, medication error risk level of high-alert medication, and medication safety competency, as well as the factors affecting medication safety competency. Methods : The participants were 266 ICU nurses of one higher-tier general hospital and one general hospital in Province. The data were collected using structured self-administered questionnaire from August 10 to August 31, 2021. Measurements included the critical thinking disposition questionnaire, nurses's knowledge of high-alert medication questionnaire, the medication safety competency scale. Data were analyzed using hierarchical multiple regressions using SPSS/WIN 28.0. Results : In the multiple regression analysis, the medication safety competence has a statistically significant correlation with the working department, the critical thinking disposition, and medication error risk level of high-alert medication. Conclusion : Based on the results of this study, it is suggested to develop and apply an educational strategy that can strengthen the knowledge and skills of critical thinking disposition and medication error risk level of high-alert medication to improve the ICU nurse's medication safety competency.

• Korean Journal of Childcare and Education
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• v.1 no.1
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• pp.83-101
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• 2005

The present study applied Bayley Scales of Infant Development to Infants with High Risk to investigate the effects of determinants such as variables related to demographic variable, prenatal and perinatal and postpartal environments, and developmental indices in infancy. First, mental and motor development index were high in infants whose mothers had high in education, mothers had not had a disease during the pregnancy, mothers had not taken medicine during the pregnancy. Second, mental and motor development index were high in infants who had used an oxygen inhaler, incubator, and in infants who had been given a timely birth. Third, mental and motor development index were higher in infants whose mumbling and the initial speaking was normal than in infants whose development was late.

• Sleep Medicine and Psychophysiology
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• v.22 no.2
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• pp.57-63
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• 2015

Background and Objectives: Internet addiction is an increasing problem in Korea. The previous studies in this area have targeted adolescents and young adults. This study was conducted to examine the risk of internet addiction in Korean adults and the effect of internet addiction on circadian rhythm. Materials and Methods: For this study, 508 subjects were chosen through population proportional sampling to represent the adult population in Korea, 325 of whom were included based on the Alcohol Use Disorder Identification Test-Korea (Audit-K), Zung's Self-Rating Depression Scale (SDS), drug use in the past year, and suicide attempts. In these subjects, sociodemographic factors including age, gender, and residential area were analyzed, and Young's Internet Addiction Scale (IAS), Morningness-Eveningness Questionnaire (MEQ), and an online survey examining sleep onset time on weekdays and weekends, wake-up time, and caffeinated drink intake were executed. Results: Of the 325 subjects, 136 (41.8%) belonged to a high-risk internet addiction group ($IAS{\geq}40$), and 189 (58.2%) belonged to a normal group (IAS < 40). There was a high proportion of male subjects (p = 0.03) in the high-risk group compared to the normal group. There was a high proportion of younger subjects (p = 0.055) in the high-risk group compared to the normal group, but this difference was not statistically significant. Compared to the normal group, there was a high proportion of the evening type ($MEQ{\leq}41$) in the high-risk group (p = 0.024), who also showed a high proportion of caffeinated drink intake (p < 0.001). Also, the high-risk group was found to go to bed and wake up late, but there was no statistically significant difference with the normal group. Conclusion: This study showed that many adults have a high-risk of internet addiction, and there was a significant correlation between internet addiction and sleep in adult, as has been found in adolescents and early adults. In the future, a longitudinal study will be needed to verify the causal relationship between internet addiction and morningness-eveningness.

• The Korean Journal of Gastroenterology
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• v.72 no.5
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• pp.271-273
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• 2018

내시경 시술 전 일시적으로 항응고제를 중단하는 것은 위장관 출혈의 위험과 혈전색전증의 위험 사이에 적절한 균형을 잡기 어렵기 때문에 논란의 여지가 많다. 와파린은 새로운 경구용 항응고제(direct oral anticoagulant agent, DOAC)보다 임상의에게 더 친숙하고, 효과를 쉽고 빠르게 전환시킬 수 있다는 장점이 있지만 복잡한 약역동학 특징과 좁은 치료적 범위 때문에 관리가 어렵다. 반면, DOAC는 약물의 모니터링 및 용량 조절 없이 정해진 용량으로 처방이 가능하며, 빠르게 작용하고, 반감기가 짧아 관리가 쉽지만 해독제가 없다는 단점이 있다. 이전 연구들에서 DOAC를 복용한 환자들은 와파린을 복용한 환자들보다 시술과 관련되지 않은 위장관 출혈의 위험이 높았다고 보고한 바 있다. 하지만 시술과 관련된 위장관 출혈 위험에 대하여는 알려진 바가 없는 실정이다. 미국이나 유럽 내시경 가이드라인들에서는 저위험 내시경 시술을 받는 환자들에서는 와파린과 DOAC를 유지하도록 권고하고 있으며, 고위험 시술의 경우에는 와파린를 사용하는 환자들에서 헤파린 교량 요법(heparin bridging)을 시행하도록 권고하고 있다. 임상적으로 DOAC를 사용하는 환자들 또한 혈전색전증을 예방하기 위하여 헤파린 교량 요법을 시행해볼 수 있는데, 와파린 및 DOAC의 헤파린 교량 요법과 관련된 출혈 및 혈전색전증 위험의 차이 또한 명확하지 않다. 따라서 저자들은 1) 와파린과 DOAC 치료를 받는 환자들에서의 출혈, 혈전색전증 및 사망의 위험을 비교하고자 하였으며, 2) 13종류의 고위험 내시경 시술 중에서 시술별 위험을 비교하고, 3) 헤파린 교량 요법이 합병증의 발생을 증가시키지 않는지 확인하고자 본 연구를 진행하였다. 일본 대규모 국가 입원 환자 데이터베이스를 이용하여 2014년 4월부터 2015년 5월까지 시술 전 와파린 또는 DOAC(rivaroxaban, apixaban, dabigatran, edoxaban)를 복용하고, 13종류의 고위험 내시경 시술을 시행받은 20세 이상의 성인 환자 총 16,977명을 확인하였다. 고위험 시술은 용종 절제술, 내시경 점막절제술, 내시경 점막하박리술, 협착 부위의 풍선확장술, 내시경 지혈술, 내시경 정맥결찰술, 내시경 주사 경화요법, 내시경 괄약근절개술, 내시경 초음파 유도하 미세침 흡인 검사, 경피적 위루술을 포함하였다. 일대일 성향 점수 매칭 분석(propensity score matching, 나이, 성별, 체질량 지수, 기저 질환, 병원의 규모, 시술의 종류, 약물의 종류를 매칭)을 시행하여 와파린군과 DOAC군에서 시술 위장관 출혈 및 혈전색전증, 사망의 발생을 비교하였다. 또한 경구항혈전제와 헤파린 교량 치료 시행 유무에 따라, DOAC 단독군, 와파린 단독군, DOAC와 헤파린 교량 요법군, 와파린과 헤파린 교량요법군으로 나누어, 하위군(subgroup) 분석을 시행하였다. 5,046쌍이 성향 점수 매칭 분석에 포함되었으며, 와파린군에서 DOAC군보다 통계적으로 의미 있게 위장관 출혈의 비율이 높았다(12.0% vs. 9.9% p=0.02). 혈전색전증 발생률(5.4% vs. 4.7%)과 입원중 사망률(5.4% vs. 4.7%)은 양 군에서 의미 있는 차이는 없었다. DOAC 종류별로 나누어 하위군 분석을 시행하였을 때, 와파린군은 rivaroxaban군에 비하여 위장관 출혈의 비율이 높았으며, rivaroxaban군, dabigatran군에 비하여 혈전색전증의 비율이 높았고, 입원 중 사망률에서는 의미 있는 차이는 없었다. 내시경 시술의 종류로 보정하였을 때 위장관 출혈 및 혈전색전증, 사망률은 DOAC 단독으로 치료한 환자에서보다 와파린과 헤파린 교량 요법(bridging) 또는 DOAC과 헤파린 교량 요법을 시행한 환자에서 높았다. 시술 종류 중에서는 위루관 삽입술에 비하여 내시경 점막하박리술, 내시경 점막절제술 및 내시경 정맥류결찰술, 내시경 주사경화요법을 시행한 환자에서 위장관 출혈의 위험이 가장 높았으며, 하부 내시경 점막절제술, 하부 용종 절제술, 내시경적 유두괄약근절제술 또는 내시경 초음파 유도하 미세침 흡인 검사는 중등도 위험을 보였다.

• Proceedings of the Korea Information Processing Society Conference
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• 2017.04a
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• pp.810-811
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• 2017

신약 개발은 고부가가치를 창출하는 차세대 전략 산업으로 주목받고 있지만, 동물 실험과 임상 시험에 막대한 비용이 필요한 고위험-초고소득(high risk-super high return) 산업이다. 따라서 신약 후보군의 선정이 매우 중요하며 약물 유사도를 랭킹함수를 사용하는 top-k 질의 처리를 통해 후보군을 효과적으로 선정할 수 있다. 본 논문에서는 ChEMBL 데이터베이스[4]에 존재하는 화합물들 중 사용자가 원하는 특성을 갖는 k개의 화합물들을 후보군으로 추천해주는 검색 엔진을 개발하였다.

• Journal of the Korean Society of Food Science and Nutrition
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• v.37 no.7
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• pp.858-868
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• 2008

This study was carried out to investigate the effects of Gastrodiae Rhizoma powder on plasma lipid profiles in elderly volunteers with hyperlipidemia, hypertension, diabetes or heart disease. 32 elderly people, 11 males and 21 females aged $60{\sim}77$ years, were given Gastrodiae Rhizoma powder 15 g twice daily for 6 months. We investigated the antheropometric data, general characteristics and dietary habit by using questionnaires. Fasting blood samples were collected from the subjects before and after this 6 months intervention study. Blood pressure, glucose, hemoglobin and lipid levels of plasma, atherogenic index (AI) and cardiac risk factors (CRF, LHR, HTR) were determined before and after consumption of Gastrodiae Rhizoma powder. The mean body mass index (BMI) of the male and female subjects were 22.4 and 23.6, respectively. The percent of ideal body weight (PIBW) of males and females were 105.6% and 122.3%, respectively. The subjects had decreased intake frequency of fish and meat in their dietary habit. After consumption of Gastrodiae Rhizoma powder, there were no significant differences in blood pressure; however, the blood glucose significantly decreased with Gastrodiae Rhizoma intake in the males. In the subjects, the levels of plasma total cholesterol, triglyceride, and LDL-cholesterol were decreased by the consumption of Gastrodiae Rhizoma powder; while the levels of plasma LDL-cholesterol was significantly decreased in female. Blood pressure and biochemical assessment (blood glucose, hemoglobin, triglyceride, total cholesterol, LDL and HDL-cholesterol) of the subjects were within the normal range. It was found that AI, CRF and LHR were significantly decreased by Gastrodiae Rhizoma intake. The present results indicate that dietary supplementation of Gastrodiae Rhizoma improved lipid metabolism and cardiac risk factor in cardiovascular disease.