• Title/Summary/Keyword: 의료사고 환자

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Effect of Leadership WalkRounds Convergence to Establish a Patient Safety Culture (환자안전문화 정착을 위한 리더십 워크라운드(Leadership WalkRounds)의 융복합적 적용 효과)

  • Lee, Mi-Hyang;Kim, Chang-Hee
    • Journal of Digital Convergence
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    • v.13 no.6
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    • pp.185-195
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    • 2015
  • This study aims to study the change in the level of awareness of medical personnels regarding the patient safety culture(PSC) before and after the Leadership WalkRounds(LWR). The LWR in this study was based on the IHI and the models of the Patient Safety Rounds(PSRs) at University of Michigan, emphasizing the 5 steps of Preparation--Scheduling--Conducting--Reporting--Resolving. After the LWR the scores for the level of awareness showed a statistically significant increase from 2.63 to 3.36(p<.001). Among the participants, those who are pharmaceutists, women, 30.0~39.9 years old, or had work experience of a year or less showed particularly notable increase in awareness. The effect was significant across all categories of PSC, especially in Safety Accident Reporting(p<.001), then in Communication(p<.001). Therefore the LWR proved an convergent concept for applying new leadership skill and the concept of patient safety management as an method to elevate the frontline staffs' awareness of PSC.

A literature review of patient safety in Korea: focused on domestic studies (환자안전에 관한 문헌 연구: 국내연구를 중심으로)

  • Hwang, Ji-Young;Kim, Jin-Kyung
    • Journal of Korean society of Dental Hygiene
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    • v.18 no.1
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    • pp.1-8
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    • 2018
  • Objectives: The purpose of this study is to provide basic data on the continuous management and institutional measures in the future by understanding the research trends of patient safety in healthcare field. Methods:The data were extracted from 2011-2016 KoreaMed, KMBase, KISS, NDSL and KISTI. Data were analysis by frequency analysis using the SPSS 14.0 program. Results: 87.0% of the studies were quantitative studies. As for the method of sampling, 'No use' was the highest at 56.5%. Most of the participants in the study were 'nurses' (50.7%). 19 hospitals (35.8%) were the most common. The subjects of the study consisted of 35 (51.5%) patients' safety culture (awareness) and 20 (29.4%) 'safety nursing activities'. Conclusions: Patient safety and patient safety should be maintained. Further, a mature patient safety culture should be settled through cooperation management among medical staff.

Simulation of MultiAgent-based Emergency Medical System Using ARENA (ARENA를 이용한 멀티 에이전트 기반 응급 의료 시스템 시뮬레이션)

  • Noh, Seon-Taek;Yi, Keun-Sang;Choi, Young-Keun
    • Proceedings of the Korean Information Science Society Conference
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    • 2007.10b
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    • pp.408-413
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    • 2007
  • 최근 인구와 기계문명의 발달로 예전에 비해 좀더 복잡한 응급 사고가 발생하고 있다. 현재 응급 구조 시스템은 타인에 의한 신고나 정적인 웹페이지로 수집된 정보를 통해 당시 상황에 맞춰 응급 체계를 수립하고 있다. 이는 비전문 의료인인 구급대원의 현장 판단과 의료기관으로의 부적절한 판단으로 인해 응급 환자의 적절한 치료의 가능성을 낮추는 요인이 될 수 있다. 따라서 선행연구로써 기존의 응급 의료 시스템에 멀티 에이전트 개념을 도입하여 멀티 에이전트 기반의 응급 의료 시스템(MAEMS)을 모델링하였다. 멀티 에이전트 시스템은 독립적인 성격과 자율적인 성격으로 않은 부분에 응용되어 설계되고 있다. 특히 에이전트의 독립적인 성격은 이질적인 환경에서 동일한 목적의 행위를 수행할 수 있으며, 동적으로 많은 변화가 있는 상황에서 자율적으로 판단하여 행동할 수 있다. 본 논문에서는 MAEMS에 구성되어 있는 각 에이전트를 구현하며, ARENA를 통해 시뮬레이션함으로써 실제 통계자료와 비교하여 멀티 에이전트를 도입한 응급 의료 시스템의 효율성에 대해 연구한다.

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Isolated Power System : IPS (비접지배선 방식에 의한 전원 공급 시스템)

  • Kim, Y.B.
    • Proceedings of the KIEE Conference
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    • 2005.05b
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    • pp.80-83
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    • 2005
  • 우리나라의 실내의 배전로는 접지방식(Grounded System)이 일반적이고, 전로의 일선 지락 시에는 누전전류 차단기 혹은 과전류 차단기에 의해 전로를 차단하여 전기적인 사고 예방을 도모하고 있다. 그러나, 생명 유지 장치(Life-Sustaining Equipment)를 사용하고 있는 수술실 등 의료실의 배전 계통에 있어서의 전로의 차단은 치명적인 사고를 유발 할 수 있다. 이에 비하여, 비접지 배선방식(Isolated Power System)은 일선 지락 시에도 지락 전류 ((Ground-Fault Current)를 현저히 적게 할 수 있기 때문에 전원 공급은 계속되어 질 수 있다. 그러므로, 전원 공급의 높은 신뢰성이 요구되는 의료용 전기기기의 회로에는 비접지배선 방식으로 시설토록 규정 하고 있다. 또한, 지락 전류가 현저히 적기 때문에 선로 절연 감지기(Line Isolation Monitor)를 설치하여 의료진이나, 환자를 누설 전류에 의한 전기적 쇼크(Electrical Shock)를 방지하는 시스템이다.

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The Basic Study on the Preventive Measures against Medical Accident Induced by Acupuncture and Moxibustion Therapy I. A Literature Research on the Essence of Prohibitive Acupuncture Point, Jīn-Zhėn-Xué-Gė (禁鍼穴歌) (침구 의료행위에 기인하는 의료사고 예방에 관한 기초적 연구 (I) - 금침혈가에 관한 문헌적 고찰 -)

  • Moon, Jin-Young
    • The Journal of Dong Guk Oriental Medicine
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    • v.8 no.2
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    • pp.175-199
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    • 2000
  • Acupuncture and moxibustion play an important role not only in the medical service and health care of Korea, China and japan but also in those of many western countries such as Germany, France, United States of America. An unexpected results induced by careless acupuncture and moxibustion treatments may be mild or severe, and are due to practitioner's mistake and particular body condition of a patient. This study was performed to establish a preventive measures against medical accident induced by acupuncture therapy. Total 23 acupuncture points which are included in a J${\bar{l}}$n-Zh${\dot{e}}$n-Xu${\acute{e}}$-G${\dot{e}}$ were selected as prohibited acupuncture points. Although the records in J${\bar{l}}$n-Zh${\dot{e}}$n-Xu${\acute{e}}$-G${\dot{e}}$ are an important data historically which show dangerous acupuncture points, there are few a full investigation on J${\bar{l}}$n-Zh${\dot{e}}$n-Xu${\acute{e}}$-G${\dot{e}}$ up to the present. So present study was done for literature review to understand a feasibility of the records in J${\bar{l}}$n-Zh${\dot{e}}$n-Xu${\acute{e}}$-G${\dot{e}}$ in association with dangerous acupuncture points. Based upon the locations of these acupuncture points, the dangerous region were classified three categories, head, soma and limb. And abnormal signs related to the improperly performed acupuncture treatment on each point were investigated by using historical reference books on acupuncture and moxibustion. And then names, locations, depth of insertion, operation methods and side effects of each point were investigated.

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Implementation of Integrated Embedded Control System for drive control and collision avoidance of Mobile Intraoperative CT (모바일 수술 중 CT 의 구동 제어와 충돌방지를 위한 통합 임베디드 시스템 구현)

  • Shin, Jin-Woo;Kim, Sea-Jung;Roh, Tae-Seong;Ryu, Jong-Hyun;Jun, Hong Young;Jeong, Kil-Hwan;Yoon, Kwon-Ha;Kim, Dae-Won;Kim, Kou-Gyeom
    • Proceedings of the Korea Information Processing Society Conference
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    • 2020.11a
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    • pp.548-551
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    • 2020
  • 최근 의료시장에 상용화된 모바일 수술 중 CT(intra-operative computed tomography, iCT)는 수술실 내 이동이 자유로울 뿐만 아니라 수술 후 즉각적인 환자 모니터링이 실시간으로 이루어져 수술 후 환자의 예후 향상과 재수술 확률을 낮출 수 있다. 이동성을 갖춘 iCT 는 편의성과 유용성이 검증되었지만, 이동시 발생될 수 있는 충돌사고의 단점이 존재한다. 따라서, iCT 의 이동시 발생할 수 있는 위험을 최소화 할 수 있는 안전장치가 요구된다. 본 연구에서는 모바일 iCT 의 구동 제어의 편의성과 안전성을 확보 할 수 있는 CT 촬영을 제어하기 위한 리모트 컨트롤러, 이동시 전방 시야를 확보하기 위한 전방 모니터링 카메라 출력, 충돌 위험을 알릴 수 있는 초음파 센서를 통합하는 임베디드 컨트롤러를 개발하고자 한다.

A study on Establishment and Management of the CCTV in Operating Room (수술실 CCTV 설치 및 운영에 대한 고찰)

  • Kim, Minji
    • The Korean Society of Law and Medicine
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    • v.20 no.1
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    • pp.109-132
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    • 2019
  • Recently, medical accidents related to surgical procedures have increased. In addition, the media reported that some of these accidents were involved in health crimes. Patient-advocate groups have called for mandatory establishment and management of CCTV in operating rooms. There is a lot of discussion among the interested parties, so it is necessary to review the relevant laws and regulations. The purpose of this study is to identify the characteristics of CCTV in operating rooms and to review legislations related to establishment and management of the CCTV in operating rooms. Medical institutions use CCTV for management of facilities and patient safety and install it in operating rooms optionally. The Constitution guarantees the privacy and the privacy of correspondence of every citizen, but it can be limited by the law for public welfare. Currently, however, there is no existing law about establishment and management of the CCTV in operating rooms and it can be defect of legal system. Under the current legislations, it is likely that the Self-determination can be violated due to the characteristic of healthcare provider when CCTV is mandatorily installed in operating room. In addition, the regulations on access and leakage of confidential information known by operator are insufficient. So that, the safety of the visual data might be threatened. Furthermore, unless the period and the place of storage of the visual data are clearly defined, it is highly unlikely to meet the original purpose of patient safety and prevention of medical accidents. This study is meaningful as there is few previous study on this topic although the need for legal review about this is growing and several bills are being proposed. It is expected that the results of this study can be utilized as basic data for enactment or amendment of the laws and regulations about establishment and management of CCTV in operating rooms.

Analysis of Medical Expenses for patients by Automobile Accident (자동차사고에 의한 환자의 진료비 성향 분석)

  • Ko, Min-seok;Kim, Seung-Hee
    • Journal of the Korean Society of Mechanical Technology
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    • v.13 no.1
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    • pp.1-9
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    • 2011
  • The present study aimed to compare and analyze the particulars of and difference in medical expenses and their composition ratio for 2,026 patients hospitalized at 2 types of medical institutions (443 at a clinic and 1,583 at a hospital) in Jeonju-si, Jeollabuk-do under coverage of automobile insurance during 2009. From the analysis, it became evident that there were differences in individual characters of inpatients covered by automobile insurance, and details, composition and composition ratio of medical treatment for them depending on types of medical institutions. There was no difference, however, between the total and average medical expenses per capita even when markup rate was applied to the automobile insurance by types of hospitals. The ratio of radiotherapy and physical therapy in the composition of medical expenses was found to be extraordinarily high in clinics compared to that of hospitals. The composition ratio of the fixed cost including charge for hospitalization also turned out to be fairly high in all medical institutions.

Medicolegal Problems in Pediatric Area (소아과 영역에서 의료분쟁)

  • Kwon, Soo Jeong;Jang, Ji Young;Kim, Nam Su;Yum, Myung Kul;Seol, In Joon;Jung, Ku Won
    • Clinical and Experimental Pediatrics
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    • v.48 no.8
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    • pp.813-819
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    • 2005
  • Purpose : Medicolegal problems start when the patient asserts the mistake of doctor and doctor does not accept it. The purpose of this study is to assess the actual condition of medicolegal problems and to provide solutions of medicolegal problems in the pediatric field. Methods : There is not official statistical data about medicolegal problems in our country. We gathered data of legal insurance program of Korean Medical Association(KMA) and court cases and other fragmentary data. Results : Between 1981 and 1995, of total 2,338 cases reported to legal problem insurance program of KMA, most common ones were 748 cases of obstetrics and gynecology. Pediatric case was ranked at the 5th, 74 cases(3.1%). According to analysis of 41 medicolegal cases' after 1990, maltreatment of patient had the highest incidence of 14 cases, injection and medication were related to 12 cases, misdiagnosis was 9 cases, patient management were related to 4 cases, and others were 2 cases. The trial result of the medicolegal cases was that 31 cases were compensated, and 8 cases were defeated, and 2 cases were still in the process. Conclusion : The aspect of medical legal problem has the tendency of radicalism and systematization. This brings an economic destitution in the patient and gives damage to a doctor. In order to reduce medicolegal problem, doctor should offer a duty of explanation and efforts to his best to satisfy patient and endeavor to make an intimate doctor-patient relationship.

Legal Issues To Be Considered Before Implementing Telehealth in South Korea (원격진료 실시에 수반되는 법적 쟁점들에 대한 고찰)

  • Lee, Won Bok
    • The Korean Society of Law and Medicine
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    • v.22 no.1
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    • pp.57-90
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    • 2021
  • Telehealth has been a hotly debated health policy issue in South Korea, mostly because the medical community - especially primary care practitioners - have strongly opposed it. As a result, telehealth has remained forbidden under law. However, the temporary permission of telehealth in Korea, as well as its exploding use in other countries, all in response to COVID-19, is re-igniting the discussion on telehealth in Korea. This article explores general legal issues that may arise if and when telehealth is fully implemented in Korea. The article's analysis shows that legislative changes are necessary to allow reimbursement of telehealth as well as remote purchase of medicine. The article also advocates introducing new evidentiary rules to curtail covert recording of telehealth sessions. On the other hand, additional legislation is probably not necessary to address the medical liability of physicians practicing telehealth or to adress much-discussed privacy issues. The existing laws in those domains are already robust enough to operate without much difficulty in the context of telehealth too.