• Title/Summary/Keyword: 환자안전 사고

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Factors Related to In-Hospital Death of Injured Patients by Patient Safety Accident : Using 2013-2017 Korean National Hospital Discharge In-depth Injury Survey (환자안전사고에 의한 손상환자의 병원내 사망 관련 요인 : 2013-2017 퇴원손상심층조사자료 활용)

  • Kim, Sang Mi;Lee, Hyun Sook
    • Korea Journal of Hospital Management
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    • v.26 no.1
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    • pp.17-25
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    • 2021
  • This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.

Factor Associated with Injury Related to Home Mechanical Ventilation in General Ward Patients: A Retrospective Study (가정용 인공호흡기 관련 안전사고 특성 및 손상 영향 요인 분석: 상급종합병원 일반병동 환자 중심으로)

  • Kim, Hyang Sook;Choi, Mona;Yang, Yong Sook
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.2
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    • pp.131-140
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    • 2020
  • Purpose: This study aims to describe the characteristics of safety incidents and factors associated with injury for patients with Home Mechanical Ventilation (HMV) at the hospital. Methods: This is a retrospective study. Data were collected from the work log of respiratory home care nurses and the patients' electronic medical records were investigated. In order to compare group differences, independent t-test and χ2 test were used. Associated factors with injury development were identified by generalized mixed modeling analysis controlling for age and gender. Results: A total of 304 patients on HMV were included in this study, among which 129 (42.4%) experienced 352 HMV-related incidents. Mean frequency of incidents for each patient was 5.11±3.98, ranged from 1 to 15 times. In 19.0% of the incidents, injury was developed. Types of incident and persons involved in the incidents were significantly associated with the patient's injury. In the case of the safety incidents, patient's injury was significantly higher in accidents caused by respiratory circuit problems compared to those caused by problems with the ventilator operation by the medical staff (coefficient=1.25, p=.020). In addition, in the case of those involved in the safety incidents, patient's injury was significantly higher in the accident caused by the patient family members or caregivers than that caused by the medical personnel (coefficient=1.25, p=.019). Conclusion: In order to minimize injury caused by incidents in patients with HMV, hospitals need to provide systemic education to their medical staff and caregivers to enhance awareness of the importance of reporting and safety management.

Design and Implementation of Emergency Calamity System within Wireless Personal Area Network (근거리 무선 통신을 이용한 긴급재난상황 설계 및 구현)

  • Kim, Young-Ji;Lim, Choong-Soo
    • Proceedings of the Korean Society of Computer Information Conference
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    • 2008.06a
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    • pp.269-273
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    • 2008
  • 본 논문에서는 근거리 무선 통신을 이용하여 사용자의 현재 위치에서 일어나고 있는 교통사고, 화재, 환자발생 등의 긴급재난상황 목격시 사용자가 해당 상황을 ZigBee 기반의 무선 센서 네트워크 사용자에게 알리고, 알린 정보를 실시간 쉽게 확인 할 수 있도록 긴급재난상황을 모니터링 하는 시스템을 제안하였다. 근거리 무선 통신 중센서와 사용자 무선 단말기 사이의 데이터 전송 구조가 간단하고, 초저가의 센서 네트워크 구성시 낮은 전력을 소모하는 장점을 가진 ZigBee로 구현하였다. 현재 사용자 주변의 일어나는 긴급재난 상황을 주변 사용자와 ZigBee 기반의 무선 센서 네트워크를 구축하여 실시간으로 보다 정확한 정보를 주변 사용자에게 알려주거나 혹은 사용자가 모니터링을 하여 사용자의 피해를 최소화로 줄여 사용자의 안전과 편의를 향상시킨다.

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Study on Types and Counterplans of Medical Accident Experienced by Dentists in Seoul(2004) (서울특별시 개원 치과의사의 의료사고 및 분쟁의 유형과 대책에 관한 연구(2004년))

  • Yoon, Jeong-Ah;Kang, Jin-Kyu;Ahn, Hyoung-Joon;Choi, Jong-Hoon;Kim, Chong-Youl
    • Journal of Oral Medicine and Pain
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    • v.30 no.2
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    • pp.163-199
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    • 2005
  • Dentistry had been considered to be a relatively safe zone from the risk of medical accidents for there are less number of emergency cases. However, in these days, the number of medical dispute is increasing that the dentists would not be able to overlook it as if it is none of their matters. Hence, researches on various medical accidents and analyses on related matters to seek proper management have been carried out recently, but the datas are not enough yet. This study analysed the actual conditions of medical accidents as well as disputes and the general awareness of dental practitioners in local clinics with the purpose of understanding the general situation and to suggest counterplan. The study was conducted by analysing 1,882 questionnaires collected from total of 3,684 dentists belonging to Seoul Dental Association and where Doctors and Hospitals Medical Malpractice Insurance for dentists is administered. The results were as follows: 1. 98.47% of the respondents doubted the risk of medical accident and dispute. 2. 27.42% of the respondents experienced medical dispute, and there was no significant difference between the rate of medical disputes and the resident training. 3. Among the cases of medical accidents, those related to the periodontal/operative treatment showed the highest rate of 20.50%, and that related to implant treatment was 6.17%. 4. 43.02% of the respondents explained about the treatment procedure before the treatment while 25.90% started the treatment without consent of the patients. 5. Medical dispute resulted from not having any explanation or consent of the patients were of 16.55%. 10.26% had difficulties in solving the problem for missing the medical records. 6. 49.73% responded to be capable of administering first aid treatment. Among them, 23.60% were equipped with accurate knowledge regarding the emergency care. 7. During medical dispute, 88.09% sought counsel from other dentists, and Local district dental association was found to be the most frequently asked group. 8. In cases of medical dispute, 5.26% of the respondents were asked to submit relevant data from customer protection organization, and among them, 75.61% acceded the demand sincerely. 9. After the settlement of the dispute, 83.63% recovered relatively stable state of mind. 10. 99.46% of the respondents felt the necessity of medical dispute management organization, and 78.58% responded that it was urgent. 11. 66.70% of the respondents joined Doctors and Hospitals Medical Malpractice Insurance, although they had not experienced medical dispute. However, 73.36% of the respondent were not aware of it, and 93.36% of the members were not aware of the procedure of the dispute settlement. 12. 79.0% of the respondents who joined the Doctors and Hospitals Medical Malpractice Insurance still felt confused when medical dispute occured, but relatively safer than before. 13. When medical dispute was settled through Doctors and Hospitals Medical Malpractice Insurance, 71.92% of the dentists were contented more than moderately, however, 35.16% of the patients were contented. 14. For complement of Doctors and Hospitals Medical Malpractice Insurance, 53.22% of the respondents felt that insurance company, dentist, and patient should all participate in bringing mutual agreement for quick settlement of the dispute. In addition, 29.08% of the respondents wanted insurance company to prevent patients from disturbing their practices. From the above results, improvement of the general awareness on increasing rate of medical disputes, and education as well as complementary measures for settlement of the disputes are required.

A Study on the Development of Virtual Training System for Automated External Defibrillator (자동제세동기(AED) 가상훈련 시스템 개발에 관한 연구)

  • Song, Eun-Jee
    • Journal of the Korea Institute of Information and Communication Engineering
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    • v.21 no.7
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    • pp.1379-1385
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    • 2017
  • Virtual training is a kind of training that proceeds as if it were a real situation. In recent years, there has been a growing demand for experiencing a situation in which a virtual reality technology has not been experienced directly in the real world due to the rapid development of the technology. Especially, safety education is very necessary in Korea where safety accidents are caused by many disasters. Therefore, simulation of disaster response training using virtual reality is more urgent than ever. Although the automatic defibrillator is the medical device that is most needed to rescue patients with cardiac arrest, few people know how to use it. Therefore, there are very few cases where the use of automatic defibrillators has saved the patient's life in Korea. The proposed Automated External Defibrillator virtual training system enables immersive and experiential training in real situations and effective training at low cost.

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.

Legislation Status and Legal Issues of Non-Face-to-Face Treatment (비대면진료 관련 입법 현황과 법적 쟁점)

  • Jinsuk, Kim;Eol, Lee
    • The Korean Society of Law and Medicine
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    • v.24 no.4
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    • pp.131-160
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    • 2023
  • An amendment to Medical Law allowing permanent face-to-face treatment has been proposed in the 21st National Assembly, with five different bills introduced. However, each proposed amendment focuses on different aspects, and the issue is currently in a state of 'ongoing review' due to factors such as opposition from the medical profession and political considerations. However, from the perspective that the introduction of non-face-to-face treatment should be institutionalized and legislated prioritizing patient safety, certain directions are proposed. These include focusing on returning patients as the primary target, chronic diseases as the focal conditions, outpatient medical institutions as the implementing agencies, restricting non-face-to-face means primarily to video systems, and legally exempting healthcare professionals from responsibility for incidents beyond their control. The proposed directions also emphasize establishing the right to demand face-to-face treatment. It is suggested to legislate initial standards that ensure a minimum level of safety and gradually expand the scope of non-face-to-face treatment through future research, evaluation, and similar step-by-step approaches.

Driving State of the stroke patients after Cognitive Perceptual Assessment for Driving evaluation at the National Rehabilitation Center (국립재활원에서 운전인지평가를 받은 뇌졸중 환자의 운전 실태조사)

  • Lee, J.A.;Choi, H.;Lee, S.
    • Journal of rehabilitation welfare engineering & assistive technology
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    • v.7 no.2
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    • pp.117-124
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    • 2013
  • Objective : To investigate the actual driving state of the stroke patients who had assessed CPAD. Methods : We conducted a follow-up survey with 48 stroke patients who had assessed CPAD. First, we reviewed the medical chart and then carried out the telephone survey. Results : Of the 48 subjects, 12 were driving and 36 were not driving. Current drivers' CPAD score, it was 54.13, was higher than non-drivers' CPAD score(p<0.05). Those who passed the CPAD were driving more than who failed(OR=8.3, 95%CI=1.931-35.558). Conclusion : The pass group of CPAD have higher chance of driving than fail group and have lower chance of car accidence than fail group. Thus we can apply the CPAD for driving cognitive evaluation tests.

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Creative Use of College Laboratory in Nursing Education (간호교육에 있어서 창의적인 대학 실습실의 이용에 관한 고찰)

  • Lee Miok
    • The Korean Nurse
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    • v.24 no.4 s.132
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    • pp.118-130
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    • 1985
  • 실행(practice)를 위주로 하는 전문직 교육은 실지 실습이나 임상교육등이 필수적이며 중요한 것은 주지의 사실이다. 그러나 전통적으로 대부분의 간호학교가 병원에 소속되어 있어서 간호 임상교육은 그 본 목적인 학생들의 학습보다는 오히려 병원 업무를 돕는 방향으로 잘못 전개되어왔다. 간호교육이 병원에 소속된 간호학교로 부터 학문의 전당인 대학안으로 옮겨지면서 많은 뜻있는 간호교육자들의 노력과 시도로 학생들이 고용인으로 이용되는 상황에서 탈피하여 임상교육이 학생들에게 이론적인 지식을 실지로 응용할 수 있는 복합적이고 통합적인 배움의 경험이 되도록 조금씩 발전해 가고는 있지만 아직도 바라는 만큼 이루어지지는 못하는 실정이다. 현재는 임상실습에 임하는 학생들이 기능적인 일을 반복하며 주어진 시간만을 채우는 경향이 많고 배운 이론을 대학 실습실에서 응용해 보지 못한채 직접 환자 간호에 적응하려면 지나친 불안과 긴장으로 오히려 학습에 장애가 오기도 한다. 또한 환자의 입장을 고려해 보면 그들은 안전하고 완벽한 간호를 받을 권리가 있음에도 불구하고 때로 서투른 학생들의 실습의 대상으로 노출되어 불안을 느끼고 바람직한 간호를 받지 못하는 경우가 많다. 따라서 몇 뜻있는 간호 교육자들은 임상들의 실습장소로 택하는 것은 학생에게는 부적절한 학습 환경이 될 뿐 아니라 환자에게는 도덕적, 윤리적으로 부당하다고 주장한다. 본 연구는 좀 더 잘 설비된 대학의 실습실이 급선무이고 또한 교화적이고 창의적인 실습실의 이용으로 반복적인 임상 실습의 양은 줄이는 한편 학생들의 실력이나 적용 능력의 토대를 탄탄히 하는 몇가지 교육방법을 제시하였다. 물론 제시된 시법이나 작은 그룹별 학습등은 기초 간호학실에서 많이 이용된 방법이기는 하지만 더욱 잘 응용되어야하겠고 역할 재현(role play)이나 유사 상황(simulation) 조성등의 학습 방법으로 기술적인면 뿐만 아니라 대인 관계나 면담기술 및 창의적이며 논리적인 사고의 발달등도 이루어 지리라 기대된다.학생들이 적정량의 기술과 지식을 익힌 후에 좀 더 복합적이고 통괄적인 지식의 응용 및 평가가 필요할 때 실지 임상 실습을 시도하는 것이 바람직한 것이다.

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Characteristics of Puffer Fish Poisoning Outbreaks in Korea (1991-2002) (대한민국에서 복어독에 의한 식중독 발생 특성)

  • Kim, Ji-Hoe;Gong, Qing-Li;Mok, Jong-Soo;Min, Jin-Gi;Lee, Tae-Seek;Park, Jeong-Heum
    • Journal of Food Hygiene and Safety
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    • v.18 no.3
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    • pp.133-138
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    • 2003
  • The data on outbreaks of puffer fish poisoning during 1991 to 2002 in Korea were gathered from press reports, and characterized information collected. During the period, a total of 32 outbreaks of puffer fish poisoning was reported. These outbreaks caused 111 persons to become poisoning, among the cases 30 persons were fatal. The mean case fatality rate was 27.0%, and most of deaths (93.3%) were the male of above 29 years old. Patient number of below 4 persons per a poisoning accident occupied 75.0% of total outbreaks; 65.8% of total cases; and 66.7% of total deaths) was occurred in the months, November through January. Most of puffer fish poisoning (75.0% of total outbreaks; 68.5% of total cases; and 73.3% of total deaths) were found along the south coastal area of Korea, including Busan, Gyeongsangnam-do, Jeollanam-do and Jeju-do. Over than 80% of puffer fish poisoning outbreaks occurred at fishing boat and home where privately made food was cause, and outbreaks in restaurants accounted for 15.6%. Most commonly implicated foods were Guk, boiled soup with puffer fish meat and spices.