• 제목/요약/키워드: Best Practice

검색결과 778건 처리시간 0.038초

당직 근무 중 발생한 의료사고에서 당직의료인의 업무상과실을 인정하기 위한 요건 - 대법원 2005.6.10. 선고 2005도314 판결을 중심으로 - (Requirements to Accept the Medical-service Person's Professional Negligence in the Medical Malpractice Case Occurred being on Duty - With its focus on the Precedent case no. 2005Do314, Sentenced by June 10, 2005, by The Supreme Court -)

  • 김영태
    • 의료법학
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    • 제9권1호
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    • pp.285-317
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    • 2008
  • To accept the doctor's professional negligence in the medical malpractice, the mistakes, by which the doctor did not foresee the production of the results in spite of the possibility of foresight and did not avoid the production of the results in spite of the possibility of avoidance, must be considered, and to decide the presence of the doctor's professional negligence, the standard must be the attention standard of general-common doctor engaged in the same business and the same function, and the medical enviornments, the conditions, the extraordinary nature of medical behavior, and etc should be considered by the general level of medical science at the time of accident. This principlel must be applied to the medical malpractice case occurred being on duty without exception. But, because of the extraordinary nature of duty work, it is difficult for any doctor to do one's best technical practice by making all diagnosis, medical treatment with all the equipment on the same plane as the ordinary times. That cannot be also expected for any doctor to do one's best technical practice in the terms of a social idea. From this point of view looking into The Precedent case related to Medical-service person being on duty sentenced by The Supreme Court, unlike the general medical malpractice case, the presence of the professional negligence in the medical malpractice occurred being on duty seems to be decided with more consideration on the general level of medical science, the medical enviornments and the conditions, particularities of medical practice at the time of accident. Especially, the extraordinary nature of medical behavior of the medical service person being on duty in the emergency room seems to be admitted compared to that of the medical service person being on duty in ward.

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한국의 경사지 밭의 토양 및 물의 보전 관리 전략 (Management Strategies to Conserve Soil and Water Qualities in the Sloping Uplands in Korea)

  • 양재이;유진희;김시주;정덕영
    • 농업과학연구
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    • 제37권3호
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    • pp.435-449
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    • 2010
  • Soils in the sloping uplands in Korea are subject to intensive land use with high input of agrochemicals and are vulnerable to soil erosion. Development of the environmentally sound land management strategy is essential for a sustainable production system in the sloping upland. This report addresses the status of upland agriculture and the best management practices for the uplands toward the sustainable agriculture. More than 60% of Korean lands are forest and only 21% are cultivating paddy and upland. Uplands are about 7% of the total lands and about 62% of the uplands are in the slopes higher than 7%. Due to the site-specificity of the upland, many managerial and environmental problems are occurring, such as severe erosion, shallow surface soils with rocky fragments, and loadings of non-point source (NPS) contaminants into the watershed. Based on the field trials, most of the sloping uplands were classified as Suitability Class III-V and the major limiting factor was slope and rock fragments. Due to this, soils were over-applied with N fertilizer, even though N rate was the recommendation. This resulted in decreases in yield, degradation of soil quality and increases in N loading to the leachate. Various case studies drew management practices toward sustainable production systems. The suggested BMP on the managerial, vegetative, and structural options were to practice buffer strips along the edges of fields and streams, winter cover crop, contour and mulching farming, detention weir, diversion drains, grassed waterway, and slope arrangement. With these options, conservation effects such as reductions in raindrop impact, flow velocity, runoff and sediment loss, and rill and gully erosion were observed. The proper management practice is a key element of the conservation of the soil and water in the sloping upland.

A Systematic Review of Evidence for Education and Training Interventions in Microsurgery

  • Ghanem, Ali M.;Hachach-Haram, Nadine;Leung, Clement Chi Ming;Myers, Simon Richard
    • Archives of Plastic Surgery
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    • 제40권4호
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    • pp.312-319
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    • 2013
  • Over the past decade, driven by advances in educational theory and pressures for efficiency in the clinical environment, there has been a shift in surgical education and training towards enhanced simulation training. Microsurgery is a technical skill with a steep competency learning curve on which the clinical outcome greatly depends. This paper investigates the evidence for educational and training interventions of traditional microsurgical skills courses in order to establish the best evidence practice in education and training and curriculum design. A systematic review of MEDLINE, EMBASE, and PubMed databases was performed to identify randomized control trials looking at educational and training interventions that objectively improved microsurgical skill acquisition, and these were critically appraised using the BestBETs group methodology. The databases search yielded 1,148, 1,460, and 2,277 citations respectively. These were then further limited to randomized controlled trials from which abstract reviews reduced the number to 5 relevant randomised controlled clinical trials. The best evidence supported a laboratory based low fidelity model microsurgical skills curriculum. There was strong evidence that technical skills acquired on low fidelity models transfers to improved performance on higher fidelity human cadaver models and that self directed practice leads to improved technical performance. Although there is significant paucity in the literature to support current microsurgical education and training practices, simulated training on low fidelity models in microsurgery is an effective intervention that leads to acquisition of transferable skills and improved technical performance. Further research to identify educational interventions associated with accelerated skill acquisition is required.

SWAT 모형을 이용한 별미천 유역의 최적관리기법 적용 연구 (A Study on Best Management Practices in Byulmicheon Watershed Using SWAT Model)

  • 박혜선;김상호;정혁;김성준
    • 한국수자원학회:학술대회논문집
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    • 한국수자원학회 2012년도 학술발표회
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    • pp.781-781
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    • 2012
  • 본 연구에서는 수문-수질 모의가 가능한 SWAT (Soil and Water Assessment Tool) 모형을 이용하여 경안천 상류의 별미천 유역($1.21km^2$)을 대상으로 최적관리기법(Best Management Practice, BMP) 적용에 따른 비점오염원 저감효과를 분석하고자 한다. 이를 위해, 별미천 유역내 논($0.049km^2$)과 밭($0.018km^2$) 지역에 대한 BMP 시나리오를 작성하였다. 먼저, 논에서는 계단식(Terrace) 재배 방법을 적용하였으며, 밭에서는 등고선(Contour farming) 재배 방법과 볏짚지표피복 시나리오를 적용하였다. 여기서, 볏짚지표피복 시나리오는 현재 $1276.6m^2$, 경사도 약 3.2%의 콩 재배가 이루어지고 있는 시험포장에서 수행된 결과를 이용하여 SWAT 모형의 지표유출관련 매개 변수를 조정하였다. SWAT 모형의 적용성 평가를 위해, 1:5,000 수치지도로부터 2m DEM(Digital Elevation Model) 및 QuickBird(2006.05.01) 위성영상으로부터 스크린 디지타이징기법(On-Screen Digitizing Method)을 이용하여 총 21개 토지이용항목의 1:5,000급 정밀토지이용도를 작성하고, 농촌진흥청에서 제공하는 1:25,000 정밀토양도를 구축하였다. 또한, 유역출구점에서 자동수위 및 강우량 계측기, 수질측정을 위한 오토샘플러를 설치하여 시간당 수위(유량), 강우 자료와 강우발생에 따른 수질자료(Sediment, Total Nitrogen, Total Phosphorus)를 이용하여 모형의 검보정(2011.06.08 ~ 2011.10.31)을 실시하였다. 모형의 검보정 후, 논에서의 Terrace 및 밭에서의 Contour farming, 밭 시험포장에서의 저감효과가 분석된 지표피복시나리오의 적용을 위한 SWAT 모형의 관련 매개변수를 정의하고, 각 BMP 시나리오별 비점오염원 저감효과를 분석하였다.

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치위생과 학생의 감염관리에 대한 인지도와 실천도 조사 (A study on recognition and practice of dental hygiene students for Infection control dental hygiene major courses)

  • 이지영;정미경
    • 한국치위생학회지
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    • 제9권2호
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    • pp.73-88
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    • 2009
  • The purpose of the study was to provide the basic for the prevention of infection control by analyzing the level of recognition and practice of dental hygiene students. It is important for dental clinic staffs to know and practice infection control measures in favor of effective infection control. Thus, this study conducted an one-month questionnaire survey (during October 2008) for dental hygiene students who ever experienced in 16-week clinical practice, and analyzed total 206 questionnaire forms as collected from them, so that it could determine potential associations between their recognition and practice of infection control and thereby suggest an efficient solution for infection control in dental hygiene. 1. It was found that our students' recognition about infection control averaged $4.49{\pm}.58$ points on the whole, and they were best aware of instrumental disinfection and sterilization among other measures, which was followed by hand washing, extirpation control, post-sterilization management, personal protective outfit and instrumental surface maintenance respectively. 2. It was found that our students' practice of infection control averaged $3.85{\pm}.57$ points on the whole, and they practiced hand washing most actively among other measures, which was followed by extirpation control, post-sterilization management, instrumental disinfection and sterilization, personal protective outfit and instrumental surface maintenance respectively. 3. It was found that our students scored higher mean points in recognition about every measure of infection control than those in practice (t=15.676, p=0.000). Particularly, it was notable that there were significant differences between their mean points in recognition and practice of some infection control measures, such as instrumental surface maintenance (t=15.361, p=0.000), personal protective outfit (t=15.245, p=0.000) and instrumental disinfection and sterilization (t=11.169, p=0.000). But there was least significant difference between mean points in recognition and practice of hand washing (t=5.460, p=0.000). 4. For potential associations between recognition and practice of infection control, it was found that higher recognition was in significantly positive associations with higher practice in every measure of infection control (r=.478, p=.000), such as extirpation control (r=.630, p=.000), instrumental disinfection and sterilization (r=.477, p=.000) and post-sterilization management (r=.433, p=.000). 5. It was found that there were differences in our students' recognition depending upon availability of infection control guideline (t=4.587, p=.011), and there were significant differences in practice depending on necessity of infection control education on a statistical basis (t=2.229, p=.027). Overall, it is found that our dental hygiene students are very likely to practice hand washing and extirpation control, because both of these measures are relatively easy to practice or are considered legally binding.

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Quantification Model for Applying Construction Management Practices in Consideration of Project Characteristic Factors

  • Cha, Hee Sung;Kim, Jin Lee
    • Journal of Construction Engineering and Project Management
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    • 제3권1호
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    • pp.35-38
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    • 2013
  • No single project is identical to one another in the construction industry. Furthermore, many construction projects are suffering from tighter budget, shortened schedule and higher client satisfaction level. To overcome these, project managers and engineers are willing to apply various best management practices to their projects. However, it is non-trivial to select the most appropriate practices for their projects. In many cases, it is much more important to find the appropriateness of the management practices than just to use the practices. Although many researchers are focusing on the development of new management practices, there is little research on matching between the circumstances of projects and the developed management practices. The objective of this study is to provide a structured process to suggest the best management practices for individual construction projects by developing a computerized system where an individual project is matched with the most optimal management practices to increase the value of the project. At this stage of writing, the authors have developed a computerized system to effectively find out the best suitable management practices for individual projects. By maximizing the usages of this system, it would facilitate the application of the best management practices in the industry.

QUANTIFICATION MODEL FOR APPLYING CONSTRUCTION MANAGEMENT PRACTICES IN CONSIDERATION OF PROJECT CHARACTERISTIC FACTORS

  • Hee Sung Cha;Jin Lee Kim
    • 국제학술발표논문집
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    • The 5th International Conference on Construction Engineering and Project Management
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    • pp.624-627
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    • 2013
  • No single project is identical to one another in the construction industry. Furthermore, many construction projects are suffering from tighter budget, shortened schedule and higher client satisfaction level. To overcome these, project managers and engineers are willing to apply various best management practices to their projects. However, it is non-trivial to select the most appropriate practices for their projects. In many cases, it is much more important to find the appropriateness of the management practices than just to use the practices. Although many researchers are focusing on the development of new management practices, there is little research on matching between the circumstances of projects and the developed management practices. The objective of this study is to provide a structured process to suggest the best management practices for individual construction projects by developing a computerized system where an individual project is matched with the most optimal management practices to increase the value of the project. At this stage of writing, the authors have developed a computerized system to effectively find out the best suitable management practices for individual projects. By maximizing the usages of this system, it would facilitate the application of the best management practices in the industry.

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실행공동체를 이용하여 지식공유의 제약사항 극복: 철강회사 사례를 중심으로 (Overcoming Barriers of Knowledge Sharing through Communities of Practice: A Case Study of Steel Company)

  • 홍대근;구충효;서의호
    • 경영정보학연구
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    • 제11권2호
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    • pp.131-145
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    • 2009
  • 지식경영은 조직의 중요한 자원인 지식을 개발, 수집, 체계화, 이용 및 활용이라는 프로세스를 통해서 지식을 체계적으로 관리하는 것이다. 지식은 조직의 지식자산으로서 조직의 경쟁력을 강화시키는 중요하기 요소이기 때문에 어떻게 조직 내에서 지식공유를 활성화할 것이냐가 조직의 당면과제이다. 지식공유활동은 제약하는 요소를 감안하지 않고 지식공유와 팀 협력을 시도하는 것은 조직의 지식경영문화 증진을 오히려 저해할 수 있다. 따라서, 본 연구에서는 조직 내에서 지식공유활동을 제약하는 문제점을 개인적 측면과 사회적 측면에서 파악하고 효과적인 지식공유도구로서 실행공동체 활용모형을 제안한다. 제안된 실행공동체 활용모형에서는 지식공유활동 저해요소를 극복하고 지식공유활동을 활성화할 수 있는 방안을 제시한다. 또한, 제안된 모형을 적용한 철강회사의 실행공동체 활용 우수사례를 소개한다. 마지막으로 구체적인 사례분석을 통해서 조직 내에서 지식공유를 활성화하기 위한 방법으로 실행공동체의 적용가능성과 효과성을 가늠해본다.

신경계물리치료에서의 근거중심실기(1) -임상의사결정과정에 EBP 적용하기- (Evidence-Based Practice in Neurological Physical Therapy (1) -Applying EBP to Clinical Decision Making-)

  • 이문규;임재헌;김태윤
    • PNF and Movement
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    • 제14권3호
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    • pp.157-176
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    • 2016
  • Purpose: The purpose of this study was to share an experience about processes and lessons learned to execute evidence-based practice (EBP) in neurological physical therapy. Methods: The most important thing in applying EBP to practice is to search, find, and appraise the existing evidence. Many evidence databases are available, such as CENTRAL, PEDro, PUBMED, and EMBASE. However, the knowledge represented in these databases is not always perfect. The practice model is a set of processes to resolve client problems. Therapists should make hypothesis-focused decisions through EBP. Integrating clinical reasoning and evidence is most important when it comes to the execution of EBP. Results: The process of EBP consisted of following: coming up with clinical questions, followed by searching for, appraising, evaluating, and integrating evidence. To integrate EBP into practice, it is necessary to consider clinical expertise, patient value and preferences, as well as research wth the best evidence. We provided an example of a clinical case with a stroke patient to show how this process and framework concerning clinical reasoning through evidences can be integrateds. During this process, we also utilized information technology to improve EBP ability. Conclusion: We should recognize what manner of information is needed to resolve eash patient's problem, and we should search for this information efficiently. Then, we should judge the value of the information obtained as it applies, to the clinical setting.

안경광학과 임상실습 실태에 관한 연구 (A Study on the Clinical Practice in Ophthalmic Optics)

  • 이옥진;신진아;정세훈
    • 한국안광학회지
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    • 제15권4호
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    • pp.319-328
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    • 2010
  • 목적: 안경광학과 임상실습의 현황 및 실태를 파악하여 임상실습의 효율적 운영과 질적 개선을 위한 자료를 얻고자 하였다. 방법: 전국의 30개 안경광학과를 대상으로 임상실습 현황에 대한 설문조사를 하였고 이중 4개 대학에서 161명의 학생으로부터 임상실습 실태에 대한 설문조사를 실시하였다. 결과: '임상실습을 위한 구체적 프로그램'이 마련되지 않은 곳은 60.7%였다. 대부분의 대학에서 임상실습을 졸업학점에 반영(96.4%)하였고, 각 대학의 임상실습에 관한 교과목명과 해당학점은 다양하였다. 실습 학생들에게 임상실습 수행 중 가장 어려웠던 사항은 '고객응대'였고 임상실습의 주 업무는 '안경원 청소 및 안경테와 도구정리'였다. 임상실습을 통해 가장 유익했던 점은 '안경업계 현실파악'이었다. 임상실습 전과 후의 진로 비교에서 '안경원'과 '안경/콘택트렌즈 관련업체'의 선호도는 감소하고 '안과 병의원'과 '전공과 관련 없는 일'의 선호도는 높아졌다. 결론: 안경광학과 임상실습의 효율적 운영과 학생들의 만족도를 높이기 위한 폭 넓은 연구와 학교와 실습업체 간의 긴밀한 협조와 관심이 요구된다.