• 제목/요약/키워드: Clinical safety

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병원 간호사의 환자안전문화 인식, 사건보고 및 안전간호활동: 일 대학병원을 중심으로 (A Study on Patient Safety Culture, Incident Reporting and Safety Care Activities of Clinical Nurses in a University-Affiliated Hospital)

  • 하수진;이민주
    • 근관절건강학회지
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    • 제26권1호
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    • pp.35-45
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    • 2019
  • Purpose: This study aimed to investigate perception of patient safety culture, incident reporting, and safety care activities among clinical nurses and to identify factors associated with the safety care activities. Methods: Structured questionnaires were used to collect data from 155 nurses who were involved in direct patient-care. Results: Descriptive statistical anaylses revealed that the mean score of patient safety culture was $3.26{\pm}0.32$ and $4.19{\pm}0.41$ was for the safety care activities. In incident reporting, reporting intention ($3.56{\pm}0.68$), belief in improvement ($3.42{\pm}0.60$), worry about appraisal ($3.37{\pm}0.65$) and reporting knowledge ($3.36{\pm}0.72$) respectively. Correlational analyses showed that perceived patient safety culture (r=.36), reporting intention (r=.34), belief in improvement (r=.32), and the knowledge (r=.38) in incident reporting were positively correlated with safety care activities, while the worry about appraisal in incident reporting attitude was negatively correlated. The factors associated with safety care activities were incident reporting knowledge (${\beta}=.31$, p<.001), supervisor/managers' attitudes toward patient safety culture (${\beta}=.29$, p<.001), belief in improvement of incident reporting attitude (${\beta}=.16$, p=.041). Conclusion: These results suggest that to improve safety care activities among hospital nurses, it is necessary to educate nurses on incident reporting. Also, a system-level approach is needed to support leadership in patient safety and to provide positive feedback on incident reporting.

'첨단재생의료 및 첨단바이오의약품 안전 및 지원에 관한 법률' 개정에 따른 '기관생명윤리위원회(Institutional Review Board)' 역할 및 '임상시험 및 대상자보호프로그램(Human Research Protections Program)' 강화의 중요성 (The Importance of Strengthening the Role of the Institutional Review Board and the Human Research Protections Program following the Revision of the Act on the Safety and Support of Advanced Regenerative Medicine and Advanced Biopharmaceuticals)

  • 김병수
    • 대한기관윤리심의기구협의회지
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    • 제6권1호
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    • pp.1-4
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    • 2024
  • The strengthening of Institutional Review Board (IRB) and Human Research Protection Program (HRPP) for clinical research on advanced regenerative medicine reflecting the 3 Principles of the Belmont Report (Respect, Beneficence, Justice) is very important. The research institution IRB should naturally be in charge of managing the clinical research process. And it is crucial to reinforce HRPP for the protection of research subjects in institutions conducting advanced regeneration clinical research. So, it is needed to establish a Protection System for Advanced Regenerative Medical Research Subjects composed of clinical research management communication system for advanced regenerative medicine between KAIRB (Korean Association of IRB) of research institutes and National Management Agency for Advanced Regenerative Medical Research. In advanced regenerative medicine clinical research to verify safety and efficacy of the investigational drugs to the subjects with rare and incurable diseases rather than to treat the patients, it is hoped that a management system that guarantees the scientific characteristics of research and the rights of research subjects would be well organized and operated.

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곡지혈 매선침 시술이 경피수분 손실량에 미치는 영향 (Pilot Clinical Trial to Evaluate the Efficacy of Needle-Embedding Acupuncture Therapy at Gokji(LI11) on TEWL)

  • 이호찬;정미영;최정화;정민영;박수연
    • 동의생리병리학회지
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    • 제32권4호
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    • pp.291-297
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    • 2018
  • The purpose of pilot clinical trial is to evaluate the efiicacy and safety of Needle-Embedding acupuncture therapy on TEWL(Transepidermal Water Loss) and Skin hydration. A total of 24 human who visited Dongshin Oriental Medical Center from December 1st, 2016 to July 31st, 2017 were included in the pilot clinical trial. Needle-Embedding acupuncture therapy performed at Gokji(LI11). We observed change of TEWL(Transepidermal Water Loss), Skin hydration before and after Needle-Embedding acupuncture therapy. In the primary endpoint, index of TEWL showed a statistically insignificant decline ($8.5{\pm}2.12{\rightarrow}7.8{\pm}1.53g/h/m^2$). Index of skin hydration showed a statistically significant result ($38.2{\pm}6.77{\rightarrow}36.8{\pm}6.64$). To evaluate the safety, Adverse events and Vital sign check were conducted and there were no problem. And when the physical response, self-awareness, skin system, musculoskeletal pain, and other abnormal responses were assessed 60 minutes and 24 hours and 7 days after Needle-Embedding acupuncture therapy at Gokji(LI11) for stability assessment, Adverse events disappeared during a pilot clinical trial. According to the above pilot clinical trial, it is suggested Needle-Embedding acupuncture therapy were effective for Skin moisturizing and safe.

C형 간염 바이러스 감염 치료를 위한 grazoprevir 및 elbasvir의 유효성 및 안전성에 대한 메타 분석 (Meta-analysis of the Efficacy and Safety of Grazoprevir and Elbasvir for the Treatment of Hepatitis C Virus Infection)

  • 강민구;강민정;지은희;유봉규
    • 한국임상약학회지
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    • 제27권3호
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    • pp.150-160
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    • 2017
  • Background: Recently, a fixed combination of grazoprevir and elbasvir (GE) has been introduced to the arsenal of chemotherapeutics to fight against this virus. The study aimed to provide information on the efficacy and safety of GE for the treatment of HCV infection by performing a meta-analysis of literature data. Methods: PubMed and EMBASE database searches were conducted. Among the literature retrieved, pivotal Phase III clinical studies were analyzed. Statistical analysis of the data was performed by RevMan. Results: Four pivotal Phase III clinical studies compared the efficacy and safety of GE. When HCV patients were treated with GE for 12 weeks, the sustained virologic response, defined as the viral RNA level below the lower limit of quantification at 12 weeks after the cessation of therapy (SVR12), was 94.7%. The clinical advantage of GE involves its use by patients with cirrhosis and/or renal failure without dose adjustment. If the genotype (GT) of the causative virus was GT1a with NS5A polymorphism or GT4 with resistance to peginterferon/ribavirin, treatment with GE plus ribavirin for 16 weeks resulted in a better outcome compared to treatment with GE alone for 12 weeks. Adverse events reported during the four clinical studies were 71.09% in the GE arms and it was 76.61% in the non-GE arms, with the most frequent events being mild central nervous system symptoms. Conclusion: GE was generally safe and effective for the treatment of HCV infection. However, since HCV mutates very rapidly and becomes resistant to antiviral agents, long-term monitoring should be mandatory.

Safety and Effectiveness of Fluoroscopy-Guided Acupotomy for Carpal Tunnel Syndrome: Protocol for a Pilot Randomized, Patient-Assessor Blind, Parallel Clinical Trial

  • Yang, Muhack;Kim, Jae Kyoun;Park, Gun Woo;Cha, Eunhye;Jang, Jongwon;Seo, Jihye;Lee, Sangkwan;Kim, Sungchul
    • Journal of Acupuncture Research
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    • 제36권2호
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    • pp.100-106
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    • 2019
  • Background: In Korean medicine, carpal tunnel syndrome is treated by stimulating the acupoints around the wrist. Although a deep understanding of anatomy and guidance is needed to stimulate these acupoints to avoid undesirable side-effects, currently there are no published guidelines for acupotomy treatment. The aim of this study is to evaluate the effectiveness and safety of fluoroscopy-guided acupotomy compared with conventional acupotomy treatment. Methods: This is a randomized, patient-assessor, patient blind, parallel clinical trial. A total of 30 patients will be enrolled at Wonkwang University Gwangju Hospital, and will be allocated to either an experimental group or a control group. The experimental group will be treated using fluoroscopy-guided acupotomy and the control group will be treated using the conventional acupotomy method. Results: The primary outcome measure will be identification of a cross-section area of the median nerve measured by ultrasonography, and the secondary outcome measure will be the alleviation of pain measured by the Visual Analogue Scale, improvement in the Nerve Conduction Study, Tinel test, Phalen's test, EuroQol 5-dimension scale, and Boston Carpal Tunnel Questionnaire score. Safety components will be measured by monitoring vital signs, electrocardiographs, blood tests, general chemical tests, urine tests and pregnancy tests. In addition, observations for adverse effects will be performed during the trial. Conclusion: This study will provide a more effective, and less harmful way of treating carpal tunnel syndrome compared with conventional acupotomy. Fluoroscopy-guided acupotomy will help practitioners to be accurate in direction and depth of the needle for treating carpal tunnel syndrome.

판례를 이용한 환자안전관련 간호과오 예방교육이 간호사의 안전지각, 안전통제감, 자율성 및 책임수용성에 미치는 효과 (Effects of an Education Program on Prevention of Malpractice using Precedent Cases related to Patient Safety in Safety Perception, Safety Control, Autonomy and Accountability in Clinical Nurses)

  • 김기경;송말순;이준상;김영신;윤소영;백지은;허혜경
    • 간호행정학회지
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    • 제18권1호
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    • pp.67-75
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    • 2012
  • Purpose: The purpose of this study was to identify the effects of an education program on safety perception, safety control, autonomy and accountability in clinical nurses. Precedent cases related to patient safety were used in the education program. Methods: A quasi-experimental design with pretest and posttest measures was used. Participants in the study, 72 nurses in the experimental group, 71 nurses in the control group, were enrolled for 3 months. The education program was composed of the 20 precedent cases related to patient safety from home and foreign countries. Results: The major findings of this study were as follows: Safety perception (p=.000), Safety control (p=.000), attitude toward autonomy (p=.000), and attitude toward accountability (p=.000) improved after the education program. Conclusion: The findings from this study indicate that an education program using precedent cases is an efficient method to improve behavior and change attitudes towards protecting patients' safety and preventing malpractice claims against nurses.

Data-driven Adaptive Safety Monitoring Using Virtual Subjects in Medical Cyber-Physical Systems: A Glucose Control Case Study

  • Chen, Sanjian;Sokolsky, Oleg;Weimer, James;Lee, Insup
    • Journal of Computing Science and Engineering
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    • 제10권3호
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    • pp.75-84
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    • 2016
  • Medical cyber-physical systems (MCPS) integrate sensors, actuators, and software to improve patient safety and quality of healthcare. These systems introduce major challenges to safety analysis because the patient's physiology is complex, nonlinear, unobservable, and uncertain. To cope with the challenge that unidentified physiological parameters may exhibit short-term variances in certain clinical scenarios, we propose a novel run-time predictive safety monitoring technique that leverages a maximal model coupled with online training of a computational virtual subject (CVS) set. The proposed monitor predicts safety-critical events at run-time using only clinically available measurements. We apply the technique to a surgical glucose control case study. Evaluation on retrospective real clinical data shows that the algorithm achieves 96% sensitivity with a low average false alarm rate of 0.5 false alarm per surgery.

A case of hypothyroidism concurrent with myxedema coma in a Cocker spaniel dog

  • Kim, Yun-Hye;Kim, Jun-Hwan;Lee, Hyun-Seok;Cho, Ho-Seong;Park, Jin-Ho;Park, Chul
    • 한국동물위생학회지
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    • 제35권2호
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    • pp.159-163
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    • 2012
  • A 4-year-old female Cocker spaniel weighing 7.74 kg was presented with a seven-month history of lethargy and skin problems. On the basis of clinical history, physical examination, laboratory tests, electrocardiogram, radiography, ultrasonography, and thyroid function tests, the dog was diagnosed as hypothyroidism. The dog was administered levothyroxine and presented a good response to the therapy. However, uncontrolled for about 6 months, the dog was re-admitted to hospital with depression and three seizure episodes. The dog was diagnosed as hypothyroidism with concurrent myxedema coma and gallbladder mucocele. With fluid therapy and administration of levothyroxine, the dog was successfully controlled for 3 months after starting treatment. This report describes the clinical features and successful treatment of a Cocker spaniel dog with concurrent hypothyroidism and myxedema coma.

임상간호사의 환자안전 간호활동 측정도구 개발 (Development of the Patient Safety Nursing Activities Scale for Clinical Nurses)

  • 김화영;류세앙
    • 디지털융복합연구
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    • 제16권9호
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    • pp.207-217
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    • 2018
  • 본 연구는 임상간호사의 환자안전 간호활동 측정도구를 개발하여 도구의 타당도와 신뢰도를 검증하기 위해 수행되었다. 문헌고찰, 포커스그룹 인터뷰, 내용타당도 검증 및 사전조사를 통해 예비도구를 개발하고, 전국 종합병원급 이상의 병원을 대상으로 비례층화표본추출 방법으로 선정된 28개 병원의 간호사를 대상으로 자료를 수집하였다. 도구의 구성타당도는 탐색적 요인분석으로, 준거타당도는 환자안전문화 도구와 상관관계로 분석하였고, 내적일관도는 Cronbach's ${\alpha}$로 검증하였다. 개발된 도구는 최종 10영역 72문항으로 구성된 4점 총화평정척도였고, 탐색적 요인분석 결과 총 설명변량은 70.3%이었으며, 요인적재량은 .74이상이었다. 본 도구는 환자안전문화 측정도구와 유의한 상관관계(r=.51, p<.001)를 나타냈으며 Cronbach's ${\alpha}$는 .99였다. 결론적으로 임상간호사의 환자안전 간호활동을 측정하기 위해 개발된 본 도구는 타당도와 신뢰도가 검증되었고 실무현장에서 유용한 도구가 될 것이다.

오행체질론에 의한 안전직무 설계 (Job Design for Safety Based on Five Elements Constitution)

  • 이동형;김재두
    • 대한안전경영과학회지
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    • 제5권3호
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    • pp.31-43
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    • 2003
  • In the Oriental Medicine, the physical constitution of a human being can be classified into five characteristic elements. The remedy based on the five elements constitution has revealed excellent clinical effects so far. Therefore, it may be worthwhile to conduct job design researches considering the five elements constitution for improving the efficiency and safety of job. In this study, we examine whether the theory can be applied for job design through the experiment by ‘Digital-type Speed Anticipation Reaction Tester’ or not and suggest the desirable direction of job design.