• The Korean Journal of Emergency Medical Services
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• v.12 no.3
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• pp.115-127
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• 2008

Purpose : This study aimed to examine the effects of empowerment of the paramedics on critical thinking and provide the basic materials for the qualitative improvement of emergency medical service. Methods : This study collected data with the paramedics working at general hospital and hospital emergency room in G metropolitan city, B metropolitan city, U metropolitan city, D metropolitan city and J province from July 1 to 31, 2008. Total 180 questionnaires were collected and 152 were used for final analysis, and the following results were obtained through statistical analysis using SPSS 12.0 program. Results : 1) Average score of empowerment was 4.44 out of 6 and according to average score by areas, significance was 4.94, capacity 4.92, self-determination 4.28, and effective-ness 3.62. 2) Empowerment by general characteristics was statistically significant in age (F = 3.313, p < 0.05), the final scholastic attainments(F = 2.436, p < 0.05), and salary(F = 1.695, p < 0.01). 3) Average score of critical thinking was 3.12 out of 7 and according to scores by areas, maturity was highest as 3.71, followed by no prejudice as 3.70, systemicity as 3.14, pursuit of truth as 3.05, much curiosity as 2.93, critical thinking and self-confidence as 2.92, and analysis as 2.91. 4) Critical thinking by general characteristics was statistically significant in marital status (F = 15.695, p < 0.01) and the final scholastic attainments (F = 2.606, p < 0.05). 5) Correlations between empowerment and critical thinking showed positive correlations as Pearson's correlation coefficient r = 0.400 and positive correlation in all areas including empowerment and critical thinking were found (r = 0.116-0.710). 6) The effect of empowerment on critical thinking was statistically significant in p < 0.01 and was explained as $R^2=0.155$. In the effects of empowerment on critical thinking, significance, capacity and self-determination were statistically significant in p < 0.01, effectiveness in p < 0.05 and were explained as R2 = 0.244. Conclusion : From the above results, it was found that empowerment had the influence on critical thinking, so it was considered that hospital managers and emergency room chiefs must develop and operate education and training program based on the concept of empowerment, maintenance and management strategies.

• The Journal of KAIRB
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• v.2 no.2
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• pp.37-48
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• 2020

Purpose: The purpose of this study is to assess the operational status and level of understanding among IRB and HRPP staffs at a hospital or a research institute to the HRPP guideline set by the Ministry of Food and Drug Safety (MFDS) and to provide recommendations. Methods: Online survey was distributed among members of Korean Association of IRB (KAIRB) through each IRB office. The result was separated according to topic and descriptive statistics was used for analysis. Result: Survey notification was sent out to 176 institutions and 65 (37.1%) institutions answered the survey by online. Of 65 institutions that answered the survey; 83.1% was hospital, 12.3% was university, 3.1% was medical college, 1.5% was research institution. 23 institutions (25.4%) established independent HRPP offices and 39 institutions (60.0%) did not. 12 institutions (18.5%) had separate IRB and HRPP heads, 21 (32.3%) institutions separated business reporting procedure and person in charge, 12 institutions separated the responsibility of IRB and HRPP among staff, and 45 institutions (69.2%) had audit & non-compliance managers. When asked about the most important basic task for HRPP, 23% answered self-audit. And according to 43.52%, self-audit was also the most by both institutions that operated HRPP and institutions that did not. When basic task performance status was analyzed, on average, the institutions that operated HRPP was 14% higher than institutions that only operated IRB. 9 (13.8%) institutions were evaluated and obtained HRPP accreditation from MFDS and the most common reason for obtaining the accreditation was to be selected as Institution for the education of persons conducting clinical trial (6 institutions). The most common reason for not obtaining HRPP accreditation was because of insufficient staff and limited capacity of the institution (28%). Institutions with and without a plan to be HRPP accredited by MFDS were 20 (37.7%) each. 34 institutions (52.3%) answered HRPP evaluation method and accreditation by MFDS was appropriate while 31 institutions (47.7%) answered otherwise. 36 institutions answered that HRPP evaluation and accreditation by MFDS was credible while 29 institutions (44.5%) answered that HRPP evaluation method and accreditation by MFDS was not credible. Conclusion: 1. MFDS's HRPP accreditation program can facilitate the main objective of HRPP and MFDS's HRPP accreditation program should be encouraged to non-tertiary hospitals by taking small staff size into consideration and issuing accreditation by segregating accreditation. 2. While issuing Institution for the education of persons conducting clinical trial status as a benefit of MFDS's HRPP accreditation program, it can also hinder access to MFDS's HRPP accreditation program. It should also be considered that the non-contact culture during COVID-19 pandemic eliminated time and space limitation for education. 3. For clinical research conducted internally by an institution, internal audit is the most effective and sole method of protecting safety and right of the test subjects and integrity for research in Korea. For this reason, regardless of the size of the institution, an internal audit should be enforced. 4. It is necessary for KAIRB and MFDSto improve HRPP awareness by advocating and educating the concept and necessity of HRPP in clinical research. 5. A new HRPP accreditation system should be setup for all clinical research with human subjects, including Investigational New Drug (IND) application in near future.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.6
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• pp.2607-2616
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• 2012

This study was designed to figure out patient safety culture of medical institutions and try to utilize the study results as basic data for analyzing doctor's awareness of patient safety culture. To this end, questionnaire survey was conducted from August 1st to September 5th, 2011, targeting doctors working at senior general hospitals located in G city, and 194 questionnaires were utilized for final analysis. The research results are as follows. First, there was a difference in awareness of deployment of staffs depending on gender, age, term of service in the hospital, contact with patients and working hours per week in relationship between subjects, wards and hospital safety culture, and organizational learning and teamwork in the ward turned out to be significant in accordance with working hours per week, and all sub-areas of the ward safety culture by departments. Second, feedback about the malpractice, communication, report on malpractice frequency and overall safety awareness were found to be significant by departments in relationship of subjects, medical incident reporting system, patient safety evaluation and overall level of consciousness, and the overall safety awareness showed significant results according to contact with patients and working hours per week. Third, there was a positive corelation in sub-areas of the ward and hospital safety culture awareness, overall recognition and patient safety evaluation, and a positive corelation with medical incident reporting system was found in all areas except for attitude of managers/immediate supervisors and that of hospital executives. Fourth, sub-areas of patient safety culture which has a effect on patient safety showed significant results in organizational learning, openness of communication, overall safety awareness, systematic cooperation between departments, feedback/communication and non-punitive response. In conclusion, to increase the level of the ward and hospital patient safety culture of doctors and implement medical incident reporting system faithfully, it is necessary to activate teamwork through organizational learning in the ward based on the adequate staffing and working hours, promote open communication between departments and provide feedback on medical malpractice, thereby establishing a cooperative system by departments and active support of hospital executives for patient safet.

• Korean Journal of Occupational Health Nursing
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• v.14 no.2
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• pp.164-170
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• 2005

Purpose: The present study attempted to find subjective musculoskeletal symptoms of operating room nurses (OR nurses) and then to use them as basic data for prevention and management of musculoskeletal symptoms of OR nurses. Method: This study was an exploratory research, and data were collected from OR nurses working in 8 polyclinics in Korea from July 26 to August 19, 2004, using a self-report questionnaire. The questionnaire contains items concerned with subjective musculoskeletal symptoms include ones with the presence of symptoms and with the degree of discomfort, in the joints such as neck, shoulder, arm/elbow, hand/wrist/finger and waist. For data collection, the aim of the study was explained to the operating room managers to obtain their help, and these questionnaires were sent to hospitals, and were retrieved by post. 271(90.3%) questionnaires were returned among those sent to 300 nurses. 249 questionnaires excluding 22 insufficient ones such as no response were used for data analysis. Data were analyzed using SPSS WIN 12.0. Subjective musculoskeletal symptoms were analyzed in the number and percentage. Result: 187(75.1%) nurses said they 'had' subjective musculoskeletal symptoms and 62 (24.9%) said they had 'nothing'. 130(52.2%), 125 (50.2%), 113 (45.4%), 86(34.5%), and 42 (16.9%) nurses had subjective musculoskeletal symptoms in waist, shoulder, hand/wrist/finger, neck, and arm/elbow, respectively. 51(27.3%) and 136 (72.7%) nurses complained of the pain in one site, and in two or more sites, respectively. In particular, 51% and 47.4% nurses said that they were 'discomforted' due to the pain in waist and in shoulder, respectively. Conclusion: Subjective musculoskeletal symptoms which OR nurses complained of were significant. This may cause difficulty in nursing tasks in the operating room. So various arrangements have to be made for OR nurse with subjective musculoskeletal symptoms at an early stage.

• Journal of Korean Academy of Nursing
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• v.29 no.5
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• pp.1072-1086
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• 1999

This study has been attempted using the Q methodology to clarify leader type of nurse managers that head nurses and general nurses recognize, and to clarify its relative relation. Sixty-three statements were extracted through interviews with general and professional people interested in the subject of nurse leaders to extract the Q population. A total of 314 Q population was formed added with 251 questions extracted from related documents. Final 32 Q samples were selected by reorganization of 314 Q population after reexamining statements through inquiry of 1 professor of the nurse department, 2 students in course of nurse science masters degree and 2 students in course of doctoral degree. The P sample selection standard of this study were 25 nurses and 30 head nurses. Examination subjects themselves filled out 32 statements classified in a measure of 9 points from agreeable items to disagreeable items. Principal component factors were analyzed using the QUANL pc program after grading the contents of the P sample. Nurses recognizing subjective structure for leader behaviors of nurse manager were analyzed to be 3 factors: vision presentation type, self-capability consideration type, relationship consideration type, and head nurses recognizing subjective structure were analyzed to be 2 types: task pursuit leader type, and concord pursuit type. Nursing manager's leader behavior, expected by staff nurse are more complex and higher level which may combined with task pursuit leader type in concord pursuit leader of head nurse. Also according to Horsey and Blanchard theory(1977), the effectiveness of leadership becomes to be larger as the accordance rate between the behaviors of nurse leaders and followers reaction increase Two suggestions have been made based on the conclusion. 1. Studies on creating strategies in relation to development, management, selection of nurse leaders should be made based on this study. 2. There is a need for relative study of production and degree of similarity of leadership types based on this study.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.3
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• pp.535-545
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• 1999

The purpose of this study is to investigate the nurses' needs in the general hospitals as a basic study to develop ICU clinical nurse from Aug. 3 to Sept. 26 1998 at 13 general or university hospitals that have ICU nurse training course and are accredited at KNA. The subjects of study were ICU nurses and nurse managers at the department of nursing. The questionnaire items were developed from literature review, interviews with 30 ICU nurses at an university hospital in Pusan. The results were as follows : The subjects of study educated in ICU nurse training course were 44.3% of total. The 93.1% responded the necessity of ICU CNS and 89.1% wanted to have ICU CNS certification. The 43.8% answered that ICU should be a center of CNS education and 32.0% answered the department of nursing. Most of subjects responded that the clinical experience of ICU should be needed prior to CNS education. Regarding the treatment of ICU CNS, the 34.2% of total subjects responded it would be suitable to pay additional allowance and the 28.3% answered to grade-up salary step, and then the 13.7% to promote level position. Concerning the assignment department, the 63.5% answered that the charge nurse would be proper than general nurse or head nurse. As to the working time of ICU CNS, the 93.2% responded that D-duty is needed, the 79.5% to E-duty and the 64.4% to N-duty. It is suggested that the consensus of ICU nurses for the concept, the role and the system of ICU CNS is needed.

• The Korean Society of Law and Medicine
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• v.11 no.2
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• pp.181-208
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• 2010

Maternity services is often perceived as a troublesome business and obstetric litigation is on the increase in Western countries. Overall, the number of claim and cost of litigation to the NHS Litigation Authority (NHSLA) from maternity services in the UK is increasing every year. Maternity services account for 60-70% of the total sum paid. This has widespread implications for both the individual practitioners and the institutions where they work, due to increasing malpractice insurance premiums. Fear of litigation is also attracting fewer medical graduates into the specialty, leading to a recruitment crisis in obstetrics and gynaecology. The litigation process can cause pain, suffering and distress to clinicians as well as to the patients and their families. Litigation in maternity services is the result of a complex of events when malpractice (presumed or real) impacts on the attitude of pregnant women and their environment. In such complexity, information is mandatory but may often be misinterpreted. If messages are not tailored to the receiver's capacity, communicating well with the pregnant patient becomes crucial. Therefore, to reduce medicallegal issues in obstetrics, increasing attention and an applicable standard of obstetric care to avoid negligence and medical errors should go along with other measures. Considering UK's experiences, NHS redress scheme make it easier to pursue small claims and birth related claims, without necessarily reducing the number of claims processed through the conventional legal system and perhaps encouraging even more of them. The task of dealing with the greater number of inquiries into their practice would inevitably create an added burden for clinicians and hospital managers. Thus further proposals are required to limit the cost of processing inflated claims and to consider whether clinicians should be given some protection from litigation alleging a failure to prevent birth related impairment.

• Safety and Health at Work
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• v.11 no.3
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• pp.335-346
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• 2020

Background: Nursing service is a nonroutine work with an excessive physical load and diverse tasks. This study derived representative common tasks based on the frequently occurring tasks with a high physical load in the nursing workers' daily work and developed indicators to evaluate the work risk by reflecting the characteristics of nonroutine work. Methods: Common tasks were classified through the following stages: literature review, first focus group interview (FGI) with experts, first classification of common tasks, second FGI with hospital health managers, a survey of nursing service workers, and the final classification of common tasks for each task type. To develop an objective risk index for physical load assessment, we investigated the frequency and duration of the derived common tasks via survey. Results: Nursing common tasks were categorized into six task types and 56 subtasks. To evaluate the risks of various tasks in nonroutine works, three frequencies and three working time levels were defined by examining the task frequency and working hours. Exposure time was defined to reflect the characteristics of a nonroutine job. The final risk assessment was the product of the exposure time level and job intensity level. From this, four risk action levels were derived. Conclusion: This study has the advantage of solving the problem of focusing on some tasks in evaluating the physical load. It was meaningful in that a new risk assessment index based on exposure time was proposed based on the development of an evaluation scale for frequency and time by reflecting the characteristics of nonroutine work.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.4
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• pp.517-526
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• 2010

Purpose: The purpose of this study was to identify the major trends of research in the Journal of Korean Nursing Administration from 2007 to 2009. Method: Research designs, participants, research domains, and key words were analyzed from the Journal of Korean Nursing Administration. Results: Job satisfaction, organizational commitment, job stress, turnover intention, nursing performance, self-efficiency, leadership, empowerment, nursing informatics, and quality control were the major key words commonly listed in the journal articles. Of the research in the Nursing Administration Journal, quantitative methods were used in 94.5% of the research studies and qualitative methods in only 5.5%. The major participants in the research were nurses, nurse managers, and patients. Statistical methods like ANOVA, correlation, t-test, regression, chi-square test, LISREL were the dominant method of analysis used in the research. The primary domains in the journal articles were directing, organizing, control, planning, and informatics. Conclusion: Through this study, the trend of research in nursing administration can be identified. We recommend that collaboration, nurse work environment, evidence-based practice, scheduling, coaching, patient falls and safety, and positive culture should be included as topics for the future research.

• Research in Community and Public Health Nursing
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• v.4 no.1
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• pp.77-83
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• 1993

This study was carried out to idedtify Worker's general health diagnosis and specific health diagnosis state and provide the basic data about occupational health nursing services in Kyung Sang Nam Do. Data was obtained from 36 industry in Chang-won, Jin-joo, Geo-jeoi, Chung-moo area during Dec. 20. 1992-Feb. 18. 1993 through questionaire survey. Data was analyzed into frequency, percentage, average, standard deviation and score sum The main findings are as follows : 1) 83.3% of subject was manufactures. The factory which have over 1000 Worker's are 41.7% and 500-999 are 36.1%. 2) Health managers are composed of 5 man power. Doctors occupied in 44.4% of factories, average age of them are 43.9 years, average careers are 4.0 years. Nurses occupied in all factories and their average ages are 27.6, average careers are 3.0 years. Industrial hygienist occupied in 33.3% of factories, environmental hygienist occupied 69.4% of industries, and nurse aids occupied in 19.4%. 3) 99.9% of workers are received general health diagonosis. And 10.8% of workers are received elaborate health diagnosis. Among them 30.9% are C class and 23.4% are D class. Among D class, 50% of workers are treated as work time shortening, work replacement, being under treatment. Total specific health diagnosis' subject are 19.3% of workers but 79.9% of them are received specific health diagnosis. Among them 18.6% are needed follow up treatement. Only 44.9% of them are received follow up treatement. 4) 69.4% of industries have their referral hospital and 97.2% have their clinics. Among Occupational health services, health diagnosis are carried out first. of all and the next, environmental management, industrial diagnosis, health education are carried out.