Purpose: The purpose of this study was to investigate provide basic data for improving patient safety in nursing homes in Korea by measuring the patient safety culture of nursing homes and understanding its influencing factors. Methods: This study is a secondary analysis of a descriptive research study using data from development and validation of the Korean patient safety culture scale for nursing homes. A total of 982 cases were analyzed using the SPSS Statistics 20 program. Results: For the safety culture of the patient, there was a significant difference based on the size and location of the facility. For the degree of patient safety, age, education, occupation, marital status, and the size of the nursing home were significant factors. Patient safety culture and the degree of patient safety had a positive correlation. The regression model of the degree of patient safety was significant (F=20.73, p<.001) and the explanatory power of the model was 27.4%. Conclusion: The study results indicate that patient safety culture is a factor influencing safety of elders in nursing homes. To improve patient safety for nursing homes in Korea, continuous evaluation and improvement projects need to be done at a national level.
The author obtained individualized lateral cephalometric tomograms from 23 young adults (46 of left and right normal TMJ) with normal occlusion and 20 patients (14 of patient asymptomatic TMJ and 26 of patient symptomatic TMJ) with clicking and painful TMJ after the analysis of submental vertex view. Individualized lateral cephlometric tomogram analysis and TMJ space analysis were performed after tracing each film. All data from these analysis was recorded and statistically processed with CYBER computer system. 1. The results were obtained as follows. In submental vertex view, the mean condylar angulation of Rt. side in normal group was 20.348°±6.358°, Lt. side was 18.870°±7.777° and Rt. side in patient group was 19.350°±7.576° Lt. side was 17.750°±6.146° respectively. The mean condylar angulation of Rt. side was larger than Lt. side in normal and patient group. 2. When the mandible was moved from centric occlusion to centric relation, condylar position relating to the glenoid fossa was placed posteriorly and superiorly in normal TMJ group and patient symptomatic TMJ group. 3. In centric relation position, the proportion of anterior space to posterior space was 1.593 for normal TMJ group, 1.604 for patient asymptomatic TMJ group and 1.671 for patient symptomatic TMJ group. In centric occlusion position, 1.390 for normal TMJ group, 1.539 for patient asymptomatic TMJ group and 1.196 for patient symptomatic group. Normal TMJ group, patient asymptomatic TMJ group and patient symptomatic TMJ group and patient symptomatic TMJ group revealed significant difference in ∠C₂ measurement. (ANOVA-test, p<0.05) 5. Normal group and patient group revealed significant difference in Fh, ∠C₁and ∠C₂ measurement. (T-test, p<0.05) 6. There were strong positive correlation (0.8771) between Fp and Fm, and strong negative correlation (-0.9039) between ∠C₂ and ∠C₁ from the lateral cephalometric tomogram analysis.
The purpose of this study was to evaluate the effect of craniocervical posture on craniomandibular disorders with chronic headache. The author measured craniocervical posture on frontal and sagittal plane with photographs for 26 headache patients, 23 TMD patients, and 27 nonpatients. Range of cervical spine motion was also measured. The bilateral electromyograms of masseter and anterior temporalis muscles were recorded at rest and during maximum clenching. The results were as follows : On the lateral view photos, eye-tragus-C7 line angle was larger and the tragus-C7-horizontal line angle was smaller in the patient groups than in the nonpatient group (p<0.05). On the frontal view photos, mouth corner line angle was larger in the headache patient group than in the nonpatient group and TMD patient group (p<0.05) Interclavicular angle was smaller in the headache patient group and TMD patient grop than in the nonpatient (p<0.01) The right and left differences of SAIC-plane distance and finger tip-plane distance were significantly larger in headache patient group than TMD patient group and nonpatient group (p<0.01, p<0.001). Cervical motion range was smaller in the TMD patient group and headache patient group than in the nonpatient group (p<-.001, p<0.05, p<0.05). The resting EMG activities of right masseter muscle were higher in the headache patient group than in the nonpatient group (p<0.05). However, the EMG activities of masseter and anterior temporalis muscles during maximal clenching were lower in the patient group than in the nonpatient grop (p<0.01). The asymmetry index of resting EMG of masseter muscles was higher in the headache patient group than nonpatient group (p<0.05).
Purpose: This study examined the influence of nurses' communication competency, critical thinking disposition, and perception of patient safety culture on patient safety competency in armed forces hospitals. Methods: A crosssectional design was employed with a convenience sample of 204 nurse officers from four armed forces hospitals in South Korea. Data were collected through a self-administered questionnaire from August 10~23, 2019, and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression. All analyses were conducted using SPSS for Windows 21.0. Results: Patient safety competency scores were 4.35±0.40 for patient safety attitudes, 3.63±0.64 for patient safety knowledge, and 3.94±0.51 for patient safety skill. Communication competency, critical thinking disposition, and perception of patient safety culture were positively correlated with patient safety competency. Communication competency (β=.30, p=.002) and perception of patient safety culture (β=.24, p=.001) were identified as particularly important factors influencing patient safety competency. Conclusion: This study's results suggest that education programs to enhance communication competency and patient safety culture could increase patient safety competency among nurses in armed forces hospitals.
Purpose: The purpose of this study was to examine the effect of professional autonomy, organizational commitment, and perceived patient safety culture on patient safety management activities of nurses in medium and small-sized hospitals. Methods: A cross-sectional design was employed. Self-reported questionnaires were completed by 121 nurses with at least 3 months of working experience in medium and small-sized hospitals located in B city. Data were analyzed using descriptive statistics, a t-test, a one-way ANOVA, Pearson correlation coefficients, and a multiple regression analysis. Results: Professional autonomy (r=.22, p=.016), organizational commitment (r=.34, p<.001), and perceived patient safety culture (r=.55, p<.001) had a statistically significant positive correlation with patient safety management activities. The factors that might affect patient safety management activities were professional autonomy (${\beta}=.23$, p=.003) and perceived patient safety culture (${\beta}=.55$, p<.001). The explanatory power of these factors for patient safety management activities was 33.5% (F=21.19, p<.001). Conclusions: The development of repetitive and continuous education programs is needed to improve a nurse's professional autonomy and perceived patient safety culture.
Purpose: This study was to investigate the relationships among patient safety culture, safety competence and safety nursing activity among nurses in anesthetic and recovery rooms, and to identify the factors contributing to safety nursing activity. Methods: A descriptive correlational study was conducted. Participants were 156 nurses from 13 hospitals. Data were collected from February 11 to March 15th, 2019, and analyzed using descriptive statistics, t-test, Mann-Whitney U test, one-way ANOVA, Pearson's correlation and multiple regression analysis with SPSS statistics 24.0 Program. Results: Safety nursing activity was significantly different in relation to nurses' level of education, position at work, clinical career, clinical career at anesthetic and recovery rooms, and work experience in patient safety. Safety nursing activity demonstrated a significant positive correlation with patient safety culture and patient safety competence. Factors contributing to safety nursing activity were patient safety knowledge, skill and attitude, clinical career, clinical career at anesthetic and recovery rooms, and the patient safety improvement system which explained 57.0% of total variance of safety nursing activity. Conclusion: To improve safety nursing activities at anesthetic and recovery rooms, it is necessary to develop patient safety programs with enhanced knowledge, skill and attitude to take patient safety as a top priority.
Purpose: This study aims to compare and analysis job stress, patient safety culture, and patient safety management activities of nurses in comprehensive nursing care service wards and general wards. Methods: Through an online survey conducted on nurses with more than three months of working experience at five general hospitals in the metropolitan area, 156 participants's data were used for 𝜒2-test, t-test, ANOVA using SPSS ver. 26.0. Result: There were no significant differences in the nurses' job stress and patient safety management activities between the comprehensive nursing care service wards and general wards. However, the patient safety culture of nurses in the comprehensive nursing care service ward was significantly lower than that of general ward. Conclusion: Patient safety culture should be promoted through continuous regular patient safety education, training, and organizational support to increase patient safety management activities. Additionally, institutional programs should be prepared to reduce job stress of nurses at the frontline of patient safety.
Doctors and patients for the purpose of healing and treatment of disease through the contract will make a relationship. Doctors perform the medical practice for the state and illness of patient. Given that the patient did not cooperate in the doctor's medical practice, it is difficult to achieve the goal of disease healing. If the patient don't cooperate the medical care, and it is linked with a doctor's medical malpractice, patient's violation of obligation in medical cooperation is considered with negligence on the part of patients. However, this negligence should be limited to obvious cases that the patient's behavior is unreasonable although the doctor provides medical information to patients and induced the patient's response. Also, patient's violation of obligation in medical cooperation must result in adjusting the indemnification via a setoff of fault except the cases having causal relationship between doctor's fault and malpractice.
Inter-hospital transfer, depending on its medical and legal appropriateness, affect the prognosis of patients and can even lead to legal disputes. As Emergency Medical Service Act, any physician shall, in case where deemed that pertinent medical service is unavailable for such patient with the capacities of the relevant medical institution, transfer without delay such patient to another medical institution where a pertinent medical service is available. For medico-legally appropriate inter-hospital transfer, the head of a medical institution shall, in case where he transfers an emergency patient provide medical instruments and manpower required for a safe transfer of the emergency patient, and furnish the medical records necessary for a medical examination at the medical institution in receipt of such patient. And transfer process must comply with the requirements prescribed by executive rule such as attachment of the referral, provision of ambulance, fellow riders and informed consent of transfer. Those engaged in emergency medical service shall explain an emergency medical service to an emergency patient and secure his consent. In addition to the duty to inform about emergency medical service to the patient and his or her legally representative, there is also a duty for doctors to sufficiently explain to the patient and his or her legally representative during inter-hospital transfer that the need for the transfer, the medical conditions of the patient to be transferred and emergency treatment that will be provided by the hospital from which the patient is going to transferred. Likewise, the hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer by transferring doctors.
Purpose: The study was conducted to investigate the correlation between perception of patient safety risk factors, patient safety competency, and safety nursing activities of nurses in hemodialysis units and identify factors affecting patient safety activities. Methods: The participants were 146 nurses from 16 hemodialysis units located in Gyeongsangnam-do. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis using the SPSS, version 24.0. Results: The mean safety nursing activity score was 3.47±0.38. safety nursing activities of the participants were significantly correlated with patient safety competency. The characteristics showing significant differences in safety nursing activities were educational level, hospital type, hospital work experience, number of hemodialysis treatment per day, number of hemodialysis treatment per nurse, educational experience of patient safety, presence of a patient safety incident report registration system, and direct registration of patient safety incident report. The multiple regression analysis revealed that the factors influencing safety nursing activities were patient safety incident report, patient safety competency, and number of daily hemodialysis treatment (<5~7 times/day) per nurse (R2=.34). Conclusion: The results of this study suggest that the safety nursing activities of hemodialysis unit nurses should be intensified. In addition, the registration system of patient safety incident report and nurses' competency on patient safety should be improved, and the number of hemodialysis per nurse should be fewer than 7 times per day.
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