Purpose: This study aimed to identify the factors affecting the practice of medical waste management of nurses in tertiary general hospitals after the coronavirus disease 2019 (COVID-19). Methods: The participants were 154 nurses working in two tertiary general hospitals. Data were collected using structured questionnaires and analyzed using an Independent t-test, One-way ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis using the SPSS/WIN 27.0 program. Results: Factors significantly influencing the subject's practice of medical waste management include medical waste education(β=.18, p=.013), recognition of infection control organizational culture (β=.26, p=.007), and attitudes toward medical waste management (β=.23, p=.011). The explanatory power of these variables for medical waste management practice was 29.0% (F=7.34, p<.001). Conclusion: To improve the practice of medical waste management, a strategy to provide positive attitudes toward medical waste management should be needed when developing medical waste management training programs, and various measures are necessary to make the organizational culture positive for the implementation of infection control guidelines at the organizational level.
Nurses are medical personnels under the Medical Service Act and perform medical practice such as medical assistance at medical institutions. The nurse, a medical personnel, provides emergency medical service to emergency patients in the pre-hospital emergency medical system as a 119 rescuer based on the Act on 119 Rescue and Emergency Medical Services. The scope of practice of nurses is comprehensively defined in the Medical Service Act and specified through precedents. In contrast, The scope of work of emergency medical technician is listed in detail. It is understood that nurses in the pre-hospital emergency medical service system have a wider scope of practice than emergency medical technician. In particular, the scope of practice of nurses as emergency medical personnel in the pre-hospital emergency medical system should be interpreted differently within the medical institution, considering the urgency of the patient, being transferred to the emergency medical institution, and the specificity of medical direction through tele-communication.
Purpose: This study investigated factors related to empowerment of paramedic students. Methods: A total of 208 students in the department of emergency medical services who experienced clinical practice at 5 universities were selected by convenience sampling methods. Differences in empowerment by general and major-related characteristics were evaluated using a t-test and analysis of variance. The association between satisfaction with clinical practice and empowerment was tested using correlation coefficients. Multiple linear regression analysis was performed to investigate the factors associated with empowerment. Results: The levels of overall satisfaction with clinical practice and empowerment were 107.48 and 99.46, respectively. In simple analysis, empowerment level was associated with general characteristics, major-related characteristics, characteristics of clinical practice, and satisfaction with clinical practice. Empowerment level was significantly higher in older subjects (${\beta}=5.282$, p = .023), subjects with very good (${\beta}=8.487$, p = .002) or fair (${\beta}=4.879$, p = .010) subjective health status, and high subjective school record (${\beta}=5.837$, p = .008) in multiple linear regression analysis. Satisfaction with clinical practice was positively associated with empowerment (${\beta}=0.250$, p < .001). Conclusion: Empowerment was associated with major-related factors and satisfaction with clinical practice. Increased satisfaction with clinical practice could positively influence empowerment for paramedic students.
Objective : This study aims to investigate legal and regulatory status of traditional and complementary medicine (T&CM) focusing on regulation on health practitioners and health practice in 33 countries. Method : 33 countries were selected based on several factors such as interest of Korean medical doctors, strategic importance, and distribution over the world. The questionnaire was distributed to Korean embassies in 33 countries in March 2014 through Ministry of Foreign Affairs, and the answers from those countries were collected from April to September. 24 countries that provided sufficient information were included in the analysis. Results : 18 countries have law or regulation on T&CM. Only five countries regulate T&CM practitioners as medical personnel or health practitioner by law, and 12 countries have regulation on license or certificate. Half of 24 countries recognize license of T&CM practitioners issued abroad. There are nine countries that recognize T&CM practice as medical practice, and four of them regulate acupuncture as medical practice by western medical doctors or a few health practitioners recognized by the government. There are six countries that do not recognize T&CM practice as medical practice by law, but regulate it as practice that affect public health, and these countries have law or regulation on T&CM. Conclusion : As T&CM have great impact on public health, many countries have recently legislated law or regulation on T&CM. Rapid change in regulatory status of T&CM affects globalization of Korean medicine. Thus, development of timely strategies will be essential for it.
Pharmacopunture is a new combined method of acupunture and oriental drugs. Recently, this method is widely used to treat traffic accident patients in oriental medicine. However, there is no evidences of treatment, no information of effects and side-effects of this method, and no information of drugs used. In South Korea, western medicine and oriental medicine are regulated differently. When a new technology is invented in the area of western medicine, that method should pass several stages of clinical trials. After that processes, that method can be done as a medical practice. However, in the area of oriental medicine, there is no process like that. According to in South Korea, medical practice without license are composed of two behaviors. First type is that medical practice is done by a person who has no medical license. Second type is that medical practice is done by a person who has a medical license but the area of the license is different. Because of this reason, the distinction between the western medical practices and the oriental medical practices is very important. Medical practices are protected by license mainly because they can harm human life or body. When we invented new medical practice and try to practice it to the patients, we should consider the risk of that method whether it is western medical practice or oriental medical practice. It is not clear that the pharmcopunture which has been done is satisfied the standard of medical treatment.
This study was conducted to acquire the basic materials for effective field training to identify performance activities of emergency medical technology students. The method used in the study was a descriptive survey using a skill checklist. The subjects for the study were 43 emergency medical technology students who were 2nd grade in D college. The collected data were analyzed using the SPSS computer program, yielding frequencies and percentage. The results of study were as follows; 1. In 'emergency treatment skill', 26.6% of subjects are revealed as 'performed' in 'ambulance practice' and 22.1% of subjects are revealed as 'performed' in 'clinical practice'. 2. In 'airway management', 41.9% of subjects are revealed as 'performed' in 'ambulance practice' and 14.1% of subjects are revealed as 'performed' in 'clinical practice'. 3. In 'oxygen therapy', 52.8% of subjects are revealed as 'performed' in 'ambulance practice' and 35.6% of subjects are revealed as 'performed' in 'clinical practice'. 4. In 'ventilation skill', 17.8% of subjects are revealed as 'performed' in 'ambulance practice' and 10.7% of subjects are revealed as 'performed' in 'clinical practice'. 5. In 'vital sign check', 61.1% of subjects are revealed as 'performed' in 'ambulance practice' and 56.3% of subjects are revealed as 'performed' in 'clinical practice'. 6. In 'patient assessment', 40.7% of subjects are revealed as 'performed' in 'ambulance practice' and 20.0% of subjects are revealed as 'performed' in 'clinical practice'. 7. In 'basic life support(CPR)', 1.7% of subjects are revealed as 'performed' in 'ambulance practice' and 11.9% of subjects are revealed as 'performed' in 'clinical practice'. 8. In 'airway obstruction', 6.4% of subjects are revealed as 'performed' in 'ambulance practice' and 1.1% of subjects are revealed as 'performed' in 'clinical practice'. 9. In 'electrical therapy', 0.7% of subjects are revealed as 'performed' in 'ambulance practice' and 20.0% of subjects are revealed as 'performed' in 'clinical practice'.
The number of dental hygiene students is increasing as dental hygiene departments are extended or newly installed continuously, and in other to keep up with the quantitative increase, we need to standardize dental hygiene curriculums. The present study conducted a questionnaire survey with dental hygiene students who had completed clinical practice. The obtained results as follows. 1. According to the contents of clinical practice at dental clinics, the frequency of dental hygiene students' observation practice was high in basic medical service, dental prosthesis, and orthodontics. 2. The frequency of performance practice was high in basic medical service, oral medicine, preventive dentistry, pediatric dentistry, periodontology, and oral surgery. According to the area of clinical practice. 3. According to the contents of clinical practice at university hospitals, the frequency of dental hygiene students' observation practice was high in basic medical service, dental prosthesis, and orthodontics. 4. The frequency of performance practice was high in basic medical service, oral medicine, preventive dentistry, pediatric dentistry, periodontology, and dental prosthesis. 5. The students' satisfaction was high in basic medical service, oral medicine, preventive dentistry, and periodontology. The period of clinical practice varies according to school curriculum and circumstance among dental clinics and university hospitals where clinical practices are performed, students' satisfaction with their observation practice and performance practice may be different. Thus, for dental hygiene students' clinical practice, it is considered desirable to prepare integrated education programs that standardize the period and contents of clinical practice.
It has become a general idea today that the characteristics of medicine should be considered as a basis when discussing a medical personnel's duty of care and whether or not it has been violated, and when discussing its duty of explanation and whether or not it has been fulfilled in medical practice. However, in the discussion of its characteristics, some shortcomings still exist, so the need for a re-discussion has been raised. Firstly, existing discussions on characteristics have failed to comprehensively grasp and explain the characteristics of medical practice. Secondly, in some researchers' arguments, there are discrepancies between the terms used to express characteristics and their conceptual definitions or content. Thirdly, the lack of exemplified cases that reflect the characteristics of medicine - especially Supreme Court precedents - has led some to think negatively about the recognition and reflection of certain characteristics. In my early writings, I have described five characteristics of medical practice: 'conflict in medical goals', 'initiating appropriate medical actions (progression of illness)', 'dynamics of medical intervention (diversity of symptoms)', 'diversity of medical effects', 'inherent risk of medical treatment (invasiveness)'. In this paper, keeping in mind the reasons for the need for reconsideration, I aim to analyze the characteristics of medicine in detail and cite key parts of representative Korean Supreme Court precedents that reflect each characteristic. The characteristics of medicine extracted from this paper are; There are ten factors, including the legitimacy of the essence of medical practice, timeliness of medical execution, dynamics of medical progress, diversity of medical effects, risk of medical invasion, non-uniformity of medical methods, limitations of medical capabilities, intervention of the medical subject, high degree of medical standards, and maldistribution of medical data.
There are two aspects of clinical practice guidelines that act as non-legal control before medical practice and as legal control standards after medical practice. The essential purpose of clinical practice guidelines is the former, but the latter action cannot be excluded. The clinical practice guidelines are a means of linking law and medical care. The negative perception of clinical practice guidelines that medical professionals' autonomy can be violated by the enactment of clinical practice guidelines is an excessive negative evaluation of clinical practice guidelines. Rather, judicial judgment based on clinical practice guidelines plays a role in respecting the autonomy of medical professionals. In other words, the clinical practice guidelines suppress legal regulations on medical care as much as possible and are based on doctors' professional ethics and self-discipline, and patient awareness and cooperation. In order to establish an ideal relationship of cooperation between doctors and patients, 'medical ethics' must be incorporated as a legal means. Clinical practice guidelines are the most appropriate means for incorporating such medical ethics into legal procedures. The lawyer solves the case with a legal syllogism that establishes a norm and applies facts to it to conclude. For the resolution of medical disputes, Clinical practice guidelines are used to establish norms that doctors should perform for specific diseases, and conclusions are drawn by applying the established norms to specific medical practices. When it is not easy to apply the established norms to specific medical practices, medical judgments by experts, such as emotions, expert testimony, and explanations by expert members, are used. As such, the Law respects the autonomy of medical care even in the establishment of norms and the application of norms. In particular, Clinical practice guidelines prepared independently by the medical community are referred to in establishing norms, which are the prerequisites for legal syllogism. This shows that doctors participate in the formation of precedents and contribute to the formation of norms. The use of clinical practice guidelines in trials is respect and consideration for the autonomy of medical care. Although there may be an aspect in which the autonomy of individual doctors is limited by clinical practice guidelines, it should be considered that the autonomy of doctors as a group is respected. In this way, the clinical practice guidelines play a role in protecting the autonomy of the "medical" group from the logic of the "law."
Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.
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