• Title/Summary/Keyword: Malpractice

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Stress among Hospital OR Nurses (수술실 간호사의 스트레스와 관련된 요인 분석)

  • 홍복화;김석범;강복수
    • Korean Journal of Health Education and Promotion
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    • v.13 no.1
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    • pp.52-71
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    • 1996
  • To measure the degree of work stress and identify factors influencing the stress among OR nurses, a study was implemented for 131 OR nurses working at four university hospitals in Taegu city through self administered questionnaires. Mean score of total work stress of nurses was 3.71, when maximum score was 5. Relatively high degrees of work stress was evident among OR nurses. When the related factors of the stress specified in the questionnaire were grouped into 11 categories, the respondents turned out to feel the highest stress when they were faced with the categories of non-peculiar duty and personal conflict with doctors. The most stressful events were nursing malpractice during surgical operations and damage to OR equipments. The nurses more susceptible to workstress were married with one child, less educated and worked at OR for 3 to 6 years.

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Dental implant bottom-up cost analysis (치과 임플란트 상향식(bottom-up) 원가산정)

  • Kim, Min-Young;Choi, Ha-Na;Shin, Ho-Sung
    • The Journal of Korean Academy of Prosthodontics
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    • v.52 no.1
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    • pp.18-26
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    • 2014
  • Purpose: The purpose of this study was to estimate the cost of dental implant using the bottom-up approach with the current data from dental clinics. Materials and methods: In this study, direct and indirect costs required for each treatment were calculated using the bottom-up approach. In the bottom-up costing, the average monthly total cost of dental clinic includes labor and material costs, administrative expenses, medical malpractice costs, and opportunity costs of invested capital. For the dental implant cost components, those include direct costs (labor costs, laboratory costs, material costs, depreciation or other operating costs), indirect costs (administrative costs), and the opportunity costs of investment for dental clinic. Results: Dental implant costs of metal crown, porcelain crown and over-denture were 1,449,000 won, 1,583,000 won, and 2,471,000 won respectively. The proportion of cost components was as follows. The labor cost were 50%, and material, administrative and other cost were 33%, 15% and 2%, respectively. For direct, indirect and investment cost, the ratio were 83%, 15% and 2%, respectively. Conclusion: The labor costs were evaluated to comprise largest proportion (about 50%, 730,000 won). Dental implant cost using Bottom-up costing was 1,450,000 won for metal crown and 1,580,000 won for porcelain crown.

Physician's Duty to Inform Treatment Risk: Function, Requirements and Sanctions (의사의 위험설명의무 - 법적 기능, 요건 및 위반에 대한 제재 -)

  • Lee, Dongjin
    • The Korean Society of Law and Medicine
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    • v.21 no.1
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    • pp.3-32
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    • 2020
  • Under the Korean case law, physicians are obliged to disclose or inform the risk associated with a specific treatment to their patients before they perform the treatment. If they fail to do this, they are liable to compensate pain and sufferings. If the patient can establish that he or she would not have consented at all to the treatment had he or she been informed, the physicians are liable to compensate all the loss incurred by the treatment. In this article, the author examines the legitimacy of this case law from the perspective of legal doctrine as well as its practical affect on the medical practice and the furtherance of self-determination of the patient. The fundamental findings are as follows: The case law that has physicians who failed to inform treatment risk compensate pain and sufferings for the infringement of the right of self-determination seems to be a disguised and reduced compensation of all the loss based on the possible malpractice, which cannot be justified in view of the general principles of tort liability. It is necessary to adhere to the requirements of causation and imputation between the failure to inform treatment risk and the specific patient's consent to the treatment. If this causation and imputation is established, all the loss should be compensated. Otherwise, there shall be no liability. The so-called hypothetical consent defence shall be regarded as a part of causation between the failure to inform and the consent. The suggested approach can preserve the essence of physician-patient relationship and fit for the very logic of informed consent better.

Importance of Education Contents and Competencies on Home Care Nursing of the Hospital and Public Health Nurses in Korea (임상간호사와 보건간호사가 지각한 가정간호 교육내용의 중요도 및 업무수행능력)

  • Yu, Sook-Ja;Kim, Soon-Lae;Baek, Hee-Chong;Lee, Jong-Eun
    • Journal of Home Health Care Nursing
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    • v.7 no.1
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    • pp.5-14
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    • 2000
  • This study was conducted during the time period of September 1997 to February 1999. in order to provide data concerning important facets of horne care nursing and the degree to which practicing hospital and public health nurses believe themselves to be competent in each area. The study subjects consisted of 610 hospital nurses, 158 public health nurses and 21 other nurses from Seoul and the province of Kyunggi. Korea. Data was collected through self-reporting questionnaires which was used by Kim et al.(1999) to evaluate the status of home health nursing and the varying ideas of self-competence that practicing nurses have. The results of the study were as follows: 1) The mean scores of perceived important components and competencies on home health nursing measured on the Likert 4 point scale were $3.15{\pm}0.36$ for importance. and $2.56{\pm}0.36$ for competency. Of the four categories regarding nursing services, the 'Nursing skill' factor had the highest importance and competency. 2) There were significantly higher scores for hospital nurses' importance components and competencies of home care nursing as compared to those scores for public health nurses. 3) The significant factors of the importance component of home care nursing listed in order of priority were 'general infection control', 'bed sore care skill', 'rehabilitation care', 'keeping maintenance of the client's confidentiality', 'malpractice', 'diabetes patient care', 'ability for problem solving' respectively. In contrast, of low priority in the importance components of home care nursing were 'referring nursing as a job to others'. 'record keeping', 'family dynamics', 'medical equipment', 'economic problems', 'environmental assessment', 'suture removal', 'multidisciplinary coordination' respectively. 4) The high priority of the degree to which practicing nurses believe themselves to be competent in home health nursing were the 'blood sugar test', 'enema skill', 'injection skill', 'skin care', 'bed sore care skill', etc. In contrast, lower competence for home care nursing as perceived by nurses were 'AIDS care', 'family violence care', 'substance abuse care', 'mental health care' respectively.

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THE CHANGE OF VITAL SIGNS IN STEPS WHEN IT IS EXTRACTED A THIRD MOLOR OF MANDIBLE (제3대구치 발치시 단계별 생체징후(vital sign)의 변화에 대한 연구)

  • Oh, Hae-Soo;Kang, Hee-In;Choi, Bin;Park, Jun-Woo;Sin, Sung-Soo;Choi, Je-Won;Lee, Sun-Keun;Kim, Mi-Ja
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.32 no.2
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    • pp.142-150
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    • 2006
  • PURPOSE : The 3rd molar extraction of mandible is common in out-patient office of oral and maxillofacial surgery. And it is dynamic minor operation with changes of vital signs. most of patients are already sensitive about their dental treatment. The changes of emotion are reached to the highest level when patients is laid down to be treated on unit chair. It can be induced to undesirable accidents as to this fear. The undesirable complications are nausea, vomiting, hyperventilation, dyspnea, syncope, shock and so on. The severe changes of vital signs may influence their behavior and make serious medical malpractice or suit such as fracture of dental instruments and injury of proximal area. METHOD AND PATIENTS : A total of 99 selected normal patients were reviewed. Among this, 70 patients(43 men, 27 women with statistical significance) were included in this study. Each steps(pre-anesthesis, 5 minutes after anesthesis, just after mucogingival incision, just after tooth section, just after suture and gauze biting) were investigated for a change of a vital signs. It is analyzed to 2 categories,"Means" and "Tendency". The "Means" is the amount of vital signs changed in comparison with pre-step during operation. That means is the amount of vital changes by each step operation. Next, " Tendency" is changes of vital signs in comparison with step1 during operation. RESULT : This is the changing tendency of vital signs with time. That is active effect of fear and pain. Thus this "Means" and "Tendency" will present a sudden changes of vital signs and it can lead to more safe treatment. CONCLUSION : Thus, the purpose of this study is, through careful operation in each step, to less on patients' complication and increase trust between patient and OMFS. This study is a first article shown with the amount of "Means" and "Tendency" in vital signs, when a third molar of mandible is extracted. This study will be base study of patients with general diseases, because it selected only patients without general diseases.

The Analysis on the Perception of Medical Accident and Dispute of Dental Hygienist (치과위생사의 의료사고 및 의료분쟁에 대한 인식정도 분석)

  • Lee, Sun-Mi;Lim, Mi-Hee;Han, Myeong-Suk
    • Journal of dental hygiene science
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    • v.8 no.4
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    • pp.241-246
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    • 2008
  • he purpose of this study was to examine the awareness of dental hygienists about medical malpractice and dispute. The subjects in this study were 206 dental hygienists at dental clinics, on whom a survey was conducted. After SPSSWIN 14.0 program was utilized to analyze the collected data, the following findings were given: 1. As for experiences of being complained from patients by age, the dental hygienists who were at the age of 21 to 23 made up the largest age group (39.2%) who had ever meet patients who had grievances. By career, those who had worked for less than a year constituted the greatest group (30.4%) who had the same experiences. It indicated that the dental hygienists who were younger and had a less career had been more complained from patients. 2. In terms of problems posed by patients, scaling came into question the most (14.5%), followed by diagnosis (14.4%), impression (12.9%) and radiography (11.0%). 3. Regarding perception of scaling treatment, 90.8 percent, the greatest percentage, kept records of patients about scaling. As to how to do that, 34.5 percent, the largest percentage, wrote it down and then signed their name. Concerning the way of explaining how to take care of oral health, 82.5 percent gave an explanation without any prints. 4. As to knowledge on the medical law, they got a mean of 12.34 out of possible 16 points. 5. Concerning the necessity of education about the prevention of medical accidents and countermeasures, 70.4 percent felt the strong and urgent need for that.

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A Comparative Study on the Perceptions of Nursing Students and Clinical Instructors on the Importance of Learning Contents of Nursing Management and Practical Experience (간호관리학실습 교과내용에 대한 중요도와 실습 경험에 대한 간호대학생과 임상현장지도자의 인식 비교 연구)

  • Koo, OK-Hee;Hong, Sung-Woo
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.6
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    • pp.90-99
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    • 2021
  • This study was conducted to provide basic data for improving nursing management practice by comparing and analyzing the perceptions of nursing students and clinical instructors about the importance of the learning contents of nursing management and their practical experience. The final 343 copies were analyzed using the Mann-Whitney test and cross-analysis, targeting 4th-grade students and clinical instructors at three universities. Both nursing students and clinical instructors recognized 'communication', 'interpersonal relationship', 'responsibility', 'trust', and 'morality' as important factors in the evaluation items of practice. Among the top 10 most importantly recognized items among nursing-management practice learning content, six items ('infection control', 'nursing record management', 'patient nursing management', 'drug management', 'patient safety', and 'nursing malpractice') were matched in the two groups. Moreover, clinical instructors recognized that interpersonal relationships and relationship ethics were important, while nursing students chose legal responsibility. As a result of the practical experience analysis between the two groups, nursing students had high experience of indirect participation, but the clinical instructors had a high experience of direct instruction. A plan is needed to reduce the difference by establishing an organic partnership relationship between the university and practice institutions and increase the experience of direct practice of nursing students.

Review of 2020 Major Medical Decisions (2020년 주요 의료판결 분석)

  • Park, Nohmin;Jeong, Heyseung;Park, Taeshin;Yoo, Hyunjung;Lee, Jeongmin;Cho, Woosun
    • The Korean Society of Law and Medicine
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    • v.22 no.2
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    • pp.3-48
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    • 2021
  • Among the major rulings handed down in 2020, there were cases involving anaphylaxis, which is timely as a side effect of coronavirus and flu vaccine. And as a rare case, a ruling was handed down that if medical treatment was done so unfaithfully beyond the limit of patience of ordinary people, it can be an independent illegal act and a cause of compensation for emotional distress. Also, there was a ruling in the appellate court that evaluated disability rate applying the Korean Academy of Medical Sciences Guides for the Evaluation of Permanent Impairment, not McBride system. And the supreme court made it clear that telemedicine is illegitimate. In relation to duty of explanation, it is in the process of adding detail criterion on the firm principles in the individual cases. In regard of medical records, there was a case that even when a medical record is strongly suspected to be tampered with, it is not considered to be an obstruction of proof. There were cases that resulted in different conclusion between the court of first instance and the appellate court rulings. Lastly, in the face of a growing number of cases in which doctors are sentenced to prison for malpractice, we reviewed a ruling that sentenced a doctor to prison.

Categorization of medical activities in the essential surgical field that require criminal immunity -As part of solving the manpower shortage in essential medical hospitals in the surgical field- (형사면책이 필요한 외과계 필수의료행위의 범주화 - 외과계 필수의료 병원 인력난 해결을 위한 일환으로 -)

  • Phils Kim
    • The Korean Society of Law and Medicine
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    • v.24 no.1
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    • pp.101-130
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    • 2023
  • Korea has very easy access to tertiary hospitals, including university hospitals, among OECD countries, and patients can reach the emergency room of a university hospital within 1-2 hours. However, there are many so-called 'essential medical' blind spots where people die because they do not receive surgery in time. In particular, in the case of essential medical care in the surgical field, despite basic surgery, there is a shortage of medical staff to perform outpatient surgery in emergency situations at university hospitals. Although this lack of manpower has a problem with low insurance premiums for surgery, it also has a very large impact on the burden of criminal liability for medical malpractice, which increases the incidence in case of emergencies. Here, we propose crime immunity to solve the manpower shortage of converged smart surgical essential medical (SES) hospitals. Currently, the medical community agrees on the need for crime immunity, but it is an ambiguous scope of immunity that has not reached a national consensus. We would like to present clear standards for essential medical practices (surgery) that require criminal immunity.

Spontaneous Resolution of Iatrogenic Calcinosis Cutis after Parenteral Calcium Gluconate Therapy in Neonates (신생아에서 비경구적 칼슘 글루코네이트 요법 이후의 의인성 피부 석회침착증 후 자연관해)

  • Song, Kwang Soon;Lee, Si Wook;Kim, Du-Han;Min, Kyung-Keun;Yon, Chang Jin
    • Journal of the Korean Orthopaedic Association
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    • v.54 no.2
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    • pp.192-196
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    • 2019
  • Iatrogenic calcinosis cutis is due to the intravenous administration of calcium gluconate or calcium chloride to treat hypocalcemia. The arthors report three cases of calcinosis cutis with calcifications involving the upper or lower extremities in neonates following the extravasation of calcium gluconate. Three neonates, a 2-week-old girl, 4-week-old boy, and a 4-week-old girl, were consulted for indurated nodules after the intravenous administration of calcium gluconate at the intensive care unit. Complete remission of palpable nodule and calcification was observed on the radiograph at three weeks, four weeks and six months after the initial presentation in each. All three neonates with iatrogenic calcinosis curtis were resolved spontaneously without functional and cosmetic complications. According to enhancement of the patient's cognition about benign disease, a suitable explanation of the disease and avoiding unnecessary treatment through an early diagnosis of iatrogenic calcinosis cutis will reduce a number of potential medical malpractice disputes.