• 의료법학
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• 제9권2호
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• pp.181-207
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• 2008

With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.

• 대한한방내과학회지
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• 제33권4호
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• pp.347-366
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• 2012

The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

• 한국콘텐츠학회논문지
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• 제16권1호
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• pp.585-594
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• 2016

본 연구는 졸업 후 의무기록사로 근무하게 될 의무기록 전공 학생들의 환자 의료정보 보호인식과 실천인식을 조사 분석하여 정보의 중요성을 인식하게하고, 의무기록 교육과정 개발 및 전공교육과 의료정보 보호정책 수립 시 기초 자료를 제공하고자 하였다. 자료조사는 4개 대학에 재학생 340명을 대상으로 2015년 5월 18일부터 6월 5일까지 실시하였고, 자료 분석은 t-검정과 분산분석, 피어슨 상관분석, 다중회귀로 분석하였다. 연구결과 보호인식과 실천인식의 점수는 5점 만점에 각각 3.55점과 3.49점이었으며, 의료정보에 대한 보호인식에서는 학년, 전공만족, 의료정보 보호 교육경험, 법률인지, 실천인식에서는 학년, 전공만족, 교육경험, 의료정보 노출피해에서 유의한 차이를 보였다. 보호인식과 실천인식은 유의한 정(+)의 상관관계가 있었으며, 실천인식에 미치는 요인으로는 정보노출 인식과 사회적 쟁점 인식, 법제도 인식이 유의미한 정(+)의 영향을 미쳤다. 이러한 연구를 바탕으로 보호인식과 실천인식을 높이기 위해서 대학에서부터 의료정보의 유출로 인한 피해와 의무기록 관리의 중요성을 교육시켜 인식을 향상시켜 나가는데 기여할 수 있을 것으로 기대된다.

• 한국응급구조학회지
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• 제18권2호
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• pp.21-33
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• 2014

Purpose: A descriptive study design was used to investigate infection management awareness and infection management performance for clothing management in 119 emergency medical technicians (EMTs). Method: 188 paramedics and basic EMTs completed questionnaires between March 1 and April 30, 2013 in Jeollabuk-do. Results: Participants' average score for infection control awareness was 2.69 and that for performance was 1.58, with the differences being statistically significant (t = 931.455, p = .003). Participants' general characteristics resulted in differences in infection management performance. Women (1.63) have scored higher than men (1.28), and the difference was statistically significant (t = 11.174, p = .001). Participants who had clinical experience (1.63) had higher scores than participants who did have clinical experience before (1.53) and, again, the difference was significant (t = 7.167, p = .009). Conclusion: Education program for infection management is need to be developed for more effective infection management.

• 대한통합의학회지
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• 제7권3호
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• pp.95-107
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• 2019

Objective : The aim of this study was to investigate the infection management awareness and infection prevention management status of students who participated in occupational therapy and clinical practice. Methods : The study was carried out from June 27th to August 4th, 2017, to survey the awareness and practice of infection control in 11 practice institutes among 193 students who had experience in 8 universities. Results : A total of 93.3 % of the respondents said that they needed education about infectious diseases, but 53.3 % of them did not receive infection prevention education at school or in clinical trial institutes. Hygienic practices for infection prevention and infection control practices related to handwashing were high, but the use of protective equipment was poor in the observation of swallowing disorder treatment. It is also important to educate students who have been trained in infection control. However, infection prevention training at universities and training centers is insufficient suggesting the importance of future infection education. Conclusion : Infection control education to prevent infection is necessary not only for clinicians but also for students participating in on-the-job training. Effective efforts are also needed in universities and clinical practice institutes so that infectious disease prevention education can be implemented. This study provides basic data for infection control education in universities and practice educational institute that perform clinical training and occupational therapy.

• The Korean Journal of Pain
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• 제24권4호
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• pp.205-215
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• 2011

Background: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Result: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusion: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.

• 보건행정학회지
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• 제5권2호
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• pp.202-229
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• 1995

In Korea, Resource-Based Relative Value Scale(RBRVS) is suggesting to the alternative of Korean Medical Fee Schedule. This study developed to methodology of RBRVS applicable to Korean situation and applied to services of internal medicine and general surgery. Our methodology of RBRVS is basically same to Hsiao's. But there are some differences between our method and H냐매's because Korean medical situation differs to American. The first difference is method of measurement of work. The Unit of work in our study is total work including intra-servic work and pre-/post-service work. Secondly, in extrapolation, we use primary data gathered to small group of physician. Tertially, in measurement of practice cost, we directly survey to budget data of hosptials and analyse practice costs by service. Some results are presented in a companion article.

• 한국산학기술학회논문지
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• 제22권2호
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• pp.418-426
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• 2021

이 연구는 방사선 발생장치 제조업체 종사자와 의료기관 종사자들 간의 방사선안전관리에 대한 인식을 알아보고 적극적인 대처능력과 안전수준을 향상시키는데 기초자료로 활용하기 위하여 연구조사하게 되었다. 방사선에 대한 지식, 태도 실천 점수는 성별, 연령, 결혼상태, 직종, 직위, 현 직장근무기간, 직장 총 근무기간, 방사선 관련 유사업무 유무, 매뉴얼 비치 여부, 방어 시설유지 여부, 방어 장비보유 수, 방사선 안전교육 여부, 특수건강검진 여부, 방사선 용어인지 여부와 관련이 있었으며, 특히 방사선 관련 직종에서 방사선사의 지식 점수가 가장 높았다(p<0.05). 방사선 안전관리는 방사선제조업체 종사자 및 의료기관 종사자 모두 방사선 노출에 적극적인 방어 노력이 필요하며방사선 안전관리를 위해서는 지침 준수, 주기적인 교육, 시설보강, 매뉴얼 작성, 특수 건강검진 등 제도적 장치가 필요하다.

• 한국치위생학회지
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• 제7권4호
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• pp.595-609
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• 2007

The purpose of this study was to classify the courses of the dental-hygiene curricula into several categories by field, to incorporate the subjects in the same category into an integrated course, and to suggest how to ensure the successful phase-in application of integrative education according to Ronald M. Harden's 11-stage integrative ladder model. The findings of the study were as follows: 1. When the existing curricula were analyzed, it's found that many credits were provided to the courses in the area of basic dentistry that offered both theory and practice. In particular, the subjects tested by the national examination were offered by every college. In the field of public oral health, the largest number of credits was allocated to theory of oral prophylaxis and practice courses. In clinical area, clinical practice, in the area of dental office management, dental insurance course was given the largest credit. There were 31 to 61 major subjects in the colleges, which indicated that the major subjects were segmented in detail. 2. It seemed necessary to incorporate the subjects in the field of basic dentistry into oral biology, and theory of oral prophylaxis/practice, preventive dentistry/practice, preclinical stage, emergency treatment and introduction to dental hygiene should be integrated in to clinical dental hygiene. The courses in clinical area should be combined into clinical dentistry, and in the field of medical management, dental insurance, hospital management and medical relation law should be incorporated into management of dental clinic. 3. In the 11-stage integrative ladder, the subjects in the same field could perfectly be incorporated as the stages advanced. Each of the subjects was less emphasized, and communication and joint plans among teachers who were respectively in charge of the courses were increasingly considered important. Specifically, there should be a consensus among the teachers in regard to the outline of teaching programs, order of education. objects and objectives of programs and what and how to evaluate.

• 한국전자통신학회논문지
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• 제12권5호
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• pp.957-964
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• 2017

본 연구에서는 NCS 기반 의료정보관리 직무수행을 위한 교육과정을 수행하고, 학습자의 실무지식을 이해할 수 있는 프로그램을 제작하였다. 이 프로그램은 의무기록의 데이터를 발생시키고 저장한 후 의무기록의 데이터를 분석하여 의료정보를 생성할 수 있는 교육용 프로그램이다. 의무기록의 내용이 다양하고 의무기록의 양적 차이가 있기 때문에 교육용 데이터의 표준을 위해 퇴원분석 프로그램에 의무기록의 내용을 요약하고 저장할 수 있도록 하였다. 프로그램을 사용하여 의료정보관리 NCS 능력단위 요소인 의료용어 DB, 의료용어 관련 DB, 진료관련 DB를 구축하고 관리할 수 있다. 다음은 프로그램 운영을 통해 학습 할 수있는 내용이다. 첫 번째로 데이터베이스의 구조를 이해하여 의료정보 DB 관리규정을 작성할 수 있다. 두 번째로 퇴원분석 프로그램에 입력하는 진단코드 및 의료행위코드의 구조와 기능을 이해할 수 있다. 또한 퇴원분석 프로그램에서 입력된 진단코드 및 의료행위코드들을 각 필드별로 검색하고 분석할 수 있다. 세 번째로 데이터를 입력하고 추출하여 의료정보를 생성함으로써 의료정보관리 능력을 향상시킬 수 있다. 본 연구에서는 퇴원분석 프로그램을 이용하여 학생들이 의무기록의 데이터를 발생시키고 분석하여 의료정보를 생성함으로써 의료정보관리에 대한 지식을 습득하고 실무능력을 향상시킬 수 있는 프로그램을 개발하였다.