• 의학교육논단
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• 제17권1호
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• pp.26-32
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• 2015

Recently, the student internship has been introduced in medical schools as a way of preparing students with training experience and medical knowledge by performing clinical practice. This study discusses student internship management and ways to operate the internship effectively. Catholic University of Daegu School of Medicine has set up a 6-week internship program for fourth-year undergraduate students. In most of the sections, students have shown their satisfaction, particularly when they have received appropriate feedback and attention from their professors. The students found that performing the evaluation and treatment of patients and individual chart recording were informative and helpful. However, they felt a lack of basic knowledge and clinical skills and had difficulty in understanding their roles and in time management. The success of an internship depends on the passion and interest that professors show for their students along with active support from the other faculty and thoughtful consideration of patients and all their friends and family members. In addition, with growing awareness of the need for the student internship, it is necessary that the school executive provide financial and administrative support to the faculty and staff, clarify roles and the work needed to perform the tasks, ensure substantiality of the individual program with professors or departments, provide enough preliminary courses, and monitor outcomes and reflection.

• Clinics in Shoulder and Elbow
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• 제26권1호
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• pp.25-31
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• 2023

Background: This study analyzed questions searched by rotator cuff patients and determined types and quality of websites providing information. Methods: Three strings related to rotator cuff repair were explored by Google Search. Result pages were collected under the "People also ask" function for frequent questions and associated webpages. Questions were categorized using Rothwell classification and topical subcategorization. Webpages were evaluated by Journal of the American Medical Association (JAMA) benchmark criteria for source quality. Results: One hundred twenty "People also ask" questions were collected with associated webpages. Using the Rothwell classification of questions, queries were organized into fact (41.7%), value (31.7%), and policy (26.7%). The most common webpage categories were academic (28.3%) and medical practice (27.5%). The most common question subcategories were timeline of recovery (21.7%), indications/management (21.7%), and pain (18.3%). Average JAMA score for all 120 webpages was 1.50. Journal articles had the highest average JAMA score (3.77), while commercial websites had the lowest JAMA score (0.91). The most commonly suggested question for rotator cuff repair/surgery was, "Is rotator cuff surgery worth having?," while the most commonly suggested question for rotator cuff repair pain was, "What happens if a rotator cuff is not repaired?" Conclusions: The most commonly asked questions pertaining to rotator cuff repair evaluate management options and relate to timeline of recovery and pain management. Most information is provided by medical practice, academic, and medical information websites, which have highly variable reliability. By understanding questions their patients search online, surgeons can tailor preoperative education to patient concerns and improve postoperative outcomes.

• 대한치과마취과학회지
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• 제10권2호
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• pp.183-189
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• 2010

Medical emergencies are not rare in dental practice but when an emergency does occur it can be life-threatening. Medical emergency such as hypertensive crisis can be encountered in dental practice and the dentist should be competent in emergency management by taking life support courses. This report shows 3 cases of hypertensive crisis during dental treatment and we discuss proper management of the patients. The medical and dental management for the hypertensive crisis included a correct diagnosis, pharmacological usages for pain control and stress relieving environment making.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2012년도 추계학술대회
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• pp.495-497
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• 2012

의료기기 소프트웨어 테스트 위험관리 적용 방안에 대해 연구하였다. 먼저 설문조사를 통해 의료기기 제조업체의 소프트웨어 밸리데이션 및 위험관리 현황을 분석하고 두 번째로 블랙박스 테스트와 화이트 박스 테스트를 비교하여 차이점을 분석하였다. 세 번째로 소프트웨어 분석 도구를 활용한 코드 분석 후 잠재적인 위해요인을 도출하고 이를 정량화 하였으며, 마지막으로 도출된 위해요인을 FMEA 기법을 이용하여 의료기기 위험관리 프로세스에 적용할 수 있도록 프레임워크를 구축하였다. 이를 통해 의료기기 품질관리(GMP) 업무 중 소프트웨어 밸리데이션 및 위험관리 프로세스를 구축하기 어려운 제조업체를 위한 업무 지원에 활용하고자 한다.

• 임상간호연구
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• 제20권1호
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• pp.40-52
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• 2014

Purpose: This study was done to develop an evidence-based nursing clinical practice guideline (PU CPG) for pressure ulcer prevention and management in Korea. Methods: The guideline adaptation process was used and conducted according to the guideline adaptation manual developed by Gu et al. (2012) which consists of three main phases and 9 modules including a total of 24 steps. Results: The newly developed PU CPG included the introduction, pressure ulcers, summary of recommendations, recommendations, references, appendices, and glossary. The total number of recommendations was 148 in 4 sections (organizational policy, assessment, pressure ulcer prevention and management, and education) and 16 domains. Of the recommendations 4.7% were graded A, 16.9%, B, and 78.4%, C. Conclusion: Results indicate that this new PU CPG is an evidence-based practice guidance for pressure ulcer prevention and management and can be recommended for dissemination and utilization by nurses nationwide to improve the quality of pressure ulcer prevention and management. Regular revision is recommended.

• 한국의료질향상학회지
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• 제4권1호
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• 대한간호학회지
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• 제38권6호
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• pp.789-801
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• 2008

Purpose: The purpose of this study was to develop a substantive theory of case management (CM) practice by investigating the experience of nurse case managers caring for Medical Aid enrollees in Korea. Methods: A total of 12 nurses were interviewed regarding their own experience in CM practice. Data were recorded and analyzed using grounded theory. Results: Empowerment was the core category of CM for Medical Aid enrollees. The case managers engaged in five phases as follows, phase of inquiring in advance, building a relationship with the client, giving the client critical mind, facilitating positive changes in the client's use of healthcare services, and maintaining relationship bonds. These phases moved gradually and were circular if necessary. Also, they were accelerated or slowed depending on factors including clients' characteristics, case managers' competency level, families' support level, and availability of community resources. Conclusion: This study helps understand what CM practice is and how nurses are performing this innovative CM role. It is recommended that nurse leaders and policy makers integrate empowerment as a core category and the five critical CM phases into future CM programs.

• 임상간호연구
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• 제27권2호
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• pp.187-198
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• 2021

Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.

• 임상간호연구
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• 제26권1호
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• pp.10-25
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• 2020

Purpose: The purpose of this study was to update the previously developed nursing practice guideline for enteral nutrition (EN). Methods: The guideline update was done in 22 steps using standardized methodology for nursing practice guidelines. Results: The updated EN guideline consisted of 16 domains and 228 recommendations. The domains and number of recommendations in each domain were for IDSA (Infectious Diseases Society of America): 8 on general instruction, 9 on general instruction for special nutrition, 9 on general instruction for EN, 3 on assessment of EN, 10 on access to EN, 18 on EN device insertion, 16 on selection and preparation of nutritional supplements, 46 on administration and stopping EN, 22 on maintenance and management of EN, 9 on monitoring EN, 16 on prevention and management of complications of EN, 18 on medication administration, 20 on EN in various situations, 20 on prevention of errors, 1 on nursing education, and 3 on nursing documentation. For the levels of evidence, there were 9.7% for level I, 13.1% for level II, 62.5% for level III and 1.1% for GRADE (Grading of Recommendations Assessment, Development and Evaluation): 3.3% for low, 0.8% for moderate, 9.3% for very low. A total of 133 recommendations were newly developed and 10 previous recommendations were modified. Conclusion: This updated EN nursing practice guideline can be used to enhance evidence-based practice in fundamentals of nursing practice and it should be disseminated to nurses nationwide in order to improve the efficiency of EN practice.

• 대한예방한의학회지
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• 제18권3호
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• pp.105-115
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• 2014

Objective : Traditional medicine (TM) has been playing its role in national healthcare system and it is taken as complementary and alternative medicine (CAM) from the viewpoint of modern Western medicine. In the UK, not a few practitioners of Traditional Chinese Medicine (TCM) are working as CAM practitioners using herbal medicine and acupuncture therapy. Cases of dispute in the TCM practice are not rare these days because patients who take TCM service are increasing by year. Method : In the UK, dispute cases of the Traditional Medicine of East Asia can be found these days, however, it is hard to find a reported court case. A medical dispute case of TCM will be analysed to see the legal management and the resolving principle in the alternative medicine practice with some cases of Korean Medicine (KM) being discussed. Results : The usual pattern of clinical negligence can be discussed from the points of a duty of care, breach of that duty by negligence, and the harm to the patient from that breach of duty. The judge followed this procedure In this case to discuss the claims. The department of health proposed to introduce regulation to provide the reasonable quality in TCM practice, and the governmental system would be essential to regulate both the TCM practice and practitioners. Conclusion : The dispute case of traditional Chinese herbal medicine (TCHM) practice is important for the clinical negligence in TCHM practice. Judging the negligence of a TCHM practitioner involves the conventional negligence principle in tort law, and the TCHM practitioners are required to keep up with the up-to-date information on the related medical specialty. The reasoning is almost the same as that shown in the court case of Korea. The TCHM practice in the UK needs to be under the regulation by the government. The standard of care we expect of a TCHM practitioner is a further matter to discuss from the healthcare and social viewpoints.