• International journal of advanced smart convergence
• /
• v.11 no.2
• /
• pp.194-204
• /
• 2022

This study is a one-group pretest-posttest design to evaluate the effect of problem-based learning (PBL) for patient safety on self-leadership, patient safety competencies, and reflective thinking of nursing students. The research was conducted from March 2 to April 15, 2022, in which 57 nursing students participated. PBL for patient safety was examined in a total of 8 sessions in the order of motivation, problem identification, task performance planning, problem-solving methods, summary and solution, presentation, and evaluation. The following topics of patient safety were selected for each team: nursing records, high-alert medication, medication error and intravenous fluid regulation, blood transfusion care, fall, bedsore, infection control, and pain management. We provided feedback on the learning process and outcomes of nursing students. According to the results, self-leadership showed a statistically significant improvement in self-expectations (t=2.60, p=0.01), goal setting (t=2.84, p<0.01), self-reward (t=3.32, p<0.01), and self-criticism (t=2.32, p=0.02). Patient safety competencies showed a statistically significant improvement in patient safety knowledge (t=13.05, p<0.001) and patient safety skills (t=4.87, p<0.001) but not in reflective thinking. The results prove that PBL for patient safety is an effective teaching-learning strategy to improve self-leadership and patient safety competencies. Future studies must develop and validate specific and long-term teaching-learning methods to improve reflective thinking.

• Journal of Korean Biological Nursing Science
• /
• v.26 no.1
• /
• pp.60-69
• /
• 2024

Purpose: This descriptive research study attempted to determine how general hospital nurses' awareness of the importance of patient safety management and patient safety competency affected patient safety management activities. Methods: From September 13 to 26, 2022, a survey was administered to 230 ward nurses who provided direct care to patients at five non-accredited general hospitals being evaluated for accreditation located in metropolitan cities. The collected data were analyzed with descriptive statistics, the t-test, one-way analysis, the Scheffé test, Pearson correlation coefficients, and hierarchical regression using SPSS for Windows version 26.0. Results: In total, 221 (96.1%) respondents were female. The average age was 32.2 years, and the average clinical experience was 3.5 years; 196 participants (85.2%) were general nurses. Patient safety competency (β = .44, p < .001), awareness of the importance of safety management (β = .31, p < .001), and medication error experience (β = -.15, p = .002) all had statistically significant associations with patient safety management activities. The explanatory power of these variables for patient safety management activities was 50.7%. Conclusion: This study confirmed that patient safety competency, awareness of the importance of patient safety management, and experience with medication errors significantly influenced patient safety management activities.

• Journal of Korean Academy of Nursing Administration
• /
• v.16 no.4
• /
• pp.455-465
• /
• 2010

Purpose: To determine the impact of the Patient Safety Program on the safety culture of nursing department. Methods: Patient Safety Program focused on medication safety was launched by QI team and patient safety committee. Patient Safety Program was composed of the establishment of improved reporting system as s way to learn from error, 'Patient Safety Guard' movement, and continuous education for medication safety. With one group pretest-posttest design, nurses' perception of the safety culture were measured with self-administered questionnaire. Subjects were all nurses and managers in nursing department of a tertiary teaching hospital in Seoul. Collected data from survey was statistically analyzed using t-test. Results: Patient Safety Program had been continued for 20 months in participation of all nurses and managers. Safety culture was improved (pretest=2.84, posttest=2.90, p<.001; 4 point scale). Conclusions: This study indicates that there has been a statistically significant increase in the nurses' perception of safety culture. These findings suggest that Patient Safety Program had made great contribution toward system wide safety culture in the hospital. To improve safety culture, leadership supports and flexibility to apply tailored interventions to the hospital were required necessarily.

• Korean Journal of Clinical Pharmacy
• /
• v.33 no.3
• /
• pp.168-177
• /
• 2023

Background & Objectives: Fixed-dose combinations (FDCs) offer advantages in adherence and cost-effectiveness compared to free combinations (FCs), but they can also complicate the prescribing process, potentially leading to therapeutic duplication (TD). This study aimed to identify the prescribing patterns of FDCs for dyslipidemia and investigate their associated risk of TD. Methods: This was a retrospective cohort study involving drugs that included statins, using Health Insurance Review & Assessment Service-National Patient Sample (HIRA-NPS) data from 2018. The unit of analysis was a prescription claim. The primary outcome was TD. The risk ratio of TD was calculated and adjusted for patient, prescriber, and the number of cardiovascular drugs prescribed using a multivariable Poisson model. Results: Our study included 252,797 FDC prescriptions and 515,666 FC prescriptions. Of the FDC group, 46.52% were male patients and 56.21% were aged 41 to 65. Ezetimibe was included in 71.61% of the FDC group, but only 0.25% of the FC group. TD occurred in 0.18% of the FDC group, and the adjusted risk ratio of TD in FDC prescriptions compared to FC was 6. 44 (95% CI 5. 30-7. 82). Conclusions: Prescribing FDCs for dyslipidemia was associated with a higher risk of TD compared to free combinations. Despite the relatively low absolute prevalence of TD, the findings underline the necessity for strategies to mitigate this risk when prescribing FDCs for dyslipidemia. Our study suggests the potential utility of Clinical Decision Support Systems and standardizing nomenclature in reducing medication errors, providing valuable insights for clinical practice and future research.

• Korean Journal of Clinical Pharmacy
• /
• v.33 no.2
• /
• pp.135-142
• /
• 2023

Background: Pharmacists communicate with a variety of healthcare experts to prevent medication errors. Situation-Background-Assessment-Recommendation (SBAR) is a tool used for concise and accurate communication. In 2018, we developed the pharmacy-SBAR (P-SBAR) to deliver pharmacists intervention more quickly and effectively through quality improvement activities. Objectives: This study evaluates the efficacy of P-SBAR on pharmacists' intervention activities before and after the implementation of P-SBAR applications. We assessed the impact of P-SBAR on reducing the burden of intervention work, promoting pharmacists' participation, and enhancing the acceptance rate. Methods: This is a retrospective study of the two groups before and after P-SBAR implementation. All pharmacists' intervention records during two periods (2016-2017 and 2019-2020) were extracted from the data warehouse system at Kyunghee University Hospital at Gangdong, Seoul. The outcome was the number of inpatients and pharmacists who participated in the prescription monitoring activity, the number of interventions, and the physicians' acceptance rate. Results: Although the total number of inpatients decreased (364,753 vs. 348,229), the number of pharmacists who participated in intervention activity increased (monthly mean: 15.8 vs. 18.0, p=0.001). The total number of interventions (2,767 vs. 4,389), the frequency of full acceptance (2,018 vs. 3,710), and the monthly acceptance rate increased significantly (73.8% vs. 83.8%, p<0.001). Conclusion: P-SBAR improved accessibility and convenience by digitalizing the intervention activities performed in an offline environment. Improvement in work burden and acceptance rate using P-SBAR is expected to contribute toward reducing medication errors.

• Korean Journal of Clinical Pharmacy
• /
• v.20 no.2
• /
• pp.120-127
• /
• 2010

Objective: The purpose of this study was to identify the type and frequency of chemotherapy-related prescribing errors and assess the pharmacist intervention in preventing potential harm. Methods: This study was performed in satellite pharmacy of oncology/hematology unit in tertiary teaching hospital from April to September, 2009. All chemotherapy prescribing errors detected by pharmacists were recorded. Frequency and characteristics of prescribing errors were analyzed. Pharmacists reviewed 28, 495 chemotherapy orders from 12,719 patients during 6-month periods. Results: A total of 835 prescription errors (2.93%) in 734 patients (5.77%) were detected by pharmacists. Alkylating agents (37.6%) followed by antimetabolite (23.35%), and mitotic inhibitors (21.44%) were the most prevalent classes in which errors occurs. The most common types of error detected were incorrect dose (34%), incorrect solution (33%), incorrect route (9%) and omission errors (8%). Changes in chemotherapy order due to pharmacists' intervention occurred in all error cases. Conclusion: Pharmacists' intervention in reviewing chemotherapy and drug orders intercepted potential harm due to prescribing errors. The current study provided strategies for reduction of medication errors.

• Proceedings of the Korea Information Processing Society Conference
• /
• 2013.05a
• /
• pp.695-697
• /
• 2013

Medical data sharing is increasing due to treatment duplication which increases the cost of medication. Medical healthcare system has been improved to combine with cloud computing. It reduces treatment delay and the medical data error. However, the concern about the privacy protection of medical information is also significant. Medical information is more sensitive than other information because involuntary disclosure can affect in both personal and social life. Privacy cloud brokerage has conquered great attention for solving these problems. Our method provides a security model in the cloud computing environment that facilitates the exchange of medical records between assigned custodians. It allows doctors to obtain a complete patient medical records which can help to avoid duplication, reduce the medical error and healthcare cost as well. In addition, our method offers a trustworthy solution against the privacy violence.

• Journal of Physiology & Pathology in Korean Medicine
• /
• v.16 no.5
• /
• pp.1066-1069
• /
• 2002

Wilson's disease is a rare inborn error of metabolism inherited as a autosomal recessive trait. The disease has varied mode of manifestations. It is characterized by different neurologic disorder and hepatic disease. I experienced a case of Wilson's disease in 40 year old woman who was suffered from liver cirrhosis, severe anorexia, and classical neurologic symptoms such as tremour, dysarthria and ataxia. The symptoms was not relieved by D-penicillamine, Youngyanggaksan and Samchulgunbi-tang but anorexia was improved significantly by same medication.

• Korean Journal of Clinical Pharmacy
• /
• v.19 no.1
• /
• pp.37-42
• /
• 2009

The purpose of this study was to evaluate barriers to pharmacists' routine work in community setting. A survey was given to 281 pharmacists who enrolled in 16-week clinical pharmacy educating program in continuous education center for advanced pharmacy at Seoul National University. Three main questions that pharmacists were asked to answer were: (1) difficulties on dispensing prescription, (2) difficulties on communicating with doctors, (3) most difficult disease on patients counseling. The response rates for the survey were more than 60 % for each three questions (62.63 %, 63.7 %, and 64.41 %, respectively). The top three barriers to dispensing prescription were lack of professional knowledge about medications, prescription error and its solving ability and patient counseling. The top three barriers to communicating with doctors were lacking of opportunity to discuss about patients' medication due to unavailability of doctors, doctors' attitude using authoritative manner, and a pharmacist's lack of knowledge. The top 4 most difficult diseases on patients counseling were cardiovascular disorders, dermatologic disorders, endocrinologic disorders, and psychiatric disorders.

• Quality Improvement in Health Care
• /
• v.18 no.1
• /
• pp.79-87
• /
• 2012

문제: 투약오류는 의료기관 전반에서 가장 많이 발생하는 오류의 하나이며, 환자에게 중대한 위해를 초래하기도 한다. 특히 고농축전해질은 문제발생의 가능성과 위험성이 높아 지속적인 관리 및 교육을 필요로 하고 있다. 목적: 발생한 투약오류 건에 대한 근본원인분석을 시행함으로써 유사사례가 발생하는 것을 예방하여 환자안전을 도모하고자 한다. 의료기관: 연세대학교 세브란스병원 질 향상 활동: 투약오류 건에 대해 근본원인분석 시행 후 고위험약물 관련 내규를 보완하였고, 고위험약물에 대한 Alert System 개발, 고위험약물 라벨 부착, 약 처방 관련 의료진 교육을 시행하였다. 개선효과: 고위험약물 투여와 관련된 시스템 개선 활동 이후 유사사례는 발생하지 않았고, 의료진 교육을 통하여 환자안전에 대한 인식과 중요성을 더욱 증가시켰다.