• 제목/요약/키워드: Operation factors

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A Study on the Nurse's Due Care in Medical Malpractice (의료과오시(醫療過誤時) 간호사의(看護師)의 주의의무(注意義務)에 관한 연구(硏究))

  • Kang, Sun-Joo
    • Journal of Korean Academy of Nursing Administration
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    • 제5권1호
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    • pp.113-136
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    • 1999
  • There are some new trends in judgments concerning medical malpractice. which include emphasis on medical professionals' explanation duty in order to materialize patient's rights of self-determination. Now, patient is not a mere subject of medical and nursing care any more, but a subject, participating in medical practice on equal terms with medical professionals. Legal accountability is no limited to nurses in advanced practice: it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital, a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to indentify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's due care, especially in nursing malpractice. To clarify nurses' due care. chapter II has focused on nursing behavior and the scope of nursing practice based on the medical law and health care related study results. Chapter III deals with the content and scope of nurse's due care. Generally. negligence is defined as not doing something which a resonable person. guided by those ordinary considerations which or dinarily regulate human affairs. would do. or doing something which a resonable and prudent man would not do. Next. it describes how we can set the standard of due care in nursing practice. There is objective factors and subjective factors. And we also discuss about the limitation of due care in nursing practice. Finally. chapter IV deals with the case studies related to nursing negligence in the situation of determination. Now', patient is not a mere subject of medical and nursing care any more, but a subject participating in medical practice on equal terms with medical professionals. Legal accountability is not limited to nurses in advanced practice; it is a recognized fact of life for every practicing nurse. whether she is an RN employed as a staff nurse in a hospital. a Certified Nurse-Midwife in independent practice or a patient's home. Therefore, it is essential for nurses to be as familiar as possible with the legal guidelines that govern their patient care responsibilities. However. there are only a few studies focused on nursing negligence. To define nurse's civil liability in medical malpractice, it is necessary to identify both legal nursing behaviors and nurse's due care in those nursing behaviors. So this paper focused on nurse's intravenous injection. post operation nursing care. blood transfusion. and patient nursing care. The result of this paper is as follows. First. there are several cases dealing with nurse's negligence in nursing practice. however, those cases didn't judge nurse's due care based on individual -specific standard but general-objective standard. Second, there is a tendency to put an emphasis on the principal of belief to distinguish who has the liability in the case of medical malpractice among medical care team. So nurses shoud practice nursing care more actively to protect themselves and patients because there is an effort to form professional nurse system and the scope of nursing practice will be deeper and broader. Third, standard of care is a necessary element in establishing negligence. If a nurse is able to meet the standard of care, no breach will be found.

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A Clinical Study for Gall Bladder Stones in Children (소아 담석증에 대한 임상적 연구)

  • Eun, Ho Seon;Baek, Seoung Yon;Chung, Ki Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제8권2호
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    • pp.194-201
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    • 2005
  • Purpose: Gall bladder (GB) stones in children are rarely observed, and so reports of them have been quite limited in Korea. Therefore, we tried to assess the epidemiology and clinical features of children with GB stone diagnosed at Severance Hospital. Methods: A clinical study was performed on 18 patients below 15 years of age diagnosed with GB stone by abdominal ultrasonography or CT scan at Severance hospital from January 1999 to May 2005. Results: Concerning patients' profile, their sex ratio of male to female in total 18 cases was 2 : 1 with the mean age of $6{\pm}4.3years$. 15 patients (83.3%) were asymptomatic. Inducing factors were found in 14 children (77.8%) including ceftriaxone therapy in 6 cases (33.3%), infection in 4 cases (22.2%), spherocytosis in 3 cases (16.7%), Down syndrome and abdominal operation in 1 case (5.6%) respectively. Single stone was found in 13 cases (76.5%) and multiple in 4 cases (23.5%). 15 cases (88.2%) had the stones less than 5 mm in size, and 2 cases (11.8%) between 5 and 10 mm. 17 patients received conservative treatment, and one patient had cholecystectomy due to Meckel diverticulum. Conclusion: In this report, Pediatric GB stones are predominant in male children, without typical symptoms, having inducing factors, single and small. Recently the diagnosis of them has been increased because of the development of imaging study. But the reports for them were still rare in Korea. Therefore the study for them is more necessary to find it's clinical characteristics.

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Long-term Outcome of Glycogen Storage Disease Type 1; Analysis of Risk Factors for Hepatic Adenoma (당원병 제1형의 장기 추적 관찰; 간선종 발생의 위험 요인에 대한 연구)

  • Yang, Hye-Ran;Seo, Jeong-Kee
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제6권2호
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    • pp.129-139
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    • 2003
  • Purpose: The aim of the study was to evaluate the long-term outcome of glycogen storage disease (GSD) type 1 with particular reference to hepatic adenoma and hepatocellular carcinoma, and to analyze risk factors affecting the development of hepatic adenoma in GSD type 1. Methods: Forty-three GSD type 1 patients (31 males and 12 females, mean age $13.9{\pm}6.4$ years) were analyzed retrospectively. Hepatic adenoma was detected on abdominal USG and diagnosed on histologic examination. Clinical profiles were compared between patients with hepatic adenoma (n=16) and age-matched controls without hepatic adenoma (n=16). Results: 1) Of 43 GSD type 1 patients, 16 (37.2%) had hepatic adeoma. Hepatic adenoma was detected at the age of mean $14.2{\pm}4.1$ years (range: 7.9~25.7 years). Fourteen (87.5%) adenomas were multiple at detection. 2) Comparison of the clinical profiles between adenoma group and non-adenoma group revealed that age at first introduction of uncooked cornstarch treatment was significantly late in adenoma group compared with non-adenoma group ($9.1{\pm}5.2$ years vs. $3.0{\pm}1.8$ years, p=0.003). Portocaval shunt surgery was performed in 11 (68.8%) patients in adenoma group and 3 (18.8%) in non-adenoma group (p=0.004). Hepatic adenoma developed mean $5.8{\pm}4.2$ years after shunt operation. 3) One patient was diagnosed as hepatocellular carcinoma at the age of 25.7 years. Conclusion: Hepatic adenoma is an important late complication of GSD type 1 with the risk of malignant transformation. Early introduction of cornstarch therapy with strict metabolic control is needed to prevent the development of hepatic adenoma in GSD type 1.

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A Study on their Health Promotion Behavior Influenced by Primary School Students' Self-concept (초등학생의 자아개념이 건강증진행위에 미치는 영향)

  • Lee, Deog-Weon;Park, Young-Soo
    • The Journal of Korean Society for School & Community Health Education
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    • 제1권2호
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    • pp.29-48
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    • 2000
  • This study was designed to diagnose the correlations between health promotion behavior and primary school students' demographic characteristics and their self-concept, and also this study was aimed at representing the basic data of proper instruction method and school health program with the respective to primary school students' health promotion behavior through the above things. For this, author selected as 5th, 6th graders, 400 persons at 5 elementary schools located on Kyonggi province. This data utilized ANOVA, multiple regression analysis and correlation analysis by SPSS program. The findings of this study were as follows; First, there showed meaningful differences concerning their health promotion behavior according to students' demographic traits. There were a birth date, living standard, domestic environments etc. as a factors which influenced on their health promotion behavior. With this, from ex-past-facto verification for these variable factors, as their birth date was faster, living standard was higher, domestic environments was better, as their health promotion behavior was more promotive. Second, students' health promotion behavior marked 3.61 among total 5 paint with the respective to its fulfillment degree, their self-concept marked 3.45 among total 5 paint. Their mental health promotion behavior marked 3.71 with the respective to inferior category of health promotion behavior, which was the highest score. In the other hands, their physical health promotion behavior marked 3.71, social health promotion behavior marked 3.45. contrary the disease prevention, first-aid & safety, oral health, health & nutrition(P>.05). Third, there show meaningful difference, in the level of p-value <.001 with the respective to the correlations between primary school students' health promotion behavior and their self-concept, more their self-concept was positive, more their more their whole health promotion behavior(r=.479), the fulfillment degree of physical health promotion behavior(r=.384), mental health promotion behavior(r=.543), social health promotion behavior(r=.372) were high. Fourth, with the respective to the results of difference verification concerning their fulfillment degree of health promotion behavior according to the upper, middle, inferior group of self-concept, there showed statistically meaningful difference, in the level of p-value<.001. In the long run, more their self-concept was positive, more their whole health promotion behavior was high. With this, from the results of $Scheff\acute{e}$ verification, there showed meaning differences among the upper and middle group, upper and inferior group, middle and inferior group. Fifth, self-concept played the role as the most important prognostic factor with the respective to primary school students' health promotion behavior(23.0%), in the other hands, there showed positive weight of 24.0% concerning the fulfillment of whole health promotion behavior by domestic environments(1.0%). From the above results, primary school students' the fulfillment degree of health promotion behavior didn't reach to middle or inferior level. In the other hands, there showed positive effects in the correlations between self-concept and the fulfillment degree of health promotion behavior, and also high self-concept group was much positive considering inferior group in the fulfillment degree of health promotion behavior. Accordingly, more their self-concept was positive, more their fulfillment degree of health promotion behavior was effective. Eventually, in the future, there have to make an efforts to develope positive, substantial programs through their self-concept enhancement etc. in the adequate planning or operation for primary school students' health education and school health program.

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Entry Types and Locational Determinants of North Korean Workers in Cross-border Regions between North Korea and China (중국 대북 접경지역의 북한 노동력 진입 유형과 요인)

  • Lee, Sung-Cheol;Lee, Yong-Hee;Kim, Boo-Heon
    • Journal of the Economic Geographical Society of Korea
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    • 제22권4호
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    • pp.438-457
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    • 2019
  • The main purpose of this paper is to identify the entry types and locational determinants of North Korean workers in cross-border regions between North Korea and China. More specifically, the paper has attempted to divide the entry type of them in the regions into two; 1) entry via transactions between Chinese traders with North Korea and North Korea trade companies, and 2) entry via transactions between Korean-Chinese middlemen and North Korean trade companies. Also, it has analyzed main factors of their locational determinants in the spatial contexts of the regions. There have been changes in two perspectives in terms of the entry paths and types of them in accordance with the transformation of characteristics of United Nations sanction against North Korea from 'call-upon' to 'decide' after UN Security Council Resolution 2094 in 2013. Firstly, main agents who have dealing with North Korean trade companies which have right to dispatch North Korean workers have been changed from Chinese traders into Korean-Chinese brokers who are specialized in the introduction of North Korean workers with one-stop service from visa administrative to labor managements. Secondly, there has been a transfer of North Korean workers in the regions from formal to informal workers who has been admitted into China with a short stay or a tourist visa, and then remained illegally to be employed in China. Therefore, as demands on service which is able to guarantee the security of North Korean informal workers and their managements have increased, Korean-Chinese brokers have been stimulated in the regions after the operation of real international sanctions against overseas North Korean workers. In addition, the main factors of their locational determinants in cross-border regions between North Korea and China are could be analyzed in three perspectives; 1) an increase in real wages in accordance with the reform of the Chinese social insurance system after 2011, 2) the structural vulnerability of labor markets in the regions, 3) the utilization of stable and manageable workers.

Analysis on the Users′ Behaviors and Satisfaction on the Actual Conditions of Management in Chiri Mountain National Park (지리산국립공원의 이용자 행태분석과 관리실태에 대한 만족도 조사에 관한 연구)

  • 김광래;진희성;김세천
    • Journal of the Korean Institute of Landscape Architecture
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    • 제16권2호
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    • pp.43-57
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    • 1988
  • The purpose of this thesis is to suggest objective basic data for park management proposal through the quantitative analysis of users' behaviors and satisfaction for the actual conditions of management in the Chiri Mountain National Park. For this users' behaviors and socio-economic characteristics have been cross-analyzed. Specifically, it attempts to investigate users' anticipate and degree of satisfaction applied Expectancy Theory by Likert attitude scale. Users'behaviors patterns of each site have been analyzed by the factor analysis algorithm, and each factor scores of sites have been clustered by the cluster method. And also user' satisfaction for the actual conditions of management have been analyzed by using the multiple regression. The major user groups were students and youth groups accompanied by their friends ranging from 3 to 10. The values of user'post occupancy-evaluation for such as rockwall climbing and praying on the mountain of each site showed higher than those of anticipated, but evaluation values of other activities were lower. The user'behaviors of each site have been analyzed five factors by factor analysis algorithm. By using the control method for the number of factors, T.V. has been obtained as 50.58%. The factor score of factor covering the behavior patterns of student and youth yield high EV. and C.V.. On the analysis of cluster using factor score, factor IV in Hwaomsa temple site and Ssanggyesa temple site, factor II, v in Jungsanri Valley site, factor, I, III in Bangmudong valley site and factor I. IV in Baemsagol vallry site showed very high values, respectively. According to the multiple regression analysis, the major variables related to the satisfaction for the actual conditions of vegetation and landscape managements were reservation of groundcover, recovery of artificial injury, the surroundings of camping and temple site. In the park facilities and operation, the major variables related to the satisfaction were conditions of management such amenity facilities as privy, sign board, junk yard, camping site, and guidance of excursion, campaign and preservation of nature.

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The Factors Influencing Survival of Out-of-hospital Cardiac Arrest with Cardiac Etiology (병원 밖에서 발생한 심인성 심장정지환자의 생존 관련 요인 7년간 국가심장정지조사사업 자료 활용)

  • Jeong, Su-Yeon;Kim, Chul-Woung;Hong, Sung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제17권2호
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    • pp.560-569
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    • 2016
  • Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.

A Study on the Factors Causing Analytical Errors through the Estimation of Uncertainty for Cadmium and Lead Analysis in Tomato Paste (불확도 추정을 통한 토마토 페이스트에서 카드뮴 및 납 분석의 오차 발생 요인 규명)

  • Kim, Ji-Young;Kim, Young-Jun;Yoo, Ji-Hyock;Lee, Ji-Ho;Kim, Min-Ji;Kang, Dae-Won;Im, Geon-Jae;Hong, Moo-Ki;Shin, Young-Jae;Kim, Won-Il
    • Korean Journal of Environmental Agriculture
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    • 제30권2호
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    • pp.169-178
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    • 2011
  • BACKGROUND: This study aimed to estimate the measurement uncertainty associated with determination of cadmium and lead from tomato paste by ICP/MS. The sources of measurement uncertainty (i.e. sample weight, final volume, standard weight, purity, molecular weight, working standard solution, calibration curve, recovery and repeatability) in associated with the analysis of cadmium and lead were evaluated. METHODS AND RESULTS: The guide to the expression of uncertainty was used for the GUM (Guide to the expression of Uncertainty in Measurement) and Draft EURACHEM/CITAC (EURACHEM: A network of organization for analytical chemistry in Europe/Co-Operation on International Traceability in Analytical Chemistry) Guide with mathematical calculation and statistical analysis. The uncertainty components were evaluated by either Type A or Type B methods and the combined standard uncertainty were calculated by statistical analysis using several factors. Expected uncertainty of cadmium and lead was $0.106{\pm}0.015$ mg/kg (k=2.09) and $0.302{\pm}0.029$ mg/kg (k=2.16), on basis of 95% confidence of Certified Reference Material (CRM) which was within certification range of $0.112{\pm}0.007$ mg/kg for cadmium (k=2.03) and $0.316{\pm}0.021$ mg/kg for lead (k=2.01), respectively. CONCLUSION(s): The most influential components in the uncertainty of heavy metals analysis were confirmed as recovery, standard calibration curve and standard solution were identified as the most influential components causing uncertainty of heavy metal analysis. Therefore, more careful consideration is required in these steps to reduce uncertainty of heavy metals analysis in tomato paste.

A Study on Childbrith in Late Maternal Age (노령출산에 관한 연구)

  • Han Yea Young
    • Journal of Korean Public Health Nursing
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    • 제8권2호
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    • pp.101-113
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    • 1994
  • Maternity means all the women who are capable to conceive. In the aspect of health and medical care. however. it means the women who are now in pregnancy or have already given birth to a baby or are in a period of being recoverd from physiological changes occurred by pregnancy. According to the rapidly changing social structure. both the Quality and Quantity of the capacity of childbirth experienced by women are changing. Our society. having established a great economical growth by virtue of the highly developing and growing industrialization and urbanization. stimulates the women's advance into society and thereby increasing the number of employed women. When the women's participation in society is increased. their age of marriage is also affected. Which means there are a decrease of the capacity of childbirth in terms of quantity and a trend for women to have less children and to deliver a baby in their old age in terms of quality. On the contrary. since the number of multipara who want to have a baby in their old age is increasing. as a counter functional effect to the political project of decrease of a birth rate. concern has been focussed on childbirth in old age in the present study. And also such kind of the childbirth may be danger to the health of both mother and baby. Therefore the present study intended to provide some basic data of health education in the part of the health management of both mother and baby in the general hospital. based on understanding the realities of childbirth in. old age and things related to them. To achieve such a purpose of the present study. an analytical study by means of SPSS. was done using the data of 269 clinical records on both the newborn .babies and their mothers who had been supported by public general hospitals located in Seoul for 3 years from Jan. 1. 1991 to Dec. 31. 1993. Some significant results from the analytic study are as follows: 1. It appeared that the average age of normal. natural delivery was 33.8 years old and the average age of delivery through the cesarean operation was 35.4 years old. 2. It appeared that danger factors to childbirth women were types of the delivery and placental extrusion and danger factors to newborn babies are not so outstanding. 3. It appeared that the variables of the childbirth capacity which showed a significant difference according to each age group of women were the number of pregnancy. number of still birth, and number of existing children. That is. the age group of 'more than 35 years' had more frequency of experience In all 3 variables than the age group of 'less than 35 years'. 4. It appeared that the variables of the childbrith capacity which showed a significant difference a according to the sex of a newborn baby were number of pregnancy, number of still birth, and number of existing children. That is, the age group of 'more than 35 years' had more frequency of experience in all 3 variables than the age group of 'less than 35 years'. 5. It appeared that the health index of newborn babies which showed a significant difference was only 5 minute APGAR. That is, the health index 9.46 in the age group of 'more than 35 years' was less than an index of 9.72 in the age group of 'less than 35 years'. 6. Since a counter correlation of -0.10, as Pearson Correlation Coefficient, was showed between the age of childbirth mothers and the weight of newborn babies, it indicated that the higher age of childbirth woman, the lesser the weight of newborn baby. 7. It appeared that the number of women who had confirmed the sex of their baby before their delivery were 45 women, $67.2\%$ of total 67 women who had delivered a baby. and the expected sex by women in childbed was male with $73.1\%$ of total childbirth women expecting male birth and with their expression of feeling of female delivery. very regretful' by $39.3\%$ of total childbirth women. The results as shown above may indicate that instead of the possibility of danger to both the mother delivering a baby in old age and the baby delivered, the expectation of getting a son motivates childbirth in old age. As a conclusion, in a dimension of general hospital as well as national reform. it is required that a program of health education for childbirth in late maternal age have to be developed in the part of the health management of both mother and baby in the near future.

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Problems Analysis and Revitalization Plan of Urban Development Projects by the Land Readjustment Method (환지방식에 의한 도시개발사업의 문제분석 및 활성화대책)

  • Kim, Hyoung-Soo;Lee, Young-Dai;Lee, Jun-Yong
    • Korean Journal of Construction Engineering and Management
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    • 제10권5호
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    • pp.37-46
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    • 2009
  • This research will focus on the public agencies, designers, supervisors, building cooperation, and contractor who involved in urban development plan. By understanding the complexity and the priorities in urban development process, all problems of the urban development projects can be solved or improved. These priorities are specified using AHP (Analytic Hierarchy Process). A questionnaire survey is employed to identify the problems of urban development process and the methods of revitalizing urban in this research. Through the survey, 35 issues are drawn out. Factor analysis technique is applied to extract the underlying interrelationships possibly existing. Using latent root criterion and varimax rotation method, 9 factors are extracted(by using 34 issues after deleting 1 issue less than 0.4 of factor loading) These 9 factors named as PIF (Problem Improvement Factor) consist of integration estimation (PIF1), cooperation operation capability (PIF2), contractor corporation capability (PIF3), capital for infrastructure investment (PIF4), misunderstanding of effective land use (PIF5), financial capability (PIF6), obscure goal of project (PIF7), shortage of cooperation expertise (PIFS), administrative procedures (PIF9). PIF 6 is the most important factor and PIF 1 is the most widely effective factor to succeed urban land development projects. It is recognized that administrative office is most responsible for PIF1 cooperation is most responsible for PIF2, 7, 8 and 9; contractors is most responsible for PIF3 and PIF6; administrative agencies is most responsible for PIF4; cooperation and consultants are responsible for PIF5. From findings in this study, some suggestions are proposed for the revitalization methods of urban development projects through the land readjustment method.