• Health Policy and Management
• /
• v.25 no.3
• /
• pp.174-184
• /
• 2015

This paper reviewed structure and current status of laws related to patient safety using patient safety law matrix to promote systematic approach in legal system of patient safety. Laws related to patient safety can be divided into three areas: laws for preventing; laws for knowing about; and laws for responding. In the case of Korea, gaps are especially prominent in the areas of laws for knowing about and responding. Patient safety law which will be enacted in July 2016 will fill the gap in the area of laws for knowing about. This law will be comprehensive law, covering the full spectrum of laws related to patient safety. However, after reviewing current patient safety law in Korea, the following drawbacks were identified: absence of code for grasping the current patient safety level; absence of code for mandatory reporting in patient safety reporting system; and absence of code for privilege about patient safety work product. Furthermore we need wider discussions about covering issues of open disclosure, apology law, coroners system, and complaint management system in patient safety law.

• The Korean Journal of Health Service Management
• /
• v.11 no.3
• /
• pp.23-35
• /
• 2017

Objectives : This study analyzed the trends of patient costs in 7diagnosis-related groups(DRG) since July 2013 when the government made it mandatory for all hospitals and clinics. Methods : Data were collected from the 7DRG score chart published by the Ministry of Health and Welfare(MoHW) from July 2013 to January 2017. The average value of the weekday relative value scale was multiplied by unit price, referred to as'- "patient costs by disease group"-' and they were analyzed by time series. Results : Patient costs had increased among all patients with a comprehensive disease. Small and medium-sized hospitals (hospitals and clinics) showed a slight increase in patient costs. Conclusions : Enforcement of the Korean diagnosis-related groups has led to management crisis in small and medium-sized hospitals and deterioration medical service quality. To solve this problem, The weekday relative value scale of small and medium-sized hospitals should be increased significantly.

• The Korean Journal of Pain
• /
• v.10 no.1
• /
• pp.117-120
• /
• 1997

Cancer is a devastating disease, and the treatment of related pain is an extremely challenging task. Providing adequate analgesia while avoiding unnecessary drug effects often requires a polypharmacologic approach in cancer pain management. A 36-year old woman with breast cancer metastatic to the axial skeleton and bilateral hip joints was admitted to hemato-oncology service with complaints of intractable abdominal and hip pain. Despite rapidly increasing doses of intravenous morphine up to 350 mg per day; transdermal fentanyl; midazolam; ketorolac; lorazepam; dexamethasone, the patient continued to describe her pain as 10 of 10, refusing all surgical/diagnostic interventions not directly related to pain control. She did, however, consent to lumbar epidural catheter placement. The patient was sedated with titrating doses of propofol to assist with positioning. Even though the procedure was not successful due to significant thoracolumbar scoliosis, the patient admitted feeling better than she has in months during attempted placement. After continuous infusion of propofol was initiated at subhypnotic dose, the patient's analgesic demand was drastically reduced and described her pain as "1 to 3" of "10". Approximately 96 hours after the propofol infusion was started, the patient expired comfortably. There had been no change in her medical regimen during fecal 48 hours. In the case described, propofol was extremely advantageous as an adjuvant in the management of cancer related pain.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.19 no.1
• /
• pp.35-45
• /
• 2012

Purpose: This study was done to explore the relationship between perceived patient safety culture and patient safety management activities among health personnel. Methods: This study was a cross-sectional survey. Participants were 342 health personnel working in two tertiary hospitals. Self-administered questionnaires were used to collect data from a convenience sample of 254 nurses and 88 doctors. Results: Scores on participants' perceived patient safety culture and patient safety management activities were just over the mean. There were significant differences in patient safety management activities by type of occupation, nurses' position, length of service, and work week. Doctors scored perceived patient safety culture and patient safety management activities significantly lower than nurses. In addition, perceived patient safety culture was significantly related to patient safety management activities. Factors which influence participants' patient safety management activities were communication, type of occupation, overall evaluation of patient safety, supervisor/manager, frequency with which events were reported, and nurse's position. Conclusion: Findings provide significant evidence that patient safety management activities are associated with perceived patient safety culture. Therefore, to build a positive safety culture, health personnel, especially doctors and general nurses need to visibly commit to patient safety management activities and be role models to ensure patient safety.

• Journal of Korean Academy of Nursing
• /
• v.29 no.4
• /
• pp.880-891
• /
• 1999

The purpose of this study was to describe nursing decision tasks, their characteristics, and problems associated with decision making. The subjects were 32 nurses who had at least one-year nursing experience and worked on medical-surgical units or intensive care units(ICU). They were asked to describe their decision making experiences in patient care situations and to identify the characteristics of each decisions. They were also asked to describe perceived problems associated with decision making in nursing. The responses on nursing decision tasks and problems were analyzed with content analysis and the decision characteristics were identified by statistical analysis of variance. It was found that there were 16 nursing decisions which are as follows : decisions related to interpreting and selecting appropriate strategies for pain management(6.6%) ; decisions related to providing emotional support (0.7%) ; decisions related to explaining the patient's condition and rationale for procedures(1.1%) ; decisions related to assisting patients to integrate the implications of illness and recovering into their lifestyles(2.9%) ; decisions related to detecting significant changes In patients and selecting appropriate intervention strategies (17.2%) ; decisions related to anticipating problems and selecting preventive measures(4.2%) ; decisions related to identifying emergency situations(0.4%) ; decisions related to effective management of patient crisis until physician assistance becomes available(2.8%) ; decisions related to starting and maintaining intravenous therapy(2.6%) ; decisions related to administering medications(8.1%) ; decisions related to combating the hazards of immobility(7.3%) : decisions related to treating wound management strategies(5.5%) ; decisions related to relieving patient discomfort(13.9) ; decisions related to selecting appropriate strategy according to the changing situation of the patient(18.2%) ; decisions related to selecting the best strategy for patient management(5.3%) ; and decisions related to coordinating, ordering, and meeting the various needs of the patient (3.1%). The nurses reported the fellowing problems in decision making : difficulties due to lack of knowledge and experience (18.6%) ; uncertainty and complexity of decision tasks(15.2%) ; lack of time to make decisions(2.9%) ; personal values which conflict with other staff(15.7%) ; lack of selection autonomy(30.0%) ; and organizational barriers(7.6%). Continuing education programs and decision support systems for frequent nursing decision tasks can be established on the basis of these results. Then decision ability in nurses will increase through the education programs and decision support systems, and then quality of nursing service will be better.

• The Journal of the Convergence on Culture Technology
• /
• v.10 no.2
• /
• pp.149-157
• /
• 2024

Despite continuous efforts by healthcare institutions and professionals, incidents threatening patient safety continue to occur. Policies related to patient safety are being strengthened, and nursing students are recognized as key personnel in patient safety management. Identifying factors influencing patient safety management behavior can enhance competency in patient safety management and prevent and improve patient safety incidents. Therefore, the purpose of this study is to clarify the impact of nursing students' knowledge, attitudes, and performance confidence related to patient safety management on their patient safety management behavior. A descriptive survey study was conducted, and data collection targeted 138 fourth-year nursing students in K region from October 25th to October 28th, 2022. Statistical analysis was performed using SPSS 25.0 program. The research findings showed that knowledge, attitudes, and confidence regarding patient safety management were positively correlated with patient safety management behavior. Factors influencing patient safety management behavior were identified as patient safety management education experience (β=.22, p<.001) and confidence (β=.66, p<.001). Based on these results, it is suggested that educational programs aimed at improving patient safety management behavior among nursing students should focus on enhancing patient safety management education experience and confidence.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.11 no.12
• /
• pp.4954-4961
• /
• 2010

Background: Competition among hospitals has intensified, because hospitals and beds are oversupplying and the global medical market has opened in Korea. Method: we developed questionnaires of the patient's satisfaction about 20 items. We surveyed 297 out-patients and 302 in-patients. We analyzed the descriptive statistics and regression by SPSS(Version 17) and Excel. Results: The relations with the patient's loyalty and the specialized hospital service are 1) Recommend to other person: FHR use and the assistant for follow-up treatment were related positively for out-patient and PHR and FHR use were related positively for out-patient. 2) Revisiting: PHR use and the need of an assistant for follow-up patients were related for them and the PayTV were negatively related. Conclusion: FHR, PHR and assistant system for follow-up patient's condition were very useful factors to increase patient's loyalty.

• Asian Oncology Nursing
• /
• v.12 no.1
• /
• pp.77-83
• /
• 2012

Purpose: This study was designed to describe outcomes of pain management, to identify pain intensity, pain management and barriers to pain management, and to test correlation among the variables in cancer patients who are registered in public health centers. Methods: By using a descriptive survey design, 3 instruments were used to collect data: the Numeric Rating Scale for pain, the Barriers Questionnaire-Korean version, and a one-item self-report tool about patient satisfaction. A sample of 190 patients with cancer was recruited from a public health center. Results: The mean rating for pain during the past 24 hours was mild and the mean score of barriers to pain management was 3.20. Patients were satisfied with pain management but they also had concerns it. A negative correlation was found among pain severity, pain relief and satisfaction of pain management. However, there was not significant correlation between the patient-related barriers to pain management and other variables. Conclusion: These results suggest that the intervention for cancer patients should focus not only on patient-related barriers to pain management, but also address health-care system related barriers.

• Clinical Endoscopy
• /
• v.56 no.4
• /
• pp.433-445
• /
• 2023

Endoscopic retrograde cholangiopancreatography (ERCP) plays a crucial role in the management of pancreaticobiliary disorders. Although the ERCP technique has been refined over the past five decades, it remains one of the endoscopic procedures with the highest rate of complications. Risk factors for ERCP-related complications are broadly classified into patient-, procedure-, and operator-related risk factors. Although non-modifiable, patient-related risk factors allow for the closer monitoring and instatement of preventive measures. Post-ERCP pancreatitis is the most common complication of ERCP. Risk reduction strategies include intravenous hydration, rectal nonsteroidal anti-inflammatory drugs, and pancreatic stent placement in selected patients. Perforation is associated with significant morbidity and mortality, and prompt recognition and treatment of ERCP-related perforations are key to ensuring good clinical outcomes. Endoscopy plays an expanding role in the treatment of perforations. Specific management strategies depend on the location of the perforation and the patient's clinical status. The risk of post-ERCP bleeding can be attenuated by preprocedural optimization and adoption of intra-procedural techniques. Endoscopic measures are the mainstay of management for post-ERCP bleeding. Escalation to angioembolization or surgery may be required for refractory bleeding. Post-ERCP cholangitis can be reduced with antibiotic prophylaxis in high risk patients. Bile culture-directed therapy plays an important role in antimicrobial treatment.

• Journal of Industrial Convergence
• /
• v.18 no.2
• /
• pp.9-18
• /
• 2020

Purpose is to systematically examine the factors related to patient safety nursing of nursing university students in a convergent and complex aspect and to identify the effect size through meta-analysis. The research method used PRISMA(Preferred Reporting Items for Systematic Reviews and Meta-Analyses). Medline, Embases, CINAHL, DBpia, Research Information Service System (Riss), and Korean Studies Information Service (Kiss) were used, while overseas databases were searched using MeSH terms and Emtrees. The search term was [(patient safety or patient harm or safety management) and (students, nursing)] or [(patient safety or patient harm or safety management) and (education, nursing, graduate)].The research found that nursing performance, knowledge, attitude, self-confidence, recognition, and cognition were found to be relevant factors in the order of confidence, attitude, recognition, and knowledge.