• 보건행정학회지
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• 제25권3호
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• pp.174-184
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• 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.

• 보건의료산업학회지
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• 제11권3호
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• pp.23-35
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• 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
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• 제10권1호
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• pp.117-120
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• 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.

• 기본간호학회지
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• 제19권1호
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• pp.35-45
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• 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.

• 대한간호학회지
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• 제29권4호
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• pp.880-891
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• 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.

• 문화기술의 융합
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• 제10권2호
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• pp.149-157
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• 2024

의료기관 및 의료인의 지속적인 노력에도 불구하고 환자 안전을 위협하는 사고가 지속적으로 발생하고 있다. 환자안전사고를 줄이기 위해서는 의료인의 환자안전에 대한 올바른 지식과 태도, 수행능력을 갖추는 것이 필요하다. 간호대학생은 환자안전관리와 관련된 주요인력 중 하나로 간호대학생의 환자안전관리 행위에 미치는 영향요인을 파악하는 것은 환자안전관리 역량 향상 및 안전사고예방에 필수적이라 할 수 있다. 이에 본 연구는 간호대학생의 환자안전관리 관련 지식, 태도, 수행자신감이 환자안전관리 행위에 미치는 영향을 규명하고자 하였다. 서술적 조사연구로 연구대상 및 자료수집은 2022년 10월 25일부터 10월 28일까지 K 지역에 소재한 4학년 간호대학생 138명을 대상으로 하였고, 통계분석은 SPSS 25.0 프로그램을 이용하였다. 연구 결과, 환자안전관리 지식, 태도, 수행자신감은 환자안전관리 행위와 양의 상관관계를 보였으며, 환자안전관리 행위에 미치는 영향요인은 환자안전관리 교육경험(β=.22, p<.001)과 수행자신감(β=.66, p<.001)으로 나타났다. 본 결과를 토대로 간호대학생의 환자안전관리 행위 역량을 증진시키기 위해서는 환자안전관리 교육경험 및 수행자신감을 향상시킬 수 있는 교육프로그램이 필요할 것으로 사료된다.

• 한국산학기술학회논문지
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• 제11권12호
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• pp.4954-4961
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• 2010

본 배경 : 병원들과 병상 수들의 과잉공급과 의료시장 개방으로 인해 병원들 사이의 경쟁이 매우 심화되고 있다. 더 많은 환자 유치를 위해 환자들이 선호하는 특화서비스에 대해 조사하게 되었다. 방법 : 환자만족도를 조사하기 위해 약 20개 항목의 설문지를 개발하여 병원들 방문한 외래 환자 297명과 입원환자 302명을 조사하였으며 Excel과 SPSS를 이용하여 기술통계와 회귀분석을 하였다. 결과 : 환자의 충성도와 특화된 병원서비스의 관련성이 지인에게 이 병원 이용을 추천하겠다와 관련이 있으며 1) FHR사용과 지속적인 치료 및 관리를 위한 도우미는 외래환자와 PHR사용에서 양의 관련성을 가지고 있었고 FHR은 외래환자에서 양의 관련성을 갖고 있었다. 2) 병원의 재방문 : PHR사용자와 환자치료 도우미의 요구가 있었으며 TV사용료 지불은 부정적 관련성을 가지고 있었다. 결론 : FHR, PHR과 환자치료 도우미들은 환자의 충성도를 증가시키는데 매우 중요한 요인들이었다.

• 종양간호연구
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• 제12권1호
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• pp.77-83
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• 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
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• 제56권4호
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• pp.433-445
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• 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.

• 산업융합연구
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• 제18권2호
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• pp.9-18
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• 2020

본 연구의 목적은 간호대학생의 환자안전간호와 관련된 요인을 융·복합적 측면에서 체계적으로 고찰하고, 메타분석을 통해 관련 요인의 효과크기를 파악하는 것이다. 연구방법은 문헌검색은 Medline, Embases, CINAHL, DBpia, Research Information Service System(Riss), Korean Studies Information Service System(Kiss)을 이용하였으며, 국외 데이터베이스는 MeSH용어와 Emtree를 활용하여 검색하였다. 검색식은 [(patient safety or patient harm or safety management) and (students, nursing)] or [(patient safety or patient harm or safety management) and (education, nursing, graduate)] 이었다. 문헌선정은 PRISMA(Preferred Reporting Items for Systematic Reviews and Meta-Analyses)를 이용하였다. 연구결과 관련 요인으로는 간호수행, 지식, 태도, 자신감, 인식 및 인지 등이 확인되었고, 그 중 환자안전간호 수행과 관련성이 높은 요인에는 자신감, 태도, 인식, 지식 순으로 파악되었다.