Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.
Purpose: This study is aimed to provide the fundamental data for building the patient safety culture by identifying the perceptions of patient safety culture of hospital nurses. Methods: this study was a cross-sectional survey. For this study, 816 nurses participated from three general hospital and one university hospital located in Gwangju and Chonnam. The data were collected from April to June, 2012 by self-administrated questionnaires. The 'Hospital Survey on Patient Safety Culture'developed AHRQ(2004) and translated in Korean and edited by Je(2006), was used to measure the patient safety culture which the nurses were perceived. The collected data were analyzed with descriptive statistics, t-test, ANOVA, Scheffe test using SPSS window 18.0. Results: With a possible score of 5 points, the average score for nurses'perceived patient safety culture 3.32. In the sub dimension of patient safety culture, the score hospital-level aspects was the highest level of 3.27(0.50) and reporting system medical errors was the lowest of 3.08(0.40). The difference of perception level on patient safety culture were statistically significant depending on demographic and job-related characteristics such as age, hospital level, work experience in present hospital, work experience in present unit, work experience in present area, positions, work hours of week. Conclusion: The scores of perception of which were shown to be relatively low in this study, needed to be improved through continuous education, evaluation and researches. We suggest developing a new tool on patient safety culture fit our country which will help to manage ongoing patient safety culture.
Objective: This study is to understand medical management method in shipbuilding industry. Background: In shipbuilding industry, medical management for prevention of work-related musculoskeletal diseases due to limitations of engineering measures may be important measure. Results: Medical management of musculoskeletal diseases can be divided into primary, secondary, tertiary preventions. Primary preventions consist of symptom survey, appropriate work placement with work capacity evaluation, health promotion. Second preventions are early detection of symptomatic patient and appropriate treatment. Tertiary preventions are rehabilitation treatment and early return-to-work by return-to-work evaluation. In addition, patients with psychological counseling for emotional problems are needed. Conclusion: Medical management measures such as improving the work environment to be made are expected to exert greater effects.
Purpose: The objective of this research was to explore levels of patient safety and safe nursing activities depending on the level of nurse staffing, in order to provide effective management of nurse personnel. Methods: The research was conducted with 455 nurses from eight hospitals in B city. Data were collected according to the level of nurse personnel from second (nurse vs. patient ratio of 2.0-2.5) to fifth (ratio of 3.5-4.0) rank. The survey tools were, 'Questionnaire on Patient Safety, a Hospital Survey on Patient Safety Culture developed by AHRQ (2007), and 'Questionnaire on Patient Safety Nursing Act, in which the questions were selected from nursing-related items (Medication 6 & Safety Nursing Assurance Act 4) in the Safety Evaluation developed by Evaluation Institute of Medical Institution. Data were analyzed with SPSS PC 12.0 program using descriptive statistics, $x^2$ test, ANCOVA and $Scheff{\grave{e}}$. Results: The nurses' overall cognition level on patient safety and safe nursing activities showed that nurses who are in the second and third rank had higher scores than those in lower ranks. Conclusion: The results of this study indicate that hospitals need a higher ratio level for nurse personnel in order to assure patient safety and safe nursing activities.
Kim, Yang-Kyun;Jung, Ki-Teak;Ann, Young-Song;Lee, Sang-Eun;Jang, Young-Hwa;Han, Bo-Ra
Korea Journal of Hospital Management
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v.8
no.3
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pp.49-71
/
2003
The purpose of the study is exploring the relationship among patient perceived quality of dental care, satisfaction, and royalty in dental clinics and hospitals. The observation of the study is outpatient visiting dental clinics and hospitals located in Seoul and Kyung-Gi Do area, and surveyed the outpatients. The contents of the survey are consisted with questions including quality of care perceived by the patients, costumer satisfaction, and royalty, and measurement for each question is using five point Likert scale. According to result of bi-variate analysis, there was the significant relationship among specialized care, value of the care, and kindness in quality of dental services, level of care in dentists significantly influenced on costumer satisfaction and costumer royalty, and there was the significant relationship between costumer satisfaction and royalty. According to result of regression analysis on the costumer satisfaction, the costumer satisfaction positively related with the convenience of facility, specialized care, value of care, patient age, number of visit, and spend time for treatment, and housewives and self-employees were likely to satisfy on care than regular employees. By result of full regression model and reduced model on costumer royalty, satisfaction could explain 86% on the costumer royalty such as re-visit and promoting other people, and increase of explain power is not significant when other independent variables joined model (full model). Considering efficiency of model, costumer royalty could be explained by satisfaction only rather than other independent variables used. Finally, This study shows that the social-demographic variables of patient influenced the patient satisfaction, and the patient satisfaction influenced patient royalty directly.
The purpose of this study is to analyze domestic patient safety culture research topics using text mining and CONCOR analysis. The research method was conducted in the stages of data collection, data preprocessing, text mining and social network analysis, and CONCOR analysis. A total of 136 articles were analyzed excluding papers that were not published. Data analysis was performed using Textom and UCINET programs. As a result of this study, TF (frequency) of patient safety culture-related studies showed that patient safety was the highest, and TF-IDF (importance in documents) was highest in nursing. As a result of the CONCOR analysis, a total of seven clusters were derived: knowledge and attitude, communication, medical service, team, work environment, structure, organization and management that constitute the patient safety culture. In the future, it is necessary to conduct research on the relationship between the establishment of a patient safety culture and patient outcomes.
This article examined relationships between selected variables, such as demographic background, care, treatment variables, environmental characteristics, and patient's daily behavior and mood change. Relationship were determined between independent variabltherapeutic-rapeutie approach, demographic data, environmental management approach-,and dependent variable-patient's daily behavioral and mood change. 35 patients selected within some criteria in a psychiatric ward, were obserbed during 5 weeks by use of Wyatt's Behavior & Mood Rating Scale ac-cording to the object of the study. At the same time, the frequence of the care and treatment were collected. Criteria for sample selection and independent variables as an influential factor to the patient behavioral change, based on a literature revienw and clinical experiences. Pearson's correlation and multiple regression analysis were used to determine the influfntial factors to the patient behavioral change. Systematic reading (r=.8324), Psychiatrist's individual interview (r=.5764), tranquilizer (r=.3441) and hospitalization processing date (r=.4143) were related with patient's behavioral change. That is these 4 variables can be said to influence to the patient's behavior and mood. A stepwise multiple regression analysis of the effect of the independent varibles of systematic reading, psychintrists individual interview, tranquilizer and hospitalization processing date on the dependent variable, patient's behavioral change was carried out. Systematic reading with on R²of. 69 revealed to be the main influential factor to the patient's behavior and mood change, as the next factor psychiatrist individual interview. A total inclusion of these factors revealed a 73% prediction for the patient's behavior and mood change. But the most influential factor was the interaction of the systematic reading and psychiatrist's individual interview.
Pain management is a major issue in caring of cancer patients. Patients' concerns for reporting pain and taking analgesics are patient-related barriers to the management of cancer pain. Since such study has not been done at all in Korea, it is clearly needed to study on these problems. The purpose of this study is to attain basic data in order to improve cancer pain management in Korea. This is done by: 1) examining the extent of patients' concerns that might be barriers to the optimal pain management, and the extent of related factors (pain management hesitancy, adequacy of using analgesics, pain severity and pain interference); 2) identifying the relationship between patients' concerns and the related factors. The data has been collected from 180 cancer patients who were hospitalized in medical wards of one university hospital in Seoul, Korea during the period from November 1, 1997 to February 28, 1998. The data has been collected through interviews with (1) Barriers Questionnaire - Korean Version (BQ-K); (2) Hesitancy Experience Questionnaires (HQ); (3) Pain Management Index (PMI); (4) Brief Pain Inventory (BPI); and (5) Demographic Data. The data were analyzed by descriptive statistics and by t-test, One-way ANOVA, Pearson correlation using SPSSWIN program. The Results are as following: 1) The mean scores of Pain Management Concerns (PMC) by BQ-K were toward the moderate with a little high points(2.59). Most of the patients (99.4%) had some extent of concerns (over lout of maximum 5 points). Among the eight subscales of BQ-K, the Pain Management Concerns (PMC) about 'Fear of tolerance' was the highest (3.80) and 'Worry about side effects' was the least (1.40). 2) The extent of Pain Management Hesitancy (PMH) by HQ of wnom had pain on the day of the interview was a little higher than moderate score(5.53 out of maximum 10 points). 6.7% of the patients with experiencing pain used less adequate analgesics for the severity of pain than they were expected. 27.8% of them never used any analgesics at all. The mean score of pain severity by BPI was 16.59 (maximum: 40), and that of the interference with daily life by BPI was 32.03 (maximum: 70). 3) The patients who were older, less educated, and in low socio-economic status were likely to have more concerns. Pain Management Concerns (PMC) was positively correlated with Pain Management Hesitancy (PMH) (r=.75), pain severity (r=.44) and pain interference (r=.50). Those who were not using adequate analgesics had higher Pain Management Concerns (PMC) than did those who were using adequate analgesics (t=-5.42). The patients who had more Pain Management Concerns (PMC) tended to hesitate more to report pain and to use analgesics. They used more inadequate analgesics for the severity of pain and also had experienced more pain severity and interference with daily life. In conclusion, the patients' concerns for reporting pain and for using analgesics are major patient-related barriers to cancer pain management in Korea. The patients' concerns were correlated significantly with the level of the hesitancy experience, inadequate use of analgesics, the pain severity and the interference with daily life. Considering this, an educational program for cancer patients under the treatment with analgesics should be developed in order to solve these problems.
Kim, Sun-Kyung;Choi, Jae-Woo;Lee, Sang-Gyu;Cho, Young-Dae;Han, Eun-A;Kim, Tae-Hyun
Journal of Korean society of Dental Hygiene
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v.16
no.6
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pp.1033-1045
/
2016
Objectives: This research was conducted to recognize dental health care employees' awareness of patient safety culture and to examine the association between awareness of patient safety culture and patient safety activities. Methods: The subject of this research includes the dental health care employees from 11 different dental hospitals in the nation, dental offices in the 6 different general hospitals in Seoul, and 4 different private dental offices in 2014. A self-reported questionnaire was completed by 485 dental health care employees from March 17 to April 3, 2014. Multiple regression models were used in the analysis. Results: First, the dental health employees' awareness of patient safety culture was 3.25 on average. The extent of patient safety activities was 2.75. The behavior of the supervisor/manager and the adequate explanation showed positive correlation with r=0.213 (p<0.001). The process of communication and the preventative inspection of the medical equipment showed negative correlation with r=-0.258 (p<0.001), and especially the awareness of patient safety culture and the infection control exercise showed the most significant correlation (r=0.293, p<0.001). Second, hospital environment factor of patient safety perceptions positively were related to most of patient safety management activities after controlling several covariates. Conclusions: The result of this research showed that most of the patient safety culture perceptions positively were correlated with patient safety activities. We also found that proper hospital environment, simple communication process, and positive perceptions for patient safety level were more likely to perform patient safety management activities after controlling several covariates. Improving the patient safety perceptions of dental hospital workers is an important consideration.
Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.
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