• 제목/요약/키워드: Patient Safety Management

검색결과 436건 처리시간 0.026초

치위생과 학생의 치과방사선 팬텀활용 촬영실습 분석 (Analysis of dental radiography phantom practice of dental hygiene students)

  • 원복연;황미영;장계원;허남숙;윤미숙;박성숙
    • 한국치위생학회지
    • /
    • 제18권6호
    • /
    • pp.1013-1023
    • /
    • 2018
  • Objectives: The purpose of this study is to evaluate dental hygiene students' recognition of safety management and phantom practice in dental radiology. Methods: The study subjects were 409 students in six regions who completed a dental radiology practice course and had on-job experience more than once. After understanding the study purpose and contents, they answered a questionnaire. The main jobs in dental radiology were analyzed. Results: As a result, regarding the most difficult aspects of dental radiology practice, "it is impossible to irradiate the mouth directly with X-rays" was the most common response (29.1%). Regarding the question "what is the main role of students in dental radiology practice?", the answer "it is shooting simulations using phantoms" accounted for 59.7% of responses. The most difficult regions in bisecting and paralleling radiography with a phantom were found to be the maxillary & mandibular molars and premolars. The most difficult technique was reported to be locating XCP maintenance to fit inside the mouth for both molars and premolars. The most difficult region to perform bitewing radiography using the phantom was the molar region (2.87), and the most difficult to perform occlusal radiography approaches were maxillary anterior general occlusal radiography (2.92) and mandibular cross-sectional occlusal radiography (3.00). Conclusions: The most technically difficult point in bitewing and occlusal radiography was the correct positioning of the vertical and horizontal angles. Radiography practice was considered to be more effective than previous mutual practice in terms of analysis of anatomical structures and patient treatment methods. Therefore, it will be necessary to improve policy regarding dental radiography practice at the department of dental hygienics and revise the necessary laws and regulations.

저전력장거리 기술과 임베디드 보드를 이용한 치매 돌봄 스마트 신발 구현 (Implementation of Smart Shoes for Dementia Patients using Embedded Board and Low Power Wide Area Technology)

  • 이성진;최준형;서창성;박병권;최병윤
    • 한국정보통신학회논문지
    • /
    • 제24권1호
    • /
    • pp.100-106
    • /
    • 2020
  • 본 논문에서는 저전력장거리 기술과 임베디드 보드를 이용한 치매 돌봄 스마트 신발과 응용 소프트웨어를 구현하였다. Cortex-M3 보드와 로라 모듈로 구성된 통신 모듈은 신발 밑창의 홈에 내장 된다. 위치추적 응용 소프트웨어는 임베디드 보드에서 제공하는 신호와 GPS와 로라 망을 이용하여 보호자가 치매 환자의 위치 추적할 수 있다. 외부 환경에서 스마트 신발의 위치 추적 및 데이터 전송 동작이 성공적으로 확인되었다. 이러한 실험을 통해 본 논문에서 개발한 스마트 신발이 치매 환자의 돌봄을 위한 실종을 막는 안전장치로 응용 가능할 것으로 판단된다.

지역약사의 시리즈형 OTC 약물에 대한 약사의 직능 수행에 대한 평가 (Relationship between the Series named OTC Products and Pharmacist's Professional Workloads in Community Pharmacy)

  • 김정은;임성실
    • 한국임상약학회지
    • /
    • 제30권4호
    • /
    • pp.226-233
    • /
    • 2020
  • Background: Currently, the over-the-counter (OTC) drug market is flooded with series OTC products. The pharmacist must follow the OTC product's indication, given that the most critical role of a pharmacist is the right selection and recommendation of an OTC drug for a patient's symptoms in a dynamic pharmacy environment. Therefore, pharmacists must know each OTC product information precisely to avoid any ambiguity due to several OTC series brand names. Objective: We evaluated the risk and effectiveness of OTC series medicines. Methods: From December 5 to December 18, 2019, an online survey was conducted among 145 community pharmacists. Results: A total of 51.0% of pharmacists knew the difference between products named in a series and could explain it spontaneously. Only 0.7% of the pharmacists admitted to not knowing the difference between products named in a series. While 42.9% of pharmacists who owned a pharmacy opined that the OTC medicines named in a series have health benefits for patients, 50.0% of employee pharmacists admitted that they were rather confused because there are several OTC series medicines. In contrast, 69.2% of pharmacists who owned pharmacies and 72.2% of employee pharmacists admitted that OTC series drugs with names similar to popular OTC drugs sell better. Conclusion: While pharmacists had different opinions regarding OTC series drugs per employment status, they opined that OTC series are more helpful in pharmacy management than completely new brand names. Further studies in this regard are needed.

Transcranial direct current stimulation for spinal cord injury-associated neuropathic pain

  • Li, Caixia;Jirachaipitak, Sukunya;Wrigley, Paul;Xu, Hua;Euasobhon, Pramote
    • The Korean Journal of Pain
    • /
    • 제34권2호
    • /
    • pp.156-164
    • /
    • 2021
  • Several types of pain occur following spinal cord injury (SCI); however, neuropathic pain (NP) is one of the most intractable. Invasive and non-invasive brain stimulation techniques have been studied in clinical trials to treat chronic NP following SCI. The evidence for invasive stimulation including motor cortex and deep brain stimulation via the use of implanted electrodes to reduce SCI-related NP remains limited, due to the small scale of existing studies. The lower risk of complications associated with non-invasive stimulation, including transcranial direct current stimulation (tDCS) and repetitive transcranial magnetic stimulation (rTMS), provide potentially attractive alternative central neuromodulation techniques. Compared to rTMS, tDCS is technically easier to apply, more affordable, available, and potentially feasible for home use. Accordingly, several new studies have investigated the efficacy of tDCS to treat NP after SCI. In this review, articles relating to the mechanisms, clinical efficacy and safety of tDCS on SCI-related NP were searched from inception to December 2019. Six clinical trials, including five randomized placebo-controlled trials and one prospective controlled trial, were included for evidence specific to the efficacy of tDCS for treating SCI-related NP. The mechanisms of action of tDCS are complex and not fully understood. Several factors including stimulation parameters and individual patient characteristics may affect the efficacy of tDCS intervention. Current evidence to support the efficacy of utilizing tDCS for relieving chronic NP after SCI remains limited. Further strong evidence is needed to confirm the efficacy of tDCS intervention for treating SCI-related NP.

Lessons Learnt from an 11-year Experience with Lymphatic Surgery and a Systematic Review of Reported Complications: Technical Considerations to Reduce Morbidity

  • Ciudad, Pedro;Escandon, Joseph M.;Manrique, Oscar J.;Bustos, Valeria P.
    • Archives of Plastic Surgery
    • /
    • 제49권2호
    • /
    • pp.227-239
    • /
    • 2022
  • Complications experienced during lymphatic surgery have not been ubiquitously reported, and little has been described regarding how to prevent them. We present a review of complications reported during the surgical management of lymphedema and our experience with technical considerations to reduce morbidity from lymphatic surgery. A comprehensive search across different databases was conducted through November 2020. Based on the complications identified, we discussed the best approach for reducing the incidence of complications during lymphatic surgery based on our experience. The most common complications reported following lymphovenous anastomosis were re-exploration of the anastomosis, venous reflux, and surgical site infection. The most common complications using groin vascularized lymph node transfer (VLNT), submental VLNT, lateral thoracic VLNT, and supraclavicular VLNT included delayed wound healing, seroma and hematoma formation, lymphatic fluid leakage, iatrogenic lymphedema, soft-tissue infection, venous congestion, marginal nerve pseudoparalysis, and partial flap loss. Regarding intra-abdominal lymph node flaps, incisional hernia, hematoma, lymphatic fluid leakage, and postoperative ileus were commonly reported. Following suction-assisted lipectomy, significant blood loss and transient paresthesia were frequently reported. The reported complications of excisional procedures included soft-tissue infections, seroma and hematoma formation, skin-graft loss, significant blood loss, and minor skin flap necrosis. Evidently, lymphedema continues to represent a challenging condition; however, thorough patient selection, compliance with physiotherapy, and an experienced surgeon with adequate understanding of the lymphatic system can help maximize the safety of lymphatic surgery.

Measurement of S1 foramen depth for ultrasound-guided S1 transforaminal epidural injection

  • Ye Sull Kim;SeongOk Park;Chanhong Lee;Sang-Kyi Lee;A Ram Doo;Ji-Seon Son
    • The Korean Journal of Pain
    • /
    • 제36권1호
    • /
    • pp.98-105
    • /
    • 2023
  • Background: Ultrasound-guided first sacral transforaminal epidural steroid injection (S1 TFESI) is a useful and easily applicable alternative to fluoroscopy or computed tomography (CT) in lumbosacral radiculopathy. When a needle approach is used, poor visualization of the needle tip reduces the accuracy of the procedure, increasing its difficulty. This study aimed to improve ultrasound-guided S1 TFESI by evaluating radiological S1 posterior foramen data obtained using three-dimensional CT (3D-CT). Methods: Axial 3D-CT images of the pelvis were retrospectively analyzed. The radiological measurements obtained from the images included 1st posterior sacral foramen depth (S1D, mm), 1st posterior sacral foramen width (S1W, mm), the angle of the 1st posterior sacral foramen (S1A, °), and 1st posterior sacral foramen distance (S1ds, mm). The relationship between the demographic factors and measured values were then analyzed. Results: A total of 632 patients (287 male and 345 female) were examined. The mean S1D values for males and females were 11.9 ± 1.9 mm and 10.6 ± 1.8 mm, respectively (P < 0.001); the mean S1A 28.2 ± 4.8° and 30.1 ± 4.9°, respectively (P < 0.001); and the mean S1ds, 24.1 ± 2.9 mm and 22.9 ± 2.6 mm, respectively (P < 0.001); however, the mean S1W values were not significantly different. Height was the only significant predictor of S1D (β = 0.318, P = 0.004). Conclusions: Ultrasound-guided S1 TFESI performance and safety may be improved with adjustment of needle insertion depth congruent with the patient's height.

Protocol for management of pregnant patients requiring emergency minor oral surgical procedures: a prospective study in 52 patients

  • Ajinath Nanasaheb Jadhav;Shushma G;Uzma Hamidullah Siddiqui;Minal Sharma;Yaseer Irfan Shaikh;Pooja Raosaheb Tarte
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
    • /
    • 제49권1호
    • /
    • pp.21-29
    • /
    • 2023
  • Objectives: Dental or maxillofacial emergencies are uncommon during pregnancy, but if they occur, they are challenging to treat due to potential risks. The mother should not be denied necessary medical or dental care because of pregnancy. The aim of the study is to observe outcomes of pregnancy in patients requiring emergency minor oral surgical procedures during gestation and to determine the safety of the pregnant woman undergoing the procedure and the fetus. Materials and Methods: The study was conducted on 52 pregnant women requiring emergency oral surgical procedures. A standard treatment protocol for treatment of specific entities was followed. Close monitoring and observation were the primary goal of treatment. All patients were followed postoperatively until complete recovery from the surgical procedures and then until birth of the baby. A control group of 52 healthy pregnant patients who did not require oral surgical procedures was considered for statistical analysis. The measurements to calculate observation were fetal loss (spontaneous abortion), preterm birth, low-birth weight, or incidence of any congenital anomalies in the baby and its association with surgical procedures. Results: No fetal loss occurred in any of the cases. However, four patients experienced preterm birth and seven neonates exhibited low birth weights. No congenital abnormalities were discovered. In one instance, a patient who underwent surgery for a mandibular symphysis fracture under general anesthesia in the 31st week of pregnancy experienced labor pain on the fourth postoperative day, requiring an emergency Caesarean section. Conclusion: The results of our study demonstrate that, compared to the control group, minor emergency surgeries performed during pregnancy have no discernible negative effects on the fetus. These procedures can safely be performed by adhering to our described protocols.

일 상급종합병원 간호사의 4차 산업혁명에 대한 인식 및 미래핵심간호역량 중요도-실행도 분석 (A Study on the Analysis of Nurses' Perception of the Fourth Industrial Revolution and the Importance and Performance of Future Core Nursing Competencies in a Tertiary Hospital)

  • 권지혜;김미순
    • 임상간호연구
    • /
    • 제29권1호
    • /
    • pp.95-106
    • /
    • 2023
  • Purpose: This study is descriptive survey research on the analysis of nurses' perception of the 4th industrial revolution and the importance and performance of future core nursing competencies in a tertiary hospital located in Seoul. Methods: Data were collected from 149 nurses with more than a year of work experience and analyzed using descriptive statistics, t-test, one-way ANOVA, and Importance Performance Analysis(IPA) with the IBM SPSS/WIN 25.0 program. Results: The nurses' perception of the 4th industrial revolution was 3.23±0.71 out of 5 points. The importance of future core nursing competencies was 4.31±0.48, and the performance of it was 3.47±0.54. The analysis results of IPA showed that A (area of continuous maintenance) included critical thinking, problem-solving skills, teamwork and collaboration, evidence-based practice, communication, quality improvement and safety, professionalism, self-regulation and self-management, and personal literacy. The specific competencies were not included in B (area of priority improvement). Creativity, informatics, healthcare policy, leadership, research ability, and continuing education were included in C (area of progressive improvement). Knowledge and patient-centered care, ability to manage resources as well as professional, legal, and ethical responsibility were included in D (area of overinvestment). Conclusion: The nurses seemed not to be fully prepared for the 4th industrial revolution. However, they were well aware of the importance of the future core nursing competencies. Therefore, if nurses increase the performance of core competencies in order of priority according to the IPA results, they will be able to independently lead the changing nursing field.

간호대학생의 임상실습 적용을 위한 의도적 간호순회 프로토콜 개발 (Development of an intentional rounding protocol for nursing undergraduates to apply in clinical practice)

  • 김수은;옥종선;최진이;최희정
    • 한국간호교육학회지
    • /
    • 제29권4호
    • /
    • pp.381-394
    • /
    • 2023
  • Purpose: This study aimed to develop an intentional rounding protocol to enhance the clinical competence of nursing students. Methods: An intentional rounding protocol for nursing students' clinical practice was developed following the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A convenient sampling method was used to select 23 junior year university nursing students during their clinical practice in adult nursing. The program evaluation included a quantitative assessment (communication and relationship efficacy, empathy, and patient safety competency) and focus group interviews. Results: The intentional rounding protocol focused on the 4Ps (pain, position, potty, and possessions) and encompassed aspects such as level of consciousness, pain management, personal care needs, intravenous injection, oxygen administration, nasogastric/nasoenteric tube care, maintenance of urine collection bags, and the identification of environmental fall risks. Nursing students performed intentional rounding at least twice a day. Following the implementation of this protocol, nursing students demonstrated a significant improvement in communication and interpersonal efficacy. The focus group interviews revealed four main themes: growth of human relationships, acquiring knowledge in and about the clinical field, becoming a nurse, and barriers in reality. Conclusion: The intentional rounding protocol has the potential to enhance nursing students' communication and interpersonal skills during clinical practice and to provide them with positive experiences in nursing clinical education. Therefore, it is recommended that this protocol be incorporated into nursing clinical practice education.

부가필터를 이용한 kVp 측정의 실효성 평가 (Effectiveness Evaluation of the Tube Voltage Measurement by using Additional Filter)

  • 황준호;이경호;최윤봉;강병삼
    • 대한방사선기술학회지:방사선기술과학
    • /
    • 제38권4호
    • /
    • pp.355-363
    • /
    • 2015
  • 의료산업의 성장은 의료수준 및 의료기기의 발전의 계기가 되었고, 이는 정확한 질병의 진단과 치료를 가능하게 하였다. 그러나 많은 수의 검사는 장비의 노후화를 야기하고, 환자의 피폭선량에 관여하기 때문에 국내에서는 정기적인 안전관리 체계를 구축하여 정도관리를 시행하고 있다. 그 중 정도관리 항목 중 하나인 kVp는 장비의 수명과 환자의 피폭선량에 직접 관여하는 부분이나, 정도관리의 시간과 비용의 문제점으로 정기적으로 시행하는 데에는 한계가 따르고 있다. 이에 본 논문에서는 kVp 측정에 Cu와 Y을 이용하여 kVp 측정의 실효성과 유용성을 평가하고 또한 제안하고자 하는 정도관리 방법의 정확성을 평가하여 kVp 측정의 정도관리 방안을 제시하고자 한다. 실험방법은 Cu와 Y이 같은 필름농도를 내는 조건의 kVp를 찾아 Cu와 Y을 통한 kVp 측정의 실효성과 유용성을 평가한다. 농도 범위가 0.5 ~ 1.0을 내는 관전압과 관전류 량의 조건을 고정한 뒤, Cu와 Y이 같은 농도를 내는 kVp의 Y에 대한 Cu의 비의 백분율을 기준점 100%로 정하여, ${\pm}10%$범위로 kVp를 변화시켜가며 Y에 대한 Cu의 백분율의 농도비를 기록하여 농도단계를 만든다. 실험 결과 같은 농도를 내는 kVp의 Y에 대한 Cu의 백분율의 농도비를 기준으로 ${\pm}10%$ 범위의 Y에 대한 Cu의 백분율의 농도비가 85 ~ 110%로 일정한 단계를 가진다는 것을 알 수 있었다.