• 제목/요약/키워드: Patient Safety Management Activities

검색결과 84건 처리시간 0.027초

의료기관 사회적 책임(HSR)활동의 IPA 평가 (IPA Assessment of Hospital Social Responsibility Activities)

  • 조경원;사공미
    • 보건의료산업학회지
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    • 제12권4호
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    • pp.1-15
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    • 2018
  • Objectives: We analyzed the importance and performance of hospital social responsibility (HSR) according to the characteristics of hospitals, and presented strategies for HSR activities. Methods: An online HSR questionnaire was sent to hospitals nationwide from October 12 to 26, 2018. The 206 responses received were analyzed in accordance with the IPA to assess the performance and importance of HSR. Results: There was a statistically significant difference between the employees and hospitals regarding the importance and performance of HSR activities. In the area of "sustained maintenance", items related to consumer issues such as "compliance with personal information processing policy", "patient confidentiality", "fair information provision", and "system for patient safety and infection prevention" were derived. In the area of "'high priority for improvement", there were three common items between hospitals and general hospitals: "regular donations and support from local communities", "active cooperation with related institutions", and "compliance with process-related laws and regulations". In the area of "low priority", four items were derived: "support for employee participation in community activities", "efforts to hire local residents", "education and cultural programs for local communities", and "transparent support for political activities". In the area of "sublation of excessive efforts", two items of "employee welfare efforts" and "efforts to improve labor relations", were commonly found in hospitals and general hospitals. Conclusions: It is necessary to improve the management efficiency of hospitals by the systematic allocation of manpower and resources through the establishment of four regional strategies based on the results of IPA analysis.

한국 표준 간호행위 분류 (The Classification of Standard Nursing Activities in Korea)

  • 박정호;성영희;송미숙;조정숙;심원희
    • 대한간호학회지
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    • 제30권6호
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    • pp.1411-1426
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    • 2000
  • A nursing activity classification for hospitalized patients was performed based on an article review regarding nursing definition and nursing activity classification system. The study was conducted as follows: 1) Taxonomy was developed by the research team through the Delphi process and review article. The taxonomy consists of four nursing processes, (assessment, diagnosis, intervention and evaluation) and twelve nursing activity domains space (resperation, nutrition, elimination, exercise/alignment maintenance, comfort, hygiene, safety, spiritual support, counseling/ education, medication, communication, patient and information management). 2) First, nursing activities of the intervention process were listed and then classified by the nursing process of assessment, diagnosis, intervention and evaluation. The list consists of twelve nursing activity domains and 136 nursing activities. 3) A pilot study was conducted in two hospitals to verify validity and appropriateness of nursing activities. 4) The content validity index, which was calculated by 6 clinical practice experts, was 0.95. Also, a nursing activity classification system should also be developed in the department of community nursing and home health care nursing.

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핵의학과 내에서의 효과적인 고객위험관리: 위험관리 응대 MOT 개발적용 및 홍보동영상 제작 (Effective Customer Risk Management at the Nuclear Medicine Department: Risk Managemont MOT Development Application and Producing Public Relations Film)

  • 함종훈;황재봉;김준호;이귀원
    • 핵의학기술
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    • 제13권3호
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    • pp.110-122
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    • 2009
  • 목적: 최근 의료기관평가제도는 의료의 질에 대한 병원들의 관심을 높게 하고 그것을 향상시키기 위한 활동을 활발히 전개하고 있다. 또한 추가된 항목인 환자의 위험관리에 대해서도 많은 관심을 보이고 있다. 의정부성모병원 핵의학과는 2008년도 PET/CT도입으로 시작된 부서내 리모델링은 과내 구조 및 업무 프로세스에 많은 변화를 가져왔다. 따라서 변경된 구조와 기존의 업무 처리방식은 미처 알지 못하는 위험요인을 내포하게 되었다. 그러므로 영상 검사 과정에서 발생할 수 있는 위험요인을 다각도로 찾고 분석하여, 부서의 특수한 환경에 맞는 위험관리 프로세스와 위험요인 제거업무를 포함한 개선 활동을 목적으로 한다. 실험재료 및 방법: 핵의학과의 새로워진 프로세스를 다각도로 분석하여 첫째, 위험관리 응대메뉴얼을 제작하여 교육후 실제 업무에 적용한다. 결과분석은 전년도 위험사고 발생건수와 개선활동 후 위험사고 발생건수를 비교하였다. 둘째, 위험관리 홍보동영상은 제작 후 검사전 해당 환자에게 상영하였고 그 후 자체 제작된 설문지로 해당 환자 100명에게 만족도 조사를 하였다. 셋째, 위험요소를 개선할 수 있는 시설물 참여형 개선활동을 통해서 위험요소를 제거하였다. 결과: 안전사고 발생건수는 개선활동이후 PET/CT와 감마카메라 영상 검사 모두 검사건수대비 투약오류, 낙상, 충돌 등의 안전사고가 0건으로 조사되었다. 설문조사 결과는 동영상 상영 후 검사진행과정 이해 74%, 불안감해소 81%로 "만족한다"는 결과가 조사되었다. "위험요소에 대해 주의했습니까?" 라는 물음의 경우 PET/CT는 94%, 감마카메라는 89%가 주의했다는 결과로 조사되었다. 개선활동을 통해서 핵의학과내에서의 고객위험관리를 효과적으로 수행할 수 있었다. 결론: 본 개선활동을 통하여 영상 검사 시 산재된 위험요소를 체계적으로 나열하고 분석하는 계기가 되었다. 또한 안전사고에 대처하는 방사선사의 업무방법에서도 기준이 되는 응대메뉴얼을 적용시킨다면 안전사고의 최소화와 안전사고시 체계적인 피드백이 가능함을 알 수 있었다. 위험요소를 알려주는 방법론적인 부분에서도 일상생활에서 쉽게 접할 수 있는 시청각자료로 제공 되었을 때 보다 효과적이였다. 따라서 이런 활동이 지속적이고 세부화 된 업그레이드 작업을 통해서 환자들에게 제작되어 제공된다면 핵의학 검사 이용의 안전성과 편리성에 도움을 줄 수 있으리라 생각된다.

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일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정 (Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital)

  • 김경운
    • 간호행정학회지
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    • 제6권3호
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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의료의 질 개선 전문가의 자격 시스템에 대한 현황 (The review of qualifying systems of quality improvement specialists in healthcare)

  • 박성희;황정해;최윤경;이순교
    • 한국의료질향상학회지
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    • 제19권2호
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    • pp.14-34
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    • 2013
  • Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

환자경험 평가와 의료 현장의 변화: 의료기관 환자경험 업무 담당자의 관점 (Implementation of Patient Experience Assessment and Subsequent Changes at the Ground Level in Health Care: Patient Experience Employees' Perspective)

  • 송영채;윤은실;한세영;태지연;유수경;도영경
    • 한국의료질향상학회지
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    • 제28권1호
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    • pp.14-33
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    • 2022
  • Purpose: To examine whether the Patient Experience Assessment (PEA) has led to perceptible changes at the ground level of health care, as a way of evaluating PEA as a policy intervention for quality improvement. Methods: Four focus group discussions (FGDs) were conducted, each comprising six to eight participants who were employees responsible for patient experience at their respective hospitals. The primary focus of the FGDs was on questions such as: 1) How do hospitals respond to PEA? 2) What significant changes were observed after the implementation of PEA? 3) What were the unintended consequences of implementing PEA, if any? 4) What areas of improvement have been identified for maximizing the potential of PEA? Results: Two broad themes emerged out of the FGDs: changes observed post implementation of PEA, and areas for improvement of PEA. Four significant changes were reported by participants: changes in perception and attitude regarding patient experience in hospital employees, increased active involvement by the hospital leadership, enhanced efforts to improve patient experience, and increased cooperation between such activities. Furthermore, eight areas of improvement were identified, which have been grouped in three categories: improving the process of data collection for PEA, introducing additional catalysts to facilitate further changes, and paying attention to structure- and patient-level constraints that must be addressed in parallel. Conclusion: The implementation of PEA led to perceptible changes within hospitals, which implies that it can serve as an effective catalyst for improving patient experience. A number of areas of improvement that would aid in maximizing the potential of PEA were also identified.

수술실의 간호오류 및 과오 예방을 위한 E-learning 실무교육 프로그램의 개발 및 평가 (Development of an E-learning Education Program for Preventing Nursing Errors and Adverse Events of Operating Room Nurses)

  • 김정순;김명수;황선경
    • 성인간호학회지
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    • 제17권5호
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    • pp.697-708
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    • 2005
  • Purpose: This study was to develop, implement, and evaluate an e-learning education program for improving practical knowledge and preventing nursing errors and adverse events of nurses working in the operating room (OR). Method: The e-learning program was developed and evaluated according to the following processes: 1) preparation phase 2) implementation phase 3) evaluation phase. In evaluation phase, the effectiveness was analyzed based on the Kirkpatrick's model. Results: The e-learning program consisted of OR basic nursing skills and techniques and nursing activities' manual based on the categories of nursing errors: surgical operation preparation, nursing skills and techniques, environment management, patient safety and comfort, and patient monitoring. The program was provided through on-line, http://cafe.daum.net/pnuhorn, for 4 weeks. The mean score(percent) of participants' satisfaction was $21.24{\pm}1.71$(68.2%). Their total knowledge level was significantly improved(Z=-3.00, p=.003) and specifically in the category of environment management(Z=-3.77, p<.001) and patient monitoring(Z=-2.46, p=.014). The occurrence of nursing errors or adverse events was a little decreased, but not statistically significant(Z=-3.10, p=.756). Conclusion: E-learning for nurses is one way of effective and efficient teaching-learning strategies. For better e-learning, it is important to develop the vital content of the education and objective measures for detecting nursing errors and adverse events.

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SERVQUAL 모델을 이용한 간호 서비스 질 측정 (Measurement of Nursing Service Quality using SERVQUAL Model)

  • 임지영;김소인
    • 간호행정학회지
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    • 제6권2호
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    • pp.259-279
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    • 2000
  • This study is a descriptive analytic research measuring nursing service quality, using SERVQUAL model, to make fundamental data and strategies for nursing service improvement. Data were collected by self-reported questionnaire from 202 patients and 142 nurses, from June 7 to 14, 1999. The reliability of instrument were adequate(Cronbach ${\alpha}=.94$). SAS program was utilized for statistical analysis of collected data. The results were as follows; 1. There was a gab between patient's expectation and perception on nursing service(Gap B). Gap D was indicated an affecting factor to decide nursing service quality. Gap C was indicated an indirect affecting factor of nursing service quality. Because it was not statistically significant in total item analysis, but in individual item analysis, 7 items were appeared statistically significant. Gap A was not a gap occurrence factor of nursing service quality. 2. Focuses of nursing service quality improvement strategies were; (1) to direct qualitative improvement of nursing service in order to correspondence patient's nursing service expectation. (2) to make nurse's service activity modified because nurse's practice were not reached patient's expectation level. (3) to need internal, external factor analysis affecting nurse's service activity. 3. Nursing service quality was decided by rather environmental inappropriateness provided nursing service than itself. Therefore, to make nursing service quality improvement, it is required to improve nursing service environment. For this, followings are required; (1) to strengthen nurse's education on lower part of nursing service satisfaction and QI activities. (2) to balance demand and supply of nursing personnel. 3) to fix computerized system for reducing other duties weight except nursing care through analysis of nursing activity. (4) to construct rational cooperating system among related departments. 4. The important parts for nursing service quality improvement were indicated as follows: (1) Gap B: 'prompt reaction', 'examination symptom before patient's complaint', 'hearted nursing service reducing patient's dissatisfaction', 'explanation goals of nursing activities', 'having special Knowledge enough', 'maintenance position comfortably', 'management of patient's physical hygiene'. (2) Gap C: 'maintenance physical safety', 'explanation about hospital rules and facilities'. (3) Gap D: 'tender, safe injection and wound care'. Because above items are mostly improved through nurse's attitude change and quality improvement, it is required to establish nursing standardization and to strengthen nurse's clinical education. As the based on above results, followings are suggested; 1. SERVQUAL model is very useful to make strategies for nursing service quality improvement because it indicates multiple factors affecting hap occurrence. 2. At individual items analysis of Gap C, statistically significant 7 items appeared higher nurse's perception level than patient's perception level on nursing service were trouble perception level on nursing service quality improvement. So. it need further research to analysis about these difference occurring factors. 3. At analysis of Gap D, it is indicated that in nursing service performance process, multiple factors lowing nursing service quality were intruded. So it needs further research to analysis what these factors are and how each factors affect on nursing performance process. 4. nursing service quality measurement is changeable according to sample select time or sampled subject's characteristics. So to develope strategy for nursing service quality improvement is based on the results of periodical analysis.

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IC 카드에 의한 원외 전자처방전 보안을 위한 시스템 구축 (Implementation of the Electronic Prescription Security System Using by an If Card)

  • 강세나;이기한
    • 정보처리학회논문지C
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    • 제10C권3호
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    • pp.281-286
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    • 2003
  • 최근 환자의 개인적인 의료정보가 외부에 노출되는 것은 사생활적인 측면뿐 아니라 사회 활동 및 환경에도 영향을 준다. 그러므로 불법적인 조작으로부터 환자의 개인적인 의료정보를 안전히 보호하는 것은 중요하다. 이에 본 논문에서는 첫 번째, IC 카드에 전자처방전 정보를 저장하는 방법을 연구하고 두 번째, IC 카드에 저장된 정보에 접근하기 위한 사용자(의사, 간호사, 의료기관 관계자, 약국, 약사, 환자 등)의 접근 권한을 설계한다. 마지막으로 윈도우즈 2000이 지원하는 인증 관리 모델의 보안 API를 이용하여 인증서를 발급하고, 보안 서비스 제공 프로그램을 이용하여 공개키/개인키를 생성하여, 전자처방전에 대해 전자서명을 한다. 본 논문에서 제시한 시스템은 전자처방전의 안전성과 신뢰성을 확실히 보장할 수 있으며, 진료에 대한 서비스를 향상시킬 수 있을 것으로 기대된다.

일 상급종합병원 병동간호사의 업무량 측정 및 간호사 배치수준의 적절성 연구: 혼합연구 설계 적용 (Analysis of the Adequacy of Nurse Staffing Level through the Estimation of Nursing Activity Hours and Implementation of Focus Group Interviews in a Tertiary Hospital: Using a Mixed-Method Design)

  • 김현주;이선희;이재정;성선숙;양희;이향열
    • 대한간호학회지
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    • 제54권2호
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    • pp.237-249
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    • 2024
  • Purpose: This study aimed to examine the adequacy of current nurse staffing levels by identifying nursing activities and workload. Methods: The study used a mixed-method design. A nursing activity survey was conducted using the work sampling method over 2 working days with 119 general ward nurses. A focus group interview was conducted with 12 nurses. Quantitative and qualitative data were analyzed using SPSS 20.0 and content analysis, respectively. Results: The most amount of time was spent on medication (in direct nursing) and electronic medical record documentation (in indirect nursing). The appropriate nurse-to-patient ratio is 1:7.7 for the day shift, 1:9.0 for the evening shift, and 1:11.9 for the night shift. However, the current nurse-to-patient ratio is 1:9.4, 1:11.0, and 1:13.8 for the day, evening, and night shifts, respectively. Therefore, the current nurse staffing level is insufficient for the workload. In the focus group interview, the main reasons cited for being unable to complete tasks within working hours were communication and coordination, and the nursing electronic medical record. The essential nursing activities of basic nursing and emotional support were overlooked owing to a heavy workload. Therefore, an adequate nurse staffing level should be higher than the measured quantitative workload. Conclusion: These results suggest the general wards of tertiary hospitals should evaluate the adequacy of their current nurse staffing and allocate sufficient nurses to improve patient safety and nursing care quality.