• 의학교육논단
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• 제21권1호
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• pp.1-12
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• 2019

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

• 대한간호학회지
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• 제48권6호
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• pp.720-730
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• 2018

Purpose: The purpose of this study was to investigate patient safety teaching competency of nursing faculty and the extent of teaching patient safety topics in the nursing curriculum. Methods: A national survey was conducted with full-time nursing faculty in 4-year nursing schools. Regional quota sampling method was used. An online survey was sent to 1,028 nursing faculty and 207 of them were completed. Among the 207, we analyzed data from 184 participants. The revised Health Professional Education in Patient Safety Survey was used. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation analysis, and multiple linear regression analyses. Results: The faculty's self-confidence was lower than their perceived importance of patient safety education. The mean score of teaching patient safety was $3.52{\pm}0.67$ out of 5, and the contents were mostly delivered through lectures. The extent of faculty's teaching varied depending on faculty's clinical career, teaching subjects, participation in practicum courses, and previous experience of patient safety education. The significant predictors of the extent of teaching patient safety were the faculty's self-confidence in teaching patient safety (${\beta}=.39$) during clinical practicum, their perceived importance of patient safety education during lectures (${\beta}=.23$), and the teaching subject (${\beta}=.15$). Conclusion: To enhance the competency of nursing faculty for effective patient safety education, a patient safety education program tailored to faculty characteristics should be developed and continuously provided for faculty. In addition, it is necessary to improve patient safety curriculum, strengthen clinical and school linkages, and utilize various education methods in patient safety education.

• 한국산학기술학회논문지
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• 제20권3호
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• pp.216-223
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• 2019

본 연구는 간호대학생의 환자안전 역량이 환자안전관리 행위에 미치는 영향을 확인하여 환자안전관리 행위 향상을 위한 프로그램 개발의 기초자료를 제공하기 위하여 시도되었다. 참여자는 1년 이상 학생 간호사로 임상 실습을 받은 293명의 4학년 간호대학생이다. 데이터는 2018년 4월 26일부터 5월 9일까지 수집되었다. 수집된 자료는 SPSS/WIN 24.0 컴퓨터 프로그램으로 빈도, 백분율, 평균, 표준 편차, t-test, ANOVA, Pearson's Correlation Coefficient, Multiple regression으로 분석하였다. 간호대학생의 환자안전 역량은 평균 $2.90{\pm}0.38$점 (환자안전 지식 $2.68{\pm}0.65$, 환자안전 기술 $3.26{\pm}0.56$, 환자안전 태도 $2.75{\pm}0.40$)이었다. 환자안전관리 행위 점수는 평균 $4.13{\pm}0.57$점이었다. 간호대학생의 환자안전 지식, 기술, 태도 및 환자안전관리 행위 간의 상관관계에서, 기술 및 관리 행위는 r=.337, p<.001, 태도 및 관리 행위는 r=-.150, p=.010, 지식 및 관리 행위는 r=.171, p=.003이었다. 대학생의 환자안전 관리 행위에 영향을 미치는 요인은 환자안전 기술(${\beta}=.307$, p<.001), 화재에 대한 안전사고 경험(${\beta}=-.127$, p=.026), 환자안전 태도(${\beta}=-.121$, p=.026), 환자교육에 대한 안전사고 경험(${\beta}=-.119$, p=.034)으로 나타났고, 설명력은 15.7%였다. 본 연구결과를 통하여 간호대학생의 환자안전관리 행위에 영향을 미치는 다양한 요인을 확인하기 위한 반복연구가 필요하고, 환자안전관리 행위를 높일 수 있는 교육프로그램 개발이 요구된다.

• 한국산학기술학회논문지
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• 제19권10호
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• pp.194-205
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• 2018

본 연구에서는 요양병원 간호보조인력 즉 간호조무사, 요양보호사의 환자안전에 대한 지식, 태도 및 환자안전활동 정도를 파악하여, 요양병원 환자안전관리 역량증진 및 간호보조인력을 위한 교육과정 개발의 기초자료로 활용하고자 시도된 서술적 조사연구이다. 자료 수집은 2017년 3월 2일부터 3월 26일까지 B광역시 소재 요양병원 중 2013년 적정성평가 2등급 이상, 200병상 이상의 6곳에서 근무하는 간호보조인력 230명을 대상으로 구조화된 설문지를 이용하여 수집하였다. 수집된 자료는 SPSS/WIN 20.0 프로그램을 이용하여 실수와 백분율, 평균, 표준편차, t-test, ANOVA, $Scheff{\acute{e}}$ test, 상관관계분석 및 다중회귀분석을 실시하였다. 본 연구의 결과, 요양보호사보다 간호조무사가, 고학력일수록, 환자안전교육을 받은 횟수가 많을수록 환자안전활동 정도가 높은 것으로 나타났다. 또한 환자안전에 대한 지식이 태도에 영향을 미치고, 태도는 환자안전활동에 영향을 미치는 것으로 나타났다. 따라서 바람직한 태도 개선을 위해 직종별 차별화된 교육과 연간 5회 이상의 실제적이고 지속적인 교육 프로그램의 제공이 필요하고 적절한 근무시간 등의 제도개선 또한 필요할 것으로 사료된다. 이 결과를 토대로 요양병원 간호보조인력의 환자안전관리 역량증진 및 환자안전에 대한 지식 향상과 바람직한 태도개선을 위한 교육과정 개발의 기초 자료로 활용할 수 있을 것이다.

• 한국보건간호학회지
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• 제34권3호
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• pp.490-502
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• 2020

Purpose: This study aimed to identify the factors influencing competency for Multi-Drug Resistant Organisms (MDRO) infection control in nursing students with clinical practice experience. Methods: This cross-sectional descriptive study was conducted from May 2020 to August 2020 by including 175 nursing students in two nursing schools located in Daegu. The data were collected using self-report questionnaires. The data were analyzed using the SPSS/WIN 25.0 program with descriptive statistics, independent t-test, ANOVA, correlation, and multiple regression. Results: The competency of MDRO infection control was 3.41.±0.38. The attitude to patient safety management and - knowledge of MDRO infection control were 3.81±0.47 and 16.98±3.02, respectively. Factors influencing the competency of MDRO infection control were perceived benefit(β=.38, p<.001), knowledge toward MDRO infection control(β=.21, p=.001), attitude in patient safety management(β=.17, p=.028), and perceived barrier(β=-.15, p=.029) with an explanatory power of 34.2%. Conclusion: A systemic education program regarding MDRO infection control is needed for nursing students to provide knowledge related to MDRO infection control and help establish positive beliefs toward MDRO infection control and attitudes in patient safety management.

• 한국산학기술학회논문지
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• 제19권1호
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• pp.398-407
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• 2018

본 연구는 Walker와 Avant의 방법을 이용한 학생간호사의 윤리역량에 대한 개념분석 연구이다. 최근 10년 간 윤리역량에 대한 국내 및 국외 선행연구 최종 11편을 선정하여 분석에 이용하였다. 본 연구에서 학생간호사의 윤리역량의 개념은 윤리적 민감성, 윤리적 판단력, 윤리적 행위에 대한 실천의지, 윤리적 행위의 실행력이 속성으로 도출되었다. 선행요인은 자기이해, 지지적 환경, 윤리적 갈등 경험, 윤리교육 경험이었으며, 결과는 간호전문직관, 간호직에 대한 만족도, 환자안전으로 나타났다. 즉, 학생간호사의 윤리역량 향상을 위해서는 다차원 간 균형적인 성장과 발달이 이루어져야 하며, 이를 통해 학생간호사의 윤리적 민감성, 윤리적 판단력, 윤리적 행위에 대한 실천의지, 윤리적 행위의 실행력이 향상될 수 있다. 이를 위해서는 학생간호사 스스로 충분한 자기이해와 학생간호사를 지원해줄 수 있는 지지적 환경, 과거에 윤리적 갈등상황에 직면했던 경험 및 윤리역량을 향상시키기 위한 교육의 경험이 선행되어야 하며, 학생간호사의 윤리역량 향상은 결과적으로 간호전문직관을 확립하고, 간호직에 대한 만족도가 높아지며, 환자안전에 기여할 수 있다. 이를 기초로 학생간호사의 특성을 반영한 윤리역량의 속성이 잘 반영된 도구 개발 연구를 제언하며, 학생간호사의 윤리역량을 향상시키기 위한 전략 및 효과적인 프로그램을 개발하기 위한 추후 연구를 제언한다.

• 간호행정학회지
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• 제22권4호
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• pp.406-414
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• 2016

Purpose: The purpose of this study was to analyze the concept of nurses' safety within the context of the hospital environment. Methods: We used Rodgers' method of evolutionary concept analysis and reviewed the relevant literature and noted and categorized characteristics that appeared frequently. Results: Nurses' safety was defined as safe status and safe activity among nurses. Three key defining attributes were identified as: (a) the minimization of actual or perceived risk, (b) personal duties and rights, and (c) ensuring within a safe working environment. Antecedents of nurses' safety were categorized into three dimensions: (a) individual, including vigilance and knowledge gained through education and training; (b) institutional, including safety provision in the organizations; and (c) national, including legislation. The outcomes of nurses' safety included the following: (a) continued competence in nurses' work; (b) enhancement of the quality of patient care; and (c) reductions in nurses' turnover rates. Conclusion: Nurses' safety ensures that qualified nurses are able to continue to perform their duties and provide good patient care. The findings of this study could contribute to future research examining nurses' safety. In addition, appropriate tools must be developed to measure the concept.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.315-318
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• 2022

Aqualyx (Marllor International Ltd, Rimini, Italy) was originally developed in Italy by Professor Pasquale Motolese and has been commercially available since 2009. It is a deoxycholate, aqueous gelatinous solution mixed with saline and buffering compounds. It is the only drug approved by the European Union for the reduction in localized fat. Aqualyx is sold exclusively to doctors and nurses trained in intralipotherapy. In the case of our patient, the product administered was advertised as Aqualyx, but was not administered by a trained health professional and was administered too superficially. The patient developed severe pain following the injection and was unable to sit for several weeks. There was localized skin necrosis, and palpable collections where the injection was administered. Our initial suspicion was development of an abscess or hematoma. To characterize further, we arranged an ultrasound scan that showed a "superficial hypoechoic lesion" but no deeper infection or spread. The numerous painful nodules ruptured onto the skin surface, resulting in purulent and bleeding lesions. This case demonstrates the importance of appropriate training and competence in performing cosmetic procedures including injections and fat dissolving treatments.

• 임상간호연구
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• 제26권1호
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• pp.117-130
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• 2020

Purpose: This study aimed to develop a bedside nursing shift report protocol and evaluate the effect of the protocol in a tertiary hospital in South Korea. Methods: The bedside nursing handoff protocol with patient engagement was developed based on the literature review and the validation of an expert group. The effect of the protocol on clinical implication was tested in three medical-surgical units in a tertiary hospital. Outcomes were assessed by patient perception, nurse perception, and reporting time. Data collected from June to August in 2018 and analyzed with descriptive statistics and One-way ANOVA using SPSS version 25.0. Results: The bedside nursing shift report protocol with patient engagement consisted of two steps: nurse to nurse report and bedside report with patients. Nurse's perception with patient engagement was significantly increased after applying protocol (F=17.85, p<.001). Patient's perception was significantly improved in the areas of discharge plan (F=7.86, p<.001), health information privacy (F=4.46, p=.012) and identify attending nurse (F=3.19, p=.042). There were no differences in reporting time between the bedside nursing shift report and a traditional shift report (F=0.61, p=.054). Conclusion: Patient perception was significantly increased, while nurse perception was not different after applying this protocol. For the change in the perception of nurses, education may be preceded to improve nurses' competence for the bedside shift report. Furthermore, the support in enough nurse staffing should be needed for encouraging the bedside shift report. The bedside shift report may enhance patient engagement. Therefore it may improve patient safety and health outcome in clinics.

• 간호행정학회지
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• 제4권2호
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• pp.405-418
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• 1998

The purpose of this study was to describe patients satisfaction with nursing care in the emergency department and factors influencing satisfaction rates. 1. The mean score of patient satisfaction with nursing care in the emergency departments was 2.70. The mean scores of patient satisfaction with different aspects of nursing care services were 3.05 for nursing services for psychological safety: 2.67 for technical competence: 2.49 for information giving: and 1.35 for discharge teaching. 2. Patient satisfaction with nursing care services provided. according to the general characteristics of the patients. was revealed as being significantly high for the groups of patients made up of those who were male. those over 51years of age. married subjects. those with an education level of high school or below level. housewives. Buddhists. and those in the middle economic level. Patient satisfaction with nursing care according to their service utilization in the emergency departments revealed that satisfaction was significantly high for patients who were in internal medicine. neurology or psychiatry. those admitted for the first time. those for whom the distance from the department to home was less than 30 minutes. patients who visited between monday and Friday and between 8AM and 4PM. patients who did not have to wait to be seen and those who stayed in the department less than 24 hours. 3. The correlation between the patients' general characteristics. nursing service utilization of the patients in the department and their satisfaction with nursing care showed that patients with longer waiting time had lower satisfactory scores for nursing service. 4. The registered nurses working in the emergency department reported that the main reasons for low satisfaction rates included 'over worked nurses' and 'too many patients' in the emergency department. In conclusion. the results of this study suggest the necessity of developing relevant nursing interventions for discharge teaching to increase patient satisfaction with nursing care services in emergency departments: and the need for adequate support from hospital administrators to improve patients' service utilization.