• 대한임상검사과학회지
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• 제50권3호
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• pp.359-369
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• 2018

의료 관련 감염을 예방하기 위한 필수적 방법은 일관성이 있는 감염감시 시스템을 구축하고 효율적인 감시 통제를 수행하기 위해 신뢰할 수 있는 상황에 대해 진단을 향상시켜나가는 것이다. 또한 의료 종사자의 손과 의복 및 장비는 환자 관리 및 환경과 접촉하여 병원체가 오염되는 요인이다. 병원체를 가진 시설 표면(예: 침대 레일, 침대 옆 탁자), 음용수, 냉각탑용수, 내시경기구, 급식위생, 공기매개, 멸균검사, 내독소검사, 및 의료 장비를 포함한 의료 환경의 오염은 일반적으로 발생한다. 또한 이러한 감염원을 활동 감시를 통해 MLST, PFGE의 기법으로 역학분석을 수행한다. 따라서 HAI 예방을 위한 환경 감시배양 검사는 환자의 안전과 감염원의 차단을 향상시킬 뿐만 아니라 국가의 감염관리 시스템을 통제하여 최적의 효율적인 감염관리 예방을 가능케 하고 국가의 감염관리 시스템의 안전을 향상시킨다. 결론적으로 감시배양 검사의 표준화를 통해 실효성 있는 감염관리체계에 이바지하고 감염관리 전문인력으로서의 전문성을 확보하고자 한다. 이를 통해 표준화 마련의 일차적인 목표는 의료관련 감염을 줄이고 국가적 의료관리 체계를 향상시키는데 있다.

• 한국안전학회지
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• 제34권3호
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• pp.57-64
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• 2019

Lack of incident reporting culture has been pointed out as a potential risk factor across industries. Consequently, comprehensive understanding of the factors affecting the willingness to report (WTR) is necessary. However, our knowledge on the related studies are not enough to date and even most parts of the existing studies have focused on patient safety, which makes it difficult to universally apply the factors to all industries. Therefore, this study aimed to identify WTR factors in chemical plants and evaluate the influence degree of the factors. To do this, 45 candidate factors were summarized throughout the previous studies and surveying plant safety staff. A questionnaire survey was conducted for 614 all employees from 9 chemical plants which belong to one company, and finally 32 WTR factors were identified throughout 520 responses. Of these, 19 factors were consistent with the previous studies and 13 factors were newly identified. The most influential factor was 'Views on the necessity of incident reporting', and 'Reporting practice by outcome severity', 'Fear of vilification, conflicts, blame, or sanctions' were followed. This result not only suggests various WTR factors suitable for chemical plants, but also shows need to derive specific factors that are appropriate to each industry. An empirical study could be expected to increase incident reporting by using these factors and verify its effectiveness on injury rate.

• 대한의사협회지
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• 제61권12호
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• pp.702-705
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• 2018

Advances in technology lead to advances in medical devices, and these advances have the positive effect of creating opportunities for beneficial developments in healthcare, such as innovating traditional healthcare processes or expanding opportunities for diagnosing and treating diseases. Nonetheless, device developers, suppliers, users, insurers, and patients all face the challenge of balancing patient safety and health effectiveness with a reasonable profit. In Korea, the New Health Technology Assessment system aims to introduce safe and effective health technology, but this is only effective for the entry of devices onto the healthcare market. This system is not enough for creating a healthy ecosystem in which high-quality technologies and devices survive in the market and naturally exit from the market if not successful. The nation must not lag in the rapid development of medical devices, but the concomitant requirement for patient safety is like two rabbits moving in different directions. There is not enough time to resolve each source of uncertainty for both developers and users. The early adoption of health technologies, including medical devices, offers new opportunities for treatment and diagnosis, but also poses unexpected health risks. Thus, we need to design a plan to generate scientific evidence related to medical devices after they introduced into practice. Additionally, regarding the use of individual medical devices, we believe that the creation of a healthy ecosystem for medical devices by implementing medical device surveillance culture is a way to manage the opportunities and risks of the early introduction of innovative medical devices.

• 대한방사선기술학회지:방사선기술과학
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• 제44권6호
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• pp.599-605
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• 2021

The International Electrotechnical Commission (IEC) 62494-1 has defined the exposure index (EI) that have a proportional relationship with the dose incident on the image receptor, and target exposure index (EI_T), deviation index (DI). In this study, an appropriate EI_T for skull radiography was established through the diagnostic reference level (DRL) and changes in DI were confirmed. Entrance surface dose (ESD) and EI were obtained using the computed radiography system displayed the EI as per IEC on console and skull phantom by experiment based on the national average exposure conditions announced in 2012 and 2019. And appropriate EI_T was established by applying the DRL in 2012 and 2019. As a results, the EI_T is changed according to the change in the DRL, and the exposure condition that becomes the ideal DI according to the change in the EI_T also has a difference of about 1.41 times. DRL is recommended to optimize the patient dose, however it is difficult to measure in real time at medical institutions whereas EI and DI are displayed on the console at the same time as exposure. When the EI_T is set based on the DRL and the DI is closed to an ideal value, it is useful as a patient dose management tool. Therefore, when the EI_T is periodically managed along with the revision of the DRLs, the patient dose can be optimized through the EI, EI_T and DI.

• 한국융합학회논문지
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• 제11권10호
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• pp.409-416
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• 2020

본 연구는 노인요양시설에서 근무하는 요양보호사를 대상으로 안전에 대한 지식, 태도 및 안전수행의 관계를 확인하고 안전수행 능력을 향상 시킬 수 있는 기초자료를 제공하고자 시도되었다. 본 연구 참여자는 S시 소재 노인요양시설에서 근무하는 요양보호사 134명을 대상으로 실시 하였다. 자료분석은 SPSS WIN 21.0 프로그램을 이용하여 실수, 백분율, 평균, 표준편차, t-test, ANOVA, 피어슨 상관관계, 다중회귀분석을 실시하였다. 요양보호사의 안전에 대한 태도와 안전수행, 안전에 대한 지식과 태도는 유의한 양의 상관관계가 있었으나 안전에 대한 지식과 안전수행은 유의한 상관관계가 없었다. 요양보호사의 안전수행에 영향을 미치는 요인은 안전에 대한 태도였으며 설명력은 36.1%이었다. 본 연구결과를 토대로 요양보호사의 안전수행에 영향을 미칠 수 있는 실무중심의 반복적 교육이 필할 뿐 아니라 노인요양시설 내 올바른 안전문화를 형성할 수 있는 정책 수립도 필요하다.

• 문화기술의 융합
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• 제10권3호
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• pp.625-633
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• 2024

병원간호사의 고위험 정맥주사 약물의 투약오류에 대한 인식과 경험을 파악하고 투약오류의 원인과 개선방안을 파악하기 위해 시도되었다. 연구 대상은 D시에 위치한 일개 대학병원에 근무하는 고위험 정맥투약 관련 업무경험이 있는 간호사를 대상으로 2021년 5월 16일~30일 간 자료 수집하였다. 연구 결과 고위험 정맥주사 투약안전 문제점의 핵심요인으로 병동 별 주요 약물의 투약 protocol 부재, 투약 주입기기의 작동 교육 부족, 표준화 된 고위험 정맥주사 투약수행 절차 미확립, 간호사 대상의 개별화 투약교육 부족, 병원 자체 약물집 부족 혹은 미비치, 비슷한 용기의 포장 약물 확인 부족의 6가지가 도출되었다. 간호실무적 차원에서 고위험 정맥주사 투약안전 프로그램을 적용하고 안전결과 지표를 확인할 수 있는 추후 연구 수행을 제언한다.

• 한국병원경영학회지
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• 제22권4호
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• pp.74-86
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• 2017

Purposes: This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are related to hospital management performances, so that the study can suggest plans for activation and development of the accreditation program. Methodology: This study was performed targeting 98 hospitals answered th the survey among 189 acute care hospitals that acquired accreditation from December 2010 to February 2014. For data analysis, frequency analysis, ${\chi}^2$-test, reliability analysis, ANOVA, Kruskal-Wallis H test and multiple regression analysis with SPSS 21.0 were used. Findings: The hospitals that had staff in charge of patient safety had bigger hospital culture change than those that didn't have(p<.05). In addition, the hospital culture change was bigger as internal motives were bigger, and as CEO's will was bigger(p<.05). Meanwhile, as maintenance rate of internal management after accreditation was higher, and as CEO's will was bigger, process improvement level was higher(p<.05). The quality improvement and patient satisfaction level were higher as CEO's will was bigger, and as suitability of survey process was recognized to be high(p<.05). As a result of analyzing the factors that affect hospital management performances with hospital culture change, process improvement and quality improvement combined, as internal management maintenance rate was higher, as CEO's will was bigger, and as suitability of survey process was higher, performances were higher(p<.05). Practical Implications: Hospitals need to reinforce internal motives to improve internal competences such as the whole system maintenance opportunity and staff training. In addition, the will of hospital director is most important, and if there is hospital director's interest in quality improvement and improvement intention definitely, employees voluntarily participate in and cooperate with the accreditation program, so that prompt medical service provision and high quality of medical services can be guaranteed, leading to hospitals' management performances.

• 한국의료질향상학회지
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• 제22권2호
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• pp.15-25
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• 2016

Objectives: In this study, we examined the validity of Clostridium difficile culture results as a proxy measure of Clostridium difficile infection, and inferred the epidemiologic characteristics of Clostridium difficile infection by tracking the trends of Clostridium difficile culture results. Methods: We reviewed the medical records to figure out the actual possibilities of Clostridium difficile infection of those with positive or negative results of Clostridium difficile culture during the time span from January 2012 to March 2012. We calculated the positive and negative predictive value of Clostridium difficile culture results for Clostridium difficile infection. Furthermore, epidemiologic characteristics of Clostridium difficile infection in a tertiary general hospital in 2012 were analyzed. Result: The estimated positive predictive value of Clostridium difficile culture tests for Clostridium difficile infection was 100%, and the estimated negative predictive value was around 94.4~99.3% depending on the cutoff value of possibility of Clostridium difficile infection. A total of 622 cases were identified as Clostridium difficile infection in a tertiary general hospital in 2012 and there were 4.9 patients with Clostridium difficile infection per 1,000 inpatients. Conclusion: In conclusion, we identified that Clostridium difficile culture results can be used as a proxy measure of Clostridium difficile infection.

• 한국의료질향상학회지
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• 제21권1호
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• pp.12-31
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• 2015

Objectives : The purpose of this study was to develop the qualification system for training of Quality improvement professionals who work for improving patients' safety and healthcare quality. Methods : Based on the various laws and regulations, and the operational status of other professionals' qualification systems, a basic plan of professional qualification system of QI was drawn. And through meetings with QI experts, the final scheme of the concrete qualification system was developed. Results : For management of professionals's certification or qualification, fairness and reliability are important. To do this, setting the official standard, providing a standardized training program and having appropriate qualification test are required. In order to operate the qualification system strategically, 1) the introduction step, 2) dissemination and expansion step, and 3) fusing step should be considered. As a governing body for QI specialists' qualification, 'QI professionals' qualification Center (tentative)' must have the committee to assure fairness, professionalism, and reliability. In addition, 'QI Experts Certification Department (tentative)" to develop standards for the qualification tests and conduct the tests program,' QI experts Education Department (tentative name)" must be able to operate and maintain the QI training for professional qualifications. QI professional qualification exam must be taken by everyone regardless of age, gender, race, occupation, education, and work experience. The examination should include management, leadership, strategic planning and design, quality management, health care information, patient safety culture. Practical training courses can have three step programs; beginning, intermediate and special level. Conclusion : The QI qualification system need strategic approaches for the experts working for healthcare quality improvement and patient safety. It should include the program of standardized contents and test, and operating protocol of the qualificaton system.

• 문화기술의 융합
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• 제9권1호
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• pp.619-625
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• 2023

본 논문에서는 다수의 체압 센서가 내장된 의료용 침대의 원격 케어에 관해 기술한다. 낙상은 환자의 안전을 심각하게 위협하고 건강을 해치는 요인중의 하나이다. 본 연구에서는 이를 극복하기 위해 새로운 침대가 개발하였다. 침대 시스템은 동작이 가능한 건반, 건반의 동작을 관리하는 건반 제어기, 체압을 측정하는 센서, 센서의 값을 송수신하는 센서 제어기, 이를 확인하여 알고리즘에 따라 자동 혹은 수동으로 동작하게 하는 메인 제어기, 이 모든 정보를 총괄하는 서버로 이루어져 있다. 침대 시스템은 센서를 통해 환자의 위치를 확인하여 환자가 낙상의 위험이 있다고 판단하게 되면 메인 제어기를 통해 무선으로 서버에 경고를 보내 간호인 혹은 간호사가 환자의 위험한 상태를 인지할 수 있도록 한다. 서버는 유무선 단말에서 송신된 상태 데이터를 전송받아 침대 시스템이 정상적으로 동작하고 있는지 모니터링할 수 있다. 건반의 제어기는 건반형 메커니즘을 구동하고 체압 센서가 연결된 욕창 예방 제어를 자동으로 행하여 환자의 압력이 가해지는 부위를 물리적으로 분리해 욕창을 예방한다. 메인 제어기는 환자의 침상 존재를 확인하여 서버에 전송한다. 결론적으로 제안된 시스템은 사용자의 상태를 스마트 모니터링하고 원격 케어를 행할 수 있게 된다.