• 한국산학기술학회논문지
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• 제13권12호
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• pp.5968-5975
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• 2012

본 연구의 목적은 임상 응급구조사 특성과 업무범위 간의 상관관계를 밝히는데 있다. 2012년 4월 9일부터 5월 12일까지 181명의 1급응급구조사가 성별, 학력, 경력, 실행업무, 의료지도 등의 조사내용에 무기명으로 답변한 자료를 대상으로 1종오류를 범할 확률 ${\alpha}$=0.05 수준에서 양측 검정으로 상관관계 등을 분석하였다. 실행하고 있거나 필요하다고 보는 업무는 32가지로 구분되었으며 응급환자를 위한 처치로 의료인이 행하는 침습적인 처치가 주를 이루었다. 1급응급구조사 업무범위에 대한 수행능력이 우수하다고 판단하면 법에 따른 업무, 실행하고 있는 업무, 필요한 업무에서 통계적으로 유의하게 업무범위가 확대되는 것으로 나타났다. 경력이 늘면 법에 따른 업무, 필요한 업무에서 통계적으로 유의하게 업무범위가 확대되는 것으로 나타났다. 그렇지만 전반적으로 상관계수는 0.238이하로 낮았다. 능력과 경력에 따라서, 1급응급구조사로 하여금 의사-환자 사이의 매개역할을 원활히 형성하도록 지원해 주는 의료지도체계가 빨리 확립되어 의료서비스의 질을 높이고 효율성을 기해야 하며, 1급응급구조사가 지도의사의 교육, 훈련, 지침, 근무규정 등에 의해 업무를 수행하게 하고 처치 활동은 질관리를 하면 처치의 안정성을 높일 수 있을 것으로 보인다.

• 한국치위생학회지
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• 제19권2호
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• pp.207-219
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• 2019

Objectives: This study investigates the dental hygienist's main duties in clinical dental practice and examine whether dental hygienists can safely perform each duty by referring to the educational contents of dental hygiene departments and national examinations of dental hygienists. Methods: A questionnaire on the main duties of dental hygienists was administered to 477 clinical dental hygienists working at dental clinics and hospitals, general dental hospitals, and university dental hospitals in Seoul, Gyeonggi-do, and Incheon. We divide the dental hygienists' clinical dental hygiene practice and clinical dental assist and analyze the legal scope of practice, university educational contents, and national examination contents. Statistical analysis was performed through frequency analysis, and multi-frequency data were analyzed using Excel 2013. Results: All 48 items (except 2 items of 29 dental hygiene practice and 21 assist practice items) surveyed were covered in the National Examination for Dental Hygienists and included in the Dental Hygiene Education Learning Objective. The multi-frequency clinical dental practice of eight items of clinical dental hygiene practice and two assist practice items were within the legal scope of the dental hygienist's role. Conclusions: Further discussions are needed to redefine the legal scope of the role of the dental hygienist.

• 대한간호학회지
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• 제53권1호
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• pp.39-54
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• 2023

Purpose: This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs). Methods: Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN. Results: The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks. Conclusion: To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.

• 대한예방한의학회지
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• 제18권3호
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• pp.91-104
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• 2014

Objective : This study aims to compare the scope of practice of Korean Medicine doctors and western medicine doctors based on laws related to medical practice Method : We searched for laws related to medical practice using terminologies such as "Korean Medical practice", "Korean Medicine", "Principles of Korean Medicine", "western medicine", "Korean Medicine doctor", "western medicine doctor" at the national law information center(http://law.go.kr/main.html). Results : We categorized the laws we found into four categories: diagnosis, treatment, prescription, and all the other areas including public health. In diagnosis, both Korean Medicine doctors and western medicine doctors have a right to issue medical certificates including birth and death. However, diagnosis of a few specific diseases is allowed only to western medicine doctors. In treatment, laws related to emergency medicine and nursing at home were searched. Korean Medicine doctors and western medicine doctors are emergency care providers; however, most of emergency medicine can be done by western medicine doctors. In prescription, the scope of practice is divided by herbal medicine and western medicine. Finally, as public health professionals, both of them need to do lots of public health works. However, in some area such as vaccination, maternal and child health care, and industrial health, only western medicine doctors can practice. Conclusion : This study suggests that, in diagnosis, treatment, prescription, and all the other areas including public health, the scope of practice of Korean Medicine doctors and western medicine doctors has huge difference. There is also lack of consistency in current law, and some laws do not reflect current health care system and health care services.

• 의료법학
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• 제20권2호
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• pp.141-171
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• 2019

간호사는 의료법 상 의료인으로서 의료기관에서 진료의 보조 등의 업무를 수행한다. 의료인인 간호사는 119 구조·구급에 관한 법률에 근거 구급대원으로서 병원 전 단계 응급의료체계에서 응급환자를 대상으로 응급의료를 제공한다. 병원 전 응급의료체계에서 업무를 수행하는 간호사의 업무범위는 의료법 상 포괄적으로 규정되어 있는 업무를 판례 등을 통해 구체화되어 왔다. 반대로 응급구조사의 업무범위는 응급의료법에 의해 구체적 행위를 열거하는 방식으로 규정되어 있다. 병원 전 단계 응급의료체계에서 응급의료종사자로서 업무를 수행하는 간호사의 업무범위는 대상 환자의 긴급성, 응급의료기관으로의 이송 중이라는 점, 통신 상의 의료지도라는 특수성을 고려하여 간호사의 업무범위를 의료기관 내에서와 달리 적용하여 해석되어야 한다. 따라서 상대적으로 병원 전단계에서 간호사가 응급구조사보다 넓은 업무범위가 인정되고 이것이 정책목표에도 부합된다.

• 한국치위생학회지
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• 제21권6호
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• pp.685-693
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• 2021

Objectives: The purpose of this study was to identify dentists' perception of work performance and scope of work of dental hygienists. Methods: A phenomenological research method was applied for the proper role performance on March 1st, 2021 and June 10th to investigation eight dentists running their own dental clinics located in Gwangju and Daejeon metropolitan city. Results: The legal scope of dental hygienists has not been properly recognized. Conflicts have been experienced due to problems between dental hygienists and staff and their differences in knowledge or proficiency in their work. The performance of dental hygienists has been evaluated based on the size of the dental clinic's profit. Reviews and improvements in dental hygienists' scope of work and new business regulations are required. Conclusions: Consequently, it is recommended that the dental business industry carry out directional discussions and negotiations to review dental hygienists' scope of practice and bring improvements so that their work can be, in the end, be stably performed within the legal system.

• 대한예방한의학회지
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• 제27권3호
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• pp.13-24
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• 2023

Objective : This study was aimed to reassess the scope of practice for medical personnel based on laws. Method : The law specifying the scope of practice for medical personnel has been selected searching Korean Law Information Center(https://www.law.gov.kr). The result was categorized as 'examination, diagnosis, treatment, procedure, prescription, and others'. Results : The laws related to medical procedures were divided into three categories: diagnosis, treatments, and public health and others. In the field of diagnosis, traditional Korean medicine practitioners are generally allowed to play a role. However, some laws specify that only medical doctors can be the primary authorities for diagnosing infectious diseases. In the area of treatments, particularly in emergency medical situations, only medical doctors or nurses are typically mentioned. There are debates in the field of public health and other areas concerning issues such as vaccination, disability diagnosis, and the qualifications for health center directors. A reevaluation is also needed for the Occupational Safety and Health Act, where only medical doctors are set as the personnel standard for workers' health examinations. Conclusion : To safeguard and promote the health of the citizens, there is a need for a clear definition of the licensure and scope of practice for healthcare professionals. Consistent interpretation of conflicting provisions among various laws and clear criteria for the term 'physician' in legal contexts are essential.

• 한국응급구조학회지
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• 제11권3호
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• pp.65-79
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• 2007

Purpose : It was to find out demand and supply of EMT from 2007 to 2045 and to expand scope of practice of paramedic in Korea. Methods : This study was conducted by applying a projection formula to the data from admission quota for EMT of the Ministry of Education & Human Resources Development, rate of successful candidates of annual report of the National Health Personnel Licensing Examination Board etc. Results : The number of EMTs were 6,043 paramedics, 5,378 EMT-Bs until 2006 and two produce constants derived from simple estimation were paramedic 0.81, EMT-B 0.86. On the American basis of 5.6 EMTs per 10,000, the number of paramedics under the present act will reach the basis around 2015(5.02), the number of paramedics under the amended act will reach the basis around 2030(5.50). Conclusion : There was relationship between scope of practice of paramedic in the act and demand-supply of paramedic, this necessitates surveys, studies, amendment of the act, legalization for expanded scope of practice of paramedic.

• Journal of Hospice and Palliative Care
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• 제24권1호
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• pp.1-12
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• 2021

Hospice palliative care refers to holistic care provided by an interdisciplinary team aimed at improving the quality of life of patients suffering from life-threatening diseases and their families. Among interdisciplinary team members, hospice advanced practice nurses (APNs) trained as master's-level advanced nursing professionals are leaders who play an important role in providing patient-centered care and improving the quality of services. The Medical Service Act revised in 2018 requires the scope of practice of APNs in each field to be specified in the Ordinance of the Ministry of Health and Welfare. Accordingly, discussions on the role and scope of practice of hospice APNs are actively underway. In this review, the curriculum of hospice APNs, their work responsibilities and roles, and their current status are reviewed, and the future direction of the hospice APN system is also discussed.

• Journal of Hospice and Palliative Care
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• 제20권4호
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• pp.242-252
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• 2017

목적: 본 연구의 목적은 델파이 합의방식을 통해 '완화의료 도우미'라는 새로운 직종의 직무범위를 개발하는 것이다. 방법: 호스피스 완화의료 실무와 정책에 관여하는 전문가 패널 36명이 참여하였고, 4단계에 걸친 델파이 조사를 통해 각 책무-과업-과업요소의 내용 타당도를 검증하였다. 내용 타당도는 5점 척도에서 4점 이상인 항목을 채택하였다. 결과: 4단계의 델파이 조사결과를 분석하여, 완화의료 도우미의 직무로 책무 4개, 과업 15개, 과업요소 46개를 최종 확정하였다. 결론: 본 연구를 통해 완화의료 도우미의 직무범위가 명시되었으며, 이를 통해 역할갈등과 혼란을 예방하고 서비스의 질 향상에 기여할 것으로 기대한다.