• Quality Improvement in Health Care
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• v.5 no.2
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• pp.176-189
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• 1998

This study was conducted to evaluate the subjective ideas about the determinants of quality in ambulatory care unit among outpatients and medical staff of a university hospital, and to compare the differences of the ideas, between patients themselves and hospital staff. A self-administered questionnaire survey was conducted covering 799 outpatients and 190 hospital staff in March, 1998. The questionnaire included general characteristics and 26 determinants of ambulatory care quality. The following are summaries of the findings: 1. Both of outpatients and hospital staff perceived, "Physician's knowledge" as the most important determinant of medical care quality. 2. In respect of 7 determinants related to physician's knowledge and skill, both outpatients and hospital staff perceived "physician's knowledge and skill" as important determinants. The scores of determinants such as, "Not doing unnecessary examinations", and "Assignment of adequate number of patients and duty schedule for the physician" were significantly different between outpatients and hospital staff. 3. In respect of 4 determinants related to doctor-patient relationship, both outpatients and hospital staff perceived "attention to patient's complaints" as the most important determinant. The scores related to the determinants such as "kindness of physician" and "explanation of treatment outcome" were significantly different between outpatients and hospital staff. 4. Among the amenities related determinants, "Modern facilities and equipments" were perceived as the most important determinant in both group. 5. In respect of 8 determinants related to non-financial accommodation, outpatients perceived, "Waiting hours for treatment" as the most important determinant, and hospital staff perceived, "Kindness of hospital staff". 6. In respect of 4 determinants related to financial accommodation, outpatients perceived, "Fare account of medical cost" as the most important determinant, and hospital staff perceived, "Increasing reimbursements". Further comprehensive research should be made on the evaluation of perceptions of medical care quality, both of outpatient and inpatient care, among patients and hospital staff. So good quality in medical care will be achieved based on clients' needs.

• Research in Community and Public Health Nursing
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• v.18 no.3
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• pp.410-419
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• 2007

Purpose: This study is a descriptive survey to find out musculoskeletal symptoms in care workers working at medical welfare facilities for elders and factors affecting such symptoms. Methods: Data were collected from 115 care workers selected through convenient sampling from 6 medical welfare facilities in Seoul and Gyeonggi-do during the period from May 15th to May 19th. 2006. The Korean version of Job Content Questionnaire (JCQ) were used. Result: Of the subjects, 81.7% complained of musculoskeletal symptoms in two or more parts of their body. The frequency of body parts with musculoskeletal symptoms was high in order of shoulder, leg/foot, waist, neck/hand/wrist/finger and arm/elbow. The average job insecurity instability in the age group of 50-59 was 9.19, the average degree of regular exercise was 59.68. and the average job demand in those diagnosed with musculoskeletal diseases was 47.06, and the average job demand in those wounded during exercise or by an accident was 47.78, and all these were statistically significant. The heavier physical load in their work was, the higher their complaint of musculoskeletal symptoms was. In the lower social support group, the degree of complaint on musculoskeletal symptoms was remarkably high. Conclusion: The physical load of their duty and social support worked as the factors affecting musculoskeletal symptoms in care workers.

• Korea Journal of Hospital Management
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• v.21 no.3
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• pp.65-70
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• 2016

The Long-Term Care Hospital (LTCH) accreditation system was initiated in 2013 in the form of mandatory accreditation system in order to improve patient safety and the quality of medical service at LTCHs. By June 2016, the accredited LTCHs were 76.2%. This research was conducted to review the implementation process in the first cycle and to promote development of the second cycle of LTCH accreditation system. There are some changes which reinforced the accreditation standards, accreditation survey, and public access to accreditation results in order to strengthen patient safety in the first cycle LTCH accreditation system. LTCHs which participated in the accreditation system achieved certain outcomes in respect to patient safety and employee satisfaction. However, there are several urgent problems in placement criteria of night duty health care providers, reinforcement plans in the accreditation system, and incentives for accredited hospitals. In order to solve these problems, the most important thing is to clearly recognize the fact that the healthcare accreditation system is not the means for control and regulate hospitals but a system to induce hospitals to continue to strive for improvements in patient safety and medical service quality. In addition, it is required that LTCHs, accrediting agency and the Ministry of Health and Welfare compromise and cooperate to seek solutions every time issues related to the accreditation system arise.

• Journal of Hospice and Palliative Care
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• v.20 no.4
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• pp.242-252
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• 2017

Purpose: Given the emergence of a new profession called a palliative care aide, this study aims to develop the scope of its practice using the Delphi consensus method. Methods: This study was participated by a panel of experts comprising 36 members who were involved in either hospice palliative care practice or making relevant policies. Through a four-step Delphi study, the feasibility of the duty, task and task element was examined. Among the results, items that scored over 4.0 out of 5.0 were selected. Results: The analysis of the Delphi study suggested four job duties, 15 tasks and 46 task elements to be included in the practice scope for palliative care aides. Conclusion: This study defined the scope of practice for palliative care aides, which is expected to prevent any conflict or confusion regarding their job and to promote the quality of their service.

• Perspectives in Nursing Science
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• v.10 no.1
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• pp.65-76
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• 2013

Purpose: To identify an associations between health care workers' uniforms and health care-associated infection. Methods: Electronic databases, including Ovid-Medline, the Cochrane Library, CINAHL, EMBASE, KMbase, and KoreaMed, were searched. The search terms included doctor, nurse, health care worker/staff/assistant, clothing, (white) gown, uniform, (neck)tie, and attire. Only papers published in English and Korean were included. Results: 16 studies were selected from 1,900 references screened. All of the studies were non-comparative studies except for one. Four were conducted with doctors, six with nurses, one with health care workers including physiotherapists and one for medical staff plus visitors in a neonatal intensive care unit. Doctors more frequently changed their uniforms than neckties; therefore, the degree of contamination was more serious in neckties. The cuff zone was more likely to be heavily contaminated than other areas of long-sleeve gowns. Coats become contaminated quickly once worn, and colony counts reached a similar level within the first few hours after wearing them. Wearing a plastic apron or protective clothing did not prevent the bacterial contamination of nurses' uniforms, and the best way to decrease the contamination was changing to newly laundered uniforms before starting every duty. Conclusion: Healthcare workers' uniforms are a potential source of health care-associated infection although there was no robust evidence. The government must establish standards for laundering of uniforms or a requirement for institutions to provide a laundering service for healthcare workers' uniforms.

• The Korean Society of Law and Medicine
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• v.23 no.4
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• pp.133-170
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• 2022

Supreme Court 2018Da228486, on July 29, 2021, ruled Article 750 of the Civil Act as the basis for liability for damages due to the violation of the supervisory duty of the responsible mental patient. This judgment recognizes that the legal guardian is liable for tort due to neglect of the responsibility of supervision under Article 750 of the Civil Act because the duty of protection bears the duty of supervision over the mental patient under the law. However, unlike the case of Article 755 Paragraph 1, which explicitly requires a legal obligation to supervise, Article 750 only stipulates general tort liability. Thus, to admit tort liability under Article 750, it is not necessary that the basis of the supervisory duty by the law. In this case, the supervisory duty may also be acknowledged according to customary law or sound reasoning. The duty of supervision of a legal guardian is not a general duty to prevent all consequences of the behavior of a mental patient but a duty within a reasonably limited scope. Therefore, the responsibility of the burden of care should be acknowledged only when the objective circumstances in which it is appropriate to hold the legal guardian for the acts of the mental patient are admitted. Under the Act on the improvement of mental health and the support for welfare services for mental patients, a legal guardian cannot even be granted the supervisory duty to prevent the mental patient from harming others.

• Journal of Hospice and Palliative Care
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• v.24 no.2
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• pp.116-129
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• 2021

Purpose: The purpose of this study was to examine the knowledge, caregiving performance, stress levels, and mental health of family caregivers of terminal cancer patients with delirium, insofar as these characteristics are relevant for delirium. Methods: Between May 1, 2019, and June 1, 2020, 96 family caregivers of terminal cancer patients with delirium completed a structured survey, the results of which were analyzed. Results: The average correct answer rate for delirium-related knowledge was 53.2% across all subcategories, which included knowledge of causes (41.5%), symptoms (65.4%), and caregiving (51.7%). The average score for family caregivers' performance of caregiving for delirium was 2.60±0.5, with subcategories including caregiving for patients without delirium (2.16±0.95), caregiving for patients with delirium (2.84±1.01), and stress related to caregiving for delirium (39.88±16.55), as well as categories such as patient-related caregiving (44.32±28.98), duty-related caregiving (44.21±30.15), and interpersonal relationship-related caregiving (22.35±25.03). For mental health, the average score among family caregivers was 1.96±0.70, with the highest score being for the category of additional items (2.28±0.84). Family caregivers of patients with hyperactive delirium as the delirium subtype had higher scores for caregiving performance than caregivers of patients with mixed delirium. Conclusion: Scores for the delirium-related knowledge and caregiving performance of family caregivers were low, while their caregiving stress levels were high due to their lack of knowledge and experience. This indicates the importance of delirium-related education for family members of patients with delirium and the necessity of developing nursing intervention programs to help manage stress and promote mental health among family caregivers.

• Korean Journal of Social Welfare Studies
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• v.40 no.2
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• pp.89-122
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• 2009

This study was carried out to analyze the job of care managers in their social welfare practicing fields about the frequency of care management duties they perform, types of duties considered to be most important and the reason, and types of jobs counted to be the most difficult and the reason by qualitative case study research methods. The job area of care management was elicited using DACUM method, and those 9 job areas derived from it were analysed according to frequency of performance, importance and difficulty. The subjects were 10 social workers serving more than 3 years with major duty of care management and chosen by reputational-case selection, and those collected data analysis was operated according to embedded analysis types. We discussed the implication of this research. : The experience of participants are the process of maintaining the tension, and search the equilibrium point between client centered service and institutional pressure. According to the results we proposed ① Construction of community based social work network, ② Institutional installation for guarantee care manager's Job competence ③ Standard manual for equilibrium and upward equalization

• Journal of The Korea Institute of Healthcare Architecture
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• v.20 no.4
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• pp.67-80
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• 2014

Purpose : Long-term Care Insurance sets up facility standard and installation standard of aged care facilities and decides the presence of minimum number of rooms and its size in care facilities by using systematic instruments. Therefore, most aged care facilities had renovation in expansion and reconstruction following the revised regulations and even facility space structure and space composition are continuously improving. The study is to determine the purpose and trend by comparing before and after space composition of facilities which followed the implementation of Long-term Care Insurance and also to suggest hierarchical space composition suitable for aged care facilities through derived problems and to provide basic materials to plan the most appropriate facility for the aged. Methods : J-graph based on Space Syntax Theory will be schematized through in-site facility survey and before and after facility floor plan. Space composition trend will be analyzed by comparing indexes through S3 program. Results : As a result of 5 cases analysis, the following results were found; the average of whole space depth is increasing due to the Extension, the number of volunteers is decreasing and rooms for geriatric care helpers are being created due to the geriatric care helper introduction duty. Also, there are solariums being created to improve the health of the aged and dispensaries are being placed on every floor with the increase of documentary work for geriatric care helpers. With the policy implementation, care facility space composition and structure are changing with facility standard and it was analyzed that facilities were mostly put under the control of limited number of people in care room and total ground area per person. It was also found that there is increase in care space integration through before and after comparison of whole integration value. This is considered as the important result not only in facility standard satisfaction, but also in care support of geriatric care helpers and the aged, its main users. Implication : In order for elderly care facilities to have quality improvement and to develop as suitable facilities for characteristics of the aged, independent environmental facility standard preparation of elderly care facilities is needed through mutual cooperation of construction fields with regulation and policy related researches.

• The Korean Journal of Air & Space Law and Policy
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• v.1
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• pp.47-85
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• 1989

The Fundamental purpose of the Warsaw Convention was to establish uniform rules applicable to international air transportation. The emphasis on the benefits of uniformity was considered important in the beginning and continues to be important to the present. If the desire for uniformity is indeed the mortar which holds the Warsaw system together then it should be possible to agree on a worldwide liability limit. This liability limit would not be so unreasonable, that it would be impossible for nations to adhere to it. It would preclude any national supplemental compensation plan or Montreal Agreement type of requirement in any jurisdiction. The differentiation of liability limits by national requirement seems to be what is occurring. There is a plethora of mandated limits and Montreal Agreement type 'voluntary' limits. It is becoming difficult to find more than a few major States where an unmodified Warsaw Convention or Hague Protocol limitation is still in effect. If this is the real world in the 1980's, then let the treaty so reflect it. Upon reviewing the Warsaw Convention, its history and the several attempts to amend it, strengths become apparent. Hijackings of international flights have given rise to a number of lawsuits by passengers to recover damages for injuries suffered. This comment is concerned with the liability of an airline for injuries to its passengers resulting from aviation terrorism. In addition, analysis is focused on current airline security measures, particularly the pre-boarding screening system, and the duty of air carriers to prevent weapons from penetrating that system. An airline has a duty to exercise a high degree of care to protect its passengers from the threat of aviation terrorism. This duty would seemingly require the airline to exercise a high degree of care to prevent any passenger from smuggling a weapon or explosive device aboard its aircraft. In the case an unarmed hijacker who boards having no instrument in his possession with which to promote the hoax, a plaintiff-passenger would be hard-pressed to show that the airline was negligent in screening the hijacker prior to boarding. In light of the airline's duty to exercise a high degree of care to provide for the safety of all the passengers on board, an acquiescene to a hijacker's demands on the part of the air carrier could constitute a breach of duty only when it is clearly shown that the carrier's employees knew or plainly should have known that the hijacker was unarmed. A finding of willful misconduct on the part of an air carrier, which is a prerequisite to imposing unlimited liability, remains a question to be determined by a jury using the definition or standard of willful misconduct prevailing in the jurisdiction of the forum court. Through the willful misconduct provision of the Warsaw Convention, air carrier face the possibility of unlimited liability for failure to implement proper preventive precautions against terrorist. Courts, therefore, should broadly construe the willful misconduct provision of the Warsaw Convention in order to find unlimited liability for passenger injuries whenever air carrier security precautions are lacking. In this way, the courts can help ensure air carrier safety and prevention against terrorist attack. Air carriers, therefore, would have an incentive to increase, impose and maintain security precautions designed to thwart such potential terrorist attacks as in the case of Korean Air Lines Flight No.858 incident having a tremendous impact on the civil aviation community. The crash of a commercial airliner, with the attending tragic loss of life and massive destruction of property, always gives rise to shock and indignation. The general opinion is that the legal system could be sufficient, provided that the political will is there to use and apply it effectively. All agreed that the main responsibility for security has to be borne by the governments. I would like to remind all passengers that every discovery of the human spirit may be used for opposite ends; thus, aircraft can be used for air travel but also as targets of terrorism. A state that supports aviation terrorism is responsible for violation of International Aviation Law. Generally speaking, terrorism is a violation of international law. It violates the soverign rights of the states, and the human rights of the individuals. I think that aviation terrorism as becoming an ever more serious issue, has to be solved by internationally agreed and closely co-ordinated measures. We have to contribute more to the creation of a general consensus amongst all states about the need to combat the threat of aviation terrorism.