• Title/Summary/Keyword: medication errors

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Perceived Importance and Performance of Intravenous Fluid Therapy by Nurses in Small-Medium General Hospitals (중소 종합병원 간호사가 인지하는 정맥수액요법의 중요도와 수행정도)

  • Kim, Jong Im;Lee, Jihyun;Chang, Ockja
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.20 no.4
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    • pp.372-380
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    • 2013
  • Purpose: This study was done to investigate nurses' perceived importance of, and performance of intravenous fluid therapy. Methods: Data were collected from a convenience sample of 234 nurses (return rate: 93%) working in 3 small-medium general hospitals. Results: The score for perceived importance of intravenous fluid therapy ($3.65{\pm}0.37$) was higher than that of performance ($3.45{\pm}0.39$). There were positive correlations between perceived importance and performance (r=.576, p<.001). There were 180 (80.8%) errors in intravenous fluid therapy. Perceived importance and performance scores were higher in nurses who had not experienced medication errors in intravenous fluid therapy. Conclusion: The results indicate a need to develop appropriate strategies to improve perceived importance and performance and enhance safety management during intravenous fluid therapy for nurses in small-medium general hospitals.

Augmentative Effects of Working Memory Training on Clinical Symptoms and Neuropsychology in Medicated Children and Adolescents with Attention-Deficit Hyperactivity Disorder (약물치료 중인 주의력결핍 과잉행동장애 아동 청소년에서 작업기억력 훈련이 임상증상과 신경심리소견에 미치는 부가적 효과)

  • Kim, Hye Sun;Lee, Eun Kyung;Hong, In Hwa;An, Jung Sook;Yoo, Hanik K.
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.28 no.2
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    • pp.123-131
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    • 2017
  • Objectives: Executive dysfunction including working memory deficit has been suggested to be one of the major neuropsychological etiologies of attention-deficit hyperactivity disorder (ADHD). The purpose of this study was to investigate the augmentative effects of Cogmed working memory training on the symptoms and neurocognitive functions in medicated children and adolescents with ADHD. Methods: Twenty-five children with ADHD, aged 7 to 19 years, taking ADHD medication participated in this study. The participants were trained for 5 weeks with a commercially available and computerized working memory program ($Cogmed^{(R)}$) without any changes to their medication. The Korean version of the ADHD Rating Scale, Clinical Global Impression Scale, and Comprehensive Attention Test were administered before training and 4 weeks and 7 months after training, respectively. Results: After completing the training, the clinical symptoms and function, rated by the parents and clinician, were improved. In addition, the level of commission errors was significantly reduced in the selective attention (visual/auditory) task, sustained attention to response task, and flanker task. The untrained visuospatial short-term memory and working memory were also improved. These effects were still observed 7 months after the training. Conclusion: Cogmed working memory training can be a promising training option for the additional improvement of the symptoms and deficits in working memory and response inhibition in medicated children with ADHD.

Comparison of Neuropsychological Deficits between Depressed Episode and Remission in First-onset Patients with Major Depressive Disorder (초발 주요우울장애 환자의 우울 삽화 및 관해 상태에서 신경인지기능 결함 비교)

  • Hur, Ji-Won;Kim, Yong-Ku
    • Korean Journal of Biological Psychiatry
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    • v.15 no.2
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    • pp.92-100
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    • 2008
  • Objectives : The purpose of this study was to investigate 1) the neuropsychological deficits with major depressive disorder(MDD) in depressed state and 2) the changes of neuropsychological dysfunctions during depressed episodes and remitted periods in the MDD group. Methods : 12 patients with MDD and 70 normal controls who were diagnosed and classified by DSM-IV and SCID-IV interview participated in this study. The psychopathology was measured using the Hamilton rating scale for depression(HAM-D) and Brief Psychiatric Rating Scale(BPRS). The memory function, executive function, and sustained attention were measured by a trained psychologist using the Korean version of Memory Assessment Scale(K-MAS), Wisconsin Card Sorting Test(WCST), and Vigilance(VIG) and Cognitrone (COG) in Vienna Test System. After 6 weeks of treatment, we retested the cognitive tests in order to measure the cognitive functions in remitted states. Results : Patients with MDD achieved significantly lower score in sentence immediately recall, verbal memory score and total memory score of the K-MAS, total errors of the WCST, response time of Vigilance and response time at "Yes" response of Cognitrone than normal controls at baseline. After 6 weeks of medication, the psychiatric symptoms in the patient group were attenuated, and most of the neuropsychological functions including attention, memory, and frontal/executive function were improved except for response time of Cognitrone. Conclusions : This study provides evidence for distinct neuropsychological deficits in patients with MDD on their depressed states and remitted periods. The impairment on response time remains after remission, and this would be a trait marker of major depressive disorder.

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Factors Influencing Confidence in Patient Safety Management in Nursing Students (간호대학생의 환자안전관리 수행자신감에 영향을 미치는 요인)

  • Jeong, Hyun-Sook;Kong, Jeong-Hyeon;Jeon, Mi-Yang
    • Journal of the Korea Convergence Society
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    • v.8 no.6
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    • pp.121-130
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    • 2017
  • The purposed of this study was to identify the factors that affect Confidence in Performance Patient Safety Management targeted nursing students. The study subjects were 228 nursing students. The nursing students experienced patientl safety accidents in the fall (50.0%), needle puncture (18.5%), Patient identification error (12.0%), injection medication error (7.5%) and oral medication errors (4.3%). In the logistic regression analysis, Attitude of Patient Safety Management(t=6.09, p<.001), Clinical Decision Making(t=3.97, p<.001) and gender(t=2.56, p=.011) were significant factors related to Confidence of Performance Patient Safety Management. Based on the results of this study, we propose to develop a convergence education program that considers patient safety management attitude, clinical decision making ability, and gender in order to improve confidence of performance patient safety management of nursing students.

Selecting QA Items & Guidelines for Hospital Safety Management (병원내 안전관리 향상을 위한 항목 및 지침 선정)

  • Park, Jee-Won;Kim, Yong-Soon;Jin, Hye-Young
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.78-93
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    • 1996
  • Background : The goal of this study was to establish the QA items and guidelines for preventing and improving of safety management. Therefore we investigated the nurses' recognition and knowledge of the safety and risk procedures and policies, and the agreement between the nurses beliefs on the degree of importance of those procedures and policies, with actual implementation in hospitals. Method : The subjects of this study were 201 nurses who participated in a program called continuing education for nurses, which held in December, 1993. Result: The results of this study were as follows: 1. Among 18 types of hospital risks, the items that scored highest or the need of closer attention in safety management was the needle stick, medication errors, falling, and bed sores. 2. In most questions of the 18 incidences, the nurses showed that the estimated result would have positive signs except for hospital infections, burns, and bed sores. 3. Even though the survey shows that incidences and types of occurences varies according to the person's age and the time of incident, they mostly occur between midnight to 6AM. Falls and bed sores can be seen more in the elderly. Medications errors, hospital infections and burns are frequently found between the ages of one through twenty. 4. There was a higher mean score for recognizing the importance of those items than the importance of implementing them. Conclusion : In summary, nurses did perceive the need of safety management but the hospital policy for proper safety management was not established. So we recommended that the hospital administration would undertake an early detection and proper management system for hospital precautions, based on QA items & guidelines presented in this study.

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Review of Medical Dispute Cases in the Pain Management in Korea: A Medical Malpractice Liability Insurance Database Study

  • Kim, Yeon Dong;Moon, Hyun Seog
    • The Korean Journal of Pain
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    • v.28 no.4
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    • pp.254-264
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    • 2015
  • Background: Pain medicine often requires medico-legal involvement, even though diagnosis and treatments have improved considerably. Multiple guidelines for pain physicians contain many recommendations regarding interventional treatment. Unfortunately, no definite treatment guidelines exist because there is no complete consensus among individual guidelines. Pain intervention procedures are widely practiced and highly associated with adverse events and complications. However, a comprehensive, systemic review of medical-dispute cases (MDCs) in Korea has not yet been reported. The purpose of this article is to analyze the frequency and type of medical dispute activity undertaken by pain specialists in Korea. Methods: Data on medical disputes cases were collected through the Korea Medical Association mutual aid and through a private medical malpractice liability insurance company. Data regarding the frequency and type of MDCs, along with brief case descriptions, were obtained. Results: Pain in the lumbar region made up a major proportion of MDCs and compensation costs. Infection, nerve injury, and diagnosis related cases were the most major contents of MDCs. Only a small proportion of cases involved patient death or unconsciousness, but compensation costs were the highest. Conclusions: More systemic guidelines and recommendations on interventional pain management are needed, especially those focused on medico-legal cases. Complications arising from pain management procedures and treatments may be avoided by physicians who have the required knowledge and expertise regarding anatomy and pain intervention procedures and know how to recognize procedural aberrations as soon as they occur.

Effects of Perceived Patient Safety Culture on Safety Care Activities among Nurses in General Hospitals (지방 중소병원 간호사의 환자안전문화 인식이 안전간호활동에 미치는 영향)

  • Kim, Hye Young;Lee, Eun Sook
    • Journal of East-West Nursing Research
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    • v.19 no.1
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    • pp.46-54
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    • 2013
  • Purpose: An objective of this study was to investigate nurses' perceptions toward patient safety culture and to examine the factors affecting safety care activities. Methods: The participants were 429 nurses, at 6 hospitals located in regions, which have 150 to 300 beds, and HSOPSC (AHRQ, 2009) and questionnaire on safety care activities were used as measurement tools. Descriptive statistics, independent t-test, one way ANOVA, and stepwise multiple regression with SPSS/WIN version12.0 were used to analyze the data. Results: Supervisor manager expectations and actions promoting patients safety and frequency of events reported were the highest as positive responses, whereas staffing and nonpunitive response to errors showed the lowest scores as positive responses. Scores of medication surveillance is the highest while firefighting surveillance is the lowest in terms of safety care activities. Significant predictors influencing safety care activities were frequency of events report, handoffs and transitions, work unit a patient safety grade, organizational learning-continuous improvement, and teamwork across units. These predictors account for 23% of the variance. Conclusion: These results suggest that hospital policies and systems should be built to settle patient safety culture effectively. Development of standard manuals for safety care activities is another critical element for promoting patient safety.

Comparing the Postoperative Complications, Hospitalization Days and Treatment Expenses Depending on the Administration of Postoperative Prophylactic Antibiotics to Hysterectomy (자궁적출술 후 예방적 항생제 사용 여부별 수술 후 합병증, 재원기간 및 치료비 비교)

  • Jung, Mi Young;Park, Kyung-Yeon
    • Women's Health Nursing
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    • v.23 no.1
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    • pp.42-51
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    • 2017
  • Purpose: This study was conducted to compare postoperative complications, hospitalization days and treatment expenses to postoperative prophylactic antibiotics administrated to hysterectomy or not. Methods: A retrospective survey study was performed with 128 cases in which elective hysterectomy had undergone. They were divided into two groups by identifying whether postoperative prophylactic antibiotics was administered for hysterectomy: a) one group who received postoperative prophylactic antibiotics and; b) those who did not. Data were collected using the electric medical record at a hospital and analyzed by SPSS 23.0 for $x^2$ test, t-test and ANCOVA. Results:Postoperative complications including wound infection (p=1.000), pneumonia (p=.496), hematoma (p=.530), and pneumoperitoneum (p=.496) showed no significant differences between two groups. Hospitalization days for the prophylactic antibioticsadministrated group were significantly longer than the non-administered for prophylactic antibiotics (p=.004). The treatment expenses of the prophylactic antibiotics-administrated group were significantly higher than those of the non-administered prophylactic antibiotics (F=4.31, p=.040). Conclusion: These results can be provided for the evidence of administrating postoperative prophylactic antibiotics to hysterectomy. Additionally, it can contribute to decreasing the medication errors caused by infrequently administrating postoperative prophylactic antibiotics as well as to lessening likelihood of infection of intravenous injection site.

Safety Education Programs for Patients and Families in Overseas Institutions (국외 환자대상의 환자안전 교육 사례)

  • Kim, Yoon-Sook;Kwak, Mi-Jeong;Kim, Moon-Sook;Kim, Hyun-Ah;Kim, Hyuo-Sun;Chun, Ja-Hae;Hwang, Jee-In
    • Quality Improvement in Health Care
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    • v.25 no.1
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    • pp.2-10
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    • 2019
  • Purpose: The purpose of this study was to share program and/or resource on patient safety education for patients and families conducted overseas agency. This study will help the patient safety officer establish and implement an educational plan for patients and families. Methods: We searched the Internet for patient safety related organizations. We chose an institution that provided education for patients and families. Results: Most of the program and/or resource was about patient and family involvement; Taking Care of Myself, My Questions for This Visit, Patient Prep Card, 20 Tips to Help Prevent Medical Errors, Ask Me 3(R), Health and Safety Passport, My Medication log etc. Conclusions: It is necessary to distribute educational materials for patients and families in the country through the results of this study. For patient safety, education and publicity are needed so that developed educational materials can be actively used.

Evaluation of Pharmacists' Intervention Activities in Community Pharmacy (지역약국 약사의 처방중재 활동 평가)

  • Hyunji Koo;Jong-Mi Seong;Sun-Young Jung;Kyeong Hye Jeong
    • Korean Journal of Clinical Pharmacy
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    • v.34 no.1
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    • pp.62-70
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    • 2024
  • Background: Drug-related problems have the potential to threaten patient health, and pharmacists are in a position to prevent such problems through prescription reviews and patient counseling, actively engaging in pharmaceutical care activities. This study aims to categorize and analyze the intervention activities of pharmacists in community pharmacies concerning drug-related problems, following international criteria. Methods: Over a six-month period, prescription interventions completed in a community pharmacy in Seoul were selected as the research subjects. The causes of interventions were classified according to the Pharmaceutical Care Network Europe (PCNE) drug-related problems (DRPs) classification system and the types and frequencies of DRPs were identified. Results: Among a total of 49,334 prescriptions, 527 interventions were completed, constituting approximately 1.07% of the daily average filled prescriptions. Individuals over 60 years of age represented more than 50%. The primary cause of DRPs was prescribing and drug selection issues, comprising 256 cases (48.58%), with specific subcategories including 109 cases of drug selection, 79 cases of treatment duration errors, 47 cases of dose selection, and 21 cases of inappropriate dosage form selection. Patient-related issues accounted for 204 cases (38.71%). Conclusion: The study demonstrated that the pharmacists' intervention in community pharmacies contributes to the safe use of medication by patients.