• 제목/요약/키워드: out patient

검색결과 3,397건 처리시간 0.031초

Patient-controlled sedation using remimazolam during third molar extraction: a case report

  • Kyung Nam Park;Myong-Hwan Karm;Kwang-Suk Seo;Hyun Jeong Kim;Seung-Hwa Ryoo
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제24권1호
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    • pp.75-80
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    • 2024
  • Dental sedation plays a pivotal role in alleviating patient anxiety during various procedures. Remimazolam, a benzodiazepine derivative, stands out for its distinctive attributes, particularly its rapid onset of sedation coupled with a brief duration, making it an invaluable option for dental applications. The patient was admitted for the extraction of impacted third molars via patient-controlled sedation and not only demonstrated stable vital signs but also expressed a high level of satisfaction with the procedure. An in-depth analysis of plasma remimazolam concentrations and changes in the Patient State Index revealed negative correlation patterns, highlighting the inherent potential of remimazolam in achieving effective sedation. This expanded research scope aims to provide a more nuanced understanding of the pharmacological responses to remimazolam in dental sedation scenarios. This case report offers valuable insights into the evolving landscape of dental sedation methodologies and paves the way for a more informed and evidence-based approach to the use of remimazolam in patient-controlled sedation.

진료환경이 환자참여에 미치는 영향: 부정적 감정의 조절효과를 중심으로 (Effect of Treatment Setting of the Medical Services on the Patient Participation : Focusing on Moderating Effect of Negative Emotion)

  • 김찬중;이종학
    • 경영과정보연구
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    • 제35권1호
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    • pp.235-251
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    • 2016
  • 본 연구는 의료서비스 제공 과정에서의 진료환경이 환자참여에 미치는 영향과 이들 간의 관계에서 부정적 감정의 조절효과를 분석하고자 하였다. 이러한 연구목적 달성을 위하여 국내 C 지역의 병의원 환자 중 진료를 마친 320명을 대상으로 수집한 자료를 SPSS 19.0을 이용하여 단계적 회귀분석을 수행하였다. 실증분석 결과는 다음과 같다. 진료환경의 청결성은 행동적 참여에, 환자의 연령이 높을수록 감정적 참여에, 진료환경의 제3자의 존재는 감정과 정보적 참여에 긍정적 영향을 미치는 것으로 확인하였다. 환자의 부정적 감정은 감정적 참여와 정보적 참여에 부정적 영향을 미쳤고, 진료환경의 시간압박은 환자의 정보적 참여수준에 부정적 영향을 미쳤다. 둘째, 조절효과로는 진료환경의 청결성과 감정적 참여 간에 부정적 감정은 긍정적인 영향을 미쳤다. 마지막으로 이러한 연구결과를 중심으로 의료서비스의 진료환경과 부정적 감정을 고려하여 환자참여를 향상시키기 위한 방법 등 이론적, 실무적 시사점을 제시하였다.

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Current Status of Patient Safety Regulations, Guidelines and Support Mechanisms in Korean Hospitals

  • Lee, Jae Ho;Kim, Jeong Eun;Kim, Suk Wha;Lee, Sang Il;Jung, Yoen Yi;Kim, Moon Sook;Jang, Seon Mi
    • Perspectives in Nursing Science
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    • 제10권2호
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    • pp.158-166
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    • 2013
  • Purpose: This study was conducted to investigate patient safety regulations and guidelines in order to understand their current status, and to examine support measures to improve patient safety in Korean hospitals. Methods: The participants were the safety officers from hospitals with 200 or more beds and 112 hospitals responded to the online survey. The questions covered patient safety regulations, the performance level of patient safety activities, patient safety incident reporting systems, the dedicated professional, training, support mechanisms, and expectations of reporting systems. Results: Among preventative measures, fall prevention and hand hygiene were reported to be most widely practiced (92% and 91%, respectively). Time-out for invasive procedures showed a relatively low practice rate at 70%. Among patient care activities, transfusion, surgery and sedation, medication, and infection management were performed by 84, 74, 93 and 93% of the hospitals, respectively. Patient safety activities included patient safety committee, patient safety cooperation between decision-making bodies, patient safety workshops, seminars, lectures, and training for employees. Conclusion: Patient safety regulations and guidelines have not yet been sufficiently prepared, and a public institution such as a certification authority is of crucial importance to enforce these guidelines.

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의과대학에서의 환자안전 교육과정 도입을 위한 환자안전 교육현황조사 및 향후 운영방안 (Current Practices and Future Directions in Patient Safety Education and Curriculum in Medical Schools)

  • 오혜미;이원;장승경;김소윤
    • 의학교육논단
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    • 제21권3호
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    • pp.143-149
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    • 2019
  • In 2018, The Ministry of Health and Welfare announced its first comprehensive plan for patient safety, which included the imperative to develop a patient safety curriculum for students studying to become health professionals. The aim of this study is to assess current patient safety education and points of consideration for introducing new curriculum. An online survey was used to understand the status of patient safety education in medical schools, and key informant interviews and focus group interviews were used to collect qualitative data on the experience of patient safety education. The results of the online survey from 16 out of 40 medical schools (40% response rate) and the qualitative data analysis were integrated and analyzed. Twelve schools (75%) had established courses related to patient safety. The qualitative responses suggest that patient safety education is appropriate both before and after clinical training through a variety of educational methods, and that the topics should be linked with clinical training. The challenge of securing lecture time to address patient safety was mentioned as a realistic obstacle. When patient safety education is integrated in future curriculum, it is necessary to consider it as a priority. Moreover, in the early stages of introducing patient safety education, a step-by-step, policy-based approach is required for seamless adoption and settlement.

중환자실 간호사의 환자안전간호활동 영향요인 (Factors Influencing Patient Safety Nursing Activities of Intensive Care Unit Nurses)

  • 김재은;송주은;안정아;부선주
    • 중환자간호학회지
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    • 제14권2호
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    • pp.12-23
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    • 2021
  • Purpose : The purposes of this study were to examine the levels of job stress, perceptions of the patient safety culture, and patient safety nursing activities, and to identify factors influencing patient safety nursing activities among intensive care unit (ICU) nurses. Methods : For this cross-sectional study, data were collected from 161 ICU nurses working in two university-affiliated hospitals in Gyeonggi-do between June 30 and July 30, 2020. The data were analyzed with descriptive statistics, an independent t-test, a one-way ANOVA, the Pearson correlation method, and multiple regression using the SPSS program. Results : The average levels of job stress, perception of patient safety culture, and patient safety nursing activities were 3.48, 3.44, and 4.45 out of 5, respectively. Multiple regression showed that perception of patient safety culture and career in current workplace were found to be statistically significant correlates of patient safety nursing activities. Conclusion : In order to promote patient safety nursing activities, patient safety culture needs to be incorporated into the education of ICU nurses. Perception of patient safety should be enhanced to improve patients safety nursing activity.

암환자 인식에 관한 연구 - 간호사ㆍ의사를 중심으로

  • 조인향
    • 호스피스학술지
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    • 제2권1호
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    • pp.58-74
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    • 2002
  • This paper constitutes a descriptive investigation and used a structured questionnaire to investigate nurses' and doctors' recognition of cancer patients. The subjects were extracted from the medical personnel working at the internal medicine, the surgery ward, the obstetrics and gynecology department, the pediatrics department, the cancer ward, and the emergency room of five general hospitals located in Seoul and Gyeonggi Province. The research lasted from August, 2001 to September 2001. Total 137 nurses and 65 doctors were included and made out the questionnaires directly distributed by the investigator. The study tool was also developed by the investigator and consisted of such items as the demographic and social characteristics, the medical personnel's recognition degree of cancer and cancer patients, their recognition of the management of cancer patients, and their participation in a hospice. The results were analyzed using the SPSS Window program in terms of technological statistics, ranks, t-test, and ANOVA. The reliability was represented in Cronbach' α=.75. The nurses' and doctors' recognition degree of cancer and cancer patients had an overall average of 3.86 at the 5 point-scale. The items that received an average of 4.0 or more included 'Medical personnel should explain about the cancer cure plans to the cancer patient and his or her family', 'A patient whose case has been diagnosed as a terminal cancer should be notified of it, 'If I were a cancer patient, I would want to get informed of it,' and 'Cancer shall be conquered whenever it is'. In the meantime, the items that received an average of 3.0 or less was 'My relationship with the cancer patient's family has gotten worse since I announced his or her impending death.' And according to the general characteristics and the difference test, the recognition degree of cancer and cancer patient was high among the subgroups of nurses, females, married persons, who were in their 30s, who had a family member that was a cancer patient, and who received a hospice education. The biggest number of the nurses and doctors saw 'a gradual approach over several days'(68.8%) as a method to tell a cancer patient about his or her cancer diagnosis or impending death. Those who usually tell tragic news were the physician in charge(62.8%), the family members or relatives(32.1%) and the clergymen(3.8%) in the order. The greatest number of them recommended a cancer patient's home as the place where he or she should face death because they thought 'it would stabilize his or her mentality'(91.9%) while a number of them recommended the hospital because they 'should give the psychological satisfaction to the patient'(40%) or 'should try their best until the last moment of the patient's death'(30%). A majority of the medical personnel regarded 'smoking or drinking' and 'diet' as the causes of cancer. The biggest symptom of a cancer patient was 'pain' and the pain management of a cancer patient was mostly impeded by the 'excessive fear of drug addiction, tolerance to drugs and side effects of drugs' by medical personnel, the patient, and his or her family. The most frequently adopted treatment plan of a terminal cancer patient was 'to do whatever the patient or his or her family wants' to resort to a hospice' and 'to continue active treatment efforts' in the order. The biggest reasons why a terminal cancer patient went to see a doctor were 'pain alleviation' 'control of symptoms other than pain(intravenous supply)' and 'incapability of the patient's family' in the order. Terminal cancer patients placed their major concern in 'spiritual(religious) matter' 'emotional matters' their family' 'existence' and 'physical matters' in the order. 113(58.5%) of the whole medical personnel answered they 'would recommend' an alternative treatment to a terminal cancer patient mostly because they assumed it would 'stabilize the patient's mentality.' Meanwhile, 80(41.5%) of them chose 'not to recommend it mostly due to the unverified effects and high cost of it(78.7%). A majority of them, I. e. 190(94.1%) subjects said they 'would recommend' a hospice to a terminal cancer patient mostly because they thought it would help the patient to 'mentally prepare'(66.6%) Only 17.3% of them, however, had received a hospice education, most of which was done through the hospital duty education(41.4%) and volunteer training(34.5%). The follows are results of this study: 1. The nurses and the doctors turned out to be still passive and experience confusion in dealing with a cancer patient despite their great sense of responsibility for him or her. 2.Nurses and Doctors realize the need of a hospice, but an extremely small number of them participate in a hospice education or performance. Thus, a whole recognition of a hospice should be changed, for which purpose a hospice education for nurses and doctors should be provided. 3.Terminal cancer patients preferred their home to a hospital as the place to face their impending death because they felt it would bring 'mental stability.' And most of nurses and doctors think it would be unnecessary for them to be hospitalized just for control of their symptoms. Accordingly a terminal cancer patient can be cared at home, and a home hospice care needs to be activated.

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임상간호사의 비판적 성찰 역량, 전문직 자부심, 인간중심간호 수행이 환자안전간호활동에 미치는 영향 (Effects of Clinical Nurses Critical Reflection Competency, Professional Pride, and Person-Centered Care Practice on Patient Safety Management Activities)

  • 이수빈;신수진
    • 중환자간호학회지
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    • 제16권3호
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    • pp.87-98
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    • 2023
  • Purpose : This descriptive survey investigated the effects of clinical nurses' critical reflection competency, professional pride, and person-centered care practices on patient safety management activities. Methods : The participants were 183 clinical nurses working at a tertiary hospital in South Korea. The questionnaires consisted of the Critical Reflection Competency Scale for Clinical Nurses Professional Pride the Person-Centered Nursing Assessment Tool and Patient Safety Management Activities. The collected data were analyzed using descriptive statistics, t-tests, ANOVA, Tukey's HSD, Pearson's correlation coefficient, and multiple regression using SPSS 29.0. Results : The mean score for patient safety management activities was 4.65±0.34 out of 5. There were significant differences in patient safety management activities according to age (F=3.90, p =.010), education level (t=-2.56, p =.013), total work experience (F=3.87, p =.010), and the number of healthcare accreditation system experiences (F=5.22, p =.006). Patient safety management activities were positively correlated with critical reflection competency (r=.337, p <.001), professional pride (r=.271, p <.001), and person-centered care practices (r=.399, p <.001). The results indicated that person-centered care practices affected patient safety management activities (𝛽=.358, p <.001) with the explanatory power of 22.5%. Conclusion : To improve clinical nurses' patient safety management activities, it is necessary to develop participatory educational programs that can integrate skills and attitudes based on conceptual knowledge of person-centered care. Intervention studies are needed to test the effect of person-centered care on patient safety when applied in clinical practice.

요양병원 근무한의사의 소진에 영향을 미치는 요인 - 광주.전남지역을 중심으로 - (A study on burn out of K.M.D.s (Korean medicine doctors) work at convalescent hospitals in Kwang-ju and Jeon-nam, Korea)

  • 문준석;신헌태
    • 대한예방한의학회지
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    • 제17권3호
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    • pp.115-128
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    • 2013
  • Objectives : This study was aimed to investigate burn out degree of K.M.D.s(Korean medicine doctors) who work at convalescent hospitals and to find contributional factors for the result. The relationship between burn out and job performance was also studied. Methods : 77 K.M.D.s(Male 49(63.6%), Female 28(36.4%)) participated in this survey that has 62 main questions about burn out, job performance, job environment and Social demographic characteristics. Survey was conducted from 19th Aug. 2013 to 6th Nov. 2013. Results : Average of burn out degree of K.M.D.s was 2.62 out of 5. Emotional exhaustion was highest (2.80) and depersonalization was lowest(2.20) among subordinate concepts of burn out. Work place location and average income of the subjective which are subordinate concepts of social demographic characteristics showed significant correlation with job performance. Role conflict, relation of co-worker, workload were significant factors for emotional exhaustion and meaning of the job, will of patient, challenge were significant factors for lack of feeling of accomplishment by multiple regression analysis. Relation of co-worker, aggression of patient and meaning of the job were also significant factors for depersonalization. Conclusion : Emotional exhaustion and lack of feeling of accomplishment among subordinate concepts of burn out were high in the subjective who participated this study. Significant factors that contribute to burn out of this study, shows different result compare to the studies that show other factors contribute to burn out who works at convalescent hospital or other place.

의료보험(醫療保險) 의약품(醫藥品)의 요양취급기관(療養取扱機關) 종별(種別), 약효군별(藥效群別), 상병별(傷病別) 사용(使用)에 관(關)한 조사연구(調査硏究) (Study of the Amount and Share of Drug Cost in the Total Medical Fee under Medical Insurance Scheme)

  • 이주원;한오석
    • Journal of Preventive Medicine and Public Health
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    • 제22권2호
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    • pp.223-235
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    • 1989
  • To grasp the idea about how drugs are used under Medical Insurance Scheme, the amount and share of drug cost in the total medical fee have been reviewed and analyzed for different types of patients (in-patient out-patient), medical institutions and frequently seen diseases and following findings were revealed. In 1986, drug cost took 32.78% of total medical fee for in-patients and 32.98% for out-patients averaged over 30% share as a whole. When drug cost per case in 1980 be indexed to 100, it has shown steady growth to become 200 for in-patients and about 150 for out-patients in 1986. The contribution of drug cost to the total medical fee is, regardless of patient type-in-patients and out-patients, the highest in University hospitals and followed by General hospitals, Hospitals and Clinics in decending order That for the most frequent 10 diseases came out the highest,79 a with the essential benign hypertension of out-patients in the General hospitals, 61% for the gastric ulcer of out-patients in Hospitals and 33% for the female genital diseases of out-patients in Clinics. The drug cost of oral formula was contributed the most, 7.93% by cardiovascular agents followed by hepatic detoxicants(5.47%) and out-patients(4.93%), and that of injectable formula was contributed the most by antibiotics(24.17%), followed by protein amino-acid preparations(6.19%). The order of drug usage by specialty for the in-patients was the highest with internal medicine followed by general surgery and E.N.T, and that for the out-parients was in the order of Internal medicine, neuropsychology and Ob/Gy. This study revealed that the drug dependency was characteristically different to specialty. In view of the fact that drug cost on average exceeds over 30% of total medical fee, proper drug administration appears to be vitally important for the stabilization of the financial standing of the Medical Insurance Scheme. As a consequence, drug usage guidelines including antibiotics usage shall be established first of all and the voluntary participation for the regulation of drug usage and propagation of the guidelines to medical institutions are strongly coerced.

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노인병원의 운명 및 재무구조 특성에 관한 연구 (The research for the management and financial affairs of geriatric hospital)

  • 김도훈;이종길;정기선;이창은
    • 한국병원경영학회지
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    • 제6권1호
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    • pp.1-17
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    • 2001
  • According to the increase of the proportion of aged people, the medical demand for a senile chronic disease has been increased; therefore, aged people call for a geriatric hospital for special geriatric medical service. The main purpose of this study was to analyze the general characteristics and financial status of geriatric hospitals. For the study, a questionnaire was designed and sent to the geriatric hospitals to fill out the patient statistics, number of headcount by department, etc. to find out the stability, profitability, activity and so on financial statements of the hospitals were analyzed. The major findings of this study were as belows. 1. The ratio of the medical expenses to the revenue of the geriatric hospitals is much lower than acute care hospitals. But the probability of bankruptcy is higher due to the high ratio of the liabilities therefore it is required to stabilize the financial position by donating more money. 2. Government budget for the elderly people is not enough. To support the geriatric hospitals by going subsides, government should increase the budget. 3. Portion's of the patient of the geriatric hospitals are government support patient. Since the government doesn't pay the medical charges quickly, geriatric hospitals have a serious cash flow problem. Therefore, it is required that government is to prepay the bill. 4. Since geriatric hospitals treat elderly patient and most patients are government support patients, geriatric hospitals can be said to operate under the strict. 5. When we introduce the daily medical charge, the self-liability will be reduced on approximately 50% of current. This affection will bring a huge progressing financial structure to the medical profit of the geriatric hospital, and also patient family will feel less economical burden.

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