• 의학교육논단
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• 제21권1호
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• pp.1-12
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• 2019

This study is a narrative review introducing global trends in patient safety education within medical schools and exploring the status of Korean education. Core competences for patient safety include patient centeredness, teamwork, evidence- and information-based practice, quality improvement, addressing medical errors, managing human factors and system complexity, and patient safety knowledge and responsibility. According to a Korean report addressing the role of doctors, patient safety was described as a subcategory of clinical care. Doctors' roles in patient safety included taking precautions, educating patients about the side effects of drugs, and implementing rapid treatment and appropriate follow-up when patient safety is compromised. The Korean Association of Medical Colleges suggested patient safety competence as one of eight essential human and society-centered learning outcomes. They included appropriate attitude and knowledge, human factors, a systematic approach, teamwork skills, engaging with patients and carers, and dealing with common errors. Four Korean medical schools reported integration of a patient safety course in their preclinical curriculum. Studies have shown that students experience difficulty in reporting medical errors because of hierarchical culture. It seems that patient safety is considered in a narrow sense and its education is limited in Korea. Patient safety is not a topic for dealing with only adverse events, but a science to prevent and detect early system failure. Patient safety emphasizes patient perspectives, so it has a different paradigm of medical ethics and professionalism, which have doctor-centered perspectives. Medical educators in Korea should understand patient safety concepts to implement patient safety curriculum. Further research should be done on communication in hierarchical culture and patient safety education during clerkship.

• 가정간호학회지
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• 제27권3호
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• pp.250-258
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• 2020

Purpose: This study aimed to investigate the relationship between nursing work environment, patient safety culture, and patient safety nursing activities in hemodialysis units at primary care centers. Methods: In this cross-sectional descriptive study, 116 nurses working in hemodialysis units at 22 primary care centers were enrolled as participants. They were selected them by the convenience sampling method. Data were collected using structured questionnaires that included questions on general characteristics, nursing work environment, patient safety culture, and patient safety nursing activities. Results: The nursing work environment was relatively good; however, the patient safety culture and patient safety nursing activities were poor. A positive correlation was found between nursing work environment, patient safety culture, and patient safety nursing activities. Factors that affect patient safety culture were rated high in the order of nursing work environment and patient safety nursing activities, and factors affecting patient safety nursing activities were rated high in the order of patient safety culture and age. Conclusion: This study showed that the development of tailored patient safety training for nurses in hemodialysis units working in primary care and administrative support from those institutions are needed. In particular, strategies accounting for nurses' characteristics such as age are required to strengthen patient safety nursing activities.

• Archives of Plastic Surgery
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• 제39권2호
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• pp.150-153
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• 2012

Hemophilia B is a rare blood coagulation disorder. Complications such as bleeding and hematoma can cause necrosis of flaps, wound disruption, and the disturbance of wound healing. In particular, guidelines for flap operations in hemophilia B patients have still not been defined, and case reports are rare. We reconstructed the heel of a 41-year-old male hemophilia B patient using a reverse sural artery flap operation. The patient presented with mild hemophilia, having 27% of the normal value of coagulation factor IX. Coagulation and the changing value of the coagulation factor were regularly measured, and 70% of the normal value of coagulation factor IX was maintained through the injection of recombinant coagulation factors and antihemorrhagics. Hematoma developed twice (postoperative day [POD] 5 and POD 7) and in each case the hematoma was removed. Injections of recombinant coagulation factors and antihemorrhagics were continuously administered until postoperative week 2. When the coagulation factors were within normal ranges. In this article, a hemophilia B patient underwent reverse sural artery flap surgery and the healing progress was analyzed. We conclude that higher than baseline levels of coagulation factors are needed for successful healing in reverse sural artery flap surgery.

• The Journal of Korean Physical Therapy
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• 제1권1호
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• pp.73-82
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• 1989

The purpose of this study was to contribute to the relatively neglected area of out -patient satisfaction with physical therapy service by measuring and determining the factors affecting patient satisfaction in the Andong region. One hundred and forty-five subjects (81 males and 64 females) at 11 facilities with a mean age of 39.2 years (SD=16.2) responded to the satisfaction questionnaire. Each questionnaire contained a set of demographic questions and 19 patient satisfaction items. Cronbach's alpha test of reliability was used as the measure of internal consistency . The satisfaction scale had a good reliability coefficient : Cronbach's alpha=.8688. The average satisfaction score (minimum score=19, maximum score=95) was 75.4 ranging from 38 to 90. Respondent variables including sex, education, marital status, religion, medical security, average monthly income, and number of physical therapy out-patient department treatment visits were analyzed by t-test, ANOVA, and ANCOVA. Satisfaction with the service was largely unrelated to mallets of sex, education, occupation, or other demographic variables. However, marital status, age, average monthly income, and number of treatment visits in the out-patient department were significantly related to patient satisfaction. The analysis presented here could be replicatied with a larger sample in other areas. Other factors such as physical therapist availability, physical therapist competence, accessibility, waiting time, and atmosphere of the treatment area should be considered in further studies.

• 보건의료산업학회지
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• 제14권1호
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• pp.1-14
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• 2020

Objectives: This study examined factors influencing hospital workers' perception of patient safety culture, job boredom and job crafting in reporting of safety compliance. Methods: Structured questionnaires were used to collect data from 245 hospital workers who were full-time staff for six months or more. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and hierarchical multiple regressions with SPSS/WIN version 22.0. Results: The mean score for perception of patient safety culture was 3.16±0.32, for job boredom was 2.52±0.52, for job crafting was 3.35±0.49 and for degree of safety compliance was 2.87±0.3. The hierarchical multiple analysis revealed that hospital work environment (β=.27, p<.001), communication process (β=.27, p<.001) of subarea perception of patient safety culture and cognitive crafting (β=.15, p=.039) of subarea job crafting were predictive of patient safety compliance (R2=.47, p<.001). Conclusions: The findings indicate that perception of patient safety culture and job crafting are important factors to be considered in working to improve hospital workers' safety compliance. Therefore, education and systematic programs to improve perception of patient safety culture and job crafting should be developed.

• 기본간호학회지
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• 제15권3호
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• pp.301-311
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• 2008

Purpose: The purpose of this study was to identify the factors related to the functioning of family caregivers of patients with cancer. Method: Data were collected by questionnaires from 124 patient-family caregiver dyads at a hospital in Seoul. Data collection was done between August, 2004 and January, 2005. Data were analyzed using Pearson correlation coefficients and stepwise multiple regression. Results: The mean score for family functioning was 68.73. Family functioning showed a significant negative correlation with burden of family caregiver and performance status of patients with cancer, and a significant positive correlation with previous relationship between the patient with cancer and caregiver. The most powerful predictor of family functioning was the relationship between the patient and caregiver. The relationship between the patient with cancer and caregiver, and performance status of the patient accounted for 25.4% of the variance of family functioning. Conclusion: The results showed that the relationship between patients with cancer and caregivers and performance status of patients with cancer were significant factors influencing family functioning in family caregiver of patients with cancer.

• 한국의료질향상학회지
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• 제12권1호
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• pp.6-16
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• 2006

Objectives : The purpose of this study was to identify the characteristics influencing consultation and waiting time in ambulatory patients. Methods : This study was conducted in a tertiary teaching hospital. Subjects were a total of 10,383 ambulatory patients. Consultation time was measured by time spent for meeting with his/her physician per patient. Waiting time was defined as the time difference between each patient's reserved time and time to meet with his/her physician for ambulatory care. Multiple regression analyses were performed to determine the factors influencing consultation and waiting time. Results : Consultation time was different according to patient' age, previous experience of clinic visit, recent admission history, medical department, specialist care, type of reservation, and day of the week. Significant factors influencing waiting time were patient' age, residential area, previous experience of clinic visit, recent admission history, medical department, specialist care, time spent after ambulatory care begins, and day of the week. Conclusions : The medical department was the strongest factor affecting both consultation time and waiting time. The ambulatory reservation management systems should take into account patient characteristics as well as care-related features.

• 보건행정학회지
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• 제15권3호
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• pp.94-113
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• 2005

The purpose of this study was to determine the level of appropriateness in hospital stays and factors influencing inappropriate hospital stays. The study was conducted at fifteen general care units in a tertiary university hospital. Appropriateness of hospital stay was assessed using Appropriateness Evaluation Protocol by trained head nurses. The total of 447 patient records were reviewed. Among them, 352 patient data were included in the final data set. A unit of observation was patient day. A rate of appropriate hospital stay was calculated per patient as a unit of analysis. Multiple regression analysis was performed to determine the factors affecting inappropriate hospital stay. The eighty-three percent (2030/2651) of hospital stays were evaluated as appropriate. There were significant differences in appropriateness of hospital stay according to patient's age, type of health insurance, medical specialty, and length of stay(p<0.05). In the multiple regression analysis, medical speciality was the most significant factor to predict the inappropriate hospital stay. The study showed a substantial proportion of hospital stay was found to inappropriate. Level of appropriateness was significantly different from medical specialty. Interdepartmental approach should be required to coordinate and improve appropriate resource utilization.

• 대한간호학회지
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• 제43권3호
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• pp.379-388
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• 2013

Purpose: The purpose of this study was to develop a tool to evaluate patient safety culture in nursing homes and to test its validity and reliability. Methods: A preliminary tool was developed through interviews with focus group, content validity tests, and a pilot study. A nationwide survey was conducted from February to April, 2011, using self-report questionnaires. Participants were 982 employees in nursing homes. Data were analyzed using Cronbach's alpha, item analysis, factor analysis, and multitrait/multi-Item analysis. Results: From the results of the analysis, 27 final items were selected from 49 items on the preliminary tool. Items with low correlation with total scale were excluded. The 4 factors sorted by factor analysis contributed 63.4% of the variance in the total scale. The factors were labeled as leadership, organizational system, working attitude, management practice. Cronbach's alpha for internal consistency was .95 and the range for the 4 factors was from .86 to .93. Conclusion: The results of this study indicate that the Korean Patient Safety Culture Scale has reliability and validity and is suitable for evaluation of patient safety culture in Korean nursing homes.

• 한국보건간호학회지
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• 제33권3호
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• pp.379-389
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• 2019

Purpose: The study investigated the factors associated with compassion satisfaction of nurses in long-term care hospitals with a focus on the culture of patient safety. Methods: This study was conducted using a descriptive survey. The participants were nurses in 1 metropolitan city and 2 other cities (N=164). The data was collected in October, 2018 and analyzed using the SPSS Win 25.0 program. Results: The factors associated with compassion satisfaction were job satisfaction, work attitude, management practice, leadership of the managers of patient safety culture, and clinical career (F=21.66, p<.001). These variables explained 49.3% of the variance in compassion satisfaction of long-term care hospital nurses. Conclusion: These results highlight the importance of long-term care hospital nurses' compassion satisfaction and can be used as meaningful data for intervention to promote a culture of patient safety, and nurses' job satisfaction.