• Journal of Korean Academy of Nursing Administration
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• v.12 no.3
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• pp.373-384
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• 2006

Purpose: This is a pilot study to identify patient safety risk factors and strategies for patient safety management perceived by nurses. Methods: Data were collected and analyzed with an open questionnaire from April to May 2005, targeted on 100 nurses working in two hospitals. The issues were 'what are risk factors for patients, nurses, and other medical practitioners? How do they prevent with the aftermath of risk factors, causes of incidents?' For data analysis, types and frequency of risk factors were worked out, using the Australian Incident Monitoring System Taxonomy. Results: The types of patient safety risk factor perceived by nurses were as follows ; therapeutic devices or equipment, infrastructure and services (29.5%), nosocomial infections (16.3%), clinical processes or procedures (15.4%), behavior, human performance, violence, aggression, security and safety (12.2%), therapeutic agents (9.7%), injuries and pressure ulcers (8.7%), logistics, organization, documentation, and infrastructure technology (5.6%). Strategies for patient safety included training of prevention of infection, education about safety management for patients and medical professionals, establishment of reporting system, culture of care, pre-elimination of risk factors, cooperative system among employees, and sharing information. Conclusion: These results will be used to provide evidences for patient safety management and educational program.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.4
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• pp.380-391
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• 2014

Purpose: This was a descriptive research study to examine the patient safety risk factors and the level of safety management of nurses in emergency service, hospitals and to analyze the relationship between the two factors. Method: Data for analysis were collected from 232 nurses in emergency service, hospitals in Busan and Gyeongnam from July 30 to September 7, 2013. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, and Pearson correlation coefficients. Results: Therapeutic agents showed the highest risk level. The prevention of transfusion errors showed the highest performance. As the nurses were working in regional emergency medical centers and received education more than 7 sessions on patient safety, they readily recognized the riskiness of the safety risk factors. In addition, as the nurses were older than 40, married, having more education about safety and understood the incident report registration system well, they performed safety management better. There were significant correlations between perception of the patient safety risk factors and performance for safety management. Conclusion: Nurses in emergency service, hospitals should try to improve safety management to reduce the risk factors shown to be higher based on the results and ensure the patient safety.

• Journal of The Korea Institute of Healthcare Architecture
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• v.27 no.4
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• pp.61-70
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• 2021

Purpose: The study aims at identifying patient-related and environmental factors associated with an increased risk of falling and, therefore, both caregivers and designers can be aware of fall risk factors and can contribute to prevent inpatient falls in their own areas of expertise. Methods: A case-control study has been conducted, utilizing patient data and physical environmental data in the unit of General Medicine in the United States. The case-control study investigated data about patients who had suffered falls as well as patients with similar characteristics (e.g., age, gender, and diagnosis) who did not suffer falls. Results: The study identified both patient-related and physical environmental factors associated with inpatient falls. Morse fall risk score, patient visibility, and patient accessibilityB were identified as significant predictors to inpatient falls, when controlling for other significant variables. Implications: The findings of the study can provide implications to both caregivers and healthcare and hospital environment designers. Caregivers should give special attention to patients with high Morse Fall Risk Scores to prevent inpatient falls. Designers also need to examine and to fine-tune the unit layout of inpatient care units to maximize each patient room's patient visibility from the rest of the unit and patient accessibilityB from working areas of nurses.

• Journal of Preventive Medicine and Public Health
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• v.39 no.1
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• pp.13-20
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• 2006

Objectives: To propose a risk-adjustment model with using insurance claims data and to analyze whether or not the outcomes of non-emergent and isolated coronary artery bypass graft surgery (CABG) differed between the low- and high-volume hospitals for the patients who are at different levels of surgical risk. Methods: This is a cross-sectional study that used the 2002 data of the national health insurance claims. The study data set included the patient level data as well as all the ICD-10 diagnosis and procedure codes that were recorded in the claims. The patient's biological, admission and comorbidity information were used in the risk-adjustment model. The risk factors were adjusted with the logistic regression model. The subjects were classified into five groups based on the predicted surgical risk: minimal (<0.5%), low (0.5% to 2%), moderate (2% to 5%), high (5% to 20%), and severe (=20%). The differences between the low- and high-volume hospitals were assessed in each of the five risk groups. Results: The final risk-adjustment model consisted of ten risk factors and these factors were found to have statistically significant effects on patient mortality. The C-statistic (0.83) and Hosmer-Lemeshow test ($x^2=6.92$, p=0.55) showed that the model's performance was good. A total of 30 low-volume hospitals (971 patients) and 4 high-volume hospitals (1,087 patients) were identified. Significant differences for the in-hospital mortality were found between the low- and high-volume hospitals for the high (21.6% vs. 7.2%, p=0.00) and severe (44.4% vs. 11.8%, p=0.00) risk patient groups. Conclusions: Good model performance showed that insurance claims data can be used for comparing hospital mortality after adjusting for the patients' risk. Negative correlation was existed between surgery volume and in-hospital mortality. However, only patients in high and severe risk groups had such a relationship.

• Quality Improvement in Health Care
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• v.17 no.1
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• pp.69-78
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• 2011

Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

• Korean Journal of Occupational Health Nursing
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• v.11 no.1
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• pp.44-51
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• 2002

Purpose: Surgical Site Infection(SSI) is the third most common cause of nosocomial infection, so that it results in serious socioeconomic impact such as extra hospitalization, mortality and health care cost. The aim of this study was to analyses the SSI that based on the degree of wound contamination and patient risk index after general surgery and to generate a reference data for the effective management and reducing SSI. Method: From July, 1999 to June, 2000, 1080 cases which presented with surgical site infection after general surgery at S hospital in chunchon city were included in this study. The data were collected by review of the medical records retrospectively. The collected data, in accordance with the test purpose, is analyzed by SPSS/PC+ program, using real numbers, percentage, $X^2$ test, Pearson's correlation and stepwise logistic regression. Result: The overall wound infection rate was 4.7%(51 cases out of 1,080). The infection rate of clean wounds was 1.4%. Surgical site infection rate for patient risk index scores of 0, 1, 2 and 3 was 1.9%, 8.0%, 13.1% and 20.0%, respectively and increased significantly according to patient risk index(p=.000). Sixteen of the fifty one(31.4%) surgical site infections were found during an outpatient visit after discharge. Multivariate analysis, identified two independent variables : duration of postoperation stay(p=.000), age(p=.037). The most frequent isolated organisms were Pseudomonas aeruginosa(21%) and Staphylococcus aureus(21%). Also Staphylococcus aureus were all MRSA(Methicillin Resistant S. aureus). Conclusion: In this study, SSI was analysed according to the degree of wound contamination and patient risk index after general surgery. The data that obtained from this study is expected that it would be available for surveillance and control of SSI.

• Journal of Chest Surgery
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• v.25 no.11
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• pp.1218-1220
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• 1992

Pneumonectomy on a patient with documented poor pulmonary function indicating a contraindication to surgery can be associated with a high risk of serious postoperative morbidity or mortality. However the usual criterias, on the performance of a pneumonectomy on a high risk patient based on the preoperative assessment of the pulmonary function may not sometimes predict with accuracy the operative outcome in the postoperative period. We recently performed pneumonectomy with good results on a patient with poor pulmonary function that would otherwise have been an absolute contraindication to surgery by usual criteria.

• Korean Journal of Clinical Pharmacy
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• v.22 no.3
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• pp.211-219
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• 2012

Nonsteroidal antiinflammatory drugs (NSAIDs) are used in the treatment of extensive diseases related to various symptoms; inflammation, pain and fever. NSAIDs work by blocking prostaglandin synthesis, but adverse drug events (ADEs) have been increasing dramatically such as gastrointestinal bleeding, perforation and stenosis, a kind of serious ADEs. Therefore, NSAID-related ulcer complication guidelines have been announced containing various risk factors and symptoms. Thus, this study aims to evaluate of NSAID usage and appropriateness for prevention of NSAID-related ulcer complication based on American journal of gastroenterology (AJG) guideline 2009. Further, the study suggests Korean guideline for prevention of NSAID-related ulcer compared to AJG guideline. For this study, data was collected through electronic medical record (EMR) at Seoul national university of Bundang hospital. The primary end point was a composite of NSAID-related ulcer risk factor, types of NSAIDs, co-prescribed NSAID ulcer prevention drugs and NSAID-related ulcer after taking NSAID. The risk factors include over 65 years, high dose NSAID, previous ulcer history and taking drugs (e.g. aspirin, anticoagulant and steroid) causing ulcer. If a patient has 3 or 4 factors, that patient was classified high risk group. And if 1 or 2 factors that patient was classified moderate risk group. The patient who has no risk factor was in low risk group. I studied 8,120 patients who received NSAID from 1 January 2009 to 31 December 2009. High risk group was 16(0.2%), moderate risk group was 4,364(53.7%), and low risk group was 3,740(46.1%). The results show that high risk group should be prescribed COX-2 inhibitors with ulcer prevention drugs, and moderate or low risk group need traditional NSAIDs with ulcer prevention drugs. This may be different with 2009 AJG guideline because AJG guideline suggested taking COX-2 inhibitor alone in moderate group or taking traditional NSAID alone in low risk group could get higher ulcer complication. The results indicated that choosing preventive drug is important in case that how many risk factors the patients have. The proper drugs would be helpful for safe and effective NSAID usage in each patient group.

• Journal of Korean Society for Quality Management
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• v.51 no.2
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• pp.203-221
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• 2023

Purpose: The purpose of the research is to explore the role of social media in attracting international patients for cosmetic services in South Korea during the COVID-19 pandemic. The study aims to conceptualize social media as an effective marketing tool for minimizing perceived risks associated with cosmetic services and increasing patient satisfaction. Methods: The study validated proposed hypotheses using the PROCESS macro for SPSS with overseas patients who received cosmetic treatment in private Korean plastic surgery clinics in Busan. Results: This study found that information delivery capability reduced perceived risk and contributed to patient satisfaction, while communication capability did not show any significant relationship with perceived risk and satisfaction. In addition, information delivery capability had a significant direct effect on patient satisfaction, but communication capability did not. Conclusion: It is expected that the outcomes of this study will broaden our understanding of the use of social media in reducing perceived risk and increasing satisfaction.

• Proceedings of the Korean Society of Toxicology Conference
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• 2003.05a
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• pp.102-102
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• 2003

Diethylhexyl phthalate (DEHP) was known as endocrine disrupter revealing reproductive / developmental toxicity. For a long time, risk due to DEHP released from PVC medical devices was became an issue for patient receiving blood bag, iv injection solution like saline and Hartman's solution. This study was conducted to suggest permissible intake level (PIL) of DEHP based on reproductive toxicity, to quantify daily intake level of DEHP can be exposed to patient through various medical treatment and to estimate risk values of DEHP released from PVC medical devices.(omitted)