Journal of Korean Academy of Nursing Administration
/
v.20
no.1
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pp.35-47
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2014
Purpose: The purpose of this study was to describe nurses' experiences of accidents in patient safety. Methods: Data were collected from October 8, 2011 to January 31, 2012 through in-depth interviews with seven nurses who had worked on wards or in the ICU in a university hospital. Data were analyzed by applying Colaizzi's phenomenological methodology. Results: The following six categories were extracted: Fear of the patient's condition caused by the accident, Conflict in the accident report, Blame on others and circumstances, Feeling guilty and sorry as the patient's condition is improving, Being disappointed with the unfavorable atmosphere in dealing with the accident, After the accident, being sensitive in performing nursing duties and being faithful to the principles. Conclusion: The results indicate that the organizational culture in the hospital related to accidents in patient safety is still closed and punitive, and such an atmosphere causes nurses to feel seriously hurt, but through this experience nurses are likely to mature as nursing professionals. Programs on prevention of accidents in patient safety and a system to guard against these accidents should be established. Also the organizational safety culture should be improved.
Journal of the Korea Academia-Industrial cooperation Society
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v.13
no.1
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pp.117-124
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2012
This study is aimed to investigate the relationship among safety accident and perception of patient safety culture, to provide the basic data for building the patient safety culture of hospital nurses. The self-administered questionnaires were given to 129 nurses employed in hospital during the period from November 10th to 15th, 2011. The safety accident occurrence of patient was statistically significant difference according to safety education of nurse and job satisfaction of nurses. As a results, nurses' perception to the patient safety culture of hospital shows on the average score($3.46{\pm}0.3$). Among three categories, patient safety culture in a ward, and patient safety culture within hospital and safety awareness in a ward show respectively on the average score $3.59{\pm}0.3$, $3.41{\pm}0.5$, $3.41{\pm}0.4$. The score of level of patient safety culture of hospital nurses was statistically significant difference according to marital status, safety education, occupational satisfaction and health status. In correlation among safety accident occurrence of patient and safety education of nurse, patient safety culture in a ward, patient safety culture within hospital and safety awareness in a ward showed positive relationship. The results of this study indicate that education program are needed to prevent safety accident occurrence of patient, and to build the patient safety culture of hospital nurses, and to increase the safety education and occupational satisfaction, and to improve the nurses' health status.
This study aimed to analysis factors related to in-hospital death of injured patients by patient safety accident. A total of 1,529 inpatients were selected from Korea Centers for Disease Control and Prevention database(2013-2017). Frequency, Fisher's exact test, t-test, ANOVA, logistic regression analyses by using STATA 12.0 were performed. Analysis results show that the mortality rate was lower for female than male but the mortality rate was higher for the older age, the higher the CCI, head (or neck), multiple, systemic damage sites, internal and others, metropolitan cities based on Seoul and 300-499 based on the bed size of 100-299. Based on these findings, the possibility of using the in-depth investigation of discharge damage from the Korea Centers for Disease Control and Prevention as a data source for the patient safety survey conducted to understand the actual status of patient safety accident types, frequency, and trends should be reviewed. Also, it is necessary to prevent injury and minimize death by identifying factors that affect death after injury by patient safety accident.
There is a need to comprehend dental accidents accurately, and construct patient-safety-system in order to prevent consistently increasing dental accident or dispute. This study is aimed to provide basic data for an efficient counterplain by looking through and classifying already occurred dental accidents from an angle of patient safety. Recently, the number of dispute on dental implant was the highest according to rapid growth of dental implant. As a result of classifying dental accidents by International Classification for Patient Safety (ICPS), it is confirmed that cause of accident is different by each type of dental treatment. It is expected to help preventing and managing dental disputes properly by studying actual state of dental disputes in perspective of patient safety. Effort to reduce dental accidents and activity to pursue patient safety have thread in connection. I believe that financial profits of dental clinic and improvement of quality in dental treatment can be achieved through these efforts.
Patient safety culture for the general hospital to investigate the perception of radiological technologists, managing of the patient safety provides the Foundation for the safety activities as a basis to develop a program for providing. Patient safety culture for the general hospital to investigate the perception of Radiological technologists, the duration of the survey of the study on June 13, 2012 to June 20, and five general hospitals worked on Radiological technologists workers were material and analyzed the target of 198 (SPSS ver. 19.0). Patient safety activities within the Department, the factors affecting direct care, communication, medical malpractice, hospitals rated, safe for the patient safety culture and the reported accidents, dangerous and caused an accident, most feel that patient safety incident reporting system according to the results of evaluating medical accidents patient safety culture regarding recognition, work appeared in more than 25 years, even the most highly evaluated, the working period of 10 patient safety to 15 years the most highly. Therefore, General Hospital, Director of the patient safety culture improvement of radiation in order to have sufficient staffing, aggressive approach to patient safety issues, and safe working period of relapse prevention of accidents to the radiation as well as giving systematic consideration of mission medical accident reporting system will be active.
Journal of the Korea Academia-Industrial cooperation Society
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v.20
no.3
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pp.216-223
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2019
This study was conducted to identify the effects of patient safety competency on patient safety management practice by nursing students and provide basic data for the development of the program to improve patient safety management practice. Participants were 293 fourth year nursing students who had clinical practice as student nurses for more than one year. Data were collected from April 26 to May 9, 2018. Collected data were analyzed for frequency, percentage, mean, standard deviation, t-test, ANOVA, Pearson' s correlation coefficient, and multiple regression with SPSS/WIN 24.0 computer program. Nursing students' patient safety competency was an average $2.90{\pm}0.38$ points (patient safety knowledge $2.68{\pm}0.65$; patient safety skills $3.26{\pm}0.56$; patient safety attitudes $2.75{\pm}0.40$). The average core of management practices to patient safety recorded $4.13{\pm}0.57$ points. In terms of the correlation among subjects' patient safety knowledge, skills, attitudes and patient safety management practices, significant correlation existed between skills and management practices (r=.337, p<.001), attitudes and management practices (r=-.150, p =.010), knowledge and management practices (r=.171, p=.003). Regression analysis revealed that 15.7% of the variance in patient safety management practice by nursing students could be explained by patient safety skills (${\beta}=.307$, p<.001), patient safety accident experience of Fire (${\beta}=-.127$, p=.026), patient safety attitudes (${\beta}=-.121$, p=.026), and patient safety accident experience of patient education (${\beta}=-.119$, p=.034). Additional studies to determine the various factors affecting patient safety management practice of nursing students and to develop educational program for increasing patient safety management practice should be conducted.
Journal of Korean Academy of Nursing Administration
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v.17
no.4
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pp.413-422
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2011
Purpose: This descriptive correlation study was done to identify how perception of patient safety culture of general hospital nurses affects safety during nursing activities. Data from this study should provide information on management of patient safety as well as improvement in patient safety. Method: Participants in this study were 357 clinical nurses working in a general hospital in M city which had two medical evaluations. A survey was conducted to gather the data. Results: The score for perception of patient safety culture of the general hospital nurses was 3.42, out of a possible 5 points, and the score for safety care activities was 3.90. There was a statistically significant positive relationship between the nurses' perception of patient safety culture and their safety care activities, Perception of patient safety culture, Supervisor/manager, communication and procedures, and frequency of accident reporting were factors that impacted significantly on safety nursing activity. Conclusion: The results of the study indicate that patient safety cultural perception significantly affects the safety of nursing activities and thus systematic educational strategies to increase perception should be provided to increase the level of patient safety culture. Also, other specific methods that increase the level of patient safety culture should be considered.
Patient safety remains one of the most important health care issues in Korea. To improve patient safety, we have introduced concepts from the field of safety science such as the Swiss cheese model, and adopted several methodologies previously used in other industries, including incident reporting systems, root cause analysis, and failure mode and effects analysis. This approach has enabled substantial progress in patient safety to be made through undertaking patient safety improvement activities in hospitals that are systems-based, rather than individual-based. However, these methods have the shared limitation of focusing on negative consequences of patient safety. Therefore, the paradigm shift from Safety I to Safety-II in safety science becomes the focus of our discussion. We believe that Safety-II will complement, rather than replace, Safety-I in the discipline of patient safety. In order to continuously advance patient safety practices in Korea, it is necessary that Korea keeps abreast of the recent global trends and development in safety science. In addition, more focus should be placed on testing the feasibility of new patient safety approaches in real-world situations.
Purpose: Despite the rapidly changing healthcare environment, healthcare organizations have recognized the importance of patient safety management. But patient safety management has the problem of the lack of participation of members due to the process of focusing on the follow-up service and punishment. The department of nuclear medicine in Uijeongbu St. Mary's Hospital started this research to reduce the near miss and prevent patient safety accidents by both initiating the participatory near-miss-proof activities as an advance management and constructing a system without disadvantages of reporting. In addition, this research aims to establish a differentiated patient safety management system in the department of nuclear medicine. Materials and Methods: 1. Colleting cases of team members' past and present near miss and accidents(First data collection). 2. Quantifying the cases of near miss and accidents after identifying the degree of importance and urgency through surveys(Second data collection). 3. Quantifying cases and indentifying important points of contact through data analysis. 4. Making and standardizing a manual for important points of contact, and initiating participatory activities to prevent errors. 5. Activating web-based community for establishing the report system of near miss. 6. Estimating the result of before and after activities through surveys and focus group interviews. Results: 1) Quantified safety accidents and near miss in the department of nuclear medicine. About 50 near misses a month and one safety accident a year. 2) Establishing improvement measurements based on quantified data. About 11 participatory activities, the improvement of process, a manual for standardization. 3) Creating a system of safety culture and high participation rate of team members. Constructing a report system, making a check list and a slogan for safety culture, and establishing assessment index. 4) Activating communities for sharing the information of cases of near misses and accidents. 5) As the result of activities, the rate of near miss occurrence declined by 50% and the safety accident did not happen. Conclusion: The best service in the department of nuclear medicine is to provide patients with safety-guaranteed high-quality examination and cure. This research started from the question, 'what is the most faithful-to-the-basics way to provide the best service for patients?' and team members' common answer for this question was building a system with participation of all members. Building a system through the participatory improvement activities for preventing near miss and creating safety culture resulted in the 50% decline of near miss occurrence and no accident. This is a meaningful result from the perspective of advance management for patient safety. Moreover, this research paved the way for creating a culture to report and admit near miss or accidents by establishing a report system with no disadvantage of reporting. The system which sticks to the basics is the best service for patients and will form a patient safety culture system, which will lead to the customer satisfaction. Therefore, all members of the department of nuclear medicine will develop a differentiated patient safety culture with stabilizing the established system.
Purpose: The purpose of this study was to identify and analyze the characteristics of nurses' medication errors during three years. Methods: Retrospective survey study design was used to analyze medication errors by nurses among patient safety accidents. Data were collected for three years from January, 2017 to December, 2019. Data were analyzed using frequency, percentage, 𝑥2-test, and logistic regression with SPSS 26.0 program. Results: Of a total 677 medication errors, 40.6% were caused by nurses. Among the medication errors, near miss (n=154, 56.0%), intravenous bolus injection (n=170, 61.8%), wrong dose (n=102, 37.1%) and carelessness for repetitive work (n=98, 35.6%) were the most common. Medication errors differed by department, and nurses' career, and patient safety accident type. The results of the logistic regression analysis showed that the risk factors of adverse events were medication of fluids (OR=3.93, 95% CI: 1.26~12.27), insulin subcutaneous injection (OR=39.06, 95% CI: 4.58~333.18), and occurrence of extravasation/infiltration (OR=7.26, 95% CI: 1.85~28.53). Conclusion: The simplest and most effective way to prevent medication errors is to keep 5 right, and a differentiated education program according to department and nurse career is needed rather than general education programs. Hospital-level integrated interventions such as a medication barcode system or a team nursing method are also necessary.
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