• Quality Improvement in Health Care
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• v.29 no.2
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• pp.15-31
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• 2023

Purpose: This study aimed to identify the characteristics of patient safety incidents (PSIs) related to nursing and to provide primary data for preventing the recurrence of similar incidents. Methods: This secondary analysis study included damage claims rulings filed for clinical negligence from 2014 to 2018 that contained the keyword 'nurse'. It excluded judgments irrelevant to nursing care and in which clinical negligence or causal damages were overruled. A total of 93 cases were analyzed. The characteristics of PSIs were derived through descriptive statistics, and two instances of nursing-related PSIs were examined by qualitative content analysis focusing on root causes. Results: The analysis of PSIs related to nursing suggested that the medical institutions where the PSIs occurred most frequently were hospitals, and the most common types of PSIs were medication, surgery, and treatment/procedure, in that order. In addition, it indicated that nursing-related PSIs occurred most frequently in general wards during the day shift, with the most common related nursing practice being managing potential risk factors. The qualitative analysis showed that careless monitoring and institutional inertia were causes of PSIs. Conclusion: To prevent nursing-related PSIs, nurses need to individually monitor and assess patient conditions. In addition, support should be accompanied by the improvement in the systems in place aimed at preventing the recurrence of nursing-related PSIs at the institutional and national level, such as securing appropriate nursing personnel and improving labor conditions.

• Quality Improvement in Health Care
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• v.27 no.2
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• pp.57-72
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• 2021

Purpose: At present, there are a variety of serious patient safety incidents related to problems in health information technology (HIT), specifically involving electronic medical records (EMRs). This emphasizes the need for an enhanced electronic medical record system (EMRS). As such, this study analyzed both the nature of and potential to prevent incidents associated with HIT/EMRS based on data from the Korea Patient Safety Reporting and Learning System (KOPS). Methods: This study analyzed patient safety incidents submitted to KOPS between August 2016 and December 2019. HIT keywords were used to extract HIT/EMRS incidents. Each case was reviewed to confirm whether the contributing factors were related to HIT/EMRS (HIT/EMRS-related incidents) and if the incident could have been prevented (HIT/EMRS-preventable incidents). The selected reports were summarized for general clarity (e.g., incident type, and degree of harm). Results: Of the 25,515 obtained reports, 2,664 incidents (10.4%) were HIT-related, while 2,525 (9.9%) were EMRS-related. HIT/EMRS-related incidents were the third largest type of incident followed by 'fall' and 'medication incidents.' More than 80% of HIT/EMRS-related incidents were medication-related, accounting for approximately one-third of the total number of medication incidents. Approximately 10% of HIT/EMRS-related incidents resulted in patient harm, with more than 94% of these deemed as preventable; further, sentinel events were wholly preventable. Conclusion: This study provides basic data for improving EMR use/safety standards based on real-world patient safety incidents. Such improvements entail the establishment of long-term plans, research, and incident analysis, thus ensuring a safe healthcare environment for patients and healthcare providers.

• Journal of radiological science and technology
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• v.29 no.1
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• pp.39-46
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• 2006

The rules and terms are described different meaning, in this results the research is accomplished for preventing practical workers from confusion. Atomic law are kept up modification and development in our situation by the ICRP's recommendation, on the other hand, the rules of diagnosis radiation equipment safety managements are modified partial, then resulted in confusion. The study was comparison between the rules of diagnosis radiation equipment safety management and atomic energy law, and the modification items obtained were as follows. 1. With each other different the terms and units are used. With the exception of special terms for affairs usage, it is needless to say that common term uniformity is standardized. The standardization of rules and guidance have not need to confusion radiological practical workers. 2. The following is omitted. 1) The radiation protection against tile patient and the hospital visitor. 2) Radiation dose limit of the woman patient who is in the process of becoming pregnant. 3) Radiation dose limit of the person who is not regarded as madical madical exposure. 4) The control of the exposure of pregnant of women at work.

• The Korean Society of Law and Medicine
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• v.14 no.2
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• pp.119-142
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• 2013

It is not easy to regulate the amount of radiation used for the medical purpose as there usually is more good than harm to the patient's health and life caused by the medical exposure to the radiation. However, the rapid increase of the use of diagnostic radiation involves a high possibility of increasing the radiation hazard exposure. Therefore, it is imperative to implement effective regulations in order to secure the safety of diagnostic radiation. The one and only rule we currently have for the diagnostic radiation is "Medicine Act" with only one clause dedicated to regulate the safety management that does not include any rules for the medical radiation. A set of inclusive rules for the whole medical radiation inclusive of diagnostic radiation and therapeutic radiation need to be based on the "Medicine Act" rather than "Nuclear Safety Act" in order to protect the medical professionals, patients and the guardians of patients from the hazards of diagnostic and/or therapeutic radiation that was not used the purpose of medical treatment. If there is an administrative measure to be imposed to secure the safety of diagnostic radiation, it is considered as exertion of governmental authority of administrative agency. There must be clear and realistic legal guidelines for in-fringe on people's interests. The administrative measures for the safety management of the diagnostic radiation must be clearly and specifically based on the law and the detailed standards for the administrative measures must be dele-gated by the presidential decree or departmental ordinance. Accordingly, the restrictions imposed by the administrative measures to the "Safety Inspection Institute of Radiation along with Radiation Exposure Measuring Institutes" should have clear legal basis as well and the detailed standards for the administrative measures should be regulated by the Ministry of Health and Welfare decree instead of the notification by the Director of Korean Centers for Disease Control and Prevention. While securing the safety of radiation on one side, careful review and up-grade on our legal system for the safety management of the diagnostic radiation is required on the other side to guarantee the legality, interest balance and reliability of the administrative measures.

• The Korean Society of Law and Medicine
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• v.20 no.1
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• pp.109-132
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• 2019

Recently, medical accidents related to surgical procedures have increased. In addition, the media reported that some of these accidents were involved in health crimes. Patient-advocate groups have called for mandatory establishment and management of CCTV in operating rooms. There is a lot of discussion among the interested parties, so it is necessary to review the relevant laws and regulations. The purpose of this study is to identify the characteristics of CCTV in operating rooms and to review legislations related to establishment and management of the CCTV in operating rooms. Medical institutions use CCTV for management of facilities and patient safety and install it in operating rooms optionally. The Constitution guarantees the privacy and the privacy of correspondence of every citizen, but it can be limited by the law for public welfare. Currently, however, there is no existing law about establishment and management of the CCTV in operating rooms and it can be defect of legal system. Under the current legislations, it is likely that the Self-determination can be violated due to the characteristic of healthcare provider when CCTV is mandatorily installed in operating room. In addition, the regulations on access and leakage of confidential information known by operator are insufficient. So that, the safety of the visual data might be threatened. Furthermore, unless the period and the place of storage of the visual data are clearly defined, it is highly unlikely to meet the original purpose of patient safety and prevention of medical accidents. This study is meaningful as there is few previous study on this topic although the need for legal review about this is growing and several bills are being proposed. It is expected that the results of this study can be utilized as basic data for enactment or amendment of the laws and regulations about establishment and management of CCTV in operating rooms.

• The Korean Society of Law and Medicine
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• v.15 no.2
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• pp.285-316
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• 2014

As the number of medical disputes regarding nurses has increased after medical disputes have increase, there is a need for a study on it. However, the legal relationship between nurses and patients has not yet been analyzed. Recently, the role and function of nurses are expanded according to the development of the science of nursing; moreover their activity and limitation of responsibility are also expanded. For this reason, the medical disputes regarding nurses have been increasing. However, the majority of these kind of dispute are just passed over because their practice is usually considered to be a mere action to assist doctor's role. In addition, nurse practice is not a secondary action of doctor's role, but forms part of a medical treatment. Of course, nurses handle many secondary tasks after doctors finish their medical treatment. But this is only part of the whole tasks of nurses. Furthermore, the general details of their medical treatment are not different from those of doctors because they also belong to the medical service personnel. Considering these features of nurse and the medical condition in South Korea, their task is becoming increasingly developed and specialized and they are also establishing their own field. With this stream of times, there is a growing interest in enacting a Nursing Practice Act, in other words, the independent law on nurse for the sake of patient safety and national health promotion. Then, their responsibility will distinctly be expanded as much more. That is, the time that nurses practice their medical care by following doctors' order and also pass over their responsibility to doctors is closed. Thus, this study examines the features and responsibilities of nursing practice, and discusses an institutional framework to efficiently cope with the legal disputes between nurses and patients. It aims to throw light on the decision making on nurse-patient disputes in future.

• The Korean Journal of Emergency Medical Services
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• v.14 no.3
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• pp.13-28
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• 2010

Purpose: In this study, we investigated the better application of the law which is about the AED installation and more effective ways of emergency medical care system, to understand the law and to research the current condition of public facilities which belong to local governments, and to seize the aspect of safety guards who currently work in order to provide the installation of AED in the public facilities and to provide more efficient emergency medical service with the effectuation of the immunity law of the good intention of first-aid treatment. Methods: In Gwang-ju, 234 public facilities have been identified by 31 December, 2008. With the exception of the duplication, we researched 158 facilities and received the answers from 95 of them. Results: In the research, 53% of them have had internal emergency first-aid education, and 55% of them didn't have this education and a CPR education manual, and 30% of the facilities even didn't know how to connect with the manager of the company for the first-aid department. On the other hand, most of them were highly interested in CPR and AED education on the ratio of 91% and 93%. 88% of them have been trained about first-aid, 51% of them haven't been retrained, 17% have never been trained. so, the reality of emergency system at public facilities is serious. 78% of them knew they are working at public facilities, though 49% of them didn't know about AED installation. 57% of them didn't know the fact there is the immunity law related with good intentions for first-aid treatment. 63% of the facilities have security guards, and 30% of them didn't answer the questions. Also, many of them agreed to the opinion that all employees should have first-aid training. At representative survey report of participator of public-facility, emergency treatment is 61%, 16% of patients calling. Accordingly they importantly think better doing an on-site first-aid than evacuating the patient. And the rates show that 57% of them answerers tend to call Fire-Office(119) for evacuating the patients, and 28% of them EMIC(1339) for the first-aid. Conclusions: In this study, we are suggest to improve the details of the efficient operations and management after the grasp of the uninstallation, indifference, and unreliable conditions of AED. 1) Need a publicity of AED install cognition which is an emergency medical instrument at public facilities. 2) Arrangement of safety agents at facilities and concerns about them for good management from the parties concerned. 3) Need a designation of legal details according to the decision of the AED installation and the standard of the AED installation. 4) Training about first-aid of safety guards and the persons concerned in the facilities should be practiced participation with the positive and through this, first-aid treatment could be done by anyone who knows the immunity law related to medical emergency. 5) The brochures for the potential users and the results form practicing the instructions need to be improved in many ways through recording the emergency cases that have happened.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.1
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• pp.33-43
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• 2011

Purpose: This study was done to develop a web-based diagnostic evaluation program for nurses to prevent malpractice liability. Methods: A comprehensive review of the literature and 9 specialist interviews were used to search for learning goals and content for protection for nurses from malpractice. Data on needs for learning goals were collected from 56 hospital nurses who agreed to complete a self-report questionnaire. The diagnostic program was evaluated between September 2008 and August 2009 by 35 new hospital nurses using an application of the web-based program evaluation tools by Chung (2000). Results: A comprehensive review of the literature and interviews were used to search for learning goals and content. The evaluation program was composed of the 73 questions for diagnostic evaluation under 23 learning goals and 6 grand learning goals which included the principles of law, patient's rights, legal responsibility, patient's safety, regulation on nursing practice and patient's rights protection. Evaluation of the program showed that the mean for program evaluation was 3.43 (SD=.37). Conclusion: This diagnostic evaluation program could be an efficient method for teachers and learners to improve nurses' behavior in protecting the patient's rights and preventing malpractice claims.

• The Korean Society of Law and Medicine
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• v.24 no.4
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• pp.131-160
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• 2023

An amendment to Medical Law allowing permanent face-to-face treatment has been proposed in the 21st National Assembly, with five different bills introduced. However, each proposed amendment focuses on different aspects, and the issue is currently in a state of 'ongoing review' due to factors such as opposition from the medical profession and political considerations. However, from the perspective that the introduction of non-face-to-face treatment should be institutionalized and legislated prioritizing patient safety, certain directions are proposed. These include focusing on returning patients as the primary target, chronic diseases as the focal conditions, outpatient medical institutions as the implementing agencies, restricting non-face-to-face means primarily to video systems, and legally exempting healthcare professionals from responsibility for incidents beyond their control. The proposed directions also emphasize establishing the right to demand face-to-face treatment. It is suggested to legislate initial standards that ensure a minimum level of safety and gradually expand the scope of non-face-to-face treatment through future research, evaluation, and similar step-by-step approaches.

• The Korean Journal of Emergency Medical Services
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• v.13 no.3
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• pp.77-90
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• 2009

Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.