Kim, Jin-Young;Kim, Yeong-Mee;Kim, Day-Sung;Im, Heung-Jae;Kim, Jeung-Ho;Kang, Seong-Kyu
Journal of the Ergonomics Society of Korea
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v.26
no.3
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pp.91-100
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2007
The purposes of this research are to survey work-related risk factors of musculoskeletal disorders(MSDs) in various departments and tasks at general hospitals in non-manufacturing sectors, and to use basic data derived from the survey results in preventing work-related MSDs in hospital workers. Investigation started in March of 2006 and continued for 6 months in 220 general hospitals at Seoul, Incheon, Kyeongi, and Kangwon area. Investigators visited and interviewed workers in hospitals to identify the presence of tasks of musculoskeletal burden, the investigation results of ergonomic risk factors required by the Occupational Safety and Health Law, statistical analysis from questionnaire for musculoskeletal symptoms, and major departments and tasks that have such risk factors. Twenty-seven percents of hospitals finished the investigation of ergonomic risk factors, and 69% did not do the investigation while remained 4% did not have such factors in their hospitals. The rank order of major departments that had such musculoskeletal burdens was kitchen rooms of 143, managing departments/computer rooms/dispensaries of 137, physical treatment rooms of 109, nursing departments of 96, radiological and clinical laboratories of 63. Eighteen hospitals that did not hold legal duties by the section 148 of labor minister decree practiced prevention programs of MSDs according to the labor-management cooperation. Nursing departments ranked in the first place for the numbers of musculoskeletal symptoms of 438. Managing departments/computer rooms/dispensaries, kitchen rooms, and medical treatment departments held 127, 52 and 45 symptoms, respectively. The magnitude order of physical symptom areas followed shoulder of 185, backs and waist of 166, hand wrists of 120, necks of 110, and legs/feet of 106. The departments and jobs that had major work-related ergonomic risks were patient transporting, central supplying, patient nursing (moving patients into wheel-chairs, changing of patient posture and sheet alteration), manual transporting, operation, and managing/computer departments.
The significance of the enactment of the 「Act On The Safety Of And Support For Advanced Regenerative Medicine And Advanced Biological Products」 is to break away from the regulation of the Pharmaceutical Affairs Act and expand patient treatment opportunities through a medical technology approach to regenerative medicine, which is essentially a medical practice called 'transplantation'. However, more than a year after the law was enacted, clinical study has not been activated, with not a single high-risk study approved by the Ministry of Food and Drug Safety being approved. The reason is that despite the legal purpose of expanding patient treatment opportunities, the data requirements for clinical study approval are set in connection with drug development despite the insufficient legal basis, making it difficult for many researchers to meet the data requirements. Prior to the enactment of the Act, submitted data for clinical study on cell therapy products within the Pharmaceutical Affairs Act were cosiderably exempted from quality and non-clinical test data, but with the enforcement of the Advanced Regenerative Bio Act, quality and non-clinical test data are required in accordance with pharmaceuticals when applying for approval of a clinical study plan. To rectify this, when considering the identity of clinical study on advanced regenerative medicine to expand treatment opportunities, recognize that there are limitations in connection with drug development. And it is necessary to preserve the identity of clinical study on advanced regenerative medicine, and on the other hand, in the case of drug product approval, clinical study results should be utilized while specifying usage requirements. Therefore, with the power of the market and the voluntary motive of the clinical researcher, it is necessary to prepare the necessary data by themselves rather than the basic requirements for clinical study approval.
Purpose: All acts which are enforced from the radioactive iodine therapeutic team is a in its own way principle and provision. Therefore unification of all acts can not be appropriately. We will make the standard coherence. Materials & Methods: From 5 November, 2007 to 17 November 2007, we conducted a questionnaire survey of the nuclear medicine manager of 30 hospitals. The contents of a questionnaire is medical treatment section, patient management, prosecuting attorney section, waste management and safety supervision in about the patient and a questionnaire was drawn up in the method which selects an item. Results: 30 hospital agencies are operating purely for I-131 high dose ablation therapy. Diagnostic study and daily schedule had the difference of some. The most of education for the patients took charge of doctor and nurse. The satisfaction of education was evaluated as the high thing. The safety supervision of waste management accomplishment and Safety supervision the patient and the worker observed on the basis of atomic energy law. Conclusion: Specific standards with sufficient amount of information and practical contents should have been presented through the following data. However, it seems to be lacking in many aspects. Nevertheless, respondents rated 70.9%, which is relatively high, on the value of clinical utilization, and I am very thankful for the evaluation. For many years from now, it may seem necessary for a lot of research on the specific matters based on these data to be conducted.
According to the changes of the medical environment of the times, it is necessary to discuss the issues of the doctor's medical guidance and to conduct continuous research so that alternatives can be prepared systematically. Furthermore, in order to enhance the professionalism of radiological technologists and to develop the medical technician system, the new Radiological Technologist Independent Act has been established, which contains the overall contents of the scope of work, professional qualifications, and specialized education of radiological technologists, and provides quality medical services to patients through professional procedures and treatment. In order to increase the level of medical care, the purpose, definition, mission, role, and scope of work specified in the Medical Act, Medical Service Technologists, etc. Act, the Enforcement Decree, and the Enforcement Rules were variously analyzed and new directions were presented. First, the definition of a medical technician should use a generic term so that the factors of conflict and prejudice could be resolved. Second, change the doctor's guide to doctor's prescription; and then legislate the authority to sign and write medical records after examination by radiological technologists, thereby prohibiting unlicensed technicians that seriously endanger patient safety. Third, an accurate definition of radiological technologists' roles should be established; not only selection and management of radiological technologists' work but also procedures and treatment for each radiology field should be specified to suit the current medical system. Fourth, a professional radiological technologists' qualification system and a specialized education system should be established in order to secure human resources that could provide patients trust in procedures and treatment based on professional knowledge and experience in the field of radiology. Fifth, the Education and Evaluation Institute should be operated in Korea education system to educate the professional knowledge and competency for students. In addition, it is necessary to in-depth analysis of foreign cases could be applied to the medical system and education system in Korea; it could strive to nurture systematic human resources.
Recently, the long-term care insurance for the elderly was carried out according to the elderly is increased rapidly and the formation of sympathy that a nation and society try commonly to share health and welfare promotion of the elderly. The purpose of this study is to analyze the present status of nursing home after that the long-term care insurance is enforced in chungcheongbuk-do and to utilize as basic data. The study limited its survey to those facilities that refer to the Ministry of Health and Welfare data, that had the capacity of more than 50 people. The result are as followings. Firstly, most of the nursing home were located on the outskirts of the city. But it must be constructed in the city center if the recent deinstitutionalization trend is reflected. Secondly, notwithstanding the provisions of the Elderly Welfare Law, if the Livability and amenity are considered, the plan of a single or a twin room is needed. The ondol(溫突) system bedroom for the safety of the elderly had to be planned and for the color planning of a bedroom, a heating, the furniture, the form of a door, corridors, etc. should be partly improved. The fastener in which it is appropriate for the main exit, a stair, an elevator, the lighting device, and etc. is needed and the installation of a wandering path for the dementia patient and etc. is required. Thirdly, most of the dining room arranged on the first floor but it is not nearly used and it used for employee or the other use. Therefore, we have to consider the system in which it can deliver the meal to a bedroom. If the smell of the elderly and etc. is considered, the sufficient height of the floor should be reflected for the ventilation equipment. Lastly, The improvement of the existing law are required.
Exposed doses to the patient's caregiver and their house due to the 131I from patients discharged from the hospital were measured using OSL dosimeters. Usually, 3.37-5.55 GBq (100-150 mCi) of $^{131}I$ administrated patients are discharged from the hospital after 3 or 4 days of hospitalization in Korea. In addition, after 5 to 8 days, the accumulated doses of the patient's caregiver and house after hospitalization of the patient were measured using OSL dosimeters. The results of the measured average accumulated doses were 0.1 mSv, which is 10% of 1 mSv, the public dose limit in the Korean Atomic Energy Law. And it's standard deviation was 0.087 mSv. Based on the results of this study, we anticipate that we could assure the compliance of the regulation requirement 5 mSv of MEST (Ministry of Education, Science and Technology) Notice No. 2008-45 for the patient's caregiver or family, even if we reduce the 3-4 days of hospitalization to 1-2 days or less.
There were also various decisions made in medical area in 2015. In the case that an inmate in a sanatorium was injured due to the reason which can be attributable to the sanatorium and the social welfare foundation that operates the sanatorium request treatment of the patient, the court set the standard of fixation of a party in medical contract. In the case that the family of the patient who was declared brain dead required withdrawal of meaningless life sustaining treatment but the hospital rejected and continued the treatment, the court made a decision regarding chargeable fee for such treatment. When it comes to the eye brightening operation which received measure of suspension from the Ministry of Health and Welfare for the first time in February, 2011, because of uncertainty of its safety, the court did not accept the illegality of such operation itself, however, ordered compensation of the whole damage based on the violation of liability for explanation, which is the omission of explanation about the fact that the cost-effectiveness is not sure as it is still in clinical test stage. There were numerous cases that courts actively acknowledged malpractices; in the cases of paresis syndrome after back surgery, quite a few malpractices during the surgery were acknowledged by the court and in the case of nosocomial infection, hospital's negligence to cause such nosocomial infection was acknowledged by the court. There was a decision which acknowledged malpractice by distinguishing the duty of installation of emergency equipment according to the Emergency Medical Service Act and duty of emergency measure in emergency situations, and a decision which acknowledged negligence of a hospital if the hospital did not take appropriate measures, although it was a very rare disease. In connection with the scope of compensation for damage, there were decisions which comply with substantive truth such as; a court applied different labor ability loss rate as the labor ability loss rate decreased after result of reappraisal of physical ability in appeal compared to the one in the first trial, and a court acknowledged lower labor ability loss rate than the result of appraisal of physical ability considering the condition of a patient, etc. In the event of any damage caused by malpractice, in regard to whether there is a limitation on liability in fee charge after such medical malpractice, the court rejected the hospital's claim for setoff saying that if the hospital only continued treatments to cure the patient or prevent aggravation of disease, the hospital cannot charge Medical bills to the patient. In regard to the provision of the Medical Law that prohibit medical advertisement which was not reviewed preliminarily and punish the violation of such, a decision of unconstitutionality was made as it is a precensorship by an administrative agency as the deliberative bodies such as Korean Medical Association, etc. cannot be denied to be considered as administrative bodies. When it comes to the issue whether PRP treatment, which is commonly performed clinically, should be considered as legally determined uninsured treatment, the court made it clear that legally determined uninsured treatment should not be decided by theoretical possibility or actual implementation but should be acknowledged its medical safety and effectiveness and included in medical care or legally determined uninsured treatment. Moreover, court acknowledged the illegality of investigation method or process in the administrative litigation regarding evaluation of suitability of sanatorium, however, denied the compensation liability or restitution of unjust enrichment of the Health Insurance Review & Assessment Service and the National Health Insurance Corporation as the evaluation agents did not cause such violation intentionally or negligently. We hope there will be more decisions which are closer to substantive truth through clear legal principles in respect of variously arisen issues in the future.
The purpose of this study is to check the extent to which "instruction of physician or dentist" defined in the Medical Service Technologists, etc. Act is applied in relation to radiography examination procedures for radiological technologists. In addition, it is intended to present basic data on the requirement to revise the Medical Service Technologists, etc. Act in the radiological technologist's duty area and scope of work, The subjects of this study were radiological technologists with license, and the response data were collected after sending the questionnaire link written on the online questionnaire form. The final number of respondents were 1,018, and the response rate was 6.8%. Most of the negative responses were "I have never received 'instruction' for radiologic examination by a physician or dentist, including a radiologist in a medical environment." There were a high perception that "the professionalism in radiation examination on radiological technologists are higher than that of a physician or dentist." They answered that the current continuing education has a great impact on maintaining and continuing professionalism and learning new knowledge in the radiology field. In addition, the radiological technologists provide a very high level of education in areas related to radiography procedure ethics such as patient care, patient safety, and patient privacy protection, as well as specialized fields such as radiation-related examination methods, radiography examination dose, and patient exposure dose. Radiological technologists replied that they were receiving it consistently. In conclusion, in the current medical environment, the 'instruction' of a physician or dentist cannot be seen as being realistically performed. The phrase 'instruction' of a physician or dentist as defined in the Medical Service Technologists, etc. Act is considered inappropriate in respect of the fact that the state recognizes the qualifications of the medical service technologist through a license. It is thought that revision to a new term suitable for the current medical environment is necessary.
Jeong, Hye Seung;Lee, Dong Pil;Yoo, Hyun Jung;Lee, Jung Sun
The Korean Society of Law and Medicine
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v.16
no.1
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pp.155-190
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2015
The court sentenced meaningful decisions related to the medical service in 2014. The court assumed the negligence of medical staff in the accident if being broken while using the medical equipment for not an original purpose at the time of surgery and ruled that the compensation for damage can be recognized in recognition of the causal relationship between the explanation duty violation and side effect's happening when unproven surgery on safety is implemented regarding the duty of explanation, that in the case of cosmetic surgery, the subject on the duty of explanation needs to be expanded compared to the general medical practice and that the duty of explanation cannot be accepted for the range that cannot be expectable. Also, the court has provided the requirement and limitation of self-determination exercise in case of the crash between patient's self-determination and doctor's duty of care and has ruled that as automobile insurance contract is a contract with the insurance company to pay regarding liability for car accidents, treating patients and taking the insurance money is not illegal activity even for the unlicensed hospital violating the medical law while established. The judgment stating the opinion that medical practitioners cannot be punished according to the medical law prohibiting the receiving of rebate in case that medical practitioners did not receive benefit while the medical institution itself gained an unfair economic benefit also stands out. And the court has ruled that even if the medical institution who received a business suspension is closed, the suspension is still effective in case that the same operator opens a new medical institution in the same place, ruled on the requirement to conduct a medical service outside of the medical institution that the doctor opened and ruled that the administrative penalty cannot be conducted prior to the conviction on charge of violating the medical law.
The rate that women's EMTs(emergency medical technicians) in fire department occupy is increasing, but my general plan is aimed at suggesting the improving plan for the working environment of women's EMTs paying attention to the duty stresses of increasing women's EMTs, because improvement for the working environment of women's EMTs is being proceeded slowly. I suggested my improving plan for solving the working stress on the basis of a survey of the Recognition against women's EMTs as follows. Firstly, I suggested that physical strength of women's EMTs should be managed well continually via program establishment and a defined evaluation not only by employing a professional person in charge for physical strength in firehouse, but also by replenishing the suitable number for the urgent mobilization. Secondly, I suggested that the suitable number for the urgent mobilization should be increased to 3 including an ambulance driver. Thirdly, I suggested necessity such as the fruitful education and the creation of circumstances that can focus on education for improving participation rate, development of various new educational program, incentive program and penalty. finally, I suggested the fact that is related to the actual re-amendment of the concerned law and ordinance such as not only the smooth treatment of penalty for a traffic signal violation of ambulance and the legal remedy system due to aggravation of a patient's condition during a first-aid course, but also workshop and meeting among the periodical EMTs and administration of special therapy program and sufficient recess.
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