• Title/Summary/Keyword: the Duty of care

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Consumer Attitude towards Physicians' Duty to Provide Information and Patient' Self-determination Options and Related Variables (의사의 설명의무와 환자의 자기결정권에 대한 소비자태도에 관한 연구)

  • 서정희
    • Journal of the Korean Home Economics Association
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    • v.30 no.3
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    • pp.193-204
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    • 1992
  • The purpose of this article is (1) to measure the attitudes of health care consumers towards medical service, the physicians' duty to provide information and patient self-determination options, (2) to discover the their related variables. The attitude of health care consumers towards medical service reveals statistically significant corelation with age and education. Among the statistically significant independent variables it is significantly related with age in the multiple regression analysis. The attitude of health care consumers towards the physicians' duty to provide information reveals statistically significant corelation with age, education and the attitude of health care consumers towards medical service. Among these independent variables it is significantly related with the attitude of health care consumers towards medical service in the multiple regression analysis. The attitude of health care consumers towards patients' self-determination options reveals statistically significant corelation with age, the attitude of health care consumers towards medical service and the attitude of health care consumers towards the physicians' duty to provide information. Among these independent variables it is significantly related with the attitude of health care consumers towards the physicians' duty to provide information in the multiple regression analysis.

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Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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The Study on Job Satisfaction of Care Helpers (요양보호사의 직무만족도에 관한 연구)

  • Yoo, Kwang-Soo
    • Journal of Korean Public Health Nursing
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    • v.26 no.2
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    • pp.341-353
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    • 2012
  • Purpose: The purpose of this study was to evaluate Job Satisfaction of Care Helpers. Method: Subjects included 306 Care Helpers. working at geriatric care facilities; these data were collected from May 4 to May 15, 2012. The SPSS WIN 12.0 program was used for statistical analysis of collected data, including actual number, percentage, average, standard deviation, t-test, one way ANOVA, and Cronbach alpha coefficient. Results: 1. The average Job satisfaction was 3.76 and the average of each job satisfaction was the task (3.83), co-worker (2.23), and job turn over (2.25). 2. The satisfaction of the job itself, depending on back ground, had a significantly effect on age, protective person for a day, duty pattern, contract pattern, and motive. 3. The job satisfaction of human relationships, depending on their back ground, had a significant effect on degree, care-giving experience, duty place, protective person for a day, duty pattern, contract pattern, and duty motive. 4. The Job satisfaction of job turn over, depending on back ground had an. effect on job satisfaction statistically: age, degree, duty place, protective person for a day, duty pattern, and motive. Conclusion: These results found showed to contribute to job satisfaction of care helpers.

Job Analysis of Medical Care Client Managers based on DACUM (데이컴 (DACUM)기법을 이용한 의료급여관리사의 직무분석)

  • Choi, Jeong-Myung
    • Korean Journal of Occupational Health Nursing
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    • v.20 no.3
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    • pp.299-307
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    • 2011
  • Purpose: The purpose of this study is to establish the standards for duty of Medical Care Client Managers and analyze the extent of accomplishment, importance, and difficulty according to the standards. Methods: The draft for duty of Medical Care Client Managers was formed by the method of developing a curriculum (DACUM) and data were collected from 185 Medical Aid Client Managers in 234 areas to evaluate the actual frequency of accomplishment, importance and difficulty in comparison with the standards for duties. Results: The standard duty draft for Medical Care Client Manager is composed of five separate groups of duties and thirty five tasks. The five duties are Case Management, Extension Approval, External Cause of Injury, Duplicate Claims and Other Administrations. Seven Tasks are allocated to each duty such as Case Management, Extension Approval and External Cause of Injury. Five tasks are allocated to 'Duplicate Claims' duty and nine tasks are allocated to 'Other Administrations' duty. Conclusion: From the results of analysis for duties, it was apprehensive about overburdened responsibilities and carelessness in professional duties. It was necessary to establish specific guidelines for duties because of redundent application or regional variation in frequency of accomplishing other administrative duties. It was necessary to relieve a regional disparity of business charge and also was necessary to propose an alternative plan to relieve the overburdened responsibilities.

The New Understanding of Korean Medicine Practice in Korean Medicine Doctor's Medical Devices Using and Duty of Care (한의사의 의료기기 사용과 주의의무에 있어서 한방의료행위의 새로운 이해)

  • Park, Yong-Sin
    • Journal of Society of Preventive Korean Medicine
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    • v.23 no.2
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    • pp.117-127
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    • 2019
  • Objectives : Korean medicine practice is not specifically described in medical law, and then has always been a quarrel. So far The criteria for judgment in Korean Medicine Doctor's Medical Devices Using should clinically prove it only by Korean medicine theory and academic Traditionally descending from old ancestors. Comprehensively review of Korean Medicine Doctor's Medical Devices Using and Duty of Care, and then present a new understandings to determine future Korean Medicine Practice. Method : An existing court cases of Korean Medicine Doctor's Medical Devices Using and Duty of Care were reviewed. After reviewing various papers published for several years, various opinions were reviewed and suggested. Results : The range of Korean Medicine Doctor's Medical Devices Using has changed since the 1951 National Medical Law stipulated Korean medicine as medical professionals. The issue of the recent ruling that distinguishes medical practice from Korean medicine practice were condensed into what emphasis to interpret amongst 1) The basic principles of learning, 2) Curriculum and professionalism, 3) Risks. The Constitutional Court's ruling was important in order of 'Risk', 'curriculum and expertise', and 'basic principles of learning.' A duty of Care means an obligation to pay attention to something. A duty of Care does not mean a "highest level," but requires a "best care" and does "best under given conditions." Even in the duty of Care, Because Korean medicine has a purpose to protect and promote the health of the people, Some standards of western medicine have to be adapted to the current general medical technology. Korean Medicine doctors can recognize the duty of care in the "some basic range" of knowledge belonging to western medicine. Conclusions : The interpretation of Korean Medicine practice are currently in compatible the argument that should clearly divide Korean medicine from Western medicine, and that should be changed in light of the changing medical environment. Therefore If Korean medicine's standard is applied to the extent to which Korean Medicine doctors are educated, it is necessary to define a new definition to actively interpret Korean Medical practice. The academic basis of Korean medicine and the level of Korean medicine practice based on the books that are traditionally available, and then current textbooks of Korean Medicine College, Korean Medicine Clinical Care Guidelines, and classification of Korean standard medical practices should be standardized. Increasingly, Korean Medicine practice should be interpreted according to reality, focusing on protecting and promoting the health of the people rather than academic differences.

Liability for Damage due to Doctors' Unfaithful Medical Practice (의사의 불성실한 진료행위로 인한 손해배상책임)

  • Jeon, Byeon-Nam
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.317-343
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    • 2014
  • In order to account for whether a doctor should indemnify damages resulted from violation of duty of care, the fact that a doctor violated duty of care, that damages were incurred, and the link between violation of duty of care and damages incurred, respectively, should be verified. So even though a doctor violated duty of care to patients, he or she will not bear the responsibility to indemnify damages unless it is not verified. If a doctor's negligence in medical practices is assessed that obviously unfaithful medical practice far exceeds the limit of admission of a patient, it will not go against people's general perception of justice or law and order to constitute a medical malpractice itself as an illegal action that will require liabiliy for damage. However, when the limit of admission is set too low, a patient's benefit and expectation of proper medical treatment can be violated. In contrast, if the limit of admission is set high, it can leave too little room for doctors' discretion for treatments due to a bigger risk of indemnification for damages. Thus, a reasonable balance that can satisfy both benefit and expectation of patients and doctors' right to treatment is needed.

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Calculation of nursing care hours in a pediatric oncology nursing unit (일개 대학병원의 소아혈액종양 간호단위의 간호업무량 측정)

  • Kim, Young-Mee
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.3
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    • pp.513-524
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    • 1999
  • The shortage of nursing personnel was become one of the most serious problems in operating pediatric oncology nursing unit which was the first pediatric oncology nursing unit in Korea. The purpose of this study was to estimate the optimal number of nursing personnel by calculating nursing care hours. The subjects were 13 staff nurses and inpatients of pediatric oncology nursing unit at Seoul National University Hospital during the period of May 20, 1996, to June 2, 1996. The number of nurses' duty was 132, the number of patients treated was 1288 for these 2 weeks. The tools used for this study were pediatric patient classification indexes and direct & indirect care indexes. Each nurse measured the time that they spent for their activities by self record under the supervision of their nurse manager. The method used to calculate the number of nursing personnel was multiplication of the average number of nursing care hours per patient per day with the number of patients. Percentage, average, t-test, F-test were used for data analysis. The results of this study were as follows : 1) The distribution of patient class : Class I & II none, Class III 86.8%. Class IV 12.9% 2) Direct nursing care hours for a patient per shift according to patient classification: Class III : 27.64 minutes, Class IV : 54.64 minutes The average direct nursing service hours for a patient per shift(3 shift) was 31.54 minutes(94.62 m/day). The average indirect nursing service hours for each patient per duty(3 shift) is 21.3 minutes (63. 91 m/day). 3) The average nursing hours for a patient per duty was 52.80 minutes(2.64h/day). 4) The group of administering medications in direct care activities showed the highest percentage (38.9%). Checking vital signs among observation took the most time am.ong each direct care activity (6.88 minutes for a patient per duty). 5) Charting took the most time of each indirect care activity(52.53 minutes/ duty/nurse). 6) The average personal time per duty is 29.40 minutes, which 'was below 30 minutes of this hospital regulations. 7) The average nursing hours that a nurse provided for a duty was 8.60 hours, which meant that a nurse worked 1.10 hours overtime. 8) Standardizing to a 33 bed to a unit, 17 nurses were needed at the present nursing level.

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Needs for the employer-supported day care service of the married man and women workers (기혼취업남녀의 직장보육시설에 대한 요구)

  • 곽인숙;홍성희
    • Journal of the Korean Home Economics Association
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    • v.38 no.1
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    • pp.171-183
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    • 2000
  • The purposes of this study were to identify the needs for the employer-supported day care service and to analyze the factors related to the needs for the day care service of the married employees. KLFI(1995)'s National data were used and three Logistic models and one Catmod model were employed to analyse the effects of the independent variables on the needs for the day care service. The results of this study were as follows: First, half of employed workers needed the employer-supported child care service. Second, they preferred the day care center near their residential area than in their work site. Third, according to their age, type of occupation, and their difficulties for the childcare and household work, employed men and women needs on site day care differently. Finally, their needs for the expenditure of duty care service differed by their age, sex, and occupation, and their levels of difficulties for the childcare and household work. These findings suggest that duty care service for the employed man and woman are supported diversely according to their needs and preferences.

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The Utilization of Medical Care Benefits of School Personnel on Duty (교직원의 공무상 요양급여제도 이용 현황)

  • Lee, Hee-Woo;Shin, Sun-Mi;Kim, Joo-Ja;Kang, Se-Won
    • Journal of the Korean Society of School Health
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    • v.21 no.2
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    • pp.107-117
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    • 2008
  • Purpose: To investigate the utilization of medical care benefits of school personnel on duty in Seoul. Method: The subjects were 551 workers under Seoul Metropolitan Office of Education(male 301, female 250) who got medical care benefits from March 2000 to February 2005. To analyze the data, frequency, chi-square test, and t-test by SAS package 9.12 were used. Result: The results show that elementary school personnel got the highest ranking, 314(57.0%). Among subjects, 57.2% personnel got accident when they were working on their own duty, 21% during school events and 13.5% were during commutes. They got medical care from orthopedics 75.9%, neurosurgery 7.6%, dental 4%, and 8 male and 2 female died during these days. The most frequent diseases of males and female were fracture and joints related disease. The reason of most health problem was due to injury(92.3%). Conclusion: The results of this study suggest that the continuous health care services like regular health check for school personnel, or social safety network to prevent injury are needed.