• Title, Summary, Keyword: 간호사의 의료사고

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Development and effect of Simulation-based Educational Program for Communication to Prevent Patients from Safety Accident by Nurses working in the Public Medical Institutions (공공의료기관 간호사의 환자안전사고 대처를 위한 시뮬레이션 기반 의사소통 교육프로그램 개발 및 효과)

  • Mok, Seung Hyun;Kim, Sung Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.21 no.10
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    • pp.115-126
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    • 2020
  • This study focused on the development of a simulation-based educational program for communication, targeted to prevent safety accidents of patients. Application of the program to nurses working in public medical institutions was assessed to identify the effects of the program in terms of communication skill, self-efficacy, critical thinking disposition, and problem solving ability of nurses, before and after completion of the education. Method: A total of 32 nurses, working in hospitals designated as public medical institutions, were selected as subject participants in the present study. Data were collected during the period August 19 to 20, 2019, and analyzed by SPSS 23.0. Results: Results obtained from the present study reveals significant efficacy of the educational program, in respect of improved communication skill, self-efficacy, and problem-solving ability. On completion of the educational program, we observed an increase in the critical thinking disposition of nurses, although it was statistically insignificant. Conclusions: We believe that the educational program developed in the present study can be exploited as a foundation for developing other programs intending to improve the communication skill of nurses employed in clinics of public medical institutions, targeted to prevent occurrence of safety accidents of patients.

A Study on the Nurse's Medical Malpractice Liability (간호사의 의료과오 책임에 관한 연구)

  • Jang, Mi-Hee
    • The Korean Society of Law and Medicine
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    • v.15 no.2
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    • pp.195-223
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    • 2014
  • Nurses are medical care providers most closely associated with the national health. Their works are subdivided and specialized, and it is such a factor making nurse's role more important, and with the appearance of specialized nurses, they have secured a position as an independent medical care provider. As the domain of nurse's service becomes broader, there are more accidents and disputes related to nurses. However, there are not many studies conducted on such problems, and even when medical disputes take place related to nurses, the court does not make consistent judgments as a matter of fact. Besides, as the ambiguity of nurse's range of service and the lack of nursing workforce work as a factor causing nurse's medical malpractice, more legal discussions and studies are required to seek proper solutions to such problems. Thus, as a plan to clarify legal issues likely to occur due to nurse's medical practice, this study classified nurse's work into medical assistance practice and other jobs based on their own independent judgments, and proposed establishing concrete regulations on the range of their work, while reviewing common problems extracted from precedents related nurse's medical malpractice. Moreover, while examining Japanese precedents related to the Act of Medical Service Personnel, Nurses and Midwives, which is the sole act of nurses in Japan, this study reviewed the necessity of revising the present nurse-related regulations in Medical Service Act, or enacting a sole act of nurses.

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The influencing factor of Consciousness of Biomedical Ethics, Moral Sensitivity and Critical Thinking Disposition on the Code of Nurses Ethics of Nursing Student (간호학생의 생명의료윤리의식, 도덕적 민감성 및 비판적 사고성향이 간호사윤리강령 인식에 미치는 영향요인)

  • Jeong, Gye-Seon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.11
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    • pp.544-555
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    • 2017
  • This study was conducted to identify the factors influencing consciousness of biomedical ethics, moral sensitivity and critical thinking disposition with respect to the Code of Ethics of nurses among nursing students. A descriptive correlation research design was used for this study. The subjects were 299 nursing students in two large cities from 1 June to 31 July 2015. Collected data were analyzed using a t-test, ANOVA, Scheffe's test and stepwise multiple regression by the SPSS 22.0 program. The results revealed that female subjects comprised 86.65% of the subjects and the mean age was 21.67 years. Awareness of the Code of Ethics for nurses was positively correlated with the consciousness of biomedical ethics(p<0.001), moral sensitivity(p<0.001), and critical thinking disposition(p<0.001). However, there were negative correlations between grade(p=0.017), marital state(p=0.012), and the possibility of increasing ethical problems according to the development of bioscience(p=0.012). Significant influencing factors of the awareness of the Code of Ethics for nurses included grade(p=0.013), marital state(p=0.030), consciousness of biomedical ethics(p=0.017), moral sensitivity(p<0.001), and critical thinking disposition(p=0.001), with apower of explanation of 26.3%. The results of this study show that the consciousness of biomedical ethics, moral sensitivity and critical thinking disposition are factors influencing the code of ethics for nurses among nursing students.

Development of a Comprehensive Model of Disaster Management in Korea Based on the Result of Response to Sampung Building Collapse (1995), - Disaster Law, and 98 Disaster Preparedness Plan of Seoul City - (우리나라 사고예방과 재난관리 모형 개발을 위한 연구)

  • Lee, In-Sook
    • Journal of Korean Academy of Community Health Nursing
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    • v.11 no.1
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    • pp.289-316
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    • 2000
  • 우리나라의 경우 지역사회 재난 관리계획과 훈련이 보건의료적 모형이라기 보다는 민방위 모형에 입각하기 때문에 사고 현장에서의 환자 중증도 분류, 합리적 환자배분 및 이송, 병원 응급실에서의 대처 등이 체계적으로 이루어지지 못하고 있으며, 지역사회가 이에 즉각적으로 반응할 수 없다. 본 연구는 삼풍 붕괴사고 시에 대응방식과 그 후의 우리나라 응급의료 체계를 분석함으로써 대형사고 예방과 재난관리를 위한 우리나라 응급의료체계의 개선방안과 간호교육에서의 준비부분을 제시하고자 한다. 1 삼풍 사고 발생시에는 이를 관장할 만한 법적 근거인 인위적 재해에 관한 재난관리법이 없었다. 따라서 현장에서는 의학적 명령체계를 확보하지 못했기 때문에 현장에서의 응급 처치는 전혀 이루어지지 못하였다. 현장에서의 중증도 분류. 응급조치와 의뢰, 병원과 현장본부 그리고 구급차간의 통신 체계 두절, 환자 운송 중 의료지시를 받을 수 있도록 인력, 장비, 통신 체계가 준비되지 못하였던 점이 주요한 문제였다. 또한 병원 응급실에서는 재난 계획이 없거나 있었더라도 이를 활성화하여 병원의 운영 체계를 변환해가지 못하였다. 2. 삼풍백화점 붕괴사고 한달 후에는 인위적 재해에 대한 재난관리법이 제정되고, 행정부 수준별로 매년 지역요구에 합당한 재난관리 계획을 세우도록 법으로 규정하였다. 재난 관리법에는 보건의료 측면에서의 현장대응, 주민 참여, 응급 의료적 대처, 정보의 배된. 교육/훈련 등이 포함되어 있어야 한다. 그러나 법적 기반이 마련된 이후에도 한국 재난 계획 내에는 응급의료 측면의 대응 영역은 부처간 역할의 명시가 미흡하며, 현장에서의 응급 대응과정을 수행할 수 있는 운영 지침이 없이 명목상 언급으로 그치고 있기 때문에 계획을 활성화시켜 지역사회에서 운영하기는 어렵다. 즉 이 내용 속에는 사고의 확인 /공고, 응급 사고 지령, 요구 평가, 사상자의 중증도 분류와 안정화, 사상자 수집, 현장 처치 생명보존과 내과 외과적 응급처치가 수반된 이송, 사고 후 정신적 스트레스 관리, 사고의 총괄적 평가 부분에 대한 인력간 부처간 역할과 업무가 분명히 제시되어 있지 못하여, 사고 발생시 가장 중요한 연계적 업무 처리나 부문간 협조를 하기 어렵다. 의료 기관과 응급실/중환자실, 시민 안전을 책임지고 있는 기관들과의 상호 협력의 연계는 부족하다. 즉 현재의 재난 대비 계획 속에는 부처별 분명한 업무 분장, 재난 상황에 따른 시나리오적 대비 계획과 이를 훈련할 틀을 확보하고 있지 못하다. 3. 지방 정부 수준의 재난 계획서에는 재난 발생시 보건의료에 관한 사항 전반을 공공 보건소가 핵심적 역할을 하며 재난 관리에 대처해야 된다고 규정하고 있다. 그러므로 보건소는 지역사회 중심의 재난 관리 계획을 구성하고 이를 운영하며, 재난 현장에서의 응급 치료 대응 과정은 구조/ 구명을 책임지고 있는 공공기관인 소방서와 지역의 응급의료병원에게 위임한다. 즉 지역사회 재난 관리 계획이 보건소 주도하에 관내 병원과 관련기관(소방서. 경찰서)이 협동하여 만들고 업무를 명확히 분담하여 연계방안을 만든다. 이는 재난관리 대처에 성공여부를 결정하는 주요 요인이다. 4 대한 적십자사의 지역사회 주민에 대한 교육 프로그램은 연중 열리고 있다. 그러나 대부분의 교육주제는 건강증진 영역이며. 응급의료 관리는 전체 교육시간의 8%를 차지하며 이중 재난 준비를 위한 주민 교육 프로그램은 없다. 또한 특정 연령층이 모여있는 학교의 경우도 정규 보건교육 시간이 없기 때문에 생명구조나 응급처치를 체계적으로 배우고 연습할 기회가 없으면서 국민의 재난 준비의 기반확대가 되고 있지 못하다. 5. 병원은 재난 관리 위원회를 군성하여 병원의 진료권역 내에 있는 여러 자원을 감안한 포괄적인 재난관리계획을 세우고, 지역사회를 포함한 훈련을 해야 한다. 그러나 현재 병원은 명목상의 재난 관리 계획을 갖고 있을 뿐이다. 6. 재난관리 준비도를 평가할 때 병원응급실 치료 팀의 인력과 장비 등은 비교적 기준을 충족시키고 있었으나 병원의 재난 관리 계획은 전혀 훈련되고 있지 못하였다 그러므로 우리나라 재난 관리의 준비를 위해서는 현장의 응급의료체계, 재난 대응 계획, 이의 훈련을 통한 주민교육이 선행되어야만 개선될 수 있다. 즉 민방위 훈련 모델이 아닌 응급의료 서비스 모델에 입각한 장기적 노력과 재원의 투입이 필요하며, 지역사회를 중심으로 대응 준비와 이의 활성화 전략 개발, 훈련과 연습. 교육에 노력을 부여해야 한다. 7. 현장의 1차 응급처치자에 대해서는 법적으로 명시하고 있는 역할이 없다. 한국에서는 응급구조사 1급과 2급에 대한 교육과 규정을 1995년 이후 응급의료에 관한 법률에서 정하고 있다. 이 교육과정은 미국이 정하고 있는 응급구조사 과정 기준과 유사하지만 실습실이나 현장에서의 실습시간이 절대적으로 부족하다. 덧붙여 승인된 응급구조사 교육 기관의 강사는 강사로서의 자격기준을 충족할 뿐 아니라 실습강사는 대체적으로 1주일의 1/2은 응급 구조차를 탑승하여 현장 활동을 끊임없이 하고 있으며, 실습은 시나리오 유형으로 진행된다. 그러므로 우리나라의 경우 응급 구조사가 현장 기술 인력으로 역할 할 수 있도록 교과과정 내에서 실습을 강화 시켜야하며, 졸업생은 인턴쉽을 통한 현장 능력을 배양시키는 것이 필요하다. 8. 간호사의 경우 응급전문간호사의 자격을 부여받게 됨에 따라, 이를 위한 표준 교육 지침을 개발함으로써 병원 전 처치와 재난시 대응할 수 있는 역량을 보완해야 한다. 또한 현 자격 부여 프로그램 내용을 고려하여 정규자격 간호사가 현장 1차 치료자(first responder)로 역할 할 수 있도록 간호학 교과과정을 부분 보완해야한다.

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The Survey on the Influence of Clinical Nurse's Critical Thinking Disposition, Problem-solving Skill and Self-efficacy on Patients Safety Competencies (간호사의 비판적 사고성향, 문제해결능력 및 자기효능감이 환자안전역량에 미치는 영향)

  • Kim, Hyo-Sun;Han, Suk-Jung
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.6
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    • pp.598-608
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    • 2016
  • This study examined the relationships among patient safety competence, critical thinking disposition, problem-solving competence, and self-efficacy of clinical nurses to identify the factors influencing the patient safety competence. A convenience sample of 373 nurses working in 4 general hospitals in a Metropolitan area in Korea was selected. After obtaining IRB approval, data collection was done with a structured self-administered questionnaire from October 14th to November 4th, 2014. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple regression analysis using the SPSS WIN 21.0 program. The participants showed a moderate level of patient safety competence ($3.75{\pm}0.37$), of critical thinking disposition ($3.43{\pm}0.27$), of problem solving competence ($3.54{\pm}0.30$), and of self-efficacy ($3.58{\pm}0.47$). The patient safety competence of the participants showed a significant correlation with the critical thinking disposition (r=.493, p<.001), problem solving competence (r=.616, p<.001), and self-efficacy (r=.475, p<.001). The significant factors influencing the patient safety competence were problem solving competence (${\beta}=.403$, p<.001), self-efficacy (${\beta}=.156$, p=.005), critical thinking disposition (${\beta}=.130$, p=.018), and having the experience of reporting patient safety accidents (${\beta}=.137$, p=.002). The results suggest that educational programs to enhance the critical thinking disposition, problem-solving competence, and self-efficacy would develop the patient safety competence of clinical nurses. In addition, more effort should be placed into reinforcing the patient safety competence by activating the report of patient safety accidents.

Nurses' learning experiences from falling accidents on patient safety (환자안전에 관한 간호사의 경험학습: 낙상 사고를 중심으로)

  • Yoon, Seon-Hee;Kim, Kwang-Jum
    • Korea Journal of Hospital Management
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    • v.20 no.2
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    • pp.1-14
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    • 2015
  • Purpose : The aim of this article is to describe the nurses' experiential learning mechanism on patient safety. Methods : To analyze nurses' learning experiences on patient safety cases, a focus-group interview method was used. The Kolb's experiential learning model was used as a reference model. Findings : Without deep reflective reasoning about specific experiences, there is no creative or innovative solutions to experiment actively. Nurses are likely to be reluctant learners when there is no systemic support from formal departments which is in charge of patient safety and quality of care. Conclusion : In order to build patient safety culture in hospital, there should be efforts to make nurses as active learners on patient safety as well as to build learning environments in medical units.

Effects of Biomedical Ethics Education on Moral sensitivity, Critical thinking and Biomedical ethics Awareness of Nursing Students (생명의료 윤리교육이 간호학생의 도덕적 민감성, 비판적 사고성향, 생명의료 윤리의식에 미치는 효과)

  • Kim, Kyung-Ah;Jeong, Gye-Seon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.2
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    • pp.240-249
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    • 2019
  • The purpose of this study was to find the effect of systemic biomedical ethics education program on moral sensitivity, critical thinking disposition and consciousness of biomedical ethics nursing student. This study is a quasi-experimental research design and repeated measured ANOVA was used to analyzed the collected data statistically on this study. Data was collected from 1st September to 31 of December 2014. Nursing students and nurses in A and S cities participated in this study as subjects. 32 nursing students were assigned to an experimental group, and 33 nursing students were assigned to control group A, 26 nurses were assigned control group B, total subjects were 91. There are significant different in consciousness of biomedical ethics(F=3.432, p=.037). In the category of consciousness of biomedical ethics, there are significant different in 'right to life of fetus'(F=4.476, p=.014) and 'prenatal diagnosis of fetus'(F=6.207, p=.003), and 'right to life of newborn(F=6.207, p=.003) between experimental group and two control groups. The biomedical ethics education influenced the positive effect on moral sensitivity, critical thinking disposition and consciousness of biomedical ethics of nursing students, and shown the significant effect to enhance the consciousness of biomedical ethics for nursing students.

Development of Case-based Multimedia Learning Contents for Preventing Malpractice in Operating Room (수술실 간호오류 예방을 위한 사례중심 멀티미디어 학습콘텐츠 개발)

  • Park, Ji Myung;Hwang, Seon Young
    • The Journal of the Korea Contents Association
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    • v.16 no.10
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    • pp.522-532
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    • 2016
  • Purpose: This study was conducted to develop case-based self-learning multimedia contents for preventing malpractice that frequently occurred among nurses working in the operating room. Methods: Based on the learning needs of operating room nurses, real case reports, and literature reviews, the case-based multimedia learning contents were developed according to the instructional design procedure. The assessment of learning needs was performed by the combination of surveys using structured questionnaire and of interviews for 40 operating room nurses. Results: The learning contents included four learning modules with real malpractice cases from the areas of operating preparation, nursing skills during operation, environmental management of operating room, and patient safety and observation-related. The 80 minute long case-based multimedia learning contents were finally developed after content validity tests from clinical experts. Each module contained photos, sounds and flash animation with voice recording on the contents of nursing error cases and standardized protocols. Conclusion: The developed multimedia learning contents based on real error cases in this study can be utilized as an educational hands-on training materials for nurses to prevent malpractice in the operating room.

Awareness about Convergent Patient Safety Culture of Health Professional Working in Tertiary Hospital (상급 종합병원 종사자들의 융합형 환자안전 문화 인식)

  • Choi, Seon-Wook;Jeon, Min-Cheol
    • Journal of the Korea Convergence Society
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    • v.9 no.1
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    • pp.103-109
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    • 2018
  • This study was to measure the awareness of the patient safety culture of medical workers in various occupations working in hospitals and tried to be used as useful data. As a result of evaluating department (ward), hospital, immediate supervisor/manager, communication & procedures and frequency of accident reports, the patient safety accidents considered to be the most dangerous, technicians showed high results in the department(ward), nurses showed high results in the immediate supervisor/manager area. Radiological technologists and physical therapists recognized falls and clinical pathologists and nurses recognized before during after the test as the most dangerous patient safety accidents. To raise awareness of patient safety culture, executives and practitioners should create an atmosphere in which practitioners can prioritize patient safety, gain and manage appropriate personnel, manage cooperative systems between workers or departments.