• Title, Summary, Keyword: Nurse's medical accidents

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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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Perception on the Nursing Accident Experience of the Nurses and Its Cause (간호사(看護師)들의 간호사고(看護事故) 경험(經驗)과 사고원인(事故原因)에 관한 지각(知覺))

  • Lee, Soon-Bok;Moon, Heui-Ja
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.2
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    • pp.246-267
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    • 1995
  • Recently the request of the patients to participate in the medical courses has been expanding due to the elevated sense of right on the people's health, merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the patients have been in the thought of solving such accidents only by regulation of the laws which they think to be all powerful, Such trends are same in the area of nursing service. Also today the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurse has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accident. The following is the conclusion based by the above examination. 1) The experience degree of the whole nursing accidents has been appeared as 1.90 in average. And the degree according to service area has been 1.77 in the area of supervising management of patients, 1.54 in the area of the same management of patients by head-nurses, 1.84 in the area of doctors' treatment performances, 14 in the enforcement and education areas of the nursing technology, 2.04 in the area of observing patients and judgement and 2.07 in the area of nursing records and maintaining confidentials. Accordingly there has been higher degree of accidental experiences in the independent service areas of the patients than in the dependent ones directed by the doctors. 2) The perception of the nurses showed that the cause of the nursing accident has been due to the heavy work of the nurses with the 60.4% of the response rate, the highest rate. They report the accident to the head nurse first by 2/3 nurses after accident. And the hour of the accident has been frequently happened regardless of service hours with 48.1% in response rate, the highest rate, and the nursing accident happens in the night more than the daytime with the rate of 37.5% at night while 14. 4% daytime. 3) The nurses are in the perception that the patients are responsible for the accident with 48.2% response rate while 43.9% rate in response showed that it has been caused by many people. They are in the perception that 41.7% when the nursing power was lacking, 46.7% lower recognition of actual state about indivitual patient in the section of technical speciality and 35.8% when the patients were not cooperative and 37.8% when the wards were dirty and in disorder. 4) the attitude of the patients after the various nursing accidents has been violent words in 72.7%, violence in 17.4% and 3.9% in attending the court by the sue of the patient's side(18 nurses). 5) The action of the hospital has been : requesting the submission of the story of the accident in 22.8%, the report of the accidents in 14.4%, thus the written statement disposal was most, 4.5% was the transfer to the other departments when the accident was larger or the patients' guardians protested strongly and 0.6% of the dismissals of the nurses. 6) In regard to the responsiblity of the nurse accidents, 78.9% was the highest rate of supplying the nursing manpowers, 48.4% of mutual cooperation of the medical personnels, 37.2% of strengthening the education for the nurses and hospital facilities reformation in 32.7%. 7) The review of relation between the general characters of the object of the study and the degree of experience of nursing accidents showed the significant differences in ages (F=4.04, p=0.000).

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A Study of Nurses' Knowledge, Attitude on the Nurses' Law and Nurses' Perception on the Causes, Coping Patterns with the Nursing Accidents (간호사의 간호관련법에 대한 지식$\cdot$태도 및 간호사고에 대한 원인$\cdot$대처양상에 관한 연구)

  • Mun Heui Ja;Lee Mi Aie
    • Journal of Korean Public Health Nursing
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    • v.13 no.1
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    • pp.41-62
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    • 1999
  • Recently the request of the patients to participate in the medical courses has been expanding due to elevated sense of right on the people's health. merchandised medical treatment by mass supply, human right declaration of the patients, generalized medical informations by the mass media and the change of human relation between the medical personnels and the patients. Under these phenomena the accident by the nurses have been increasing by the area of the nurses having been expanded and their independent roles having been increased. Such nursing accidents are the important subject which the professional occupation of the nurses has been facing but legal protective capability of the nurses has been very weak. Therefore this study has examined the degree of the experience of the nursing accident that happens in the clinical nursing scenes in the general hospital to provide the basic materials for the protection and the counter measures of the nursing accidents. The following is the conclusion based by the above examination. 1) The general characters of the subjects of this study is that they are mostly single in their twenties and graduate from nursing college. Their total clinical career is above 5 years$(44.8\%)$ and their current clinical parts' career is between 1-3 years$(40.1\%)$. So these facts suggest that most hospitals has taken the working rotation policy on nurses. 2) The level of nurses' knowledge on the nursing law is accurate partially but isn't it patially. So it is suggested that nurses need the accurate information and education about the nursing law. But the nurses' attitude is very approved of the establishment of a unilateral nursing law. 3) The relation between the demographic characters of the subjects and their attitudes on the nursing law shows that there is no significant differences except the relation between the attitude 6(the sufficient level of education on nursing law in formal education course) and age. total clinical career. 4) The perception of the nurses shows that the cause of the nursing accident has been due to the heavy work$(78.2\%)$. short of professional knowledge and skill$(60.2\%)$, discordance with Doctors. patients and patients' families. They report the accident to the head nurse first$(81.8\%)$ and within 30 minute$(75.1\%)$. The hour of nursing accident frequently happened is regardless of service hour with $49.4\%$ in response rate. the highest rate. and the nursing accident happens in the night more than the daytime. Even though most nurses think that they are themselves responsible for nursing accident. it is found that the chief cause of the nursing accident is due to the nurses' heavy work$(78.2\%)$. So the causes of nursing accidents is analysed. it may be suggested that the endeavor of hospital and nursing organizations to decrease nursing accidents is very important. 5) The coping patterns of patients with nursing accidents are mostly active attitude such as a violent words$(69\%)$. sue or accusation$(36.4\%)$, monetary compensation $(35.6\%)$ except a understanding cases$(38.7\%)$. But the coping patterns of hospitals with nursing accidents are mostly to investigate the accurate cause.

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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.

Reduction of Fall Incidence through Operation of the Staff Nurse-Centered Peer Review Group (낙상 peer review group 운영을 통한 낙상발생률 감소)

  • Sung, Il Soon;Song, Mi Ra;Kim, Hee Sun;Kim, Eun Sook;Jung, Mi A;Lee, Su Mi;Sung, Young Hee;Ha, Kook Hee;Kim, Seong Hwa;Lee, Hye Ran;An, Kyoung Jin;Shim, Mi Ok;Kim, Nag Hee;Sung, Young Hee
    • Quality Improvement in Health Care
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    • v.14 no.1
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    • pp.49-54
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    • 2008
  • Background : This study was to reduce incidence of falls by analyzing actual problem and drawing out improvement plan applicable to the clinical practice through operation of the staff nurses-centered fall peer review group. Method : The fall peer review group was composed of 8 nurses having patient nursing experience for over 5 years, and each of fall cases was reviewed and the root cause was analyzed. As a result, it was found that the patients and their families did not fully understandthe content of the education, and the staff nurses did not completely inspect the risk factors of falls and perform immediate intervention when patient's condition changed. Based on the above-mentioned results, improvement activity was conducted for the purposes of consolidating patients education method and supplementing computerized system to support nurses' decision making as well as devices and facilities. Result : As a result of conducting improvement activity in the aspects of education for patients, support of nurse's decision-making, and devices and facilities through operation of the staff nurses-centered fall peer review group, falls decreased by 9.5% compared to before improvement activity. Conclusion : It is concluded that operation of the clinical nurses-centered fall peer review group played a role of promoter to draw out practical and applicable improvement plan to the clinical practice and apply directions of the field-centered, and increased nurses' interest in falls and ultimately, reduced incidence of falls. Therefore the Center will continue to operate the staff nurses-centered peer review group, and recommends participation of nurses who actually take the charge of nursing patients in further analysis of patients' safety accidents.

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A Study of Nurse Legal Obligation and Responsibility Related to their work (간호업무와 관련한 법적 의무 및 책임에 대한 조사 연구)

  • Yang, Kyung-Hee;Hwang, Jong-Hoon;Kim, Young-Hee
    • Journal of Korean Academy of Community Health Nursing
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    • v.9 no.2
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    • pp.303-312
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    • 1998
  • The purpose of this study was to survey the knowledge level, attitude and practice of nurses toward their work. The subjects of the study were composed of 98 nurses from 3 general hospitals, 1 oriental medical hospital, 2 health centers and several community health posts and schools. Data were collected from May to October, 1998. In data analysis, an SPSS PC program was utilized for descriptions. 1) 16 nurses (16.3%) experienced medical accidents on the 7 nurses(7.1%) 1 time, 6 nurses (6.1%) 2 times, and 3 nurses(3.1%) 3 times. 2) Concerning knowledge of their legal obligations ; the prohibition of telling secrets was .89, the prohibition of reading medical records was .58, the keeping of medical records was 1.0 and the teaching of recuperation was. 79. The total mean score was. 86. Concerning attitude and practice; the prohibition of telling secrets was 81.6%, 63.3%. The prohibition of reading medical records was 61.2%, 60.2%. The keeping of medical records was 98%, 98%. The explanation for treatment, care and test was 91.8%, 66.3%. The teaching for recuperation was 63.3%, 63.3%. 3) Knowledge of their legal responsibilities; 29. 6% of the subjects thought that they should report a medical accident to their headnurse, but 75.5% of the subjects actually reported to the headnurse. 39.8% of the subjects thought that nurses were liable for the faults of nursing aides. The total mean score was .45. 46% of the subjects asked a senior staff's advide on difficult affairs. Nurses obeyed legal obligations when concern ing the protection of a client, but were passive when concerning self protection. Also, headnurses were required as adviser, guide and advocate.

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An Exploratory Study about the Importance of Selected Nursing Activities during the Puerperal Period, as Viewed by Women in the Puerperal Period and by Nurses Caring for Them (산모와 간호원이 본 선택된 산욕기 간호활동의 중요도에 관한 탐색적 연구)

  • 박주봉
    • Journal of Korean Academy of Nursing
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    • v.8 no.1
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    • pp.152-162
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    • 1978
  • The desire to maintain health is increasing, consequently the role of nursing which has as one chief aim the solving of man′s basic problems is more and more important. Today, in spite of a growing concern about the nursing activities which nurses provide for individual human having specific needs, clinically in fact, it is questionable that individual′s expectation of nursing activities agrees with nurse′s performance of nursing activities. In this study the importance and agreement of the importance of the nursing activities during the hospitalized puerperal period as viewed by women in the puerperal period and by nurses caring for them, were assessed. The present study was undertaken in an attempt to furnish the basic data for expediting the progress of research activities in this area and further to be helpful in planning maternity nursing practice. The study population defined and selected was nurses (13) caring for women in the puerperal period and doing duty on obstetric & gynecologic ward at Y. hospital, and the women in puerperal period (39) as sum of 3 women selected by each nurse during the period of May 13th-June 4th 1976. The study data was collected by the direct interview method based on the questionnaire which the investigator made out. The study result was analyzed by percentage, t - test. The findings can be summarized as follows: 1. General characteristics of nurses doing duty on puerperal ward: a. Nurses′average age was 24.8 years old. b. 84.6% had educational background of 4 years of college. c. 69.2% had a religion. d. 53.8% were married. e. 53.8% had clinical experience of 1 year -3 years. f, 61.5% did duty on puerperal ward during 1 year -3 years. g. 46.2% desired to do duty on obstetric ? gynecologic ward. 2. General characteristics of the women who were studied during their puerperal period: a. Women′s average age was 26.4 years old. b. 79.5% had educational background above high school. c. 56.4% had a religion. d. 84.6% had living standard above medium. e. 89.7% had no occupation. f, 53,8% had previous hospitalization experience. g. 56.4% had previous delivery experience. 3. Examining the importance of 39 nursing activities during puerperal period selected by investigator, studied group of women considered that the most important nursing activity was "Record precisely about condition, medical treatment and nursing activity results etc". Nurses considered that the most important nursing activity was "Notice whether having pain and care for that". Both groups considered that the least important nursing activity was "Talk with her about topics such as news, hobbies, other interests". 4. Examining the importance of nursing activities in 4 specific categories, studied group of women considered that the most important nursing activity in physical nursing category was "Be sure of safety measure to prevent accidents, injuries", and nurses considered that the most important nursing activity was "Make her sleep and rest sufficiently". Studied group of women considered that the most important nursing activity in psychological category was "Explain about medical treatment and nursing activity ahead of time so she knows what to expect" , and nurses considered that the most important nursing activity was "Explain about puerperal period so she understands". Studied group of women considered that the most important nursing activity in relation to medical care was "Record precisely about condition, medical treatment and nursing activity results etc.", and nurses considered that the most important nursing activity was "Observing, cleaning and protecting the perineum" Studied group of women considered that the most important nursing activity in nursing category in preparation for discharge was "Instruct about personnel hygiene during puerperal period", and nurses considered that the most important nursing activity was "Instruct self-care to protect the perineum". 5. The analysis of this study showed a significant amount of disagreement computed by subtracting the nurse′s score from the patient′s score. Studied group of women put greater importance on physical nursing category, psychological nursing category, nursing in relation to medical care, than the nurses. These results were statistically significant at 0.01 level.

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The study of Needs and Demands for First Aid Education of School Health Educator (보건교사의 응급처치 교육 필요도 및 교육 요구도에 관한 연구)

  • Choi, Uk-Jin;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.1
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    • pp.27-41
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    • 2008
  • Purpose : With increasing number of school accidents, it is crucial to find out necessity of first aid training among school health educator. This study has been conducted to have an clear idea on the demands and necessity for first aid training and what kind of training is most required from school health educator. Method : In this study, questionnaires from 87 school health educator in elementary, middle and high school health educator in the city D were analyzed. The survey was carned out from May 26, 2008 to June 7, 2008 and from the collected data, frequency, independent two samples t-test, paired T-test, one way ANOVA and pearson's correlation were conducted with SPSS 14.0. Result: 1. 51.61 % of nurse-teachers experienced emergency situations and the relations between the necessity they felt from experiencing those situations and demands for first aid training were not statistically meaningful(t=1.87, p= .175). 2. Necessity and demands for the first-aid training were checked with three point scale and there were statistical significance between the two with $2.44{\pm}.47$ and $2.24{\pm}.47$ respectively(t=3.275, p= .000). 3. 86.20%(75 persons) of the respondents have had received first aid training and the training they received were CPR 82.75%(72 persons), primary survey 81.60%(7l persons), contact to 911 79.30%(69 persons) and wounds treatment(lacerated wounds, bum and chilblains) 75.86%( 66 persons) in order. 4. As for the questions that ask on confidence of first-aid treatment, 80% answered they are confident on some limited kinds of treatments, 16% said they are confident and 4% answered they lack confidence. As for the treatment that they can show the highest confidence, wounds treatment topped the list with 93.24%, nose bleeding and removing foreign substance, and stanching followed the list with 82.43% and 81.08% respectively. 5. 97.67% of respondents said they were willing to take training and 89.62% answered to take the training to deal with emergency situations that are taking place in their schools. As for the question that asks for the most wanted treatments, CPR topped the list with 32.18%(28 persons) and treatment for obstruction of airway and shock followed the list with 35.63%(31 persons) and 27.59%(24 persons). Conclusion : Currently, first aid treatment has been centered on CPR, primary survey, contact to 119 and wounds treatment. However, since most of school health educator are fairly confident with wounds treatment, stanching and other first aids, in future training it will be more desirable to focus on CPR and treatment for obstruction of airway and shock that were shown to be most wanted by school health educator.

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The Hospital Life of the Patient with Femoral Neck Fracture (대퇴경부 골절 환자의 입원 생활)

  • Kim, Kyung-Ja;Chi, Sung-Ai
    • Journal of Korean Academy of Nursing Administration
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    • v.2 no.1
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    • pp.35-56
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    • 1996
  • Nowerdays, the increase of traffic accidents and old age population make the Femoral Neck Fracture(FNF) patients increase. By the improvement of education and standard of living the patients demand better medical service than before. This study is designed to give practical help for the FNF patients by observing their hospital life and establish practical nursing strategies for the FNF patients. For these purposes the Ethnographic Participant Observation was adopted. By this study is focused on the hospital life patient's view. For this end, the field study adopted orthopedic ward in the C University Hospital with 400 beds in Seoul. The object patients of the study were twelve patients. The patients experienced five stages : Embarrassment, Conflict, Stability, Independent, and Extension Stage. The findings and prepared nursing strategies are stated as follows. First, in the Embarrassment Stage they suffered embarrassment, anxiety, pain, they could not do ordinary things. The patients who accidental fractures had anxiety from unfamiliar tests and from hospitalization itself. They lamented that they could not ordinary things, and do nothing but obeying the hospital, and endure the pain. They recognized the changed environment and resigned themselves to life in the ward. In this stage, full openness by the nurses is needed. Second, the attribute of the Conflict Stage were conflict, fear, curiosity, belief, reflection. When they sign the consentment form, they experience conflicts about the possibility of complication, fear of recovery from anesthesia, curiosity about the operation procedure, post - operation state, reflection on their past life, and promise to care for their family members after discharge and keep their religious life faithfully. And they accepted the operation depending on God, believing in modern medicine, and the surgeon. Asking for their changed informations, they expected positive results from the operation. In this stage, an empathic attitude by the nurses is needed. Third, the attribute of the Stability Stage were relief, gratitude, difficulty with excretion, and pain. When they awoke from anesthesia, they felt relief because of a the end of the operation, but they experienced extreme pain, difficulty of excretion in bed. They accepted the changed environment and expected recovery. In this stage, support by the nurses is needed. Fourth, the attributes of the Independence Stage were freedom, exercise, nurturing, anxiety, and discomfort. When they ambulated and exercised, they experienced freedom. They showed exhibited weakness of the digestive organs and discomfort hospital's space, structure, and facilities, the delay of medical certificate issue the lack of prompt response by the medical agents. They ate nurturious food and felt anxiety on the end of hospital life and returning to their ordinary life. They showed the independence of overcoming their environment by increasing exercise and expected their discharges. In this stage, respect by the nurses is needed for the patients to, overcome their environment and prepare for their independence. Fifth, the attributes of the Extension Stage were pessimism, isolation, dissatisfaction, and pain. Accompanied injury and old age made their ward life extend to over seven weeks. They exhibited weariness, melancholy, skeptisis, general pessimistic feeling, and desperation caused by their isolated life. They experienced the digestive discomfort caused by the prolonged medication and psycological pain caused by long-time hospitalization. As a, result, their dissatisfaction on the human, physical, and systematic environments had been increased. They acquired critical power and sought for something to do spending their time. They expected vaguely about the returning of their ordinary life. In this stage, counseling is needed by the nurse to overcome positively their psychological, social, and physical problems. The process of the FNF patient's ward life starts from the dependent state, when they are hospitalized, and gradually progresses to self-fulfillment in order to keep independent life. As a result, the FNF patients showed "Response in Challenge" or "Adaptation in Conflict" through their experiences of social, physical, and psychological difficulties.

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