• Title/Summary/Keyword: 분만실

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A Study on Imposing Contribution in the Compensation for Uncontrollable Medical Malpractice during Delivery (분만관련 불가항력적 의료사고 보상제도에 있어 분담금부과에 관한 연구 -헌법재판소 2018. 4. 26. 선고 2015헌가13 사건을 중심으로-)

  • Beom, Kyung Chul
    • The Korean Society of Law and Medicine
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    • v.19 no.2
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    • pp.139-171
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    • 2018
  • The 「Act on Remedies for Injuries from Medical Malpractice and Mediation of Medical Disputes」(hereinafter referred to as 'the Act on Mediation of Medical Disputes') provides that the state should compensate the victims of medical accidents occurred irresistibly in childbirth despite that health and medical service personnel fulfilled their duty of care for their damage within the range of its budget(Article 46 of the Act on Mediation of Medical Disputes). Given that victims of medical accidents could expect demage recovery only through lawsuits thus far, this act can be said to be a groundbreaking act. However, However, as 30% of the costs for such medical accident compensation projects are borne by those who have records of childbirth among the founders of health and medical institutions (Article 21 of the Act on Mediation of Medical Disputes), there has been a question about whether doctors are held responsible despite that the accidents such as the deaths of mothers and newborn babies occurred irresistibly without doctors' fault. However, recently, the Constitutional Court ruled that 'the range of founders of health and medical institutions' and 'share ratios of finances for compensation' in Article 46 (3) of the Act on Mediation of Medical Disputes' related to the imposition of the share of costs are institutional (Constitutional Court ruling dated April 26, 2018, 2015Heonga13, hereinafter referred to as 'the ruling in the case'). Although the ruling in the case was made based on only the principle of statutory reservation and the principle of ban on comprehensive authorization, this paper added a practical judgment. This paper proved that the share of costs in this case has the nature of burden charges in pursuit of study and does not infringe on the property rights of the founders of health medical institutions even in light of the principle of proportionality because there is a legitimate reason for imposing the burden charge. The imposition of the share of costs in the system for compensation for medical accidents occurred irresistibly is against the principle of liability with fault in part. However, the medical accident compensation projects are rational a national policy for the victims of medical accidents and the medical world clearly gains some benefits from the effect to terminate medical disputes. The expansion of finances for compensation through the payments of the share of costs will reduce the suffering and misunderstanding of victims of medical accidents occurred in the process of childbirth and will be very helpful to the construction of stable treatment environments of medical workers by quickly establishing the medical accident compensation projects as such.

The Research about Expected Hospital Management in Gynecology area based on the Medical Information Record of a University Hospital (일개 대학병원 의무기록정보 통계를 활용한 산부인과 병원경영 예측에 관한연구)

  • Kim, Kwang-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.10
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    • pp.2959-2965
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    • 2009
  • This research is based on the medical information record of a university hospital on analysis of outpatients, inpatients and delivery related information in gynecology area. The result of application having analysis of patients as basic material for hospital management is as follows. The number of new patients in average was 140.9, and as the year passes by, it seemed to decrease noticeably(p=0.000). In the first year (2001) the number was only 212.6, but increased to 140 by the year of 2007, showing increase of 80.9. The actual number of patients in the hospital was 124.6 in average and it showed noticeable decrease after each year (p=0.000), from 144.6 patients on the first year 2001, to 104.8 patients in 2007, showing approximately 40 patients decreased. Multiple regression analysis was performed having independent variables as characteristics of patients and cause of delivery related factors, and dependent variables as the number of patients in the hospital. According to analysis, the cause of affecting the number of patients in the hospital was selected as the number of new patients, the number of delivery per year. The reliability rate was recorded as 62.8%. Therefore, apart from the services on marketing and patient management which must come first, the effect of inviting them cannot be avoided, which directly links to trust resulting from the consideration to patients.

Prevalence Study of Mothers' Perception on Pregnancy, Childbirth, and Childcare: Comparison Between Years 2002 and 2007 (영아기 첫 자녀를 둔 어머니의 임신 및 출산, 양육 변인에 관한 연구: 2002년과 2007년 실태 비교를 중심으로)

  • Kim, Yang Eun;Cho, Bok Hee;Jung, Min Ja
    • Korean Journal of Childcare and Education
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    • v.3 no.2
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    • pp.68-85
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    • 2007
  • The purpose of this study is to investigate the changes of mothers' condition including the level of knowledge and parenting stress that mothers have on infant development. The subjects of this study are 270 mothers whose infants range in age from birth to 36 months. The instruments used are: 1)KCDI(Knowledge of Child Development Inventory, Larsen & Juhasz, 1985) 2)Parenting Stress Scale(Kim & Kang, 1997), and a demographic questionnaire. The data analyses use SPSS 12.0 which employs basic statistics, reliability test, and t-test. This study is time-lag design covering five years. Therefore, the data collected originates from 2002 and 2007 to constitute input from two times. The results of this study indicate that the average pregnancy from the 2007 statistics occurred 0.46 months earlier, after marriage, as compared to pregnancies in 2002. Mothers who gave birth by natural birth increased from 59.9 % to 75.3 % over the five year period. Regarding knowledge of infant development, the level of mothers' knowledge was lower in 2007 than in 2002 according to study results. The level of parenting stress of mothers increased for the 2007 statistics as compared to the 2002 survey.

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Carriage Rates of Methicillin-resistant Staphylococcus aureus in Neonates with Neonatal Jaundice (신생아황달 환아에서의 메티실린내성 황색포도알균 보균율에 관한 연구)

  • Na, Dong Cheon;Seo, Jae Min;Lee, Jung Hyun;Lee, Won Uk;Kim, Eun Ryoung
    • Pediatric Infection and Vaccine
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    • v.18 no.2
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    • pp.143-153
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    • 2011
  • Purpose : It is known that carriage rates of Staphylococcus aureus (S. aureus) are highest in newborns and that the asymptomatic carriage of methicillin-resistant Staphylococcus aureus (MRSA) is associated with invasive MRSA infection with the colonizing strain. This study was carried out to investigate the carriage rates of MRSA in neonates with neonatal jaundice. Methods : We reviewed the medical records of 545 neonates admitted with neonatal jaundice to neonatal intensive care units between January 2006 and December 2010. Nasal and inguinal swab specimens had been taken from them and cultured for the isolation of S. aureus. Antimicrobial susceptibility tests had been done for such isolates to determine methicillinresistance. Results : Out of 545 neonates, 318 (58.3%) were colonized with S. aureus and 214 (39.3%) were colonized with MRSA. Results of the antibiogram analysis showed that 65.7% of MRSA isolates were likely to be community-associated (CA) MRSA. Conclusion : Based on the MRSA carriage rate of 39.3%, a surveillance program for MRSA colonization is considered necessary in neonates transferred from other clinics or hospitals. Out of MRSA isolates, 65.7% were likely to be CA-MRSA. This suggests that CA-MRSA strains were already present in obstetric clinic environments where the neonates were born. It is thought that MRSA surveillance programs in these environments are also necessary.

Change of Body Weight and Hematologic Value with Aging in Hybrid Mice - Preliminary Study - (한국산 잡종쥐의 성장에 따른 체중 및 혈액상의 변화에 대한 연구)

  • Lee Sung Heon;Cho Kil Ho;Shin Sei One;Kim Myung Se
    • Radiation Oncology Journal
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    • v.3 no.2
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    • pp.169-174
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    • 1985
  • The mouse is one of the most popular experimental animal which has wide variation of strains, diet, environment, breeding technique, and diurnal cycle. Total 731 mice (male 372, female 359) were used for the standard data of our laboratory. Proper age for experiment were $30\pm3$days, body weight were $25\pm2gm (male)$, $23\pm1gm$. (female), minimal diurnal variation showed from 9A.M. to 12P.M.

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Development and effects of a labor nursing education program using a high-fidelity simulator for nursing students (간호대학생 대상의 고충실도 시뮬레이터를 이용한 분만 간호 교육 프로그램의 개발 및 효과)

  • Park, Seo-A;Kim, Hye Young
    • Women's Health Nursing
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    • v.26 no.3
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    • pp.240-249
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    • 2020
  • Purpose: This study was conducted to investigate the effects of an education program using a high-fidelity simulator of labor and delivery on nursing knowledge, critical thinking, and clinical performance among nursing students who had not yet experienced clinical practicum. Methods: The development of a 5-week maternity nursing education programs using high-fidelity simulators included modules containing case-oriented scenarios, knowledge, and skills required for maternity care. A randomized controlled study was conducted to verify the effects of the developed program. Data were collected from October 21 to December 9, 2019. The experimental group (n=36) participated in a 5-week high-fidelity simulation program on care for the woman in labor, whereas the control group (n=36) received standard education as lecture and practice with delivery model. The collected data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation), the Chi-square test, Fisher exact test, and t-test. Results: For participants who received education using the high-fidelity simulation program, nursing knowledge (t=2.33, p=.011), critical thinking (t=3.73, p<.001), and clinical performance (t=2.53, p=.006) were significantly higher than in the control group. Conclusion: Even for students with no clinical experience, high-fidelity simulation-based nursing education was effective in improving nursing knowledge, critical thinking, and clinical performance among nursing students. Nurse educators will be able to use this high-fidelity simulator effectively, especially in situations where direct clinical practicum may not be feasible.

A Study on the Causes of Child Hearing Loss Under Age 5 in Korea (우리나라 유아난청의 원인에 관한 고찰)

  • 노관택;민양기;이희배;고건성
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1978.06a
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    • pp.8.2-8
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    • 1978
  • This paper was designed to investigate the causes of child hearing loss which is essential to language development especialy in young childhood. Accurate history taking, precise otolaryngological examination and impedence audiometry were performed on 185 hard of hearing children under age 5 during last 8 months and investigated its causes. The results were as follows: 1. Infections diseases were the most common causes of sensorineural hearing loss (44/123cases, 30.1%), and mother's condition during pregnancy the second, and birth injury or head trauma the third. 2. Acute or chronic ear ear diseases were the most common causes of counductive hearing loss (32/62, 51.6%), frequent URI the second (19/62, .30.6%), and adenoid vegetation the third (7/62, 11.3%). 3. The majority of causes of child hearing loss under age 5 was exogenous (179/185 cases, 96.8%), and the minority was endogenous (6/185 cases, 3.2%).

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The Effects of High Fidelity Simulation-Based Education on Clinical Competence and Confidence in Nursing Students: A Systematic Review (고충실도 시뮬레이션 기반 교육이 간호학생의 임상수행능력과 간호수행 자신감에 미치는 효과: 체계적 문헌 고찰)

  • Lee, Chong-Mi;So, Hyang-Sook;Kim, Younkyoung;Kim, Jeong-Ee;An, Minjeong
    • The Journal of the Korea Contents Association
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    • v.14 no.10
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    • pp.850-861
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    • 2014
  • The purpose of this review was to evaluate the effects of simulation-based education on clinical competence and confidence in nursing students and summarize the available evidence on the simulation-based intervention. A systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses: the PRISMA Statement was conducted. Studies published between 2005 and 2014 were reviewed using the following databases: RISS, KISS, and Google Scholar. The keywords used were nursing and either simulation or simulator. Selected studies were assessed for methodological quality using Quality Assessment Tool for Quantitative Studies. Seventeen studies were identified, including a total of 1,912 nursing students. All the 16 studies found simulation as a valid strategy on clinical competence and confidence in nursing education. This review provides updated evidence for simulation-based learning in nursing education. Further studies are needed to increase generalizability using randomized controlled trials, enough sample size, and longitudinal study design. In addition, valid measurements are needed to assess the main outcomes.

Clinical Characteristics and Prognosis of Neonatal Seizures (신생아 경련의 임상적 양상 및 예후에 관한 고찰)

  • Kim, Chang Wu;Jang, Chang Hwan;Kim, Heng Mi;Choe, Byung Ho;Kwon, Soon Hak
    • Clinical and Experimental Pediatrics
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    • v.46 no.12
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    • pp.1253-1259
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    • 2003
  • Backgroud : Seizures in the neonate are relatively common and their clinical features are different from those in children and adults. The study aimed to provide the clinical profiles of neonatal seizure in our hospital. Methods : A total of 41 newborns with seizures were enrolled in this study over a period of three years. They were evaluated with special reference to risk factors, neurologic examinations, laboratory data, neuroimaging studies, EEG findings, seizure types, response to treatment, and prognosis, etc. Results : The average age at onset of seizures was $6.1{\pm}4.6days$ and the majority of patients(42%) had multifocal clonic seizure and 24% had subtle seizure. Factors that are known to increase risk of neonatal seizures include abnormal delivery history, birth asphyxia, and electrolyte imbalance, etc. However, they remain obscure in about 20% of cases. More than 50 percent showed abnormal lesions on neuroimaging studies such as brain hemorrhage, periventricular leukomalacia, brain infarction, cortical dysplasia, hydrocephalus, etc. and 17 out of 32 patients showed abnormal electroencephalographic patterns. Phenobarbital was tried as a first line antiepileptic drug and phenytoin was added if it failed to control seizures. The treatments were terminated in the majority of patients during the hospital stay. The overall prognosis was relatively good except for those with abnormal EEG background or congenital central nervous system malformations. Conclusion : Neonatal seizures may permanently disrupt brain development. Better understanding of their clinical profiles and appropriate management may lead to a reduction in neurological disability in later childhood.

The effects of early surfactant treatment and minimal ventilation on prevention of bronchopulmonary dysplasia in respiratory distress syndrome (미숙아 호흡곤란증후군에서 폐표면활성제의 조기 투여와 연성 환기요법이 만성폐질환의 예방에 미치는 영향에 관하여)

  • Park, Jong Jin;Lee, Pil Sang;Lee, Sang Geel
    • Clinical and Experimental Pediatrics
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    • v.52 no.1
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    • pp.44-49
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    • 2009
  • Purpose : Early surfactant treatment and minimal ventilation, bronchopulmonary dysplasia needed prolonged oxygen supplement is a problem. This study aimed to report the effects of early surfactant treatment and minimal ventilation on the prevention of bronchopulmonary dysplasia in respiratory distress syndrome. Methods : We retrospectively studied 139 premature newborn infants (gestational age, 36 weeks; birth weight, 1,500 gm) admitted to the neonatal intensive care unit of Daegu Fatima Hospital between January 2001 and December 2006. We analyzed the occurrence of bronchopulmonary dysplasia with respect to ventilator care and surfactant treatment. Results : The incidence of bronchopulmonary dysplasia was significantly higher with prolonged ventilator care, moderate to severe respiratory distress syndrome, and low Apgar score (P<0.001). Despite early surfactant treatment and minimal ventilation, mild bronchopulmonary dysplasia occurs in a considerable number of patients with mild respiratory distress syndrome. The patient group with low Apgar scores required ventilator care for a prolonged period (P=0.020). Conclusion : Early surfactant treatment and minimal ventilation shortens the duration of ventilator care; however, the preventive effects on bronchopulmonary dysplasia are limited. Therefore, not only early surfactant treatment and minimal ventilation but also appropriate management in the delivery room is essential.