• Title/Summary/Keyword: 환자안전 지식

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Decreasing the application rate of unnecessary physical restraint through the establishment of a guideline for restraint application (억제대 적용지침 개발을 통한 불필요한 억제대 적용율 감소 활동)

  • Kwak, Kyung-Sun;Kim, Sung-Eun;Bae, Eun-Kyoung;Lee, Eun-Sook;Lee, Eun-Hye;Choi, Yun-Jeong;Lee, Yun-Kyung
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.93-103
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    • 2009
  • 문제: 억제대 적용에 대한 구체적 적용 지침 없이 의례적으로 억제대를 사용함으로 인해 환자들의 신체적 또는 정신적 안전을 위협할 수 있다. 목적: 완전 진정 상태 이거나 근력이 약하여 발관 능력이 없는 환자에 대한 예방적 적용, 바빠서 환자를 볼 수 없는 경우, 간호사 본인의 판단이 없이 타인의 요구에 따르는 등의 불필요한 억제대 적용이 증가하는 원인을 파악하여 중환자실의 특수성에 맞는 억제대 적용 및 제거 지침을 마련하고자한다. 의료기관: 인천광역시에 소재한 의과대학 소속병원의 집중치료실 질 향상 활동: 불필요한 억제대 적용에 영향을 미치는 요인을 선정하여 개선활동 수행. 개선효과: 억제대 적용에 대한 중환자실 간호사에게 미치는 영향을 보면 태도 정도 p=0.09(p<0.1), 올바른 수행 능력은 p=0.005(p<0.05)로 통계적으로 유의한 것으로 나타났다. 지식 정도 p=0.172(p<0.05) 통계적으로 유의 하지는 않지만 모든 항목이 개선 활동 전 에 비해 2,3차 개선 활동 후에 향상 한 것으로 나타났다. 개선 활동 전에 8.1%였던 간호 기록, 0.7%였던 간호 중재, 0%였던 의사 처방율이 3차 개선 활동 후 3가지 모두 100% 달성되었다. 이는 억제대 적용율 감소 및 부적절한 억제대 적용율은 유의하게 감소 하였다. 교훈: 중환자실 간호사의 억제대 적용에 대한 태도, 지식, 올바른 간호 수행 능력은 지속적으로 재평가 되어지고, 교육내용은 좀 더 나은 간호 제공을 위하여 개발되어져야 할 것이다. 억제대 적용 기준과 제거 기준을 Check List 하여 객관성의 유지를 위한 개선 활동은 계속적으로 Feedback 되어야 할 것이다.

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ICT Medical Service Provider's Knowledge and level of recognizing how to cope with fire fighting safety (ICT 의료시설 기반에서 종사자의 소방안전 지식과 대처방법 인식수준)

  • Kim, Ja-Sook;Kim, Ja-Ok;Ahn, Young-Joon
    • The Journal of the Korea institute of electronic communication sciences
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    • v.9 no.1
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    • pp.51-60
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    • 2014
  • In this study, ICT medical service provider's level of knowledge fire fighting safety and methods on coping with fires in the regions of Gwangju and Jeonam Province of Korea were investigated to determine the elements affecting such levels and provide basic information on the manuals for educating how to cope with the fire fighting safety in medical facilities. The data were analyzed using SPSS Win 14.0. The scores of level of knowledge fire fighting safety of ICT medical service provider's were 7.06(10 point scale), and the scores of level of recognizing how to cope with fire fighting safety were 6.61(11 point scale). level of recognizing how to cope with fire fighting safety were significantly different according to gender(t=4.12, p<.001), age(${\chi}^2$=17.24, p<.001), length of career(${\chi}^2$=22.76, p<.001), experience with fire fighting safety education(t=6.10, p<.001), level of subjective knowledge on fire fighting safety(${\chi}^2$=53.83, p<.001). In order to enhance the level of understanding of fire fighting safety and methods of coping by the ICT medical service providers it is found that: self-directed learning through avoiding the education just conveying knowledge by lecture tailored learning for individuals fire fighting education focused on experiencing actual work by developing various contents emphasizing cooperative learning deploying patients by classification systems using simulations and a study on the implementation of digital anti-fire monitoring system with multipoint communication protocol, a design and development of the smoke detection system using infra-red laser for fire detection in the wide space, video based fire detection algorithm using gaussian mixture mode developing an education manual for coping with fire fighting safety through multi learning approach at the medical facilities are required.

Effect of Fall Prevention Education for Older Patients in Comprehensive Nursing Care Service Ward (간호·간병 통합병동에 입원한 노인환자의 낙상예방교육 효과)

  • Shim, Song-mi;Kim, Eunha
    • Journal of Korean Public Health Nursing
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    • v.33 no.2
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    • pp.200-213
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    • 2019
  • Purpose: This study was conducted to examine the effect of a fall prevention education on the fall related knowledge and fall prevention behavior of the elderly patients in comprehensive nursing care service wards. Method: A quasi experimental study with control group and experimental group was used. A total 62 elderly patients in comprehensive nursing care service wards were randomly divided into the experimental group(n=30) and the control group(n=32). The data collection period was from August to December, 2017. Data were analyzed with $X^2-test$, paired t-test, independent t-test and Pearson's correlation coefficient by using SPSS 25.0. Results: Experimental group reported higher score in fall related knowledge than the control group(t=-10.28, p<.001). Participants who viewed DVD and received the leaflet education reported higher score than those with routine admission education(t=-6.51, p<.001). The experimental group showed significant improvement in fall related knowledge and fall prevention behavior(r=.21, p=.015). Conclusion: The fall prevention program was effective in improving fall-related knowledge and fall prevention behavior among elderly patients. Since the DVD plus leaflet education was effective in improving prevention behaviors, it might be included in routine orientation on admission for the elderly patient in comprehensive nursing care service wards.

The Relationship between Behavior of Radiographic Safety Control and Job Stress in Dental Hygienist (치과위생사의 방사선안전관리 행위와 직무스트레스와의 관계)

  • Jang, Jong-Hwa;Hwang, Su-Lyun;Jung, Hong-ryang
    • Journal of dental hygiene science
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    • v.10 no.4
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    • pp.265-271
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    • 2010
  • This study was to investigate the level of knowledge, recognition, behavior of radiographic safety control and job stress in dental hygienists and to determine the relationship among variables. The subjects were 256(56.9%), who were worked in dental hospital and clinic with mean age of $29.59{\pm}7.30$. Data was collected using a self administrated questionnaire from April 4 to May 15, 2010. Behavior of radiographic safety control was measured using the 15-items and job stress was measured using the 5-items with 5-point likert scale. The data were analyzed with t-test, one-way ANOVA and pearson correlation coefficient using the SPSS WIN 17.0 program. Regarding job stress, the subjects was a mean of 2.63 out of a maximum 5 points. The level of knowledge, recognition, behavior of radiographic safety control a mean of 3.11, 4.08 and 3.43 out of a maximum 5 points. Recognition and behavior of radiographic safety control was negative related job stress in this study. Based on the findings, behavior of radiographic safety control is associated with job stress. These results suggest that various program should be considered for radiation safety control of dental hygienists.

Education Need of the Visit ing Health Service Workers in Gwangju and Jeollanam-do Public Health Facilities (일부 공공보건기관 방문보건요원의 교육요구도 조사)

  • Kim, Young-Lak;Kim, Shin-Woel;Chung, Eun-Kyung;Choi, Jin-Su
    • Journal of agricultural medicine and community health
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    • v.27 no.1
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    • pp.51-64
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    • 2002
  • This study was aimed to provide the basic data for the development of effective educational program by reflecting the opinions of the visiting health service workers. The subjects were 144 visiting health service workers in Gwangju and Jeollanam-do area who responded the mail questionnaire. The data were collected from June to July, 2001 using questionnaire composed of the education need, knowledge by subjective appraisal, and experience of education. The major findings of this study were as follows: 1. The number of respondents who received at least one education within recent three years were 43(29.9%) at the central level, 57(39.6%) at the provincial level and 53(36.8%) at the district level. The satisfaction with education was higher at the central level than at the provincial and district level. 2. Knowledges by subjective appraisal on the 'chronic degenerative diseases management' and 'health promotion' was relatively high. while that of 'rehabilitation' was low. 3. The knowledge by subjective appraisal of visiting health service was related with experience of education and license status. The knowledge was higher in registered nurses than in nurse aids. The curricula related to increased level of knowledge of visting health service workers were 'elderly health care', 'rehabilitation' and 'psychiatric-mental health nursing' educations at the central level 'continuing education for the community health practioners' and 'psychiatric-mental health education' at the provincial level and 'elderly health care', 'rehabilitation' 'psychiatric-mental health' and 'acute diseases control' educations at the district level. 4. The respondents preferred elderly health management as the contents of education, officer group education as the method of education, province(30.4%) as the main body of education, exercise and practice as the form of education, 2-3 times per year as the frequency of education, and 3-5days as the period of education. The findings of this study could suggest that future education program should be planned to increae the knowledge level of visiting health service workers by reflecting their educational need.

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Clinical Therapeutic Drug Monitoring

  • 윤영란
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1997.11a
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    • pp.93-106
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    • 1997
  • 약물 투여 후 약효의 출현은 흡수, 분포 등의 약동학적 단계(pharmacokinetic phase)를 거쳐 수용체 부위에서 약물과 수용체 사이의 약력학적(pharmacodynamic) 상호작용에 의해 나타난다. 따라서 약물요법 시 약효나 독성 발현의 큰 개인차는 약동학적 또는 약력학적 개인차에 의해 나타나며, 많은 약물에서 약효의 개인차는 흔히 약동학적 차이가 주역할을 함이 알려져 있고, 약물의 특성에 따라 약물의 대사 및 배설과 관련 있는 신장, 간장 및 심장 질환자에서는 현저한 약동학적 변화로 용법 조정이 필수적으로 요구되는 경우가 많다. 약동학적 개인차는 안전역이 좁은 약물에서 더욱 문제가 되며 이러한 약물의 적정 요법을 위해서는 수용체 부위와 평형을 이루고 있는 혈장약물농도를 적정 유지하는 것이 약동학적 개체차를 배제할 수 있는 한 방안이다. 근자에 이르러 체액내 약물 및 이의 대사물을 측정하는 분석 화학의 발전과, 임상 약물 동태학(clinical pharmacokinetics)의 도입 등으로 개개 환자에서의 적정 약물요법을 위한 TDM (Therapeutic Drug Monitoring)이 구미에서는 이미 보편화되어 있다 또한 국내에서도 이러한 새로운 의료분야의 연구 및 임상응용의 필요성이 점차 증가하고 있으므로, 이러한 시대적 요구에 발맞추어 본 지면을 통하여 임상약리학적 지식을 이용한 혈장 농도 데이터의 분석을 통하여 개개인에서의 적정 약물요법을 제시하는 TDM에 관하여 소개하고자 한다.

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Literature Review of the Safety Studies among Nursing Students (간호대학생 대상 안전 관련 국내 연구 동향)

  • Lee, Seonhye
    • The Journal of the Convergence on Culture Technology
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    • v.8 no.1
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    • pp.131-138
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    • 2022
  • This study was to investigate the characteristics of nursing students' safety by reviewing literature reported in Korea. Methods: A total of 29 articles were selected by the combination with 'safety', 'safety*', 'patient safety', 'patient safety*' 'nursing students', and 'nursing * students' from the database(via DBpia, KCI, KISS, NANET, NDSL, NL, RISS). Results: Publication year of researchs are '2015-2019' 69.0%, publication journal 'non-nursing' 79.3%, mean of participants 242.4 persons, 'under 200 persons' 51.7%, number of participating area 'one region' 48.2%, number of participating schools 'over three schools' 42.3%, participating grade 'senior in colleges' 56.2%. Participant were calculated by G*Power and unapproved by Institutional Review of Board(IRB) were 58.6%. Most of statistics measures were 'regression' 75.9%, and authors' number were '2 co-authors' 58.6%. In keyword analysis, it has changed from knowledge-oriented to patient-centered. Conclusion: Future research will require research and policy support for the development of an integrated educational approach and intervention plan to strengthen the safety competency of nursing students.

Literature Review of Therapeutic Milieu of Psychiatric Patient and Suggestion for Changing Environment of Psychiatric Wards in Korea (치료적 환경에 대한 문헌적 고찰 및 정신과병동 환경변화에 대한 몇가지 제언)

  • Lee, So-Woo
    • Journal of Korean Academy of Nursing
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    • v.6 no.1
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    • pp.80-90
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    • 1976
  • 정신과 영역의 환자를 위해 간호원의 역활을 필요로 한 이래 여러 가지 간호의 개념으로 간호원의 역할이 변화되어오고 있다. 정신과 환자의 안전만이 가장 큰 치료의 중심일 때는 병동열쇠의 위엄에 곁따라 보호관리에만 치중해 왔으며 정신의학에서 약물요법, 전기요법의 치료과정이 생기면서 간호원의 역할 변화 및 지식의 요구를 필요로 하게 되었으며, 환경과 개인의 밀접한 관계를 중시해오면서 치료적 환경속으로 환자의 인간적 치료가 강조되었을 때 의사소통과 대인관계의 인적 환경으로써 또한 간호원의 역활이 중요시 되어왔다. 이런 관점에서 치료적 환경에 대한 정확한 이해는 간호행위과정의 불완전을 제거하며 보다 활발한 정신과 환자간호에 기여하는 일 일 것이다. DR. Bartom은 병실 환경이 비생산적이고 비 치료적일때 성격의 변화는 물론 행동적 특성의 변화까지 가져올 수 있다고 말했다. 즉 무감동적이고, 무조건적 순종이 있으며 솔선하여 행하는 행위가 줄고 장래 계획에 대한 자극이 줄어들고 될대로 되어 가는 상태 그 자체에 머물러 있어 인간의 특징적 의미와 가치를 상실하게 된다는 것이다. 정신과 병실은 잠정적 체류지로 보아야 하겠고 이 체류지에서의 영향이 환자에게 보다 유익하게 끼칠려면 간호원이 지속적으로 치료적 분위기를 유지해야 할 것이다. 치료적 입장으로서의 간호의 활동 초점은 대인관계에서 환자의 의식수준과 자아관련 수준에서의 취급이 무의식 수준에서의 탐구조사보다 바람직하다. 치료적 가치로써 치료적 환경의 이론적 근거를 DR. Sullivan 은 인간의 상호관련 문제에 두고 있다. 즉 상호작용이 존재하는 환경은 어떠한 곳이든 성격에 영향이 있고 이 성격은 대인관계의 복잡성으로부터 결코 떨어질 수 없다는 얘기다. 자아구성 또한 환경의 영향을 받는데 Cumming은 병동환경과 자아구성 재동기간에 밀접성을 시사한바 있다. Visher와 O'sullivan은 정신과적 치료중에서 일상생활에서 경험되어지는 의사소통과 대인관계속에서 학습되어지는 여러 가지가 있기 때문에 매일의 활동획이 치료적 방향으로 계획되어 져야 한다고 말했다. Maxwell Jones 또한 치료적 환경의 유용한 가동은 전 직원의 기여에 있으며 이는 정신건강을 최적으로 올려 줄 것이다. 라고 말했다. 이러한 상황에서 간호원은 의미 없이 환자의 감정 욕구를 깨닫지 못하고 감정지지를 주지 못하며 정서적 긴장을 예방하지 못한 체 환자와의 관계를 유지한다면 현대간호의 개념에서 이탈되어지고 발달되어지지 못한 미숙아 현상이 유지 될 것이다. 보다 바람직한 치료적 환경 유지는 간호로써 환자에게 기여해 주는 일이다. 간호의 역활과 더불어 전문적 태도는 따뜻하고 포용성 있게 그리고 융통성 있게 대함은 물론 간호인 자신의 "자기이용"을 깊이 그리고 치료적으로 이용할 것을 깨달아야 할 것이다. 즉 정신과 병실에서의 간호원 존재 자제가 환자에게 미치는 영향도 고려해야 한다는 것이다. 덧붙여 환자를 위한 일주일 병동 행사표를 Model로 제시하였고 그 안에서의 간호원의 역활을 약술하였다.

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The Convergence study of Nurses' Experience in developing Medical supplies (간호사의 의료용품 개발 경험에 관한 융합연구)

  • Kim, Sung-Hye;Lee, Young-Hee;Yun, Ok-Jong
    • Journal of the Korea Convergence Society
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    • v.8 no.12
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    • pp.139-148
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    • 2017
  • This purpose of the study was to investigate nurses' experience in developing medical supplies. The participants were six nurses, data were collected by open in-depth interviews from January to December, 2016, and analyzed using thematic analysis. Three themes and six sub-themes were identified. Nurse's experience in medical supplies development were 'new challenge for better patient care', 'the reality of nonprofessional beyond compare', and 'difficult but fruitful work'. The participants tried to improve the convenience of nursing work and to minimize the economic burden of patients by medical supplies development. They faced the difficulties as a laymen that a lack of information and knowledge about developing process, but felt worth. Based on these findings, there are necessary for the system and the support of the hospital that can reflect the idea of nurses and education about process on medical supplies development.

Factors Influencing Nursing Practices of Physical Restraints Use by nursing students (간호대학생의 신체적 억제대 사용 관련 간호실무 예측 요인)

  • Ha, Sun-Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.4
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    • pp.529-537
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    • 2021
  • Although the use of physical restraints is controversial, it is still commonly used in hospitalized patients to prevent patient accidents in clinical practice. It is, therefore, necessary to evaluate the knowledge, attitude, perception, and nursing practices related to the use of physical restraints. This was a cross-sectional descriptive study in which self-administered questionnaires were collected from 144 nursing students at two Universities. Descriptive statistics, including t-test, one-way ANOVA, Pearson correlation coefficients, and multiple regression, were applied to analyze the data collected. Our results reveal that the mean knowledge score of nursing students regarding the use of physical restraints was 11.55±2.81, the mean attitude score was 60.01±7.24, the mean perception score was 59.97±10.68, and the mean nursing practice score was 38.04±4.15. Significant positive correlations were observed between nursing practice and knowledge, attitude, and perception. Multiple regression analysis showed that the factors significantly related to nursing practice and the use of physical restraints were perception (β=.23, p=.005) and attitude (β=.21, p=.009), having a total explained variance of 13.0%. The findings from this study suggest that perception is the strongest predictor of the use of physical restraints in nursing practice. Thus, it is necessary to develop and apply an evidence-based educational intervention program to ensure that nursing students correctly understand the need for physical restraints and later use them appropriately in clinical practice.