• 중환자간호학회지
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• 제8권1호
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• pp.1-10
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• 2015

This study was conducted to examine the relationship among the error risk of high-alert medication, attitudes to single-person checking of medication, and medication safety activities. The participants were 60 nurses working in the intensive care unit. Data were analyzed using descriptive analysis, t-test, analysis of variance, and Pearson's correlation coefficient. The mean scores of the knowledge and certainty of high-alert medication were $0.71{\pm}0.11$ and $2.74{\pm}0.59$, respectively. The mean score of the error risk of high-alert medication was $1.63{\pm}0.24$ and that of attitudes to single checking medication was $3.32{\pm}0.49$. The error risk of high-alert medication had a positive correlation with nurses' attitudes to single checking medication (r = .258, p = .047), which is correlated with the scores for certainty of knowledge (r = .284, p = .028). Based on the results of this study, continuing education for high-alert medication and the development of an accurate protocol for single checking medication are needed to improve the stability of high-alert medication.

• 중환자간호학회지
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• 제15권2호
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• pp.1-13
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• 2022

Purpose : The study aimed to identify relationship among intensive care unit (ICU) nurses' critical thinking disposition, medication error risk level of high-alert medication, and medication safety competency, as well as the factors affecting medication safety competency. Methods : The participants were 266 ICU nurses of one higher-tier general hospital and one general hospital in Province. The data were collected using structured self-administered questionnaire from August 10 to August 31, 2021. Measurements included the critical thinking disposition questionnaire, nurses's knowledge of high-alert medication questionnaire, the medication safety competency scale. Data were analyzed using hierarchical multiple regressions using SPSS/WIN 28.0. Results : In the multiple regression analysis, the medication safety competence has a statistically significant correlation with the working department, the critical thinking disposition, and medication error risk level of high-alert medication. Conclusion : Based on the results of this study, it is suggested to develop and apply an educational strategy that can strengthen the knowledge and skills of critical thinking disposition and medication error risk level of high-alert medication to improve the ICU nurse's medication safety competency.

• 성인간호학회지
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• 제26권3호
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• pp.253-265
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• 2014

Purpose: This study was done to develop and evaluate a smartphone application for the medication confirmation of high-alert medications. Methods: A nonequivalent control group non-synchronized design was used for this study. Participants in the treatment group used the application for four weeks. Data were analyzed using descriptive analysis, ${\chi}^2$-test, and t-test for the homogeneity of participants, and a paired t-test for effectiveness in each group with the SPSS 18.0. Results: Stability of medication administration was estimated by knowledge and certainty, ranged from a score of one to three. A correct answer with high certainty was coded as high stability, low certainty regardless of correct answer was coded as a moderate stability, and incorrect answers with high certainty were rated as low stability. There were no differences in 'knowledge of high alert medication', 'Certainty of knowledge', 'stability of medication administration', 'confidence of single checking medication', and 'medication safety activities' between the treatment group and the comparison group. The treatment group reported a greater difference between pretest and post-test in 'certainty of medication knowledge' (t=3.51, p=.001) than the comparison group. Conclusion: Smartphone application for medication confirmation of high-alert medications will provide an important platform for reducing medication errors risk.

• 한국임상약학회지
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• 제32권2호
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• pp.116-124
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• 2022

Background: High-alert medications (HAMs) are medications that bear a heightened risk of causing significant patient harm if used in error. To facilitate safe use of HAMs, identifying specific HAM lists for clinical setting is necessary. We aimed to develop the national level HAM list for acute care setting. Methods: We used three-step process. First, we compiled the pre-existing lists referring HAMs. Second, we analyzed medication related incidents reported from national patient safety incident report data and adverse events indicating medication errors from the Korea Adverse Event Reporting System (KAERS). We also surveyed the assistant staffs to support patient safety tasks and pharmacist in charge of medication safety in acute care hospital. From findings from analysis and survey results we created additional candidate list of HAMs. Third, we derived the final list for HAMs in acute care settings through expert panel surveys. Results: From pre-existing HAM list, preliminary list consisting of 42 medication class/ingredients was derived. Eight assistant staff to support patient safety tasks and 39 pharmacists in charge of medication safety responded to the survey. Additional 44 medication were listed from national patient safety incident report data, KAERS data and common medications involved in prescribing errors and dispensing errors from survey data. A list of mandatory and optional HAMs consisting of 10 and 6 medication classes, respectively, was developed by consensus of the expert group. Conclusion: We developed national level HAM list for Korean acute care setting from pre-existing lists, analyzing medication error data, survey and expert panel consensus.

• 한국산학기술학회논문지
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• 제15권3호
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• pp.1650-1662
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• 2014

본 연구는 고위험약물의 투약조정을 위한 스마트 폰 어플리케이션의 내용을 구축하고 개발된 어플리케이션의 만족도를 평가하기 위해 수행되었다. xcode 4.5와 ios 6.1 SDK(software development kit)을 이용하여 시스템을 구축하였다. 4주간의 중재 후 35명의 중환자실 간호사들에게 기능적, 내용적, 화용적 측면의 만족도를 물었다. 또한 하루의 사용횟수와 사용의 빈도에 따른 만족도의 차이를 평가하였다. 이를 위해서는 SPSS WIN 18.0을 활용하여 서술적 분석, ANOVA를 적용하였다. 약물계산 식을 개발하고 과다 혹은 과소 용량에 대한 알람을 주는 과정을 개발하였고, 고위험 약물에 대한 정보를 구축하였다. 만족도와 관련된 문항 중 이 어플리케이션은 약물계산을 수행하는데 도움이 된다는 문항이 3.14점이었으나 이 어플리케이션에 만족한다는 문항은 2.94에 그쳤다. 하루의 사용횟수와 사용빈도와 관련해서 만족도의 차이는 없었다. 이 연구의 결과에 근거할 때 추후 더욱 진보된 고위험약물을 위한 투약조정용 스마트폰 어플리케이션은 환자안전을 위한 중요한 기반을 제공해 줄 수 있을 것이다.

• 한국임상약학회지
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• 제32권3호
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• pp.260-269
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• 2022

Background: Comprehensive medication management is essential to achieve safe and optimal drug use for the elderly in long-term care facilities (LTCF). This study aimed to develop eligibility criteria for "Comprehensive medication management program in LTCF" using the RAND/UCLA Appropriateness Method (RAM). Furthermore, we attempted to estimate the number of beneficiaries who met the criteria by analyzing the National Health Insurance claims data. Methods: Twelve criteria were selected initially. We composed a panel of 14 experts with expertise in long-term care. We conducted two survey rounds to reach a consensus. Rating for appropriateness and decision regarding agreement were applied per RAM. We analyzed the National Health Insurance data to estimate the number of LTCF residents who met each eligibility criterion. Results: Of the 11 items agreed upon, ten items were determined to be appropriate. In 2018, 83.6% of 165,994 residents of LTCF met one or more eligibility criteria. The largest number of subjects met the "New residents of LTCF" criterion, followed by "Take high-alert drugs" and "Chronic excessive polypharmacy." Since the items evaluated as most appropriate by the expert panel and those with a large number of subjects were similar, we confirmed the external validity of our criteria. Conclusion: It is worth noting that this is the first attempt to establish the eligibility criteria for medication management in LTCF. Further preliminary research is needed to identify the selected subjects' drug-related problems and revise the criteria according to the results.

• International journal of advanced smart convergence
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• 제11권2호
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• pp.194-204
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• 2022

This study is a one-group pretest-posttest design to evaluate the effect of problem-based learning (PBL) for patient safety on self-leadership, patient safety competencies, and reflective thinking of nursing students. The research was conducted from March 2 to April 15, 2022, in which 57 nursing students participated. PBL for patient safety was examined in a total of 8 sessions in the order of motivation, problem identification, task performance planning, problem-solving methods, summary and solution, presentation, and evaluation. The following topics of patient safety were selected for each team: nursing records, high-alert medication, medication error and intravenous fluid regulation, blood transfusion care, fall, bedsore, infection control, and pain management. We provided feedback on the learning process and outcomes of nursing students. According to the results, self-leadership showed a statistically significant improvement in self-expectations (t=2.60, p=0.01), goal setting (t=2.84, p<0.01), self-reward (t=3.32, p<0.01), and self-criticism (t=2.32, p=0.02). Patient safety competencies showed a statistically significant improvement in patient safety knowledge (t=13.05, p<0.001) and patient safety skills (t=4.87, p<0.001) but not in reflective thinking. The results prove that PBL for patient safety is an effective teaching-learning strategy to improve self-leadership and patient safety competencies. Future studies must develop and validate specific and long-term teaching-learning methods to improve reflective thinking.

• Mass Spectrometry Letters
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• 제13권3호
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• pp.58-83
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• 2022

We developed analytical methods using high performance chromatography (HPLC) and liquid chromatography tandem mass spectrometry (LC-MS/MS) for the simultaneous determination of 80 unapproved compounds in dietary supplements. The target compounds for analysis were unapproved ingredients (e.g., pharmaceuticals) that have potential adverse effects on consumers owing to accidental misuse, overuse, and interaction with other medication in dietary supplement. Two analytical methods were tested to identify the optimal validation results according to AOAC guideline. As a result, limit of quantification (LOQ) was 0.14-0.5 ㎍ mL^-1; linearity (r²) was ≥ 0.99; accuracy (expressed as recovery) was 78.9-114%; precision (relative standard deviation) was ≤ 4.28% in the HPLC method. In the LC-MS/MS method, LOQ was 0.01-2 ng mL^-1, linearity (r²) was ≥0.98, accuracy was 71.7-119%; precision was ≤ 12.5%. The developed methods were applied to 51 dietary supplements collected from 2019 to 2021 through MFDS alert system. Based on our previous monitoring study, major compounds were icariin, sibutramine, yohimbine, sildenafil, tadalafil, sennosides (A, B), cascarosides (A, B, C, D), and phenolphthalein. In this study, we re-analyzed samples of detected compounds, and evaluated the statistical difference using Bland-Altman analysis to compare two analytical approaches between HPLC and LC-MS/MS. These results showed a good agreement between two methods that can be used to monitor the unapproved ingredients in dietary supplements. The developed two methods are complementarily suitable for monitoring the adulteration of 80 unapproved compounds in dietary supplements.

• 대한간호
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• 제36권1호
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• pp.59-76
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• 1997

The purposes of this study were to identify the contents and satisfaction level of the patients received home care service, and to compare the differences of the contents by the characteristics of the patients. Seventy eight patients received home care service from 1st Jan. to 30th Sept., 1996 were data-collected to analyze the contents and outcomes of home care service. Sixty-nine patients currently receiving home care service were participated to evaluate the satisfaction level of home care service. The data were analyzed using mean, standard deviation, $x^2$ test, and ANOVA by SPSS $PC^+$ program. The findings of this study were as follow : 1. The contents & outcomes of home care service 1) The mean age of the subjects was 64.4 years: 58% of them were female. Those who living in Seoul were 83% and the rest of the subjects was living in Kyung-Gi. 2) The subjects who had one diagnosis were 41%. Over 60% of them had the disease of neurologic & sensory system. 3) The mean number of visit was 6. Only one visit was 22%. The mean time of care was 79 minutes. Duration of visit from 31 minutes to 60 minutes were 47 %. The subjects who terminated the visit because of death were 67.3%. 62% of the persons who referred them to the home care service were nurses. 4) The pain after the service was more relieved than before. The amounts of intake, the degree of bed sore, edema & fracture after the service were more improved than before. Health status after the service was improved in general. 5) There were significant differences between initial and last conscious level in tracheostomy care & oxygen inhalation care. There was significant difference between initial and last degree of activity in blood sugar check. 6) There were significant differences on the number of visit in assessment of the status, evaluation & observation, vital sign check, skin care, injection, medication, bed sore care, colostomy care, relaxation therapy for pain relief, patient education, family care, exercise therapy, position change, supply of disinfected equipments and infection control. There were significant differences on visiting time in nasogastric tube care, drainage tube care and oxygen inhalation care. 2. The satisfaction level of home care service 1) 50% were male. Over 60 years of the subjects was 61 %. Those who living in Seoul were 82%. 2) The subjects who had one or two diagnosis were 32% respectively. 55% of the persons who referred them to the home care service were nurses. 3) Total level of satisfaction of home care service was very high. 4) The older the age, the higher the satisfaction level. The larger the number of visit, the higher the satisfaction level. 5) The subjects who were in cloudy state were higher level of satisfaction than in alert or coma state. The subjects whose activity were normal or who needed assistance were higher level of satisfaction than bedridden or immobilized subjects. These findings suggested that the patients had substantial need for posthospital care. They tended to be elderly and to have experienced the wide range of health problems associated with aging, chronicity, including limitations in activities, and other serious health problems. So, the nationwide home care systems beyond the limit of demonstration program by local association and the development of the effective financial system of home based health care are necessary for the clients who are in need of home care.