• Archives of Plastic Surgery
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• 제48권3호
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• pp.295-304
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• 2021

Clinical photography is an essential component of patient care in plastic surgery. The use of unsecured smartphone cameras, digital cameras, social media, instant messaging, and commercially available cloud-based storage devices threatens patients' data safety. This paper Identifies potential risks of clinical photography and heightens awareness of safe clinical photography. Specifically, we evaluated existing risk-mitigation strategies globally, comparing them to industry standards in similar settings, and formulated a framework for developing a risk-mitigation plan for avoiding data breaches by identifying the safest methods of picture taking, transfer to storage, retrieval, and use, both within and outside the organization. Since threats evolve constantly, the framework must evolve too. Based on a literature search of both PubMed and the web (via Google) with key phrases and child terms (for PubMed), the risks and consequences of data breaches in individual processes in clinical photography are identified. Current clinical-photography practices are described. Lastly, we evaluate current risk mitigation strategies for clinical photography by examining guidelines from professional organizations, governmental agencies, and non-healthcare industries. Combining lessons learned from the steps above into a comprehensive framework that could contribute to national/international guidelines on safe clinical photography, we provide recommendations for best practice guidelines. It is imperative that best practice guidelines for the simple, safe, and secure capture, transfer, storage, and retrieval of clinical photographs be co-developed through cooperative efforts between providers, hospital administrators, clinical informaticians, IT governance structures, and national professional organizations. This would significantly safeguard patient data security and provide the privacy that patients deserve and expect.

• 중환자간호학회지
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• 제16권3호
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• pp.87-98
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• 2023

Purpose : This descriptive survey investigated the effects of clinical nurses' critical reflection competency, professional pride, and person-centered care practices on patient safety management activities. Methods : The participants were 183 clinical nurses working at a tertiary hospital in South Korea. The questionnaires consisted of the Critical Reflection Competency Scale for Clinical Nurses Professional Pride the Person-Centered Nursing Assessment Tool and Patient Safety Management Activities. The collected data were analyzed using descriptive statistics, t-tests, ANOVA, Tukey's HSD, Pearson's correlation coefficient, and multiple regression using SPSS 29.0. Results : The mean score for patient safety management activities was 4.65±0.34 out of 5. There were significant differences in patient safety management activities according to age (F=3.90, p =.010), education level (t=-2.56, p =.013), total work experience (F=3.87, p =.010), and the number of healthcare accreditation system experiences (F=5.22, p =.006). Patient safety management activities were positively correlated with critical reflection competency (r=.337, p <.001), professional pride (r=.271, p <.001), and person-centered care practices (r=.399, p <.001). The results indicated that person-centered care practices affected patient safety management activities (𝛽=.358, p <.001) with the explanatory power of 22.5%. Conclusion : To improve clinical nurses' patient safety management activities, it is necessary to develop participatory educational programs that can integrate skills and attitudes based on conceptual knowledge of person-centered care. Intervention studies are needed to test the effect of person-centered care on patient safety when applied in clinical practice.

• 치위생과학회지
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• 제22권2호
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• pp.108-114
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• 2022

Background: Students in the department of dental hygiene are exposed to injections and sharp instruments during clinical practice. Therefore, it is necessary to develop measures for a safe practice environment. This study aimed to investigate dental stabbing accidents caused by dental instruments during clinical practice among students in the department of dental hygiene and suggest appropriate preventative measures. Methods: This study was conducted from May 1 to June 30, 2016, with students in the department of dental hygiene located at several universities in Seoul and Gyeonggi area. The study included 339 participants. A frequency analysis was performed to determine the general characteristics of dental infection control. A cross-analysis was conducted to identify the relationship between dental infection control education, stabbing accident prevention education, and treatment after stabbing accidents with a dental instrument. Results: Among the participants, 81.1% received dental infection control education and 66.4% received stabbing accident prevention education. Only 50.9% received hepatitis B vaccinations. Conclusion: Dental infection control education and stabbing accident prevention education were shown to be effective in preventing dental instrument stabbing in students. However, post-accident processing, such as reporting to upper management and medical treatment after the accident, was insufficient. Therefore, it is necessary to present a treatment flowchart for dealing with stab accidents in clinical practice for students in the department of dental hygiene and strengthen education.

• 대한암한의학회지
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• 제26권1호
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• pp.17-27
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• 2021

Objective: This study aimed to evaluate which information of cancer patients should be collected for the Korean medicine cancer registry in order to assess the efficacy and safety of Korean medicine (KM) treatment and to identify Korean medical prognostic predictors. Methods: A total of fifteen Korean medical specialists completed an online survey questionnaire including items about general characteristics of cancer patients and clinical practice patterns. Results: The four main types of cancer at Korean medical hospitals were breast, lung, stomach, and colorectal cancer. The majority of patients with cancer at Korean medical hospitals were in the advanced or metastatic stage (50.0%). The prominent purposes of KM treatment were to alleviate cancer-related symptoms, reduce the side effects of conventional therapy, and improve quality of life. The major options for treatment were traditional herbal medicine (THM), acupuncture, moxibustion, thermotherapy, pharmacoacupuncture, and meditation, with THM being the most frequently used (35.7%). Almost all Korean medical specialists (93.9%) used syndrome differentiation in clinical practice and identified over half the cancer patients as deficiency syndrome (57.2%). Conclusion: Physicians considered the primary goal of KM treatment for cancer patients to be symptom management since advanced or metastatic stage patients were the majority at Korean medical hospitals. THM were the most common treatment option and syndrome differentiation was used by almost all physicians. Further research is needed to monitor and ensure optimal KM treatment for patients with cancer.

• 산업공학
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• 제20권4호
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• pp.488-497
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• 2007

In order to provide appropriate decision supports in medical domain, it is required that clinical knowledge should be implemented in a computable form and integrated with hospital information systems. Healthcare organizations are increasingly adopting tools that provide decision support functions to improve patient outcomes and reduce medical errors. This paper proposes a process centric clinical decision support system based on medical knowledge. The proposed system consists of three major parts - CPG (Clinical Practice Guideline) repository, service pool, and decision support module. The decision support module interprets knowledge base generated by the CPG and service part and then generates a personalized and patient centered clinical process satisfying specific requirements of an individual patient during the entire treatment in hospitals. The proposed system helps health professionals to select appropriate clinical procedures according to the circumstances of each patient resulting in improving the quality of care and reducing medical errors.

• Child Health Nursing Research
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• 제16권1호
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• pp.30-40
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• 2010

Purpose: The purposes of this review were to identify whether available evidence supports the nursing interventions that are commonly used to reduce fever in children and to introduce research findings into practice. Methods: Journal databases and clinical guidelines from 1990 to 2009 were searched. The search terms were fever, febrile convulsion, fever management, fever phobia, child, antipyretics, temperature, external cooling, tepid sponge bath, and physical treatment. Results: Evidence suggests that uncomplicated fever is relatively harmless, but it is an important immunological defense. Antipyretics should not routinely be used with the sole aim of reducing body temperature in children with fever who are otherwise well. Currently a lack of evidence supports the practice of alternating acetaminophen and ibuprofen, and the routine use of tepid sponge bath. Conclusion: Currently, fever management in children does not reflect research evidence. Pediatric nurses can play an important role by encouraging clinical research in this area and also by enhancing research utilization in their practice. Moreover, pediatric nurses can educate parents about evidence-based fever management. Evidence-based educational interventions for pediatric nurses need to be developed and evaluated to improve the quality of nursing care in the management of childhood fever.

• 임상간호연구
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• 제29권1호
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• pp.42-55
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• 2023

Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

• 산업융합연구
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• 제22권8호
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• pp.63-72
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• 2024

본 연구는 간호대학생의 유머감각과 스트레스 대처 방식이 임상실습적응에 미치는 영향을 파악하기 위해 시도되었다. 연구대상은 180명의 간호대학생으로, 자료수집은 자기기입식 설문지를 이용하여 2024년 4월 15일부터 26일까지 실시하였다. 수집된 자료는 t-test, one-way ANOVA, Pearson's 상관관계, 다중회귀분석을 시행하여 분석하였다. 연구결과, 유머감각은 3.52점, 스트레스 대처 방식은 3.40점, 임상실습적응은 3.46점이었다. 일반적 특성에 따른 임상실습 적응은 전공만족도(F=29.80, p<.001), 임상실습 만족도(F=40.46, p<.001), 실습동료와의 관계(t=5.05, p<.001), 성격(t=-3.41, p<.05)에 따라 통계적으로 유의한 차이를 나타냈다. 임상실습 적응은 유머감각(r=.31, p<.001), 스트레스 대처 방식(r=.43, p<.001)과 통계적으로 유의한 양의 상관관계를 나타냈다. 임상실습 적응에 대한 영향요인은 임상실습 만족도(β=.34, p<.001), 스트레스 대처 방식(β=.29, p<.001), 전공 만족도(β=.23, p<.05)로 총 변화량의 40%를 설명하였다. 본 연구결과를 통해 간호대학생의 임상실습 적응을 향상시키기 위해서 전공 만족도, 임상실습 만족도, 스트레스 대처 방식을 높일 수 있는 프로그램 개발과 전략이 필요하다.

• 한국간호교육학회지
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• 제29권4호
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• pp.381-394
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• 2023

Purpose: This study aimed to develop an intentional rounding protocol to enhance the clinical competence of nursing students. Methods: An intentional rounding protocol for nursing students' clinical practice was developed following the ADDIE (Analysis, Design, Development, Implementation, and Evaluation) model. A convenient sampling method was used to select 23 junior year university nursing students during their clinical practice in adult nursing. The program evaluation included a quantitative assessment (communication and relationship efficacy, empathy, and patient safety competency) and focus group interviews. Results: The intentional rounding protocol focused on the 4Ps (pain, position, potty, and possessions) and encompassed aspects such as level of consciousness, pain management, personal care needs, intravenous injection, oxygen administration, nasogastric/nasoenteric tube care, maintenance of urine collection bags, and the identification of environmental fall risks. Nursing students performed intentional rounding at least twice a day. Following the implementation of this protocol, nursing students demonstrated a significant improvement in communication and interpersonal efficacy. The focus group interviews revealed four main themes: growth of human relationships, acquiring knowledge in and about the clinical field, becoming a nurse, and barriers in reality. Conclusion: The intentional rounding protocol has the potential to enhance nursing students' communication and interpersonal skills during clinical practice and to provide them with positive experiences in nursing clinical education. Therefore, it is recommended that this protocol be incorporated into nursing clinical practice education.

• 보건행정학회지
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• 제11권3호
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• pp.121-150
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• 2001

This study was conducted to investigate provider's behavior change after releasing the information on the Cesarean section rate. Claims data filed at the National Health Insurance Corporation was used for this analysis and the focus of this study was the change of cesarean rate after the public disclosure of information. Average rates of the year 1999 and 2000 were compared, on the institutional basis, and range and coefficient of variation were estimated. For the last decade, Cesarean section rate has been increased dramatically. Clinical or demographic factors could not adequately explain the increase. Instead, nonclinical factors, such as financial incentive, physician's convenience, practice characteristics, etc., were more significant in explaining the increasing rate. Providers' behavior was significantly affected by the public release of information: after the release, average rate was decreased by 10.2%, and variations were also decreased. In particular, the extent of decrease was explained mainly by nonclinical factor rather than clinical ones. The results suggest that disseminating practice information to providers and consumers could contribute to reducing unnecessary medical service.