• Title/Summary/Keyword: Medical conflict

Search Result 272, Processing Time 0.026 seconds

A Case Study of Implementation of Concurrent Drug Utilization Review System at a General Hospital (동시적 의약품 사용평가(cDUR) 시스템 구축 및 적용 사례 연구 : 국내 한 대학병원을 중심으로)

  • Choi, Jong Soo;Kim, Dongsoo
    • Journal of Korean Institute of Industrial Engineers
    • /
    • v.39 no.1
    • /
    • pp.20-29
    • /
    • 2013
  • Medical errors such as adverse drug event, improper transfusion, wrong-site surgery, mistaken patient identity and so on commonly occur at health care practice. Information technology, like Drug Utilization Review(DUR) system which reviews, analyzes, and interprets medication data when prescribing, can play a key role in reducing such medical errors and improving patient safety. Korean Government has guided all hospitals to implement concurrent DUR(cDUR) system, which is the first case worldwide in that all healthcare providers have to use cDUR system when prescribing. This paper introduced a case study that a tertiary hospital has integrated the cDUR system into its comprehensive Hospital Information System(HIS) and analyzed the whole prescription data during a week right after adoption of cDUR system. Considering technical strength and weakness, the cDUR system was integrated into the HIS, using Broker Servers for minimizing doctors' anxiety. As the quantitative analysis of the whole prescription data, DUR conflict events, which mainly included duplicate medications and contra-indicated drug interactions for outpatients, were 2.77%. Although only 0.7% is for the contra-indicated drug interactions, it will be greatly devoted to achieve the purpose of DUR such as improving patient safety.

Rule Weight-Based Fuzzy Classification Model for Analyzing Admission-Discharge of Dyspnea Patients (호흡곤란환자의 입-퇴원 분석을 위한 규칙가중치 기반 퍼지 분류모델)

  • Son, Chang-Sik;Shin, A-Mi;Lee, Young-Dong;Park, Hyoung-Seob;Park, Hee-Joon;Kim, Yoon-Nyun
    • Journal of Biomedical Engineering Research
    • /
    • v.31 no.1
    • /
    • pp.40-49
    • /
    • 2010
  • A rule weight -based fuzzy classification model is proposed to analyze the patterns of admission-discharge of patients as a previous research for differential diagnosis of dyspnea. The proposed model is automatically generated from a labeled data set, supervised learning strategy, using three procedure methodology: i) select fuzzy partition regions from spatial distribution of data; ii) generate fuzzy membership functions from the selected partition regions; and iii) extract a set of candidate rules and resolve a conflict problem among the candidate rules. The effectiveness of the proposed fuzzy classification model was demonstrated by comparing the experimental results for the dyspnea patients' data set with 11 features selected from 55 features by clinicians with those obtained using the conventional classification methods, such as standard fuzzy classifier without rule weights, C4.5, QDA, kNN, and SVMs.

The Cause of Motion Sickness in Oriental Medicine (멀미의 병인(病因)에 대한 한의학적(韓醫學的) 접근(接近))

  • Han, Yun-Jeong;Jang, Gyu-Tae
    • The Journal of Pediatrics of Korean Medicine
    • /
    • v.22 no.1
    • /
    • pp.149-162
    • /
    • 2008
  • Objectives The purpose of this study is to investigate that causes of motion sickness in oriental medicine. Methods The internal and external studies about motion sickness were searched Results and Conclusions The motion sickness is induced by conflict of balance system including vestibular, visual and proprioceptive system. The motion sickness is more common in female and in children between 2 and 12 years old. In western medicine, antihistamine and anticholinergic has been used for treatment of motion sickness, but these anti-motion sickness drug turn out to be not a perfect solution and have several side effects. On the other hands, In oriental medical terminology, there is no words equivalent to the "motion sickness", but we consider the motion sickness as state with dizziness, nausea and vomiting. The motion sickness can be induced by either internal or external causes and the internal causes can thought to be a constitutional factor of an individuals, and the general transportation can be an external cause. The important internal cause is a dysfunction of the spleen, stomch(脾胃不調), retention of phlegm and fluids(痰飮), and deficiency of the kidney jing(腎精不足). The wind(風) and fire(火) in the upper part of the body, especially in the head, also can be an important cause of the motion sickness.

  • PDF

Evaluation of Results and Workloads of the Horizon Scanning of the Emerging Health Technology in Korea (국내 신개발 유망의료기술 탐색활동 결과 및 업무량 분석)

  • Joo, Yea Il;Lee, Hyeong Il;Song, Yeong Chae;Park, Joo Yeon;Shin, Ho Gyun
    • The Journal of Health Technology Assessment
    • /
    • v.6 no.2
    • /
    • pp.156-161
    • /
    • 2018
  • Objectives: To evaluate results and workloads of the horizon scanning of the emerging health technology since 2014 to 2016. Methods: In order to analyze the results of the emerging health technology, we identified the number of research procedure between 2014 and 2016. The sixteen findings were calculated annual workload by person, and categorized by medical phase, classification of disease, and healthcare technology. Results: An average of 5.67 personnel were involved over three years, assessment of each emerging healthcare technology was performed for each person of identifying 54 cases, filtering 2.4 cases, prioritizing 0.9 cases were performed. According to the mapping by healthcare technologies, nine medical devices (56.3%), six drugs (37.5%), and one material of the medical treatment (6.3%) were assessed. Among sixteen findings, fifteen cases were health technologies for treatment and only one case for diagnosis. Conclusion: Future plans of the horizon scanning of the emerging health technology is required appropriate manpower in charge each target number of assessment. And a legal basis should be provided for policy reflection rate. Furthermore, an evaluation criteria and procedures should be transparent to avoid a conflict of interest.

A Study on the Goal-Orientation of QI Performers in the Medical Centers (의료기관 QI 담당자의 목표추구몰입에 관한 연구)

  • Kim, Mi-Sook;Park, Jae-Sung
    • The Korean Journal of Health Service Management
    • /
    • v.2 no.1
    • /
    • pp.105-124
    • /
    • 2008
  • The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

  • PDF

Oriental Medicine Based Psychotherapy for Somatoform Disorder;A Case Report (한의학 정신요법 집단치료로 호전된 감별 불능 신체형장애 여환 1례)

  • Byun, Soo-Nim;Kim, Sang-Ho;Park, So-Jeong;Kim, Ji-Young;Kim, Jong-Woo;Chung, Sun-Yong;Hwang, Wei-Wan;Kim, Ji-Hyouck
    • Journal of Oriental Neuropsychiatry
    • /
    • v.17 no.3
    • /
    • pp.97-106
    • /
    • 2006
  • Oriental Medicine Based Psychotherapy is consisted of 8 sessions which are available for various kinds of patients(mood disorders, somatoform disorders, anxiety disorders, Hwabyung, adjustment disorders etc.). Through 8 sessions, patients were educated on the relationship of mind and body which is the basic concept of oriental medicine and also received several training such as Progressive Muscle Relaxation, Autogenic Training, Breathing Training, Meditation, Qi-training. After these several training they get to think of their problems and inner conflict with people and get some insight about themselves and others, it can help handling their problems. This case report is about the patient with lots of somatic complains through the whole body, who got better after treatment by oriental medicine based psychotherapy added on herbal medicine and acupuncture.

  • PDF

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
    • /
    • v.2 no.1
    • /
    • pp.35-56
    • /
    • 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.

  • PDF

A comparative study on the consciousness of bio-medical ethics of nursing and non-nursing students (간호과와 비 간호과 학생의 생명의료윤리 의식 비교)

  • Cho, Mee-Kyung
    • Journal of Digital Convergence
    • /
    • v.11 no.4
    • /
    • pp.311-320
    • /
    • 2013
  • The purpose of this study was to identify consciousness of bio-medical ethics of nursing and non-nursing students. The total mean scores of consciousness of bio-medical ethics between nursing(3.04/4) and non-nursing(2.88/4) were significantly different(t=6.79, p<.001). There were statistically significant differences between two groups in sub-categories of consciousness of bio-medical ethics: right to life of fetus, prenatal diagnosis of fetus, right to life of newborn, euthanasia, organ transplantation, brain death. The major predicting factors for consciousness of bio-medical ethics were experience of studying for biomedical ethics over 1 semester, experience of conflict for biomedical ethic problem, and ethical attitude in nursing department. Study results indicate that appropriate and various teaching-learning method for education of each department is deeded according to move up into a higher class with consciousness of bio-medical ethics, ability of decision making, critical thinking.

Research on the Conflicts and Future Direction of Integrative Medicine in Korea (한.양방 통합의료의 갈등과 방향에 대한 연구 - 한.양방 의료 및 관련 종사자 대상 심층면접을 중심으로 -)

  • Lim, Eun Jin;Kim, So Yun;Sohn, Myoung Sei;Choe, Pyung Nak;Oh, Byeong Sang
    • Journal of Physiology & Pathology in Korean Medicine
    • /
    • v.28 no.2
    • /
    • pp.243-250
    • /
    • 2014
  • This study examined the knowledge and understanding of integrative medicine in Korea, specifically conflicts between western and oriental medicine within Parallel (Dual) health care systems. Qualitative methodology using grounded theory guided semi-structured, in-depth interviews with Western Medical Doctors (W.M.D., n = 6), Oriental Medical Doctors (O.M.D., n = 5) and Traditional Chinese Medicine Practitioners (T.C.M.P., n = 4). Thematic analysis was used to determine broad themes from the interviews. 15 professionals (W.M.D. (40%), O.M.D. (33%), T.C.M.P. (27%), 10 males (67%) and 5 females (33%), mean age 45) were interviewed, recorded, and transcribed. Thematic analysis revealed three key themes: systematic conflicts, integration and future directions. Subthemes of systematic conflicts included: credibility of Oriental Medicine, commercial imperatives, maintaining social standing of O.M.D., professional qualifications and lack structures supporting collaborative practice. Integration subthemes included lack of academic linkage and clarity for appropriate triage, opposing medical paradigms and limited social imperative. Future directions should include: social justification, guarantee of oriental medicine legitimacy, role of government and understanding of scientific evidence. To successfully integrate dual medical systems there is a need to address differences in social-environmental factors and perceptions of scientific understanding, as well as developing strong academic links in clinical practice.

Tasks for the Separation of Prescribing and Dispensing medicinal herbs in Traditional Korean Medicine (한의약분업과 관련된 여러 가지 문제)

  • Lee, Hai-Woong;Kim, Hoon;Kim, Gyeong-Cheol;Kim, Jong-Hwan;Shin, Woo-Jin;Park, Dong-Il;Hwang, Won-Duk
    • Journal of Korean Medical classics
    • /
    • v.23 no.1
    • /
    • pp.133-142
    • /
    • 2010
  • Preconditions for the separation of prescribing and dispensing medicinal herbs in Traditional Korean Medicine are classification of medicinal herbs for general public and special medical uses, establishment of national medicinal herb distribution company of governmental base, restriction in purchase of medicinal herbs for special medical use, partnership between doctors and pharmacists of Traditional Korean Medicine, and coverage of herbal medicine-based medication in national health insurance, etc. The number of Traditional Korean Medicine Pharmacists which was born during 'the herbal medicine conflict' initiated in 1993, goes over 1,000 and will increase by 120 annually. The number of Traditional Korean Medical Doctors is over 17,000 and increases by 850 annually. So in order to engage partnership between two groups, the government have to arrange the number of outputs of each group. Standardization and classification of diagnosis and diseases in Traditional Korean Medicine is a matter of course in the separation of prescribing and dispensing medicinal herbs. Related societies and academies need to do researches with governmental fund first. After these works, we can launch a task force team for implementation of process for the separation of prescribing and dispensing medicinal herbs in Traditional Korean Medicine properly. Entering the national health insurance system for full coverage of Korean Medicine care service will be essential for the patients. Implementation the separation of prescribing and dispensing medicinal herbs in Traditional Korean Medicine would be the core of health insurance coverage for medication.