• 제목/요약/키워드: Medication error

검색결과 64건 처리시간 0.025초

비행안전 프로그램으로서의 생체 활성도 활용방안 연구 (A Study on the Practical Use of Human Alertness for Flight Safety Program)

  • 이달호;최승호
    • 대한인간공학회지
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    • 제17권3호
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    • pp.13-22
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    • 1998
  • Aircraft and the three-dimensional environment in which they operate are not user-friendly for human beings. As a result, maintaining the proficiencies necessary to safely and efficiently fly an airplane are difficult, and costly. The physiological and emotional status of the human element remains crucial in maintaining safe performance by all crew members. In the study of Hagiwara et al.(1993). they called the physiological and emotional status of the human element into the human alertness or physiological activity and stress, fatigue, circadian rhythm, alcohol. smoking, and self-medication are known the major factors that deteriorate the human alertness. Accordingly. this paper deals with the quantitative and objective performance test based on tracking error and reaction time by means of the new computer test program into which the perception-motion system of human beings is applied. Throughout this experiment using performance test, the results suggest that performance capability in state of sleep deprivation 2 hours and alcoholic 0.05~0.06% in blood were more impaired than one in a normal state, and they further showed statistically significant differences between them, which were influenced by impairment factors of body regulation and pilot's grade. We also obtained the prediction value and the 95% confidence interval of tracking error and reaction time at the normal state for the purpose of distinguishing performance capability between the normal state and the abnormal state. And it is expected that the evaluation of human alertness using performance test will be applied to the quantitative assessment of an each pilot's realistic consciousness/attention, and will lead a flight commander to the accurate decision of mission approval prior to a flight.

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자료포락분석을 활용한 일 병동 간호사의 성과평가 방안 (Performance Evaluation of Nurses in a General Ward Using Data Envelopment Analysis (DEA))

  • 박연홍;임지영
    • 가정∙방문간호학회지
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    • 제25권1호
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    • pp.67-77
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    • 2018
  • Purpose: The purpose of this study was to compare the efficiency of general ward nurses in hospitals using Data Envelopment Analysis (DEA). Methods: Participants were 30 nurses working at a general ward. Input variables were labor cost and time of direct nursing. Output variables were prevention rate of medication error and bedsores, and patient satisfaction. These variables were extracted using literature review and CVI of an expert group. Data were collected from September 18 to October 7, 2017. Data were analyzed using EMS 3.1 program for DEA and descriptive statistics. Results: The average efficiency score of 30 nurses was 0.986, which was very high over all. In the super-efficiency analysis of 11 nurses, their efficiency ranged from 1.0 to 1.047. In addition, when the current output was fixed, the labor cost of nurses did not affect efficiency. Conclusion: This study attempted a new approach concerning performance evaluation of nurses using DEA. This method was useful during appraisal of nurses. We suggest that various input and output variables that were not considered in this study should be added to develop a integrative performance analysis model for nurses.

Genetic and Environmental Deterrents to Breeding for Disease Resistance in Dairy Cattle

  • Lin, C.Y.;Aggrey, S.E.
    • Asian-Australasian Journal of Animal Sciences
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    • 제16권9호
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    • pp.1247-1253
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    • 2003
  • Selection for increased milk production in dairy cows has often resulted in a higher incidence of disease and thus incurred a greater health costs. Considerable interests have been shown in breeding dairy cattle for disease resistance in recent years. This paper discusses the limitations of breeding dairy cattle for genetic resistance in six parts: 1) complexity of disease resistance, 2) difficulty in estimating genetic parameters for planning breeding programs against disease, 3) undesirable relationship between production traits and disease, 4) disease as affected by recessive genes, 5) new mutation of the pathogens, and 6) variable environmental factors. The hidden problems of estimating genetic and phenotypic parameters involving disease incidence were examined in terms of categorical nature, non-independence, heterogeneity of error variance, non-randomness, and automatic relationship between disease and production traits. In light of these limitations, the prospect for increasing genetic resistance by conventional breeding methods would not be so bright as we like. Since the phenomenon of disease is the result of a joint interaction among host genotype, pathogen genotype and environment, it becomes essential to adopt an integrated approach of increasing genetic resistance of the host animals, manipulating the pathogen genotypes, developing effective vaccines and drugs, and improving the environmental conditions. The advances in DNA-based technology show considerable promise in directly manipulating host and pathogen genomes for genetic resistance and producing vaccines and drugs for prevention and medication to promote the wellbeing of the animals.

중환자실 간호사의 수면장애가 피로, 졸음과 근접오류에 미치는 영향 (Effect of Sleep Disturbance on Fatigue, Sleepiness, and Near-Miss among Nurses in Intensive Care Units)

  • 문경미;최수정
    • 중환자간호학회지
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    • 제13권3호
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    • pp.1-10
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    • 2020
  • Purpose : This study aims to investigate the differences in fatigue, sleepiness, and near-miss according to sleep disturbance among shift nurses in intensive care units (ICUs). Methods : A cross-sectional study in a tertiary hospital was performed. A total of 122 shift nurses working in the six ICUs were recruited. They completed self-reported questionnaires about sleep disturbance, fatigue, sleepiness, and near-miss in the past two weeks. Results : The prevalence of reported sleep disturbance was 30.3% (37 out of 122 subjects). Compared to the non-sleep disturbance group, the sleep disturbance group reported significantly more sleepiness (11.46 vs. 8.86) and higher fatigue (82.62 vs. 69.39). The sleep disturbance group showed higher rates of near-miss (78.4 vs. 57.6%) and a higher frequency of them (4.49 vs. 2.11/2weeks) compared to the non-sleep disturbance group. Medication error was the most common type of near-miss. Conclusions : This study suggests that sleep disturbances could increase fatigue, sleepiness, and near-miss among ICU shift nurses. Personal and organizational programs should be developed to support the sleep of ICU nurses.

뉴로피드백을 이용한 명상훈련이 정상 성인의 기억과 집중력에 미치는 영향 (The Effects of Breath Meditation with Neurofeedback on Memory and Concentration of Healthy Adult Volunteers)

  • 정선용;서진우;김종우;황의완
    • 동의신경정신과학회지
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    • 제19권2호
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    • pp.15-39
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    • 2008
  • Objective : The objective of this study was to investigate the effects of breath meditation with neurofeedback on memory, concentration of healthy adult volunteers Method 25 healthy adult volunteers were divided into two groups. One group was treated with breath meditation and real neurofeedback, but the other group was administered with breath meditation and sham neurofeedback three times a week for 10 sessions, Before and after 10 sessions neurofeedback, all subjects were measured by cognitive functions assessment, heart rate variability, BDI, STAI, K-WAIS, HRSD, VAS about amnesia. Results : 1. Breath Meditation decreased error rate and increased concentration, cognition strength, and success rate of Cognitive Functions Assessment. Also, Breath Medication elevated IQ score of K-WAIS short form. 2. Sham : neurofeedback increased concentration, cognition strength compared to Real neurofeedback. Conclusion : The results suggest that breath meditation might effect cognitive function of healthy adult positively, but neurofeedback is not clear. In order to prove whether neurofeedback is effective or not, it should be studied more.

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한국인에서의 페닐케톤뇨증의 유전자변이에 대한 고찰 (The Study of DNA Mutations of Phenylketonuria in Koreans)

  • 유수정;홍용희;이용화;정성철;기창석;이동환
    • Journal of Genetic Medicine
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    • 제5권1호
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    • pp.26-33
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    • 2008
  • 목 적 : 페닐케톤뇨증은 상염색체 열성으로 유전되는 아미노산 대사질환으로 PAH와 조효소인 $BH_4$의 활성이 저하되어 발생한다. 본 연구에서는 PAH 유전자 돌연변이와 임상양상과의 연관성을 조사하였고 PAH DNA 변이의 국가간의 차이를 분석하였다. 방 법 : 페닐케톤뇨증 환자와 환자 가족의 동의하에 DNA를 말초혈액의 백혈구에서 분리하여 PAH 유전자를 PCR을 통해 증폭하여 유전자 서열을 분석하였고 PAH 돌연변이가 하나의 대립유전자에서만 발견이 되거나 없는 경우는 분석된 서열을 MLPA를 시행하여 분석을 하였다. 결 과 : 유전자 검사를 시행한 102명의 대립유전자 204개 중 199개의 돌연변이가 발견되어 97%의 검출률을 보였다. 발견된 돌연변이는 총 44가지의 유전자형으로 9개는 novel missense mutation이었고 1개는 novel splice site mutation이었다. 가장 많은 대립 유전자형은 R243Q와 $IVS4^{-1}$G>A로 각각 13.1%와 11.6%를 나타내었다. 전형적 페닐케톤뇨증에서는 R243Q와 $IVS4^{-1}$G>A가 각각 14.2%를 차지하였고 $BH_4$ 반응형 페닐케톤뇨증의 경우에는 R241C가 33.3%, 양성 고페닐알라닌혈증이 R241C가 40%에서 나타났다. $BH_4$ 반응형 페닐케톤뇨증의 경우에는 약물 치료만으로 조절이 되는 환자에서 T278I와 V388M mutation이 발견되었고 약물 치료만으로 조절이 되지 않고 식사요법을 병행해야하는 환자들에서만 K95del과 A447P의 돌연변이가 나타났다. 그리고 2004년 이전에는 동양인에게서 A259T 대립유전자 돌연변이가 발견되지 않은 것으로 보고되었으나 본 연구에서는 10.1%에서 발견되었다. 결 론 : 페닐케톤뇨증과 관련된 새로운 유전자 변이들이 발견되고 있으며 $BH_4$에 반응하는 유전자 변이들의 유전자형들이 확인되면서 PAH 유전자 분석은 페닐케톤뇨증 환자에서 진단, 유전상담, 식사 요법과 치료 계획 수립에 기여할 것이다.

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간호윤리 교육이 간호학생의 도덕적 사고와 윤리적 딜레마 상황에서의 의사결정에 미치는 효과 (Effects of Nursing Ethics Education on Moral Reasoning and Ethical Decision Making for Student Nurses)

  • 한성숙;안성희
    • 간호행정학회지
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    • 제1권2호
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    • pp.268-284
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    • 1995
  • This study was designed to test effects of nursing ethics education (NEE) on moral reasoning and ethical decision making of subjects. This NEE that was teached for 10 hours course was composed of these : Nurses' ethical code, moral responsibility, Moral value and professional accountability, Respect for human life, General ethics, Theory and Norms of biomedical ethics, Ethical decision making model and Discussion about hypothetical ethical dilemmas Twenty-five senior student nurses were sampled from four year college of nursing from Nov. 3rd, 1993 to Nov. 24th, 1993. Data were collected through self-reported questionnaires included two kinds of tests. Rest's Defining Issues Test was adopted to measure the stage of moral development, which was classified with the stage 2 (instrumental relativist orientation), the stage 3 (interpersonal concordance), the stage 4 (law and order), the stage 5A (societal consensus), and the stage 5B (intuitional humanism), the stage 6 (universal ethical practice). In particular, the level of principled thinking (P) was measured by summing these scores of the stages 5A, 5B, and 6. The possible range of P is 0 to 95. As for measuring the levels of morality and nursing dilemma, Crisham's Nursing Dilemma Test was adopted. This test generated the morality score(MS) and the dilemma score (DS). The data were analyzed by t-test, ANOVA, Kruskal-Wallis test, Mc Nemar's test and Pearson correlation coefficients. The results were as follows ; 1. For the Moral Reasoning both before and after NEE, The Mean score of the stage 5A was significantly higher than that of other stages.(P=0.0001) Before NEE, the mean score of the stage 4 was significantly different from stage 2, 3, 5A, and after NEE, different from stage 2, 5B,6. 2. The analysis of change of moral development level revealed that the score of stage 4 increased after NEE.(P=0.0004) 3. The Effect of NEE for the mean score of 5A, 6, P after education was significantly different by birth place. 4. With regard to the five dilemmas postulated such as forcing medication performing cardiac pulmonary resuscitation, reporting a medication error, informing diagnosis to terminally ill adult, and providing new-nurse orientation, the mean score of the MS and the DS was no significant difference with general characteristics of the students. Effect of NEE morality score and dilemma score after education was no significant difference. 5. As for the correlations between moral reasoning and decision making, the score of the stage 2, 5A, 6, DS was positively correlated with the scores of before and after. Positive correlation was also observed between the scores of stage 2 and stage 4, stage 3 and 6. On the other hand, the score of P was negatively correlated with the scores of stage 2 and of stage 4 and of stage 5A. The score of the stage 5A was also negatively correlated with the score of the sge 6.

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간호학생의 도덕적 사고와 윤리적 딜레마 상황에서의 의사결정 (Moral Reasoning and Ethical Decision Making among Student Nurses in Moral Dilemmas)

  • 한성숙;안성희
    • 간호행정학회지
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    • 제1권1호
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    • pp.5-21
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    • 1995
  • This study purports to investigate moral reasoning and ethical decision making among student nurses in the hypothetical moral dilemmas. The subjects consisted of 25 senior nursing students attending at a four-year college. Data were collected through self-reported questionnaires in November, 1993. The questionnaires included two kinds of tests. Rest's Defining Issues Test was adopted to measure the stage of moral development, which was classified with the stage 2 (instrumental relativist orientation), the stage 3 (interpersonal concordance), the stage 4 (law and order), the stage 5A (societal consensus), and the stage 5B (intuitional humanism). In particular, the level of principled thinking (P) was measured by summing those scores of the stages 5A, 5B, and 6. The possible range of P is 0 to 95. As for measuring the levels of morality and nursing dilemma, Crisham's Nursing Dilemma Test was adopted. This test generated the morality score(MS) and the dilemma score (DS). The data were analyzed by t-test, ANOVA, Kruskal-Wallis test, and Pearson correlation coefficients. The findings are following. 1. The mean score of P was 52.93 (SD=12.82). The mean score of the stage 5A was significantly higher than the scores of other stages (17.92, p=.0001). 2. The mean score of P was not significantly different by general characteristics of the students. Of the scores of each stage, only the mean score of the stage 3 revealed significant difference by the status of living with parents(p=.0283). The score was highest when "living with both parents"(15.22), which was followed by "living with no parents"(10.0), "living with father only"(9.0), and "living with mother only"(7.50). 3. With regard to the five dilemmas postulated such as forcing medication, performing cardiac pulmonary resuscitation, reporting a medication error, informing diagnosis to terminally ill adult, and providing new-nurse orientation, most students perceived them as moral dilemma rather than nonmoral one. Most students made a positive decision according to moral reasoning in the above situations except for providing new-nurse orientation. 4. The mean score of the MS was 3.30 and that of the DS was 3.32. These scores did not show significant difference with general characteristics of the students. 5. As for the correlations between moral reasoning and decision making, the score of the stage 5A was positively correlated with the scores of P(.74, p<.0001) and DS(.56, p<.001). Positive correlation was also observed between the scores of stage 2 and stage 4(.68, p<.0001). On the other hand, the score of P was negatively correlated with the scores of stage 3(-.47, p<.05) and of stage 4(-.55, p<.001). The score of the stage 5A was also negatively correlated with the score of the stage 6(-.42, p<.05).

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족삼리(足三里)에 시술(施術)된 죽력(竹歷) 약침(藥鍼)이 Intraluminal Filament 삽입술(揷入術)에 의하여 유발(誘發)된 백서(白鼠)의 허혈성(虛血性) 국소(局所) 뇌손상(腦損傷)에 미치는 영향(影響) (Effects of BCL herbal acupuncture into Choksamni(ST36) on focal brain ischemic injury induced by intraluminal filament insertion in the rats)

  • 윤대환;이봄비;심인섭;나창수
    • Korean Journal of Acupuncture
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    • 제22권2호
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    • pp.25-41
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    • 2005
  • Objectives : Bambusae Caulis in Liquamen(BCL) has been used to medication for early stroke in the Oriental Medicine. So this study was planned to investigate the effects of BCL on the focal ischemia-induced by intraluminal filament insertion in the rats. Materials and methods: The focal ischemia was induced by Intraluminal Filament insertion into middle cerebral artery. BCL herbal acupuncture at ST36 was carried out during 3 weeks after focal ischemia-induced. Eight-arm radial maze was used for the behavioral task and neuroprotective effect of BCL acupuncture was observed by Cresyl violet, AchE, ChAT-stain Results : The error rate in the eight-arm radial maze task was significantly decreased in BCL1(0.89mg/kg) herbal acupuncture group compared to control group on 3,4,5days, compared to saline acupuncture group on 3,5days. The rate of correct choice was significantly increased in saline acupuncture, BCL1 herbal acupuncture group, BCL2(0.089mg/kg) herbal acupuncture groups compared to control group. The density of neurons in the hippocampal CA1 was the most increased in BCL1 herbal acupuncture group compared to the others. The density of AchE in the hippocampal CA1 was significantly increased in BCL1 herbal acupuncture, BCL2 herbal acupuncture groups compared to control group, and in BCL2 herbal acupuncture groups increased compared to saline acupuncture, control groups. The density of ChAT in the hippocampal CA1 was significantly increased in BCLl herbal acupuncture group compared to saline acupuncture, control groups. Conclusions : These results suggest that BCL herbal acupuncture could be used as a medication for controlling the early stroke.

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녹용 약침이 국소 뇌허혈 모델 백서에서 방사형 미로과제 학습 및 뇌신경 보호에 미치는 영향 (Effect of Cervus Elaphus-Herbal Acupuncture on Focal Ischemia Induced by Inserted Intraluminal Filament in MCA of Rats)

  • 김성옥;윤대환;나창수
    • Korean Journal of Acupuncture
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    • 제22권4호
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    • pp.67-81
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    • 2005
  • Objectives : Cervus Elaphus(CE) has been used to medication for ischemic stroke in the Oriental Medicine. So this study was planned to investigate the effects of CE herbal acupuncture therapy(CE-HAT) on the focal ischemia-induced by intraluminal filament insertion in the rats. Materials and methods : The focal ischemia was induced by middle cerebral artery occlusion for 2hours. The groups divided into 6 groups, normal(intachess group), control(no theray group after ischemia-induced), CE-HAT1(Cervus Elaphus-herbal acupuncture therapy group at LR1, HT9 after ischemia-induced), CE-HAT2(Cervus Elaphus-herbal acupuncture therapy group at LU8, KI7 after ischemia-induced), CE-HAT3(Cervus Elaphus-herbal acupuncture therapy group at LR1, HT9, LU8, KI7 after ischemia-induced), CE-HAT4(Cervus Elaphus-herbal acupuncture therapy group at LR1, HT9, HT3, KI10 after ischemia-induced). CE-HAT was carried out during 3 weeks after focal ischemia-induced. Eight-arm radial maze was used for the behavioral task and neuropretective effect of CE-HAT was observed by Cresyl violet, AchE, ChAT-stain. Results : The error rate in the eight-arm radial maze task was significantly decreased in CE-HAT1, CE-HAT2, CE-HAT4 on 3days, CE-HAT4 on 4days, CE-HAT2, CE-HAT4 on 5days, CE-HAT3, CE-HAT4 on 6days. The rate of correct choice was significantly increased in CE-HAT4. The density of neurons in the hippocampal CA1 was significantly increased in CE-HAT1, CE-HAT2, CE-HAT3, CE-HAT4, compared to control group. The density of ChAT in the hippocampal CA1 was significantly increase in CE-HAT4. The density of ChAT in the hippocampal CA1 was significantly increased CE-HAT1. Conrlusions : These results suggest that the Cervus Elaphus-herbal acupuncture therapy could be used as a medication for controlling the stroke induced by deficiency.

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