• Title/Summary/Keyword: Medication safety

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Revisiting History of Treatment of Attention Deficit Hyperactivity Disorder : Pharmacologic Approach (주의력결핍 과잉행동장애 치료의 역사적 재조명 : 약물치료적 접근)

  • Bahn, Geon Ho;Hong, Min Ha;Lee, Yeon Jung;Han, Ju Hee;Oh, Soo Hyun
    • Korean Journal of Biological Psychiatry
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    • v.21 no.2
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    • pp.37-48
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    • 2014
  • Besides from medical data, the patients who were previously called as attention disorder, mental instability, moral imbeciles, or moral defectives, can also be identified by exploring literatures and historical figures. In the past, as we can notice from the titles, they were recognized as a 'moral defect group'. And rather than treating them, separation from the society was the main solution. After the endemic encephalitis from 1917 to late 1920s, however, many survivors suffered from behavioral problems similar to those of the previous 'moral defect group' and studies on the relationship between brain damage and behavior problems were started henceforth. After being known as the 'minimal brain dysfunction', it was developed into the current attention-deficit/hyperactivity disorder. While the disease concept changed and developed over time, after numerous trials and errors, treatment medication starting from central nervous system stimulants such as amphetamine and methylphenidate is used for treatment in children and adult patients with ADHD, and most recently non-stimulants such as atomoxetine has become the one of the first line treatment options. Although we went through a thorough verification process of the safety and efficacy of the medication by contemplating the historical development process, we believe that adjustment is needed for remaining concerns on medication abuse and slight differences in disease paradigm and therapeutic philosophy depending on cultures.

Influencing Factors and Consequences of Near Miss Experience in Nurses' Medication Error (간호사의 투약 근접오류경험의 영향 요인과 결과)

  • Park, Jin Hee;Lee, Eun Nam
    • Journal of Korean Academy of Nursing
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    • v.49 no.5
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    • pp.631-642
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    • 2019
  • Purpose: This study aimed to predict the influencing factors and the consequences of near miss in nurses' medication error based upon Salazar & Primomo's ecological system theory. Methods: A convenience sample of 198 nurses was recruited for the cross-sectional survey design. Data were collected from July to September 2016. Using the collected data, the developed model was verified by structural equation modeling analysis using SPSS and AMOS program. Results: For the fitness of the hypothetical model, the results showed that $x^2$ ($x^2=258.50$, p<.001) was not fit, but standardized $x^2$ ($x^2/df=2.35$) was a good fit for this model. Additionally, absolute fit index RMR=.06, RMSEA=.08, GFI=.86, AGFI=.81 reached the recommended level, but the Incremental fit index TLI=.82, CFI=.85 was not enough to reach to the recommended level. With the path diagram of the hypothetical model, caution (${\beta}=-.29$ p<.001), patient safety culture (${\beta}=-.20$, p=.041), and work load (${\beta}=.18$, p=.037) had a significant effect on the near miss experiences in nurses' medication error, while fatigue (${\beta}=-.06$, p=.575) did not affect it. Moreover, the near miss experience had a significant effect on work productivity (${\beta}=-.25$, p=.001). Conclusion: These results have shown that to decrease the near miss experience by nurses and increase their work productivity in hospital environments would require both personal and organizational effort.

A Study on Self-medication for Health Promotion of the Silver Generation

  • Oh, Soonhwan;Ryu, Gihwan
    • International Journal of Advanced Culture Technology
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    • v.8 no.4
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    • pp.82-88
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    • 2020
  • With the development of medical care in the 21st century and the rapid development of the 4th industry, electronic devices and household goods taking into account the physical and mental aging of the silver generation have been developed, and apps related to health and health are generally developed and operated. The apps currently used by the silver generation are a form that provides information on diseases by focusing on prevention rather than treatment, such as safety management apps for the elderly living alone and methods for preventing diseases. There are not many apps that provide information on foods that have a direct effect and nutrients in that food, and research on apps that can obtain information about individual foods is insufficient. In this paper, we propose an app that analyzes food factors and provides self-medication for health promotion of the silver generation. This app allows the silver generation to conveniently and easily obtain information such as nutrients, calories, and efficacy of food they need. In addition, this app collects/categorizes healthy food information through a textom solution-based crawling agent, and stores highly relevant words in a data resource. In addition, wide deep learning was applied to enable self-medication recommendations for food. When this technique is applied, the most appropriate healthy food is suggested to people with similar eating patterns and tastes in the same age group, and users can receive recommendations on customized healthy foods that they need before eating. This made it possible to obtain convenient healthy food information through a customized interface for the elderly through a smartphone.

Qualitative Study for Barriers for Medication and Health Care Service Use among the Visually Impaired and Hearing Impaired in Korea (시각장애인 또는 청각장애인의 의료기관 이용 및 의약품 안전사용 저해요인 관련 심층면접조사)

  • Lee, Soo-Hyun;Choi, Minji;Han, Euna
    • Korean Journal of Clinical Pharmacy
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    • v.31 no.4
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    • pp.311-323
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    • 2021
  • Objective: The disabled are in a blind spot for obtaining information on drugs, and the pharmacies' counseling on drug use is centered on non-disabled people. Few studies have investigated the current statuses of drug use by type of disability. The purpose of this study is to understand the drug use by type of disability and by life cycle of visually impaired and hearing impaired in Korea. Methods: The study participants consisted of 16 people with visually impairments, 12 people with hearing impairments. One in-depth interview was conducted per participant, and each interview was recorded and documented. Results: Common barriers against safe medication and medical service uses across disability types are 'lack of consideration and service for the disabled, limited access to medical facilities due to disability, limited access to information regarding medication use, psychological anxiety about drug use and side effects, and inconvenience regarding COVID-19 epidemic. The specific factors were 'difficulties in identifying proper medicines and following prescribed dosages' in the case of visually impaired, and 'problems with sign language interpretation system' for the hearing impaired. Conclusion: Disabled people are hindered from using medicines properly due to various factors. Based on the content derived from this study, it is necessary to eliminate the inhibition factors and devise specific measures for the safety of each type of disorder such as developing a method for medication counseling considering disabilities and establishing communication support systems.

Efficacy and safety of dienogest in patients with endometriosis: A single-center observational study over 12 months

  • Park, So Yun;Kim, Sung Hoon;Chae, Hee Dong;Kim, Chung-Hoon;Kang, Byung Moon
    • Clinical and Experimental Reproductive Medicine
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    • v.43 no.4
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    • pp.215-220
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    • 2016
  • Objective: To evaluate the efficacy and safety of dienogest treatment in patients who had received dienogest for 12 months or more to treat endometriosis. Methods: We analyzed the clinical data of 188 women with endometriosis who had been treated with 2 mg of dienogest once a day for 12 months or more at a single institute. We evaluated changes in endometriosis-associated pain and endometrioma size, recurrence rate, and adverse events following dienogest administration. Bone mineral density (BMD) was measured in patients who were prescribed dienogest for more than 18 months. Results: Pain was significantly reduced at 12 months after dienogest medication. In those treated with dienogest due to recurrent endometrioma, the size of the endometrioma was significantly decreased at the 12-month and 18-month follow-ups. We found only one case of sonographic recurrence during dienogest administration among those who were treated postoperatively to prevent recurrence (1 of 114, 0.9%). The most common adverse drug reaction was uterine bleeding (3.2%), and other adverse events were generally tolerable and associated with low discontinuation rates (5.2%). Among the 50 patients in whom BMD was measured, 10 patients (20%) had a Z-score below the expected range for age. Conclusion: The administration of dienogest for a year or more seems to be highly effective in preventing recurrence after surgery, reducing endometriosis-associated pain, and decreasing the size of recurrent endometrioma, with a favorable safety and tolerability profile. However, BMD should be checked in patients on long-term medication due to possible bone loss in some women.

Real-time Monitoring of the Actual Infusion Rate of Syringe Pump Using 2D Image Marker Tracking (2D 영상마커 추적 기반 시린지펌프 투약속도 실시간 감시 기술 개발)

  • Gun Ho, Kim;Young Jun, Hwang;Min Jae, Kim;Kyoung Won, Nam
    • Journal of Biomedical Engineering Research
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    • v.44 no.1
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    • pp.92-98
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    • 2023
  • Purpose: To propose a new infusion rate monitoring technique based on the 2D image marker tacking to improve patient safety by preventing syringe pump-related medication accidents due to decreased infusion rate control accuracy. Materials and Methods: The infusion rate of the syringe pump and drug residue in the pump-equipped syringe were monitored in real time by tracking the movement of the 2D image markers attached to the syringe pump. Results: The error rate between the set and the estimated infusion rates was 1.03, 0.66, 1.95, 0.23, and 1.05% when the infusion rate setting was 10, 20, 30, 40, and 50 mL/H, respectively. In addition, the error rate between the actual and the estimated drug residues was 1.04, 0.47, 0.60, 3.66, and 0.00% when the infusion rate setting was 10, 20, 30, 40, and 50 mL/H, respectively. Conclusion: Experimental results demonstrated that the proposed technique can increase the efficiency of the safety management system for seriously ill inpatients by decreasing a possibility of syringe pump-related medication accidents in hospitals.

Safety Education Programs for Patients and Families in Overseas Institutions (국외 환자대상의 환자안전 교육 사례)

  • Kim, Yoon-Sook;Kwak, Mi-Jeong;Kim, Moon-Sook;Kim, Hyun-Ah;Kim, Hyuo-Sun;Chun, Ja-Hae;Hwang, Jee-In
    • Quality Improvement in Health Care
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    • v.25 no.1
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    • pp.2-10
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    • 2019
  • Purpose: The purpose of this study was to share program and/or resource on patient safety education for patients and families conducted overseas agency. This study will help the patient safety officer establish and implement an educational plan for patients and families. Methods: We searched the Internet for patient safety related organizations. We chose an institution that provided education for patients and families. Results: Most of the program and/or resource was about patient and family involvement; Taking Care of Myself, My Questions for This Visit, Patient Prep Card, 20 Tips to Help Prevent Medical Errors, Ask Me 3(R), Health and Safety Passport, My Medication log etc. Conclusions: It is necessary to distribute educational materials for patients and families in the country through the results of this study. For patient safety, education and publicity are needed so that developed educational materials can be actively used.

A Study on the Relationship between Patient Safety and Patient-Centeredness in Hospitals (의료기관 환자안전과 환자중심성 간 관계 연구)

  • Kook, Sun-Pyo;Kang, Jegu;Lee, Kwang-Soo
    • Korea Journal of Hospital Management
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    • v.27 no.3
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    • pp.39-49
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    • 2022
  • Purposes: This study purposed to analyze the relationship between patient safety and patient-centerendess. Methodology: The comprehensive scores from patient safety assessment program and patient experience survey conducted by Health Insurance Review & Assessment Service were used as independent variables and dependent variables. This study analyzed the relationship between 4 patient safety-related areas(i.e. risk standardized readmission ratio, intensive care unit, preventive antibiotic, the drug evaluation) and 6 patient experience areas(i.e. nurse services, doctor services, medication & treatment, hospital environment, patient's right, overall experience) by using robust regression analysis. Findings: According to results, the score in 'patient's right' and 'risk standardized readmission ratio' areas were found to have a significant relationship, and 'overall experience' and the 'preventive antibiotic' areas. The ratio of senior beds and specialists was a general characteristics of hospitals that had a significant relationship on patient experience assessment. Practical Implication: The relationships between patient safety and patient experience assessment were varied depending on areas. Further study is needed to make clear the supposed relationship.

The Effectiveness and Safety of Dokwhalkisaeng-tang Combined with the Medication on Rheumatoid Arthritis: A Study Protocol for Systematic Review and Meta-analysis (류마티스 관절염 치료제와 병용한 독활기생탕의 효과 및 안전성: 체계적 문헌고찰 및 메타분석 프로토콜)

  • Chae, Soo-Yeon;Jung, Chan-Yung;Kim, Joo-Hee;Kim, Eun-Jung;Seo, Byung-Kwan;Hwang, Min-Seop;Park, Seong-Sik;Kim, Kyung-Ho;Yoon, Jong-hwa;Sung, Won-Suk
    • Herbal Formula Science
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    • v.30 no.2
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    • pp.95-100
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    • 2022
  • Objectives : Recent studies reported that Dokwhalkisaeng-tang (DHJST) could relieve the clinical rheumatoid arthritis (RA) symptoms and the level of RA-related blood test. However, evidence-based review on effectiveness and safety of DHJST with medication on RA was not yet provided. Methods : Searching randomized controlled trials on the use of DHJST for RA will be performed using multiple electronic databases, manual search, and contact to author. Studies will be selected according to the pre-defined criteria and collected data on study participants, interventions, control groups, outcome measurements, the results, adverse events, and risk of bias will be summarized. Primary outcome will be the disease activity score (including effective rate, swollen joint count, tender joint count, and morning stiffness), and the secondary outcomes will be RA-related blood test and adverse events. We will use Review Manager software to perform a meta-analysis, Cochrane Collaboration "risk of bias" tool for assessing the risk of bias, and Grades of Recommendation, Assessment, Development and Evaluation for the determination of quality of evidence. Results : We are going to investigate the effectiveness and safety of DHJST with medication for RA. Conclusion : This study will provide reliable evidence on whether DHJST combined with medicine is more effective on RA than medicine monotherapy.

Current Status of Patient Safety Regulations, Guidelines and Support Mechanisms in Korean Hospitals

  • Lee, Jae Ho;Kim, Jeong Eun;Kim, Suk Wha;Lee, Sang Il;Jung, Yoen Yi;Kim, Moon Sook;Jang, Seon Mi
    • Perspectives in Nursing Science
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    • v.10 no.2
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    • pp.158-166
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    • 2013
  • Purpose: This study was conducted to investigate patient safety regulations and guidelines in order to understand their current status, and to examine support measures to improve patient safety in Korean hospitals. Methods: The participants were the safety officers from hospitals with 200 or more beds and 112 hospitals responded to the online survey. The questions covered patient safety regulations, the performance level of patient safety activities, patient safety incident reporting systems, the dedicated professional, training, support mechanisms, and expectations of reporting systems. Results: Among preventative measures, fall prevention and hand hygiene were reported to be most widely practiced (92% and 91%, respectively). Time-out for invasive procedures showed a relatively low practice rate at 70%. Among patient care activities, transfusion, surgery and sedation, medication, and infection management were performed by 84, 74, 93 and 93% of the hospitals, respectively. Patient safety activities included patient safety committee, patient safety cooperation between decision-making bodies, patient safety workshops, seminars, lectures, and training for employees. Conclusion: Patient safety regulations and guidelines have not yet been sufficiently prepared, and a public institution such as a certification authority is of crucial importance to enforce these guidelines.

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