• 의료법학
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• 제13권1호
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• pp.249-293
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• 2012

Inter-hospital transfer, depending on its medical and legal appropriateness, affect the prognosis of patients and can even lead to legal disputes. As Emergency Medical Service Act, any physician shall, in case where deemed that pertinent medical service is unavailable for such patient with the capacities of the relevant medical institution, transfer without delay such patient to another medical institution where a pertinent medical service is available. For medico-legally appropriate inter-hospital transfer, the head of a medical institution shall, in case where he transfers an emergency patient provide medical instruments and manpower required for a safe transfer of the emergency patient, and furnish the medical records necessary for a medical examination at the medical institution in receipt of such patient. And transfer process must comply with the requirements prescribed by executive rule such as attachment of the referral, provision of ambulance, fellow riders and informed consent of transfer. Those engaged in emergency medical service shall explain an emergency medical service to an emergency patient and secure his consent. In addition to the duty to inform about emergency medical service to the patient and his or her legally representative, there is also a duty for doctors to sufficiently explain to the patient and his or her legally representative during inter-hospital transfer that the need for the transfer, the medical conditions of the patient to be transferred and emergency treatment that will be provided by the hospital from which the patient is going to transferred. Likewise, the hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer by transferring doctors.

• 의료법학
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• 제10권1호
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• pp.389-420
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• 2009

Main Issue of Supreme Court Decision 2005Da16713 Delivered on June 24, 2005 is about the duty of medical care in the interhospital transfer of patients. According to the above Supreme Court Decision, in the interhospital transfer of patients, the decision to transfer should make from the aspect of medical treatment. The hospitals and doctors keep the duty of medical care. In addition to the duty for hospitals/doctors to check the capacity and availability of the hospital to which the patient is transferred, there are also duties to inform about emergency medical service and to sufficiently explain the need for the transfer, the medical conditions of the patient to be transferred and the hospital from which the patient is transferred. The hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer. including information upon referral, completeness of medical records, patient monitoring and so on. The interhospital transfer requires the consent of doctor belonging to the hospital to which the patient is transferred after the consideration of capacity and availability of the hospital and the informed consent of patients or legal representatives.

• 임상간호연구
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• 제19권1호
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• pp.115-127
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• 2013

Purpose: This study aimed to describe how nurses in neurological intensive care units (ICU) perceive their roles about patient transfer and liaison. Methods: A cross-sectional survey was conducted using a questionnaire developed for the study. Data were collected from a convenience sample of 115 nurses working in the neurological intensive care units ofsix university hospitals. Data were analyzed using SPSS software (version 15.0). Results: Staff nurses were mainly in charge of patient transfer, and the awareness about its importance was significantly related with the burden about the practice of patient transfer (p<.001). Patient liaison was mainly conducted by staff nurses as well. Liaison practice wassuggested to be started from the ICU at the time of transfer; the suggested time for completion of liaison service and evaluation was when patients were adjusted to the transferred ward. Preparing job descriptions and increasing nursing staffing for patient liasion service were strongly recommended. Conclusion: The results suggest that the ICU nurses' burden in relation to patient transfer is commensurate with their awareness about itsimportance. To improve the continuity of care from ICU to transferred ward, it isrequired to reduce the burden about patient transfer and improve perceptions about patient liaison.

• 대한간호학회지
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• 제48권5호
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• pp.554-564
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• 2018

Purpose: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. Methods: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. Results: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. Conclusion: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.

• 로봇학회논문지
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• 제18권4호
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• pp.403-408
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• 2023

In this paper, we introduce the results of the development of a care robot for the safe lifting and transportation of bedridden patients with difficulty moving by themselves, especially, in medical facilities. The purpose of the developed patient transfer robot is to improve the convenience of care givers and enhance the safety and comfort of care recipients by facilitating patient lifting and patient transfer tasks by applying robot technology. In order to implement the lifting function, a hoist was designed and developed, and a sway control and rollover warning system were included in the hoist module as product differentiators. In addition, in terms of implementing the transfer function, an omnidirectional movement mechanism to improve operability in confined spaces and an active safety system to prevent collisions were developed. The function of the developed patient transfer robot was verified through performance evaluation by an authorized testing agency.

• 간호행정학회지
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• 제22권3호
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• pp.230-238
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• 2016

Purpose: The purpose of this study was to investigate predictors of nurses' patient safety behavior during inter-hospital transfer. The study was based on the Theory of Planned Behavior (TPB). Methods: A descriptive survey design was used. Data were collected with a self-administrated 39-item questionnaire completed by 111 nurses from a university hospital in Seoul, South Korea. The questionnaire was developed based on the Theory of Planned Behavior (TPB) guideline and included measure of self-reported past patient safety behaviors, intentions, attitudes, subjective norms and perceived behavioral controls. Ethical approval was granted by the hospital review board. Hierarchical regression analyses were carried out. Results: The average score of patient safety behavior was $4.21{\pm}0.63$ (5 point scale). The TPB variables explained 49.9%of the variance in patient safety behavior. Intention and subjective norm were the most significant predictors of nurses' patient safety behavior. Attitude was related to nurses' patient safety behavior. Conclusion: TPB variables predicted the nurses' patient safety behavior during inter-hospital transfer of patients except for perceived behavioral controls. The results of this study suggest that better strategies for subjective norms and intentions related to patient safety behavior will be helpful in safety culture reform.

• 대한간호학회지
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• 제46권1호
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• pp.39-49
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• 2016

Purpose: This study was done to develop a postural-stability patient transfer technique for care helpers in nursing homes and to evaluate its effectiveness. Methods: Four types of patient transfer techniques (Lifting towards the head board of the bed, turning to the lateral position, sitting upright on the bed, transferring from wheel chair to bed) were practiced in accordance with the following three methods; Care helpers habitually used transfer methods (Method 1), patient transfer methods according to care helper standard textbooks (Method 2), and a method developed by the author ensuring postural-stability (Method 3). The care helpers' muscle activity and four joint angles were measured. The collected data were analyzed using the program SPSS Statistic 21.0. To differentiate the muscle activity and joint angle, the Friedman test was executed and the post-hoc analysis was conducted using the Wilcoxon Signed Rank test. Results: Muscle activity was significantly lower during Method 3 compared to Methods 1 and 2. In addition, the joint angle was significantly lower for the knee and shoulder joint angle while performing Method 3 compared to Methods 1 and 2. Discussion: Findings indicate that using postural-stability patient transfer techniques can contribute to the prevention of musculoskeletal disease which care helpers suffer from due to physically demanding patient care in nursing homes.

• 한국응급구조학회지
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• 제25권1호
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• pp.147-158
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• 2021

Purpose: This study was conducted as a direct investigation of the data in the dispatch logbooks and status of patient transportation provided by private emergency transport companies in Busan. Methods: This study was conducted using SPSS 23.0 version for a total of 1,000 processed records of private emergency ambulance services in Busan from September 23, 2017 to November 5, 2019. Results: First, 100% of the emergency patient transfers by private emergency ambulances were carried out between medical institutions; 76.4% of all transfer patients had emergency conditions, and 86.0% had serious diseases. Second, 59.3% of the emergency patients were located at distances less than 10 km and 43.2%, at more than 10 km from the medical institutions. Third, 63.5% of the passengers were accompanied by first-class emergency rescuers according to the severity of the condition. Fourth, 92.7% of the reasons for the selection of medical institutions were transferred to places where professional care was available, accounting for most of the reasons for the selection. Finally, the medical institutions were selected according to the severity of the patient's condition; 76.5% patients were transported to institutions with a large number of doctors, and 42.9% of those were transported to specialized care institutions. Conclusion: This study collected data from 1,000 dispatch records of private emergency transport companies in Busan; these records reflect the government's policies to improve the emergency patient transfer system. The current status of emergency patient transfer offered by private transport companies was analyzed. All of the emergency patient transfers were carried out between medical institutions, and 76% of the transferred patients had emergency conditions.

• 한국응급구조학회지
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• 제13권3호
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• pp.77-90
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• 2009

Civil complaints and lawsuits filed in the process of providing emergency medical service include fall accident on the way of carrying the patient, transfer consent, refusal and rejection of rescue request, range and behavior restriction of emergency medical technicians, false registry of logbook, neglect of duty and emergency patient, and violation of traffic laws on the way of dispatch to the scene of accident. This study suggested the measures by cases as follows. 1. The accidents on the way of carrying a patient could be divided into fall of patient and fall by paramedic's mistake. In the former case, damages caused by the ambulance's shaking must be notified to the patient and guardian and recommended to fasten seat belt, in the latter case, the plan of patient's posture, route of transport, rescue and equipments should be comfirmed before fixing the patient. 2. Transfer consent must be made as implied when the patient is unconscious under delusion and was not able to consent physically, and paramedic must take an action by his judgment and record details of services on logbook. 3. When a patient refused to transfer, get 'confirmation of transfer refusal' and inform him of refusal. Paramedic should receive the signature. In addition, in case of refusal, transfer request should be made after hearing doctor's opinion and it should be notified to transfer request and superintendent of fire station after making 'confirmation of transfer refusal'. 4. Emergency medical technicians should perform their duties within the range of services prescribed by Article 41 of Law of Emergency Medical Service and Article 33 of Its Enforcement Regulations and shall not make announcement of death. In case of reporting the death to guardian, it is desirable to use record data like ECG results. 5. The best way to have protection from legal problems is making and keeping the exact records of accident and patient. Paramedic should not mention his subjective opinion about the accident-related matter. He must record correctly and keep the original medical records. 6. As emergency medical technicians are responsible for taking care of emergency patients, they must contact a briefing room when they meet a difficult situation suddenly due to vehicle stop or treatment of other patients and then must have support from neighboring hospital and other safety centers. 7. Since the ambulance operator is responsible for safety and careful driving of ambulance, he must be careful when he violates traffic regulations unavoidably. The operator should drive slowly below 10km/h at an intersection and pass it after getting way from general vehicles driving from all directions.

• 한국임상보건과학회지
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• 제7권1호
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• pp.1215-1223
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• 2019

Purpose: This study is to figure out not only the characteristics relating to transfer time of inter-hospital transfer patient which is transferred by a private ambulance, but also factors influencing the transfer time. Methods: In this study, an analysis of 750 patients with high severity levels among those transferred to another hospital by a private ambulance in Busan for whole year of 2017. Results: The results showed that the following factors significantly influence the total inter-hospital transfer time: Ambulance crew (${\beta}=10.525$, p=.001) and patient and carer (${\beta}=37.606$, p<.001) when setting a doctor (selecting a medical institution) as a criterion; availability of the specialized care (${\beta}=12.435$, p=.008) when setting the near distance (reason for selecting a hospital for transfer) as a criterion. The explanatory power of this analysis was R2=0.423, whereas the explanatory power of calibration was R2=0.411. Conclusions: Factors that increase the total inter-hospital transfer time were the ambulance crew, and patient and carer's selecting a medical institution, and the reason for selecting a hospital where enables to offer the specialized care services.