• 한국응급구조학회지
• /
• 제3권1호
• /
• pp.55-64
• /
• 1999

This study was conducted to acquire the basic materials for effective field training to identify performance activities of emergency medical technology students. The method used in the study was a descriptive survey using a skill checklist. The subjects for the study were 43 emergency medical technology students who were 2nd grade in D college. The collected data were analyzed using the SPSS computer program, yielding frequencies and percentage. The results of study were as follows; 1. In 'emergency treatment skill', 26.6% of subjects are revealed as 'performed' in 'ambulance practice' and 22.1% of subjects are revealed as 'performed' in 'clinical practice'. 2. In 'airway management', 41.9% of subjects are revealed as 'performed' in 'ambulance practice' and 14.1% of subjects are revealed as 'performed' in 'clinical practice'. 3. In 'oxygen therapy', 52.8% of subjects are revealed as 'performed' in 'ambulance practice' and 35.6% of subjects are revealed as 'performed' in 'clinical practice'. 4. In 'ventilation skill', 17.8% of subjects are revealed as 'performed' in 'ambulance practice' and 10.7% of subjects are revealed as 'performed' in 'clinical practice'. 5. In 'vital sign check', 61.1% of subjects are revealed as 'performed' in 'ambulance practice' and 56.3% of subjects are revealed as 'performed' in 'clinical practice'. 6. In 'patient assessment', 40.7% of subjects are revealed as 'performed' in 'ambulance practice' and 20.0% of subjects are revealed as 'performed' in 'clinical practice'. 7. In 'basic life support(CPR)', 1.7% of subjects are revealed as 'performed' in 'ambulance practice' and 11.9% of subjects are revealed as 'performed' in 'clinical practice'. 8. In 'airway obstruction', 6.4% of subjects are revealed as 'performed' in 'ambulance practice' and 1.1% of subjects are revealed as 'performed' in 'clinical practice'. 9. In 'electrical therapy', 0.7% of subjects are revealed as 'performed' in 'ambulance practice' and 20.0% of subjects are revealed as 'performed' in 'clinical practice'.

• 의료법학
• /
• 제23권2호
• /
• pp.39-65
• /
• 2022

진료가이드라인은 의료행위 전의 비법적 통제로서 작용하는 측면과 의료행위 후의 법적인 통제기준으로 작용하는 두 가지 측면이 있다. 진료가이드라인의 본질적 목적은 전자이지만, 후자의 작용을 배제할 수 없다. 진료가이드라인은 법과 의료를 연결하는 수단이다. 진료가이드라인의 제정에 의해 의료전문가의 자율성이 침해될 수 있다는 진료가이드라인에 대한 부정적 인식은 진료가이드라인에 대한 지나친 부정적 평가이다. 오히려 진료가이드라인에 의한 사법판단은 의료전문가의 자율성을 존중하는 역할을 한다. 즉 진료가이드라인은 의료에 대한 법적 규제를 최대한 억제하고, 의사의 직업윤리 및 자기규율과 환자의 자각 및 협력을 바탕으로 하는 것이다. 의사와 환자의 협력이라는 이상적인 관계를 정립하기 위해서는 「의료윤리」를 법적 수단으로 편입해야 한다. 이러한 의료윤리의 법적 절차에의 편입작업에 가장 적절한 수단이 의료가이드라인이다. 법률가는 규범을 정립하고, 그것에 사실을 적용하여 결론을 내리는 법적 삼단논법으로 사안을 해결한다. 의료분쟁의 해결은, 의사가 특정 질환에 어떠한 의료행위를 해야 하는가라는 규범을 정립할 때에 진료가이드라인을 사용하며, 정립된 규범을 구체적인 진료행위에 적용하여 결론을 도출한다. 정립된 규범을 구체적인 진료행위에 적용하는 것이 쉽지 않은 때에는 감정이나 전문가 증언, 전문위원의 설명과 같은 전문가의 의학적 판단을 이용한다. 이처럼 사법(司法)은 규범의 정립이나 규범의 적용에도 의료의 자율성을 존중하고 있다. 특히 법적 삼단논법의 대전제인 규범의 정립에는 의료계가 자주적으로 작성한 진료가이드라인을 참고하고 있다. 이는 의료인이 판례의 형성에 참가하여 규범형성에 기여하는 모습이다. 진료가이드라인이 재판에 이용되는 것은 의료의 자율성에 대한 존중과 배려이다. 진료가이드라인에 의해 개개의 의사의 자율성이 제약되는 측면은 있을 수 있지만, 집단으로서의 의사의 자율성은 존중된다고 보아야 한다. 이처럼 진료가이드라인은 「법」의 논리에서 보면, 「의료」 집단의 자율성을 보호하는 역할을 한다.

• 의료법학
• /
• 제15권2호
• /
• pp.285-316
• /
• 2014

As the number of medical disputes regarding nurses has increased after medical disputes have increase, there is a need for a study on it. However, the legal relationship between nurses and patients has not yet been analyzed. Recently, the role and function of nurses are expanded according to the development of the science of nursing; moreover their activity and limitation of responsibility are also expanded. For this reason, the medical disputes regarding nurses have been increasing. However, the majority of these kind of dispute are just passed over because their practice is usually considered to be a mere action to assist doctor's role. In addition, nurse practice is not a secondary action of doctor's role, but forms part of a medical treatment. Of course, nurses handle many secondary tasks after doctors finish their medical treatment. But this is only part of the whole tasks of nurses. Furthermore, the general details of their medical treatment are not different from those of doctors because they also belong to the medical service personnel. Considering these features of nurse and the medical condition in South Korea, their task is becoming increasingly developed and specialized and they are also establishing their own field. With this stream of times, there is a growing interest in enacting a Nursing Practice Act, in other words, the independent law on nurse for the sake of patient safety and national health promotion. Then, their responsibility will distinctly be expanded as much more. That is, the time that nurses practice their medical care by following doctors' order and also pass over their responsibility to doctors is closed. Thus, this study examines the features and responsibilities of nursing practice, and discusses an institutional framework to efficiently cope with the legal disputes between nurses and patients. It aims to throw light on the decision making on nurse-patient disputes in future.

• 보건행정학회지
• /
• 제15권2호
• /
• pp.16-36
• /
• 2005

Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

• 의료법학
• /
• 제19권1호
• /
• pp.3-20
• /
• 2018

약침행위는 한방의료에서 행하여져 오던 침구요법과 약물요법을 결합한 요법으로 최근에 특히 교통사고 환자를 중심으로 한방의료에서 행하여져 오고 있다. 하지만 약침행위에 사용되는 약제가 무엇인지도 분명하지 않으며 약침행위가 어떠한 효능을 가지고 있으며 어떠한 부작용의 위험이 있는지에 대해서도 거의 알려진 바가 없다. 우리나라에서는 양방의료와 한방의료를 구분하여 규율하고 있으며 양자의 규율방식 또한 상이하다. 특히 새로운 의료기술이 개발된 경우 엄격한 임상시험절차를 거쳐 정당한 의료행위로 허가되는 양방의료의 경우와는 달리 한방의료는 그와 같은 절차가 존재하지 아니한다. 한편 <의료법>상 무면허 의료행위는 의료면허가 없는 자가 의료행위를 하는 경우 뿐만 아니라 의료면허가 있는 의료인이 자신의 면허영역 이외의 의료행위를 하는 경우도 포함하고 있다. 따라서 양방의료와 한방의료의 경계가 무엇인가에 대한 논의는 매우 중요한 논의 중 하나이다. 의료행위가 면허에 의하여 허가되며 보호받는 이유 중 가장 큰 것은 의료행위 자체가 가지고 있는 인간의 생명 신체에 대한 침해 가능성 때문이다. 새로운 의료행위가 출현한 경우, 그것이 양방의료의 영역이건 한방의료의 영역이건 정당화의 근거로 인간의 생명 신체에 대한 위험성을 항상 고려하여야 한다. 현재 이루어지는 약침행위는 아직 그러한 검증을 거치지 아니한 것으로 판단된다.

• 의료법학
• /
• 제20권2호
• /
• pp.141-171
• /
• 2019

간호사는 의료법 상 의료인으로서 의료기관에서 진료의 보조 등의 업무를 수행한다. 의료인인 간호사는 119 구조·구급에 관한 법률에 근거 구급대원으로서 병원 전 단계 응급의료체계에서 응급환자를 대상으로 응급의료를 제공한다. 병원 전 응급의료체계에서 업무를 수행하는 간호사의 업무범위는 의료법 상 포괄적으로 규정되어 있는 업무를 판례 등을 통해 구체화되어 왔다. 반대로 응급구조사의 업무범위는 응급의료법에 의해 구체적 행위를 열거하는 방식으로 규정되어 있다. 병원 전 단계 응급의료체계에서 응급의료종사자로서 업무를 수행하는 간호사의 업무범위는 대상 환자의 긴급성, 응급의료기관으로의 이송 중이라는 점, 통신 상의 의료지도라는 특수성을 고려하여 간호사의 업무범위를 의료기관 내에서와 달리 적용하여 해석되어야 한다. 따라서 상대적으로 병원 전단계에서 간호사가 응급구조사보다 넓은 업무범위가 인정되고 이것이 정책목표에도 부합된다.

• 한국응급구조학회지
• /
• 제3권1호
• /
• pp.43-54
• /
• 1999

This study is attempted for the purpose of clearly understanding the stressors which emergency medical technology students experience during clinical practice, giving guidance in desirable direction and improvement of clinical practice, and giving the basic materials so that emergency medical technology students may practice effectively. The design of this study was a descriptive survey. The subjects in this study were 59 emergency medical technology students who were 2nd grade in D college. The collection of questionnaires took 3 days from September 1, 1999 to September 3, 1999. This researcher explained the purpose of this study to students, after they agreed to this survey, the researcher gave the questionnaire to them, had them answer the questions and collected the questionnaire immediately. Data analysis included percentage, mean and standard deviation, t-test and ANOVA trough SPSS computer program. The results of this study are, briefly, as follows; 1. In 'satisfaction-degree to specializing in the science of emergency medical technology' 27.1% of the subjects is revealed as 'satisfied' and in 'satisfaction-degree of clinical practice', 8.5% of the subjects is revealed as 'satisfied'. 2. Viewed from each of the categories of stressors which emergency medical technology students experience during clinical practice, 'ideals and values' is the category in which emergency medical technology students experience most severe stress at a mean 3.25 and 'personal relations' is the category in which emergency medical technology students experience mildest stress at a mean 2.82. The total stress degree mean is 3.06, which emergency medical technology students experience during clinical practice is revealed as 'moderate' stress. 3. Considering the stressor involved in each category, the results are as follows; (1) In 'environment', 'orientation to the hospital before clinical practice' is revealed as the most severe stressor at a menu 3.44. (2) In 'personal relations', 'relations with doctor and nurse' is revealed as the most severe stressor at a mean 3.59. (3) In 'role', 'unilaterally when their role is seems to be obscure' is revealed as the most severe stressor at a mean 4.10. (4) In 'ideals and values', 'difference between college practice and hospital practice' is revealed as the most severe stressor at a mean 3.88. (5) In 'activity', 'repetition of simple and functional work during clinical practice' is revealed as the most severe stressor at a mean 3.98. (6) In 'total stress factors', 'unilaterally when their role is seems to be obscure' is revealed as the most severe stress factor at a mean 4.10 and 'relations with comrade students' is revealed as the stress factor causing mildest stress at a mean 2.20. 4. Considering the relationship between the categories of stressors and the general characteristics, the results are as follows; (1) 'Environment' is revealed as being positively correlated with 'satisfaction degree of clinical practice'(F=3.53, p= .0359). (2) 'Ideals and values' is revealed as being correlated with 'sex'(t=-2.31, p= .0240) and 'satisfaction degree of clinical practice'(F=3.31, p= .0438).

• 한국산학기술학회논문지
• /
• 제13권12호
• /
• pp.5968-5975
• /
• 2012

본 연구의 목적은 임상 응급구조사 특성과 업무범위 간의 상관관계를 밝히는데 있다. 2012년 4월 9일부터 5월 12일까지 181명의 1급응급구조사가 성별, 학력, 경력, 실행업무, 의료지도 등의 조사내용에 무기명으로 답변한 자료를 대상으로 1종오류를 범할 확률 ${\alpha}$=0.05 수준에서 양측 검정으로 상관관계 등을 분석하였다. 실행하고 있거나 필요하다고 보는 업무는 32가지로 구분되었으며 응급환자를 위한 처치로 의료인이 행하는 침습적인 처치가 주를 이루었다. 1급응급구조사 업무범위에 대한 수행능력이 우수하다고 판단하면 법에 따른 업무, 실행하고 있는 업무, 필요한 업무에서 통계적으로 유의하게 업무범위가 확대되는 것으로 나타났다. 경력이 늘면 법에 따른 업무, 필요한 업무에서 통계적으로 유의하게 업무범위가 확대되는 것으로 나타났다. 그렇지만 전반적으로 상관계수는 0.238이하로 낮았다. 능력과 경력에 따라서, 1급응급구조사로 하여금 의사-환자 사이의 매개역할을 원활히 형성하도록 지원해 주는 의료지도체계가 빨리 확립되어 의료서비스의 질을 높이고 효율성을 기해야 하며, 1급응급구조사가 지도의사의 교육, 훈련, 지침, 근무규정 등에 의해 업무를 수행하게 하고 처치 활동은 질관리를 하면 처치의 안정성을 높일 수 있을 것으로 보인다.

• 한국응급구조학회지
• /
• 제11권3호
• /
• pp.47-64
• /
• 2007

Purpose : This study examines satisfaction of students at the department of Emergency Medical Technology with clinical practice and relationship between motivation of achievement and satisfaction with clinical practice and aims to provide basic materials contributing to the improvement of clinical practice education. Method : It selected 237 students in the second and third grade at the dept. of Emergency Medical and having experience in clinical practice as the subjects, collected data from Sept. 1 to 30, 2007 and analyzed 237 questionnaires collected with SPSS 12.0 program. Result : 1. Degree of motivation of achievement scored 3.46 of full marks of five points and they showed motivation of achievement over average score. Students who entered the dept. of Emergency medical after beginning social career(3.78) showed higher motivation of achievement in the period of entrance and group having will to be volunteer(3.66) showed the highest motivation of achievement in selecting this major. The better personal relationship they have, the greater hospital grade and the higher their transcript, the higher motivation of achievement they have. In the desired area of employment after graduation, first-aid staffs at the field of industry group(3.85) showed the highest motivation of achievement. 2. Degree of their satisfaction with clinical practice scored 3.53 of full marks of five and they showed satisfaction with it over average score. They showed the highest satisfaction in the contents of practice(3.64). 3. There was statistically significant positive correlation between motivation of achievement and satisfaction with clinical practice(r = .165, p < .05). Conclusion : There was statistically significant positive correlation between motivation of achievement and satisfaction with clinical practice. Repeated research through sampling based on probability to generalize relevance of motivation of achievement and satisfaction with clinical practice is needed and further researches on developing program to inspire motivation of achievement in theoretical learning as well as in clinical practice are required.

• 한국치위생학회지
• /
• 제9권3호
• /
• pp.439-455
• /
• 2009

The number of dental hygiene students is increasing as dental hygiene departments are extended or newly installed continuously, and in other to keep up with the quantitative increase, we need to standardize dental hygiene curriculums. The present study conducted a questionnaire survey with dental hygiene students who had completed clinical practice. The obtained results as follows. 1. According to the contents of clinical practice at dental clinics, the frequency of dental hygiene students' observation practice was high in basic medical service, dental prosthesis, and orthodontics. 2. The frequency of performance practice was high in basic medical service, oral medicine, preventive dentistry, pediatric dentistry, periodontology, and oral surgery. According to the area of clinical practice. 3. According to the contents of clinical practice at university hospitals, the frequency of dental hygiene students' observation practice was high in basic medical service, dental prosthesis, and orthodontics. 4. The frequency of performance practice was high in basic medical service, oral medicine, preventive dentistry, pediatric dentistry, periodontology, and dental prosthesis. 5. The students' satisfaction was high in basic medical service, oral medicine, preventive dentistry, and periodontology. The period of clinical practice varies according to school curriculum and circumstance among dental clinics and university hospitals where clinical practices are performed, students' satisfaction with their observation practice and performance practice may be different. Thus, for dental hygiene students' clinical practice, it is considered desirable to prepare integrated education programs that standardize the period and contents of clinical practice.