• Journal of Korean Academy of Nursing Administration
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• v.16 no.2
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• pp.152-161
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• 2010

Purpose: The aim of this project was to develop a patient safety-focused inservice education program for surgical nurse and to test the effects of this program. Methods: Methodological designs for instruments development, a pretest-posttest and a posttest design were employed. After the education, nurses' satisfaction, confidence, usefulness and application of 137 nurses were evaluated at 15 surgical units of a tertiary teaching hospital in Seoul, Korea. The education contents are 6 skill areas (infusion pump use, suction, chest tube drainage, oxygen administration, nebulizer use, insulin administration) and medication knowledge. Teaching methods were lecture, instructor demonstration, and 1:1 skill test. Descriptive statistics, Wilcoxon test, Spearman's correlation and Stepwise regression were used. Results: Satisfaction scores for skills and medication education were 4.00-4.21 (out of 5), The more performance frequency in 6 skills, the higher score in confidence as well as in usefulness and application, and the higher satisfaction with the program, the higher score in usefulness, application, confidence, and medication knowledge. Medication knowledge improved after the education (Z=-7,757, p<.001). Significant predictors of skill confidence were application of skills in job performance, medication confidence, and career in present unit. Conclusion: The results of this study suggest that systematic and continuous inservice education will improve patient safety by promoting nursing quality.

• Journal of the Korean Home Economics Association
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• v.46 no.4
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• pp.83-96
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• 2008

The purpose of this study is to grasp the opinion of Korean feminine seniors on the life support appliances for their healthy ageing: medication dispenser, video phone, activity monitor and sleep monitor. The focus group interviews, asking the usability of the appliances, were answered by each 6 feminine seniors of more than 65 years, residing in Corvallis of U.S.(group I), Cheongju(group II), and Ulsan(group III) of Korea. The results are as follows. (1) The medication dispenser proved to be very useful to all the respondents. All the seniors, who take more than one medicine a day, felt it helpful that the medication dispenser makes them to take medicines at fixed time. In addition, they hoped the medicine envelope to be developed for the dispenser use by the supply side. (2) The seniors showed interest in the manner the video phone works; to work by the voice, rather than by the finger. They expressed the hope of the video phone to display the communication contents, in consideration of their weakening hearing. (3) The seniors who live alone, especially, felt intimacy to the activity monitor, thinking as if some helpers were beside them. The fact that it can send emergency calls immediately when situations happen, gave the seniors emotional safety as a patron. (4) The sleep monitor, although essential to the serious cases without moving ability, was proved less necessary to the healthy seniors. They expressed the hope of this appliance to be evolved for the use with the mattress without bed.

• Health Policy and Management
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• v.9 no.2
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• pp.118-138
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• 1999

This study presents the variations on drug utilization for outpatients' URI, gastritis. and hypertension by the type of hospital- tertiary hospital. general hospital. hospital. clinic. It investigated drug expenses. daily drug expenses. days of medication. the highest price of the drugs used. and the number of the different drugs used for each disease and type of hospital. This study also performed analysis to see how much the variations of variables related to drug use affect the variations of drug expenses. The dependent variable was drug expenses and the independent variables were days of medication. the average price of the drugs used. and the number of the different drugs used. Analysis of the drug utilization was performed on NFMI(National Federation of Medical Insurance) 1994 medical expense claim data. Patients with secondary diseases were excluded. In this study. 379 patients with URI, 386 patients with gastritis. 1.257 patients with hypertension were included. It was founded that there were large variation on drug utilization between the types of hospital for same diseases. Days of medication were longest in tertiary hospitals and shortest in hospitals or clinics. Clinics showed the lowest daily drug expenses in all of the diseases investigated. Daily drug expenses were highest in general hospitals or hospitals. which also tended to use drugs of higher price than other types of hospital. General hospitals and hospitals had larger variations in daily drug expenses and the highest price of drugs. It suggested that drug might be utilized overly in general hospitals and hospitals and some other factors might influence on drug utilization in these hospitals. It was found that the variations of drug expenses were affected by the variations of drug price and days of medication rather than the number of the different drugs. Then the strategy to reduce the variations of drug utilization and to improve the quality of drug utilization should focus on the drug price and days of medication. Further study is needed to assess the quality as well as the variation of drug utilization and to show the factors which affect them.

• Korean Journal of Clinical Pharmacy
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• v.18 no.2
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• pp.124-131
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• 2008

The impacts of guideline for digestives on physicians' prescription of GI medication Clinical practice guidelines provide benefits to physicians, patients, and researchers. It also helps doctors to make decisions in medical services. In many countries, practice guidelines lead to activities of quality improvement and are developed using evidence based methods. This research was to assess the impacts of Korean Medical Association's guideline for digestives on the change of physicians' behavior. This study was progressed as one-group pre-test post-test quasi-experimental design using health insurance claims data. The unit of analysis was institution. Data was analyzed using paired t-test for change of prescription rate before and after the distribution of practice guidelines. And the multiple regression analysis was performed to examine the independent impact of the guideline on the prescribing rate of GI medication. Prescription rates of GI medication per claim by medical institution increased significantly, 1.98%point (from 50.27% to 52.25%) and multivariate regression analysis showed significant increase in the prescription rate of GI medication after the distribution of guideline (p<0.001). In conclusion, the distribution of guideline for digestive might not have the effects on the change in provider's behavior. Furthermore, to activate the use of practice guideline, it would be necessary to educate the contents to physicians as well as to develop practice guideline.

• The Korean Journal of Pain
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• v.25 no.1
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• pp.28-32
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• 2012

Background: Primary hyperhidrosis is a disorder of excessive sweating, which shares several features with anxiety disorders and has a negative impact on a patient's quality of life. Oral glycopyrrolate is one of the treatments available. There are a few published studies on the use of glycopyrrolate given orally in the treatment of hyperhidrosis. Methods: Thies is study was a review of case notes in a series of 36 patients with primary hyperhidrosis. We made a comparison between the Keller's scale score of a pre-glycopyrrolate medication group and the Keller's scale score f a post-glycopyrrolate medication group. The Milanez de Campos score, Short Form_36 (SF-36) score, Beck Depression Inventory (BDI) score, Beck Anxiety Inventory (BAI) score, and autonomic nervous system (ANS) scale score were also compared between the two groups. Results: In the post-glycopyrrolate medication group, there were declines in Keller's scale, and Milanez de Campos scale score and BAI score (P < 0.001). In addition, there were increases in SF_36 score in the post-glycopyrrolate medication group (P = 0.03) However, no changes were seen in, BDI score and ANS score in the post-glycopyrrolate medication group (P < 0.001). Conclusions: Glycopyrrolate is an effective initial method of treating primary hyperhidrosis that, reduces anxiety and improve patients' quality of life.

• Quality Improvement in Health Care
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• v.9 no.2
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• pp.164-175
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• 2002

Background : The purpose of this study was to investigate the current status of medication compliance of outpatients and to analyze the factors contributing to medication non-compliance Methods : Telephone survey was conducted to the 1,000 outpatients who visited medical institutions during the period from January 2002 to April 2002. Subjects were randomly selected from the telephone directories of the nation, and the socio-demographic characteristics of the respondents such as age, gender and region were matched based on those of outpatients in 2001. Results : The results of survey revealed that those who complied with doctors' regimen in the right way accounted for 82.4%. The compliance increased with the strong belief in the medication, less unwanted side effects and inconvenience, more severity of disease, and lower perceived health status. Compliance rate was also higher in the patients group who experienced the drug education by the pharmacists than those who did not. Conclusion : In order to improve drug compliance, drug information on efficacy, adverse reaction, drug interactions, and basic disease information are to be provided to the patients. Drug education needs to be focused not only on providing knowledge of drugs and diseases but also changing attitude on drug use of the patients.

• Perspectives in Nursing Science
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• v.9 no.2
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• pp.136-145
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• 2012

Purpose: The purpose of this study was to verify the educational effectiveness of the Objective structured clinical examination (OSCE) module development activities on nursing students in the areas of performance skill, knowledge, self-directed learning readiness, and problem solving ability for medication skill. Methods: This study was a nonequivalent control group non-synchronized post-test design. The subjects (N=47), who agreed to participate in this study, were assigned to either the experimental (n=24) or control group (n=23). The experimental group was trained with OSCE module development activities for four days. The control group was trained with a traditional demonstration and practice class for the same amount of time as the experimental group. Medication performance skill and knowledge tests and surveys were done to measure self-directed learning readiness, and learning satisfaction after the experimental treatments. Results: The experimental group which participated in the OSCE module development activities showed significantly higher performance skill, self-directed learning readiness, and problem solving ability for skin test and insulin medication than that of the control group of traditional education. Conclusion: It is recommended to use the OSCE module development activities for nursing students in nursing education-learning in order to improve nursing skills.

• Korean Journal of Clinical Pharmacy
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• v.21 no.2
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• pp.106-114
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• 2011

While multiple medication is an important global medication safety issue, ununified concomitant medication by multiple prescriptions may cause more severe problems by the fact that those are neither intended nor watched. This could cause therapy duplication and severe drug interaction and etc. Korean Government made region wide scale programs twice to detect such problems and give warnings to pharmacists and doctors through the internet system in 2009-2010, which are called Drug Use Review Services Pilot Project. This study is an analysis and comparison of the results of the two DUR pilot projects. There were 5.0 and 4.2 cases of severe drug interaction by the concomitant medication of multiple doctors' prescriptions per 10 thousand prescriptions, while only 0.37 and 0 cases by the medication of same doctor's prescription(s). There were 426 and 381 cases of drug duplication by the concomitant medication of multiple doctors' prescriptions per 10 thousand cases, while only 197 and 23 cases by medication of same doctors' prescription(s). Doctors' participation to those projects improved at Jejudo the later one compared to Goyangsi the former, which means the efforts of them to make less prescription problems succeeded to decrease the number of cases caused from same doctor's prescription. But they could not decrease the number of problem cases caused from concomitant medication by multiple doctors prescriptions enough. The findings support the issue of strengthening and widening the project nation wide and the issue of recommending the patients to designate their own pharmacy, which can provide them counseling for unified and safety controlled medication.

• Korean Journal of Clinical Pharmacy
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• v.28 no.3
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• pp.216-223
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• 2018

Objective: This study aimed to assess treatment persistence in Korean children and adolescents with attention deficit hyperactivity disorder (ADHD) and the factors influencing their adherence to ADHD pharmacotherapy. Methods: The study included patients between 6 and 18 years of age with ADHD who were taking various formulations of methylphenidate and atomoxetine on June 1, 2014. Patients were dichotomized as "persistent" or "non-persistent", depending on whether they continued ADHD therapy for 6 months (therapy persistence). We also investigated if the patients were taking the same medication(s) as before and also classified the patients as "medication persistent" or "non-persistent". Patient' characteristics were correlated with therapy persistence and medication persistence. Multiple logistic regression analyses were performed to assess potential risk factors for treatment persistence. Results: Overall, 3,317 patients were included in the analysis. A majority of patients were taking stimulants (82.0%), 16.2% were taking non-stimulants and 1.8% were taking a combination therapy of stimulants and non-stimulants. After 6 months, 2,290 patients (69.0%) continued to take medication for ADHD with 1,953 patients taking the same medication(s) as 6 months previously. Common positive factors for therapy persistence and medication persistence were identified as younger age, retardation, and developmental delay, and long-acting formulations of methylphenidate as either monotherapy or in a combination therapy may be used. Conclusion: ADHD medications were proven to improve academic performance and social skills of children. Collaboration between patients, parents, school staffs, and prescribers is required to improve the persistent use of ADHD medications.

• Korean Journal of Adult Nursing
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• v.27 no.6
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• pp.665-672
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• 2015

Purpose: The aims of current study were to assess the inhaler competency and medication adherence, and to identify association of inhaler competency with medication adherence in patients with obstructive lung disease. Methods: We did a secondary analysis of the Hanyang Obstructive Pulmonary Evaluation data in a single institution from June 2014 to April 2015 after an approval of Institutional Review Board. A total of 150 patients with asthma or chronic obstructive lung disease participated in the study. Inhaler competency was evaluated accuracy in each step for using metered dose inhaler. Medication adherence was calculated using actually dispensed doses based on the prescribed inhaler doses. Results: Older adults (${\geq}65$) had lower competency in using inhaler (66.7 vs 83.3, z=-4.52, p<.001) and poorer medication adherence (67.7 vs 91.8, $x^2=14.06$, p<.001) than adults (<65). Inhaler competency was associated with medication adherence (p=.26, p=.001). Surprisingly, more than 50% of patients were current smokers. Conclusion: Inhaler competency and medication adherence were lower in older adults with obstructive lung disease than those in adult-age patients. Therefore, an individual education program for older patients should be developed to improve the rates of proper use of inhalers. Nursing management for obstructive lung disease should focus on developing behavioral intervention strategies for smoking cessation.