• Journal of Hospice and Palliative Care
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• v.25 no.3
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• pp.133-137
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• 2022

A 72-year-old woman with metastatic lung cancer to bone and brain and with left external iliac vein thrombosis was under the care of a community palliative care provider. She experienced an acute pain crisis due to acute limb ischemia of the left lower limb. Goals-of-care discussions were held with the patient and her family; she prioritized symptom control and end-of-life care at home. The family and patient were aware of her short prognosis. Her complex pain was managed by the community palliative team, and her family was empowered to give subcutaneous injections. We illustrate a case showing the importance of community health services with palliative care support in providing symptom management and support to patient and family caregivers throughout the course of a life-limiting illness. It also highlights family caregivers' potential psychological distress in delivering subcutaneous injections in terminal care for a patient at home.

• Journal of Korean Critical Care Nursing
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• v.6 no.1
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• pp.44-56
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• 2013

Purpose: The purpose of this study was to investigate emergency room nurses' recognition of patient safety culture and their performance of safety management activity. Methods: Data were collected from July 1 to August 31, 2012 on 292 emergency room nurses working at 25 general hospitals located in B city in G province. The Hospital Survey on Patient Safety Culture was used to measure patient safety culture, and an 82-item questionnaire was developed to measure safety management activity. Results: the performance of safety management activity were significantly associated with the total career years, whether the nurses had undergone safety training, and whether the nurses has been working in the regional emergency care facility. Of 6 subcategories of the patient safety culture, the perception of a directly commanding senior/manager, frequency of accident reports, and hospital environment were associated with the performance of safety management activity. Conclusion: For improving performance of safety management activity among emergency room nurses, it is necessary to develop an educational program of safety management activity by their level of performance.

• Health Policy and Management
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• v.31 no.4
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• pp.518-530
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• 2021

Background: This study examined the effect of having a usual source of care on the degree of patient-centered communication among persons with disability. The role of the usual source of care has been emphasized to improve patient experience, especially for patients with complex health conditions. Methods: This study used the 2017-2018 Korean Health Panel data, and the final study observations were 22,475 (20,806 people without disability and 1,669 people with disability). We applied generalized estimating equation model to show the effect of having a usual source of care on patient-centered communication, and subgroup analysis considering the types and severity of disabilities. Results: Persons who have disabilities, compared with ones without it, significantly had more usual sources of care (32.4% vs. 24.6%). By type of disability, persons with mental (51.4%), internal organ (43.8%), visual (37%), and physical disabilities (31.6%) had more usual sources of care than hearing/speech (26.6%), and developmental disabilities (18.6%). The average score of patient-centered communication was higher among who had a usual sources of care (3.2 vs. 2.7), and the regression analysis showed that having a usual sources of care was positively associated with higher patient-centered communication score (𝛽=0.476, p<0.05). However, the positive effects of usual sources of care was not observed among persons with severe hearing/speech, developmental, and mental disabilities. Conclusion: This study showed that role of patient-centered communication was limited in persons with severe hearing/speech disabilities, developmental, and mental disabilities. The education programs and supports are needed to improve communication skills between medical staff and persons with specific types of disabilities.

• The Korean Journal of Health Service Management
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• v.13 no.3
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• pp.39-51
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• 2019

Objectives: This study aimed to investigate the effect of satisfaction among convalescent hospital staff members on patient safety and quality of care after the certification of the medical institution. Methods: A survey was conducted on seven convalescent hospitals in Gwangju, South Jeolla Province, and North Jeolla Province, which were certified as medical institutions for convalescent hospitals by the end of May 2017, The study period lasted from July 24, 2017 to August 22, 2017. Results: There was a statistically significant correlation between staff member satisfaction and patient safety and quality of care (r = 0.586, p<0.001). Regression analysis showed that staff member satisfaction (${\beta}=0.531$, p<0.001) had a statistically significant effect on patient safety and quality of care and showed 46.9% explanatory power. Conclusions: The satisfaction of the convalescent hospital staff after the certification of the medical institution positively affected patient safety and quality of care.

• Journal of Korean Critical Care Nursing
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• v.11 no.1
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• pp.89-100
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• 2018

Purpose : The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO). Method : Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized. Results : The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %. Conclusion : The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.

• Journal of Chest Surgery
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• v.55 no.4
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• pp.325-331
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• 2022

Postoperative critical care management for lung transplant recipients in the intensive care unit (ICU) has expanded in recent years due to its complexity and impact on clinical outcomes. The practical aspects of post-transplant critical care management, especially regarding ventilation and hemodynamic management during the early postoperative period in the ICU, are discussed in this brief review. Monitoring in the ICU provides information on the patient's clinical status, diagnostic assessment of complications, and future management plans since lung transplantation involves unique pathophysiological conditions and risk factors for complications. After lung transplantation, the grafts should be appropriately ventilated with lung protective strategies to prevent ventilator-induced lung injury, as well as to promote graft function and maintain adequate gas exchange. Hypotension and varying degrees of pulmonary edema are common in the immediate postoperative lung transplantation setting. Ventricular dysfunction in lung transplant recipients should also be considered. Therefore, adequate volume and hemodynamic management with vasoactive agents based on their physiological effects and patient response are critical in the early postoperative lung transplantation period. Integrated management provided by a professional multidisciplinary team is essential for the critical care management of lung transplant recipients in the ICU.

• Korea Journal of Hospital Management
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• v.27 no.3
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• pp.15-25
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• 2022

Purposes: This study aimed to identify the relationships among personal and organizational communication skills, occupational stress, and patient safety activity levels of two nursing workforce groups (nurses and nursing assistants) who provide integrated nursing care services. Methodology: The study design is a cross-sectional study. Seventy-one nurses and forty-three nursing assistants working in the integrated nursing care service wards participated in this study. The data were collected using a self-reported questionnaire from June to July 2021. The relationships among the variables were analyzed using the Pearson correlation coefficient. Findings: Nurses' personal communication skills (r=.294, p=.013), organizational communication skills (r=.408, p<.001), and occupational stress (r=.243, p=.041) were associated with their patient safety activities. However, nursing assistants' personal communication skills, organizational communication, and occupational stress were not correlated with their patient safety activities. Practical Implication: Patient safety activities of nurses were related to their communication skills and occupational stress, but nurse assistants were not. Therefore, nurses should encourage nursing assistants to responsibly engage in patient safety activities and supervise their works appropriately to achieve high-quality care.

• Korea Journal of Hospital Management
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• v.10 no.4
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• pp.1-22
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• 2005

Quality of care and patient safety have become today's agenda for healthcare industry in worldwide. This paper describes experiences to improve quality of care and patient safety in USA and identifies some future tasks for better implementation of quality improvement efforts. The paper concludes with a discussion of the implications for Korean healthcare system.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.63-74
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• 2017

Purpose: The purpose of this study was to examine the effect of professional autonomy, organizational commitment, and perceived patient safety culture on patient safety management activities of nurses in medium and small-sized hospitals. Methods: A cross-sectional design was employed. Self-reported questionnaires were completed by 121 nurses with at least 3 months of working experience in medium and small-sized hospitals located in B city. Data were analyzed using descriptive statistics, a t-test, a one-way ANOVA, Pearson correlation coefficients, and a multiple regression analysis. Results: Professional autonomy (r=.22, p=.016), organizational commitment (r=.34, p<.001), and perceived patient safety culture (r=.55, p<.001) had a statistically significant positive correlation with patient safety management activities. The factors that might affect patient safety management activities were professional autonomy (${\beta}=.23$, p=.003) and perceived patient safety culture (${\beta}=.55$, p<.001). The explanatory power of these factors for patient safety management activities was 33.5% (F=21.19, p<.001). Conclusions: The development of repetitive and continuous education programs is needed to improve a nurse's professional autonomy and perceived patient safety culture.

• Quality Improvement in Health Care
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• v.22 no.1
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• pp.71-90
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• 2016

Purpose: Objective of this study was to investigate how often nurses to perform patient safety activities. Methods: 521 observations were collected in 9 hospitals by 107 nursing students. Nurses' patient safety care activities were measured 0 (not at all) to 10 (all the time) scores. Descriptive statistics, independent t-test, one way ANOVA, correlation, multiple regression used to analyse data. Results: Items like 'Initial nursing assessment', 'drug management bring on', 'preparation for radiology test', 'falls assessment', 'nursing record' got high scores. But, scores of 'patient identification', 'verbal order management', 'hand hygiene' were lower than others. Each scores were different significantly according to institutions and departments. Within a same institution, the variance of scores, especially in 'patient identification', 'hand hygiene' were great. Scores of activities were different according to characteristics of institutions like type, location, number of beds, teaching hospital, number of accreditation, JCI accreditation. Predictors influencing nurses' patient safety activities were type, location and accreditation. These predictors account for 19.4% of variance. Conclusion: Performance of nurses' patient safety activities were different significantly according to characteristics of institutions. The important items like 'patient identification', 'hand hygiene' had achieved lowest performance. Further researches are needed to improve the basic safety activities.