'Unlicensed medical practice by a non-medical practitioner' often represented by surrogate surgery or so-called 'ghost surgery,' causes irreparable damage to life or body, and therefore calls for very strict and effective controls. The 'bill on installment of CCTVs in an operating room' to prevent unlicensed surrogate surgery has been discussed for a long time, but due to numerous issues and heated confrontations, it has been pending in the National Assembly. Nevertheless, it is expected that the bill will be discussed again in earnest in the National Assembly because surrogate surgery and factory-type cosmetic surgery, which has been performed mainly in the field of cosmetic surgery, has also been occurring in the field of therapeutic surgery. In general, an operating room is considered as being locked or closed, as well as disallowing implicit complicity among insiders. Hence, if the insiders conspire to commit or cover up an illegal act, or if a surgeon performs rapid cosmetic surgery and then leaves the recipient (or medical institution) so as to perform more operations for profit - even if it is legitimate practice - it may result in serious consequences in terms of the recovery of a patient. In this case, installation of CCTVs can be of great help in identifying an illegal act and assessing any occurrence of negligence. On the other hand, while the fundamental purpose of therapeutic surgery is to restore a patient's life or body - that is, lifesaving - installation of CCTVs may base the relationship between a surgeon and a patient on distrust and surveillance, so it may increase the number of requests for CCTV footage or lead to more disputes, as well as placing a burden on the surgeon when best results are not achieved for a patient. As a result, the surgeon may choose non-invasive treatment contrary to conscience instead of risky but necessary surgery, or he/she may have significant difficulty in determining the timing of surgery, which may limit the provision of effective surgical medical care. Then, in terms of the relationship between a surgeon and patient, and in the long run, there could be significant disadvantages for the public and patients if CCTV footage is allowed. In this paper, we review domestic and overseas cases and issues regarding installation of CCTVs in an operating room, and present various viewpoints and suggestions to promote legislation with minimized legal problems and side effects, thereby contributing to protection of the lives and health of the public, patients, and recipients of surgery.
The use of intravenous patient-controlled analgesia is an effective and increasingly used means of providing postoperative pain relief. Recently a non-electric, disposable and portable infusor, the Baxter $Infusor^{(R)}$, has developed. This delivers not only a continuous drug infusion but can also deliver extradoses of medication on demand. The present study examined the benefits of two kinds of analgesics for pain management in 28 patients undergoing gynecological surgery. One group, 14 patients, received i.v. meperidine 0.5 mg/kg as loading dose in the recovery room and PCA with meperidine 3 mg/kg/day for 3 days only(M group). In the other group, 14 patients, also received i.v. meperidine 0.5 mg/kg as loading dose in the recovery room and PCA meperidine 3 mg/kg/day for 3 days and droperidol 5 mg(MD group). The PCA device used was the Baxter $Infusor^{(R)}$. This unit was fitted with patient control module which had a flow rate 0.5 ml/hr and the lockout time was 15 min. Resulting from the study, the MD patients in the first and second days post-operatively, reported less pain compared with the M group. VAPS(Visual Analogue Pain Scales) values were $3.52{\pm}l.61$ vs. $2.22{\pm}0.69$, $2.38{\pm}1.12$ vs. $1.45{\pm}0.48$ and $1.93{\pm}1.65$ vs. $0.98{\pm}0.36$, respectively pertaining to M and MD groups. In conclusion, the MD group with meperidine and droperidol(mixed regimen) provided more effective postoperative analgesia than M group(meperidine only).
Lee, Gyeong Sug;Kim, Mi Ja;Park, Sun Mi;Paek, Sun Young;Lee, Yang Sug;Bae, Sang Do;Choi, Jung Hoon
Quality Improvement in Health Care
/
v.7
no.1
/
pp.6-17
/
2000
Background : This study was attempted to provide a basic information necessary for the development of measures evaluating perceived discomfort of the patients under local anesthesia and the developments of nursing intervention and nursing standard. Method : The study subjects were a convenience sample of 100 surgical patients under local anesthesia. The researcher visited the patients directly and explained the purpose of the study to them. Then they were asked to fill out questionnaires which were developed and structured by the researcher, under their prior permission. Out patient's data were collected at recovery room after operation. Results : Factor analysis on measures evaluating the patients under local anesthesia showed that the measures consisted of eight factors including "explanation", "humane treatment", "motion limitation", "pain", "no togetherness", "waiting", "the environment of operating room", and "unkindness". When analyzing each of the factors regarding their degree of contribution to perceived discomfort, it was found that "waiting" was highest in terms of the degree. According to general chara-cteristics of the sampled patients, the factor of "explanation" contributed to perceived discomfort more in male patients than female ones. Regarding parts of medical examination, the patients of otorhinolaryngology felt perceived discomfort most because of the factor of "pain". Conclusion : To relieve perceived discomfort the patients under local anesthesia require providing individually systematized nursing services which can reduce perceived discomfort according to each of the factors. In doing so, an unlimited attention and much effort should be given to realize CQI reaching the dimension of increase in comfort as well as decrease perceived discomfort.
Objectives : By recording basic data of patients visiting the emergency room of the oriental medicine center, we can understand their characteristics and gain better insight about them. Methods : We performed a retrospective study of 2,674 patients who visited the emergency room of Kyunghee Oriental Medical Center, from June 1, 2006 to May 31, 2007. Results : 1. Of 2,674 total patients, the male to female ratio was 0.94:1 and the 6th decade of life was the peak age group. 2. The majority of patients visited our emergency room between 06:00 and 24:00(midnight). 3. Most patients visited on a Saturday or Sunday. 4. By monthly distribution, the patients increased slightly during June, July, August and October. 5. The majority of patients visited the emergency room within 24 hours of onset. 6. The patients were categorized as follows: neurological diseases 71.15%, musculoskeletal diseases 16.02%, internal medical disease 9.04%, psychiatric and related disease 3.79%. 7. The average transit time was about 1 hour 30 minutes. 8. Admission rate was 48% and the rate of admission to the intensive care unit (ICU) was 5% of total visiting patients. Conclusion : Assuming that this research will continue adding patient's data continuously, this work will help us to understand the features of patients who visiting the emergency room of the oriental medical center.
Song, Kyu Nam;Song, Sun Ok;Hwang, Un Soon;Koo, Bon Up;Choi, Hye Sook;Lee, Sang Yun
Quality Improvement in Health Care
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v.6
no.1_2
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pp.150-160
/
1999
Background : Because hospitals had to faced with financial hardship, we have to have more effective hospital management. In this study, we tried to improve job performance and to reduce cost maintaining safety in fields of patients care. Methods : Central Supply Room(CSR) staffs taught strategy of material cost reduction to middle level managers and staffs 14 times. All staffs and voluntary service workers, working in 33 nursing units, participated in this activity. We developed questionnaire to check the degree of participate in cost reduction activity and job performance in CSR, and quality improvement in the wards. Two hundred questionnaires were distributed and 197 returned. Results : Because CSR staffs developed new items and every item was managed at each department, stocks of each department were reduced. Overall, by comparing before and after cost reduction activity, almost 1.2 billion won reduced for one year. Staffs' loyalty and spirits of cost reduction were improved by changing clothes and duty environment. Furthermore, these activity improved patients' satisfaction. Conclusion : We suggest that CSR activity in a university hospital contributes to improve job performance and to reduce cost without any problem in patient care.
The Journal of Churna Manual Medicine for Spine and Nerves
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v.4
no.2
/
pp.75-83
/
2009
Objectives : By recording basic data of musculoskeletal patients visiting the emergency room of an oriental medicine hospital. we can understand their characteristics and gain better insight about them. Method : We performed a retrospective study of 551 patients who visited the emergency room of an oriental medicine hospital, from November 1,2008 to October 31, 2009. Result : 1. Of 551 total patients, the male to female ratio was almost same and the 3rd decade of life was the peak age group. 2. The majority of patients visited emergency room between 10:00 and 24:00(midnight). 3. Most patients visited on a Saturday or Sunday. 4. By monthly distribution, the patients increased slightly during January, May and October. 5. The majority of patients visited the emergency room within 24 hours of onset. 6. The patients were categorized as follows : lumbar sprain 66.06%, cervical sprain 16.25%, ankle sprain 9.04%. 7. Admission rate was 21.96%. Conclusion : Assuming that this research will continue adding patient's data continuously, this work will help up to understand the features of musculoskeletal patients who visiting the emergency room of the oriental medicine hospital.
The purpose of this study was to figure out clinical characteristics in young and adult acute myocardial infarction patients come to emergency room. One hundred fifty four acute myocardial infarction cases were collected and analized from January 2003 to April 2006, especially focused on below the age 50. The results of the study were summarized as follows. The results were proportion up disease occur to women disease rate as men after 50 age and acute myocardial infarction occur to spring and winter most of all. Research for this patients coronary artery condition in cardiac angiography room and coronary artery condition is left anterior descending portion was obstruction and stenosis most of all at that time in emergency room. HDL-cholesterol was not normal range of this patients. About 57.9% patients downward normal range but total cholesterol was very variant condition. Investigated chest X-ray of this patients and result in upward 75% patients was C-T ratio 50% upward condition. And it was shown result from this patients 94. 7% was obesity condition and family history showed mother or father got hypertension or diabete mellitus patients but 42. 7% patients not family history. This patients not going to direct emergency room after via local medical center result in badly condition up. Have got outcomes of youth and adults age patient of acute myocardial infarction come to emergency room. Government and administration have to support advertising this results about acute myocardial infarction condition of nation people. We need to preservation and preventing this disease but if this disease occurrence, to the utmost directly and speedly emergency room for fast therapy.
Jung, Hyun Joo;Yun, Ji Young;Park, Jee Eun;Shim, In Suk;Kim, Woon Joung;Lee, Ju Hee;Lee, Mi Ran;Lee, Keum Nam
Journal of Korean Clinical Nursing Research
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v.18
no.2
/
pp.196-204
/
2012
Purpose: This study was aimed to compare the effects of lemon ice and water ice on decreasing thirst of the patients with nasal surgery. Methods: A nonequivalent control group non-synchronized design was used for the study. The level of thirst and oral assessment were measured. A total of 60 subjects was recruited; 30 subjects for the experimental group in which lemon ice was provided and the other 30 subjects were in the control group in which on water ice was administered. Results: The scores of thirst were decreased in both lemon ice and water ice group. But it appeared that the score of thirst in the experimental group is significantly lower than that of the control group. Moreover, the score of the assessment of the patient's oral cavity was also significantly improved in the experimental group than that of the control group. Conclusion: The lemon ice seems an effective and easy-to-apply intervention in reducing thirst and mouth dryness over water ice in nursing practice.
Journal of The Korea Institute of Healthcare Architecture
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v.27
no.4
/
pp.51-60
/
2021
Purpose: Tuberculosis(TB) care unit in public health center should be carefully considered to be re-designed as an infection safety environment for both patient and healthcare workers. So, for the enhancement, this study analyses the facility requirements for co-using the screening clinic as a TB and other respiratory disease care unit. Methods: Not only screening clinic facility guidelines from "A Study for Standard Triage Design and Construction Document" but also the guidelines of TB care and related medical facility are reviewed; KDCA, CDC, ECDC and WHO as a TB care, and FGI and NHS for facility. The facility requirements are summarized space, approach, and mechanical requirement in order. By comparing the summary and screening clinic facility guidelines, supplementations are proposed for TB care unit setting. Results: The result of this study shows that both the space program and mechanical requirement of the screening clinic and that of TB care unit are almost identical and could be share, which include direct airflow or negative air pressure in an exam room. To increase functional and economical efficiency, however, it is necessary to consider a multi-functional negative pressured room, So care process may be re-designed based on a room type; face-to-face room or glass wall inbetween. Implications: The facility guidelines for TB care unit of a public health center should be developed to build a safe environment for infection control by reflecting its medical plan and budget.
Kim, Hyung-Hoi;Cho, Hune;Tran, Tung;Hong, Hae-Sook;Kim, Hwa-Sun
The Transactions of The Korean Institute of Electrical Engineers
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v.56
no.9
/
pp.1680-1687
/
2007
A hospital room has multiple patient monitoring devices at the bedside to monitor his or her status. However, vital sign monitors, ventilator and other bedside devices are made by a variety of different manufacturers and often cannot easily interface to the hospital information system. Medical environments incorporate complex and integrated data networks to transfer vast amounts of patient information, such as images, waveforms, and other forms of digital data. Hence, to assure interoperability of images, waveforms and patient data, Health Level Seven (HL7) was developed as an international standard to facilitate the communicating and storing of medical data. In this study, we developed middleware capable of receiving data from mCare 300 vital signs monitoring devices and converting the data to HL7 data format. The HL 7 middleware streamline clinical workflow and support patients. Therefore, clinical expertise are empowered to respond to dynamic healthcare situation as soon as they emerged, and consequently quality of care while helping to reduce the length of a patient's stay in a hospital.
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