• Investigative Magnetic Resonance Imaging
• /
• v.20 no.3
• /
• pp.152-157
• /
• 2016

Purpose: Operating room management is the serious and complex task for hospital managers and the common approach is to develop relevant standard operational procedures. From patient and staff safety perspective, operating room management should be well-studied and hospital should identify and address any potential risks. Simultaneous usage of different imaging and less-invasive treatment technologies demands strong management control. Materials and Methods: We have formed the multidisciplinary expert panel (surgeons, anesthesiologists, radiologists, healthcare managers etc.) for hybrid theater management standard operational procedure development. On the first stage the general concept of hybrid room design and patient routing was developed. The second stage included the technical details discussion. For patient safety improvement we modified the Surgical Safety Check-list in accordance with potential MRI-related safety challenges and concerns. Results: WHO Surgical Safety Checklist is a simple and easy-to use tool which includes three blocks of question (grouped by the surgery process). We have developed two additional blocks of questions for the intraoperative magnetic resonance investigation. It is very important to have a special detailed routing with a strong control of ferromagnetic devices and anesthesiology care. Conclusion: High-energy MRI (1.5-3.0T) is characterized by potential influence on patient and staff safety in case of hybrid surgery. It is obvious to have a strong managerial control of ferromagnetic devices and anesthesiology care. Surgical Safety Checklist is the validated tool for improving patient safety. Modification and customization of this check-list potentially provides the opportunity for surgery processes improving.

• Journal of Korean Clinical Nursing Research
• /
• v.16 no.2
• /
• pp.57-67
• /
• 2010

Purpose: The purposes of this study were to compare the level of perception and to identify factors associated with perception on patient safety culture among health care providers working in an operating room(OR). Methods: A cross-sectional survey design was used. Data were collected conveniently from 154 RNs and 116 physicians working in a tertiary hospital in Seoul. Patient safety culture was measured using "The Hospital Survey on Patient Safety Culture" developed by the Agency for Healthcare Research and Quality (AHRQ). Descriptive statistics, t-test, ANOVA, and Spearman rank correlation coefficients were used for statistical analysis with the SPSS version 17.0. Results: The perception level of nurses and physicians on patient safety culture was "moderate" (3.14). Compared to physicians, nurses showed a significantly lower perception on the items of "teamwork within units" (t=-6.904, p<.001) and "overall perception of patient safety" (t=-4.327, p<.001), but had a higher perception about "frequency of events reported" (t=2.769, p=.006). The physicians' professional positions, years of working experience, age, and working hour per week were identified as factors associated with patient safety culture. Conclusion: Level of perception on patient safety culture may vary among health care providers working in the OR. The study finding suggests that a tailored education and training strategies should be considered to develop an effective safety culture for healthcare professionals working in OR.

• Journal of Korean Academy of Nursing Administration
• /
• v.12 no.3
• /
• pp.444-453
• /
• 2006

Purpose: The purpose of the study was to identify critical indicators for the development of efficient patient classification system in a emergency room. Method: This study involved following five steps. Step 1. Selection of the lists direct nursing services in the ER. Step 2. Measurement of the time of direct nursing services from Aug. 31st to Nov. 30th, 2005. Step 3. Classification of the patients according to the nursing care time. Step 4. The determination the critical indicators for different patient classes. Result: Determinate indicators were as follow: 3 items in the first group (vital sign checking, IV route starting, blood sampling), 3 items in the second group (vital sign checking, fluid infusion, blood sampling), 9 items in the third group (I/O checking, $O_{2}$ inhalation, suction, fluid infusion, IV bolus, Central catheter preparation & management, blood sampling, intubation preparation & management, postmortem management), 7 items in the fourth group (EKG monitoring, BP monitoring, $O_{2}$ inhalation, fluid infusion, using the specific drugs, CPR, postmortem management). Conclusion: This study can help future studies which measure nursing services standard time or assigns value to emergency nursing services.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.17 no.9
• /
• pp.329-339
• /
• 2016

The purpose of this study was to investigate the level of job stress and organizational commitment, as well as to identify the factors that influence patient safety management activities among the operating room nurses. Participants were 136 nurses working at 1 university hospital and 9 general hospitals located in G metropolitan city. The data were collected between July 25 and August 7, 2014 using structured questionnaires. Data were analyzed by descriptive statistics, t-test, one-way ANOVA, Pearson's correlation, and multiple regression analysis using SPSS version 21.0. The level of job stress, organizational commitment, and patient safety management activities was 3.76, 3.09, and 4.15, respectively, out of a 5-point scale. Patient safety management activities were significantly correlated with organizational commitment. The significant factors that influence patient safety management activities were organizational commitment and number of patient safety education, which explained 23% of patient safety management activities. In conclusion, organizational commitment and patient safety education have a positive effect on the improvement of patient safety management activities of operating room nurses. It is necessary to develop various intervention programs for operating room nurses to improve organizational commitment and should be reinforced via continuous, systematic patient safety education on patient safety management.

• Progress in Medical Physics
• /
• v.26 no.2
• /
• pp.112-117
• /
• 2015

In order to establish the quality control on patient safety following the guideline presented by American Association of Physicists in Medicine (AAPM) TG-100 committee, we aim to analyze the modes based on errors occurred during treatment of patients at the radiation oncology department at Yeungnam University Hospital and establish a quality control guideline for patient safety when patient-centered radiation treatment is conducted. We aim to analyze the errors that can occur during radiation treatment at the radiation department, and assess the frequency of error, the severity of error affecting patients, and probability of proceeding without noticing error, with scores. The places where errors can take place were divided into CT simulation treatment room, treatment planning room, and treatment room for the analysis. In CT simulation treatment room, an error from using the immobilization device showed the highest Risk Priority Number (RPN) value of 60, and an error from simulation treatment information input showed the lowest of 6. In treatment planning room, an error from selecting the radiation dose calculation model showed the highest RPN value of 168, and an error of patient treatment start date showed the lowest of 36. In treatment room, a Table Bar error showed the highest RPN value of 252, a weight change error showed 190, and a Pillow error showed the lowest of 24.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.23 no.2
• /
• pp.73-82
• /
• 2017

Purpose: Since the facility guidelines for National Designated Isolation Unit wards(NDIUs) had been edited since 2016, all hospital who want to expand or install NDIU should adapt the new guidelines. Instead of providing area requirement, by the way, only essential or optional facility requirements are suggested except patient bedroom in the guidelines. So, as analyze area and area composition of the NDIUs, it could be expected that this study has a role as an area planing reference for not only NDIU but also another airborne infection isolation room. Methods: For the area analysis, 18 sample hospitals are selected among 2016 year applicants. All rooms in NDIUs are grouped as zones whether those are negative air pressurized or not and programed room or not. At the end, area of the zones are summarized and analysed a relationship between area increase and bed number by both correlation analysis and regression analysis. In addition, department usable and gross area per bed, N/G ratio, G/N ratio, and average area ratio of each zone is calculated. Results: First of all, rooms in none negative air pressurized zone of the NDIUs haven't shown a regular installation so that only those in negative air pressurized zone are targeted for the area analysis. Second of all, patient room unit(0.92) and support area(0.79), by correlation analysis, are correlated with total net area. Patient room unit(0.94) and total net area(0.79) are also shown a correlation with bed number. Department usable area($R^2=0.63$, y=36.278x + 102) and patient room unit area($R^2=0.89$, y= 27.993x - 0.8924) has a relationship with bed number by regression analysis. Average N/G is shown as 0.85 and G/N 1.36. Average area ratio of circulation, doffing area, patient room unit, and support area are 25.4%, 9.1%, 50.9%, and 14.6% in order. Implications: This study is a basic research for exploring the NDIUs guidelines to find resonable evidence to develop it for its practical use. Still, it is possibly expected that the guideline is to be developed by post occupancy evaluation in the area of where minimum requirement or facility grade needs to be defined, and by further studies with various perspectives.

• Korean Journal of Adult Nursing
• /
• v.20 no.2
• /
• pp.353-363
• /
• 2008

Purpose: This study was conducted to develop a timeout protocol as the process of patients verification in the operating room, and to evaluate its effects. Methods: The timeout protocol was developed based on the experience of practices and the universal protocol of JCAHO 2004. The subjects of this study were 192 surgical members working in the operating room at an university hospital in Daegu, Korea. Results: The timeout protocol was developed in six steps; participants verification, encouragement of compliance, verification of right 3 PSP, agreement of surgical team members, verification of the parties to a patient, patient agreement. The data which have been resulted from the experimental group show significantly higher than those of control group as follows; cognition(t = -6.580, p = .000), contents of performance; progress of anesthesiologist as leader(${\chi}^2$ = 29.029, p = .000), verification of right patient, right site and right procedure(${\chi}^2$ = 40.663, p = .000), participation of surgical team(${\chi}^2$ = 68.412, p = .000), and the number of cases of performance(${\chi}^2$ = 242.900, p = .000). Conclusion: It suggests that medical accidents caused by failures in a preoperative verification process can be prevented if a timeout is conducted active involvement and effective communication among surgical team members for a final verification of the correct patient, procedure, and site.

• Industrial Engineering and Management Systems
• /
• v.8 no.1
• /
• pp.37-46
• /
• 2009

Patient safety has become a growing concern in health care. The U.S. Institute of Medicine (IOM) report "To Err Is Human: Building a Safer Health System" in 1999 included estimations that medical error is the eighth leading cause of death in the United States and results in up to 100,000 deaths annually. However, many adverse events and errors occur in surgical practice. Within all kinds of surgical adverse events, wrong-side/wrong-site, wrong-procedure, and wrong-patient adverse events are the most devastating, unacceptable, and often result in litigation. Much literature claims that systems must be put in place to render it essentially impossible or at least extremely difficult for human error to cause harm to patients. Hence, this research aims to develop a prototype system based on active RFID that detects and prevents errors in the OR. To fully comprehend the operating room (OR) process, multiple rounds of on site discussions were conducted. IDEF0 models were subsequently constructed for identifying the opportunity of improvement and performing before-after analysis. Based on the analysis, the architecture of the proposed RFID-based OR system was developed. An on-site survey conducted subsequently for better understanding the hardware requirement will then be illustrated. Finally, an RFID-enhanced system based on both the proposed architecture and test results was developed for gaining better control and improving the safety level of the surgical operations.

• Journal of muscle and joint health
• /
• v.30 no.2
• /
• pp.93-102
• /
• 2023

Purpose: The purpose of this study was to examine the influence of safety control, nursing professionalism, and burnout on patient safety management activities of operating room nurses. Methods: Data were collected from August 10 to September 26, 2022 from 154 operating nurses who consented to participate and have worked for more than six months in hospitals with 300 or more beds in the Seoul-Incheon area. The data were analyzed using the SPSS/WIN 26.0 program. Results: The main factors affecting patient safety management activities were safety control (β=.36, p<.001) and nursing professionalism (β=.15, p=.046). The regression model was statistically significant (F=13.49, p<.001), with explanatory power of approximately 28.6%. Conclusion: Based on these results, the aforementioned activities can be promoted by preparing and providing an operating room safety management program that can improve safety control and establish proper nursing professionalism.

• Journal of Audiology & Otology
• /
• v.23 no.2
• /
• pp.76-82
• /
• 2019

Background and Objectives: Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital (SNUH) in Korea, are investigated. Materials and Methods: Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured including examination rooms, operating rooms, nurse stations, receptions, and patient rooms. Results: The A-weighted equivalent noise level, L_Aeq, ranges from 54 to 56 dBA, which is at least 10 dB lower than the noise levels of 65 to 73 dBA measured in American ERs. In an ICU, the noise level for the first night was 66 dBA, which came down to 56 dBA for the next day. The noise levels during three different ear surgeries vary from 57 to 62 dBA, depending on the use of surgical drills and suctions. The noise levels in a patient room is found to be 47 dBA, while the nurse stations and the receptions have high noise levels up to 64 dBA. The reverberation times in an operation room, examination room, and single patient room are found to be below 0.6 s. Conclusions: At SNUH, the nurse stations and receptions were found to be quite noisy. The ERs were quieter than in the previous studies. The measured reverberation times seemed low enough but some other nurse stations and examination rooms were not satisfactory according to the questionnaire.