• Title/Summary/Keyword: patient safety culture

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Presenteeism in Clinical Nurses: An Integrative Literature Review (임상간호사의 프리젠티즘 연구에 관한 통합적 고찰)

  • Kwon, Minjung;Choi, Eunsuk
    • Korean Journal of Occupational Health Nursing
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    • v.26 no.3
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    • pp.160-171
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    • 2017
  • Purpose: This review aimed to integrate the results of studies related to presenteeism in clinical nurses and to suggest directions for future research. Methods: The search for relevant studies was conducted using six data bases according to predetermined index terms, "$nurs^*$" and "presenteeism." Thirteen studies that met the inclusion criteria were selected and analyzed. Results: This review found that the conceptual use and scope of presenteeism were not consistent among the studies. Most studies investigated the nurses' health-related variables as the most important factors and reported their positive association with presenteeism. Presenteeism was also found to be associated with job stress, job satisfaction, social support, and organizational culture and had a negative impact on nursing outcomes such as patient safety. Conclusion: The research on presenteeism can be used as a way to explain outcomes in the field of nursing where direct measurement of productivity is difficult. Presenteeism is a multidimensional problem, and a theoretical foundation is needed to explain the presenteeism of clinical nurses.

Mental Health and Medical Error among Nursing Staffs at Korean Medicine Clinics: a first survey in South Korea

  • Soo-Hyun Nam;Chan-Young Kwon
    • Journal of Pharmacopuncture
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    • v.27 no.3
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    • pp.253-263
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    • 2024
  • Objectives: Nurses face mental health issues like emotional labor, stress, and depression, increasing the risk of medical errors. This study assesses the mental health and medical errors among nurses in Korean medicine clinics in South Korea. Methods: The cross-sectional analysis involved 83 nurses, examining relationships between emotional labor, stress, depression, cognitive failure, Hwa-byung (HB) (a syndrome of suppressed anger in Korean culture), and medical errors. It identified factors associated with HB and medical errors using multiple regression analysis, presenting their odds ratios (ORs) with 95% confidence intervals (CIs). Results: The findings revealed a current HB prevalence of 19.28% and a 6-month medical error prevalence of 16.87% among participants. The regression analysis showed that higher levels of depression (OR = 1.368, 95% CI = 1.098 to 1.703, p = 0.005), cognitive failure (OR = 1.072, 95% CI = 1.011 to 1.136, p = 0.020), and HB trait (OR = 1.136, 95% CI = 1.005 to 1.284, p = 0.041) significantly correlated with HB presence. Conclusion: This groundbreaking study on this previously under-researched nurse workforce highlights the critical need for comprehensive mental health care, with the objective of significantly enhancing their mental well-being and improving their overall work environment.

Bronchoscopic Diagnosis in ICU Patient Accompanying Pneumonia (폐렴이 동반된 중환자실 환자에 대한 기관지내시경적 진단)

  • Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.114-123
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    • 1997
  • Background : To assess the diagnostic role of bronchoscopic lavage for the evaluation of pneumonia in intensive care unit(ICU), the results were compared to blind endobronchial specimen. Method : From September 1993 to August 1996, twenty-eight ICU patients suspected pneumonia on the basis of clinical evidence and performed bronchoscopy under the diagnostic or therapeutic purpose were studied retrospectively for the clinical findings including culture of bronchoscopic and blind endobronchial specimen. Bronchoscopic specimen was got through small amount of bronchoalveolar lavage with 20-40ml saline, one or two times on the suspected site. Results : l. Main reasons of ICU admission were respiratory and impending respiratory failure Nosocomial pneumonia was most common with 16 cases; each for community acquired and immunocompromised type with 6 cases. Diagnostic purpose of bronchoscopy was performed in 20 cases as 71 percent in total, whereas therapeutic removal of secretion in 8 cases. The complication during bronchoscopic evaluation was trivial. 2. The agreement between blind endobronchial and bronchoscopic specimen on microbial culture was only 39.3 percent. However, 2 cases each for aspergillosis and tuberculosis were diagnosed under bronchoscopic evaluation. 3 The application of mechanical ventilation occured significantly frequently in multidrug resistant pneumonia compared with other pneumonia in terms of bronchoscopic specimen. 4. The application of mechanical ventilation was significantly common in nosocomial pneurmonia compared with other types of pneumonia. Conclusion : The selective bronchoalveolar lavage and therapeutic removal of bronchial secretion with bronchoscopy in ICU patient accompanying pneumonia is a very useful tool with safety. The multidrug resistant pneumonia or nosocomial pneumonia could be closely associated with the use of mechanical ventilation.

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The Developmental Program of Emergency Medical System in Correctional Facilities (교정시설 내 응급의료체계 발전방안)

  • Kim, Su-Il
    • Journal of forensic and investigative science
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    • v.3 no.1
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    • pp.60-73
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    • 2008
  • The purpose of Emergency Medical System(EMS) is what a patient returns to society with recovering mental tone in the shortest time as giving prompt and proper medical treatment to patient in emergency situation, and the Correctional Administration(CA) is purposed for the convict to return and settle down to society after release from prison in success as executing schooling, enlightenment activity, vocational training to convict who was quarantined from the society for the term of imprisonment. The EMS and CA will coincide each other which is reverting people to society in safety. This study aims to suggest the developmental program of EMS in correctional facilities through the cause of emergency situation, system, human resources, establishment, medical equipments, state of budget and the point issue for safety of victim who has many chances that is exposed to physical damage and disease because of particularity of lower culture in correctional facilities and the staff who works there. First, in the view of the correctional facility security system, a proper number of the emergency rescuers should be employed. Second, the effective transportation system along with some emergency medical equipment needs to be established. Third, the correctional officers and the prisoners should be learned the first-aid training which is realistic, practical and systematic. Fourth, the cooperative system should be established such as 1339 emergency medical information center in society. Fifth, the Ministry of Health and Welfare must increase EMS budget for correctional facilities.

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Deriving Criteria Weights for Acute Care Hospital Accreditation in South Korea: Using Analytic Hierarchy Process (급성기병원 인증기준의 가중치 도출: 계층적 분석법을 활용하여)

  • Hwa Yeong Oh;Hyeon-Jeong Lee;Minsu Ock;In Ho Kim;Ho Yeol Jang;Ji-Eun Choi
    • Quality Improvement in Health Care
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    • v.30 no.1
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    • pp.33-43
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    • 2024
  • Purpose:The acute hospital accreditation program launched in South Korea has shown positive effects on safety culture and quality of care. However, relative weights have not yet been investigated for accreditation criteria with a hierarchical structure. This study aimed to derive the relative weights of acute-care hospital accreditation criteria. Methods: We conducted an online survey using the analytic hierarchy process (AHP) technique to assess the validity, importance, and urgency of acute hospital accreditation criteria. The AHP online survey link was distributed in November 2022 after obtaining informed consent from 10 experts in hospital accreditation. Results: 'Basic value system' ranked highest, while 'patient care system' ranked second in terms of validity, importance, and urgency. 'Performance management system' had the lowest validity and urgency, while 'organizational management system' carried the lowest importance. Within the 'patient care system' domain, 'surgery and anesthesia sedation management' scored highest in validity and importance, and 'patient care' scored highest in urgency. 'Care delivery system and evaluation' received the lowest scores for all three aspects. In the 'organizational management system' domain, infection control ranked highest in terms of validity, importance, and urgency. The lowest validity was observed for 'management and organizational operation' and the lowest importance and urgency were noted for 'human resource management'. Conclusion: The weights for validity, importance, and urgency, as shown in each domain and chapter, and the number of measurable elements included, are largely inconsistent. This study will contribute to the development of the structure and scientific improvement of accreditation standards.

Analysis of the Journal of Korean Academy of Nursing Administration for 3 Years (2007-2009) (간호행정학회지 게재논문의 연구동향 분석 (2007-2009))

  • Kim, Jong-Kyung;Jung, Myun-Sook;Jang, Keum-Seong;Kim, Jin-Hyun;Kim, Eun-Kyung;Lee, Hae-Jung;Kim, Young-Mee;Kim, Se-Young;Park, Eun-Jun
    • Journal of Korean Academy of Nursing Administration
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    • v.16 no.4
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    • pp.517-526
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    • 2010
  • Purpose: The purpose of this study was to identify the major trends of research in the Journal of Korean Nursing Administration from 2007 to 2009. Method: Research designs, participants, research domains, and key words were analyzed from the Journal of Korean Nursing Administration. Results: Job satisfaction, organizational commitment, job stress, turnover intention, nursing performance, self-efficiency, leadership, empowerment, nursing informatics, and quality control were the major key words commonly listed in the journal articles. Of the research in the Nursing Administration Journal, quantitative methods were used in 94.5% of the research studies and qualitative methods in only 5.5%. The major participants in the research were nurses, nurse managers, and patients. Statistical methods like ANOVA, correlation, t-test, regression, chi-square test, LISREL were the dominant method of analysis used in the research. The primary domains in the journal articles were directing, organizing, control, planning, and informatics. Conclusion: Through this study, the trend of research in nursing administration can be identified. We recommend that collaboration, nurse work environment, evidence-based practice, scheduling, coaching, patient falls and safety, and positive culture should be included as topics for the future research.

Influencing Factors and Consequences of Near Miss Experience in Nurses' Medication Error (간호사의 투약 근접오류경험의 영향 요인과 결과)

  • Park, Jin Hee;Lee, Eun Nam
    • Journal of Korean Academy of Nursing
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    • v.49 no.5
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    • pp.631-642
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    • 2019
  • Purpose: This study aimed to predict the influencing factors and the consequences of near miss in nurses' medication error based upon Salazar & Primomo's ecological system theory. Methods: A convenience sample of 198 nurses was recruited for the cross-sectional survey design. Data were collected from July to September 2016. Using the collected data, the developed model was verified by structural equation modeling analysis using SPSS and AMOS program. Results: For the fitness of the hypothetical model, the results showed that $x^2$ ($x^2=258.50$, p<.001) was not fit, but standardized $x^2$ ($x^2/df=2.35$) was a good fit for this model. Additionally, absolute fit index RMR=.06, RMSEA=.08, GFI=.86, AGFI=.81 reached the recommended level, but the Incremental fit index TLI=.82, CFI=.85 was not enough to reach to the recommended level. With the path diagram of the hypothetical model, caution (${\beta}=-.29$ p<.001), patient safety culture (${\beta}=-.20$, p=.041), and work load (${\beta}=.18$, p=.037) had a significant effect on the near miss experiences in nurses' medication error, while fatigue (${\beta}=-.06$, p=.575) did not affect it. Moreover, the near miss experience had a significant effect on work productivity (${\beta}=-.25$, p=.001). Conclusion: These results have shown that to decrease the near miss experience by nurses and increase their work productivity in hospital environments would require both personal and organizational effort.

Validation of Nursing-sensitive Patient Outcomes;Focused on Knowledge outcomes (지식결과에 대한 타당성 검증;간호결과분류(NOC)에 기초하여)

  • Yom, Young-Hee;Lee, Kyu-Eun
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.357-374
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    • 2000
  • The purpose of this study was to validate knowledge outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 71 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follow: 1. All indicators were considered to be 'supporting' and no indicators were considered to be 'nonsupporting'. 2. 'Knowledge: Treatment Regimen' attained and OCV score of 0.816 and was the highest OCV score among outcomes. 3. 'Knowledge: Energy Conservation' attained an OCV score of 0.748 and was the lowest OCV score among abuse outcomes. 4. 'Knowledge: Breastfeeding' attained an OCV score of 0.790 and was the highest indicator was 'description of benefits of breastfeeding'. 5. 'Knowledge: Child Safety' attained an OCV score of 0.778 and was the highest indicator was 'demonstration of first aids techniques'. 6. 'Knowledge: Diet' attained an OCV score of 0.779 and was the highest indicator was 'performance of self-monitoring activities'. 7. 'Knowledge: Disease Process' attained an OCV score of 0.815 and was the highest indicator was 'description of signs and symptoms'. 8. 'Knowledge: Health Behaviors' attained an OCV score of 0.800 and was the highest indicator was 'description of safe use of prescription drugs'. 9. 'Knowledge: Health Resources' attained an OCV score of 0.794 and was the highest indicator was 'description of need for follow-up care'. 10. 'Knowledge: Infection Control' attained an OCV score of 0.793 and was the highest indicator was 'description of signs and symptoms'. 11. 'Knowledge: Medication' attained an OCV score of 0.789 and was the highest indicator was 'description of correct administration of medication'. 12. 'Knowledge: Personal Safety' attained an OCV score of 0.804 and was the highest indicator was 'description of measures to reduce risk of accidental injury'. 13. 'Knowledge: Prescribed Activity' attained an OCV score of 0.810 and was the highest indicator was 'proper performance of exercise'. 14. 'Knowledge: Substance Use Control' attained an OCV score of 0.809 and was the highest indicator was 'description of signs of dependence during substance withdrawl'. 15. 'Knowledge: Treatment Procedure(s)' attained an OCV score of 0.795 and was the highest indicator was 'description of appropriate action for complications'. 16. 'Knowledge: Treatment Regimen' attained an OCV score of 0.816 and was the highest indicator was 'description of self-care responsibilities for emergency situations'. More outcomes need to be validated and outcomes sensitive to Korean culture need to be developed.

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Clinical and Bacteriologic Efficacy of Cefprozil on Pharyngitis and Pharyngotonsilitis caused by Group A Beta Hemolytic Streptococci in Children (Group A-beta Hemolytic Streptococci에 의한 소아 인두편도염에 있어서 Cefprozil의 항균력과 임상적 및 세균학적 효과에 관한 연구)

  • Kim, Min-Woo;Ahn, Young-Min;Jang, Seong-Hee;Ma, Sang-Hyuk;Ahn, Byung-Moon;Kim, Jong-Duk;Lee, Jong-Kook;Kim, Mi-Lan;Chang, Jin-Kun;Park, Jin-Young;Bae, Jong-Woo;Cha, Sung-Ho
    • Pediatric Infection and Vaccine
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    • v.8 no.2
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    • pp.206-212
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    • 2001
  • Objective : To determine the clinical and bacteriologic efficacy and safety of Cefprozil in acute pharyngitis and pharyngotonsilitis caused by Group A beta hemolytic streptococci in pediatric patients. Methods : Any patient of 3 to 14 age who visited the hospitals enrolled in this study with the signs and symptoms of pharyngitis or pharyngotonsilitis since July, 2000 to March, 2001, was taken throat culture and given Cefprozil(15 mg/kg/day, in two divided doses) for 10 days. 138 patients of whom showed positive culture results were followed up for the signs and symptoms during the treatment to determine clinical efficacy. Any undesirable effect was reported to determine the safety of the drug. Follow up cultures were done at the end of the study and bacteriologic efficacy was determined. Results : 138 of 256 patients who visited the hospitals with the signs and symptoms of pharyngitis or pharyngotonsilitis showed positive growth on throat culture. Mean age of the patients was $6.1{\pm}2.5$ and males and females were equally numbered. 129 of them complained fever on the first visit and 112(86.6%) of them were improved at the end of the study. Cervical lymphadenitis was seen in 58 patients and 44(75.9%) of them improved at the end of the study. Exudative pharyngitis was seen in 96 patients and 81(84.3%) of them improved. The overall clinical effcacy based on this results showed that 110(79.7%) of the patients were cured and 17(12.3%) of them improved. On the cultures and bacteriologic efficacy, 24.6% of them showed documented eradication after treatment and 62.3% of them showed presumptive eradication. Sensitivity test was done by agar dilution method and Cefprozil showed 100% sensitivity. Erythromycin, Clarithromycin and azithromycin showed 87%, 85.6 %, 90.6% sensitivity, respectively. Conclusion : Cefprozil is proved to be effective in controlling group A streptococcal pharyngitis and pharyngotonsilitis in children and showed good sensitivity. Cefprozil can be used as an effective oral cephalosporin in the patients showing penicillin hypersensitivity or patients who other drugs have failed.

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A Study of the Safety & Effect of Products Containing Ceramide, Glucan for Atopic Dermatitis (아토피 피부염 환자에 적용한 글루칸과 세라마이드 제제의 유효성 및 안전성에 대한 연구)

  • Yu Chang-Seon;Kim Seon-Hee;Kim Ju-Duck
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.4 s.48
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    • pp.533-541
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    • 2004
  • Atopic dermatitis, also called congenital fever, is a allergic eczema of chronic itching disease. It is a recurrent and familial disease and appears on a wide age group from infant to adult. It is very common, and the ratio of occurrence is about $9{\~}l2\%$ of a child. However. it is showing trend of continuous increase by social and natural environment, food culture, and life style, recently. The human skin plays a barrier role against a physical and chemical stimulus from external environment. According to the latest study, the decreased amount of ceramide in horny layer impairs the bier function and moisture-maintaining function of skin in atopic dematitis patient. Ceramide is a kind of the sphingolipid in which a fatty acid is connected to sphingosin. Ceramide constitutes about $40\%$ of total lipid between keratinocytes and has the function of defense wall and building regular structure to suppress moisture vaporization in horny layer. In horny layer of skin a comified cell is composed of multi-layer structure of a brick shape, and, as for this cornified cell, it is strongly connected by ceramide, cholesterol, and free fatty acid. Here, we described the effects of a cream containing ceramide on the recovery of skin harrier function of atopic dermatitis patient. The safety and efficacy of latex and liquid formula were evaluated as cosmetics for atopic dermatitis. The latex products was composed of intercellular lipid components-ceramide, cholesterol, and free fatty acid-to restore skin barrier function in atopic dermatitis patients. The liquid one contained beta-glucan, magnolia extracts, and licolice extracts, which have skin immunomodulatory and anti-inflammatory effects. It is also confirmed that their possibility on new cosmetic market of atopic dermatitis.