Korean Public Health Research (대한보건연구)

The Korean Public Health Association (대한보건협회)
권호 표지

Promoting awareness of patient safety and patient engagement through patient safety education for the general public: pilot study

일반인 대상 환자안전 교육을 통한 환자안전 및 환자 참여에 대한 인식 증진: 예비 연구

  • Pyo, Jeehee (Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Won (Division of Medical Law and Bioethics, Department of Medical Humanities and Social Sciences, Yonsei University College of Medicine) ;
  • Choi, Eun Young (Department of Preventive Medicine, University of Ulsan College of Medicine) ;
  • Jang, Seung Gyeong (Asian Institute for Bioethics and Health Law) ;
  • Ock, Minsu (Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Lee, Sang-il (Department of Preventive Medicine, University of Ulsan College of Medicine)
  • 표지희 (울산대학교 의과대학 울산대학교병원 예방의학과) ;
  • 이원 (연세대학교 의과대학 인문사회의학교실 의료법윤리학과) ;
  • 최은영 (울산대학교 의과대학 예방의학교실) ;
  • 장승경 (연세대학교 의료법윤리학연구원) ;
  • 옥민수 (울산대학교 의과대학 울산대학교병원 예방의학과) ;
  • 이상일 (울산대학교 의과대학 예방의학교실)
  • Received : 2018.04.04
  • Accepted : 2018.08.07
  • Published : 2018.08.31

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Abstract

Objective: The purpose of this study was to identify the perception of patient's self-protection behaviors and patient engagement in decision making for patient safety and to evaluate the effectiveness of patient safety education. Methods: Patient safety education was conducted in the Ulsan retirement support center. Participants completed a questionnaire to evaluate the perception of patient safety before and after the education. The Wilcoxon signed rank test was performed on the patient safety questionnaire response to compare the perceptions before and after the education. Results: A total of 25 people participated in this study. Although there were some statistically insignificant results, it was found that overall patient awareness of safety and patient engagement could be improved. Particularly, patient safety education led to statistically significant difference in pre and post educating in the tendency to choose medical institutions according to whether they are certified by medical institutions, intention to accompany guardians when visiting medical institutions, intention to reflect patient's opinion on test or treatment, intention to participate in preventive activities related to infections, and to participate in fall prevention activities. Conclusion: In the future, the researchers should develop and utilize higher level patient engagement intervention in the actual clinical field.

연구목적: 이 연구의 목적은 환자의 자기 보호 행동에 대한 인식과 환자 안전에 대한 의사 결정 참여를 확인하고 환자 안전 교육의 효과를 평가하는 것이다. 연구방법: 울산지역 퇴직자 지원센터 내 일반인을 대상으로 환자안전 교육을 진행하였다. 참가자들을 대상으로 교육 전후 환자 참여에 대한 인식을 알아보기 위해 자가기입 설문지를 실시하였다. 환자안전 교육의 효과를 평가하기 위하여 교육 전후 설문 응답에 대하여 Wilcoxon signed-rank test를 수행하였다. 연구결과: 총 25명의 일반인을 대상으로 교육한 결과, 통계적으로 유의하지 않은 결과도 있었지만 환자안전 교육은 전반적으로 환자안전 및 환자 참여에 대한 인식을 높일 수 있는 것으로 나타났다. 특히, 의료기관 인증 여부에 따른 의료기관 선택의향, 의료기관 방문 시 보호자 동반 의향, 검사나 치료에 대한 환자 의견 반영 의향, 감염 및 낙상 관련 예방 활동에 대한 참여 의향에 있어 교육 전후 통계적으로 유의한 변화가 나타났다. 결론: 이 연구는 우리나라에서 처음으로 일반인 대상으로 환자안전 교육을 시행하였다는 측면에서 큰 의의가 있다. 더불어 이번 연구에서 개발된 환자안전 교육안을 참고로 하여 우리나라에서도 특정 유형의 환자안전사건들을 예방하기 위한 좀 더 자세한 교육안도 개발할 수 있을 것이다. 하지만 이 연구는 여러 선행 연구들에서 활용하고 있는 환자 참여 촉진 중재들이 낮은 수준의 단계에 머물러 있다는 제한점이 있기 때문에 후속 연구에서는 실제 임상 현장에서 적용해야 하는, 더 높은 수준의 환자 참여 중재 개발하고 활용해보는 것이 필요할 것이다.

Keywords

References

  1. van Bokhoven MA, Kok G, van der Weijden T. Designing a quality improvement intervention: a systematic approach. Qual Saf Health Care 2003;12(3):215-20. https://doi.org/10.1136/qhc.12.3.215
  2. Ock M, Kim JH, Lee SI. A legal framework for improving patient safety in Korea. Health Policy and Management; 25(3):174-84.
  3. Vincent C. Patient Safety. 2nd edition, Chichester: Wiley, 2010.
  4. Woodward HI, Mytton OT, Lemer C, Yardley IE, Ellis BM, Rutter PD, et al. What have we learned about interventions to reduce medical errors? Annu Rev Public Health. 2010;31:479-97. https://doi.org/10.1146/annurev.publhealth.012809.103544
  5. Patients for Patient Safety. World Health Organization. Available from: http://www.who.int/patientsafety/patients_for_patient/en/.
  6. Kim JM, Suarez-Cuervo C, Berger Z, Lee J, Gayleard J, Rosenberg C, et al. Evaluation of Patient and Family Engagement Strategies to Improve Medication Safety. Patient 2017. [Epub ahead of print].
  7. 20 Tips To Help Prevent Medical Errors: Patient Fact Sheet. Agency for Healthcare Research and Quality. Available from: https://www.ahrq.gov/patients-consumers/care-planning/errors/20tips/index.html.
  8. Patient Safety Unit /Health Systems and Services Cluster, WHO African Region. Available from: http://www.who.int/patientsafety/guide-for-developing-n ational-patient-safety-policy-and-strategic-plan_final.pdf.
  9. Blendon RJ, DesRoches CM, Brodie M, Benson JM, Rosen AB, Schneider E, et al. Views of practicing physicians and the public on medical errors. N Engl J Med 2002;347(24):1933-40. https://doi.org/10.1056/NEJMsa022151
  10. National Evidence-based Healthcare Collaborating Agency. Study on the consumer and healthcare professionals' perceptions of safety in hospitals. Seoul, Korea, NECA, 2014.
  11. Kim JY, Hwang EA. A Study on Improvement of Consumer Safety in Medical Services -Based on Patient Safety- Chung-cheong bukdo, Korea, Korea Consumer Agency, 2014.
  12. Prey JE, Woollen J, Wilcox L, Sackeim AD, Hripcsak G, Bakken S, et al. Patient engagement in the inpatient setting: a systematic review. J Am Med Inform Assoc 2014;21(4):742-50. https://doi.org/10.1136/amiajnl-2013-002141
  13. Tzeng HM, Yin CY. i Engaging as an innovative approach to engage patients in their own fall prevention care. Patient Prefer Adherence 2014;8:693-700.
  14. Opsahl AG, Ebright P, Cangany M, Lowder M, Scott D, Shaner T. Outcomes of Adding Patient and Family Engagement Education to Fall Prevention Bundled Interventions. J Nurs Care Qual 2017;32(3):252-258. https://doi.org/10.1097/NCQ.0000000000000232
  15. Yorkshire Quality and Safety Research Group. Patient Engagement in Patient Safety: A Framework for the NHS. Available from:
  16. Kim JE, Lee NJ, Jang SM, Kim YM. Healthcare Service Consumers' Perception of Patient Safety. Perspectives in Nursing Science 2013;10(2):133-40.
  17. An KE, Kim JE, Kim MK, Jung YY. Reducing Medical Errors : Patients' Self Protect Behaviors and Involvement in Decision Making Korean J. of Health Policy & Administration 2006;16(3):70-85. https://doi.org/10.4332/KJHPA.2006.16.3.070
  18. Berger Z, Flickinger TE, Pfoh E, Martinez KA, Dy SM. Promoting engagement by patients and families to reduce adverse events in acute care settings: a systematic review. BMJ Qual Saf 2014;23(7):548-55. https://doi.org/10.1136/bmjqs-2012-001769
  19. Schwappach DL. Review: engaging patients as vigilant partners in safety: a systematic review. Med Care Res Rev 2010;67(2):119-48. BMJ Qual Saf 2014;23(7):548-55. https://doi.org/10.1177/1077558709342254
  20. Martin BA, Chewning BA, Margolis AR, Wilson DA, Renken J. Med Wise: A theory-based program to improve older adults' communication with pharmacists about their medicines. Res Social Adm Pharm 2016;12(4):569-77. https://doi.org/10.1016/j.sapharm.2015.09.010
  21. Doherty C, Stavropoulou C. Patients' willingness and ability to participate actively in the reduction of clinical errors: a systematic literature review. Soc Sci Med 2012;75(2):257-63. https://doi.org/10.1016/j.socscimed.2012.02.056