Actual Judgment of Criminal Responsibility as Seen Through the Criminal Psychiatric Examination of a Psychiatric Hospital / 신경정신의학

Objectives@#The purpose of this study was to compare the demographic, clinical, and criminal characteristics and legal judgments of criminal cases, in which psychiatric evaluation was requested, and to identify factors affecting criminal responsibility judgments. @*Methods@#The medical records of 100 subjects that committed crimes and the judgment records of 51 subjects admitted to Yongin Mental Hospital from February 2005 to February 2021 were analyzed retrospectively. Psychiatric disorder groups were compared with respect to demographic, clinical, criminal characteristics, and legal judgments. Factors affecting criminal responsibility judgments were identified by comparing legal judgment groups. @*Results@#Psychiatric history, criminal motivation, and criminal history differed significantly between psychiatric disorder groups. Differences between the opinions of the appraiser and courts regarding criminal responsibility were significantly dependent on psychiatric disorder type, and there was a consistent tendency according to the psychiatric disorders, but there was a difference of opinion between the two groups. @*Conclusion@#The findings of the current study suggest psychiatric diagnoses and symptoms such as psychotic symptoms and cognitive impairments that provoke crime can influence criminal responsibility judgments.

Appropriateness of Surgical Antibiotic Prophylaxis in a Tertiary Hospital / 병원감염관리

BACKGROUND: This study aimed to evaluate the quality of surgical antibiotic prophylaxis (SAP) in a tertiary hospital. METHODS: Medical, anesthetic, and nursing records from the 27,320 procedures conducted in a tertiary hospital during 2012 were retrospectively reviewed. Three clinical performance indicators of SAP (selection of antibiotic, timing of the first administration, duration of prophylaxis) were included as part of the National Hospital Evaluation Program (NHEP) of the Health Insurance Review and Assessment Service. In addition, 2 other parameters were assessed according to recent guidelines (weight-based initial dosing for obesity, intraoperative re-dosing for excessive blood loss, and prolonged duration of procedures). RESULTS: Prophylactic antibiotics were administered in 19,637 (71.8%) of 27,320 total procedures. Quality of the 3 performance indicators was higher in the types of operations included in NHEP than in other procedures. However, additional doses were administered in 15 (1.2%) of 1,299 surgical procedures that lasted more than twice the half-life of the antibiotic used, and in 9 (3.3%) of 273 procedures with excessive blood loss greater than 1,500 mL. NHEP and non-NHEP results did not differ significantly. CONCLUSION: Three SAP quality indicators showed more improvement in NHEP surgical procedures than in non-NHEP, but the other parameters did not perform well regardless of NHEP assessment. Therefore, more measures to improve the appropriateness of SAP should be developed.