• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.3
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• pp.522-531
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• 1999

This research identifies the ingress to egress primary factors that causes a patient to receive delayed emergency medical care. This material was collected between February 1st to 28th, 1998. Research envolved 4,118 people who visited the college emergency medical center in Kyeongido Province, South Korea. Medical records were examined, using the retrospective method. to determine the length of stay and the main cause for waiting. Results are as follows : 1. The age group with the highest admission rate was 10 and under, approximately 1,394 (33.9%). Followed by an even distribution for ages between 11-50 at 10-15% for their respective ranges. The lowest admission rate was 50 years and above. 2. From the 4,118 records examined, 3,489 received outpatient treatment (84.7%); 601 were admitted for inpatient care (14.6%); 25 arrived dead on arrival (0.6%); and 4 people died at the hospital. 3. Between 7PM to 12AM, 42.9% were admitted to the EMC. The hours from 9PM to 11PM recorded the highest admission rate and 5AM to 8AM was the lowest From 8PM to 12AM, the most beds were occupied. 4. For most patients. the average length of stay was approximately 2.2 hours. By medical department, external medicine was the longest for 2.8 hours. Pediatrics was the shortest for 1.6 hours. The average waiting period for inpatient admission was 2.6 hours. Inpatient admission for pediatrics and external medicine was 3.4 hours and 2.2 hours respectively. 5. Theses are primary factors for delay at EMC: 1) pronged medical consultations to decide between inpatient versus outpatient treatment, and delaying to be inpatient, 2) when you call physicians they are delayed to come 3) Understaffing during peak or critical hours, 4) Excessive consulting with different medical departments, 5) some patients require longer monitoring periods, 6) medical records are delayed in transit between departments, 7) repeated laboratory tests make delay the result, 8) overcrowded emergency x-ray place causes delay taking x-ray and portable x-ray, 9) the distance between EMC and registration and cashier offices is too far. 10) hard to control patient's family members. The best way to reduce EMC waiting and staying time is by cooperation between departments, both medical and administrative. Each department must work beyond their job description or duty and help each other to provide the best medical service and satisfy the patient needs. The most important answer to shortened the EMC point from ingress to egress is to see things from a patient point of view and begin from there to find the solution.

• 유체기계공업학회:학술대회논문집
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• 2005.12a
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• pp.324-330
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• 2005

For axial-type turbines which operate at partial admission, a performance prediction model is developed. In this study, losses generated within the turbine are classified to windage loss, expansion loss and mixing loss. The developed loss model is compared with experimental results. Particularly, if a turbine operates at a very low partial admission rate, a circular-type nozzle is more efficient than a rectangular-type nozzle. For this case, a performance prediction model is developed and an experiment is conducted with the circular-type nozzle. The predicted result is compared with the measured performance, and the developed model quite well agrees with the experimental results. So the developed model could be applied to predict the performance of axial-type turbines which operate at various partial admission rates or with different nozzle shape.

• The KSFM Journal of Fluid Machinery
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• v.9 no.4 s.37
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• pp.13-19
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• 2006

For axial-type turbines which operate at partial admission, a performance prediction model is developed. In this study, losses generated within the turbine are classified to windage loss, expansion loss and mixing loss. The developed loss model is compared with experimental results. Particularly, if a turbine operates at a very low partial admission rate, a circular-type nozzle is more efficient than a rectangular-type nozzle. For this case, a performance prediction model is developed and an experiment is conducted with the circular-type nozzle. The predicted result is compared with the measured performance, and the developed model quite well agrees with the experimental results. So the developed model could be applied to predict the performance of axial-type turbines which operate at various partial admission rates or with different nozzle shape.

• Korean Journal of Adult Nursing
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• v.21 no.4
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• pp.435-445
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• 2009

Purpose: This study was to examine whether VRE infection control strategies have an effect on the decrease in incidence rates for VRE acquisition and VRE nosocomial infection in ICU. Methods: All the patients were examined for VRE carriers on ICU admission. Among them, patients hospitalized for over 48 hours were investigated for VRE acquisition rates and VRE nosocomial infection rate using VRE infection control strategies in ICU for the experimental group from September 2007 to April 2008. Before that, incidence of VRE acquisition and VRE nosocomial infection for the control group without Intervention were investigated from May to August 2007 retrospectively. Results: VRE acquisition rate in clinical specimens was 0.6% in the experimental group, that was significantly lower when compared to the control group. VRE carrier rate at admission to ICU was 15.4%. Out of 182 VRE carriers, 180 patients were identified by the active surveillance culture. Conclusion: These results suggested that active surveillance culture at admission was considered to be an essential measure for detection of VRE carrier. But without strict isolation and adherence rating after each intervention, hand washing and contact isolation alone did not significantly decrease VRE nosocomial infection, although it did significantly decrease incidence of VRE acquired from clinical specimen.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.31 no.3B
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• pp.232-238
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• 2006

We propose a novel call admission control scheme which improves the handoff drop and the new call block probabilities of high priority services, minimizing the negative impact on low priority services, in multimedia service cellular networks. This paper proposes three schemes to solve this problem; the packing scheme in which available channels of a cell distributed to each frequency channel are concentrated on one frequency channel and a high transmission rate service is assigned to the frequency channel; the queuing scheme in which the queue is used for high transmission rate calls; and the power reallocation scheme in which the power assigned to calls under service is temporarily reduced and a high transmission rate service is allowed. The simulation results revealed that our scheme improved the drop and the block probabilities of the high priority services compared with the conventional scheme.

• Journal of the Korean Institute of Telematics and Electronics S
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• v.34S no.10
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• pp.1-8
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• 1997

In this paper, we propose a call admission control scheme which can be used in real environment for the traffic cibtrik if a base station if DS-CDNA cellular systems. The proposed scheme estimates the mean and variance of other cell interference by using the values used for the closed loop power control. The reerse link capacity of the base station can be calculated by using the estimated mean and variance of other cell interference. The base station admits a call only if the number of users is less than the calculated reverse link capacity. In addition, we propose a simple method to obtain the equivalent number of voice call users per one data call user in multi-rate traffic environment. The method can be applied to call admission control in multi-rate traffic environment.

• Journal of Trauma and Injury
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• v.20 no.2
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• pp.77-82
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• 2007

Purposes: There have been many efforts to improve the service of emergency centers. In spite of these, no evidence is showing any landmark advancement of emergency services, especially in the hospital stage, exists. We need some efficient standard criteria to evaluate emergency service in the hospital stage, and a useful method might utilize the overcrowding index. We want to know the change in the overcrowding index at a regional emergency center after injury area administration. Injury area means an area in which only an assigned duty physician manages patients with injuries such as those from traffic accidents, falls, assualts, collisions, lacerations, amputations, bums, intoxication, asphyxia, drowning, animal bites, sexual assualts, etc. Methods: We started to operate an injury area in our emergency department from late 2004, and from January to June in 2004 and in 2005, we collected patients' data, age, sex, assigned department, and result from hospital order communication system to figure out overcrowding indices and result indices. We found the daily number of patients, the turnover rate, the admission rate, the ICU admission rate, the emergency operation rate, the ED stay duration, and the ED patient volume to be overcrowding indices. Also we found the withdrawal rate, the transfer rate, and mortality to be result indices. We compared these indices between 2004 to 2005 by using a t-test. Results: There was a significant increase in the daily number of visiting patients in 2005, overcrowding indices, such as the turnover rate, the admission rate, the ICU admission rate, and the emergency operation rate, also showed statistically significant increases in 2005 (P<0.001). As for the result indices, there was a noticeable decrease in the number of withdrawals (11.77/day in 2004 to 4.53/day in 2005). Conclusion: Operating an injury area in a mildly overcrowded local emergency center is beneficial. Evaluating the effect of operating an injury area and it's impact on hospital finances by conducting a similar study analyziing patients for a longer duration would be valuable.

• Korean Journal of Radiology
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• v.23 no.9
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• pp.878-888
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• 2022

Objective: To investigate the clinical impact of a quality improvement program including dedicated emergency radiology personnel (QIP-DERP) on the management of emergency surgical patients in the emergency department (ED). Materials and Methods: This retrospective study identified all adult patients (n = 3667) who underwent preoperative body CT, for which written radiology reports were generated, and who subsequently underwent non-elective surgery between 2007 and 2018 in the ED of a single urban academic tertiary medical institution. The study cohort was divided into periods before and after the initiation of QIP-DERP. We matched the control group patients (i.e., before QIP-DERP) to the QIP-DERP group patients using propensity score (PS), with a 1:2 matching ratio for the main analysis and a 1:1 ratio for sub-analyses separately for daytime (8:00 AM to 5:00 PM on weekdays) and after-hours. The primary outcome was timing of emergency surgery (TES), which was defined as the time from ED arrival to surgical intervention. The secondary outcomes included ED length of stay (LOS) and intensive care unit (ICU) admission rate. Results: According to the PS-matched analysis, compared with the control group, QIP-DERP significantly decreased the median TES from 16.7 hours (interquartile range, 9.4-27.5 hours) to 11.6 hours (6.6-21.9 hours) (p < 0.001) and the ICU admission rate from 33.3% (205/616) to 23.9% (295/1232) (p < 0.001). During after-hours, the QIP-DERP significantly reduced median TES from 19.9 hours (12.5-30.1 hours) to 9.6 hours (5.7-19.1 hours) (p < 0.001), median ED LOS from 9.1 hours (5.6-16.5 hours) to 6.7 hours (4.9-11.3 hours) (p < 0.001), and ICU admission rate from 35.5% (108/304) to 22.0% (67/304) (p < 0.001). Conclusion: QIP-DERP implementation improved the quality of emergency surgical management in the ED by reducing TES, ED LOS, and ICU admission rate, particularly during after-hours.

• The Journal of Korean Institute of Communications and Information Sciences
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• v.26 no.12B
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• pp.1677-1685
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• 2001

In this paper, we propose a call admission control scheme that can be performed within guaranteeing of required QoS(Quality of Services) in DS-CDMA(Direct Sequence-Code Division Multiple Access) reverse link. It has been performed rely on a physical channel numberonly and based on quality of received signal from MODEM(modulator/demodulator) part in established study. In other methods, the standard for services would have been set from statistical analysis of users\` location and using received power level in BTS(Base Transceiver Station). These ways bring about not only system loads but time delay or great differences from real environment. To solve these problems, we propose a call drop rate estimation algorithm for the purpose of call admission control based on measured value at LNA(Low Noise Amplifier) ports of BTS(Base Transceiver Station) in real time. This method proposed in this paper estimates a quality of offered service in real time, reduce system loads and shorten time delay which is needed to determine the standard for call admission control. But it requires a additional 17W complexity which can measure received signal power in BTS and estimate call drop rate.

• Journal of The Korean Dental Society of Anesthesiology
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• v.7 no.2
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• pp.120-125
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• 2007

Background: Propofol has been used extensively for short-acting intravenous sedative agent during monitored anesthesia care (MAC). This study was designed to evaluate the safety and availability of MAC using propofol in implant surgery of the one-day admission patients. Methods: In this study, subjects were divided into two groups according to ASA physical status. The heart rate, blood pressure, peripheral oxygen saturation and ECG of a patient were estimated under MAC by an anesthesiologist and the vital signs were recorded in recovery room periodically afterwards. The subjective satisfaction with regard to outpatient ambulatory surgery under MAC procedure was evaluated the next day. Results: Systolic and diastolic blood pressure were significantly decreased during MAC in ASA I group, but other remarkable changes in vital sign were not observed. There was no significant difference in pain and anxiety level between ASA I and ASA II, III group. Satisfaction rate was high in both groups. Conclusion: Monitored-Anesthesia Care using propofol during implant surgery of the one-day admission patients might be safe and available procedure because heart rate, blood pressure and oxygen saturation are stable before and during surgery, and adequate control of pain and anxiety is supported.