• The Korean Journal of Emergency Medical Services
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• v.23 no.1
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• pp.113-123
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• 2019

Purpose: The aim of this study was to provide basic data to improve the survival rate of pre-hospital cardiac arrest patients. This study suggests a more effective method of performing effective chest compressions for a cardiac arrest patient in a moving ambulance. Methods: To compare the differences between gender and license (qualification), SPSS 18.0 (Windows) was used. Independent and paired t-tests were used for differences between before and after wearing a rescuer's belt. Results: The success rate of chest compressions according to gender was higher in males ($68{\pm}21.91%$) than in females ($25.04{\pm}16.88%$). There was no difference according to license ($44.70{\pm}26.63$ for paramedic, $45.05{\pm}19.25$ for nurse). However, the depth (mm) and the success rate (%) were improved during the evaluation of chest compressions when wearing the rescuer's belt (depth: $46.95{\pm}6.49$ vs. $49.55{\pm}6.05$, success rate: $44.80{\pm}24.66$ vs. $57.39{\pm}26.823$). Conclusion: Wearing a rescuer's belt in an ambulance during patient transport can result in deeper and more accurate chest compressions; therefore, it is expected to be effective in recovering the circulation of patient with cardiac arrest.

• The Korean Journal of Emergency Medical Services
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• v.26 no.1
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• pp.7-19
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• 2022

Purpose: The purpose of this study is to evaluate the interrupted chest compression time during the use of an automated external defibrillator (AED) depending on different AED practice training methods, and to report differences in self-efficacy before and after training. Methods: We enrolled university freshmen who have had cardiopulmonary resuscitation (CPR) training but have not or have had AED training but over 6 months. We examined differences between the group that practiced only shockable rhythms during training and the group that practiced both shockable and non-shockable rhythms. Results: A total of 72 individuals participated in this study, with 36 individuals each in the control and experimental groups. There was no statistically significant difference in the proficiency of AED usage between the two groups. In non-shockable cases, the experimental group showed shorter chest compression interruption time than the control group (2.30±1.21sec vs. 3.16±1.73 sec; p<0.01). In terms of self-efficacy before and after training, both groups showed higher self-efficacy after than before training. Conclusion: Individuals who underwent training that provided practice on both shockable and non-shockable rhythms had a shorter interrupted chest compression time when using the AED.

• Korean Journal of Adult Nursing
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• v.28 no.2
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• pp.169-179
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• 2016

Purpose: The purpose of this study was to investigate the effects of simulation-based training (SBT) for basic life support (BLS) utilizing video-assisted debriefing (VAD) about non-technical skills (NTSs) and technical skills (TSs). The goal of the proposed study is the evaluation of a teaching method about the correct application of cardiopulmonary resuscitation (CPR). Methods: The study design was a control group pre- and post-test non-synchronized experimental design. The sample included twelve teams of 36 nursing students. Both the experimental and the control groups received the SBT for BLS. Only the experimental groups received VAD where as the control groups had a verbal debriefing. Raters who used checklists for TSs and NTSs evaluated both groups. Data were analyzed by the SPSS 20.0 using Cronbach's ${\alpha}$, Intraclass Correlation Coefficient (ICC), Mann-Whitney U test and Willcoxon signed rank test. Results: The experimental groups scored higher than the control groups in both TSs (p=.004) and the NTSs (p=.008). Conclusion: The findings of this study suggest that NTSs are an important factor that lead CPR successfully, so VAD can be used as an efficient teaching-learning strategy in the SBT for BLS for nursing students and nurses.

• The Korean Journal of Emergency Medical Services
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• v.22 no.1
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• pp.49-59
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• 2018

Purpose: The purpose of this study was to develop an assistant device for the promotion of bag-valve-mask ventilation based on a non-equivalent control group pre-test and post-test design. Methods: The experimental tool was a mask assistance device developed by the researchers. Data were analyzed using SPSS 21.0 with the cardiopulmonary resuscitation (CPR) evaluation program from August 18 to 30, 2016. The research tools included general, hand-related, and ventilation-related characteristics. Results: Before and after using the mask assistance device, the tidal volume increased by 64 mL (p<.001) from 461.76 mL to 525.86 mL. The tidal volume for control was 477.86 mL, and there was a statistical difference (p<.05). The ventilation frequency in device users was 10 times per minute for a total of 20 ventilations with before 10.65 after 10 times, and that of the control group was before 10.36 times after 10 times; there was no difference in both groups(p>.05). The accuracy of the assistance device was $81.72{\pm}30.86%$, which was a very high value. However, the accuracy of ventilation in the control group with no assistance device was $18.97{\pm}32.44%$, which was a very low accuracy rate. Conclusion: This study's results suggested utilizing the newly-developed mask assistance device in CPR, and showed increases in tidal volume and accuracy of ventilation using the bag-valve-mask ventilation equipment. The general and hand-related characteristics did not have any effect, so the use of the device proved to increase the efficacy in all users.

• Women's Health Nursing
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• v.25 no.2
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• pp.194-206
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• 2019

Purpose: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. Methods: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. Results: The education needs of nurses in MFICU had an average of 4.21 points (${\pm}0.50$) and their nursing competence was average 3.38 points (${\pm}0.60$). The items reported as high education needs but low competency by nurses in MFICU were as following: 'postpartum hemorrhage and shock,' 'cardiopulmonary resuscitation (CPR) for neonate,' 'CPR during pregnancy,' 'disseminated intravascular coagulation,' 'sepsis,' and 'mechanical ventilation during pregnancy.' Conclusion: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.

• The Korean Journal of Emergency Medical Services
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• v.27 no.3
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• pp.7-16
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• 2023

Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.2
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• pp.560-569
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• 2016

Purpose The purpose of this study was not only to explore the factors associated with the survival of OHCA(Out-of-hospital Cardiac Arrest), but to provide ideas for improving the operation of emergency medical system in Korea. Method 90,734 OHCAs(Out-of-hospital Cardiac Arrest) with a cardiac etiology, who had been transported by 119 EMS ambulances for seven years from 2006 to 2012 in Korea, were analyzed. The data had a multilevel structure in that patient's survival in the same region is interrelated, so two-level (patient-region) logistic regression analysis was applied to adjust this correlation. Results The adjusted OR in group who were given CPR(Cardiopulmonary Resuscitation) by a bystander were 1.40 for survival to discharge. In addition, the adjusted OR in the group with an implementation of AED (automated external defibrillator) before arriving in hospital was 2.98 for survival to discharge. we categorized some continuous variables (number of emergency physician, OHCAs volume fo hospital, area deprivation level) into five quintiles. The adjusted OR in the number of emergency physician compared with Q1(lowest) was 1.29(Q2), 2.89(Q3), 3.39(Q4), 4.07(Q5), respectively. the adjusted OR in OHCAs volume of each hospital compared with Q1(lowest) was 2.06(Q2), 3.06(Q3), 3.46(Q4), 4.36(Q5), respectively. Lastly, the adjusted OR in deprivation level compared with Q1(least deprived area) was 0.72(Q4), 0.64(Q5) so that the adjusted OR of survival to discharge tended to decrease in more deprived districts. Conclusion The survival to discharge was better significantly in group given CPR by a bystander and with the implementation of AED before arriving in hospital. The survival to discharge tended to be significantly better in hospitals with a larger number of emergency physicians and higher volume of OHCAs in less deprived districts.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5943-5949
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• 2012

This study aimed to identify the effects of Basic Life Support course for healthcare providers on the knowledge and attitude of the health science college students. The study was a quasi-experimental design with a non-equivalent pre-post test. The subjects included 140 health science college students from a D college in D city. BLS course for healthcare providers was given to the experimental group from August 3 to August 29, 2010. The knowledge and attitude of cardiopulmonary resuscitation were measured. The data were analyzed with ${\chi}^2$ test, Fisher's exact test, independent t-test, paired t-test and ANCOVA using the SPSS/PC 12.0 win. For the CPR knowledge, a significant increase was observed in the experimental group (F=47.227, p<.001). For the CPR attitude, the experimental group were significantly increased compared to the control group (F=40.204, p<.001). The study showed that BLS Course for Healthcare Providers has positive effects on CPR knowledge and attitude for the health science college students. Subject related to CPR through the division of health science needs to be recommended and systemic and standard educational programs should be developed.

• Quality Improvement in Health Care
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• v.4 no.1
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• Child Health Nursing Research
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• v.19 no.3
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• pp.168-176
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• 2013

Purpose: This study was conducted to examine the effects of case-based learning on the coping ability of daycare center teachers in emergency situations. In the study knowledge of emergency treatment methods, attitude, intention and ability to perform CPR between were examined in an experimental group (daycare center teachers who participated in the small groups discussing case studies and comparing them with their own experience) and a control group. Methods: The study was designed using a nonequivalent control group pretest-posttest design. Sixty-four teachers were recruited from 40 child daycare centers in S city located in J province. Thirty-three teachers were assigned to experimental group and participated in the case-based small group learning. The data were analyzed using the SPSS 18.0 program to perform ${\chi}^2$-test, Pearson correlation coefficients and t-test. Results: The experimental group showed significantly higher posttest scores in knowledge, attitude, intention, and performance ability than those of the control group. Conclusion: The study results indicate that case-based small group learning on coping ability in emergency situation is effective in increasing knowledge, attitude, intention, and performance ability for daycare center teachers.