• 제목/요약/키워드: Emergency Hospital Service

검색결과 366건 처리시간 0.029초

응급구조원, 지하철 승무원, 아동보호전문기관 사회복지사의 대리 외상과 외상 후 성장 (Vicarious Trauma and Posttraumatic Growth in Emergency Workers, Subway Operators, and Child Protective Service Workers)

  • 이영선;이소래;주성아;고영빈;김예진;한인영
    • 사회복지연구
    • /
    • 제43권1호
    • /
    • pp.249-273
    • /
    • 2012
  • 본 연구는 응급구조원, 사상 사고를 경험한 지하철승무원, 아동보호전문기관 사회복지사를 대상으로 직종, 심리적 고통, 대리 외상, 일반적 특성에 따른 외상 후 성장을 비교 분석한 연구이다. 분석 결과 첫째, 대리 외상은 세 집단 모두 위험 수준으로 높게 나타났고 특히 지하철승무원의 대리 외상이 높았으며, 외상 후 성장은 사회복지사가 가장 높고 지하철승무원이 가장 낮았다. 둘째, 대리 외상과 외상 후 성장은 상관관계가 유의한 것으로 나타났으며 특히 침습과 회피의 하위항목이 외상 후 성장과 상관관계가 높았다. 셋째, 외상 후 성장에 영향을 미치는 요인은 직종, 침습, 회피, 종교, 성별의 순서로 크게 나타났다. 본 연구에서는 이 결과를 바탕으로 대리 외상 위험 직종에 대한 정신건강서비스 제공과 외상 후 성장의 치료적 적용을 제언하였다.

최근 4년간 울릉군 지역의 헬리콥터를 이용한 응급 환자 이송의 고찰 (Study of Emergency Medical Transport by Helicopter in Ulleung Island during 4 Years)

  • 배정민;정만진;정기훈;배성한
    • 농촌의학ㆍ지역보건
    • /
    • 제30권3호
    • /
    • pp.255-262
    • /
    • 2005
  • 도서 지역이라는 울릉도의 특성상 응급 환자의 이송 수단으로 헬리콥터는 필수적이다. 울릉도 지역의 인구 분포의 변화가 고령화가 심화됨에 따라 헬리콥터의 이송 빈도는 더욱 증가될 것으로 예상된다. 그러나, 응급 환자 이송용 헬리콥터가 없어 이송 시간동안의 응급처치 등에 장애가 있으므로, 동해안에 환자 이송의 역할을 가진 헬리콥터의 배치가 필요하다고 생각된다. 아울러 최근 감소세에 들어섰던 울릉군 지역의 인구가 증가하고 있고, 독도 열풍에 따른 관광객의 증가가 현저하므로 그에 따른 울릉군의 적절한 보건 정책이 필요하다고 생각된다

  • PDF

119구급대의 스마트의료지도 직무수행능력 영향요인 (Factors influencing the performance of emergency medical technicians utilizing smart advanced life support (SALS))

  • 최준원;이효철
    • 한국응급구조학회지
    • /
    • 제23권3호
    • /
    • pp.7-16
    • /
    • 2019
  • Purpose: The present study was conducted to identify the factors influencing the perfromance of the emergency medical technicians (EMTs) utilizing smart advance life support (SALS) and to provide appropriate feedback to improve SALS performance. Methods: The study subjects were recruited from 119 EMT members working in G city participating in SALS project. A total of 155 data were used in the analysis. Results: Of the three areas, the mean score of importance was the highest (4.53±0.48). followed by educational needs (4.24±0.66), and SALS performance (4.08±0.55). Importance was identified as a significant factor influencing SALS performance (β=.187, p<.047).The length of education. work scope. amd role of level 1 EMTs vary significantly depending on the type of qualifications they have as emergency medical professionals, while the supply of level 1 EMTs has already reached a point of saturation. Accordingly, the current regulation on allowing level 2 EMTs with at least three years of experience to take the level 1 EMT test presents serious inequity for students just graduating from their emergency medical services program. It is also a factor that degrades the professionalism of level 1 EMTs. Conclusion: Based on the results of this study, it was found that mediation and education programs need to be implemented to highlight the importance of the tasks performed in SALS situations in order to improve performance.

어지럼에 대한 임상 간호사의 지식수준과 교육요구도 (Clinical Nurses' Knowledge and Educational Needs about Dizziness)

  • 박정희;이현정
    • Journal of Korean Biological Nursing Science
    • /
    • 제21권4호
    • /
    • pp.259-265
    • /
    • 2019
  • Purpose: The purpose of this paper was to investigate clinical nurses' knowledge and educational needs about dizziness. One of the most frequent complaints among adult persons visiting the hospital is experiencing dizziness. Clinical nurses in the hospital play a crucial role in managing such patients. Methods: Our paper is a cross-sectional survey using structured instruments to evaluate clinical nurses' knowledge and educational needs about dizziness. This study was conducted January through February 2018. Subjects were 246 clinical nurses in an outpatient, intensive care, internal medicine unit and emergency department at university hospital. Data were analyzed using SPSS statistics 21. Results: The average ofdizziness knowledge score was 57.66± 23.75 (range 0-100) and educational need was 3.55 ± .47(range 0-5). There were significant differences in dizziness knowledge according to age (p< .001), working unit (p< .001), career duration (p< .001), change experience of unit (p< .001), dizziness patient care experience and participation in dizziness education (p< .001). There was positive correlation between knowledge of dizziness and the need for dizziness education (r= .26 p< .001). Conclusion: Results of this paper indicate that a dizziness education program is urgently needed for clinical nurses. Such a program should be seriously considered based on our results.

How to Sustain Smart Connected Hospital Services: An Experience from a Pilot Project on IoT-Based Healthcare Services

  • Park, Arum;Chang, Hyejung;Lee, Kyoung Jun
    • Healthcare Informatics Research
    • /
    • 제24권4호
    • /
    • pp.387-393
    • /
    • 2018
  • Objectives: This paper describes an experience of implementing seamless service trials online and offline by adopting Internet of Things (IoT) technology based on near-field communication (NFC) tags and Bluetooth low-energy (BLE) beacons. The services were provided for both patients and health professionals. Methods: The pilot services were implemented to enhance healthcare service quality, improve patient safety, and provide an effective business process to health professionals in a tertiary hospital in Seoul, Korea. The services to enhance healthcare service quality include healing tours, cancer information/education, psychological assessments, indoor navigation, and exercise volume checking. The services to improve patient safety are monitoring of high-risk inpatients and delivery of real-time health information in emergency situations. In addition, the services to provide an effective business process to health professionals include surveys and web services for patient management. Results: Considering the sustainability of the pilot services, we decided to pause navigation and patient monitoring services until the interference problem could be completely resolved because beacon signal interference significantly influences the quality of services. On the other hand, we had to continue to provide new wearable beacons to high-risk patients because of hygiene issues, so the cost increased over time and was much higher than expected. Conclusions: To make the smart connected hospital services sustainable, technical feasibility (e.g., beacon signal interference), economic feasibility (e.g., continuous provision of new necklace beacons), and organizational commitment and support (e.g., renewal of new alternative medical devices and infrastructure) are required.

일산화탄소중독(一酸化炭素中毒)의 진료대책(診療對策) 수립(樹立)을 위한 추계학적(推計學的) 연구(硏究) (A Stochastic Study for the Emergency Treatment of Carbon Monoxide Poisoning in Korea)

  • 김용익;윤덕로;신영수
    • Journal of Preventive Medicine and Public Health
    • /
    • 제16권1호
    • /
    • pp.135-152
    • /
    • 1983
  • Emergency medical service is an important part of the health care delivery system, and the optimal allocation of resources and their efficient utilization are essentially demanded. Since these conditions are the prerequisite to prompt treatment which, in turn, will be crucial for life saving and in reducing the undesirable sequelae of the event. This study, taking the hyperbaric chamber for carbon monoxide poisoning as an example, is to develop a stochastic approach for solving the problems of optimal allocation of such emergency medical facility in Korea. The hyperbaric chamber, in Korea, is used almost exclusively for the treatment of acute carbon monoxide poisoning, most of which occur at home, since the coal briquette is used as domestic fuel by 69.6 per cent of the Korean population. The annual incidence rate of the comatous and fatal carbon monoxide poisoning is estimated at 45.5 per 10,000 of coal briquette-using population. It offers a serious public health problem and occupies a large portion of the emergency outpatients, especially in the winter season. The requirement of hyperbaric chambers can be calculated by setting the level of the annual queueing rate, which is here defined as the proportion of the annual number of the queued patients among the annual number of the total patients. The rate is determined by the size of the coal briquette-using population which generate a certain number of carbon monoxide poisoning patients in terms of the annual incidence rate, and the number of hyperbaric chambers per hospital to which the patients are sent, assuming that there is no referral of the patients among hospitals. The queueing occurs due to the conflicting events of the 'arrival' of the patients and the 'service' of the hyperbaric chambers. Here, we can assume that the length of the service time of hyperbaric chambers is fixed at sixty minutes, and the service discipline is based on 'first come, first served'. The arrival pattern of the carbon monoxide poisoning is relatively unique, because it usually occurs while the people are in bed. Diurnal variation of the carbon monoxide poisoning can hardly be formulated mathematically, so empirical cumulative distribution of the probability of the hourly arrival of the patients was used for Monte Carlo simulation to calculate the probability of queueing by the number of the patients per day, for the cases of one, two or three hyperbaric chambers assumed to be available per hospital. Incidence of the carbon monoxide poisoning also has strong seasonal variation, because of the four distinctive seasons in Korea. So the number of the patients per day could not be assumed to be distributed according to the Poisson distribution. Testing the fitness of various distributions of rare event, it turned out to be that the daily distribution of the carbon monoxide poisoning fits well to the Polya-Eggenberger distribution. With this model, we could forecast the number of the poisonings per day by the size of the coal-briquette using population. By combining the probability of queueing by the number of patients per day, and the probability of the number of patients per day in a year, we can estimate the number of the queued patients and the number of the patients in a year by the number of hyperbaric chamber per hospital and by the size of coal briquette-using population. Setting 5 per cent as the annual queueing rate, the required number of hyperbaric chambers was calculated for each province and for the whole country, in the cases of 25, 50, 75 and 100 per cent of the treatment rate which stand for the rate of the patients treated by hyperbaric chamber among the patients who are to be treated. Findings of the study were as follows. 1. Probability of the number of patients per day follows Polya-Eggenberger distribution. $$P(X=\gamma)=\frac{\Pi\limits_{k=1}^\gamma[m+(K-1)\times10.86]}{\gamma!}\times11.86^{-{(\frac{m}{10.86}+\gamma)}}$$ when$${\gamma}=1,2,...,n$$$$P(X=0)=11.86^{-(m/10.86)}$$ when $${\gamma}=0$$ Hourly arrival pattern of the patients turned out to be bimodal, the large peak was observed in $7 : 00{\sim}8 : 00$ a.m., and the small peak in $11 : 00{\sim}12 : 00$ p.m. 2. In the cases of only one or two hyperbaric chambers installed per hospital, the annual queueing rate will be at the level of more than 5 per cent. Only in case of three chambers, however, the rate will reach 5 per cent when the average number of the patients per day is 0.481. 3. According to the results above, a hospital equipped with three hyperbaric chambers will be able to serve 166,485, 83,242, 55,495 and 41,620 of population, when the treatmet rate are 25, 50, 75 and 100 per cent. 4. The required number of hyperbaric chambers are estimated at 483, 963, 1,441 and 1,923 when the treatment rate are taken as 25, 50, 75 and 100 per cent. Therefore, the shortage are respectively turned out to be 312, 791. 1,270 and 1,752. The author believes that the methodology developed in this study will also be applicable to the problems of resource allocation for the other kinds of the emergency medical facilities.

  • PDF

산재보험 진폐증 장기 입원환자의 의료이용 특성 (Health Care Utilization Patterns of Workers' Compensation Pneumoconiosis Patients with a Long Length of Stay)

  • 윤경일
    • 보건의료산업학회지
    • /
    • 제10권1호
    • /
    • pp.39-51
    • /
    • 2016
  • Objectives : This study investigated the health care utilization patterns of workers' compensation insurance(WCI) pneumoconiosis patients with excessively long hospital stays. Methods : The discharge summary data of 3,094 WCI pneumoconiosis patients were analyzed. The study sample was divided into 3 groups based on the length of stay(LOS). Health care utilization patterns were compared among the groups with logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the 222 long stay group patients was 1,448 days. Patients in this group tended to use private general hospitals, were admitted through the emergency room and discharged without the consent of a doctor. Conclusions : Many of the long LOS patients will maintain their inpatient status for the rest of their lives. For quality of life and efficient use of health care resources, policy makers need to establish a policy that enables patients to receive outpatient care in appropriate living conditions outside the hospital.

종합병원 간호사의 부서별 사회심리적 업무환경이 직무만족에 미치는 영향 (Impacts of Psychosocial Work Environment on Nurses' Job Satisfaction Based on the Type of Hospital Departments)

  • 원효진
    • 보건의료산업학회지
    • /
    • 제12권1호
    • /
    • pp.47-56
    • /
    • 2018
  • Objectives : The purpose of this study was to compare the characteristics of nursing work environments based on department type and to investigate the relationship between work environment and job satisfaction. Methods : The participants were 420 nurses from the ward, emergency room, intensive care unit, and operation room. The data were analyzed by descriptive statistics, ANOVA, Scheffe's test, and multiple regression test using the SPSS Win. 18.0 program. Results : The results were as follows: There was a significant difference in possibilities for development, meaning of work, recognition(reward), role clarity, and social community at work based on department type. The factors that influenced job satisfaction were influence, meaning of work, recognition(reward), role conflicts, and quality of leadership and these differed based on department type. Conclusions : The results of this study indicate that nursing work environments vary based on the type of hospital department. Therefore, it is necessary to develop diverse strategies for human resource management considering the type of department.

텍스트마이닝 기반의 재난현장 응급의료시설 대상지선정 프로세스 연구 (A Study on the Site Selection Process of Field Emergency Medical Facilities Based on Text Mining)

  • 서상욱
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
    • /
    • 제24권2호
    • /
    • pp.27-36
    • /
    • 2018
  • Purpose: In the case of mass disaster, the establishment of temporary medical facilities for the first aid and treatment is required for the stable accommodation of patients caused by the disaster. However, the criteria for decision making related to the deployment of field emergency medical facilities are not specified. So, The purpose of this study is to draw considerable factors needed for the deployment of field emergency medical facilities and to make proposal for site selection process of field emergency medical facilities on the basis of the factor. Methods: This study performs text mining of disaster-related laws, guidelines and documents to derive key factors affecting site selection, also proposes a decision making process and conducts virtual deployment to validate the process. Results: The key factors for the site selection derived as the size of the damage, the size of the DMAT inputs, the location of available place, and distance to the disaster base hospital. As a result of virtual deployment following proposed decision making process, It is confirmed that the site of field emergency medical facilities is changed depending on the type of disaster, even if the scope of the disaster damage was the same. Implications: The deployment of field emergency medical facilities requires a separate criteria for each type of disaster, not uniform, as a future research a quantitative approach of the criteria needs to be performed.

Critical pathway 적용을 통한 급성 뇌졸중 환자의 응급실 체류시간 단축 효과 (Reduction of Length of Stay in Emergency Room by Using Critical Pathway for Stroke Patients)

  • 윤여옥;김민영;김우정;강영준;박주옥;박경혜
    • 간호행정학회지
    • /
    • 제17권1호
    • /
    • pp.66-73
    • /
    • 2011
  • Purpose: The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER). Method: The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records. Result: Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA ($x^2$=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance. Conclusion: Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.