• 임상간호연구
• /
• 제14권1호
• /
• pp.99-111
• /
• 2008

Purpose: This study was done to provide basic data for developing an in-service education program to improve nurses' quality. First, frequency of nursing activities and competency levels of emergency nurses according to their career ladders were compared through job analysis and then practical education programs were presented on based of the results. Method: Data were collected from 335 nurses working in emergency rooms in 31 tertiary hospitals. Data collection was done from September to November 2005 using the job analysis questionnaire. Results: There were 41 nursing activities that showed differences in frequency and 78 activities that showed differences in perceived competency level. Irrespective of emergency nurses' careers, activities that show high frequency but low competency were sputum liquefying therapy, assessment of cranial nerve function, identification of diagnostic radiology, and communication with various departments. In-service education content according to nurse's career ladders was presented by adding high frequency nursing activities and activities with low competency level even though having high frequency. Conclusion: There is a need to develop and provide in-service education programs, which consider nurses' difference in frequency and competency level for their career ladders.

• 한국응급구조학회지
• /
• 제24권3호
• /
• pp.161-169
• /
• 2020

Purpose: This study aims to identify changes in patients' transport time and chief complaints visiting the emergency room via emergency medical services from the "pre-COVID-19 period" compared to the "COVID-19 early-stage period". Methods: This retrospective observational study analyzed the emergency medical services reports at two time periods defined by the COVID-19 virus outbreak in Korea. The study was conducted in Busan, the Republic of Korea, from January 19 through May 6, 2019. Results: The transfer time of patients transported during the "COVID-19 early-stage period" was significantly delayed compared to the "pre-COVID-19 period" (p<.05). We found a significant increase in transport time for patients complaining of respiratory infections compared to patients without symptoms (p<.05). During the "COVID-19 early-stage period", there was a significant increase in the number of patients with respiratory infections and patients complaining of general symptoms compared to the "COVID-19early-stage period" (p<.05). Conclusion: The spread of the COVID-19 virus infection delayed patient transport and increased the number of patients reporting respiratory infection symptoms. Emergency medical services will need administrative and economic support to transport the increased number of patients requiring services.

• 대한임상독성학회지
• /
• 제7권2호
• /
• pp.150-155
• /
• 2009

Purpose: Extracorporeal elimination of drugs is a critical part of managing poisonings, although the indications and optimal method remain a matter of debate. The aim of this study is to report our clinical experiences with continuous renal replacement therapy (CRRT), as performed by emergency room physicians, as method of extracorporeal drug elimination in patients with poisoning. Methods: This study was a retrospective study of the consecutive patients who underwent CRRT, as performed by an emergency room physician, for acute poisoning. The patient characteristics, the kinds of drugs and the method of extracorporeal elimination were analyzed by reviewing the patients' charts. Results: During eleven months, 26 patients with acute poisoning underwent extracorporeal elimination (2 patients; intermittent hemodialysis, 24 patients; CRRT). The mean time from the decision to performing extracorporeal elimination was $206.0{\pm}36.8$ minutes for intermittent hemodialysis, $62.9{\pm}8.5$ minutes for continuous venoveno-hemodiafiltration (CVVHDF) and $56.6{\pm}6.8$ minutes for charcoal hemoperfusion. For the patients with CRRT, CVVHDF was conducted in 10 patients (3 patients; valproic acid, 2 patients; Lithium, 1 patient; salicylates, 1 patient; methanol) and charcoal hemoperfusion by using CRRT was done in 14 patients (13 patients; paraquat, 1 patient; dapsone). For the 12 patients who required hemodialysis due to severe poisoning, 7 patients underwent CRRT because of their unstable vital signs. Conclusion: CRRT was an effective method of extracorporeal drug elimination in patients with acute poisoning, and especially for the cases with unstable vital sign and for those patients who required an early start of extracorporeal elimination according to the characteristics of the drug. (ED note: the writing of the abstract was not clear. Check it carefully.)

• 한국응급구조학회지
• /
• 제8권1호
• /
• pp.117-126
• /
• 2004

In general, the patients who transferred to the hospital by 119 rescue service at night go to the emergency room(ER) of general hospital rather than that of their nearby the 1st(clinic) and 2nd(local hospital) hospital. And the hospital is mainly selected not by 119 EMST but by patients or his/her conservators. Therefore we had studied retrospectively with emergency situation diary and medical chart for 697 patients of being transferred to one emergency medical center for 6 months since January 2004, and results are as follows. 1. The 280 patients(42.5%) of being transferred hospital at night by 119 rescue service were not emergency case and their average staying time in hospital was about $7.15{\pm}10.06$ minutes. 2. Transfer time was distributed in each time intervals of 1819, 2021, 2223, and 2401 and patients ratio in each intervals were 15.1%, 17.8%, 16.4%, and 15.2%. 3. In response of ambulance, the average time from the spot to the hospital was $14.53{\pm}9.27min$. and average distance of that was $7.95{\pm}9.21km$. 4. Diseases rather than traffic accidents or traumatic injury were main causes of ambulance calling and its value was 533(76.5%), and accidents were mainly occurred in patients' house and its value was 479(68.7%). 5. In time of transfer by 119 rescue service, hospital was mainly selected by patient/conservator and its value was 648(93.0%). In result. the hospital was selected not by EMST but by patient/conservator. 6. The case that the 1st grade EMT was rode in ambulance was 161(23.1%), and the case that 2nd EMT and emergency team member who educated for emergency were rode in ambulance were 504(72.3%). So the number of the 1st grade EMT was short in fire station of Kwangju metropolitan city than other city. 7. The first aids for patients before reaching hospital were limited to oxygen inhalation, airway control, and BLS for maintaining limbs and spine. So it seems to be a simple patients transfer. Consequently, to establish an efficient emergency medical system, it has been thought that it should be advanced a moderate education and public information about the appropriate use of emergency medical system toward citizen, and also need the hospital selection by the patients categorizing standards for 119 rescue service member, securing the 1st grade EMT, appropriate first-aids education, and securing professional human power in emergency room of the Ist(clinic) and 2nd(local hospital) hospital at night.

• 성인간호학회지
• /
• 제20권3호
• /
• pp.500-511
• /
• 2008

Purpose: The purpose of this study was to examine the effects of music therapy on anxiety of patients in emergency room. Methods: The study was designed using a noneqivalent control group nonsynchronized design. For 20 minutes, the experimental group(22 patients) had listened to music and the control group(23 patients) had bed rest. A six-item state anxiety scale developed by Marteau and Bekker, which was based on Spielberger's State-Trait Anxiety Inventory, blood pressure and pulse rate were measured to all study participants before and after the intervention. The data was analyzed by the SPSS 12.0 program. Results: 1) The experimental group's state anxiety level were significantly lower than the control group's(t=2.220, p=.032). 2) There were no significant differences in both group's diastolic(t=-.495, p=.623) and systolic blood pressure(t=831, p=.411). 3) The experimental group's pulse rate was significantly lower than the control group's(t=2.363, p=.023). Conclusion: Music therapy may be applied as a nursing intervention to decrease anxiety in emergency room.

• 근관절건강학회지
• /
• 제22권1호
• /
• pp.30-39
• /
• 2015

Purpose: This study was to identify the level of job stress and turnover intention and to explore the impact of job stress on turnover intention among emergency room (ER) nurses. Methods: With a correlational survey design, 155 emergency room nurses were recruited in D metropolitan city. Data were collected using a structured questionnaire including ER-related job stress, turnover intention, and subjects' characteristics from March 18 to March 26, 2013. Results: Overall mean score of job stress was $284.34{\pm}40.60$, indicating higher level of job stress. The highest job stress category was conflict related inside the hospital and transportation team, and followed by matters related the patient and the guardian, conflicts with doctors, and heavy workload. The average score of turnover intention was $15.41{\pm}3.68$, indicating higher intention to quit their jobs. There was a moderate level of positive correlation between job stress and turnover intention (r=.44, p<.001). Turnover intention was high when ER nurses had higher job stress (${\beta}$=.38), were female (${\beta}$=.22), and wished to move to another department (${\beta}$=.17). Conclusion: The most important factor of turnover intention was job stress among ER nurses. Strategies to lower turnover rate for ER nurses should be focused on seeking ways to reduce their job stress.

• 디지털융복합연구
• /
• 제11권12호
• /
• pp.589-598
• /
• 2013

본 연구의 목적은 종합병원 응급실 임상실습을 경험한 간호 대학생의 경험의 의미를 이해하고 서술함으로써 간호교육에서 효과적인 임상교육 전략을 개발하고 임상실습의 질을 향상하기 위함이다. 4학년 간호 대학생 30명에게 응급실 임상실습 동안 응급실의 상황에 대한 관찰경험을 서술하도록 한 후 서술 내용을 분석하여 의미를 도출하고 실행학습을 통하여 성찰학습의 의미로 분석하였다. 간호 대학생들의 응급실 임상실습 참여관찰 경험의 내용을 분석한 결과 도출된 주제는 '역동적인 간호사', '응급상황에 맞는 의사소통', '응급실 간호사는 교통정리 담당자'라는 긍정적인 주제와 '임시방편적인 사고', '환자보호자와 간호사의 갈등', '기계적인 움직임' 등의 부정적인 주제가 도출되었다. 연구의 활용과 관련하여 간호 대학생들의 응급실 관찰경험은 간호학생 측면에서는 자신의 미래 모습을 구체적으로 생각해보고 올바른 간호중재법에 대해 생각해보는 계기를 마련할 수 있으며, 간호교육측면에서는 효과적인 임상실무교육 전략 개발에 도움이 되는 기초적인 자료가 될 것이다.

• 중환자간호학회지
• /
• 제8권2호
• /
• pp.66-79
• /
• 2015

Purpose: This study aimed to derive the elements for effectively improving the management of emerging infectious diseases in the emergency room in large general hospitals. Methods: This research involved an analytic hierarchy process analysis of 10 experienced nurses working in a large general hospital located in the Seoul metropolitan area. The weighted values of the criteria for evaluating the importance of the management elements of patients with emerging infectious diseases in the emergency room of large general hospitals were derived using an analytic hierarchy process survey. Results: The results of the analytic hierarchy process analysis showed that experts considers responsiveness (0.291) as most important with respect to the criteria for the policy for isolation and control of infectious patients. The order of importance of the criteria for the policy for isolation and control of infectious patients were as follows: responsiveness (0.291), economical efficiency (0.257), feasibility (0.242), and sustainability (0.209). Subsequently, the weighted values of the management of the policy elements were determined based on the derived importance of the criteria mentioned above. These were, in order of priority, the construction of communication channels with the government authorities when dealing with emerging infectious diseases (15.9%), the equipment and provision of personal protective equipment to protect nurses from infection and dissemination of material (14.6%), and the operation of the isolation room and patient separation systems (14.1%). Conclusion: This study suggests critical strategies for infection control during a pandemic of emerging infectious disease.

• 한국의료질향상학회지
• /
• 제2권1호
• /
• pp.58-67
• /
• 1995

이 연구는 3차 진료기관 응급실의 기능을 정상화하기 위한 기초 자료를 수집하기 위하여, 한 3차 진료기관 응급실을 방문한 환자를 대상으로, 입원 결정서 발부와 환자의 입원 결정 양상 및 이에 영향을 미치는 요인을 파악하였다. 또한 적절성 평가 지침을 이용하여 응급실을 통한 입원의 적절성을 평가하였고 입원의 적절성과 응급실 입원 대기시간의 적절성에 영향을 미치는 요인을 분석하였다. 입원 결정서 발부에 영향을 미치는 요인은 환자의 내 외과계 구분, 진료과수, 환자 상태, 방문 경로, 방문 시간과 방문 요일이었다. 입원 결정서 발부 후 환자의 입원 여부는 환자의 성, 환자 상태, 방문 경로, 방문 요일에 따라 달리 나타났다. 환자의 연령, 내 외과계 구분과 방문 요일에 따라 입원의 적절성에 차이를 보였다. 입원 대기시간은 환자의 연령이 증가할수록 적절성이 낮았다. 이 연구를 통하여 응급실을 통한 입원 중 반수 이상의 입원이 부적절한 입원으로 평가되었고, 이 중 일부는 입원을 빨리 하기 위한 방법의 하나로 응급실을 편법으로 이용하고 있기 때문인 것으로 판단되었다. 또한 입원 결정서가 발부된 환자 중 상당수의 환자가 병상을 구할 수 없어 입원하지 못하고 있는 것으로 보아, 3차 진료기관의 환자 집중 현상과 응급실 과밀화 요인 해소를 위한 의료정책의 수립이 필요함을 확인할 수 있었다.

• 한국콘텐츠학회논문지
• /
• 제14권10호
• /
• pp.562-569
• /
• 2014

본 연구의 목적은 응급실을 경유한 정신 및 행동장애 중 기분[정동]장애만을 주상병으로 하는 입원환자와 정신 및 행동장애를 부상병으로 동반한 기분[정동]장애 입원환자의 총진료비에 미치는 영향 요인을 알아보고자 한다. 본 연구는 건강보험심사평가원 2009년 표본자료에서 응급실 경유 입원환자가 '정신 및 행동장애'(F00-F99)중에서 주상병 코드가 기분[정동] 장애(F30-F39)인 환자와 부상병 코드가 '정신 및 행동장애'(F00-F99)를 가진 환자를 추출하여 753명을 분석 대상으로 사용하였다. 본 연구에서 수집된 자료는 통계 프로그램 SPSS 18(Statistical Package for the Science)을 이용하여 빈도분석, t-test, ANOVA, 다중회귀분석을 실시하였다. 연구결과는 주상병의 경우, 총진료비에 영향을 미치는 변수들은 연령을 제외한 모든 성별(p<.01), 응급실 도착경로(p<.001), 진료 결과(p<.001), 입원일수(p<.001) 변수들이 통계적으로 유의한 것으로 나타났다. 또한 부상병의 경우, 총진료비에 영향을 미치는 변수들은 살펴보면, 모든 변수 즉 성별(p<.01), 연령(p<.001), 응급실 도착경로(p<.001), 진료 결과(p<.001), 입원일수(p<.001) 등이 통계적으로 유의한 것으로 나타났다. 앞으로 정부는 장기적이고 지속적으로 국민의 정신건강을 위해 효율적인 방안을 마련하고 효과적인 예방 및 관리, 정신건강 중재 프로그램 개발, 정신건강관련 진료지침, 맞춤형 치료 및 상담서비스 등 사전 사후 체계적인 정신건강증진 종합대책을 추진해야 할 것이다.