• 한국시뮬레이션학회논문지
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• 제26권3호
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• pp.125-139
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• 2017

최근 응급의료 서비스의 질 제고에 관심이 높아지고 있는 가운데 응급의료 프로세스의 혁신에 많은 노력을 기울이고 있다. ICT기술의 급속적인 진전에 의해 응급의료 프로세스의 자동화 또는 지능화가 가속화되고 있다. 본 연구는 자원 활용 최적화, 인적오류 최소화 그리고 진료 예측가능성 제고를 고려한 실시간데이터 기반 응급실 운영 방안을 제안한다. 응급실 운영지수-응급 케어지수, 체류 단축지수, 인적오류 유발지수, 대기 인내지수-를 개발하고, 이를 기반으로 한 응급실 운영규칙을 제시한다. 가상의 축소 응급실을 대상으로 시뮬레이션을 실시하여 제안한 운영규칙의 효과성을 검증하였다. 시뮬레이션 결과 응급실 체류시간에서 우수한 성능을 보였다.

• 한국경영과학회지
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• 제37권4호
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• pp.111-124
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• 2012

Emergency room process is very important in the whole hospital processes because it is first diagnosis for patient. Above all, triage is important activity which quickly diagnose the status of emergency patient and sets the priority for treatment. This paper analyzes the treatment process pattern by triage type. The results show that the treatment process after triage such as residence time, diagnosis and checkup type, and joint treatment are dependent on triage types. We can use these analysis results for improving the current triage system and developing the new triage system considering a domestic emergency medical service environment.

• 중환자간호학회지
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• 제8권2호
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• pp.66-79
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• 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.

• 간호행정학회지
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• 제4권2호
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• pp.419-437
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• 1998

Nurses use a nursing process. that is a scientific approach method. in order to understand the clients' condition and to solve their problems. Professional nurses have accepted the nursing process as a standard framework for nursing activities, and the first step of the nursing process is nursing assessment. The purpose of this study was to develop a nursing assessment tool for emergency patients. Assessment is a first step in the nursing process, and scientific assessment helps to better understand the patients. Thus the development of an assessment tool for emergency patients will improve of nursing quality and advance to efficacy of emergency room(ER) management. The study involved the development of a conceptual framework, preliminary tool, content validity verification process. and reliability verification process. The conceptual framework was developed through a review of the literature. and preliminary tool was developed from the conceptual framework that based on care flow sheet' developed James A. Haley. The preliminary tool was evaluated for validity and reliability by seven experts, one ER nurse manager, two ER head nurses, two emergency medicine doctors. and two ER charge nurses and by ten nurses with one to five year careers in ER nursing. The results of this study was as follows 1. The conceptual framework which was developed was composed of three parts. They were triage criteria, first assessment and secondary assessment. 2. The preliminary tool which was developed had 31 items based on the conceptual framework. 3. To test expert validity a 4-point scale was used. items which had gained 3-4 points from six persons of the seven experts were selected. All 31 items from the preliminary tool were selected. 4. The reliability test was done by ten nurses educated in the use of the assessment tool. Two pairs of nurses simultaneously assessed the same patients. A total agreement percentile was calculated and result was 87.3% agreement. 5. After the validity and reliability testing. the final emergency patient nursing assessment tool was finalized with 31 items. and a check-list for the responses. This study concludes that the tool which was developed is both valid and reliable will advance quality care for emergency patients. This emergency nursing assessment tool was also found to be an adequate tool for assessment of emergency patients.

• 대한방사선기술학회지:방사선기술과학
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• 제45권3호
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• pp.205-211
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• 2022

This study aimed to provide basic data for 3D printing in the medical health field by developing upper wear fixation device (UWFD), an auxiliary device for shortening chest AP examination time on emergency room beds and non-contact with patients. The standard of hooks was modeled according to the bed frame using the Autodesk Fusion 360. It was printed with Form2 (Formlabs, Somerville, MA, USA), as SLA (stereo lithography apparatus) method, and was washed and hardened using Form Wash and Form Cure. The completed UWFD conducted an online survey on 4 items of stability, convenience, availability, preference and general characteristics. The total stability average was 3.93±0.80, the total convenience average was 3.93±0.68, the total availability average was 4.01±0.89, and the total preference average was 3.80±1.08. This study was significant in suggesting improvements in the general X-ray examination process in the emergency room by designing and making aids to easily fixing the patient's top to the frame of the emergency bed while meeting promptness and non-contact with the patient.

• 한국응급구조학회지
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• 제22권2호
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• pp.51-65
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• 2018

Purpose: The purpose of this study was to investigate experiences of violence with patients or family members by paramedics working at emergency rooms. Methods: A questionnaire was administered from June 1 to 31, 2017 to 225 paramedics working at 27 emergency medical centers. The collected data were analyzed with SPSS statistics ver 24.0 program. Results: Within the past year, 208(92.9%) of 224 participants experienced violence among whom 202(90.2%) experienced verbal abuse, 193(86.2%) experienced physical threat, 89(39.7%) experienced physical violence, and 52(23.2%) experienced sexual violence. The level of violence response depending on the overlapping experience of violence type showed significant difference from emotional response (p= .001), social response (p= .001), physical response (p= .004), and overall violence response (p= .001). Conclusion: In conclusion, paramedics are frequently exposed to violence in the emergency rooms, of which they mostly experience verbal abuse. In addition, because the reporting system in the event of violence and the coping process are not well-informed, paramedics are unable to sufficiently utilize the reporting system and programs established within the institution. Therefore, the support of the legal system is needed to create a safe working environment for the medical staff who work in the emergency medical centers.

• 보건의료산업학회지
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• 제8권1호
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• pp.27-39
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• 2014

The purpose of this study is to compare and analyze the process of hospital visits according to the characteristics of the elderly visiting to emergency medical centers. The subject of study was 571 patients over the age of 65 who agreed to participate in the study of emergency medical centers from May 1 to 31, 2010. The frequency, percentage and ${\chi}^2$ test of collected data were conducted with SPSS WIN 12.0. As a result, the frequency of the aged with or without urgency revisiting emergency rooms due to chronic degenerative diseases was high. In addition, there were many cases that the aged living only with a spouse or remaining single. It was obscure to classify them into a urgent or non-emergent group which made it longer time to visit a hospital. It may be necessary that the care for urgent elderly patients considering the characteristics of the family environment functions to care the elderly were weakened.

• 한국전자통신학회논문지
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• 제10권4호
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• pp.449-459
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• 2015

2011년에 발생한 블랙아웃 사태 때 전기 공급이 중단된 엘리베이터에 많은 사람이 갇히는 일이 발생하였다. 그때 엘리베이터와 연결된 관리실 전화망이 부실하게 작동되는 문제점이 있었다. 본 논문에서는 ICT 기반 엘리베이터 비상통화장치 프로토타입 시스템을 제안하고 성능을 평가한다. 제안된 시스템은 승객의 안전을 보장하기 위하여 엘리베이터에서 위험 상황이 발생하면 신속하게 대응한다. 이를 위하여 먼저 관리실과 통화접속을 시도한다. 만일 접속이 실패하면 통화음 및 녹음음성의 분석을 통해 등록된 긴급연락번호 및 구조대로 순환 순서에 따라 순차적으로 연결을 시도한다. 또한 긴급 통화 접속이 신속하게 이루어 질 수 있도록 설계하였다. 마지막으로 제안된 시스템은 엘리베이터의 고장 정보를 고장 처리 단말기로 신속하게 전송하는 기능도 포함한다.

• 산업공학
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• 제24권4호
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• pp.274-280
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• 2011

Delayed access to surgery may lead to deterioration in the patient condition, poor clinical outcomes, increase in the probability of emergency admission, or even death. The purpose of this work is to decide the number of patients selected from a waiting list and to schedule them in accordance with the operating room capacity in the next period. We formulate the problem as an infinite horizon Markov Decision Process (MDP), which attempts to strike a balance between the patient waiting times and overtime works. Structural properties of the proposed model are investigated to facilitate the solution procedure. The proposed procedure modifies the conventional value iteration method along with the binary search technique. An example of the optimal policy is provided, and computational results are given to show that the proposed procedure improves computational efficiency.

• 대한간호학회지
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• 제26권1호
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• pp.194-222
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• 1996

Various accidents and injuries are currently occurring in Korea at increasingly high rates. Good quality emergency care service is urgently needed to cope with these various forms of accidents and injuries. In order to develop a sound emergency care system, there need to be a plan to educate and train professionals specifically in emergency care. One solution for the on going problem would be to educate and train emergency clinical nurse specialists. This study on a strategy for curriculum development for emergency clinical nurse specialist was based on the following five content areas, developed from literature related to the curriculum of emergency nursing and emergency care situation : 1. Nurses working in the emergency rooms of three university hospitals were analyzed for six days to identify categories of nursing activities. 2. Two hundreds and eleven nurses working in the emergency rooms of 12 university hospitals were surveyed to identify needs for educational content that should be included in a curriculum for the clinical nurse specialist. 3. Examination of the environment in which emergency management was provided. 4. Identification of characteristics of patients in the emergency room. 5. The role of emergency clinical nurse specialist was identified through literature, recent data, and research materials. The following curriculum was formulated using the above mentioned process. 1. The philosophy of education for emergency clinical nurse specialist was established through a realistic philosophical framework. In this frame, client, environment, health, nursing, and learning have been defined. 2. The purpose of education is framed on individual development, social structure, nursing process and responsibility along with the role and function of the emergency clinical nurse specialist. 3. The central theme was based on human, environment, health and nursing. 4. The elements of structure in the curriculum content were divided to include two major threads, I, e., vertical and horizontal : The vertical thread to consist of the client, life cycle, education, research, leadership and consultation, and the horizontal thread to consist of level of nursing (prevention to rehabilitation), and health to illness based on the health care system developed by Betty Neuman system model. 5. Behavioral objectives for education were structured according to the emergency clinical nurse specialist role and function as a master degree prepared in various emergency settings. 6. The content of the curriculum consisted of three core courses(9 credits), five major courses(15 credits), six elective courses(12 credits) and six prerequisite courses (12 credits). Thus 48 credits are required. Recommendations : 1. To promote tile quality of the emergency care system, the number of emergency professionals, has to be expanded. Further the role and function of the emergency clinical nurse specialist needs to be specified in both the medical law and the Nursing Practice Act. 2. In order to upgrade the qualification of emergency clinical nurse specialists, the course should be given as part of the graduate Program. 3. Certification should be issued through the Korean Nurses Association.