• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.12
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• pp.5968-5975
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• 2012

The aim of this study was to reveal correlation between scope of practice and clinical paramedic properties. from April 9 to May 12, 2012, one hundred and eighty-one clinical paramedics filled out anonymously to the questionnaire which includes gender, academic background, clinical career, clinical practice and medical direction. To analyse the collected data, Pearson's r at ${\alpha}$=0.05 (two-tailed) was performed using IBM SPSS 19 (Chicago, IL, USA). One hundred and forty (77.4%) working at medical facilities, one hundred and four (57.5%) graduated from four-year colleges, seventy seven (42.5%) acquired paramedic certificate in 2010-2012, one hundred and twelve (61.9%) charted on nursing records, one hundred and sixteen (69.6%) had a good knowledge in scope of practice, one hundred and six (58.5%) thought of legal restriction & absence of direct medical direction leading to narrow clinical practice. Implementing practices and practices needed were thirty two. There were significant relationships in Likert scale 1-5 between paramedic competency and legal practice (p=0.039); implementing practice (p=0.006); practice needed (p=0.049); and overall (p=0.001). Also, between knowledge on scope of practice and implementing practice (p=0.003); overall (p=0.047); clinical career and legal practice (p=0.019); practice needed (p=0.002); and overall (p=0.002). However, these correlations were relatively low (r $$\leq_-$$ 0.238). The working condition of clinical paramedics was restricted by the Emergency Medical Services Systems Act, which requires a narrow scope of practice. This condition leads to the poor quality of emergency care, therefore the scope of practice in the act will be revised from specificism to generalism, from direct medical direction to indirect medical direction by means of quality management.

• Quality Improvement in Health Care
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• v.29 no.2
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• pp.64-84
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• 2023

Purpose:Plaster splints are routinely performed in the Emergency Department (ED) and avoidable complications such as skin ulcerations and fracture instability arise mainly due to improper techniques. Despite its frequent use, there is often no formal training on the fundamental principles of plaster splint application for a medical officer rotating through ED. We aim to use Quality Improvement (QI) methodology to reduce number of incorrect plaster splint application to improve overall patient care via a bundled educational solution. Methods: We initiated a QI program implementing concepts derived from the Institute for Healthcare Improvement models, including Plan-Do-Study-Act (PDSA) cycles, to decrease the rate of incorrect plaster splint application. A bundled education solution consisting of three sequential interventions (practical teaching session, online video lecture and quick reference cards) were formulated to specifically target critical factors that had been identified as the cause of incorrect plaster splints in ED. Results: With the QI intervention, our overall rate of incorrect plaster splints was reduced from 84.1% to 68.6% over a 6-month period. Conclusion: Following the QI project implementation of the bundled educational solution, there has been a sustained reduction in incorrect plaster splints application. The continuation of the training program also ensures the sustainability of our efforts in ED.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.11
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• pp.7237-7243
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• 2015

Korea Centers for Disease Control and Prevention(CDC) has been provided not only manual of managing infectious patient but also functional requirement of space in emergency department(ED) by distributing "Guideline for infection control in emergency department(GICED)" in 2009. To understand how much the guideline enforces its functional requirement on ED planning practice, it is compared to Emergency Medical Service Act(EMSA) a basic standard for ED planning. As a result, it is clear that those have different focal point in functional program and don't share infection control issue. By reviewing target hospitals' EDs opened around 2009, all ED have satisfied with the EMSA requirement but guideline. Those are selectively adapted infection control related spaces CDC guideline suggested regardless of open year so that target EDs are not to be influenced by the guideline. This research can support as a reference research when the EMSA are going to be reinforced by infection contol issue.

• The Korean Journal of Emergency Medical Services
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• v.13 no.3
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• pp.91-105
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• 2009

Purpose : The purpose of this study was to describe the current status of 119 EMT to violence experiences in Korea. Method : The number of 119 EMT in this study 2522. Self-administering questionnaire data were collected from April 27 to March 8 in 2009. Collected data were analyzed using SPSS 14.0 program. Real number, percentage, mean and standard deviation were calculated. Pearson correlation coefficient was analyzed. Result : 119 EMTs experienced 95.32%-verbal insults, 61.54%-violence aggression, 60.51%- potential violence, 38.70%-physical assault. Within 30 days from the most recent period of violence experienced verbal insults and violence aggression-51.07%, potential violence and physical assault-48.41%. The patients(50.59%) and the patients and patient's carers(38.26%) proved to be violent offender. The main reason of violent act was drug or alcohol addiction(56.15%). Recent exposure to violence was 34.82% by 7 point reward of stress level. 5-point scale showed the average of experiences of violence. Response average of emotional reactions was 2.66 points and that of physical reaction was 2.18 points. Social reaction was 2.06 points. Conclusion : This study was based on the violence experience of 119 EMT. It is necessary to prevent the violence from emergency scene. So we proposed the preventive measure against violence as well as critical incident stress debriefing(CISD). Policy for CISD and stress management will be implemented in the near future in Korea.

• Journal of Korean Academy of Nursing
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• v.26 no.1
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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.

• Fire Science and Engineering
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• v.20 no.4 s.64
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• pp.77-90
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• 2006

This is for Criminal Law problem that can be happened during the rescue working of 119 rescue member. There are mainly 3sections can be Criminal Law Problem. At first, denying a rescue request. Second, thing that do not transfer patient or people need someone's help by their refusal. Third, emergency medical management. It can be criminal act if somebody do the 3sections thing under Law about emergency medical treatment. It also can be homicide under Criminal Law or accidental homicide, a charge of injuring a person if people need rescue die or become worse through the work. Rescuers are responsible for a criminal case by their carelessness and fault. A plan has to remain to protect them when they do violence to the life and health of a people inevitably. This paper examines the plan can protect them through the analysis and application of related Law about rescuer's work which can be Criminal Law Problem, presents rational establish plan of Rescuer Protect Law to make them their job well as a rescuer.

• The Korean Society of Law and Medicine
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• v.9 no.2
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• pp.53-75
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• 2008

The end of life problem in the United States has been evolved from the development of concept of brain death over last 50 yr. The invention of ventilator and the development of emergency medicine also played a key role to elongate the end stage of life and which caused the American people to ask a question about the patients self determination and refusing the unwarranted medical treatment in the view of the death with dignity. With regard to the patient unable to self determination, surrogate decision was also considered. To guarantee the self determination, The patient self determination act also enacted on the level of Federal regulation in 1990s. But no law has effectively dealt with the situation when medical treatment became futile. Along with the significant debates on literature and court cases. The American Medical Association's Council on Medical and Judical Affairs presented formal opinion and the Texas was the first states to regulate the medical futile situation in 1999. Even though that definition was in controversy, the concept of medical futility mainly focused on the doctors' right to refuse the treatment.

• Journal of The Korean Society of Clinical Toxicology
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• v.16 no.1
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• pp.42-48
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• 2018

Purpose: On November 15, 2012, sales of OTC (Over-The-Counter) drugs began at convenience stores, which changed the accessibility of some drugs. As a result, the exposure and access patterns of these drugs could have changed. In this study, we reviewed the changes in the characteristics of drug poisoning patients because of the reposition of nonprescription drugs according to the revised Pharmaceutical Affairs Act. Methods: A retrospective study was conducted to evaluate changes in characteristics of drug poisoning patients between 2008 and 2016. A registry was developed by an emergency medical center in a local tertiary teaching hospital, and patients who visited the center were enrolled in this registry. We compared two periods, from 2008 to 2012 (Pre OTC) and from 2013 to 2016 (Post OTC), for type of intoxicant, time from poisoning to visiting the emergency center, intention, psychiatric history, previous suicidal attempt, alcohol status, and emergency room outcomes. The primary outcome was the number of patients who took acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Secondary outcomes were ICU admission rate, mortality rate, and number of patients who visited the ER when the pharmacy was closed after taking acetaminophen and NSAIDs (nonsteroidal anti-inflammatory drugs). Results: Among 1,564 patients, 945 and 619 patients visited the emergency room during pre and post OTC periods. The number of patients with acetaminophen and NSAIDs poisoning decreased from 9.2% to 6.1% (p=0.016). The ICU admission rate and mortality rate in the emergency room did not show significant results in the relevant patient groups, and so was the number of patients visiting ER when the pharmacy was closed taking acetaminophen and NSAIDs. Conclusion: Despite the sales of nonprescription drugs at convenience stores, the number of acetaminophen and NSAIDs poisoning patients decreased.

• Journal of Multimedia Information System
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• v.7 no.2
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• pp.147-156
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• 2020

The author Nakajima was involved in the field of disaster communications and emergency medical care as guest research scientist at the Fukushima Nuclear Accident Independent Investigation Commission established by the National Diet of Japan and reviewer of the Commission's report, and Kurokawa was the chairman of this Commission. Looking back over a decade, we are on the liability issue of bureaucrats and telecom operators, so it's becoming clear what was hidden at the time. The battery of NTT DoCoMo's mobile phone repeaters had a capacity of only about 24 hours, and communication failures increased after one day. The Government also failed to issue an announcement of "Vent from reactor" under the Telecommunications Act Article No. 129. This mistake lost the opportunity to use the third-party telecommunications (e.g. taxi radios). Furthermore, as a result of LASCOM (telecommunications satellite network for local governments via GEO) and a variety of unexpected communication failures, the evacuation order "Escape!" could not be notified to the general public well. As a result, the general public was exposed to unnecessary radiation exposure. Such bureaucratic slow action in emergencies is common in the response to the 2020 coronavirus.

• Journal of Society of Preventive Korean Medicine
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• v.27 no.3
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• pp.13-24
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• 2023

Objective : This study was aimed to reassess the scope of practice for medical personnel based on laws. Method : The law specifying the scope of practice for medical personnel has been selected searching Korean Law Information Center(https://www.law.gov.kr). The result was categorized as 'examination, diagnosis, treatment, procedure, prescription, and others'. Results : The laws related to medical procedures were divided into three categories: diagnosis, treatments, and public health and others. In the field of diagnosis, traditional Korean medicine practitioners are generally allowed to play a role. However, some laws specify that only medical doctors can be the primary authorities for diagnosing infectious diseases. In the area of treatments, particularly in emergency medical situations, only medical doctors or nurses are typically mentioned. There are debates in the field of public health and other areas concerning issues such as vaccination, disability diagnosis, and the qualifications for health center directors. A reevaluation is also needed for the Occupational Safety and Health Act, where only medical doctors are set as the personnel standard for workers' health examinations. Conclusion : To safeguard and promote the health of the citizens, there is a need for a clear definition of the licensure and scope of practice for healthcare professionals. Consistent interpretation of conflicting provisions among various laws and clear criteria for the term 'physician' in legal contexts are essential.