• 의료법학
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• 제13권1호
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• pp.249-293
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• 2012

Inter-hospital transfer, depending on its medical and legal appropriateness, affect the prognosis of patients and can even lead to legal disputes. As Emergency Medical Service Act, any physician shall, in case where deemed that pertinent medical service is unavailable for such patient with the capacities of the relevant medical institution, transfer without delay such patient to another medical institution where a pertinent medical service is available. For medico-legally appropriate inter-hospital transfer, the head of a medical institution shall, in case where he transfers an emergency patient provide medical instruments and manpower required for a safe transfer of the emergency patient, and furnish the medical records necessary for a medical examination at the medical institution in receipt of such patient. And transfer process must comply with the requirements prescribed by executive rule such as attachment of the referral, provision of ambulance, fellow riders and informed consent of transfer. Those engaged in emergency medical service shall explain an emergency medical service to an emergency patient and secure his consent. In addition to the duty to inform about emergency medical service to the patient and his or her legally representative, there is also a duty for doctors to sufficiently explain to the patient and his or her legally representative during inter-hospital transfer that the need for the transfer, the medical conditions of the patient to be transferred and emergency treatment that will be provided by the hospital from which the patient is going to transferred. Likewise, the hospital to which the patient is transferred must be thoroughly informed about matters such as the patient's conditions, the treatment the patient was given and reasons for transfer by transferring doctors.

• 기본간호학회지
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• 제26권2호
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• pp.127-135
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• 2019

Purpose: The purpose of this study was to develop an informational leaflet on emergency care and to explore effects of facilitative nurse-patient interaction behavior using an informational leaflet on patient satisfaction with nurse-patient interaction behavior, patient anxiety, and patient satisfaction with use of emergency care. Methods: This study was a quasi-experimental study that applied a nonequivalent control-group posttest-only design. The participants were 81 patients who visited the emergency department of a hospital in Korea; the experimental group (n=40) received facilitative nurse-patient interaction behavior using an informational leaflet, and the control group (n=41) received care under routine protocols without an information leaflet. The effects of the two groups were analyzed using an independent t-test with SPSS computer program. Results: Patient satisfaction with nurse-patient interaction behavior and use of emergency care in the experimental group were significantly higher than in the control group. Patient anxiety related to using emergency care in the experimental group was significantly lower than the control group. Conclusion: Therefore, facilitative nurse-patient interaction behavior using an informational leaflet to the patient may be useful interventions that are easily implemented by nurses in emergency settings.

• 한국응급구조학회지
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• 제25권1호
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• pp.147-158
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• 2021

Purpose: This study was conducted as a direct investigation of the data in the dispatch logbooks and status of patient transportation provided by private emergency transport companies in Busan. Methods: This study was conducted using SPSS 23.0 version for a total of 1,000 processed records of private emergency ambulance services in Busan from September 23, 2017 to November 5, 2019. Results: First, 100% of the emergency patient transfers by private emergency ambulances were carried out between medical institutions; 76.4% of all transfer patients had emergency conditions, and 86.0% had serious diseases. Second, 59.3% of the emergency patients were located at distances less than 10 km and 43.2%, at more than 10 km from the medical institutions. Third, 63.5% of the passengers were accompanied by first-class emergency rescuers according to the severity of the condition. Fourth, 92.7% of the reasons for the selection of medical institutions were transferred to places where professional care was available, accounting for most of the reasons for the selection. Finally, the medical institutions were selected according to the severity of the patient's condition; 76.5% patients were transported to institutions with a large number of doctors, and 42.9% of those were transported to specialized care institutions. Conclusion: This study collected data from 1,000 dispatch records of private emergency transport companies in Busan; these records reflect the government's policies to improve the emergency patient transfer system. The current status of emergency patient transfer offered by private transport companies was analyzed. All of the emergency patient transfers were carried out between medical institutions, and 76% of the transferred patients had emergency conditions.

• 대한의용생체공학회:의공학회지
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• 제28권5호
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• pp.703-712
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• 2007

In this paper, we designed the RFID(Radio Frequency Identification) Emergency Medical Information System(REMIS). This REMIS offers the emergency patient's medical information using RFID and HL7(Health Level 7) to an emergency medical technician. In emergency situation as like coma, if the communication, from the patient's current location to the hospital, is possible, REMIS offer the medical information of the patient through REMIS server to an emergency medical technician. In the state of communication blocked, REMIS can offer the patient identification and the emergency information through RFID tag, which the patient wear, to an emergency medical technician. When this system was designed, the protection of the patient's medical information and their privacy was considered, and the HL7 was used to be compatible with another medical systems. Therefore, in this paper, REMIS was designed that it is always possible to offer the emergency patient's information to an emergency medical technician regardless of any communication status and to improve the emergency rescue process, effectively.

• 보건행정학회지
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• 제23권2호
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• pp.145-151
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• 2013

Background: The objective of this study was to explore patient family's evaluation of emergency department (ED) service satisfaction and to compare these with ED staff perception of patient family's evaluation. Methods: Based on two surveys of the National Emergency Medical Center: the 2008 National Survey for Recognition and Satisfaction towards Emergency Medical Services and the 2008 Opinion Survey of Emergency Medical Service Providers, satisfaction gaps among physicians, nurses, and patient family were evaluated by Kruskal-Wallis tests and Wilcoxon-Mann-Whitney tests. Furthermore, the factors associated with satisfaction of emergency medical service were identified by ordinal logistic regression models. Results: There were statistically significant gaps among physicians, nurses, and patient family in overall satisfaction with ED visit, length of stay in ED, enough explanation, physicians/nurses kindness, and ED facilities. Age and income in the patient family model, the number of beds in hospital, job satisfaction and year of service in the physicians model, and the number of beds in hospital, job satisfaction and the number of patients per duty hour in the nurses model were statistically significant factors associated with evaluation/ perception of ED service satisfaction. Conclusion: Patient satisfaction is an important indicator of the quality of care and service delivery in the ED. To improve and understand satisfaction in ED service, a dyadic view of the evaluation of service quality and satisfaction-that is, from the perspectives of both the patient and the emergency medical service providers-should be concerned.

• KSII Transactions on Internet and Information Systems (TIIS)
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• 제17권4호
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• pp.1049-1065
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• 2023

Recently, with the development of IoT, AI, and mobile terminals, medical information platforms are expanding. The medical information platform can determine a patient's emergency situation, and medical staff can easily access patient information through a mobile terminal. However, in the existing platform, emergency situation decision is delayed, and faster and stronger authentication is required in emergency situations. Therefore, we propose an edge computing-based medical information platform for automatic authentication using patient situations. We design an edge computing-based medical information platform architecture capable of rapid transmission of biometric data of IoT and quick emergency situation decision, and implement the platform data flow in emergency situations. Relying on this platform, we propose the automatic authentication using patient situations. The automatic authentication protects patient information through patient-centered authentication by using the patient's situation as an authentication factor, and enables quick authentication by automatically proceeding with mobile terminal authentication after user authentication in emergencies without user intervention. We compared the proposed platform with existing platforms to show that it can make quick and stable emergency decisions. In addition, comparing the automatic authentication with existing authentication showed that it is fast and protects medical information centered on patient situations in emergency situations.

• 한국응급구조학회지
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• 제22권3호
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• pp.47-54
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• 2018

Purpose: The purpose of this study was to present evidence for quality management based on analysis of patient transportation and response intervals among emergency medical squads. Methods: The chi-square test was used to determine whether mental status and patient assessment affected direct medical control and hospital destination. One way analysis of variance was used to compare response intervals depending on mental status and patient assessment using data drawn from 1172 prehospital care reports. Results: There was a statistically significant relationship between mental status and direct medical control (p<.001); there was a statistically significant relationship between patient assessment and hospital destination (p=.011). However, there was no statistically significant relationship between mental status and hospital destination. The interval from arrival at the patient's side to departure from the scene showed a statistically significant difference (p<.001, p<.001), however, it took the longest time (16.8 minutes) in unresponsive patients. It showed a statistically significant difference (p<.001) in the interval from arrival at patient's side to departure from the scene depending on patient assessment; however, it took the longest time (9.6 minutes) in emergency patients. Conclusion: There was call for direct medical control based on patient assessment; however, patient transportation and response intervals were not appropriate.

• 한국응급구조학회지
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• 제15권2호
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• pp.67-84
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• 2011

Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.

• 간호행정학회지
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• 제12권4호
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• pp.541-554
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• 2006

Purpose: The purpose of this study is to provide basic data for the improvement of the quality in the emergency nursing services by investigating the expectation level and actual received level with nursing care and identifying the factors that influence patient satisfaction with the emergency nursing care in the military hospitals. Method: Using a self report questionnaire, data were collected from 150 patients who had been admitted in military hospitals emergency department. The data collection was done between April 17 and April 30, 2006. At least, 145 questionnaires were analyzed and used in this study. Results: The average sum score was 61.93 out of 76 with standard deviation 9.590. The mean of the patient's expectation levels with the overall emergency nursing services was $(3.25{\pm}.504)$ out of the highest score 4. the average sum score was 63.27 out of 76 with standard deviation 9.902. The mean score of the patient's actual levels with the overall emergency nursing services was $(3.33{\pm}.521)$ out of the highest score 4. Conclusion: nursing management strategies must be established to remove patient's dissatisfaction factors and to improve the emergency nursing care quality through continuous measurement and assessment of the patient's satisfaction with emergency nursing services in military hospitals.

• 성인간호학회지
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• 제26권5호
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• pp.500-511
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• 2014

Purpose: The purpose of this study was to investigate predictors of violent behavior by patient or caregiver of patient in the emergency department. Methods: Subjects of the study were 447 residents who have visited the emergency department in community P Metropolitan City during the past year. The data collecting period was from June 1, 2012 to August 31, 2012. Data was collected using self-reported questionnaires. Results: Predictors of violent behavior in the emergency department were divided into personal and institutional factors. Personal factors included relationship with patients, presence of alcohol, reports of discontent during and past treatment and responses to deterioration in patient's conditions, institution factors included perceived attitudes toward medical workers' explanations and proficiency of medical workers, and delay in medical treatment hours. Conclusion: Knowledge of personal and institutional factors may permit emergency staff to minimize or prevent potential violence in the emergency department.