• 제목/요약/키워드: National health plan

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Analysis of Growth Environment on Old Tree, a Natural Monument in Gyeongsangbuk-do (경북지역의 천연기념물 노거수 생육현황 분석)

  • Kim, Tae Sik;Cho, Sun Hee;Kang, Hee Jin
    • Korean Journal of Heritage: History & Science
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    • v.43 no.1
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    • pp.190-211
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    • 2010
  • The purpose of this paper is to provide the preliminary data for maintenance of old trees of natural monuments and establishing protection projects. Accordingly, growth conditions, location circumstances, environment and protection management were analyzed for old trees at 34 sites in Gyeongsangbuk-do. Tree forms, crown, trunk and trees' health, leaves volume were analyzed in survey sites. As the results, the growth of Picrasma quassioides in Songsadong, Andong-si and Catalpa ovata in Hongwon-ri, Cheongsong-gun were not in good condition, along with other old trees of 6 cities (Quercus variabilis in Susan-ri, Uljin-gun, Juniperus chinensis in Hujeong-ri, Uljin-gun, Pyrus ussuriensis in Ssangjeon-ri, Uljin-gun, Salix glandulosa var. pilosa in Deokchon-ri, Cheongdo-gun, Pinus densiflora for. multicaulis in Hwasan-ri, Mungyeong-si, Pinus densiflora in Daeha-ri, Mungyeong-si). Accoding to these results, protection project and consistent monitoring are necessary. The analysis results of growth conditions per location circumstances showed that the old trees in the small spaces with large traffic of people were in bad condition. Therefore, it is necessary to secure sufficient space and soil improvement for such trees. The analysis results of growth conditions per species showed that Zelkova serrata, Quercus spp., Pinus densiflora are in good condition while Salix koreensis and others, i.e. a singular tree, are in poor condition. Thus, relatively smaller individuals and separately situated trees need careful management in their protection. The analysis results of trunk's growth ratio showed that Pinus densiflora, Ginkgo biloba, Zelkova serrata are in good condition whereas Juniperus chinensis, Quercus variabilis, Salix koreensis are not. It is a recent trend that tree surgeries are gradually decreasing; there are a number of damaged trees with no maintenance/management, and several sites requiring mend trunks management and cabling, bracing in protection and management projects. Hence, in the future, local government and management organizations should plan for systematic management and establish a protection plan for the natural monument trees. Also, 12 sites were found to be in need to purchase lands in order to secure the growth spaces, and since most of these areas are available for purchase, it is needed to promote a budget and purchase those areas through persuasion of the owner. These areas seems crucial in order to maximize the effect of conservation efforts and budgets for the preservation and restoration of the old trees.

A Study on the Tree Surgery Problem and Protection Measures in Monumental Old Trees (천연기념물 노거수 외과수술 문제점 및 보존 관리방안에 관한 연구)

  • Jung, Jong Soo
    • Korean Journal of Heritage: History & Science
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    • v.42 no.1
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    • pp.122-142
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    • 2009
  • This study explored all domestic and international theories for maintenance and health enhancement of an old and big tree, and carried out the anatomical survey of the operation part of the tree toward he current status of domestic surgery and the perception survey of an expert group, and drew out following conclusion through the process of suggesting its reform plan. First, as a result of analyzing the correlation of the 67 subject trees with their ages, growth status. surroundings, it revealed that they were closely related to positional characteristic, damage size, whereas were little related to materials by fillers. Second, the size of the affected part was the most frequent at the bough sheared part under $0.09m^2$, and the hollow size by position(part) was the biggest at 'root + stem' starting from the behind of the main root and stem As a result of analyzing the correlation, the same result was elicited at the group with low correlation. Third, the problem was serious in charging the fillers (especially urethane) in the big hollow or exposed root produced at the behind of the root and stem part, or surface-processing it. The benefit by charging the hollow part was analyzed as not so much. Fourth, the surface-processing of fillers currently used (artificial bark) is mainly 'epoxy+woven fabric+cork', but it is not flexible, so it has brought forth problems of frequent cracks and cracked surface at the joint part with the treetextured part. Fifth, the correlation with the external status of the operated part was very high with the closeness, surface condition, formation of adhesive tissue and internal survey result. Sixth, the most influential thing on flushing by the wrong management of an old and big tree was banking, and a wrong pruning was the source of the ground part damage. In pruning a small bough can easily recover itself from its damage as its formation of adhesive tissue when it is cut by a standard method. Seventh, the parameters affecting the times of related business handling of an old and big tree are 'the need of the conscious reform of the manager and related business'. Eighth, a reform plan in an institutional aspect can include the arrangement of the law and organization of the old and big tree management and preservation at an institutional aspect. This study for preparing a reform plan through the status survey of the designated old and big tree, has a limit inducing a reform plan based on the status survey through individual research, and a weak point suggesting grounds by any statistical data. This can be complemented by subsequent studies.

A Study on Public Library Finance (공공도서관의 재원확보에 관한 연구)

  • Suh Hye-ran
    • Journal of the Korean Society for Library and Information Science
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    • v.23
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    • pp.263-301
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    • 1992
  • In recent years, Korean public libraries, placed under changing circumstances, require that some new and positive financial policies be formulated for the improvement of their services. T he purpose of this study is to propose a scheme to ensure the revenues of Korean public libraries. The main contents of this study are as follows : (1) Public finance theory is applied to the question of why the public library is publicly supported. The public library does not contribute to stabilization, but it does playa role in each of the other public sector functions : allocation of resources and redistribution of income. In public finance terms there is justification for at least partial subsidy of public library services, which have the attributes of public goods, merit goods and externalities. (2) Public libraries in Korea find themselves suffering from limited budgets. They are neglected in national and local budgets. The lack of adequate funding for library collections prevents libraries from rendering efficient services. (3) In order to put the finances of the Korean public library system on a firm basis, the following proposals are made: 1) It is proposed that the parallel administration under which public libraries are organized be unified to be directly under the local governments. 2) It is proposed that the legislative and administrative system for public library finance be strengthened. (1) Library expenses should be itemized independently in the calculation of general grants-in-aid to local governments. (2) A fixed portion of the total municipal revenue should be appropriated for public library services. It can be executed by making provisions expressly in the annual guidelines for budgeting, municipal ordinances, or in the Library Promotion Law. The rate of allocation should be specified as a part of the national public library development plan. (3) Library tax as a local tax can be imposed. An indirect tax is preferable in order to avoid public misunderstanding and antagonism. 3) The augmentation of the specific grants-in-aid for the public library is proposed. The Library Promotion Law and the Law on Budget and Administration of Grants should be amended to oblige the central government to give financial assistance to local public libraries. 4) It is proposed that strategies to encourage private endowments be worked out. Revision of the Law on Tax Reduction and Exemption and the activation of an advisory library committee at each public library are recommended. 5) Funding and utilization of the envisioned Library Promotion Foundation is proposed. Government contributions, contributions from the Culture and Arts Foundation, and donations from individuals, corporations, and enterprises can be considered as the financial resources of the Foundation. 6) It is proposed that the structure of the Korean Library Association be consolidated to exercise greater influence over the formation of national policy on the public library system. 7) It is proposed as an ultimate guarantee of the health of the public libraries that the citizenry be educated to strongly support library services in responce to the active services provided by the public libraries.

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Analysis of the GIS-Based Water Cycle System for Effective Rainwater Management of Gyeongsangnam-do (경상남도의 효율적 빗물관리를 위한 GIS 기반 물순환 체계 분석)

  • Lee, Taek-Soon;Song, Bong-Geun;Han, Chi-Bok;Park, Kyung-Hun
    • Journal of the Korean Association of Geographic Information Studies
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    • v.14 no.2
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    • pp.82-95
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    • 2011
  • The objective of this paper is to analyze the GIS-based water cycle system: rainfall, evapotranspiration, surface run-off of Gyeongsanam-do for the effective rainwater management. The rainfall(1999~2008) analyzed by a spatial interpolation method, showed relatively higher amount in Hadong-gun, Sanchung-gun, and Sacheon-gun on the southwest coast than in Changnyeong-gun, Miryang-si, and Changwon-si in the mideast inland. The evapotranspiration was calculated by the three independent variables: air temperature, landuse, and NDVI(normalized difference vegetation index). The analysis showed that Namhae-gun had the highest evapotranspiration of 93.71mm, and Jinhae-si and Changwon-si had the lowest values of 81.78mm and 84.37mm. The surface run-off was analysed by a run-off equation based on the SCS hydrologic soil classification and landuse. The amount of surface run-off showed that Hadong-gun had the highest value, of 90.40mm, and Geochang-gun had the lowest, of 46.69mm. The analysis results of the GIS-based water cycle system will be used to support the establishment of the effective rainwater management plan in Gyeongasngnam-do.

Characterization of Microbial Community in the Leachate Associated with the Decomposition of Entombed Pigs

  • Yang, Seung-Hak;Hong, Sun Hwa;Cho, Sung Back;Lim, Joung Soo;Bae, Sung Eun;Ahn, Heekwon;Lee, Eun Young
    • Journal of Microbiology and Biotechnology
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    • v.22 no.10
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    • pp.1330-1335
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    • 2012
  • Foot and mouth disease (FMD) is one of the acute infectious diseases in hoofed and even-toed mammals, including pigs, and it occurs via acute infection by Aphthovirus. When FMD is suspected, animals around the location of origin are typically slaughtered and buried. Other methods such as rendering, composting, and incineration have not been verified in practice in Korea. After the FMD incident, the regular monitoring of the microbial community is required, as microorganisms greatly modify the characteristics of the ecosystem in which they live. This is the result of their metabolic activities causing chemical changes to take place in the surrounding environment. In this study, we investigated changes in the microbial community during a 24 week period with DNA extracts from leachate, formed by the decomposition of buried pigs at a laboratory test site, using denaturing gradient gel electrophoresis (DGGE) with a genomic DNA. Our results revealed that Bacteroides coprosuis, which is common in pig excreta, and Sporanaerobacter acetigenes, which is a sulfur-reduced microbe, were continuously observed. During the early stages (0~2 weeks) of tissue decomposition, Clostridium cochlearium, Fusobacterium ulcerans, and Fusobacterium sp., which are involved in skin decomposition, were also observed. In addition, various microbes such as Turicibacter sanguinis, Clostridium haemolyticum, Bacteroides propionicifaciens, and Comamonas sp. were seen during the later stages (16~24 weeks). In particular, the number of existing microbial species gradually increased during the early stages, including the exponential phase, decreased during the middle stages, and then increased again during the later stages. Therefore, these results indicate that the decomposition of pigs continues for a long period of time and leachate is created continuously during this process. It is known that leachate can easily flow into the neighboring environment, so a long-term management plan is needed in burial locations for FMD-infected animals.

Assessment of Risk of Exposure to Chemicals in the Analysis Centers of Organizations for measuring the Working Environment, using CHARM (CHARM을 이용한 작업환경측정기관 분석실의 화학물질노출 위험성 평가 연구)

  • Park, Hyun-A;Choi, Seo-Yeon;Woo, In-Sung;Rie, Dong-Ho
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.4
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    • pp.660-668
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    • 2017
  • In this study, we conducted an assessment of the risks posed by the noxious chemicals often handled at the analysis centers of organizations involved in Work Environment Measurement (WEM) using the Chemical Hazard Risk Management (CHARM) system. For this purpose, six organizations involved in WEM located in Seoul and Gyeonggi, which conducted the risk assessment, were selected and, as a result, 29 materials were selected as chemical substances presenting a risk of exposure. In terms of their physical properties, there were 16 liquid and 10 solid materials, and for the special management materials (CMR), the findings were as follows: 'Carcinogenic' 1A - 11 and 1B - 1 (2 - 8); 'Mutagenic' 1A - 4 and 1B - 3 (2 - 8); and 'Repro-toxic' 1A - 0 and 1B - 1 (2 - 6). In the risk estimation, 30.4%, 66.1% and 3.6% of the materials presented 'low', 'average' and 'high' risks, respectively. In addition, two of these six institutions had materials presenting a 'high' risk. This study is significant in that the risk assessment was conducted using CHARM, a chemical substance assessment tool. It is expected that the results will be utilized as the basic data for safety assessment, the establishment of a plan for emergency measures and drawing up a safety management manual, and the institutional and legal management of accidents and risks in the analysis centers of organizations involved in WEM and the management of chemicals by drawing attention to the risks involved.

Discharge Analysis of Chungcheongbuk-do Residents using National Hospital Discharge In-depth Injury Survey in the Recent 5 Years (퇴원손상심층조사 자료를 이용한 최근 5년간의 충청북도 거주민의 퇴원 분석)

  • Kim, Hae-Sook
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.389-401
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    • 2021
  • This study was performed to generate basic data to establish a health promotion plan for residents of Chungcheongbuk-do by identifying characteristics of discharged patients residing in the Chungcheongbuk-do area from an In-Depth Post-Discharge Injury Survey reported by the Korea Centers for Disease Control and Prevention(KCDCP). The Report provided data on demographic characteristics, medical institution use characteristics, medical use characteristics, and disease characteristics of patients discharged from medical institutions with 100 or more beds from 2013 to 2017. The total number of Chungcheongbuk-do residents who were admitted and discharged from 2013 to 2017 was estimated to be 1,656,590, and the discharge rate was 21,089, which was higher than the national average of 13,882 in 2016. The regions where the discharge rate increased during this period include Goesan, Yeongdong, Boeun, Okcheon, Jeungpyeong, and Eumseong-gun, which are mainly rural areas. Among the patients hospitalized and discharged from hospitals outside the Chungcheongbuk-do area, the discharge rate of patients who used hospitals in Incheon/Gyeonggi areas and Daejeon/Chungnam areas increased slightly. Among the malignant tumor patients, the number of lung cancer(included trachea & bronchial cancer) patients was the highest. In addition, the discharge rate was highest for patients with respiratory diseases. This study suggests that efforts need to be made to lower the discharge rate for infection, circulatory disease, genitourinary disease, and musculoskeletal disorder patients

A Survey on Patients도 Nursing Needs Following Discharge from Hospital (퇴원시 환자의 간호요구도 조사)

  • 이은옥;이선자;박성애
    • Journal of Korean Academy of Nursing
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    • v.11 no.2
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    • pp.33-54
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    • 1981
  • The purposes of this study were to determine the relevant nursing needs of patients following discharge; to identify the degree of their nursing needs; to identify types and status of discharge order and information given to patients; and to determine their specific nursing needs according to their diagnosis. In addition, opinions toward home care services provided by hospitals or by public health nurses and appointment plans with their physicians were also asked in order to determine the necessity of follow-up care for the patient after discharge. Nine hundred and eighty eight subjects were collected among patients being discharged from one national university hospital and four city hospitals. Data were collected from June,1979 to December,1979 using questionnaires and interviews. On the bases of these data the following findings were observed; 1) Almost 40 percents of total subjects discharged from the hospital with some or great degree of nursing needs in general. The most problematic nursing needs were needs for comfort which include needs for releaving pain, for sound sleep and rest, because these needs can only be met by professional help. More than 50% of total subjects have this problem. 2) Needs for mental health, general metabolism, general hygiene and activities and safety were observed in more than 20 percent of subjects. 3) Discharge orders on diet and oral medication were recorded in patients' charts in 70% of all cases. However, more than fifty percents of patients have not been told these information from doctors or nurses. Even though some of them might have had appointment plans with their physicians, they would not keep the appointments unless they completely understood the necessity of the follow-up care. If they have not had any appointment or would not visit the out-patient clinic, there is no method of caring them and prerenting funther discomfort or complications. Even in injection, ski care, dressing and bath, only one thirds of the subjects having recorded discharge orders understood what they need after discharge. The rest of cases have not known what to do for their further care. 4) More than 80 percents and 70 percents of total subjects agreed to a system of home care services provided by hospitals or public health nurses respectively. That is, regardless of sources of medical expenses, most of patients wanted to be taken care of at home following discharge. 5) While more than half of the patients having benefit of medical insurance or paying fully by themselves had appointment plans with their physicians, only one thirds of the patients fully or partially paid by government had appointment plans with their physicians. These results ex-plain that the appointment plan is directly associated with their economic power. This indicates that the home care services are more needed to the people with lower economical status. 6) Those who have been in the hospital more than 24 days wanted !o have home care services more than those who had less hospital days. They also had more appointment plans than other groups. 7) More than 70 percents of the subjects who had been in a university hospital and approximately 30 percents of the subjects in the city hospitals had appointment plans with their physicians. 8) Those who had the cerebrovascular disease, cancer or hypertension demanded more nursing needs such as needs for comfort, for general metabolism and for mental health. 9) Factors which were associated with the degree of patients' nursing needs were age, duration of hospitalization, opinion toward home care services given by public health nurses, hospital appointments and types of hospital. That is, the older they were and the longer the periods of hospitalization were, the higher were their nursing needs. The more they had nursing needs, the more they wanted to have nursing services and had appointment plans. It can be concluded that there is a great demand for a positive and systematic home care services to the people who have been discharged from hospitals following critical care. This program is definitely demanded for the low income groups of people with less education with the financial assistance of the government or other funding agencies.

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A Study of The Nursing Education Concerning Two Years Associate Degree Nursing Program (간호 교육에 대한 일 연구 -2년제 초급대학 과정 중심으로-)

  • 변창자
    • Journal of Korean Academy of Nursing
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    • v.4 no.3
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    • pp.63-79
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    • 1974
  • 1. The purpose of this study. The purpose of this study is to plan and investigate short-term nursing education of two-years associate degree program to produce middle-level professional nurses which are needed by-society and nation. Current nursing education in Korea is divided into four years degree program, three years diploma program Even (though) there are differences in the aims of their education, the curriculums are not much different between the education for producing leaders which is its basic purpose and training middle-level professional nurses. Therefore the purpose of associate degree program lies in minimizing the waste of time and finance which are invested for long-term education for middle-level professional nurses. And also this coincide with the policy of national technical training and definite supply of nurse manpower according to health policy for effective role and ability of nurse. 2. The method of study. This is based on the study of literature, research on the actual condition and investigation of opinion- through questionnaire. L) The study of literature: Domestic and foreign literatures for two years associate degree program were studied and investigated. 2) Research on the actual condition : Current three years nursing education program was collected and analysed. 3) Investigation of opinion. The problem of curried nursing education system and the possibility of two years associate degree program were investigated through questionnaire. 3. The result of the study. 1) The trend of recent nursing education. a. The aims of nursing in past chiefly taking care of physical disease of patient has recently changed to nursing of character including physical, mental, socio-economic, educational and psychological condition. b. For the performing systematic and effective nurse's duty according to her role, the-change of educational system which is classified as a range of education the period of education and certificate after graduation has been enforced or fulfilled. c. Nursing education also has a trend to become a collage or two years associate degree program which can get same legal protection as other educational institutions whose basic purpose is education. Attached nursing school to hospital is getting disappeared because of disadvantage of educational system. 2) Problems. Depending upon research on actual condition of current 3 years nursing education program. a. There are too many subjects. b. Contents of education could be doubled because major subjects are subdivided in detail. c. The credits for graduation are too heavy comparing to the period of study or the ability of students. (The necessary credits are 150.8 for three years according to actual investigation 4. There is no certain standard in organizing curriculum therefore there are too much differences between schools. 4. Basic Plan. The plan for two years associate degree program in nursing education depending on demand of professional nursing field of society is based on following items. 1) Training middle-level professional nurse lay emphasis on liberal arts and basic major field. 2) Liberal arts are divided into required and optional subjects and students could take courses by choice. 3) Major subjects are compound together by fields and they become the sciences of nursing Ⅰ,Ⅱ,Ⅲ,Ⅳ and every items has its educational purposes and contents major study includes laboratory practice and clinical experience. 4) The required credits for graduation are to which means 17-18 credits a semester. The above has been planned to solve the problems of current three years nursing education program. In conclusion for the achievement of this system, following items are needed. 1) It is necessary to change educational administration and system such as amendment of educational law or order of educational application of law. 2) Qualified professors should be available to understand and develope the idea or purpose of this educational system. 3) Local medical institutions should be opened widely and educational for clinical training. 4) The job after graduation should he secured positively.

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Development of a Comprehensive Model of Disaster Management in Korea Based on the Result of Response to Sampung Building Collapse (1995), - Disaster Law, and 98 Disaster Preparedness Plan of Seoul City - (우리나라 사고예방과 재난관리 모형 개발을 위한 연구)

  • Lee, In-Sook
    • Research in Community and Public Health Nursing
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    • v.11 no.1
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    • pp.289-316
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    • 2000
  • 우리나라의 경우 지역사회 재난 관리계획과 훈련이 보건의료적 모형이라기 보다는 민방위 모형에 입각하기 때문에 사고 현장에서의 환자 중증도 분류, 합리적 환자배분 및 이송, 병원 응급실에서의 대처 등이 체계적으로 이루어지지 못하고 있으며, 지역사회가 이에 즉각적으로 반응할 수 없다. 본 연구는 삼풍 붕괴사고 시에 대응방식과 그 후의 우리나라 응급의료 체계를 분석함으로써 대형사고 예방과 재난관리를 위한 우리나라 응급의료체계의 개선방안과 간호교육에서의 준비부분을 제시하고자 한다. 1 삼풍 사고 발생시에는 이를 관장할 만한 법적 근거인 인위적 재해에 관한 재난관리법이 없었다. 따라서 현장에서는 의학적 명령체계를 확보하지 못했기 때문에 현장에서의 응급 처치는 전혀 이루어지지 못하였다. 현장에서의 중증도 분류. 응급조치와 의뢰, 병원과 현장본부 그리고 구급차간의 통신 체계 두절, 환자 운송 중 의료지시를 받을 수 있도록 인력, 장비, 통신 체계가 준비되지 못하였던 점이 주요한 문제였다. 또한 병원 응급실에서는 재난 계획이 없거나 있었더라도 이를 활성화하여 병원의 운영 체계를 변환해가지 못하였다. 2. 삼풍백화점 붕괴사고 한달 후에는 인위적 재해에 대한 재난관리법이 제정되고, 행정부 수준별로 매년 지역요구에 합당한 재난관리 계획을 세우도록 법으로 규정하였다. 재난 관리법에는 보건의료 측면에서의 현장대응, 주민 참여, 응급 의료적 대처, 정보의 배된. 교육/훈련 등이 포함되어 있어야 한다. 그러나 법적 기반이 마련된 이후에도 한국 재난 계획 내에는 응급의료 측면의 대응 영역은 부처간 역할의 명시가 미흡하며, 현장에서의 응급 대응과정을 수행할 수 있는 운영 지침이 없이 명목상 언급으로 그치고 있기 때문에 계획을 활성화시켜 지역사회에서 운영하기는 어렵다. 즉 이 내용 속에는 사고의 확인 /공고, 응급 사고 지령, 요구 평가, 사상자의 중증도 분류와 안정화, 사상자 수집, 현장 처치 생명보존과 내과 외과적 응급처치가 수반된 이송, 사고 후 정신적 스트레스 관리, 사고의 총괄적 평가 부분에 대한 인력간 부처간 역할과 업무가 분명히 제시되어 있지 못하여, 사고 발생시 가장 중요한 연계적 업무 처리나 부문간 협조를 하기 어렵다. 의료 기관과 응급실/중환자실, 시민 안전을 책임지고 있는 기관들과의 상호 협력의 연계는 부족하다. 즉 현재의 재난 대비 계획 속에는 부처별 분명한 업무 분장, 재난 상황에 따른 시나리오적 대비 계획과 이를 훈련할 틀을 확보하고 있지 못하다. 3. 지방 정부 수준의 재난 계획서에는 재난 발생시 보건의료에 관한 사항 전반을 공공 보건소가 핵심적 역할을 하며 재난 관리에 대처해야 된다고 규정하고 있다. 그러므로 보건소는 지역사회 중심의 재난 관리 계획을 구성하고 이를 운영하며, 재난 현장에서의 응급 치료 대응 과정은 구조/ 구명을 책임지고 있는 공공기관인 소방서와 지역의 응급의료병원에게 위임한다. 즉 지역사회 재난 관리 계획이 보건소 주도하에 관내 병원과 관련기관(소방서. 경찰서)이 협동하여 만들고 업무를 명확히 분담하여 연계방안을 만든다. 이는 재난관리 대처에 성공여부를 결정하는 주요 요인이다. 4 대한 적십자사의 지역사회 주민에 대한 교육 프로그램은 연중 열리고 있다. 그러나 대부분의 교육주제는 건강증진 영역이며. 응급의료 관리는 전체 교육시간의 8%를 차지하며 이중 재난 준비를 위한 주민 교육 프로그램은 없다. 또한 특정 연령층이 모여있는 학교의 경우도 정규 보건교육 시간이 없기 때문에 생명구조나 응급처치를 체계적으로 배우고 연습할 기회가 없으면서 국민의 재난 준비의 기반확대가 되고 있지 못하다. 5. 병원은 재난 관리 위원회를 군성하여 병원의 진료권역 내에 있는 여러 자원을 감안한 포괄적인 재난관리계획을 세우고, 지역사회를 포함한 훈련을 해야 한다. 그러나 현재 병원은 명목상의 재난 관리 계획을 갖고 있을 뿐이다. 6. 재난관리 준비도를 평가할 때 병원응급실 치료 팀의 인력과 장비 등은 비교적 기준을 충족시키고 있었으나 병원의 재난 관리 계획은 전혀 훈련되고 있지 못하였다 그러므로 우리나라 재난 관리의 준비를 위해서는 현장의 응급의료체계, 재난 대응 계획, 이의 훈련을 통한 주민교육이 선행되어야만 개선될 수 있다. 즉 민방위 훈련 모델이 아닌 응급의료 서비스 모델에 입각한 장기적 노력과 재원의 투입이 필요하며, 지역사회를 중심으로 대응 준비와 이의 활성화 전략 개발, 훈련과 연습. 교육에 노력을 부여해야 한다. 7. 현장의 1차 응급처치자에 대해서는 법적으로 명시하고 있는 역할이 없다. 한국에서는 응급구조사 1급과 2급에 대한 교육과 규정을 1995년 이후 응급의료에 관한 법률에서 정하고 있다. 이 교육과정은 미국이 정하고 있는 응급구조사 과정 기준과 유사하지만 실습실이나 현장에서의 실습시간이 절대적으로 부족하다. 덧붙여 승인된 응급구조사 교육 기관의 강사는 강사로서의 자격기준을 충족할 뿐 아니라 실습강사는 대체적으로 1주일의 1/2은 응급 구조차를 탑승하여 현장 활동을 끊임없이 하고 있으며, 실습은 시나리오 유형으로 진행된다. 그러므로 우리나라의 경우 응급 구조사가 현장 기술 인력으로 역할 할 수 있도록 교과과정 내에서 실습을 강화 시켜야하며, 졸업생은 인턴쉽을 통한 현장 능력을 배양시키는 것이 필요하다. 8. 간호사의 경우 응급전문간호사의 자격을 부여받게 됨에 따라, 이를 위한 표준 교육 지침을 개발함으로써 병원 전 처치와 재난시 대응할 수 있는 역량을 보완해야 한다. 또한 현 자격 부여 프로그램 내용을 고려하여 정규자격 간호사가 현장 1차 치료자(first responder)로 역할 할 수 있도록 간호학 교과과정을 부분 보완해야한다.

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