• 한국응급구조학회지
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• 제23권1호
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• pp.113-123
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• 2019

Purpose: The aim of this study was to provide basic data to improve the survival rate of pre-hospital cardiac arrest patients. This study suggests a more effective method of performing effective chest compressions for a cardiac arrest patient in a moving ambulance. Methods: To compare the differences between gender and license (qualification), SPSS 18.0 (Windows) was used. Independent and paired t-tests were used for differences between before and after wearing a rescuer's belt. Results: The success rate of chest compressions according to gender was higher in males ($68{\pm}21.91%$) than in females ($25.04{\pm}16.88%$). There was no difference according to license ($44.70{\pm}26.63$ for paramedic, $45.05{\pm}19.25$ for nurse). However, the depth (mm) and the success rate (%) were improved during the evaluation of chest compressions when wearing the rescuer's belt (depth: $46.95{\pm}6.49$ vs. $49.55{\pm}6.05$, success rate: $44.80{\pm}24.66$ vs. $57.39{\pm}26.823$). Conclusion: Wearing a rescuer's belt in an ambulance during patient transport can result in deeper and more accurate chest compressions; therefore, it is expected to be effective in recovering the circulation of patient with cardiac arrest.

• 한국응급구조학회지
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• 제26권1호
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• pp.7-19
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• 2022

Purpose: The purpose of this study is to evaluate the interrupted chest compression time during the use of an automated external defibrillator (AED) depending on different AED practice training methods, and to report differences in self-efficacy before and after training. Methods: We enrolled university freshmen who have had cardiopulmonary resuscitation (CPR) training but have not or have had AED training but over 6 months. We examined differences between the group that practiced only shockable rhythms during training and the group that practiced both shockable and non-shockable rhythms. Results: A total of 72 individuals participated in this study, with 36 individuals each in the control and experimental groups. There was no statistically significant difference in the proficiency of AED usage between the two groups. In non-shockable cases, the experimental group showed shorter chest compression interruption time than the control group (2.30±1.21sec vs. 3.16±1.73 sec; p<0.01). In terms of self-efficacy before and after training, both groups showed higher self-efficacy after than before training. Conclusion: Individuals who underwent training that provided practice on both shockable and non-shockable rhythms had a shorter interrupted chest compression time when using the AED.

• 성인간호학회지
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• 제28권2호
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• pp.169-179
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• 2016

Purpose: The purpose of this study was to investigate the effects of simulation-based training (SBT) for basic life support (BLS) utilizing video-assisted debriefing (VAD) about non-technical skills (NTSs) and technical skills (TSs). The goal of the proposed study is the evaluation of a teaching method about the correct application of cardiopulmonary resuscitation (CPR). Methods: The study design was a control group pre- and post-test non-synchronized experimental design. The sample included twelve teams of 36 nursing students. Both the experimental and the control groups received the SBT for BLS. Only the experimental groups received VAD where as the control groups had a verbal debriefing. Raters who used checklists for TSs and NTSs evaluated both groups. Data were analyzed by the SPSS 20.0 using Cronbach's ${\alpha}$, Intraclass Correlation Coefficient (ICC), Mann-Whitney U test and Willcoxon signed rank test. Results: The experimental groups scored higher than the control groups in both TSs (p=.004) and the NTSs (p=.008). Conclusion: The findings of this study suggest that NTSs are an important factor that lead CPR successfully, so VAD can be used as an efficient teaching-learning strategy in the SBT for BLS for nursing students and nurses.

• 한국응급구조학회지
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• 제22권1호
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• pp.49-59
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• 2018

Purpose: The purpose of this study was to develop an assistant device for the promotion of bag-valve-mask ventilation based on a non-equivalent control group pre-test and post-test design. Methods: The experimental tool was a mask assistance device developed by the researchers. Data were analyzed using SPSS 21.0 with the cardiopulmonary resuscitation (CPR) evaluation program from August 18 to 30, 2016. The research tools included general, hand-related, and ventilation-related characteristics. Results: Before and after using the mask assistance device, the tidal volume increased by 64 mL (p<.001) from 461.76 mL to 525.86 mL. The tidal volume for control was 477.86 mL, and there was a statistical difference (p<.05). The ventilation frequency in device users was 10 times per minute for a total of 20 ventilations with before 10.65 after 10 times, and that of the control group was before 10.36 times after 10 times; there was no difference in both groups(p>.05). The accuracy of the assistance device was $81.72{\pm}30.86%$, which was a very high value. However, the accuracy of ventilation in the control group with no assistance device was $18.97{\pm}32.44%$, which was a very low accuracy rate. Conclusion: This study's results suggested utilizing the newly-developed mask assistance device in CPR, and showed increases in tidal volume and accuracy of ventilation using the bag-valve-mask ventilation equipment. The general and hand-related characteristics did not have any effect, so the use of the device proved to increase the efficacy in all users.

• 여성건강간호학회지
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• 제25권2호
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• pp.194-206
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• 2019

Purpose: Maternal Fetal Intensive Care Unit (MFICU), which provides intensive care to high-risk mothers with increasing maternal age and high-risk newborns, has become a new field of nursing work in South Korea. The present study was conducted to identify the educational needs and self-assessing clinical competence of nurses in MFICU. Methods: The education needs and competencies of MFICU nurses were measured through prepared questionnaires by researchers based on the previous studies on job analysis of nurses in MFICU. Data were collected from January 2019 to March 2019. The study involved 168 nurses working in MFICUs at 12 hospitals nationwide as study subjects. The data were analyzed using the SPSS WIN 23.0 program. Results: The education needs of nurses in MFICU had an average of 4.21 points (${\pm}0.50$) and their nursing competence was average 3.38 points (${\pm}0.60$). The items reported as high education needs but low competency by nurses in MFICU were as following: 'postpartum hemorrhage and shock,' 'cardiopulmonary resuscitation (CPR) for neonate,' 'CPR during pregnancy,' 'disseminated intravascular coagulation,' 'sepsis,' and 'mechanical ventilation during pregnancy.' Conclusion: Based on these results, it is proposed that a comprehensive education program for nurses in MFICU should be developed by considering low capabilities among MFICU nurses as a priority factor.

• 한국응급구조학회지
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• 제27권3호
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• pp.7-16
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• 2023

Purpose: The objective of this study was to compare the outcome of out-of-hospital cardiac arrest (OHCA) between National Health Insurance(NHI) and Medical Aid(MA), before (2019) and during 2020 COVID-19 in Seoul. Methods: This is a retrospective cohort study that used nationwide OHCA registry collected in 2019 and 2020. The participants were patients with medical etiology who lived in Seoul and were transferred by 119 ambulance in Seoul. It was classified into NHI and MA according to health insurance status. Main outcomes included survival rate and good neurological recovery. Results: A total of 2,888 patients (2,543 NHI and 345 MA) in 2019 and 2,949 patients (2,638 NHI and 311 MA) in 2020 were included. In 2020, the bystander cardiopulmonary resuscitation (CPR), was significantly lower in MA (25.7%) than in NHI (38.1%). Survival rate in the MA decreased from 11.6% in 2019 to 10.6% in 2020, while increased from 10.1% to 13.3% in NHI. The odds ratio of good neurological recovery were 0.47 (95%CI, 0.25-0.86) for the MA group compared with NHI during 2020 COVID-19. Conclusion: There were disparities in bystander CPR and good neurological recovery by health insurance status during COVID-19 pandemic. Public health interventions should strive to reduce disparity of MA group in OHCA.

• 한국산학기술학회논문지
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• 제17권2호
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• pp.560-569
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• 2016

목적 병원 밖에서 발생한 심인성 심장정지 환자의 생존 관련 요인들을 알아보고, 우리나라 응급의료제도의 개선 방향에 대해 제안하고자 본 연구를 진행하였다. 연구방법 2006년부터 2012년까지 7년간 우리나라 119 구급대가 이송한 심장정지 환자 전수 자료 중 심인성 심장정지 환자 90,734명만을 분석 대상으로 하였다. 심장정지 조사 자료는 같은 지역 내 환자의 생존 여부가 상호 관련성이 있는 다층적 구조의 자료이므로, 이를 보정하기 위하여 환자-지역 2단계 다수준 분석을 실시하였다. 결과 본 연구에서 일반인에 의해 심폐소생술(Cardiopulmonary Resuscitation, CPR)이 시행된 경우 그렇지 않은 경우에 비해 생존 퇴원 가능성이 1.40배, 병원 도착전에 제세동을 신속히 시행한 경우 생존퇴원 가능성이 2.98배 높았다. 병원별 응급의학 전문의 수를 5분위로 나누어 분석한 결과, 전문의수가 가장 적은 경우인 1분위를 기준으로 2분위인 경우 1.29배, 3분위인 경우 2.89배, 4분위인 경우 3.39배, 5분위인 경우 4.07배 생존퇴원 가능성이 높아지는 경향성을 나타냈다. 병원별 연평균 심장정지 환자수를 5분위로 나누어 분석한 결과, 심장정지 환자를 가장 적게 보는 병원인 1분위를 기준으로 각각 2분위인 경우 2.06배, 3분위인 경우 3.06배, 4분위인 경우 3.46배, 5분위인 경우 4.36배 생존퇴원 가능성이 높아지는 경향성을 나타냈다. 또 지역박탈지수를 5분위로 나누어 분석한 결과, 지역박탈지수가 가장 낮은 지역인 1분위를 기준으로 2분위인 경우 교차비가 0.96, 3분위인 경우 1.00, 4분위인 경우 0.72, 5분위인 경우 0.64를 보여 지역박탈지수가 높을수록 생존퇴원 가능성이 낮아지는 경향성을 보였다. 결론 일반인에 의해 CPR이 시행된 경우, 병원 도착 전에 제세동을 신속히 시행한 경우 생존 퇴원 가능성이 높아진다. 또 응급의학과 전문의 수가 많은 병원과 심장정지 환자를 많이 보는 병원에서 처치되었을 때, 지역 박탈지수가 낮을수록 생존 가능성이 높아지는 경향성을 나타냈다.

• 한국산학기술학회논문지
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• 제13권12호
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• pp.5943-5949
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• 2012

본 연구는 의료인 기본심폐소생술 교육이 보건계열 대학생의 지식과 태도에 미치는 효과를 검증하기 위해 시도된 비동등성 대조군 전후 유사 실험연구이다. 연구 대상은 D광역시에 소재한 D대학에 재학 중인 보건계열 학생 140명으로 하였고, 자료수집기간은 2010년 8월 3일부터 8월 29일까지였다. 연구 도구는 심폐소생술 지식과 태도를 사용하였고, 자료분석은 SPSS/PC 12.0 win을 사용하여 실수와 백분율, 평균과 표준편차, ${\chi}^2$ test, Fisher's exact test, independent t-test, paired t-test, ANCOVA를 이용하였다. 결론은 의료인 기본심폐소생술 교육을 받은 실험군은 대조군보다 지식점수가 유의하게 높았다(F=47.22, p<.001). 의료인 기본심폐소생술 교육을 받은 실험군은 대조군보다 태도점수가 유의하게 높았다(F=40.20, p<.001). 이상의 결과를 볼 때, 의료인 기본심폐소생술 교육은 보건계열 대학생의 지식과 태도에 긍정적인 효과가 있음을 확인할 수 있었다. 따라서 보건계열 학과 교과과정에 심폐소생술 관련 교과목 개설을 검토해 볼 것을 제언하며, 보건계열 대학생을 위한 체계적이고 표준화된 교육 프로그램 개발이 필요할 것으로 사료된다.

• 한국의료질향상학회지
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• 제4권1호
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• pp.82-103
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• 1997

Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

• Child Health Nursing Research
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• 제19권3호
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• pp.168-176
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• 2013

목적 본 연구는 보육교사를 대상으로 제시된 응급상황별 아동의 사례를 바탕으로 동료 교사와의 상호 작용적 토론과 자신의 경험에 대한 성찰을 유도하는 소그룹 학습을 적용한 후 대조군과 비교하여 대상자의 응급상황 대처 지식, 심폐소생술 태도와 수행의지, 심폐소생술 술기 능력에 미치는 효과를 확인하고자 하기 위함이다. 방법 본 연구는 비동등성 대조군 전후 유사실험연구로 전라남도 S시 소재 40개 보육시설의 보육교사 64명을 대상으로 하였다. 이중 33명이 실험군이였으며, 응급상황 대처 사례기반 소그룹 학습에 참여하였다. 자료는 SPSS 18.0 program을 이용하여 ${\chi}^2$-test, t-test, Pearson's correlation coefficient로 분석하였다. 결과 연구 결과 사례기반 소그룹 학습은 대상자들의 응급상황 대처 지식을 향상시키고 보육교사의 심폐소생술 태도와 심폐소생술을 수행하고자 하는 의지의 변화를 도모하여 심폐소생술 술기 능력을 유의하게 증가시켜 응급상황 대처 능력 증진을 위한 효과적인 교수방법임을 확인할 수 있었다. 결론 응급상황 대처 사례기반 소그룹 학습은 보육교사들에게 일상생활에서 발생할 수 있는 응급상황의 대처 능력을 향상시키기 위한 교수방법으로 고려할 수 있으며 본 연구 결과를 토대로 응급상황 대처 능력을 오래 지속될 수 있는 새로운 교수방법 제안 및 다양한 학습 프로그램을 개발시킬 수 있으리라 생각된다.