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Violence Episodes and Responses of Emergency Room Nurses (응급실 간호사가 경험한 폭력과 폭력반응에 관한 조사연구)

  • Kim, Su-Yon;Oh, Hee-Young;Ahn, Hye-Young;Eom, Mi-Ran
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.14 no.4
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    • pp.446-456
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    • 2007
  • Purpose: The purpose of study was to identify violence episodes by patients and/or their guardians and responses from emergency room nurses. Method: A convenient sample of 172 emergency nurses was selected from general hospitals with more than 200 beds. A survey design was used and data were collected from October 2 to October 11, 2006. using self-report questionnaires which were developed by the authors. Descriptive statistics, with the SPSS PC program were used to analyze the data. Results: The majority of nurses(97.1%) had experienced violence by patients or their guardians in the previous month. Violence offenders who were drunk comprised 68.6% of total offenders. Causes of violence were delays in examination and treatment(59.9%). The major coping behavior in dealing with violence episodes was ignoring(40.1%). Responses to violence experienced by emergency nurses were rated as 2.39. Response to violence according to general characteristics of the nurses showed no statistically significant differences. Conclusion: Considering the high prevalence of violence experienced by emergency nurses, hospitals must develop and manage preventive education programs and policy.

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Experiences of Emergency Surgical Treatment for a COVID-19 Patient with Severe Traumatic Brain Injury at a Regional Trauma Center: A Case Report

  • Yun, Jung-Ho
    • Journal of Trauma and Injury
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    • v.34 no.3
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    • pp.212-217
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    • 2021
  • Various medical scenarios have arisen with the prolonged coronavirus disease 2019 (COVID-19) pandemic. In particular, the increasing number of asymptomatic COVID-19 patients has prompted reports of emergency surgical experiences with these patients at regional trauma centers. In this report, we describe an example. A 25-year-old male was admitted to the emergency room after a traffic accident. The patient presented with stuporous mentality, and his vital signs were in the normal range. Lacerations were observed in the left eyebrow area and preauricular area, with hemotympanum in the right ear. Brain computed tomography showed a contusional hemorrhage in the right frontal area and an epidural hematoma in the right temporal area with a compound, comminuted fracture and depressed skull bone. Surgical treatment was planned, and the patient was intubated to prepare for surgery. A blood transfusion was prepared, and a central venous catheter was secured. The initial COVID-19 test administered upon presentation to the emergency room had a positive result, and a confirmatory polymerase chain reaction (PCR) test was administered. The PCR test confirmed a positive result. Emergency surgical treatment was performed because the patient's consciousness gradually deteriorated. The risk of infection was high due to the open and unclean wounds in the skull and brain. We prepared and divided the COVID-19 surgical team, including the patient's transportation team, anesthesia team, and surgical preparation team, for successful surgery without any transmission or morbidity. The patient recovered consciousness after the operation, received close monitoring, and did not show any deterioration due to COVID-19.

Experiences of traumatic events, knowledge and attitudes concerning post-traumatic stress disorder, and resilience among nurses and paramedics working in emergency department (응급실 간호사와 응급구조사의 외상성 사건의 경험, 외상후 스트레스장애에 대한 지식, 태도 및 회복탄력성)

  • Hong, Sun-Woo;Bang, Kyung-Sook;Bang, Hwal Lan;Hyun, Hye Jin;Lee, Miyoung;Jung, Yu Na
    • The Journal of Korean Academic Society of Nursing Education
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    • v.29 no.1
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    • pp.86-97
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    • 2023
  • Purpose: This study aimed to assess exposure to traumatic events, knowledge and attitudes concerning post-traumatic stress disorder (PTSD) and the level of resilience among nurses and paramedics working in emergency departments. Methods: Data were collected from May 22 to June 12, 2022, using a self-administered survey questionnaire. The participants comprised 135 nurses and 80 paramedics working in emergency departments. The collected data were analyzed with descriptive statistics, a t-test, and an analysis of variance with Scheffé's test. Results: Compared with emergency room nurses, paramedics were more positive about the government's spending on job opportunities for people with PTSD. There were no significant differences in attitude regarding government strategies and people with PTSD between nurses and paramedics. Paramedics had higher scores on the effective treatment for PTSD, while emergency room nurses showed higher scores on effective psychotherapy. General knowledge of PTSD differed according to sex (t=-2.33, p=.021) and education level (F=3.21, p=.042). Resilience scores differed significantly according to sex (t=2.02, p=.045), education level (F=4.10, p=.018), self-reported economic state (F=10.34, p<.001), and self-reported health (F=11.57, p<.001). Conclusion: The findings support that emergency department nurses and paramedics are in need of self-care programs to support their mental health and indicate that intervention programs should be developed to enhance resilience in emergency department professionals.

Factors Affecting the Utilization of Emergency Medical Services by Age Group among Elderly Individuals (노년기 연령그룹에 따른 응급의료이용 영향 요인)

  • Choi, Ryoung;Ahn, Byeung-Ki;Cho, Suck Ju
    • The Korean Journal of Health Service Management
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    • v.13 no.2
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    • pp.67-79
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    • 2019
  • Objectives: The purpose of this study was to analyze the factors affecting the utilization of emergency medical services and characteristics of emergency medical services according to age group among elderly individuals. Methods: This study conducted t-test and linear regression analysis on data of 1,960,575 participants to achieve the objective. Results: Analysis of the factors affecting the use of emergency medical services showed statistically significant correlation in all age groups. As the age of elderly people increased, the use of emergency medical service increased. Conclusions: Emergency medical policies are needed, such as coordinators with expert knowledge of medical and health administration and specialist emergency room operations that can provide specialized medical service for older patients.

Dental trauma patients visiting the emergency room in H hospital (H 병원 치과응급실에 내원한 치아 외상 환자에 대한 임상적 고찰)

  • An, So-Youn;Kim, Ah-Hyeon;Shim, Youn-Soo
    • Journal of Korean society of Dental Hygiene
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    • v.13 no.5
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    • pp.819-826
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    • 2013
  • Objectives : The purpose of this study was to analyze the types of dental emergencies. This study was carried out for dental trauma patients visiting the emergency room in H hospital from 2005 to 2006. Methods : Subjects were 252 patients. Demographic characteristics consisted of age, gender, dentition, and dental related injury. Results : Male patients had 1.65 times higher tooth injury than female. Teenagers had higher prevalence of tooth injury. Main cause of dental injury was falling down. Young children accounted for 41.7% of the injuries. Late evening was the highest outbreak time of injury. The most commonly affected teeth were central incisor and lateral incisor. The damage of oral soft tissue was more common than the that of alveolar bone. Main area of primary tooth loss was gingiva(10.7%), tongue or soft palate(7.5%), and frenulum(6.0%). Subluxation(28.6%) and luxation(28.6%) were main cause for the primary teeth. Tooth fracture(50.0%) were the most common injury. Conclusions : Thus, to understand the incidence, causes and patterns of dental trauma is to help preserving natural teeth. The results of this study could provide the clinical guidelines on the treatment of dental emergency patients.

Association between Weekend Admission and In-hospital Mortality among Cardiovascular Patients in Korea

  • Lee, Sang Ah;Park, Eun-Cheol;Shin, Jaeyong;Ju, Yeong Jun;Lee, Hoo-Yeon
    • Health Policy and Management
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    • v.29 no.2
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    • pp.237-244
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    • 2019
  • Background: Weekend admission is known for having association with increased mortality attributed by poor quality of care and severe patients. We investigated the association between hospital admission on weekends and the in-hospital mortality rates of patients with cardiovascular disease. Furthermore, we examined this association stratified by admission via emergency room or not. Methods: We analyzed claim data provided by the Health Insurance Review & Assessment in 2013. In total, 80,817 cardiovascular patients were included in this study, which treated in-hospital mortality (early and during total length of stay) as a dependent variable. A generalized linear mixed effects model was used. We conducted subgroup analyses stratified by admission via emergency room or not. Results: Patients who admitted on weekend showed higher in-hospital mortality both early (odds ratio [OR], 1.48; 95% confidence interval [CI], 1.23-1.78) and during total length of stay (OR, 1.17; 95% CI, 1.02-1.33) compared to those admitted on weekdays. Patients who were admitted to the hospital on a weekend by emergency room were more likely to experience early in-hospital mortality compared to those admitted on weekdays. Furthermore, we found that patients not admitted to the hospital through the emergency department were more likely to experience both early and total length of stay in-hospital mortality. Conclusion: Our study shows higher in-hospital mortality rates for cardiovascular patients admitted on weekends. Efforts to improve the quality of care on weekend are important to mitigate the 'weekend effect' and improve patient outcomes.

The Effects of Organizational Culture for Infection Control and Self-Efficacy on Compliance with Standard Precautions of Emergency Room Nurses (응급실 간호사의 감염관리 조직문화와 자기효능감이 표준주의 지침 수행에 미치는 영향)

  • Kim, Hyunhee;Park, Hyung-Ran
    • Journal of Korean Biological Nursing Science
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    • v.21 no.1
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    • pp.46-53
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    • 2019
  • Purpose: This study was conducted to identify the effects of organizational culture for the infection control and self-efficacy on compliance with standard precautions of emergency room nurses. Methods: This cross-sectional descriptive study was conducted from 1st July to 3rd August, 2017. The participants were 200 nurses working in emergency rooms. The data was collected using structured self-report questionnaires. Results: The average scores for the organizational culture for infection control, self-efficacy and compliance with standard precautions were 5.54, 3.65, and 4.31, respectively. The organizational culture for infection control (r = .59, p< .001) and self-efficacy (r= .28, p< .001) were found to have a positive, meaningful correlation with compliance with the standard precautions. Multiple regression analysis showed that compliance with standard precautions was significantly affected by the organizational culture for infection control (${\beta}=0.55$, p< .001) and self-efficacy (${\beta}=0.13$, p= .033). Conclusion: The results for this study indicate that the organizational culture for infection control and self-efficacy were highly influential factors affecting compliance with standard precautions of emergency room nurses. Therefore, in order to improve the nurses' use of the standard precautions, it was necessary to develop and evaluate a program that considers the environmental factors and self-efficacy.

Difference in Management Between Native Koreans and Foreigners with Penetrating Wounds In the Emergency Room (관통상으로 응급실을 내원한 내국인과 외국인 환자의 진료의 차이)

  • Kim, Yong-Kwan;Jang, Yong-Soo;Kang, Gu-Hyun;Choi, Jung-Tae;Jeon, Hoo;Kim, Jin-Ho
    • Journal of Trauma and Injury
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    • v.23 no.2
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    • pp.102-106
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    • 2010
  • Purpose: With the increasing numbers of foreign residents in Korea, the need for an emergency medical care system for foreign patients seems to be growing. Sometimes, a foreigner admitted to an emergency room is not treated sufficiently due to the absence of insurance, facility in the Korean language, and a guardian. The management of a foreigner with trauma in the ER is difficult due to various problems such as social and economic status. The purpose of this study was to investigate the current management status of foreigners with penetrating wounds in the emergency room. Methods: This study is an analysis of 580 patients that were diagnosed with penetrating wounds in one teaching Hospital from Jan. 1, 2008 to Dec. 31, 2008. We analyzed results according to nationality, alcohol ingestion, intentional or accidental trauma, trauma mechanism, injury severity, management time in the ER, and outcome in the ER. Results: Of the total 580 patients, 486 patients (83.8%) were native Koreans and 94 patients (16.2%) were foreigners. According to the Revised Trauma Score, the average score of native Korean patients was 7.808, and the average score of foreign patients was 7.638. Of native Korean patients, 22.6% had knife wounds while 38.3% of foreign patients did. Of native Korean patients, 17.3% experienced intentional trauma while 33.0% of the foreign patients did. Of native Korean patients, 22.5% had ingested alcohol while 49.4% of the foreigners had. Of native Korean patients, 10.5% were admitted while 7.6% of the foreign patients were. Of native Korean patients, 14.2% were discharged against medical advice (DAMA), while 18.5% of foreign patients were. Of native Korean patients, 1.2% ran away while 8.7% of the foreign patients did. Conclusion: Stabbing was the most common cause of penetrating wounds in foreigner patients in this study. Intentional trauma was more common in foreigners with penetrating wounds than in native Koreans. The severity was higher in foreigners with penetrating wounds than it was in native Koreans, and patients who ran away or were discharged against medical advice were more commonly foreigners with penetrating wounds. Social insurance or policy is needed for the management of foreigners with penetrating wounds.

Changes in Toxicological Characteristics after Sales of Nonprescription Drugs in Convenience Stores (안전상비의약품 판매 이후 중독환자 특성 변화)

  • Kim, Chang Yeong;Lee, Eui Jung;Lee, Sung Woo;Kim, Su Jin;Han, Kap Su
    • 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.

Effects of Visual Media Programs on Job Stress and Burnout in Emergency Room Nurses

  • Kim, Ha-Gang;Kang, Hee-Sun
    • International Journal of Advanced Culture Technology
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    • v.7 no.4
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    • pp.32-39
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    • 2019
  • The purpose of this study was to identify the effects of visual programs on job stress and burnout in emergency room nurses. This study used a nonequivalent control group pretest-posttest design. There were 26 participants in the experimental group and 27 in the control group. Data collection took place from December 12, 2017 to February 17, 2018. The program comprised eight weekly 120-minutes sessions, which included understanding and assessing job stress and burnout. Data were analyzed using the Chi-square test, paired t-test, and independent t-test. As a result, levels of job stress (t=-20.09, p<.001) and burnout (t=-22.31, p<.001) decreased significantly in the experimental group. The results suggest that the Visual Media Program could be an effective strategy for reducing job stress and burnout. Therefore, it is deemed a useful intervention for improving the quality of nursing care provided in emergency rooms.