Journal of Korean Biological Nursing Science

Korean society of Biological Nursing Science (한국기초간호학회)
권호 표지
DOI QR코드

DOI QR Code

Analysis of Characteristics of Thoracic Injury Patients and Nursing Interventions Using Nursing Intervention Classification by Emergency Room Type

응급실 유형에 따른 흉부외상환자의 특성과 간호중재분류체계를 활용한 간호중재 분석

  • Kim, Kiung (Regional Trauma Center, Cheju Halla General Hospital) ;
  • Kim, Yunhee (Department of Nursing, Pukyong National University)
  • Received : 2021.08.16
  • Accepted : 2021.11.16
  • Published : 2021.11.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The purpose of this study was to analyze the content of nursing interventions applied to patients with thoracic injury who visited a trauma emergency room (TER) or an emergency room (ER). Methods: Of 3,938 trauma patients admitted to this hospital between January 1, 2019 and December 31, 2020, 320 adult patients with thoracic injury (94 to TER, 226 to ER) who met the inclusion criteria were enrolled. Patients' data were acquired from their electronic medical records. General and clinical characteristics of these subjects along with nursing interventions were analyzed. Results: There were statistically significant differences in the length of stay, treatment outcome, and level of consciousness between thoracic injury patients who visited TER and ER. Average thoracic Abbreviated Injury Scale score and average Injury Severity Score of thoracic injury patients who visited TER were 3.13 and 13.54, respectively, which were significantly higher than those of patients who visited ER. The numbers of nursing actions applied was 4,819 for TER and 3,944 for ER, which were classified into five domains, 18 classes, and 56 interventions. The most domain of interventions carried out in both TER and ER was physiological: complex. Classes including Crisis management and Thermoregulation were not carried out in ER. On average, 16 more types of interventions were carried out in TER than in ER. Conclusion: This study demonstrated characteristics of thoracic injury patients and nursing interventions by emergency room type. Based on results of this study, standardized nursing interventions need be applied to thoracic injury patients visiting TER and ER.

Keywords

Acknowledgement

This work was supported by the Pukyong National University Research Fund in 2018.

References

  1. Ministry of Health and Welfare. The national "preventable traumatic mortality rate" has improved significantly from 30.5% to 19.9% [Internet]. Sejong: Ministry of Health and Welfare; 2019 Dec 10 [cited 2021 Sep 10]. Available from: https://www.mohw.go.kr/react/al/sal0301vw.jsp?PAR_MENU_ID=04&MENU_ID=0403&page=1&CONT_SEQ=351836
  2. Lee KH. Current status and future perspective of regional trauma center in Korea. Journal of the Korean Medical Association. 2016;59(12):917-918. https://doi.org/10.5124/jkma.2016.59.12.917
  3. Park DJ, Park CY, Cho HM, Lee KH, Han HS. Current status and future prospects of trauma centers in korea. Journal of the Korea Medical Association. 2017;60(7):530-532. https://doi.org/10.5124/jkma.2017.60.7.530
  4. Yoon HD. Background and progress of regional trauma center development. Journal of the Korea Medical Association. 2016;59(12):919-922. https://doi.org/10.5124/jkma.2016.59.12.919
  5. National Fire Agency. Standard guidelines for on-site first aid for 119 paramedics [Internet]. Sejong: Korea National Fire Agency; 2019 Nov [cited 2021 Jul 16]. Available from: http://www.nfa.go.kr/nfa/publicrelations/legalinformation/0017/0003/?boardId=bbs_0000000000001097&mode=view&cntId=4&category=&pageIdx=&searchCondition=&searchKeyword=
  6. Choi SK. The view of emergency medicine physician over the Korean emergency medical system; problems and improvements. Public Health Affairs. 2019;3(1);177-183. https://doi.org/10.29339/pha.3.1.177
  7. Kim HS, Kim OJ, Choi SW, Kim EC, Park YT, Ko TI, et al. The effect of six sigma activity in major trauma patients on the time spent in the emergency department. Journal of the Korean Society of Traumatology. 2010;23(2):119-127.
  8. Baik SY, Cho EH Kim YA, Choi MN. Emergency department nursing activities: retrospective study on data from electronic nursing records. Korean Journal of Adult Nursing. 2019;31(5):496-506. https://doi.org/10.7475/kjan.2019.31.5.496
  9. Lee HK, Kim JI. Analysis of nursing records for elderly patients with abdominal pain in the emergency medical center. Journal of Muscle and Joint Health. 2019;26(1):27-34. https://doi.org/10.5953/JMJH.2019.26.1.27
  10. Kim WS, Cho MS, Bae KS, Kang SJ, Lee KH, Hwang K, et al. Clinical analysis of death in trauma patients. Journal of the Korean Association of Traumaology. 2007;20(2):96-100.
  11. Kim MH, Kim MH, Park JH. Characteristics and nursing activities of severe trauma patients regarding the main damaged body parts. Journal of Korean Biological Nursing Science. 2013;15(4):210-218. https://doi.org/10.7586/jkbns.2013.15.4.210
  12. Whizar-Lugo V, Sauceda-Gastelum A, Hernandez-Armas A, Garzon-Garnica F, Granados-Gomez M. Chest trauma: an overview. Journal of Anesthesia & Critical Care. 2015;3(1):1-11. https://doi.org/10.15406/jaccoa.2015.03.00082
  13. Horst K, Hildebrand F. Focus on chest trauma: implications from clinical and experimental studies. European Journal of Trauma and Emergency Surgery. 2020;46(1):1-2. https://doi.org/10.1007/s00068-020-01310-7
  14. The Committee on Trauma. Advanced trauma life support student course manual. 10th ed. Chicago, IL: American College of Surgeons; 2018. p.64-65
  15. Han KN, Choi SH. Kim YC, Lee KH, Lee SE, Jeong KY, et al. Evaluation of lung injury score as a prognostic factor of critical care management in multiple trauma patients with chest Injury. Journal of the Korean Society of Traumatology. 2011;24(2):105-110.
  16. Min YI. Emergency management of thoracic trauma. Journal of Korean Medical Association. 2007;50(8):702-710. https://doi.org/10.5124/jkma.2007.50.8.702
  17. Hyun SY, Oh SW, Kim JK, Lim YS, Yang HJ, Lee G, et al. Clinical analysis of patients with thorax or neck trauma treated with emergent operations. Journal of the Korean Society of Traumatology. 2003;16(2):116-123.
  18. Kim JH. Analysis of the nursing interventions performed by nurses working in small-medium sized hospitals using nursing interventions classification. Journal of Korean Academy of Nursing Administration. 2007;13(4):431-444.
  19. Kim MH, Park JH, Kim MH, Koo JE. Emergency treatment and nursing activities of severe trauma patients according to elapsed time and vital signs. Journal of Korean Biological Nursing Science. 2014;16(3):182-191. https://doi.org/10.7586/jkbns.2014.16.3.182
  20. Kim DM, Seo EJ. Analysis of nursing interventions in trauma-bay at the regional trauma center for patients with severe thoracic injuries. Journal of Korean Biological Nursing Science. 2021;23(2):138-150. https://doi.org/10.7586/jkbns.2021.23.2.138
  21. Jang MJ, Lee YW. Analysis of nursing interventions for patients with abdominal. Korean Journal of Military Nursing Research. 2021;39(2):17-36. https://doi.org/10.31148/kjmnr.2021.39.2.17
  22. National Emergency Medical Center. Regional trauma center evaluation guide[Internet]. Seoul: Korea Ministry of Health and Welfare; 2021 [cited 2021 May 21] Available from: https://portal.nemc.or.kr:444/member/login_page.do
  23. Korea Disease Control and Prevention Agency. Community-based severe trauma surveillance[Internet]. Seoul: Korea Disease Control and Prevention Agency; 2020 Nov [cited 2021 May 31]. Available from: https://kdca.go.kr/board/board.es?mid=a20503050000&bid=0021&act=view&list_no=711962
  24. Grant PT, Henryc JM, McNaughton GW. The management of elderly blunt trauma victims in scotland: evidence of ageism?. Journal of the Care of the Injured. 2000;31(7):519-528 https://doi.org/10.1016/S0020-1383(00)00038-3
  25. Kim EJ, Kim GS, Sung KM, Shin HS, Shin HK, Lee YJ, et al. Analysis of the contents and importance of clinical practicum education in adult health nursing according to nursing intervention classification system. Journal of Korea Academy on Communication in Healthcare. 2018;13(2):205-216. https://doi.org/10.15715/kjhcom.2018.13.2.205
  26. Hong SJ, Lee SH, Kim HS. Analysis of nursing interventions performed by gynecological nursing unit nurses using the nursing interventions classification. Korean Journal of Women Health Nursing. 2011;17(3):275-284. https://doi.org/10.4069/kjwhn.2011.17.3.275
  27. Lee KM, Kim DS, Lee SW, Kim H. Clinical investigation of isolated chest injury. Journal of the Korean Society of Traumatology. 2006;19(1):35-40.
  28. Seamon MJ, Haut ER, Van Arendonk K, Barbosa RR, Chiu WC, Dente CJ, et al. An evidence-based approach to patient selection for emergency department thoracotomy: a practice management guideline from the Eastern Association for the Surgery of Trauma. Journal of Trauma and Acute Care Surgery. 2015;79(1):159-73. https://doi.org/10.1097/TA.0000000000000648
  29. Abe T, Uchida M, Nagata I, Saitoh D, Tamiya N. Resuscitative endovascular balloon occlusion of the aorta versus aortic cross clamping among patients with critical trauma: a nationwide cohort study in Japan. Critical Care. 2016;20(1):400. https://doi.org/10.1186/s13054-016-1577-x