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A Comparative Study on the Nursing Dependency of Suspected COVID-19 Patients and General Patients in the Emergency Department

응급실에 내원한 COVID-19 의심환자와 일반환자의 간호의존도 비교 연구

  • Received : 2021.05.18
  • Accepted : 2021.06.29
  • Published : 2021.08.31

Abstract

Purpose: This study was conducted to investigate the nursing needs and workload of nurses according to nursing dependency for effective placement of nursing staff in the emergency department (ED). Methods: In June 2020, 256 adult patients who visited the ED were classified as two groups, suspected COVID-19 patients and general patients. The participants'electronic medical records were analyzed using descriptive statistics, t-test, 𝑥2-test, and Fisher's exact test using the SPSS. Results: The patient dependence score showed a significant difference between the two groups, with an average of 13.99±1.85 for the suspected COVID-19 patient group and 10.58±2.10 for the general patient group (t=12.42, p<.001). There were statistically significant differences in communication (t=3.28, p=.001), mobility (t=3.29, p=.001), nutrition, elimination, and personal care (t=7.34, p<.001) among the six domains of nursing dependency. In the domains of environment, safety, health, and social needs, the dependency score was 3 for all suspected COVID-19 patients and 1 for all general patients. Conclusion: The results of this study confirmed that infection control activities of emergency patients who need isolation affect the patients' nursing dependency on nursing care.

Keywords

References

  1. Li L, Yang Z, Dang Z, Meng C, Huang J, Meng H, et al. Propagation analysis and prediction of the COVID-19. Infectious Disease Modelling. 2020;5:282-292. https://doi.org/10.1016/j.idm.2020.03.002
  2. Choi JW, Kim KH, Cho YM, Kim SH. Current epidemiological situation of Middle East respiratory syndrome coronavirus clusters and implications for public health response in South Korea. Journal of the Korean Medical Association. 2015;58(6):487-497. https://doi.org/10.5124/jkma.2015.58.6.487
  3. Nicola M, O'Neill N, Sohrabi C, Khan M, Agha M, Agha R. Evidence based management guideline for the COVID-19 pandemic - Review article. International Journal of Surgery. 2020;77:206-216. https://doi.org/10.1016/j.ijsu.2020.04.001
  4. Emergency Medical Service Act [Internet]. Sejong: Korea Ministry of Government Legislation; 2021 Jan 1 [cited 2021 Feb 2]. Available from: https://www.law.go.kr/LSW/lsInfoP.do?efYd=20210101&lsiSeq=224519#0000.
  5. Giuliani E, Lionte G, Ferri P, Barbieri A. The burden of notweighted factors: Nursing workload in a medical Intensive Care Unit. Intensive and Critical Care Nursing. 2018;47:98-101. https://doi.org/10.1016/j.iccn.2018.02.009
  6. Lee I. The limit of emergency medical services: Emergency service as public goods. HIRA Policy Trend. 2020;14(1):19-25.
  7. Horsky J, Suh EH, Sayan O, Patel V. Uncertainty, case complexity and the content of verbal handoffs at the emergency department. In: AMIA 2015 Annual Symposium Proceedings; 2015 Nov 14-18; SanFrancisco(CA): American Medical Informatics Association; 2015. p. 630-639.
  8. Kim BJ, Lee EN, Kang KH, Kim SS, Kim SA, Sung YH, et al. A study of job analysis of the emergency room nurse. Journal of Korean Clinical Nursing Research. 2006;12(1):81-95.
  9. Ha JH, Park HS. An ethnography on daily lives of nurses in emergency departments. Journal of Korean Academy of Fundamentals of Nursing. 2016;23(4):448-459. https://doi.org/10.7739/jkafn.2016.23.4.448
  10. Statistics Korea. Emergency medical status statistics [Internet]. Seoul: National Medical Center; 2015-2019 [cited 2021 Jan 29]. Available from: http://kosis.kr/statHtml/statHtml.do?orgId=411&tblId=DT_41104_111&conn_path=I2.
  11. Choi SH. A study on patient dependency in emergency medical centers [master's thesis]. Seoul: Yonsei University; 2018. p. 1-70.
  12. Doman M, Prowse M, Webb C. Exploring nurses' experiences of providing high dependency care in children's wards. Journal of Child Health Care. 2004;8(3):180-197. https://doi.org/10.1177/1367493504045819
  13. Boggatz T, Dijkstra A, Lohrmann C, Dassen T. The meaning of care dependency as shared by care givers and care recipients: A concept analysis. Journal of Advanced Nursing. 2007;60(5):561-569. https://doi.org/10.1111/j.1365-2648.2007.04456.x
  14. Varndell W, MacGregor C, Gallagher R, Fry M. Measuring patient dependency? Performance of the Jones Dependency Tool in an Australian emergency department. Australasian Emergency Nursing Journal. 2013;16(2):64-72. https://doi.org/10.1016/j.aenj.2013.04.001
  15. Jung EH, Cho SH, Lee SL, Choi MJ, Kim SS, Choi EK, et al. Nursing hours and nurse staffing according to Korean Triage Acuity Scale and patient dependency. Journal of Korean Clinical Nursing Research. 2020;26(3):395-406. https://doi.org/10.22650/JKCNR.2020.26.3.395
  16. Korea Disease Control and Prevention Agency. Coronavirus Disease-19, case definition and people subject to testing [Internet]. Sejong: Ministry of Health and Welfare; 2020 Jun 25 [cited 2021 Feb 4]. Available from: http://ncov.mohw.go.kr/en/baroView.do?brdId=11&brdGubun=112&dataGubun=&ncvContSeq=&contSeq=&board_id=&gubun=.
  17. Reeves JJ, Hollandsworth HM, Torriani FJ, Taplitz R, Abeles S, Tai-Seale M, et al. Rapid response to COVID-19: Health informatics support for outbreak management in an academic health system. Journal of the American Medical Informatics Association. 2020;27(6):853-859. https://doi.org/10.1093/jamia/ocaa037
  18. Enforcement Rules of the Emergency Medical Service Act [Internet]. Sejong: Ministry of Government Legislation; 2021 Jan 1 [cited 2021 Feb 1]. Available from: https://www.law.go.kr/LSW/lsInfoP.do?efYd=20210101&lsiSeq=224217#0000.
  19. Korean Society of Emergency Medicine, KTAS Committee. Korean Triage and Acuity Scale: Provider training manual. Version 3. Paju: Koonja Publishing; 2019. p. 16-19.
  20. Jones G. Accident and emergency nursing: A structured approach. London: Faber & Faber; 1990.
  21. O'Reilly GM, Mitchell RD, Rajiv P, Wu J, Brennecke H, Brichko L, et al. Epidemiology and clinical features of emergency department patients with suspected COVID-19: Initial results from the COVID-19 Emergency Department Quality Improvement Project(COVED-1). Emergency Medicine Australasia. 2020;32(4):638-645. https://doi.org/10.1111/1742-6723.13540
  22. Smith D, Bowden T. Using the ABCDE approach to assess the deteriorating patient. Nursing Standard. 2017;32(14):51-63. http://10.7748/ns.2017.e11030
  23. Liu Q, Luo D, Haase JE, Guo Q, Wang XQ, Liu S, et al. The experiences of health-care providers during the COVID-19 crisis in China: A qualitative study. The Lancet Global Health. 2020;8(6):e790-e798. https://doi.org/10.1016/S2214-109X(20)30204-7
  24. Lucchini A, Iozzo P, Bambi S. Nursing workload in the COVID-19 era. Intensive & Critical Care Nursing. 2020;61: 102929. https://doi.org/10.1016/j.iccn.2020.102929
  25. Sun N, Wei L, Shi S, Jiao D, Song R, Ma L, et al. A qualitative study on the psychological experience of caregivers of COVID-19 patients. American Journal of Infection Control. 2020;48 (6):592-598. https://doi.org/10.1016/j.ajic.2020.03.018
  26. Royal College of Nursing, Emergency Care Association. BEST - Baseline Emergency Staffing Tool [Internet]. London: Royal College of Nursing; c2021 [cited 2021 Feb 6] Available from: https://www.rcn.org.uk/get-involved/forums/emergencycare-association/best-tool.
  27. O'Brien A, Benger J. Patient dependency in emergency care: Do we have the nurses we need? Journal of Clinical Nursing. 2007;16(11):2081-2087. https://doi.org/10.1111/j.1365-2702.2006.01602.x
  28. Cho SH, Lee JY, Hong KJ, Yoon HJ, Sim WH, Kim MS et al. Determining nurse staffing by classifying patients based on their nursing care needs. Journal of Korean Academy of Nursing Administration. 2020;26(1):42-54. https://doi.org/10.11111/jkana.2020.26.1.42
  29. Kim BH. Nursing activities of nurse in a regional emergency medical center [master's thesis]. Gangneung: Catholic Kwandong University. 2013. p. 1-86.