• Journal of Home Health Care Nursing
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• v.29 no.1
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• pp.31-39
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• 2022

Purpose: This study investigated the effects of evidence-based practice competency, self-leadership, and organizational commitment on professional self-concept of nurses in regional trauma centers. Methods: The 98 research participants were nurses with clinical experience of a year or more. Descriptive statistics, t-tests, Mann-Whitney U test, ANOVA, and Pearson's correlation coefficients were computed, and multiple regression analysis was conducted. Results: Professional self-concept showed statistically significant differences according to marital status, religion, and educational background, and was positively correlated with and affected by evidence-based practice competency, self-leadership, and organizational commitment. Conclusion: Trauma nursing education programs should include evidence-based practice competency and self-leadership and organizational support should be provided to improve the professional self-concept of nurses in regional trauma centers.

• Journal of Korean Biological Nursing Science
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• v.25 no.4
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• pp.276-284
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• 2023

Purpose: The purpose of this study was to investigate the levels of fatigue, social support, and burnout among nurses caring for coronavirus disease 2019 (COVID-19) patients, and to identify factors that affect burnout. Methods: Data were collected from 115 nurses who were caring for COVID-19 patients in Gyeonggi Province and Seoul from December 2021 to February 2022. Results: The mean scores for fatigue, social support, and burnout were 63.31 ± 11.48 (of 95), 48.34 ± 6.97 (of 60), and 81.90 ± 15.50 (of 132) points, respectively. The level of burnout of nurses caring for patients with COVID-19 was high. Fatigue (β = .49, p < .001) and social support (β = -.21, p = .012) were significantly associated with burnout. Conclusion: Higher levels of fatigue and lower levels of social support were associated with higher levels of burnout. Reducing fatigue among nurses and strengthening their social support can be a strategy to reduce nurse burnout.

• Journal of the Korea Society of Computer and Information
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• v.25 no.11
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• pp.239-244
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• 2020

The purpose of this study is to provide basic data for injury prevention measures through the risk factors of injury occurrence by comprehending injury characteristics of the trauma patients visiting a regional emergency medical center according to distribution based on external causes and injury severity score. This study was analyzed using SPSS-Window(ver. 20.1) for 2585 trauma patients who visited a regional emergency medical center and the research period is for four months from 1st of September, 2019 to 31th of December, 2019. The following were the results of the research. First, it is shown from the analyzed data that the proportion of males (61.3%) is greater than that of females (38.7%) and the group aged from 20 to 50 had a significantly higher occurrence rate of injury but in terms of injury severity, 50 takes up the great proportion(P<.001). Second, roads and traffic areas (35.1%) were the highest in the place of occurrence of injury(P<.001). Third, the time of injury occurrence was as high as 12-18 hours(35.8%)(P<.001). Fourth, the injury part was highest in the head and face (55.4%)(P<.001). Fifth, the type of injury was higher in open wounds (31.2%)(P<.001). Therefore, it is required to establish detailed injury prevention policies according to the characteristics of injury severity.

• Journal of Trauma and Injury
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• v.28 no.3
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• pp.123-128
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• 2015

Purpose: Establishment of the trauma system changed quality of trauma care in many countries. As one of the first designated level 1 trauma center in Korea, we analyzed trauma registration data in 2014. Methods: Data was extracted from Korean Trauma Data Base (KTDB) that was started from august 2013. Variables related to demographics and trauma was collected through the year 2014. Results: There were 3269 trauma patients who admitted to our hospital and registered to KTDB in 2014. Median age was 49 years, 64.4% were men, and 90% of patients were blunt in mechanism. Median injury severity score (ISS) was 5, mean revised trauma score (RTS) was 7.65. There were 138 (4.2%) deaths and 87 (2.7%) patients of them was death after admission. Conclusion: This is the first report using KTDB registration from our institution. Trauma volume is appropriate but it should be compared with other trauma centers in Korea. In future national analysis of KTDB is mandatory.

• Journal of Trauma and Injury
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• v.28 no.4
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• pp.284-291
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• 2015

The aim of this study is to present a nonoperative treatment for abdominal injuries in patients with multiple traumas and to discuss the role of metropolitan tertiary hospital, non-regional trauma centers. We collected data from patients with multiple traumas including abdominal injuries from 2009 to 2014. Patient characteristics, associated injuries, short-term outcomes and departments that managed the patients overall were analyzed. Based on treatment modalities for abdominal injury, patients were divided into two groups: the operative treatment group and the nonoperative treatment group. We compared differences in patient characteristics, injury mechanisms, initial vital signs, detailed injury types, lengths of hospital and ICU stays. Of the 167 patients with multiple traumas, abdominal injuries were found in 57 patients. The injury mechanism for 44 patients (77.2%) was traffic accidents, and associated extra-abdominal injuries were shown in 45 patients (78.9%). The mean lengths of hospital and ICU stays for the 57 patients were 36.4 days and 8.3 days, respectively. The in-hospital mortality rate was 8.8%. Ten patients (17.5%) were treated operatively, and 47 patients (82.5%) were treated nonoperatively. Among the 47 patients in the nonoperative treatment group, 17 patients received embolization, and 3 patients underwent a percutaneous drainage procedure. Operative treatments were used more in patients with injuries to the pancreas and bowel. No patient required additional surgery or died due to the failure of nonoperative treatment. No differences in the clinical characteristics except for the detailed injury type were observed between the two groups. In appropriately selected patients with multiple traumas including abdominal injuries, nonoperative treatment is a safe and feasible. For rapid and accurate managements of these patients, well-trained trauma surgeons who can manage problems with the various systems in the human body and who can decide whether nonoperative treatment is appropriate or not are required.

• Journal of Trauma and Injury
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• v.27 no.4
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• pp.170-177
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• 2014

Purpose: The first regional trauma center selected in Korea was the Gachon University Gil hospital regional trauma center; expectation on its role has been high because of its location in the Seoul metropolitan region. To determine if those expectations are being met, we analyzed the patients visiting the center and their treatment experiences for the past 3 years in order to propose a standard for the operation of a trauma center. Methods: The visiting route, visiting methods, performance of emergency surgery, the ward and the length of stay, the injury mechanism, the injury severity score (ISS), the department that managed the surgery, and the cause of death were analyzed for 367 patients visiting the center from its establishment in June 2011 through December 2013. Results: The mean age of the patients was 47 years (285 male and 82 female patients). A total of 187 patients directly visited the center whereas 180 were transferred to the center. Traffic accidents comprised the majority of injury mechanisms, and 178 patients underwent emergency surgery. The mean length of stay per patient was 11 days for those in the ICU and 27 days for those in a general ward. These patients occupied 4 beds in the ICU and 10 beds in the general ward per day. A total of 1.21 surgeries were performed per patient, and the mean number of surgeries performed per day was 0.49. The mean ISS was 15.91, and 183 patients (50%) had an ISS of ${\geq}16$. Thirty-one patients died; they had a mean ISS of 28.42. The most frequent cause of death was multi-organ failure. The mean number of treatment consultations during a patient's stay was 6.32. Forty-five patients (13%) were discharged from the center, and 291 (79%) were transferred to another hospital. Conclusion: A systematic approach to establishing a treatment model for trauma patients, including injury mechanism, multidisciplinary treatment, and trauma surgeon intervention, is required for treating trauma patients.

• Tuberculosis and Respiratory Diseases
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• v.57 no.2
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• pp.148-159
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• 2004

Background : This study was conducted to evaluate the survival benefit of the bronchial arterial embolization (BAE) for patients presenting with non-traumatic hemoptysis. Methods : The clinical data were retrospectively collected from the medical records and the Order Communicating Systems (OCS). The information dealing with death was collected from national death certificates. After enrolled patients were divided with two group such as BAE group (patients who were managed with BAE) and non-BAE group (patients who were managed with conservative modality), the survival benefit of BAE was estimated during the observational period of 24 months through using the Kaplan-Meier survival graph and the Cox-proportional hazard regression analysis. Results : The number of total cases was 272. Of these, BAE group involved 63 and non-BAE group involved 209. 69 cases had the malignant pulmonary lesions, 149 cases had non-malignant chronic lung lesion such as the mycobacteria infection, fungus ball, or bronchiectasis (BE), and 54 cases had the other pathologic conditions. For each sub-groups such as 'malignant lung lesion' group, 'non-malignant chronic lung lesion' group as well as about all cases, the adjusted hazard ratios (HRs) of BAE for death was not significantly different compared to the conservative management. But the adjusted HRs as to underlying causes such as 'malignant lung lesion' group and 'the other conditions' group increased significantly compared to 'non-malignant chronic lung lesion' group. Conclusion : There was no significant survival benefit by BAE procedure on survival in patients presenting with non-traumatic hemoptysis.

• Journal of Trauma and Injury
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• v.23 no.1
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• pp.6-15
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• 2010

Purpose: Trauma is one of the leading causes of death, especially among young people. Life-threatening conditions are very common in multiple-traumatized patients due to concurrent multi-organ injuries. Treating such severely injured patients is time critical. However, in Korea, the transfer of severely injured patients is not uncommon due to the lack of a mature trauma care system. In developed countries, the preventable trauma death rate is very low, but the rate is still very high in Korea. This study's objective was to demonstrate the current serious state in which severely injured patients have to be transferred from a Regional Emergency Medical Center even though it actually serves as a trauma center. Methods: Ajou University Medical Center is a tertiary hospital that serves as a trauma center in Gyeonggido. The medical records at Ajou University Medical Center for a 1-year period from January 1, 2008, to December 31, 2008, were retrospectively reviewed. A severely injured patient was defined as a patient who showed more than 15 point on the ISS (injury severity score) scale. We investigated the clinical characteristics of such patients and the causes of transfer. Results: Out of 81,718 patients who visited the Regional Emergency Medical Center, 19,731 (24.1%) were injured patients. Among them, 108 severely-injured patients were transferred from one Regional Emergency Medical Center to other hospitals. The male-to-female ratio was about 3.5:1, and the mean ISS was 23.08. The most common mechanism of injury was traffic accidents (41.7%). A major cause of transfer was the shortage of intensive care units (44.4%); another was for emergent operation (27.8%). Most of the hospitals that received the severely-injured patients were secondary hospitals (86.1%). Conclusion: Although the Regional Emergency Medical Center played a role as a trauma center, actually, severely-injured patients had to be transferred to other hospitals for several reasons. Most reasons were related with the deficiencies in the trauma care system. If a mature trauma care system is well-organized, the numbers of transfer of severely injured patients will be reduced significantly.

• Journal of Trauma and Injury
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• v.22 no.2
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• pp.184-192
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• 2009

Purpose: This study was conducted to evaluate the effectiveness of the treatment strategy of transcatheter arterial embolization after pelvic CT angiography (CTA) in cases of traumatic pelvic hemorrhage. Methods: This is a retrospective analysis of pelvic hemorrhage patients who underwent transcatheter arterial embolization after pelvic CTA at our regional emergency center during a 31-month period. We reviewed the medical records and imagings of all these patients. Results: Transcatheter arterial embolization was performed in 17 patients (M:F=7:10, mean age=53.9) who underwent pelvic CTA for the evaluation of traumatic pelvic hemorrhage. Arterial bleeding was demonstrated on pelvic CTA in all patients, and the combined injury was also noted in 13 patients. The admission-to-CTA time was $84.53{\pm}66.92$ minutes, and the CTA-to-embolization time was $147.65{\pm}99.97$ minutes. Extravasation of contrast media or pseudoaneurysm was demonstrated on conventional angiography in all patients. Unilateral iliac artery embolization was performed in 8 patients, and bilateral iliac artery embolization was performed in 9 patients. Additional embolizations other than in the iliac arteries were performed in 7 patients. Initial hemostasis was achieved in 16 patients. One patient died of ongoing pelvic bleeding. Rebleeding occurred in only one patient and hemostasis was achieved with the second embolization. Another patient died of intracranial and facial bleeding in spite of pelvic hemostasis. The overall mortality was 11.8%, and there was no significant adverse effects in the other patients. Conclusion: Transcatheter arterial embolization after pelvic CTA is an effective treatment strategy in the management of traumatic pelvic hemorrhage patients.

• Korean Journal of Clinical Laboratory Science
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• v.54 no.4
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• pp.279-284
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• 2022

Certain pre-transfusion tests are not commonly performed during emergency blood transfusion. In this study, we reviewed and analyzed the data of post-blood transfusion antibody screening tests to establish the effects of unexpected antibodies causing hemolytic transfusion reactions. We reviewed information published domestically and internationally, and selected the data of 68,602 antibody screening tests and 528 antibody identification tests conducted at P hospital. We found that unexpected antibody positive (1198,1.74%), Rh type (161, 30.49%), Lewis type (67, 12.69%), others (Di (a), 28, 5.30%). The anti-E type positive was 93 (17.61%), and that of the cases with anti-C (13, 2.46%). Only data of domestic cases were included for analysis that were published before 2007, which established the presence of antibodies of the following types and numbers of cases: anti-E (196, 22.45%), anti-Le a (82, 9.39%), and anti-E+C (60, 6.87%). In 2018, anti-E (107, 17.12%), anti-E+Canti-E+C (56, 8.96%), and anti-Di a (28, 4.48%) were detected. In other domestic cases, S hospital was detect to anti-E, anti-Le a, anti-E+C. The Anti-E, anti-D, anti-E+C, and anti-C+E were detected in D hospital. In Saudi Arabia, Anti-D, anti-E, and anti-Jka was detected. The Anti-M, Anti-N, Anti-Le (a), and Anti-D were detected in India. Requests for emergency blood transfusion increased 1.8 times after the opening of the trauma center. This study has the disadvantage of being a cross-sectional study. additional studies are needed to provide basic information on alternative treatments that can increase the safety and reduce the side effects of hemolytic transfusion in emergency transfusion situations.