• Title/Summary/Keyword: 응급실 간호

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The Effect of Supportive Nursing Intervention on Patient's Response of Anxiety during Emergency Room Staying (지지적 간호중재가 응급실 환자의 불안반응에 미치는 효과)

  • Yoon Jung Won;Park Young Sook;Park Chung Ja
    • Journal of Korean Public Health Nursing
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    • v.14 no.1
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    • pp.100-113
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    • 2000
  • The purpose of this study is to examine the effect of supportive nursing intervention on patient's response of anxiety in emergency room as the suspected experimental research sequentially designed for the unequal control group. This study collected the data from 100 patients including 50 patients of experimental group and 50 patients of control group in emergency room of the only one university hospital from July 12. to September 30, 1999. This study used questionnaires that Kim, Jung Taek and Shin. Dong Kyun revised the measurement of STAI(State-Trait Anxiety Inventory) of Spielberger(1972) to measure their anxiety with using physical. spiritual. and informative support of the supportive nursing intervention, and measured blood pressure. pulse and respiration by physiological response of anxiety. After then. this study analyzed the frequency and percentage by using SPSS 7.5 program, $x^2-test$, t-test and ANCOVA. The results are as follows: First hypothesis : the point of STAI of experimental group who received the supportive nursing intervention during emergency room staying will be lower than that of control group without the supportive nursing intervention(F=22.943, p=.000). Second hypothesis : the sistolic blood pressure of experimental group who received the supportive nursing intervention during emergency room staying will be lower than that of control group without the supportive nursing intervention(F=42.603. p=.000). Third hypothesis. the diastolic blood pressure of experimental group who received the supportive nursing intervention during emergency room staying will be lower than that of control group without the supportive nursing intervention(F= 18.482, p=.000). Fourth hypothesis: the pulse of experimental group who received the supportive nursing intervention during emergency room staying will be lower than that of control group without the supportive nursing intervention. Fifth hypothesis : The respiration of experimental group who received the supportive nursing intervention during emergency room staying will be lower than that of control group without the supportive nursing intervention. In the above-mentioned result. the supportive nursing intervention was considered to be useful intervention that raised the effect on patient's response of anxiety during emergency room staying.

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Circadian Rhythm of Urinary Free Cortisol in Brain Injuryed Patients (뇌손상 환자의 요중 Free Cortisol의 Circadian Rhythm)

  • Min, Soon
    • Journal of Korean Biological Nursing Science
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    • v.3 no.1
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    • pp.1-10
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    • 2001
  • 뇌손상이라고 하는 과도한 stress를 받았을 때 free cortisol의 분비되는 양과 urinary free cortisol의 circadian 리듬에 어떻게 영향을 주는지 확인하기 위하여 시도하였다. 연구대상은 대조군은 건강한 젊은 여성 6명과 실험군응 CT상 뇌에 손상을 받은 4명의 여성으로 30대 환자이었다. 담당의사와 중환자실 관리책임자의 동의하에서 시도되었으며, 실험기간은 2000년 7월 1일에서 7월 10일까지였다. 대조군과 실험군의 뇨를 채취하여 뇨중 free cortisol 농도의 circadian rhythm을 알아보기 위해 채뇨 후 분석하였다. 채뇨는 뇌손상을 받고 응급실을 통해 신경외과 중환자실에 입원한 지 5시간 이내에 해당된 환자로 24시간 유지되는 foley catherization 상태하에서 12:00부터 3일동안 72시간을 2시간 간격으로 채뇨하였고, 대조군은 오전 12시부터 24시간 동안 2시간 간격으로 채뇨하였다. 측정방법으로는 cortisol의 정량은 solid-phase radioimmuoassay 방법을 이용하였으며, 분석재료는 Coat-A-Count(R) Cortisol kit(DPC, U.S.A.)을 사용하여 DPC사의 측정방법을 따랐다. 연구대상자의 free cortisol의 총량은 대조군에서는 $42.8{\mu}g$이었고, 실험군은 1일에 $991.2{\mu}g$, 2일에 $809{\mu}g$, 3일에 $544.2{\mu}g$으로 대조군과 통계적으로 유의한 차이를 나타내(p<.05), 실험군에서 현저하게 증가된 양상을 보였고, 시간이 지나면서 점점 감소하는 경향을 나타냈다. 시간별로 t-검정으로 분석한 결과로는 모든 시간대에서 대조군과 실험군의 평균치는 통계적으로 유의한 차이를 나타냈다. Free cortisol의 circadian에서는 대조군에서는 정상인의 cortisol의 circadian의 경우와 같은 리듬을 보였으나, 손상을 받은 실험군의 경우 분비량은 현저하게 증가했음을 보여주었다. 최고치가 제1일에 18:00과 다음날 10:00에 나타나 최고치가 2회 나타났으며, 제2일에도 제1일과 마찬가지로 18:00에 나타났고, 제3일에는 24:00에 나타나 제1일보다 제2일에는 최고치가 한 번 나타난 리듬을 보여주었고, 분비량은 2일에 감소하였다. 제3일에는 최고치가 8시간 지연된 나타난 리듬의 변화를 보여주었다. 최저치는 제1일, 제2일, 제3일 모두 24:00에 나타난 리듬을 보여주었다. 이상의 결과에서 실험군인 뇌손상 환자군에서는 뇌손상이 과도한 stress로 작용하여 환자의 free cortisol 분비량과 circadian 리듬에도 영향을 주는 것으로 나타났다. 그러므로 뇌손상환자를 간호하는 간호사는 스트레스상태인 것을 인지하여 환자 개개인에 필요한 간호를 해야 할 것으로 사료된다.

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A Study on the Guardian's Experience about Tepid Massage of Children Who were Admitted to a Pediatric Emergency Room (소아응급실을 내원한 환아 보호자의 미온수 마사지 경험실태)

  • Kang, Hae-Sook;Yun, O-Bok
    • Perspectives in Nursing Science
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    • v.7 no.1
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    • pp.65-74
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    • 2010
  • Purpose: The purpose of this study was to investigate the guardian's experience about tepid massage of children who visited Pediatric Emergency Room (PER). Methods: Data for this study was collected from August 1 to September 30, 2009 using questionnaires of 300 guardians who visited a PER. All data analyses were done using the SPSS 17.0 program and statistical data on frequency and percentage were obtained. $x^2$ test was done as well. Results: The results of this study were as follows: 73.7% of the guardians were doing the tepid massage, and 40% of them were doing the tepid massage when guardians thought that their children had a fever. 8.6% of them were incorrectly doing the tepid massage on their children such as using ice or alcohol. 90.5% of the children's condition changed when they had the tepid massage applied. Only 48% of the guardians got information about tepid massage, and 52.8% of the guardians got this information from the medical team. There were significant differences according to the education background about tepid massage (p<.001) and past hospital admissions history. There were differences according to whether their child had experience with febrile seizure(p=.085) and having more than one child at home (p=.085). Conclusion: This study revealed that the guardians were incorrectly doing the tepid massage on their children. The results of this study suggest that it is necessary to develop certain emergency nursing processes on accurate information and management strategies about tepid massage, and further studies on the effects of this kind education intervention are necessary.

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The Difference in Circadian Rhythm and Level of Fatigue Between ER and General Ward Nurse (응급실과 일반병동 간호사의 밤번 근무시 Circadian rhythm과 피로도 비교)

  • Choi, Sun-Yun;Hong, Hae-Sook
    • Journal of Korean Biological Nursing Science
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    • v.1 no.1
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    • pp.86-99
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    • 1999
  • The purpose of this study is to find out the difference in circadian rhythm and level of fatigue between ER and General Ward Nurse. This study was done through analyzing body temperature, heart rate and major electrolytes such as $Na^+$ and $K^+$ concentration on urinalysis, which are related to factors of circadian rhythm and level of fatigue. The subjects, 17 nurses from Emergency Room and 25 nurses from general ward, were selected from a General Hospital in Taegu City on August 8 to 23, 1998. And the data were analyzed by proportion, t-test, chi-square and Pearson's Correlation, ANCOVA, using SAS program. The results of this study were shown as follows: First, The difference of Maximal and minimal heart rate was significant between ER group and general ward group. However, body temperature difference wasn't notable. Second, Urine $Na^+$ concentration on urinalysis was lower and $K^+$ concentration on urinalysis was higher in ER group than general ward group significantly. Third, Fatigue level was higher in ER group than general ward group significantly. Fourth, through urine concentration, significant relations in circadian rhythm of ER nurse group and general ward group and their fatigue level were found. Urine $Na^+$ concentration on urinalysis of ER nurse was significant related with their fatigue level. In conclusion, the effect of fatigue on circadian rhythm is greater in ER group than general ward group during night shift. This study could be a help in improvement of nurse's health and understanding the effect of fatigue on health.

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A Study on the Triage and Statitical Data by the 5 Developmental Stages of the Children in Emergency Room, PNU (일 종합병원 응급실 내원아동의 Triage 및 발단단계별 통계적 고찰)

  • Kim Young Hae;Lee Hwa Ja;Cho Seok Ju
    • Child Health Nursing Research
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    • v.5 no.2
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    • pp.136-150
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    • 1999
  • The subjects, under 18 old, 2,694 children who visited ER during 1998, were surveyed by the Triage and other statitical data. The results were as follows 1. The male to female ratio was 1.7 : 1, and the toddler(1-4 old) was the majority. 2. Triage ; critical 1.3%, acute 14.6%, urgent 29.5%, nonemergent 54.6%. 3. The reasons of visiting ER ; 1) The children had diseases(46.5%), injury (36.9%), TA(5.6%) and toxication(1.0%). 2) In diseases, male to female ratio was 1.5 : 1 and in injury, male to female was 2 : 1. 3) Among the children having in TA, 12-18 old groups was the majority(34.9%). 4. The time of visiting : the 20:00 - 22:00 was the majority(16.9%). 5. By monthly and seasonal distribution ; Jan. (9.7%), Mar. and May(9% respectively, Dec. and July(6.7%) respectively. The children who visted ER in spring and autumn showed higher portion than those of summer and winter. 6. Results ; admission(27.4%), discharge(68.4%), operations(2.8%), and DOA and DAA(0.4%), The mortality of the infancy and toddler groups was 83.3%. The infancy group showed the highest rate of admission. 7. The time of staying in ER ; 1-2 hrs was the major group(23.3%) and the average was 4.6 hours. 8. By clinical departments ; Ped. was 34.4%, PS was 20.8%, Dental Surgery was 10.3% and Dermatology was 0.9%. 9. The types of visting ; the group who visited by themselves was 80%, transfer from the primary and secondary clinic was 17% and OPD was 3.0%. 10. The traffic means . by the own cars and taxi were 87.6%, by hospital ambulance was 6.1% and by 119 ambulance was 4.3%.

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A Comparison of the Rates of Hemolysis and Repeated Blood Sampling using Syringe needles versus Vacuum tube needles in the Emergency Department (응급실에서의 주사기 채혈과 진공관 채혈의 용혈과 재채혈 비교)

  • Sung, Young-Hee;Hwang, Moon-Sook;Lee, Jee-Hyang;Park, Hyung-Doo;Ryu, Kwang-Hyun;Cho, Myung-Sook;Yi, Young-Hee;Song, S.
    • Journal of Korean Academy of Nursing
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    • v.42 no.3
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    • pp.443-451
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    • 2012
  • Purpose: This study was done to compare the rates of hemolysis and repeated sampling in blood samples obtained by a syringe needle versus a vacuum tube needle. Methods: A randomized, prospective study was used to evaluate the differences between the two blood sampling methods. The study group consisted of patients seen in the emergency department (ED) for blood sampling to determine electrolyte level. ED patients were randomly assigned to either the syringe group or the vacuum tube group. All blood samples were collected by experienced ED nurses and hemolysis was determined by experienced laboratory technologists. Data were analyzed using Fisher's exact test and binary logistic regression. Results: One hundred forty-five valid samples were collected (74 in the syringe group versus 71 in the vacuum tube group). 5 of 74 (6.8%) blood samples in the syringe group and 8 of 71 (11.3%) in the vacuum tube group hemolyzed. Repeated blood sampling occurred for 2 of 74 (2.7%) and 3 of 71 (4.2%) in each group respectively. There were no significant differences in rates of hemolysis and repeated sampling between two groups (B=1.97, p=.204; B=2.36, p=.345). Conclusion: Venipuncture with syringe needles can be recommended for ED nurses to obtain blood samples.

A Patient with Propionic Acidemia with a Novel mutation who was Successfully Managed by Home Care-Based Fluid Therapy (가정 간호를 통한 수액 치료로 성공적으로 관리된 새로운 변이를 가진 프로피오닌산혈증 1례)

  • Yang, Aram;Nam, Soon Young;Kim, Jinsup;Kim, Hyun-young;Park, Hyung-Doo;Jin, Dong-Kyu;Cho, Sung Yoon
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.16 no.1
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    • pp.52-56
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    • 2016
  • Propionic acidemia (PA) is a rare autosomal recessive metabolic disease caused by the deficiency of propionyl-CoA carboxylase (PCC). PA affects the catabolism of branched chain amino acid and oddchain fatty acid then results in accumulation of propionic acid and other metabolites in plasma and urine. Catabolic stress such as infection, illness or any stress can precipitate cause acute metabolic decompensation, especially in the first years of life. Acute metabolic decompensation commonly calls for emergency treatment or admission and if the patient is in a serious condition, it can lead to coma or death. But frequent admissions or visiting the emergency room are much burden to the patients and their kins. And we experienced the propionic academia with a confirmed novel mutation and the patient suffered from frequent admission and visiting the emergency room. So, we tried the regular home carebased fluid therapy after securing a central venous line. Finally, we succeeded in preventing frequent admissions resulted from acute metabolic decompensation and could contribute to relieving the burden to the patient and their family.

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Severity of Emergency Patient classified by Triage System (중증도 분류체계를 이용한 중증도분류(Triage))

  • Bae, Jung-Hee;Sohn, Sue-Kyung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.264-274
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    • 2001
  • About the patients who visited the emergency department of a hospital, investigative study was performed to assess and to classify them with triage tool, and to estimate the characteristics of them. 210 patients older than 15 years were investigated. Among them 11 patients who had responded inappropriately were excluded and remaining 210 patients were chosen as study subjects. Investigation had been performed for 30 days from Jan. 10, 2001 to Feb. 9, 2001. The triage tool was designed through the modification of triage tools developed by Kim and Choi. The data were analyzed with the SPSS program using mean, standard deviation, frequency, percentage, ANOVA and Scheffe's test. The results were as follows: 1. Of the characteristics of the study subjects, mean age of patients were 55.76 years and 70-79 years group which included 41 patients(20.6%) were most numerous. 101 (51.8%) patients visited emergency room by 119 emergency service and 91(45.7%) patients walked with assistance. 127 patients were cared in internal medicine department. 2. The distribution of triage scores were from minimum 6 points to maximum 18 points with mean $13.76{\pm}2.58$ points. 3. Triage scores had significant relationship with age(F=13.349,P=0.000), visiting method (F=8.832, P=0.000), walking status(F=28.185, p=0.000), care department(F=2.596, P=0.019), and preexisting disease(F=12.012, P=0.000). 4. After trage there were no urgent patient, 35 emergent patients(17.6%),109 subemergent patients(54.8%), and 55 nonemergent patients (27.6%). The result of emergency care were 80 admission(40.2%), 59 discharge (29.6%), 34 ICU admission(17.1%), 14 transfer to other hospital(7%), 10 operation (5%), and 2 death (2%). 5. About the time required for triage, mean duration to triage were $7.54{\pm}2.28$ mins in emergent patients, mean $7.23{\pm}2.50$ mins in subemergent patients and mean $6.49{\pm}2.19$ mins in nonemergent patients. There were no differences in duration to triage according to the severity of triage. 6. Time required in emergency treatment were mean $116.23{\pm}88.10$ in emergent patients mean $101.61{\pm}73.27$ in subemergent patients and mean $81.56{\pm}61.01$ in nonemergent patients. There were no significant difference among groups. This study depicted that triage scores were below the middle level and there were many geriatric patients in this hospital. Among the characteristics of patients, age, visiting method, walking status, care department, and accompanying disease could be data for triage of emergency patients. With triage score of a patient, the outcome of emergency care of a patient could be anticipated and this could be basal data in determining the priority of emergency nursing.

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Factors Influencing Intensive Care Unit Length of Stay of Patients with Critical Illness (성인 중환자실에 입실한 환자의 중환자실 체류기간에 영향을 미치는 요인 탐색)

  • Son, Youn-Jung;Song, Hyo-Suk;Won, Mi Hwa;Yang, Sun Hee
    • Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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    • v.7 no.11
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    • pp.525-536
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    • 2017
  • Purpose: The aim of this study was to identify the factors influencing ICU (intensive care units) length of stay of adult patients with critical illness. Methods: This study was adopted descriptive design. 270 patients who were admitted to ICU in general hospital, Seoul were analyzed. Results: A total of 270 patients, 116 (43%) patients had stayed more than 5 days. The length of stay of intensive care unit was significant positive correlation with the FCI(Functional Comobidity Index) score(r=0.33, p<.001) and APACHE(Aacute Physiology and Chronic Health Evlauaion) II(r=0.19, p=.001). In multiple logistic regression, the predictors of ICU length of stay were admission route (p=0.013), FCI score (p<0.001), APACHE II(p=0.012). Conclusions: Heatlh care providers in ICU should be aware that patients who admit to emergency departments and have higher disease severity are more considered to reduce their ICU length of stays.

The Relation among Experience of Verbal Abuse, Emotional Labor, Emotional Intelligence, Social Support and Turnover Intention of Hospital Nurses. (병원간호사의 언어폭력 경험, 감정노동, 감성지능 및 사회적 지지와 이직의도와의 관계)

  • Park, An-Na
    • Journal of Internet of Things and Convergence
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    • v.4 no.2
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    • pp.29-46
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    • 2018
  • The purpose of this study is to understand the relation among experience of verbal abuse, emotional labor, emotional intelligence, social support and turnover intention of hospital nurses. The survey was conducted with 189 hospital nurses working at general hospital in the city of S. The data was collected by using structured questionnaires as research tools from November 17, 2015 to November 27, 2015. The collected data was analyzed by using SPSS ver. 18.0 program. As a result of the correlation analysis between the nurse 's experience of verbal abuse, emotional labor, emotional intelligence, social support and turnover intention, the turnover intention of the nurse was a significantly positive correlation between the experiences of verbal abuse from the doctor, nurses, patients, and the caregiver and the emotional labor. Also, There is a significantly negative correlation between emotional intelligence and social support. In order to identify the factors influencing the turnover intention of the subjects, multiple regression analysis was performed. The statistically significant variables were emotional labor & the ER in the working department.