• 기본간호학회지
• /
• 제16권1호
• /
• pp.103-111
• /
• 2009

Purpose: The purpose of this study was to identify relationships between violence response, coping, and burnout among emergency department nurses. Method: This descriptive study using self report questionnaires was conducted from October 1 to October 20, 2008. Participants were 147 general nurses working in emergency departments in hospitals having over 500 beds and located in Busan. ANOVA and Pearson's correlation coefficients with SPSS PC+ WIN 14.0. were used to analyze the data. Results: Scores for violence response, coping, and burnout were 3.08 (1-5 scale), 2.57 (1-4 scale), and 3.22 (1-5 scale) respectively. There were significant differences in violence response and burnout by education, clinical careers, clinical careers in ED, and plans to work in the future, and no significant differences in coping by general characteristics. There was a significant and highly positive relationship between violence response and burnout. Conclusion: The degree of violence response and burnout was comparatively high, while that of coping was average. Therefore, it is necessary to develop effective programs related to prevention and coping with violence for nurses in emergency departments. Institutional measures by hospital authorities are also needed to improve the nursing quality by providing a safe workplace.

• Journal of Trauma and Injury
• /
• 제22권2호
• /
• pp.154-160
• /
• 2009

Purpose: This study aimed to determine new criteria for detecting independent factors with high sensitivity in cases of cervical spine injury. We compared the sensitivity, the specificity, and the false negative predictive value (NPV) of plain radiographs with those of computed tomography for cervical spine injury in patients with minor head injury. Methods: We retrospectively reviewed the cases of 357 patients who underwent both cervical plain radiographs and computer tomography from January 2006, to September 2008. Patients were divided into two groups: the cervical spine injury group and the no cervical spine injury group. New criteria were organized based on variables that had significant differences in the logistic regression test. Results: Among the 357 patients, 78 patients had cervical spine injuries. The average age was $43.9{\pm}15.2$ yrs old, and the male-to-female ratio was 1.90. The most common mechanism of injury was motor vehicle accidents. There was a significant difference in loss of consciousness, Glasgow Coma Scale (GCS)=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs between the two groups on the logistic regression test. New criteria included the above five variables. If a patient has at least variable, the area under the ROC curve of the new criteria was 0.850, and the sensitivity and the false NPV were 87.2% and 5.2%, respectively. Conclusion: New criteria included loss of consciousness, GCS=14, neurologic deficit, posterior neck tenderness, and abnormality of the cervical plain radiographs. If the patient had at least 1 variable, he or she could have a of cervical spine injury with a sensitivity of 87.2% and a false NPV of 5.2%.

• 한국정보통신학회:학술대회논문집
• /
• 한국정보통신학회 2012년도 추계학술대회
• /
• pp.414-417
• /
• 2012

최근 전문의 응급의료센터 당직을 규정하는 것을 골자로 응급의료법이 개정되면서 응급의료센터 시스템에 많은 변화가 생길 것 이다. 응급환자가 응급의료센터를 찾을 경우 응급실 근무의사 ${\rightarrow}$ 해당과 인턴 ${\rightarrow}$ 1 2년차 전공의(레지던트) ${\rightarrow}$ 3 4년차 레지던트를 거쳐야 전문의 진료를 받을 수 있던 것을 응급실 근무의사 ${\rightarrow}$ 해당과 당직전문의 진료 또는 호출로 그 절차가 간소화됐다. 문제는 이런 시스템을 하려면 모든 진료과목에 대해 당직전문의를 배치해야 한다. 하지만 모든 병원이 모든 진료 과목에 대해 전문의를 배치하는 것은 어렵다. 본 논문에서는 모바일 기기를 이용하여 사용자 근처의 응급의료센터가 있는 병원과 해당 병원이 어떤 전문의가 있는지와 병원의 정보와 응급실의 사용현황을 개정되는 응급의료법을 위해 통합 응급실 관리 시스템을 설계한다.

• 보건교육건강증진학회지
• /
• 제7권1호
• /
• pp.27-32
• /
• 1990

Since the medical insurance covered the total population in Korea in July, 1989, the number of patient's visitation to the tertiary care hospital had changed because of referral regulation. In the referred patients through the secondary care hospitals such as out-patients of departments of internal medicine, general surgery, obstetrics and gynecology, pediatrics had decreased as well in-patients in these departments. However, departments of urology, dermatology, dentistry, ophthalmology and ear-nose-throat had more or less similar number of patients after medical insurance implemented for the total population. Contrarily, the number of patients visited emergency clinics and department of family medicine had increased very many. Thus, expansion of emergency clinic department, new special clinic set-ups, establishment of family medicine department in each hospital etc are strongly recommend.

• 한국응급구조학회지
• /
• 제27권2호
• /
• pp.31-40
• /
• 2023

Purpose: The study aims to provide basic data for understanding the department of paramedicines' bachelor's degree courses to enable curriculum development and reorganization. Methods: The 2023 academic curricula for all eleven universities with active departments of paramedicine offering bachelor's degrees were investigated from April 25 to May 10, 2023. Results: The average courseload was 22.0 units. There were 7.73 major subjects, with 19.45 units on average. The culture subject was available in 7 colleges and was 2.55 units on the average 1.18 subject. Grouping the major subjects showed that 15.3% of subjects were related to advanced paramedicine (the most common course), followed by 11.8% related to research methodology and seminar, and 10.8% related to radiology and simulations. Related subjects in statistics, disaster, and forensic science were also offered. Conclusion: This study found that the curricula of the departments of paramedicine differed from that of the general bachelor's degree. Going forward, university leaders should organize the paramedicine curriculum considering the environmental changes in emergency medicine and the scalability of EMT-Paramedic jobs.

• Journal of Trauma and Injury
• /
• 제30권4호
• /
• pp.173-178
• /
• 2017

Purpose: Most patients with acute low back pain visit emergency room (ER). They mostly need beds, and if their length of stay is longer, it can become difficult to accommodate new patients at the ER. We analyzed the treatment process of patients with back pain and tried to find method for shortening of the length of stay at the ER. Methods: We retrospectively analyzed the medical records of patients with back pain who visited at our ER for one year. Patients were divided into two groups according to their length of stay at ER and were compared the charateristcs of between two groups. Results: A total of 274 patients were included in the study. Eigthy-nine patients (32.5%) were in the group with less than 3 hours and 185 patients (67.5%) were in the other group. In the comparison of the two groups according to the medical departments, the number of patients who were in group with more than 3 hours were 25 (14.0%) in the emergency department, 94 (50.5%) in neurosurgery, 66 (35.5%) in orthopedic surgery. Length of stay was significantly increased in orthopedic surgery and neurosurgery (p=0.014). In addition, the length of stay was longer when computed tomography and magnetic resonance imaging examinations were performed (p=0.000). Regardless of the type of analgesic agent, the median time to the analgesic treatment was shorter in the group with less than 3 hours (p=0.034). Conclusions: In patients with back pain who visit the ER, the emergency medicine doctor will early control the pain and do not unnecessary image examination to reduce a length of stay at the ER.

• Journal of Korean Medical Science
• /
• 제33권48호
• /
• pp.295.1-295.7
• /
• 2018

Background: Vancomycin-resistant enterococci (VRE) infections have become a major healthcare-associated pathogen problem worldwide. Nosocomial VRE infections could be effectively controlled by screening patients at high risk of harboring VRE and thereby lowering the influx of VRE into healthcare centers. In this study, we evaluated factors associated with VRE colonization in patients transferred to emergency departments, to detect patients at risk for VRE carriage. Methods: This study was conducted in the emergency department of a medical college-affiliated hospital in Korea. Every patient transferred to the emergency department and admitted to the hospital from January to December 2016 was screened for VRE using rectal cultures. In this cross-sectional study, the dependent variable was VRE colonization and the independent variables were demographic and clinical factors of the patients and factors related to the transferring hospital. Patients were divided into two groups, VRE and non-VRE, and previously collected patient data were analyzed. Then we performed logistic regression analyses of characteristics that differed significantly between groups. Results: Out of 650 patients, 106 (16.3%) had positive VRE culture results. Significant variables in the logistic analysis were transfer from geriatric long-term care hospital (adjusted odds ration [aOR]: 8.017; 95% confidence interval [CI]: 1.378-46.651), hospital days (4-7 days; aOR: 7.246; 95% CI: 3.229-16.261), duration of antimicrobial exposure (1-3 days; aOR: 1.976; 95% CI: 1.137-3.436), and age (aOR: 1.025; 95% CI: 1.007-1.043). Conclusion: VRE colonization in patients transferred to the emergency department is associated primarily with factors related to the transferred hospitals rather than demographic and clinical characteristics.

• Nuclear Engineering and Technology
• /
• 제54권3호
• /
• pp.909-916
• /
• 2022

To study the developments and variations of unsafe behaviors in nuclear power plants thus reduce the possibility of human-related accidents, this paper, based on the Game Theory, focused on the changes in benefits of the Department of Management, Operational and Emergency in a nuclear power plant, and established the expected revenue functions of these departments. Additionally, the preventive measures of unsafe behaviors in nuclear power plants were also presented in terms of these 3 departments. Results showed that the violations of the Operation Department (OD) and the Emergency Department (ED) were not only relevant with the factors such as their own risks, costs, and the responsibility-sharing due to accidents, but also affected by the safety investments from the Management Department (MD). Furthermore, results also showed that the accident-induced responsibility-sharing of both the OD and the ED would rise, if the MD increased the investments in safety. As a result, the probability of violation behaviors of these 3 departments would be attenuated consciously, which would reduce the unsafe behaviors in the nuclear power plants significantly.

• 대한임상독성학회지
• /
• 제12권2호
• /
• pp.54-62
• /
• 2014

Purpose: The purpose of this study was to compare prescription patterns and clinical features according to clinical departments in sedative-hypnotic intoxication. Methods: This was a retrospective study of histories, substances of poisoning, acquisition routes, clinical courses, and outcomes of patients treated for acute intoxication in a single emergency medical center from January, 2011 to December, 2013. Results: A total of 769 patients were treated for acute intoxication, 281 patients ingested sedative hypnotics during the study period. Among 281 patients, 155 patients were prescribed by psychiatric department and 80 patients were prescribed by non-psychiatric department. Benzodiazepines were more likely to be prescribed by psychiatrists, and zolpidem was preferred by non-psychiatrists (p<0.001). Non-psychiatrists were more likely to prescribe short acting benzodiazepines than psychiatrists (p<0.001). However, there was no statistically significant difference in the clinical outcomes, including prevalence of admission to ICU, ventilator care, and length of stay in ICU. In patients prescribed by non-psychiatrists, there were more patients prescribed without psychiatric diagnosis and diagnosed as major depression disorder after hospitalization. Conclusion: To promote rational prescribing of sedative hypnotics, proper psychiatric evaluation should be performed before prescribing, and educational programs including the contents of interactions and side effects of sedative hypnotics are needed.

• 보건행정학회지
• /
• 제32권2호
• /
• pp.164-172
• /
• 2022

Background: The purpose of this study was to the impact of the coronavirus disease 2019 (COVID-19) outbreak on emergency departments (EDs) in patients under the age of 18 years with respiratory disease. Also, we analyzed similarities and differences in patients including revisit before and after the COVID-19 outbreak. Methods: This study population was respiratory patients under the age of 18 years who visited all 403 EDs in Korea between January 1st, 2019 and December 31st, 2020, using the National Emergency Department Information System Database. The primary outcome was the number of respiratory patients according to age, sex, the type of EDs, season, Korean Triage and Acuity Scale (KTAS) levels, the result of ED, and length of stay. The secondary outcome was the number of revisit respiratory patients within 72 hours. We calculated the risk-adjusted revisit rates according to the KTAS level using a multiple logistic regression model. Results: The number of ED visits decreased from 274,526 in 2019 to 79,007 in 2020; this number was 71.2% lower than that before COVID-19. In spring 2020, this number was 90.1% lower than during the same period in 2019. For the revisit rate in the study population, the adjusted odds ratio (95% confidence interval) was 1.22 (1.05-1.41) in 2019 and 1.39 (1.07-1.81) in 2020. Conclusion: Implementing appropriate emergency care policies in severe respiratory patients would have contributed to improving the safety of reducing in revisit rate.