• The Korean Journal of Emergency Medical Services
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• v.24 no.3
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• pp.129-140
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• 2020

Purpose: This descriptive correlational study investigated the effects of post-traumatic stress and compassion competence on the quality of life of 119 Emergency medical technicians(EMTs). Methods: The data of 119 EMTs were collected between May 1 and September 30, 2020. Data analysis was performed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and hierarchical multiple regression with SPSS 24.0 program. Results: Post-traumatic stress was seen to be negatively correlated with the quality of life (r=-.456, p<.001) and compassion competence was positively correlated with quality of life (r=.250, p=.006). Participants' subjective health status (β=0.30, p<.001), post-traumatic stress (β=-0.39, p=.001) and compassion competence (β=0.29, p<.001) explained 38.5% of variance in the quality of life of the 119 EMTs. Conclusion: These findings indicate that post-traumatic stress and compassion competence are important factors to improve the quality of life of EMTs. Therefore, systematic programs for reducing post-traumatic stress and enhancing compassion competence levels should be developed.

• Quality Improvement in Health Care
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• v.29 no.2
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• pp.64-84
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• 2023

Purpose:Plaster splints are routinely performed in the Emergency Department (ED) and avoidable complications such as skin ulcerations and fracture instability arise mainly due to improper techniques. Despite its frequent use, there is often no formal training on the fundamental principles of plaster splint application for a medical officer rotating through ED. We aim to use Quality Improvement (QI) methodology to reduce number of incorrect plaster splint application to improve overall patient care via a bundled educational solution. Methods: We initiated a QI program implementing concepts derived from the Institute for Healthcare Improvement models, including Plan-Do-Study-Act (PDSA) cycles, to decrease the rate of incorrect plaster splint application. A bundled education solution consisting of three sequential interventions (practical teaching session, online video lecture and quick reference cards) were formulated to specifically target critical factors that had been identified as the cause of incorrect plaster splints in ED. Results: With the QI intervention, our overall rate of incorrect plaster splints was reduced from 84.1% to 68.6% over a 6-month period. Conclusion: Following the QI project implementation of the bundled educational solution, there has been a sustained reduction in incorrect plaster splints application. The continuation of the training program also ensures the sustainability of our efforts in ED.

• Journal of East-West Nursing Research
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• v.27 no.2
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• pp.153-165
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• 2021

Purpose: The aim of study was to identify ranges of Korean nurses' competency in disaster nursing. Methods: A scoping review was conducted using the Joanna Briggs Institute methodology. The review used information from four databases: RISS, ScienceON, EBSCO Discovery Service, and CINAHL. In this review, key words were 'disaster', 'nurs*', 'competenc*', 'ability' and 'preparedness'. Inclusion and exclusion criteria were identified as strategies to use in this review. The inclusion criteria for this review focused on the following: Korean nurse, articles related to disaster nursing competency, peer-review articles published in the full text in Korean and English. Review articles were excluded. Results: Nineteen studies were eligible for result extraction. A total of 10 categories of disaster nursing competency were identified: Knowledge of disaster nursing, crisis management, disaster preparation, information collection and sharing, nursing record and document management, communication, disaster plan, nursing activities in disaster response, infection management, and chemical, biological, radiation, nuclear, and explosive management. Conclusion: It is necessary to distinguish between Korean nurses' common disaster nursing competency, professional disaster nursing competency, and disaster nursing competency required in nursing practice. Therefore, future research will be needed to explore and describe disaster nursing competency.

• The Korean Journal of Emergency Medical Services
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• v.22 no.1
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• pp.7-19
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• 2018

Purpose: With the purpose of educating and producing outstanding paramedics by enhancing their competencies, this study aimed to make policy suggestions to re-establish the education system and improve the national examination and the certification scheme. Methods: This study used focus group interviews and questionnaires to collect data. Totally, there were 277 subjects, including experts from the education and field. Data were collected from September 9 to 20, 2016, and analyzed using SPSS 22.0. Results: To strengthen the curriculum of paramedics, this study suggested 27 courses with 94 credits as the standardized curriculum and derived 9 core competencies of paramedics. For the national examination, this study suggested consolidating written test subjects, adding scenario questions to practical tests, and applying critical criteria to simple practical tests that performs a procedure, grading these tests on a pass/fail basis. In addition, this study suggested converting certification into license, reflecting paramedics' healthcare job characteristics. Conclusion: The quality of emergency medical services in Korea will improve when those with core competencies that originated from the standardized curriculum based on the results of this study acquire their certification through the national test scheme, and the certification management system creates a virtuous cycle to further enhance paramedics' professionalism.

• 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.

• Journal of Korean Clinical Nursing Research
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• v.23 no.3
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• pp.376-387
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• 2017

Purpose: This study was to systematically review the contents and effects of nurse-led transitional care programs for discharged patients from hospital to home. Methods: Randomized controlled trials published between 2005 and 2015 were searched in Pubmed, Embase, Cochrane(Central Register of Controlled Trials) and CINAHL. Data were analyzed using Cochrane Review Manager(Revman) software 5.3. Results: Nine studies were selected and analyzed. Patient assessment, education and discharge planning were included in pre-discharge phase. Referring, communication and care planning were performed by nurses in transition phase. Home and phone visits, monitoring and multidisciplinary advices were included in post-discharge phase. Various outcome measures such as hospital utilization(30 days readmission and emergency department visit), quality of life, and cost were used to identify effectiveness of nurse-led transitional care programs. 30 days readmission(OR=.73, 95% CI 0.54, 0.98; p=.03) and emergency department visit(OR=.67, 95% CI 0.50, 0.88; p=.005) were statistically significant in meta-analysis. However, participant blinding was not done in seven studies which put at the risk of performance bias. Conclusion: The results indicated that nurse-led transitional care program is effective in reducing unnecessary hospital utilization. Nevertheless, small sample size and risk at performance bias are the limitation of this study. Thus, we suggest that well-designed randomized controlled trials need to be conducted.

• Journal of The Korea Institute of Healthcare Architecture
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• v.15 no.1
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• pp.13-22
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• 2009

The nursing home for the elderly has a weak point for evacuation from the fire because most of all the users are suffering from a dementia or paralysis. When it comes to night shift, it is much difficult to get them evacuated due to the lack of staffs. In addition to that, the nursing home for the elderly has such a strict control system for access that does not have a utility for escape opening. That is why they need the differentiated evacuation planning. This study is to consider the point at issues on the present conditions of law, system, and evacuation plans for the nursing home for the elderly that has some difficulties because of impaired functions of residences. This study dealt with the point at facilities and operations of the emergency evacuation system. First of all, for the point at the facilities, I found that it need to be considered on the characteristics of the elderly who has any difficulties of the self evacuation. And the established regulation did not reflect the characteristics of closed area of the nursing home for the elderly. The second, for the point at the operation of the institutions, it is pointed that there seems to be a lack of ways to manage to a emergency situation and educations on the operation staff. And the last, for the point at the operation, the requirement for the managers of fire prevention facilities are similar to that of a normal building. Furthermore there is a lack of corporation with the fire station.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.3
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• pp.99-110
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• 2021

Purpose: The purpose of this study was to understand the experience and meaning of falls among care workers caring for the elderly. Methods: The participants comprised 10 care workers in Seoul and Gyeonggi Province, South Korea. The data collection period was from September to November 2020, and the data were obtained through individual in-depth interviews. The collected data were analyzed using the content analysis method of qualitative research. The main interview questions were as follows: First, in the event of a fall, "can you tell us about your experience and how you dealt with the fall?; second, "can you tell us about your role and the role of family members or the center that manages falls that occur outside of nursing visits.", third, "can you tell us about the difficulties in managing falls based on your experience?", and fourth, "how are falls that occur during nursing visits managed?" Results: As a result of analyzing the experiences of nursing care workers of falls while caring for elders in their homes, five main themes were derived. These were understanding the characteristics of the elderly at home, understanding possible emergency situations, providing caring services, minimizing physical harm, and delivering clear information. Conclusion: A significant finding of this study was that care workers who visit and provide care to elders at home confirmed the need for standard guidelines on appropriate responses in the event of a fall at home and the importance of managing emergencies arising from falls among elders at home. These results highlight the need for the development of emergency response education programs, such as programs on fall care among nurses and care workers who provide care to the elderly, and for enhanced understanding of the fall risk of elders who live at home.

• Journal of Home Health Care Nursing
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• v.24 no.1
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• pp.14-22
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• 2017

Purpose: To study aimed to examine the impact of the Nursing and Care=giving Integrated Service on nursing work performance, nurse' job satisfaction, and patient safety. Methods: A total of 66 nurses were selected as participants, comprising 30 nurses working in Nursing and Care=giving Integrated Service hospital ward, and 33 nurses working in a general hospital ward with a similar patient and disease group and distributed moderately. For data analysis, t-tests, ANOVA, and $X^2$ tests were conducted. Results: Nursing work performance in the Nursing and Care=giving Integrated Service ward was higher than that in the general hospital ward, but this difference was not statistically significant. Conversely, job satisfaction was lower among nurses in the Nursing and Care=giving Integrated Service ward, although again the difference was not significant. However, the Nursing and Care=giving Integrated Service ward had a significantly lower rate of safety-related accidents in patients compared to the general hospital ward. Conclusion: In order to expand and improve patient safety and other aspects of the Nursing and Care=giving Integrated Service, there is a need to establish a mediation strategy for increasing nurses' work performance and job satisfaction.

• Journal of Korean Clinical Nursing Research
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• v.26 no.3
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• pp.395-406
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• 2020

Purpose: The purpose of this study was to analyze nurse staffing according to patients' acuity and dependency by measuring nursing hours. Methods: The study sample included patients who visited the adult emergency departments (EDs) of three tertiary referral hospitals and nurses who worked on shifts for 48 hours from October 24 to 26, 2019. Hourly patient census and nurse staffing were analyzed. Patient acuity was measured using the Korean Triage and Acuity Scale (KTAS), ranging from Level 1 (highest) to Level 5 (lowest). Patient dependency was measured using six items (e.g., clinical attention and communication) and classified into four groups. Nursing activities were observed every 10 minutes and nursing hours per patient and nurse staffing were analyzed according to acuity and dependency. Results: Nurse-to-patient ratio ranged from 1:1.8 to 1:4.2 during the 48 hours of observation. The average work hours of nurses, excluding breaks and meals, was 8.57 hours; 42.5% of which was spent providing direct care. Higher acuity and dependency were associated with higher nursing hours and staffing level. Patients with KTAS Level 1 were provided 74.3 minutes per hour, 5.02 times higher than Level 5 (14.8 minutes). Patients in the highest dependency group were provided 87.4 minutes per hour, 5.75 times higher than the lowest group (15.2 minutes). Newly arrived patients received more nursing hours than continuously stayed patients within the same KTAS Levels. Conclusion: Large variations were found in hourly patient census, acuity, and dependency. Nurse staffing in EDs should be determined based on patient acuity and dependency.