• Quality Improvement in Health Care
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• v.6 no.1_2
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• pp.136-149
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• 1999

Background : Although a number of studies are related to QA improvement, there are few studies applied various method of QA tools. This study reviewed the availability of general quality assurance(QA) tools according to ten steps in performing quality improvement activities at emergency room of a tertiary teaching hospital which has more than 1,000 beds. Methods : All patients in emergency room from 15th Oct. 1997 to 5th Sep. 1998 were surveyed. The survey data based on the patient's records of emergency room were evaluated according to length of stay, and we tried to identify problems with management of emergency room. To solve the problems, our team applied general QA tools(brainstorming, flow chart, nominal group technique, benchmarking, cause-and-effect diagram, run chart, control chart) to quality improvement activities and discussed the availability of the tools. Results : After the activities such as changes of staffing, the establishment of local area network and chest pain clinic, application of triage and so on, the percentage of patient who had stayed more than six hours was reduced from 56.0% to 46.8%. The mean number of patients per day in emergency room was increased from 49 to 62. But the reporting time for laboratory test was not changed after these activities. Conclusion : Each QA tool has unique benefit and limitation, but we can implement and evaluate the quality improvement activities more scientifically and systematically by applying these tools to practice according to QA ten steps.

• The Korean Journal of Emergency Medical Services
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• v.8 no.1
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• pp.149-160
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• 2004

Background : To save out-of-hospital cardiac arrest cases is a major concern for Korea. Cardiac arrest is a very common problem, with > 18,000 cases dying each year in Korea. Overall, survival to hospital discharge remains poor. Resuscitation has become an important multidisciplinary branch of medicine, demanding a spectrum of skills and attracting a plethora of specialities and organizations. Since the "Utstein Style" was advocated in 1991, many reports about out-of-hospital cardiac arrest have been published based on this guideline. These differences prevent valid inter-hospital and international comparisons. However, we do not know the true effectiveness of resuscitation. There are no guideline for reviewing, reporting, conducting research on resuscitation in Korea. This study evaluated the out-of-hospital factor associated with survival discharge of out-of-hospital cardiac arrest, was especially to provide basic data for the unified reporting guideline of resuscitation in Korea. Methods : From January 1990 to July 2004, we collected data about out-of-hospital cardiac arrest at Wonju Christian Hospital(WCH-CAD), Ewha Women University Mokdong Hospital(Ewha-CAD), I used same record form based on the "Utstein Style". The "Utstein Style" is internationally recommended guidelines for reporting outcome data from resuscitation events. Results : Resuscitation was performed in 1443 out-of-hospital cardiac arrest patients at 2 hospitals. Five hundred eighty(40.25%) patients recovered the spontaneous circulation at least once and One hundred sixty eight(11.66%) patients discharged alive. Initial EKG showed Ventricular Tachycardia/Ventricular Fibrillation in One hundred thirty five(9.33%) patients, asystole in one thousand nine(69.73%) patients and other rhythms in one hundred thirty nine(20.94%) patients. Among one hundred two cardiogenic cardiac arrest patients, two(2.0%) patients was discharged alive. Conclusion : Overall survival rate of out-of-hospital cardiac arrest patients was 11.66% which was poorer than that of the western country. The proportion of the cardiogenic cause was 33.38% which was only half of the western country. VT/VF is relatively not common ac a initial EKG rhythm. These differences might be to due difference in the prevalence pattern of out-of-hospital cardiac arrest as well as prematurity of the EMSS. It is needed that the best survival can be achieved if all following links have been optimized : rapid access, early CPR, early defibrillation, early ACLS.

• The Journal of the Korea Contents Association
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• v.21 no.9
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• pp.806-816
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• 2021

This study aims to describe the reporting patterns of articles on the Emergency Grant for all citizens(EGAC) and compare the reporting attitudes by newspaper companies. The main results are as follows: First, conservative newspapers reported more than four times as much coverage of EGAC as liberal newspapers. Newspaper articles reported during the week of the National Assembly Election Day accounted for about a quarter of the total, and 79.1% of the articles were reported in the political realm of newspapers, and only 2.8% in the social realm. Second, a conservative newspaper reported a critical attitude toward EGAC at 52.6% and favorable articles at 5.3%. On the other hand, in a liberal newspaper, critical articles were 17.1% and favorable articles were 37.1%. The inefficiency of selectivism was reported as the basis for the argument in favor, and concerns about the burden of deterioration in the financial soundness of the opponents were reported the most. Politicians are the most cited sources of information in articles. Finally, in prior to policymaking, the proportion of the media in favor of and against the news was similar, and the proportion of articles with a neutral attitude accounted for more than half. And in the specific method discussion stage, the articles in favor of the article exceeded the proportion of articles on the opposite side.

• Journal of the Korea Convergence Society
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• v.8 no.10
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• pp.397-405
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• 2017

This study was to identify hardiness, social support, burnout which might influence burnout in emergency department nurses. Data were collected by self-reporting questionnaires from 115 nurses in 8 emergency department. Data analysis was done with SPSS/Win 21.0 program. Burnout showed significantly negative correlations with hardiness(r=-.390, p<.001), social support(r=-.400, p<.001) and hardiness showed significantly positive correlations with social support(r=.351, p<.001). As results, key factor was hardiness, social support, that continuing to work in emergency department, were significant predictors and accounted for 30.6%. Based on these results, burnout showed statistically significant differences depending on hardiness, social support and wanted department state. It is needed to develop a program in order to improve hardiness and social support of emergency department nurses.

• Journal of The Korean Society of Clinical Toxicology
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• v.12 no.2
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• pp.39-45
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• 2014

Purpose: The purpose of this study is to review the evidence comparing the efficacy and safety between L-carnitine and extracorporeal elimination therapy in the management of acute valproic acid L-carnitine vs Extracorporeal Elimination for Acute Valproic acid Intoxication Methods: PubMed, Embase, Cochrane library, Web of Science, KoreaMed, KMbase, and KISS were searched, using the terms carnitine and valproic acid. All studies, regardless of design, reporting efficacy or safety endpoints were included. Reference citations from identified publications were reviewed. Both English and Korean languages were included. Two authors extracted primary data elements including poisoning severity, presenting features, clinical management, and outcomes. Results: Thirty two articles including 33 cases were identified. Poisoning severity was classified as 3 mild, 11 moderate, and 19 severe cases. Nine cases were treated with L-carnitine while 24 cases received extracorporeal therapy without L-carnitine. All patients except one expired patient treated with hemodialysis recovered clinically and no adverse effects were noted. A case report comparing two patients who ingested the same amount of valproic acid showed increased ICU stay (3 vs 11 days) in case of delayed extracorporeal therapy. Conclusion: Published evidence comparing L-carnitine with extracorporeal therapy is limited. Based on the available evidence, it is reasonable to consider L-carnitine for patients with acute valproic acid overdose. In case of severe poisoning, extracorporeal therapy would also be considered in the early phase of treatment.

• Proceedings of KOSOMES biannual meeting
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• 2017.11a
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• pp.52-52
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• 2017

• The Korean Journal of Emergency Medical Services
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• v.17 no.2
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• pp.21-28
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• 2013

Purpose : The aim of the study is to compare the effect of cardiopulmonary resuscitation (CPR) with voice and CPR without voice by one rescuer. Methods : Subjects were 26 students in C University who had basic life support certificate for Healthcare Provider. They performed 30:2 CPR for 6 minutes by two groups of CPR with voice and CPR without voice by one rescuer from August 14 to 16, 2012. They performed CPR with Resusci Anne SkillReporter$^{TM}$ and Laerdal PC SkillReporting System Ver. 2.4.1(Laerdal Medical, Norway and recored voice using TES-1350A(TES Electrical Electronic Corp, Taiwan). Between each experiment, 1 day of rest was given, providing enough time to recover from the fatigue of CPR. Results : The depth, rate of chest compression, and ventilation volume were not affected by a voice (p >.05), and the ratio of chest compression to ventilation kept 30:2, when the subject made a sound (p <.05). Conclusion : Making voice during CPR was associated with an accurate ratio of 30:2 and the reduction in hands off time.

• Korean Journal of Occupational Health Nursing
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• v.27 no.1
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• pp.59-66
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• 2018

Purpose: This study aimed to identify the effect of role conflict, self-efficacy, and resilience on the nursing task performance of emergency department (ED) nurses. Methods: Data were collected from 140 ED nurses working in 6 general hospitals, using self-reporting questionnaires. Data were analyzed using SPSS 23.0, and the analyses included descriptive statistics, a t-test, an ANOVA, the Pearson's correlation coefficient test, and a stepwise multiple regression. Results: Nursing task performance differed significantly in terms of the following general characteristics of the participants: age, marital status, total clinical experience, clinical experience in the ED, and position at the hospital. Nursing task performance was positively correlated with role conflict, self-efficacy, and resilience. Self-efficacy, role conflict, clinical experience in the ED, and resilience were significant predictors of nursing performance, and they accounted for 36.9% of the variance. Conclusion: Self-efficacy was identified as the most significant factor affecting the nursing task performance of ED nurses. Therefore, it is necessary to develop programs to improve the self-efficacy of ED nurses.

• Korean Journal of Occupational Health Nursing
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• v.25 no.4
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• pp.268-276
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• 2016

Purpose: The purpose of this study was to identify ego-resilience, self-leadership, stress coping which might influence job satisfaction in ED nurses. Methods: Data were collected by self-reporting questionnaires from 123 nurses in 10 EDs. Data analysis was done with SPSS/WIN 18.0 program. Results: Job satisfaction showed statistically significant differences depending on age, academic background, religion, clinical career, clinical career in emergency department, position, sleeping hour and reason for working. Job satisfaction showed significantly positive correlations with ego-resilience (r=.70, p<.001), self-leadership (r=.46, p<.001) and stress coping (r=.57, p<.001). Ego-resilience (${\beta}$=.54), sleeping hours over 8 hours (${\beta}$=.17) and reason for working (${\beta}$=.17) were significant predictors and accounted for 56.6%. Conclusion: Based on these results, it is needed to develop a program in order to improve ego-resilience of ED nurses.

• Korean Journal of Occupational Health Nursing
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• v.27 no.4
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• pp.215-223
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• 2018

Purpose: This study aimed to identify the effect of job stress, coping behavior, and hardiness on burnout in nurses in the emergency department (ED). Methods: Data were acquired via self-reporting questionnaires from 148 nurses in EDs at one general hospital, four university hospitals, and six hospitals with >200 beds. Data were analyzed using the SPSS 23.0 program through descriptive statistics, t-test, analysis of variance, Pearson's correlation coefficient, and stepwise multiple regression. Results: A statistically significant difference in burnout was observed with respect to the age of the nurses. Burnout was positively correlated with job stress and wishful thinking and detachment, among coping behaviors, and was negatively correlated with hardiness. Job stress and wishful thinking, among coping behaviors, were significant predictors of burnout and were observed in 14.9% of the nurses who experienced burnout. Conclusion: According to our results, job stress was identified as the most significant factor which influenced burnout in ED nurse's. Therefore, it is necessary to develop and implement educational programs for reducing job stress and minimizing the use of wishful thinking as a coping behavior in order to alleviate the burnout in ED nurses.