• The Korean Journal of Health Service Management
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• v.10 no.1
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• pp.39-51
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• 2016

Objectives : This study investigated the health care utilization patterns of workers' compensation insurance(WCI) pneumoconiosis patients with excessively long hospital stays. Methods : The discharge summary data of 3,094 WCI pneumoconiosis patients were analyzed. The study sample was divided into 3 groups based on the length of stay(LOS). Health care utilization patterns were compared among the groups with logistic regression analysis, and the LOS determinants were identified with linear regression analysis. Results : The average LOS of the 222 long stay group patients was 1,448 days. Patients in this group tended to use private general hospitals, were admitted through the emergency room and discharged without the consent of a doctor. Conclusions : Many of the long LOS patients will maintain their inpatient status for the rest of their lives. For quality of life and efficient use of health care resources, policy makers need to establish a policy that enables patients to receive outpatient care in appropriate living conditions outside the hospital.

• The Korean Journal of Health Service Management
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• v.12 no.1
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• pp.47-56
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• 2018

Objectives : The purpose of this study was to compare the characteristics of nursing work environments based on department type and to investigate the relationship between work environment and job satisfaction. Methods : The participants were 420 nurses from the ward, emergency room, intensive care unit, and operation room. The data were analyzed by descriptive statistics, ANOVA, Scheffe's test, and multiple regression test using the SPSS Win. 18.0 program. Results : The results were as follows: There was a significant difference in possibilities for development, meaning of work, recognition(reward), role clarity, and social community at work based on department type. The factors that influenced job satisfaction were influence, meaning of work, recognition(reward), role conflicts, and quality of leadership and these differed based on department type. Conclusions : The results of this study indicate that nursing work environments vary based on the type of hospital department. Therefore, it is necessary to develop diverse strategies for human resource management considering the type of department.

• Journal of The Korea Institute of Healthcare Architecture
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• v.24 no.2
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• pp.27-36
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• 2018

Purpose: In the case of mass disaster, the establishment of temporary medical facilities for the first aid and treatment is required for the stable accommodation of patients caused by the disaster. However, the criteria for decision making related to the deployment of field emergency medical facilities are not specified. So, The purpose of this study is to draw considerable factors needed for the deployment of field emergency medical facilities and to make proposal for site selection process of field emergency medical facilities on the basis of the factor. Methods: This study performs text mining of disaster-related laws, guidelines and documents to derive key factors affecting site selection, also proposes a decision making process and conducts virtual deployment to validate the process. Results: The key factors for the site selection derived as the size of the damage, the size of the DMAT inputs, the location of available place, and distance to the disaster base hospital. As a result of virtual deployment following proposed decision making process, It is confirmed that the site of field emergency medical facilities is changed depending on the type of disaster, even if the scope of the disaster damage was the same. Implications: The deployment of field emergency medical facilities requires a separate criteria for each type of disaster, not uniform, as a future research a quantitative approach of the criteria needs to be performed.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.1
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• pp.66-73
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• 2011

Purpose: The purpose of this study was to demonstrate effects of a critical pathway (CP) for stroke patients seen in emergency rooms (ER). Method: The CP developed by the CP committee consisted of 8 criteria: behavior of doctors and nurses, laboratory tests, Image testing, medication, treatment, activity, and nutrition. According to application of CP, a control group (n=17) and experimental group (n=17) were defined. Time was checked by the electronic medical records. Result: Use of CP for stroke patients in the ER, resulted in a decreased length of stay in ER (t=2.341, p=.026), and time required for image testing (t=2.623, p=.021), and an increased number of patients using rtPA ($x^2$=4.802, p=.049). Time required for neurology doctor contact, for neurology doctor to see patient in the ER, and for report of blood tests decreased, but there were no statistical significance. Conclusion: Quick responses are most important in the ER, so CP for these patients is a very effective patient management tool. To reduce delay in stroke diagnosis, continuous education programs for similar symptoms are necessary. CPs for other patients in the ER should be developed, and studies on cost and satisfaction, as well as length of stay, should be done.

• Quality Improvement in Health Care
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• v.27 no.1
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• pp.10-19
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• 2021

Purpose: This study was designed to investigate that the prevalence of Post-traumatic stress disorder (PTSD) and occupational environmental factors that contribute to the developing of PTSD in workers who worked in emergency room in Korea. Methods: This study is a multicenter cross-sectional study that was conducted in three emergency rooms. Data was collected by self-response method through questionnaire. The Impact Event Scale-Revised was used to screen the high-risk group of PTSD. Univariate and multivariate regression analysis was used to identify the factors associated with the developing of high-risk group of PTSD. Results: Total 211 subjects responded to the questionnaire. Of these, 170 subjects experienced psychological trauma event (PTE) in the working environment. And 60 subjects classified as high risk group of PTSD, so a prevalence of high risk group for PTSD was 28.4%. Factors related to the high risk group of PTSD were the frequency of psychological trauma events experienced over the past 1 year and the high score of QIDS-SR16. Conclusion: The prevalence of high risk group for PTSD among emergency room workers in Korea is very high. This may adversely affect the safety of patients, so early screening and intervention are necessary.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.481-494
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• 2003

Purpose: This study was to develop nursing competencies, sub-competencies and behavior indicators according to the clinical ladder of emergency nurses. Method: index of content validation was used by 21 clinical experts. Results: This study had three phases to develop nursing competencies, sub-competencies and behavior indicators. In first phase: 12 nursing competencies and 33 sub-competencies were developed through the literature review on nursing competency and emergency nurses' job description. The content of 12 competencies and 33 sub-competencies were reviewed by 3 nursing professors. The 12 competencies and 33 sub-competencies were followed: clinical judgement and measures(6 sub-competencies), processing ability of ward works(2 sub-competencies), flexibility(2 sub-competencies), resources management(2 sub-competencies), confidence(3 sub-competencies), cooperation(2 sub-competencies), professional development power(2 sub-competencies), patient service orientation(3 sub-competencies), inclination toward ethical value(5 sub-competencies), influence power(2 sub-competencies), developing others(2 sub-competencies), self control(2 sub-competencies). In second phase, 132 behavior indicators were developed according to nurse clinical ladder: novice, advanced novice, competent, proficient. In Third phase, content validity was examined on 132 behavior indicators by 21 clinical experts. 126 among 132 indicators had over 70% agreement among experts and 6 indicators under 70% were revised. Conclusion: nursing competencies, sub competencies and behavior indicators can be used nurses' clinical performance as well as establishing proper directions for professional growth related to reward system.

• Journal of the Korea Convergence Society
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• v.3 no.4
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• pp.23-28
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• 2012

The aim of this study is to reveal the right approach and prognosis of cerebrovascular accident (CVA) by reviewing the various researches on CVAs. The reviews were done by BNBI PubMed, KMBase, RISS, and KoreaMed. Based on the articles, prevalence rate of CVA, prehospital CVA patients assessment and emergency care, and in-hospital care were analyzed. The most important scales are Cincinnati prehospital stroke scale(CPSS) and Los Angeles prehospital stroke screen(LAPSS). These two scales are the basic assessment tools for CVAs and it is necessary to perform the emergency care by way of these scales.

• The Korean Journal of Emergency Medical Services
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• v.22 no.3
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• pp.163-176
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• 2018

Purpose: The purpose of this study was to determine the effectiveness of hands-only CPR education according to the American Heart Association (2015) guideline for undergraduates with severe visual impairment, to provide basic data for expanding the subject of hands-only CPR education among the visually impaired. Methods: Twenty-one students attending four universities in C Province, aged 19 years or older, were enrolled in this study. These students had severe visual impairment and no other disabilities and have never received hands-only CPR education. This study data were collected from December 1, 2017 to January 11, 2018. The accuracy of the participants' technique was measured using Brayden Pro CPR manikin. The data were analyzed using SPSS version 24.0. Results: Hands-only CPR education was effective in increasing confidence and accuracy of chest compression among undergraduates with severe visual impairment. Conclusion: These findings suggest that individuals with severe visual impairment should be given more educational opportunities. Additionally, subsequent studies should develop equipment that helps increase accuracy by using video aids with commentary or other auditory components for the visually impaired.

• Journal of Veterinary Clinics
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• v.31 no.2
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• pp.90-94
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• 2014

This study was performed to investigate on the frequent chief complaints and the causes of dogs and cats visiting to an emergency department, and to suggest the minimum requirements for veterinary emergency clinics in South Korea. The medical records were reviewed for 2,368 dogs and 347 cats visiting the emergency department of Haemaru Referral Animal Hospital from March 2012 to August 2013. Among them, 255 dogs and 35 cats visited more than one time and each visit was considered as an individual case. Therefore, 2,784 cases of dogs and 396 cases of cats were reviewed. The medical records were analyzed according to the criteria such as signalment, chief complaints, diagnoses, hospital admission, and outcome. In dogs, vomiting, diarrhea, or both were the most common chief complaints, followed by dyspnea, trauma, seizure, and lethargy. The most common causes of emergency visits were gastrointestinal disorders, followed by neurologic, cardiovascular, respiratory, urologic, and hematologic disorders. In cats, dyspnea was the most common chief complaint, followed by vomiting, diarrhea, or both, trauma, dysuria, and lethargy. The most common causes of emergency visits were urologic disorders followed by gastrointestinal, respiratory, infectious, and cardiovascular disorders. According to the results, vomiting, diarrhea, dyspnea, and trauma were the most frequently encountered chief complaints, which accounted for approximately 48.6% of all cases in both dogs and cats. However common causes were differed between the dogs and the cats. In order to provide proper emergency service, it is required to prepare the clinicians and facilities to diagnose and stabilize these emergency patients.

• Health Policy and Management
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• v.28 no.2
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• pp.168-177
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• 2018

Background: This study investigates the potential volume and outcome association of coronary heart disease (CHD) patients who have undergone percutaneous coronary intervention (PCI) using a large and representative sample. Methods: We used a National Health Insurance Service-Cohort Sample Database from 2002 to 2013 released by the Korean National Health Insurance Service. A total of 8,908 subjects were analyzed. The primary analysis was based on Cox proportional hazards models to examine our hypothesis. Results: After adjusting for confounders, the hazard ratio of thirty-day and 1-year mortality in hospitals with a low volume of CHD patients with PCI was 2.8 and 2.2 times higher (p=0.00) compared to hospitals with a high volume of CHD patients with PCI, respectively. Thirty-day and 1-year mortality of CHD patients with PCI in low-volume hospitals admitted through the emergency room were 3.101 (p=0.00) and 2.8 times higher (p=0.01) than those in high-volume hospitals, respectively. Only 30-day mortality in low-volume hospitals of angina pectoris and myocardial infarction patients with PCI was 5.3 and 2.4 times those in high-volume hospitals with PCI, respectively. Conclusion: Mortality was significantly lower when PCI was performed in a high-volume hospital than in a low-volume hospital. Among patients admitted through the emergency room and diagnosed with angina pectoris, total PCI volume (low vs. high) was associated with significantly greater cardiac mortality risk of CHD patients. Thus, There is a need for better strategic approaches from both clinical and health policy standpoints for treatment of CHD patients.