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Recognition and Request for Medical Direction by 119 Emergency Medical Technicians (119 구급대원들이 지각하는 의료지도의 필요성 인식과 요구도)

  • Park, Joo-Ho
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.3
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    • pp.31-44
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    • 2011
  • Purpose : The purpose of emergency medical services(EMS) is to save human lives and assure the completeness of the body in emergency situations. Those who have been qualified on medical practice to perform such treatment as there is the risk of human life and possibility of major physical and mental injuries that could result from the urgency of time and invasiveness inflicted upon the body. In the emergency medical activities, 119 emergency medical technicians mainly perform the task but they are not able to perform such task independently and they are mandatory to receive medical direction. The purpose of this study is to examine the recognition and request for medical direction by 119 emergency medical technicians in order to provide basic information on the development of medical direction program suitable to the characteristics of EMS as well as for the studies on EMS for the sake of efficient operation of pre-hospital EMS. Method : Questionnaire via e-mail was conducted during July 1-31, 2010 for 675 participants who are emergency medical technicians, nurses and other emergency crews in Gyeongbuk. The effective 171 responses were used for the final analysis. In regards to the emergency medical technicians' scope of responsibilities defined in Attached Form 14, Enforcement regulations of EMS, t-test analysis was conducted by using the means and standard deviation of the level of request for medical direction on the scope of responsibilities of Level 1 & Level 2 emergency medical technicians as the scale of medical direction request. The general characteristics, experience result, the reason for necessity, emergency medical technicians & medical director request level, medical direction method, the place of work of the medical director, feedback content and improvement plan request level were analyzed through frequency and percentage. The level of experience in medical direction and necessity were analyzed through ${\chi}^2$ test. Results : In regards to the medical direction experience per qualification, the experience was the highest with 53.3% for Level 1 emergency medical technicians and 80.3% responded that experience was helpful. As for the recognition on the necessity of medical direction, 71.3% responded as "necessary" and it turned out to be the highest of 76.9% in nurses. As for the reason for responding "necessary", the reason for reducing the risk and side-effects from EMS for patients was the largest(75.4%), and the reason of EMS delay due to the request of medical direction was the highest(71.4%) for the reason for responding "not necessary". In regards to the request level of the task scope of emergency medical technicians, injection of certain amount of solution during a state of shock was the highest($3.10{\pm}.96$) for Level 1 emergency rescuers, and the endotracheal intubation was the highest($3.12{\pm}1.03$) for nurses, and the sublingual administration of nitroglycerine(NTG) during chest pain was the highest($2.62{\pm}1.02$) for Level 2 emergency medical technicians, and regulation of heartbeat using AED was the highest($2.76{\pm}.99$) for other emergency crews. For the revitalization of medical direction, the improvement in the capability of EMS(78.9%) was requested from emergency crew, and the ability to evaluate the medical state of patient was the highest(80.1%) in the level of request for medical director. The prehospital and direct medical direction was the highest(60.8%) for medical direction method, and the emergency medical facility was the highest(52.0%) for the placement of medical director, and the evaluation of appropriateness of EMS was the highest(66.1%) for the feedback content, and the reinforcement of emergency crew(emergency medical technicians) personnel was the highest(69.0%) for the improvement plan. Conclusion : The medical direction is an important policy in the prehospital EMS activity because 119 emergency medical technicians agreed the necessity of medical direction and over 80% of those who experienced medical direction said it was helpful. In addition, the simulation training program using algorithm and case study through feedback are necessary in order to enhance the technical capability of ambulance teams on the item of professional EMS with high level of request in the task scope of emergency medical technicians, and recognition of medical direction is the essence of the EMS field. In regards to revitalizing medical direction, the improvement of the task performance capability of 119 emergency medical technicians and medical directors, reinforcement of emergency medical activity personnel, assurance of trust between emergency medical technicians and the emergency physician, and search for professional operation plan of medical direction center are needed to expand the direct medical direction method for possible treatment beforehand through the participation by medical director even at the step in which emergency situation report is received.

Evaluation for School Facility by Disabled Experimental Activity of Middle School Students (장애 체험 활동을 통한 학교 편의시설 접근성 평가)

  • Cho, Jae-Soon;Lee, Jeong-Gyu
    • Journal of Korean Home Economics Education Association
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    • v.19 no.1 s.43
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    • pp.47-64
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    • 2007
  • The purpose of this study was to develop, apply and evaluate the teaching learning plan for disabled experimental activity to evaluate the accessibility of middle school experimental facilities. Three main resources such as 2 hours teaching learning plan for disabled activity, recording sheets and evaluation sheets had been developed. The process plan had been applied 214 senior students in 7 middle schools purposely selected by areas, constructed years, number of stories of school during November to December, 2005. General accessible levels of middle school facilities was somewhat inadequate especially exterior slops, toilets, bowls were the most unaccessible ones. Most of all students had accidents and/or injuries in school environments from minor to major ones. Male Students were more likely than female Students to get injuries. Students experience of accidents and injuries and awareness of inconvenience, danger, needed facilities supported. the result of the accessibility levels evaluated by disabled activities. Students were generally satisfied with and positive to the teaching learning process plan developed and applied in this study. Students had improved critical Perspectives as well as awareness of inaccessible chances in the school facilities through the experimental process. The evaluation as differed by school characteristics and students' interests in disability.

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Structural Relationships Among Factors to Adoption of Telehealth Service (원격의료서비스 수용요인의 구조적 관계 실증연구)

  • Kim, Sung-Soo;Ryu, See-Won
    • Asia pacific journal of information systems
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    • v.21 no.3
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    • pp.71-96
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    • 2011
  • Within the traditional medical delivery system, patients residing in medically vulnerable areas, those with body movement difficulties, and nursing facility residents have had limited access to good healthcare services. However, Information and Communication Technology (ICT) provides us with a convenient and useful means of overcoming distance and time constraints. ICT is integrated with biomedical science and technology in a way that offers a new high-quality medical service. As a result, rapid technological advancement is expected to play a pivotal role bringing about innovation in a wide range of medical service areas, such as medical management, testing, diagnosis, and treatment; offering new and improved healthcare services; and effecting dramatic changes in current medical services. The increase in aging population and chronic diseases has caused an increase in medical expenses. In response to the increasing demand for efficient healthcare services, a telehealth service based on ICT is being emphasized on a global level. Telehealth services have been implemented especially in pilot projects and system development and technological research. With the service about to be implemented in earnest, it is necessary to study its overall acceptance by consumers, which is expected to contribute to the development and activation of a variety of services. In this sense, the study aims at positively examining the structural relationship among the acceptance factors for telehealth services based on the Technology Acceptance Model (TAM). Data were collected by showing audiovisual material on telehealth services to online panels and requesting them to respond to a structured questionnaire sheet, which is known as the information acceleration method. Among the 1,165 adult respondents, 608 valid samples were finally chosen, while the remaining were excluded because of incomplete answers or allotted time overrun. In order to test the reliability and validity of the assessment scale items, we carried out reliability and factor analyses, and in order to explore the causal relation among potential variables, we conducted a structural equation modeling analysis using AMOS 7.0 and SPSS 17.0. The research outcomes are as follows. First, service quality, innovativeness of medical technology, and social influence were shown to affect perceived ease of use and perceived usefulness of the telehealth service, which was statistically significant, and the two factors had a positive impact on willingness to accept the telehealth service. In addition, social influence had a direct, significant effect on intention to use, which is paralleled by the TAM used in previous research on technology acceptance. This shows that the research model proposed in the study effectively explains the acceptance of the telehealth service. Second, the research model reveals that information privacy concerns had a insignificant impact on perceived ease of use of the telehealth service. From this, it can be gathered that the concerns over information protection and security are reduced further due to advancements in information technology compared to the initial period in the information technology industry, and thus the improvement in quality of medical services appeared to ensure that information privacy concerns did not act as a prohibiting factor in the acceptance of the telehealth service. Thus, if other factors have an enormous impact on ease of use and usefulness, concerns over these results in the initial period of technology acceptance may become irrelevant. However, it is clear that users' information privacy concerns, as other studies have revealed, is a major factor affecting technology acceptance. Thus, caution must be exercised while interpreting the result, and further study is required on the issue. Numerous information technologies with outstanding performance and innovativeness often attract few consumers. A revised bill for those urgently in need of telehealth services is about to be approved in the national assembly. As telemedicine is implemented between doctors and patients, a wide range of systems that will improve the quality of healthcare services will be designed. In this sense, the study on the consumer acceptance of telehealth services is meaningful and offers strong academic evidence. Based on the implications, it can be expected to contribute to the activation of telehealth services. Further study is needed to assess the acceptance factors for telehealth services, such as motivation to remain healthy, health care involvement, knowledge on health, and control of health-related behavior, in order to develop unique services according to the categorization of customers based on health factors. In addition, further study may focus on various theoretical cognitive behavior models other than the TAM, such as the health belief model.

A Study on the Characteristics of Humanistic Landscape in Pyongyang Castle through Pictorial Maps in the Late Joseon Dynasty (조선후기 회화식 고지도를 통해 본 평양성의 인문경관 특성)

  • Kim, Mi-Jung;So, Hyun-Su
    • Journal of the Korean Institute of Traditional Landscape Architecture
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    • v.38 no.2
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    • pp.14-30
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    • 2020
  • This study focuses on the fact that pictorial maps in the late Joseon Dynasty were conceptual diagrams with the place names perceived by the people at the time of their production. In this regard, targeting on five pictorial maps, the humanistic landscape characteristics of Pyongyang, which had cultural identities such as a historically old, commercial, and Pungnyu(appreciation for the arts) city, were derived as follows. First, the historic legitimacy of Pyongyang Castle was represented by ritual and religious facilities. They include 'Dangunjeon' and 'Gijagung' related to the nation founder, 'Munmujeong': the remains of Goguryeo, 'Sajikdan' & 'Pyongyanggangdan': the place of the national rites, Hyanggyo and Seowon: education & rite functions, Buddhism and Taoist facilities, 'Yongsindang', 'Sanshindang', and 'Jesindan': folk religion facilities. Gija-related facilities, which became symbols of Pyongyang due to the importance of Small-Sinocentrism and Gija dignity tendency, were distributed throughout Pyongyang Castle though, the facilities related to King Dongmyeong of Goguryeo and the spaces of religion praying for blessings are spread in Bukseong and on the riverside of Daedonggang each. Second, as a Pyongando Province's economic center, Pyongyang's commercial landscape was represented by logistics and transportation facilities. The Daedonggang River, which was in charge of transportation functions, had many decks such as 'Yangmyeongpo', 'Cheongryongpo' and 'Waeseongjin' and bridges, such as 'Yeongjegyo' and 'Gangdonggyo', which connected major transportation routes. The road network was created in Oeseong area to facilitate logistics transportation and management, and many warehouses named after the jurisdiction of Pyongyangbu were distributed near the roads and Provincial Offices of the main gates. In addition, it was characterized by the urban area systematically divided with hierarchical roads, 'Bukjangnim' of willow trees planted on the main entrance roads of Pyongyang Castle, a linear landscape created by 'Simnijangnim' consisting of mixed forests with elm trees. Third, Pungnyu City is realized by the distribution of amusement facilities. The riverside of Daedonggang adjacent to Naeseong exhibits characteristics of artificial landscape such as a canal leading to the inside of the castle, a docking facility with embankments, and a port with cargo ships anchored. However, Bukseong of the natural surroundings had numerous pavilions and platforms such as 'Bubyeongnu', 'Eulmildae', 'Choeseungdae', 'Jebyeokjeong' and engraved letters such as 'Cheongnyubyeok', 'Jangbangho'. 'Osunjeong', 'Byeogwolji', 'Banwolji' near 'Sachang', and 'Aeryeondang', built on the island of a square pond, created waterscape in Naeseong invisible from the Daedonggang, and for practical purposes, ponds and repeated willow vegetation landscape related to Gija were placed in the western rampart of Jungseong. In addition, 'Seonyeondong', a cemetery of Gisaeng, located near by Chilseongmun, was used as poem titles and themes by literary people, contributing to the creation of the Pungnyu image of Pyongyang.

The Present State and Curriculum Implementation Overview of the Nursing-Specialized Vocational High Schools (특성화고등학교 간호과 운영 현황 및 교육과정 운영실태 분석)

  • Yoon, In-Kyung;Jang, Myung-Hee;Lee, Hyun-Young
    • Journal of vocational education research
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    • v.35 no.4
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    • pp.19-46
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    • 2016
  • The purpose of this study is to analyze the curriculum implementation of the Nursing-Specialized Vocational High School by researching on operation, organization and environment of the program of Nursing. This study aims to improve the curriculum of the Nursing-Specialized Vocational High School. This study has analyzed previous existing studies, Link of School info, Educational Statistics and data indicating establishment, operation and curriculum of the department of Nursing which have been collected from web sites of institutions and associations relevant to Nurse Education. The major results of this study are as follows: 1) As of the first semester of the year 2016, out of a total of thirty eight Specialized Vocational High Schools and Meister High Schools in the country, 6.4% of the schools have nursing educational programs. These schools have established the programs under various names, such as Health Nursing, Dental Health Nursing, Nursing, Nursing and Medical Tourism, Accounting in Nursing and Nursing Management, etc. Since 2012, enrollment rates have increased while post-graduation employment rates have decreased, with the average employment rate of Specialized Vocational High School graduates having reached up to 46% by 2015. 2) The Nursing-Specialized Vocational High School aims to create skilled Nurses Assistant such as Nurse Aide and Care giver. The program is successful in providing necessary courses to acquire required certification and proficient field experience but requires revisional changes in order to create a long-term program of sufficient qualification. The official requirement of 780 hours of field practice was completed during the three educational breaks from the first year of high school to the second year, while the curriculum was conducted separately in the field hospitals. 3) An average of two laboratory classrooms were available based on the facility requirement standard of Cities and Provinces Educational Policies. In order to secure proficient instructors of Nursing education, establishment of specific indicated subjects, regional placement, in-service education, research and supervision are essential for establishing excellence and continual improvement.