• 융합정보논문지
• /
• 제10권4호
• /
• pp.98-103
• /
• 2020

본 연구에서는 KTAS(Korean Triage and Acuity Scale) 결과가 분류를 시행한 주체의 직종에 따른 차이가 있는지를 알아보고자 한다. 2016년 1월 1일부터 2017년 12월 31일까지의 응급의료기관으로 내원한 환자 자료 중, 국가응급진료정보망으로 전송된 자료 총 10,960,359건을 분석하였다. 분류자 직종은 전문의, 전공의, 인턴, 일반의, 간호사, 응급구조사였다. 최초 중증도 분류와 최종 중증도 분류 결과의 일치율은 일반의가 98.9%로 가장 높았고, 인턴이 80.2%로 가장 낮았다. 과대 분류에서는 일반의가 0.6%로 가장 낮았고, 인턴은 16.0%로 가장 높았다. 또한 과소 분류는 전문의와 응급구조사가 0.4%로 가장 낮았고, 인턴이 3.8%로 가장 높았다. 중증도 분류 결과는 직종별 유의미한 차이가 있었다(p<0.001). 중증도 분류는 환자의 예후에 영향을 미치는 요인 중 하나로 직종별, 숙련도에 따라 그 결과가 달라져서는 안 된다. 때문에 정확한 중증도 분류를 위한 분류자의 역량 강화가 필요하다.

• 대한간호학회지
• /
• 제49권2호
• /
• pp.171-180
• /
• 2019

Purpose: The Korean Triage and Acuity Scale (KTAS) is a tool used to classify the severity and urgency of emergency department (ED) patients, focusing on their symptoms. In consideration of the importance of the KTAS, a web-based learning program has emerged as a new mode of education; it enables ED triage nurses to access it anytime and anywhere, and according to their own learning abilities. This study aimed to develop a web-based KTAS learning program and evaluate its effects on self-efficacy and triage performance ability in ED nurses. Methods: A quasi-experimental design with a non-equivalent control group pretest-posttest was used. The conceptual framework was Bandura's self-efficacy theory. There were 30 participants in the experimental group and 29 in the control group. The experimental group attended an orientation and 4 sessions of a web-based KTAS learning program. The learning program lasted 280 minutes over five weeks, consisting of 40 minutes of orientation and four 60-minute sessions. Results: The scores of self-efficacy, triage performance ability in KTAS level, and chief complaints significantly increased in the experimental group compared to the control group. In addition, the numbers of under-triage in KTAS significantly decreased in the experimental group in comparison to the control group. Conclusion: The results suggest that the learning program was effective in improving ED nurses' level of self-efficacy and triage performance ability (KTAS level and KTAS chief complaint). Accordingly, the web-based KTAS learning program can be applied as an education intervention to improve ED nurses' triage skill.

• 정보과학회 논문지
• /
• 제44권11호
• /
• pp.1156-1164
• /
• 2017

기존의 버그 담당자 자동 배정 연구들은 대부분 기계학습 알고리즘을 기반으로 예측 시스템을 구축하는 방식이었다. 따라서, 고성능의 기계학습 모델을 적용하는 것이 담당자 자동 배정 시스템 성능의 핵심이 된다고 할 수 있으며 관련 연구에서는 높은 성능을 보이는 SVM, Naive Bayes 등의 기계학습 모델들이 주로 사용되고 있다. 본 논문에서는 기계학습 분야에서 최근 좋은 성능을 보이고 있는 딥 러닝을 버그 담당자 자동 배정에 적용하고 그 성능을 평가한다. 실험 결과, 딥 러닝 기반 Bug Triage 시스템이 활성 개발자 대상 실험에서 48%의 정확도를 달성했으며 이는 기존의 기계학습 대비 최대 69%향상된 결과이다.

• 중환자간호학회지
• /
• 제5권2호
• /
• pp.61-71
• /
• 2012

Purpose: The aim of this study was to measure the inter-rater reliability of Emergency severity index (ESI) version 4 among triage nurse. Methods: This study was carried out from August 11, 2010 to September 7, 2010 in a regional emergency department. Data collection was done by ten triage nurses who trained ESI v.4. Two research nurses and ten triage nurses scored the ESI version 4 to the patients as references, independently. We calculated the weighted kappa between the triage nurses and research nurses to evaluate the consistency of the ESI v.4. Results: A total of 233 patients were enrolled in this study. Classification of ESI level was as follows - level 1 (0.4%), level 2 (21.0%), level 3 (67.8%), level 4 (9.4%), and level 5 (1.3%). Inter-rater reliability by weighted kappa was 0.79 (95% Confidence Interval= 0.74-0.83) and agreement rate was 87.1%. Under-triage rate by triage nurse was 6.0% and over-triage rate was 6.9%. Conclusion: For this study, inter-rater reliability was measured good level between triage nurses and research nurses in Korean single ED.

• Journal of Trauma and Injury
• /
• 제27권4호
• /
• pp.126-132
• /
• 2014

Purpose: The field trauma triage for injured patients is essential for trauma care system. In this study, agreement of patient evaluation between by prehospital EMS personnel and by hospital staffs and the appropriateness of prehospital triage were evaluated. Methods: This observational study was conducted from September to October 2012 for 5 weeks. During this period, EMT evaluated patient's severity according to guideline for field triage and recorded. Same guideline was applied in 26 hospitals for patients with EMS use. Kappa statistics were used to measure agreement for each item of guideline. Finally, over-triage and under-triage rate of EMT were calculated. Results: During study period, total 3,106 patients were transferred to 26 hospital emergency departments with EMS use. Kappa statistics for "vital signs" items were 0.45 for mentality lower than V and 0.44 for systolic blood pressure lower than 90 mmHg as a moderate agreement. In "anatomy of injury" items Kappa statistics were very low. In "mechanism of injury" items Kappa statistics were 0.28 for high-rise fall down and 0.27 for high energy traffic accident but in other items Kappa statistics were very low. 362 patients (12.0%) were over-triaged and 281 patients (9.3%) were under-triaged. Conclusion: Field triage can be applied but need to evaluate and modify in order to become accurate and sensitive for decision of transportation.

• 동서간호학연구지
• /
• 제24권2호
• /
• pp.146-153
• /
• 2018

Purpose: This study aimed to identify characteristics and severity assessed by Korean Triage and Acuity Scale (KTAS) among 2,496 older adults aged 65 and over who visited an emergency department (ED) located in Chuncheon city. Methods: Data were collected via electronic medical records from two hospitals from January to December of 2016. Chi square test and logistic regression were applied using SPSS 22.0. Results: 53.5% of the participants were women and 17.6% of visits were done by aged 85 and older. ED visits by ambulance were 33.9%. More than two-third of older adults' ED visits were emergent status. Severity of the ED visits of older adults were rated by KTAS. Commonly reported chief complaints of the ED visits were dizziness, dyspnea, chest pain, abdominal pain, and hypoalbuminemia. Among them, dizziness, chest pain, dyspnea, and hypoalbuminemia were related factors for being-emergent condition. Conclusion: Strategies for older adults' chief complaints are needed in order to reduce unexpected ED visits.

• 대한간호학회지
• /
• 제49권1호
• /
• pp.26-35
• /
• 2019

Purpose: The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS). Methods: This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value. Results: In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively. Conclusion: The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

• 한국보건간호학회지
• /
• 제32권2호
• /
• pp.304-318
• /
• 2018

Purpose: This study examined the characteristic of the Injury Severity Score (ISS) of Korean geriatric patients with a traumatic injury in a nationally representative sample to determine the optimal cutoff of ISS of mortality according to age. Methods: The subjects were 3,018 non-elderly patients and 1,584 elderly patients with an ISS and Korean Triage and Acuity Scale (KTAS) in 2016 from the data of the Health Insurance Review and Assessment Service. The traumatic characteristics of the elderly and non-elderly were compared by stratifying the ISS. Receiver Operating Characteristic (ROC) curve analysis was used to find the optimal cutoff of ISS of mortality according to age. Results: The elderly were more prone to severe trauma than the non-elderly were. The distribution of KTAS grades was lower, even though the severity of ISS was as high as that of the non-elderly. The optimal cutoff score of the ISS for mortality in the ROC curve was lower in elderly over 65 years than in the other age group. Conclusion: The elderly are more prone to severe trauma and death than non-elderly, even though their ISS is low. Therefore, a strategy to prevent elderly from experiencing serious trauma and managing their geriatric trauma actively is needed.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
• /
• 제26권1호
• /
• pp.7-15
• /
• 2020

Purpose: Emergency room(ER) is the first place to enter a hospital where patients who might have been infected with contagious disease. Therefore, ER should be designed with infection control in mind. Researchers examined hospital ER layouts to identify layout design that support infection control. Methods: This study analyzed the hospital ER layout of Korean and other hospitals abroad. Researchers focused on route of incoming patients who potentially have infectious disease. Crossing of this route with other routes such as for imaging and testing should be avoided for infection control. Results: There were certain hospital ERs with better control of infection related incidents. ER floor plan layout is analyzed about allocation of key functions with movement routes for each role such as patients and medical staff in mind. To identify layout strategies for ER functions researchers simplified the routes in ER into diagrams. Layout options show that bypassing infection suspected routes over other routes is possible. Implications: Hospitals can control infection easier when they adopt strategic ER layout identified in this study.

• 한국병원경영학회지
• /
• 제28권3호
• /
• pp.39-46
• /
• 2023

Purpose: Korean medical services are not balanced across regions and social classes. To prevent mortality gaps, Korea must distribute its medical resources more efficiently. Patient factors affecting emergency room visits serve as basic data for determining best practices for public healthcare distribution. Methods: The data included 18 473 visits by 14 949 de-identified patients who visited a public emergency room over one year. The dependent variable was the number of emergency room visits. A Poisson regression was conducted with the independent variables, comprising sociodemographic, socioeconomic, and spatial accessibility factors and patient characteristics. Results: Older men with higher Korean Triage and Acuity Scale scores visited more frequently. Greater patient-hospital distance decreased visits; however, the presence of a hospital within 1 km of a patient's residence did not affect the number of visits. The use of 119 services was negatively correlated with the number of visits. Visits increased with more medical benefits. Conclusions: Patient age, distance to hospital, use of 119 services, and medical benefits should be considered when planning or managing public hospitals in Korea.