• 제목/요약/키워드: Quality of Medical Services

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응급구조과 학생의 죽음에 관한 의식 (The Death Orientation of Paramedic Student)

  • 이정은;고봉연
    • 한국응급구조학회지
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    • 제15권3호
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    • pp.45-55
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    • 2011
  • Objective : The purpose of this study was to investigate the perception of death in paramedic student. The results of this study will help develop education program for death orientation, paramedic students education and practice. Methods : A total of 201 paramedic students filled out the questionnaire. The perception of death was examined using questionnaires designed for examining Death Orientation. The data were analyzed with SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, t-test, ANOVA, cronbach alpha coefficient, factor analysis. cronbach alpha coefficient was .866. Results : The paramedic students' got a score of $2.35({\pm}.48)$ on the Orientation on death as average. The reason is that death is not yet pressing them at all and ahead of their lives they have many days to live. With respect to the Death Orientation, significant differences was found in experience of death(t=2.318, p=.021). Group of death experience was higher than group of no death experience. In view of the attitude on afterlife, students responded no afterlife(24.9%), unknown after death(22.4%). Conclusion : The results of this study suggest that paramedic curriculum should include education program on death and improve quality of prehospital care. Additional studies are needed to establish death education for paramedic.

A Systematic Review of the Mechanical CPR and Manual CPR on Out-of-Hospital Cardiac Arrest Occurring in High-rise Building

  • ChanHo, Lee;ByounGgil, Yoon;HongBeom, Ahn;YongSeok, Kim
    • International Journal of Advanced Culture Technology
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    • 제10권4호
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    • pp.434-443
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    • 2022
  • CPR in High-rise building is one of the challenging tasks to 119 paramedics, evacuating patient from the narrow and vertical area. This study was built to compare the method of mechanical CPR and manual CPR is to maximizing on-scene treatment time, and minimizing the hand-off time in cardiac arrest, transporting patient as fast as possible. The electronic data research (Science, Pubmed, Medline, Medline and 55 academic DB interworking) was conducted, and five articles were included by reviewing and excluding through the Covidence program and Review Manager version 5.4(Cochrane Collaboration). OHCA occurring on the higher floor indicates lower in survival. A total studies uniformly reported mechanical CPR is more effective during the high-rise building evacuation, than manual CPR in rate, depth, and hands-on time of chest compression. Use of mechanical CPR device is more suitable in case of High-rise building OHCA to improve the survival rate which is affected by high-quality CPR.

목소리를 동반한 가슴압박이 심폐소생술에 미치는 영향 (The effect of chest compression with voice on cardiopulmonary resuscitation)

  • 장문순
    • 한국응급구조학회지
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    • 제17권2호
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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.

슬관절 전치환술 환자의 조기퇴원 후 가정간호 운동 프로그램이 슬관절기능 상태와 삶의 질에 미치는 효과 (The Effects of Home Care Exercise Program on Knee Joint Function and Quality of Life in Patients with Total Knee Replacement Arthroplasty)

  • 이미경;이인희;주정혜;황문숙;서재곤;성영희
    • 근관절건강학회지
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    • 제12권2호
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    • pp.143-154
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    • 2005
  • Purpose: The aim of this study was to investigate the effects of home care exercise program on knee joint function(WOMAC) and the quality of life in patient with total knee replacement arthroplasty. Method: Forty-one subjects were sampled according to research criteria, and divided into two groups : 21 out of experimental group and 20 out of control group. The patients having treatment of total knee replacement arthroplasty were out of the hospital. After surgery executed, it took 8days for them to recovere their health conditions since 10th day, the experimental group received the home care exercise program per regularly four days interval. Results: 1) After applying home care exercise program, the total score on the WOMAC Index for the control group was $3.09{\pm}.76$. The score of the experimental group was $3.55{\pm}.55$ which is statistically higher than that of the control group. (P=.007). 2) After applying home care exercise program, the score of the quality of life for the control group was $3.09{\pm}.50$. The score of the experimental group was $3.46{\pm}.35$ Which is statistically higher than that of the control group. (P=.007). Conclusion: This figures show that home care exercise program has good results. These findings also indicate that the services of home care exercise program are alternatives for the hospitalization.

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병원 내 심폐소생술의 자세별 피로도와 가슴압박 정확도 비교 분석 (Comparative analysis of cardiopulmonary resuscitation accuracy and fatigue by posture in hospitals)

  • 조기화;윤종근
    • 한국응급구조학회지
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    • 제25권3호
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    • pp.179-188
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    • 2021
  • Purpose: This study aimed to identify effective cardiopulmonary resuscitation methods by comparing the fatigue of rescuers according to various positions in cardiopulmonary resuscitation situations conducted on beds in hospitals. Methods: An experimental study of students in the department of emergency medical service in H University, G Metropolitan City was conducted in four positions for applying chest pressure on mannequins on beds. Results: As a result of measuring the muscle fatigue of four muscle attachments according to the four positions conducted on the bed, the average was 3.4%, the P was significant at 0.001, and the fatigue difference was confirmed to occur depending on the attachment. An analysis of pressure depth by pose revealed that P1, P2, P3, and P4 have a depth of 58.3, 55.1, 56.4, and 56.3 mm, respectively, with P4 having the deepest depth. Conclusion: Among the various postures of the rescuer during cardiopulmonary resuscitation performed on the bed in the hospital, P1 is thought to be the most tiring, although its associated CPR quality is good.

3인 CPR 프로토콜 개발 및 타당도 검증 (Development and validation of a three-person cardiopulmonary resuscitation protocol)

  • 한승우;강민주;박주호
    • 한국응급구조학회지
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    • 제26권1호
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    • pp.139-150
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    • 2022
  • Purpose: This protocol aims to improve the simplicity of the existing two-person cardiopulmonary resuscitation (CPR) by focusing on chest compressions and artificial respiration, and classifying the roles within the scope that can be observed. Methods: In this study, the protocol was developed by forming an expert group consisting of a professor from the emergency and rescue department, a professor from the nursing department, and a first aid officer from the fire department. In addition, if the number of panels is 15 and the derived content validity ratio (CVR) value exceeds 0.49, a reference point that satisfies content validity at 95% reliability is presented. Results: All 11 performance items exceeded the CVR value of 0.49 to meet the reference point, and the CVR range of this protocol is 0.625 to 1.000. Conclusion: In order to improve the quality of three-person CPR, verification of simulation models and continuous protocol revision should be conducted by individuals specializing in various fields.

소방 119구급대원에 의해 시행된 전문기도관리 현황 및 법적 고찰 (The current status and legal review of advanced airway management implemented by 119 EMTs)

  • 박시은
    • 한국응급구조학회지
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    • 제25권2호
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    • pp.169-186
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    • 2021
  • Purpose: This study aimed to analyze the data from public information disclosure about pre-hospital advanced airway management and identify the problem by considering domestic laws and guidelines. Methods: Data were collected between 2017 and 2018 and analyzed using SPSS 25.0. Then, the problems of the analysis results based on the relevant laws and practical guidelines were reviewed. Results: The review of domestic laws and practice guidelines revealed that ambulance nurses can implement supraglottic airway device only under the following three conditions: ① smart advanced life support pilot project area, ② trained to insert I-Gel, and ③ member of a special ambulance. In total, 21,574 cases of advanced airway management (endotracheal intubation: 2,428, I-Gel: 18,502, LMA : 499, KING AIRWAY: 144) were reported. In many cases, advanced airway management was performed by ambulance nurses who did not meet the above conditions, which was in violation of laws and guidelines. In addition, the prognosis of intubated patients was not followed up. Conclusion: The Korea National Fire Agency must stop all unlicensed medical practice by untrained, uneducated, and uncertified nurses and demand quality control programs for intubated patients.

병원 의사결정지원시스템의 서비스 품질이 경영성과에 미치는 영향 : K대병원 사례 중심으로 (A Study on the Effects of the Service Quality of Hospital's Decision Support System on Management Performance : the Case of K-University Hospital)

  • 박진희;권두순;이미영
    • Journal of Information Technology Applications and Management
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    • 제21권2호
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    • pp.81-98
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    • 2014
  • Recently, due to external environment like the changes in health policy and various healthcare accreditations, along with hospital's internal efforts to improve the quality of medical services, demands for the development of medical information systems are increasing. Some examples are clinical information like DUR (Drug Utilization Review), CVR (Critical Value Report), and automatic benefit processing by treatment purposes, or hospital DSS (Decision Support System) on overall medical practice. Such systems act as a guide in making clinic judgments during practice or in other medical practice, and their effects on the medical treatment improvements are being proven by previous studies. In the reality of increasing attention in the effects of medical treatment improvement, studies related to hospital DDS were mostly focused on clinical, technical, and engineering points of view, and studies focusing on the user viewpoint are very limited. In order to verify the effects of DSS on practice improvements and hospital's management performance, this study used a research model constructed to verify how SERVQUAL of hospital DSS affects hospital management performance in BSC (Balanced Score Card) point of view. To empirically verify the research model, a questionnaire was conducted on the basis of "K-University Hospital's DSS" on clinicians and hospital employees related to system development, and the relationships between the factors were analyzed through path analysis. As a result of path analysis, excluding reactivity, tangibility, confidence, reliability, empathy among service qualities, had partially significant effects on management performance factors (learning and growth, internal process, financial affairs). This study is to prepare the theoretical ground on the management performance analysis of hospital DSS, and suggest the service quality of the system that should be considered in the planning and development stages for improved system.

문재인 정부의 건강보험 보장성 강화대책 (Moon Jae-in Government's Plan for Benefit Expansion in National Health Insurance)

  • 박은철
    • 보건행정학회지
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    • 제27권3호
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    • pp.191-198
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    • 2017
  • Moon Jae-in Government announced the Government's 5-Year Plan on July 19, 2017, President Moon directly announced the Government's Plan for Benefit Expansion in National Health Insurance on August 7, 2017. The main contents of the announced expansion include benefit coverage for all medically necessary services with control over non-covered service occurrence, a decrease in the cost-sharing upper limit, and monetary support for catastrophic medical costs. Although past governments have been continuously striving for benefit expansion in the last 15 years, this plan has its breakthrough aspect in that all medical services will be covered by the National Health Insurance. In alignment, there are important tasks to solve: attaining a proper fee schedule, reforming the healthcare delivery system, and improving healthcare quality. This plan is a symptom oriented action in that it is limited in reducing patients' out-of-pocket money, unlike the systematic approach of the National Health Insurance. The sustainability of the National Health Insurance is being threatened due to South Korea's low birth rate, rapidly aging society, and low economic growth, in addition to the unification issue of the Korean Peninsula, medical utilization of the elderly, management of non-communicable diseases, and so on. Therefore, the Government needs to plan the National Health Insurance system reformation including actions addressed toward medical consumers.

Studying the Amount of Depression and its Role in Predicting the Quality of Life of Women with Breast Cancer

  • Shakeri, Jalal;Golshani, Sanobar;Jalilian, Elham;Farnia, Vahid;Nooripour, Roghieh;Alikhani, Mostafa;Yaghoobi, Kianoosh
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권2호
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    • pp.643-646
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    • 2016
  • Background: Depression is the most common psychological reactions in women with breast cancer. This study aimed at investigating the amount of depression and its role in predicting the quality of life of women suffering from breast cancer. Materials and Methods: The present descriptive study in volved a correlation method with 98 women living in Kermanshah-Iran with breast cancer. According to the access to the patients and the condition of conducting the research, they were chosen by available sampling. Life quality inventory (World Health Organization, 1989) and depression inventory (Beck et al., 2000) were used to gather the data. Moreover, to analyze the relationships among the variables correlation analysis with Pearson method, as well as multiple regression with the enter method and frequency analysis were applied. Results: The findings revealed that not only is depression high, but also there is a negative significant relationship between depression and the quality of life, with predictive potential. Conclusions: The finding of a relationship between depression and the quality of life points to the need for addressing psychological problems of the affected individuals more appropriately. It is suggested that we consider psychological and educational services for patients in treatment planning to make people aware of different psychological aspects of their disease and ways of struggling and overcoming the problems.