Purpose: The purpose of this study was to report the treatment results of patients with traumatic cardiac tamponade after the opening of Jeju Regional Trauma Center. Methods: We analyzed the treatment outcomes of patients with traumatic cardiac tamponade who were treated at Jeju Regional Trauma Center from January 2018 to August 2022. Results: Seven patients with traumatic cardiac tamponade were treated. The male to female ratio was 1.33:1 (four male and three female patients) and the average age was 60.3±7.2 years. The mechanism of injury was blunt trauma in six cases and penetrating injury in one case. Upon arrival at the emergency department, pericardiostomy was performed in four cases, and an emergency operation was performed in six cases. Pericardiostomy alone was performed in one patient, who had cardiac tamponade due to extrapericardial suprahepatic inferior vena cava rupture. The causes of cardiac tamponade were right atrium appendage rupture in one case, right ventricle rupture in one case, inferior vena cava rupture in two cases, right atrium and left atrium rupture in one case, both atria and left ventricle rupture in one case, and intercostal artery rupture in one case. In three cases, intraoperative cardiopulmonary bypass was required. Two of the seven patients died (mortality rate, 28.5%). Conclusions: Relatively favorable treatment results were observed for traumatic cardiac tamponade patients after Jeju Regional Trauma Center was established.
Purpose: The purpose of this study was to analyze the content of nursing interventions applied to patients with thoracic injury who visited a trauma emergency room (TER) or an emergency room (ER). Methods: Of 3,938 trauma patients admitted to this hospital between January 1, 2019 and December 31, 2020, 320 adult patients with thoracic injury (94 to TER, 226 to ER) who met the inclusion criteria were enrolled. Patients' data were acquired from their electronic medical records. General and clinical characteristics of these subjects along with nursing interventions were analyzed. Results: There were statistically significant differences in the length of stay, treatment outcome, and level of consciousness between thoracic injury patients who visited TER and ER. Average thoracic Abbreviated Injury Scale score and average Injury Severity Score of thoracic injury patients who visited TER were 3.13 and 13.54, respectively, which were significantly higher than those of patients who visited ER. The numbers of nursing actions applied was 4,819 for TER and 3,944 for ER, which were classified into five domains, 18 classes, and 56 interventions. The most domain of interventions carried out in both TER and ER was physiological: complex. Classes including Crisis management and Thermoregulation were not carried out in ER. On average, 16 more types of interventions were carried out in TER than in ER. Conclusion: This study demonstrated characteristics of thoracic injury patients and nursing interventions by emergency room type. Based on results of this study, standardized nursing interventions need be applied to thoracic injury patients visiting TER and ER.
Purpose: This study was conducted to identify the influence of trauma experiences and social adjustment on health-related quality of life in North Korean defectors. Methods: The subjects were 117 North Korean defectors living in B and Y city. The data were collected from September 1 to September 20, 2014, and analyzed by the SPSS/WIN 18.0 program. Results: Significant differences were found in the health-related quality of life with respect to the subjects' education, marriage status, types of dwelling, family types, duration of residence in South Korea, jobs in South Korea and in North Korea, families left in North Korea or other surrounding countries, and subjective health status. Health-related quality of life is negatively related to trauma experiences during escape from North Korea and during their life in South Korea. Health-related quality of life positively is related to social adjustment. The meaningful variables which influenced the subjects'health-related quality include social adjustment, job in South Korea, job in North Korea, current family structure, and trauma experiences in South Korea. Total explanatory power of these factors for health-related quality in North Korean Defectors is 43.0% and social adjustment is the most influential factor. Conclusion: Therefore, in order to enhance health-related quality of life in North Korean defectors, it is necessary for them to increase social adjustment and decrease trauma experiences. In addition, methods are needed to provide job opportunities, better education and family services for North Korean defectors.
Purpose: The purpose of this study was to find stress mediation strategies for pandemic task forces in the future by identifying role stress experienced by local officials in public health centers working as COVID-19 response task force. Whether they suffered from trauma and post-traumatic stress disorder (PTSD) due to COVID-19 was also determined. Methods: Subjects for this research were 185 public health center workers in 7 northern Gyeonggi cities with at least three months of COVID-19 response task force experience. The investigation lasted for two months, from February to March of 2021. Data were collected using a self-administered questionnaire. Results: The average role stress of research subjects was 2.79±0.60. There were 64 subjects (34.6%) who answered 'yes' for trauma experience due to COVID-19. Subjects' role stress by sociodemographic and role characteristics displayed statistically significant differences in gender (t = -2.74, p= .007), age (F = 6.41, p= .002), profession (F = 0.01, p= .014), and COVID-19 response task (F= 3.01, p= .019). Specifically, role stress was higher for females than for males, those who were in their 20's (than 40's), a nursing profession (rather than others). Role stress was also higher in COVID-19 confirmed response work or in a self-quarantine work. There was a significant difference in trauma according to COVID-19 response roles (χ2 = 26.59, p= < .001) and other tasks given or not (χ2= 9.48, p= .002). Conclusion: It is necessary to take measures to reduce COVID-19 response task force's role stress and trauma.
The purpose of this study is to identify the educational status, e,ducation needs and competencies of nurses in the regional trauma intensive care unit. The questionnaires were collected from 123 nurses from 5 hospitals in the regional intensive Care Unit trauma. Data collection consisted of the education importance and needs of the nurses in the intensive Care Unit nurses and the competence of nurses. The analysis was analyzed by descriptive analysis, t-test, and one-way ANOVA, Pearson correlation using the SPSS 21.0 program. The results showed that 78.9% had experience in trauma-intensive care nursing. In the case of the importance of trauma education, 'attitud'e was 3.64, followed by 'knowledge' was 3.52 and 'skill' was 3.47. In the analysis of the educational needs of the trauma service, 'knowledge' was highest at 3.18, 'attitude' was 3.05, and 'skill' was 2.97. The nurses' ethical competence was the highest with 3.62, followed by aesthetic competence was 3.53, personal competence was 3.39, and scientific competence was 3.37. In conclusion, it is necessary to focus on the standardized curriculum and practice-oriented education development of trauma nursing education at the present time and applicable. In addition, it is necessary to seek strategies for enhancing the professionalism and nursing competence of the trauma intensive care unit nurse.
Purpose: The purpose of this study was to construct and test a hypothetical model about impact of parents' problem drinking on suicidal ideation of their children who are university students and the multiple mediating effects of childhood trauma, experiential avoidance, and depression based on stress-vulnerability model. Methods: A purposive sample of 400 university students was recruited from three universities in provincial areas and the data were collected between October and November 2016. The collected data were then analyzed using SPSS 20.0 and AMOS 20.0 programs. For data analysis, descriptive statistics, factor analysis, and structural equation modeling were performed. Multiple mediating effects analysis using phantom variable and bootstrapping were implemented to verify the mediating effect of the research model. Results: We found no significant direct effect on depression and suicidal ideation of parents' problem drinking, but multiple mediating effects of childhood trauma and experiential avoidance between parents' problem drinking and depression (B=.38, p=.001). The path from parents' problem drinking to suicidal ideation was significantly mediated by childhood trauma and depression (B=.02, p=.016) and by childhood trauma, experiential avoidance, and depression (B=.05, p=.011), but experiential avoidance did not have a significant direct effect on suicidal ideation (B=.02, p=.616). Conclusions: Based on the results of this study, it can be suggested that in order to decrease depression and prevent suicide of university students, considering of parents' problem drinking and childhood trauma, intervention methods that decreased chronic use of experiential avoidance and strengthen acceptance should be developed and made available to them.
This study was conducted to identify the domains of the competencies of trauma nursing through a scoping review using the JBI(Joanna Briggs Institute) methodology. The keywords are trauma, $nurs^*$, $competenc^*$, $role^*$, attitude, and knowledge and skill. The review used information from six databases: CINAHL, Pubmed, ProQuest, Web of Science, Scopus, and ERIC. Inclusion and exclusion criteria were identified as strategies to use in this review. 8 studies were eligible for result extraction, as they listed domains of the competencies. These domains among studies were analyzed based on Trauma Care System and Lenburg's COPA(Competency Outcomes and Performance Assessment) model. Domains in 'Prehospital care & transport', 'Hospital care' and 'Rehabilitation' of Trauma Care System were present, but no domain in 'Injury prevention' was.
Purpose : The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients. Methods : This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC). Results : Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson). Conclusion : The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.
Purpose: This study was conducted to status and needs for continuing education for trauma hospital nurses in Korea. Methods: Thirty nurses from the seven level I trauma center hospitals or trauma treatment systems were randomly selected and surveyed. The survey was conducted from March 1 to May 31, 2017. Categorical data were analyzed with Pearson chi-square tests and Continuous variables were analyzed with ANOVA. Results: Only 86 out of 204 nurses had received continuing education (42.1%). The current status of continuing education programs, delivering institution (p<0.001), education method (p<0.001), education period (p=0.003), number of participants (p=0.007), and instructors (p=0.014) were also significantly different from trauma center to trauma center. There were 108 (52.9%) nurses who responded that continuing education programs were "needed" 92 (45.1%) and "very much needed 16 (7.8%). According to each trauma center's characteristics were significantly differences in the need for continuing education (p=0.089), subject selection method (p<0.001) and the number of continuing education sessions (p=0.043) depending on the hospital. Conclusions: It is necessary to consider differences between the hospitals to develop continuing education programs that reflect the needs of nurses, in order to improve the efficiency of and satisfaction with the educational programs.
Journal of The Korea Institute of Healthcare Architecture
/
v.23
no.3
/
pp.81-90
/
2017
Purpose: The regional trauma center should be a trauma treatment center equipped with facilities, equipment, and manpower capable of providing optimal treatment such as emergency surgery to a severely traumatized patient upon arrival at the hospital. In order to establish a medical system for effective severe diseases, it is necessary to prepare architectural planning guidelines for the regional trauma centers. Methods:: Analyze the spatial configuration, and the area composition of the regional trauma center, And to provide basic data for building a more efficient regional trauma center. The spatial composition analysis divides the space into initial care, resuscitation, patient area, nursing area, diagnostic test, staff training, staff support, public, and analyzes the area and interconnection of each space. Results: The area that must be included in the regional trauma center is the resuscitation area, the patient area, the diagnostic examination area, architectural planning should be designed to enhance the interconnection of the areas. IIn addition, a regional trauma center should be planned as a separate from the existing facility so that it can be installed and operated independently. Implications: A regional trauma center should be built as a stand alone operation and the space should be planned as a more efficient route.
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