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급성심근경색 환자에서 재관류 치료 지연율과 그에 관련된 요인
김윤 ( Yoon Kim ),고봉련 ( Bong Yeun Koh ) 한국보건행정학회 2003 보건행정학회지 Vol.13 No.4
Reperfusion delay in patients with acute myocardial infarction leads to increased morbidity and mortality. We sought to measure the rates of reperfusion delay and to identify factors associated with reperfusion delay after arrival to hospitals. We included 360 patients who had acute myocardial infarction with ST-elevation or left bundle branch block on electrocardiogram and received reperfusion therapy from the three participating academic medical centers from 1997 to 2000. Through retrospective chart review, we collected data about time to reperfusion therapy, patient and hospital factors potentially associated with reperfusion delay. Factors independently associated with reperfusion delay were determined by logistic regression analysis. Median door-to-needle time was 60.0 minutes, and median door-to-balloon time was 102.5 minutes. According to recommendation of the American College of Cardiology/American Heart Association Guidelines, 226 out of 264(85.6%) of thrombolytic patients and 43 out of 96(44.8%) percutaneous transluminal coronary angioplasty(PTCA) patients experienced reperfusion delay. The significant factors associated with delay were type of reperfusion therapy, patient factors including hypertension and delayed symptom onset to presentation(>4 hours), and hospital factors including nocturnal presentation(6pm∼8am), weekend, and an individual hospital. A significant proportion of patients experienced reperfusion delay. The identified predictors of reperfusion delay may help design a hospital system to reduce the delay in reperfusion therapy.
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양호교사를 대상으로 한 최초 반응자 기본 심폐소생술 교육 평가
李正銀,高鳳蓮 동남보건대학 2001 論文集-東南保健大學 Vol.19 No.2
The purpose of this study was to evaluate the knowledge, the accuracy of CPR skills and the satisfaction of CPR Training targeted for school nurses. The sample consisted of 175 school nurses. CPR Training was designed by two components which were a 2 hour lecture and demonstration by one Professor and 4 hour individual Practice by 7 practice instructors. As tools of measurement, estimation knowledge of CPR questionaires and satisfaction of CPR Training questionaires were developed based on the educated contents. The accuracy of CPR skills were checked by Skillmeter CPR training manikin. Collected data were computerized and analyzed by SPSS-WIN Program. The results were as follows: 1. The score on the knowledge of CPR Training ranged from 56 to 92 with a mean of 73.36(SD 7.26). 2. The skills of CPR were cadiac compression 106.24/min, correct cardiac compression rate 89 13%, ventilation 8.9/min, correct ventilation rate 88.6%. 3. The mean of the accuracy of CPR skills were 2.52(SD 1.23). 4. The mean of the satisfaction of CPR training were 2.58(SD 6.57) the highest score of CPR Training satisfaction was to instructor. 5. When errors were analyzed, the highest freguering of ventilation skills was stomach distension(49.6%) and cardiac compression skills was too little(81%).
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