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- 저자 : 최희강(Choi Hee Kang) (검색결과 4 건)
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중증도 분류 간호사에 의한 응급환자 중증도 분류 신뢰도 측정 연구: Emergency Severity Index Version 4를 중심으로
최희강,최민진,김주원,이지연,신선화,이현정,Choi, Hee Kang,Choi, Min Jin,Kim, Ju Won,Lee, Ji Yeon,Shin, Sun Hwa,Lee, Hyun Jung 한국중환자간호학회 2012 중환자간호학회지 Vol.5 No.2
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.
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응급실 환자 중증도 분류(TRIAGE) 도구 개발에 관한 연구
최희강,박성애 서울대학교 간호대학 간호과학 연구소 1998 간호학 논문집 Vol.12 No.1
Hospital emergency departments provide the immediate care to patients whose needs are very different in the aquity. So the most important characteristics of the work of an emergency department is its variability. Both the number of patients arriving and the nature of the complaints fluctuate greatly. Increases in emergency use, shortages of nurses and intensive care unit beds and backlogs of emergency admissions have contributed to emergency department overcrowding and prolonged waiting times. Triage is the process by which patients are assessed upon their arrival at a health care facility to determine the appropriate health care resource. Triage involves the sorting of injured and ill persons into the categories that prioritize them for medical care according to the nature and severity of their injury or illness. The triage process evolved as and effective method to separate those requiring the immediate medical attention from those who can wait. The purpose of this study was to develop a triage tool for the adult patients in a tertiary emergency department. Expert panel developed the four triage categories : urgent, emergent, semiemergent, nonemergent and the triage tool, a list of specific guidelines based on vital signs, sings and symptom, and calculated the content validity of the indicators. A prospective study was carried out by two nurses and a doctor on 157 patients in the Seoul National University Hospital using the triage tool from February 22nd to 26th, 1997. The data were analyzed by percentage distribution, Wilcoxon signed rank test, ANOVA and multiple regression. The results were as follows : 1) The seven main indicators and six coindicators of triage tool were developed. The main indicators included airway open status, respiration rate, systolic blood pressure, pulse rate, body temperature, Glasgow Coma Scale, severity of pain and the coindicators included noisy respiration and use of respiratory accessory muscle, irregular pulse, cyanosis and diaphoretic skin, obvious significant hemorrhage, anisocoria and light reflex abnormality, trauma of head & chest & abdomen and open fracture. 2) The correspondence rate of nurses was 91.08% and there was no significant differences(p=1.0000), while the correspondence rate of a norse and the doctor was 82.17% and there was significant differences(p=.0057). 3) Among the 157 patients, the distribution of triage categories were 12 urgent patients(7.64%), 28 emergent patients(17.83%), 104 semiemergent patients(66.24%), 13 nonemergent patients(8.28%). The distribution of results after treatment corresponded with nurse's triage. 4) There were significant differences in the mean scores of the main indicator according to the categories of respiration rate and Glasgow Coma Scale(p<.05). The coindicator distributed into 58.33% of urgent patients and 42.86% of emergent patients. 5) The explanation power of this tool was 39.37%(F(12,144)=7.792, p=.0001,R2=.3937), and the significant variables were Glasgow Coma Scale(p-.0062, R2=.2079), obvious significant bleeding(p=.0001, R2=.0835), severity of pain(p=.0050, R2=.0408). In case of urgent and emergent patients, the explanation power of this tool was 53.54%(F(12,27)=2.593, p=.0914, R2=.5354), and the significant variable was Glasgow Coma Scale(p=.0250,R2=.3457). These results suggest that the effective triage can be carried out by nurse with the tool which is developed in this study.
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비외상성 성인 심폐소생술 간호업무 프로토골 개발 : 무수축 환자를 대상으로
유지성,최희강,황진향,김부자,김주원,김윤희,오현식 병원간호사회 2007 임상간호연구 Vol.13 No.1
Purpose: The purpose of this study was to develop a useful protocol for nurses participating in cardiopulmonary resuscitation (CPR) process for non-traumatic adult victims of cardiopulmonary arrest (CPA) in regional emergency center. Method: The preliminary standards of the protocol were selected by the process of referring to the known protocols for CPR nursing activity, reviewing textbooks and published papers on CPR, and analyzing the medical records of non-traumatic adult victims of CPA. The validity of protocol standards was measured with a questionnaire survey developed by experts panel, consisting of 8 emergency physicians and 22 nurses, and then the standards were revised. Throughout repeating the validating and revising process once more, the final standards were completed. The clinical effects in applying the new protocol on CPR nursing activity were analysed with comparison on time of CPR performance between with and without protocol use. Result: Thirty-one standards which showed more than 80% CVI (content validity index) were selected. With applying the new protocol, such CPR nursing activities as vasoconstrictors infusion and the confirmation of endotracheal tube depth were done (maximally 46sec, totally 152.79sec) than without it. Conclusion: New nursing protocol for CPR, developed throughout this research process would be useful for the quality of CPR in the regional emergency center. It also can could be used as an effective educational tool for nurse novice in CPR.
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