Factors Influencing Organizational Commitment of Nurses at an Infectious Disease Hospital of COVID-19 / 중환자간호학회지

Purpose@#: This study investigated coronavirus disease-19 (COVID-19) related stress, resilience, and organizational commitment, and determined the factors influencing nurses’ organizational commitment at an infectious disease hospital of COVID-19. @*Methods@#: A cross-sectional descriptive survey was conducted with 138 nurses. Data analysis, including descriptive statistics, independent t-tests, one-way ANOVA, Pearson’s correlations, and multiple regression analysis, were performed using SPSS 26.0 program. @*Results@#: Factors influencing organizational commitment included resilience (β=0.31, p<.001), position (β=0.31, p<.001), COVID-19 related stress (β=-0.26, p<.001), and COVID-19 nursing period (β=-0.19, p=.012). These variables explained 29.6% of the organizational commitment. @*Conclusion@#: In order to enhance the organizational commitment of nurses in infectious disease hospitals of COVID-19, active program development and intervention are required at the organizational level to improve nurses’ resilience and relieve stress related to nursing infectious disease patients.

Effects of Awareness of Patient Safety Culture, Emotional Labor and Job Stress on Patient Safety Nursing Activities by Comprehensive Nursing Care Medical Service Ward Nurses / 중환자간호학회지

Purpose@#: This study aimed to examine the effects of the awareness of patient safety culture, emotional labor, and job stress on patient safety nursing activities by comprehensive nursing care medical service ward nurses. @*Methods@#: The participants were 112 nurses from the comprehensive nursing care service wards from six hospitals. Data were collected using structured questionnaires and analyzed using a t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis using SPSS version 20.0. @*Results@#: The factors that significantly influenced patient safety nursing activities in the comprehensive nursing care medical service ward nurses included job stress (β=-0.18, p<.032) and awareness of patient safety culture (β=0.54, p<.001). The explanatory power of these factors was 31.0% (F=13.43, p<.001). @*Conclusion@#: This study showed that the factors that influenced patient safety management activities of comprehensive nursing care medical service ward nurses included job stress and awareness of patient safety culture.

Simulation of healthcare provider's safety on emergency transportation using advanced airway: extension tube usage or not

OBJECTIVE: Healthcare providers are exposed to risky environments during prehospital transportation when they give O₂ supply to patients. This study examined the problems with risky environments during prehospital transportation and suggests safe and efficient O₂ supply methods through extension tube simulation. METHODS: Fifty-seven volunteers participated the study. The volunteer's back angle was measured during transportation simulation. This study measured the grip strength difference and forearm circumference difference in two situations. Without an extension tube and with extension tube, the participants measured the grip strength and forearm circumference before and after giving an O₂ supply to the mannequin for 5 minutes. The participants replied which body part showed the most discomfort. RESULTS: In the without extension tube group, participants leaned forward on average. On the other hand, the mean of anterior angle was 0° with an extension tube group. Without an extension tube, the grip strength decreased by whereas it decreased by with an extension tube. The decrease in grip strength was similar in both groups (P<0.05), and there was no significant difference in the forearm circumference. With the extension tube, 43.9% of participants reported no discomfort when they gave an O₂ supply. CONCLUSION: The extension tube improved the healthcare provider's safety and O₂ supply convenience during pre-hospital transportation.

Association between Smoking and Delayed Neuropsychological Sequelae in Acute Carbon Monoxide Poisoning

PURPOSE: This study examined the association between smoking and delayed neuropsychological sequelae (DNS) in acute carbon monoxide (CO) poisoning. METHODS: Patients admitted to the medical center emergency department from March 2016 to March 2017 because of CO poisoning were examined retrospectively. The patients were divided into two groups: DNS and Non-DNS group. Multiple factors were analyzed to explain DNS, which was assessed by motor disturbances, cognitive impairment, dysphagia, Parkinson-like syndromes, epilepsy, and emotional lability in CO poisoning. RESULTS: A total of 120 patients were included. The factors related to DNS were smoking (pack-years) (p=0.002) and initial carbon monoxide-hemoglobin level (p=0.015). On the other hand, after multivariate logistic regression analysis, smoking (Odds ratio 1.07; 95% CI, 1.02-1.13; p=0.004) was the only factor associated with DNS. CONCLUSION: Smoking is a very reliable factor for predicting the occurrence of DNS. A history of smoking in patients who suffer from CO intoxication is important. If a patient smokes, treatment should be started actively and as soon as possible.

Comparison with in-hospital Korean Triage and Acuity Scale (KTAS) and prehospital triage system in a metropolitan city

OBJECTIVE: This study was conducted to analyze and compare the classifications of a prehospital triage system and an in-hospital triage system. METHODS: The records of patients transferred from the ‘119’ emergency service for 5 months (from January 1 to May 31, 2016) were collected and records of first aid activities were assessed. We examined cases classified as four (urgent, semi-urgent, potentially urgent, and non-urgent) of five stages, excluding death. In the hospital, data were collected from medical records and classifications made using the five Korean Triage and Acuity Scale (KTAS) stages (1, resuscitation; 2, emergency; 3, urgent; 4, less urgent; and 5, non-urgent) were analyzed. RESULTS: The number of patients enrolled in the study was 3,457. Of them, 2,301 were discharged after treatment and 1,156 were hospitalized. According to the prehospital triage classification, 726 of the 3,457 cases were urgent, 593 were semiurgent, 1,944 were potentially urgent, and 194 were non-urgent. The results of the in-hospital triage were as follows: 114 KTAS 1 (3.3%), 491 KTAS 2 (14.2%), 1,345 KTAS 3 (38.9%), 1,227 KTAS 4 (35.5%), and 280 KTAS 5 (8.1%). The odds ratio trend for hospitalization showed a larger decrease according to in-hospital staging (95% CI, 0.32–0.39) than according to prehospital staging (95% CI, 0.50–0.60). The odds ratio trend for intensive care unit (ICU) admission also showed a larger decrease according to in-hospital staging (95% CI, 0.16–0.22) than according to prehospital staging (95% CI, 0.37–0.48). CONCLUSION: We found little correspondence in classifications made according to the KTAS and prehospital triage systems. However, the tendencies toward decreases in the hospitalization and ICU admission rates were similar.

Considerations for physicians using ketamine for sedation of children in emergency departments

OBJECTIVE: Ketamine use in emergency departments (EDs) for procedural sedation and analgesia is becoming increasingly common. However, few studies have examined patient factors related to adverse events associated with ketamine. This study investigated factors for consideration when using ketamine to sedate pediatric ED patients. METHODS: The study included pediatric patients receiving ketamine for laceration repair in the ED. Before sedation, information was collected about upper respiratory tract infection symptoms, allergy history, and fasting time. Patients received 2 mg/kg ketamine intravenously or 4 mg/kg ketamine intramuscularly. The primary outcomes were adverse events due to ketamine. RESULTS: We studied 116 patients aged 8 months to 7 years (2.8±1.5 years). The group with adverse events was significantly younger on average than the group without adverse events (2.5±1.5 vs. 3.1±1.5, P=0.028). Upper respiratory tract infection symptoms were not significant variables affecting ketamine sedation (48.9% vs. 43.7%, P=0.719). There was no significant association between duration of fasting and adverse events (P=0.073 and P=0.897, respectively), or between food type and adverse events (P=0.734). However, the number of attempts to sedate and ketamine dose correlated with adverse events (P<0.001 and P=0.022, respectively). In multiple logistic regression analysis, intravenous injection and ketamine dose were significant factors (odds ratio, 16.77; 95% confidence interval, 1.78 to 498.54; odds ratio, 4.37; 95% confidence interval, 1.59 to 22.9, respectively). CONCLUSION: Emergency medicine physicians should consider injection type and ketamine dose when using ketamine sedation while suturing lacerations.

Analysis the Change of Recognition and Attitude between Before and After Experience of Emergency Medicine Education Program in Medical School Students

PURPOSE: This study was performed to analyze the results from a 2016 three-day emergency medicine camp for premedical students. METHODS: The Public Relations Committee of Korea Emergency Medical Association planned the camp. We sent an official letter to 41 universities to recruit participants and create programs for three days. Questionnaires were prepared and analyzed before and after the camp. RESULTS: A total of 37 participants participated. There were three times more males than females. According to the recognition survey, knowledge (3.4±2.0 vs. 7.2±1.8) and preference (5.4±1.8 vs. 7.4±1.4) after the camp were better than before the camp (p<0.05). In detail, anxiety about funerals (3.5±2.5 vs. 2.4±2.8) and perception of the role (5.8±2.2 vs. 4.5±2.6) were improved (p<0.05). Worries regarding physical and psychological burden and danger were also greatly improved (p<0.05). The mean satisfaction was 8.6 points out of 10 points, according to the general survey. CONCLUSION: The three-day camp increased awareness of emergency medicine and improved their preferences.