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관련 논문
*정책원 미소장 자료이며 관련 논문 소개 게시판입니다. 게시물 관련링크를 눌러 소속기관에서 열람가능한지 확인해주시기 바랍니다.
lib@nibp.kr
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| 발행년 : | 2019 |
|---|---|
| 구분 : | 학위논문 |
| 학술지명 : | 학위논문(석사)-- 제주대학교 대학원 : 간호학과 |
| 관련링크 : | http://www.riss.kr/link?id=T15019380 |
응급의료센터로 전원되는 노인환자의 의료정보 공유정도와 건강결과
= Information Sharing and Health Outcomes in Elderly Patients Transferred to the Emergency Department
- 저자[authors] 김형준
- 발행사항 제주 : 제주대학교 대학원, 2019
- 형태사항[Description] ; 26 cm
- 일반주기명[Note] 지도교수: 최수영
- 학위논문사항[Dissertation] 학위논문(석사)-- 제주대학교 대학원 : 간호학과 2019. 2
- 발행국(발행지)[Country] 제주도
- 출판년[Publication Year] 2019
- 소장기관[Holding] 제주대학교 중앙도서관 (249002)
- UCI식별코드 I804:49002-000000008891
초록[abstracts]
This study was conducted to examine the relationship between information
sharing and health outcomes (length of stay in emergency department, length
of stay at the hospital, and unexpected revisit to emergency department) for
elderly patients transferred from long-term care hospital or facilities to the
emergency department (ED). Also, this study aimed to provide a basic
reference in developing standardized methods to improve the level of shared
information and health outcomes for such transferred elderly patients.
This study analyzed the medical records (initial emergency examination
records, emergency progress records, nursing records, and referral forms) for
452 cases of 362 elderly patients aged 65 years or older who were transferred
from July 1, 2017 to June 30, 2018 from long-term care hospitals or facilities
to the ED in a university hospital with more than 600 beds located in a city
in Korea.
The following are this study’s results:
1) The total number of cases where the participants were referred was 452;
women accounted for 302 (66.8%), and the average age was 82.58
(±7.92) years. In the type of health institution from which the
participants were referred, “long-term care facilities” accounted for the
most with 275 cases (60.8%), and “long-term care hospitals” accounted
for 177 cases (39.2%). When it came to reasons for referral, disease
(94.0%) accounted for the most cases. Regarding consciousness status in
referrals, the “alert” accounted for 269 cases (59.5%). In the charlson
comorbidity index, those with “3 points or higher” accounted for the
most with 142 cases (48.9%). Outcomes after ED examination showed that
“Admission” accounted for the most with 278 cases (61.5%).
2) With regard to the characteristics of the participants, sex (χ2=13.97,
p<.001), age (t=-4.47, p<.001), charlson comorbidity index (t=5.44, p<.001),
and outcome after ED examination (χ2=26.80, p<.001) showed significant
differences between types of health institutions from which they were
transferred.
3) The number of shared information items was 1.33 (±2.45) on
average. In terms of the number of shared information items
depending on the type of health institution that transferred the patients,
long-term care hospitals showed 3.35 (±2.92), which was significantly
higher than 0.04 (±0.25) from long-term care facilities (t=15.01, p<.001).
4) In the relationship between the level of shared information and health
outcomes, the length of stay in ED had a significantly negative correlation
with the level of shared information (r=-.101, p=.032).
Based on the above results, the number of the shared information items
from long-term care hospitals was 3.35 (±2.92) on average out of 19, with a minimum of 0 to a maximum of 9. Meanwhile, for long-term care facilities, it
was from 0 to 2 with 0.04 (±0.25) on average. It was revealed that a lot of
information was missing when the patients were transferred to the ED, and
the higher the number of shared information items, the shorter was the
length of stay in ED. In other words, it seems that the time required to
examine patients can be reduced and the patient status can be identified more
effectively when more information is shared between institutions during
referral, and subsequently, it influences the reduction in the length of stay in
ED. Nonetheless, this study found that the level of shared information had no
significant correlation with length of stay at the hospital or unexpected ED
revisit. Hence, it would be necessary to add the factors that may affect
length of stay at hospitals or unexpected ED revisits and conduct follow-up
studies repeatedly.
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