Purpose
This study aimed to comprehensively understand the experiences of emergency nurses performing triage during the peak and plateau periods of the Coronavirus Disease 2019 (COVID-19) pandemic over the past two years. Methods: Twenty triage nurses from three emergency medical centers were recruited through purposive and snowball sampling. Data collection occurred from February to May 2022 via focus group interviews and was analyzed using qualitative content analysis. Results: The experiences of emergency nurses in triage revealed four themes: "changes in priorities due to infectious diseases", "barriers to tirage", "the emotional burden experienced by triage nurses", and "the journey toward growth". The pandemic heightened the focus on infection screening in triage. Triage nurses faced numerous challenges concerning their own safety and that of their patients and encountered difficulties in performing triage. Nonetheless, these experiences provided them with opportunities for professional growth. Conclusion: The experiences of nurses performing triage during the peak and plateau periods of the COVID-19 pandemic provide valuable insights for future preparedness and coping strategies in the face of similar infectious disease outbreaks. It is necessary to establish integrated triage guidelines for patient safety, develop operations manuals for triage, implement policies on staffing standards, and provide mental health support for triage nurses during pandemics.

Purpose
The triage process in the emergency department is a complex decision-making task influenced by individual competence and a multitude of factors. Unlike patient-related factors, nurse-related factors can be improved through education. This study sought to determine the impact of grit, self-leadership, and communication skills of emergency department nurses on their triage competency.
Methods
We surveyed a convenience sample of 152 emergency department nurses to evaluate their grit, self-leadership, communication skills, and triage competency. The differences in these skills and competencies were analyzed according to the participants' general characteristics using the independent t-test and one-way analysis of variance. Hierarchical regression analysis was performed to identify the factors influencing nurses' triage competency.
Results
Triage experience, self-leadership, and communication skills influenced triage competency. Although triage competency can be positively impacted by knowledge gained from experience, expert assessment was identified as the least developed category of triage competency.
Conclusion
To improve nurses' triage competency, it is necessary to implement educational programs that utilize various methods to address self-leadership and communication skills. Moreover, reflective methods can be employed to help develop self-leadership, thereby improving triage competency. These findings can contribute to improving the work culture and the development of educational programs. Specifically, these programs should treat nurses' mistakes during work as learning opportunities rather than failures, thereby significantly advancing their competency.

Citations

• The Association Between Self‐Esteem, Assertiveness, and Professional Competence Among Palestinian Newly Graduated Emergency and Critical Care Nurses
  Malakeh Z. Malak, Ahamd Ayed, Anas Shehadeh, Moath Abu Ejheisheh, Ahmad Batran
  International Nursing Review.2025;[Epub]     CrossRef
• Experiences of Emergency Nurses Providing End‐of‐Life Care During the COVID‐19 Pandemic
  Alysha Cowley, Julia Morphet, Kimberley Crawford
  Journal of Advanced Nursing.2025;[Epub]     CrossRef

Purpose
This study aimed to identify the factors affecting patient satisfaction in an emergency department based on the use of the Korea Triage and Acuity Scale (KTAS).
Methods
A survey and medical record review were conducted. Participants included 100 patients and 20 nurses from an emergency medical institution located in B city, between June and August 2020. Data were analyzed using descriptive statistics, independent t-test, one way analysis of variance, partial correlation, and multiple regression.
Results
The mean score of patient satisfaction was 3.99±0.63. The mean waiting time, duration of stay, and occupation rate were 14.29±10.97 min, 104.96 ±67.35 min, and 22.0±7.4%, respectively. From the multiple regression analysis, waiting time (β=-.36, p<.001), nurse’s self-efficacy (β=.19, p=.013), and professional competence (β=.36, p<.001) explained 57.9% of the patients’ satisfaction with their use of the emergency medical institution (F=34.50, p<.001).
Conclusion
Patient satisfaction after experiencing the KTAS was influenced by waiting time, nurses’ self-efficacy, and professional competence. Therefore, institutions need to define an appropriate waiting time that does not reduce patient satisfaction, and introduce an internal marketing strategy to increase nurses’ professional competence and self-efficacy.

Citations

• Factors Influencing Sleep Quality in Patients with Hepatocellular Carcinoma Undergoing Transarterial Chemoembolization: A Cross-Sectional Study
  Ji Young Park, Myoung Soo Kim, Han Byeol Lim
  Korean Journal of Adult Nursing.2024; 36(2): 160.     CrossRef
• Satisfacción de los pacientes sobre la atención recibida por la enfermera en el triaje de los servicios de urgencias hospitalarios: revisión de alcance
  Meritxell López-Hernández, Montserrat Puig-Llobet, Lidia Miralles-Sánchez, Yolanda Moreno-Mateos, Jordi Galimany-Masclans
  Enfermería Clínica.2024; 34(5): 408.     CrossRef
• Patient satisfaction with nursing triage care in hospital emergency departments: Scoping review
  Meritxell López-Hernández, Montserrat Puig-Llobet, Lidia Miralles-Sánchez, Yolanda Moreno-Mateos, Jordi Galimany-Masclans
  Enfermería Clínica (English Edition).2024; 34(5): 408.     CrossRef
• Patient Satisfaction With the Level of Competence of the Triage Nurse in Hospital Emergency Departments
  Meritxell López Hernández, Montserrat Puig‐Llobet, Sergio Higon Fernández, Marta Franco Freirut, Yolanda Moreno Mateos, Jordi Galimany Masclans
  Journal of Clinical Nursing.2024;[Epub]     CrossRef
• Emergency nurses’ communication experiences with patients and their families during the COVID-19 pandemic: A qualitative study
  Soyoung Shin, Hye Jin Yoo
  International Emergency Nursing.2023; 66: 101240.     CrossRef

Purpose
The purpose of this study was to identify the relationship between triage competency, nursing task performance, and self-efficacy among nurses working at local emergency departments, and to identify factors that affect triage competency.
Methods
Participants in this descriptive study were 111 nurses working at 20 local emergency departments. Data were collected from August 1 to August 31, 2019, and then analyzed in terms of Independent t-test and one-way ANOVA, Pearson's correlation coefficient, and multiple regression by using the SPSS/WIN 21.0 program.
Results
Triage competency was positively correlated with nursing task performance, and self-efficacy was positively correlated with nursing task performance. There were significant predictors of nursing task performance (β=.41, p<.001) and self-efficacy (β=.35, p<.001), thus explaining the 60.4% variance in triage competency.
Conclusion
Nursing task performance was identified as the most significant factor affecting the triage competency of nurses working in emergency departments. Going forward, it is recommended to conduct a follow-up study to confirm the impact of developing a program for increasing triage competency by expanding subjects and scope in terms of regions.

Purpose
As the rate of older people visiting Emergency Departments (EDs) increases, nurses are responsible for identifying patients at risk of poor outcomes and providing preventive interventions. The aim of this study was to identify the factors associated with the mortality of older adults hospitalized through EDs.
Methods
The study design was a retrospective correlational design using the electronic medical records from a tertiary hospital in Korea. Data were collected from January 3 to March 6, 2016 through the hospital information center based on elderly patients admitted from January 1, 2011 to August 31, 2015. The study variables included general and admission characterstics, disease characteristics, and mortality of older patients visiting EDs.
Results
Of the 9,896 patients, the mortality rate was 7.4%; highest in patients aged over 86 years, men, or those hospitalized from nursing homes. Older adults arriving by private ambulance were 2.36 times more likely to die than walk-ins, and 1.38 times more likely for those using the 119 government emergency ambulance. Older patients hospitalized for more than four weeks were 2.17 times more likely to die than those hospitalized for less than a week.
Conclusion
Based on the study findings ward nurses will be able to early detect older patients at risk of poor outcomes and make better clinical decisions to improve the quality of nursing care. Nurses can propose health policies such as stricter management of the private ambulance service and considering the most efficient length of hospital stay for older adults hospitalized through EDs.

Citations

• Mortality and its determinants among patients attending in emergency departments
  Mengistu Abebe Messelu, Baye Tsegaye Amlak, Gebrehiwot Berie Mekonnen, Asnake Gashaw Belayneh, Sosina Tamre, Ousman Adal, Tiruye Azene Demile, Yeshimebet Tamir Tsehay, Alamirew Enyew Belay, Henok Biresaw Netsere, Wubet Tazeb Wondie, Gebremeskel Kibret Abe
  BMC Emergency Medicine.2024;[Epub]     CrossRef
• Factors Associated with Return Visits by Elders within 72 Hours of Discharge from the Emergency Department
  Li-Hsiang Wang, Hui-Ling Lee, Chun-Chih Lin, Chia-Ju Lan, Pei-Ting Huang, Chin-Yen Han
  Healthcare.2023; 11(12): 1726.     CrossRef
• Retrospective Analysis of the Oldest-Old Patients Who Applied to the Emergency Department and Their Differences from the Young-Old And Middle-Old
  İbrahim TOKER, Ayşin KILINÇ TOKER, İrfan GÖKÇEK, Emre BULBUL, Gökhan YILMAZ, Mustafa SİLCAN, Şaban IRMAK, Mükerrem ALTUNTAŞ
  Anatolian Journal of Emergency Medicine.2023; 6(1): 20.     CrossRef
• Potentially Inappropriate Prescriptions to Older Patients in Emergency Departments in South Korea: A Retrospective Study
  Kyungim Kim, Jinyoung Jung, Haesook Kim, Jung Tae Kim, Jung Mi Oh, Hyunah Kim
  Therapeutics and Clinical Risk Management.2021; Volume 17: 173.     CrossRef

PURPOSE
This study aimed to identify the type and frequency of nursing activities targeting emergency department patients by analyzing electronic nursing records.
METHODS
This retrospective study identified the characteristics of and nursing activities for adult patients who visited a university hospital emergency department for 6 months from January to June 2018 by analyzing the hospital's electronic nursing records. Descriptive statistics and one-way analysis of variance were used to analyze the characteristics of patients and the nursing records.
RESULTS
A total of 36,435 patients, with an average age of 52.82±19.91 years and a male-to-female ratio of 1:1.16, participated in the study. The number of patients with Korean Triage and Acuity Scale levels 4 (less urgent) and 5 (non-urgent) were 24,403 (67% of the total number). Referrals were requested 1.21±0.54 times per patient. The most frequent NANDA diagnosis and Nursing Intervention Classification intervention were “Risk for unstable blood glucose level” (858, 28.4%), and “Surveillance” (83,131, 23.9%). The most frequent Clinical Care Classification action type was “Assess or Monitor” (313,729, 38.5%). The higher the severity level and the number of referrals, the more the recorded numbers of nursing diagnoses, interventions, and care activities.
CONCLUSION
This study demonstrated the possibility of nursing task analysis by identifying the type and frequency of nursing activities based on the data from electronic nursing records. Further research on electronic nursing records would contribute to the usefulness of these records for nursing workload analysis and effective workforce management.

Citations

• Improving Handover Efficiency for Emergency Nurses
  Seungeun Lee, Heeje Yun, Yukyung Lee, Minji Kang, Eunbi Jo, Sunjong Yoo, I Gyeong Jo, Jung Hwan Heo, Min Jin Choi
  Journal of Korean Academy of Nursing Administration.2024; 30(3): 294.     CrossRef
• An exploratory study of the practical impact of the COVID-19 pandemic on nursing tasks in clinical settings
  Younhee Kang, Hyeyoung Hwang
  Applied Nursing Research.2024; 76: 151790.     CrossRef
• Experiences of Recording Electronic Nursing Notes among Ward Nurses in Two Hospitals
  Hyunmi Hwang, Geun-Hee Kim, Yeoungsuk Song
  Journal of Korean Academy of Fundamentals of Nursing.2024; 31(4): 396.     CrossRef
• An exploratory study of nursing tasks that induce physical and mental stress among hospital nurses
  Younhee Kang, Aekyeong Jin
  Applied Nursing Research.2024; 80: 151853.     CrossRef
• Experiences of traumatic events, knowledge and attitudes concerning post-traumatic stress disorder, and resilience among nurses and paramedics working in emergency department
  Sun-Woo Hong, Kyung-Sook Bang, Hwal Lan Bang, Hye Jin Hyun, Miyoung Lee, Yu Na Jung
  The Journal of Korean Academic Society of Nursing Education.2023; 29(1): 86.     CrossRef
• Life‐Sustaining Treatment Decision in Palliative Care Based on Electronic Health Records Analysis
  Sanghee Kim, Arum Lim, Hyoeun Jang, Misun Jeon
  Journal of Clinical Nursing.2023; 32(1-2): 163.     CrossRef
• Use of the clinical care classification in South Korean nursing practice: Challenges and opportunities
  Hyeoun-Ae Park, Insook Cho
  International Journal of Medical Informatics.2023; 170: 104968.     CrossRef
• Effects on Triage Competency Based on Nursing Task Performance and Self-Efficacy of Nurses in Regional Emergency Medical Institutions
  Su Jin Kim, Su Ol Kim
  Korean Journal of Adult Nursing.2022; 34(3): 304.     CrossRef
• An Analysis of Tasks of Nurses Caring for Patients with COVID-19 in a Nationally-Designated Inpatient Treatment Unit
  Minho Jung, Moon-Sook Kim, Joo-Yeon Lee, Kyung Yi Lee, Yeon-Hwan Park
  Journal of Korean Academy of Nursing.2022; 52(4): 391.     CrossRef
• Association Between Symptoms of Patients With Heart Failure and Patient Outcomes Based on Electronic Nursing Records
  Seung Yeon Baik, Gi Wook Ryu, Hyangkyu Lee, Siwook Lee, Mona Choi
  CIN: Computers, Informatics, Nursing.2021; 39(12): 1027.     CrossRef
• Development of Addiction Prevention Care Program for Nurses
  Sungjae Kim, Se-Jin Joo, Young Ok Song, Jin-Gyung Cha, Jeongwoon Yang
  STRESS.2019; 27(4): 389.     CrossRef

PURPOSE
The aim of this study was to verify the effect of simulation and examine the effect of within-team debriefing for cardiac arrest emergency nursing education.
METHODS
A non-equivalent control group quasi-experimental design was used. The participants in this study were 199 senior nursing students from one nursing school in Daegu, Korea. Data were analyzed using χ² test, t-test, Fisher's exact test with SPSS 22.0 program.
RESULTS
Developed simulation protocol in this study increased the learning immersion (t=12.19, p < .001, t=5.07, p < .001), learning confidence (t=−10.36, p < .001, t=−5.99, p < .001) and clinical performance ability (t=−10.88, p < .001, t=−3.84, p=.002) among nursing students. In addition to this, learning immersion (t=2.66, p=.008), learning confidence (t=−2.78, p=.006), simulation satisfaction (t=−3.15, p=.002) and clinical performance (t=−3.02, p=.005) were significantly higher in the experiment group using within-team debriefing.
CONCLUSION
The results indicate that simulation using within-team debriefing was an effective educational method for nursing students.

Citations

• The Effects of Simulation Based Practical Education on Nursing Students' Self-efficacy, Performance Confidence, and Educational Satisfaction
  Inok Kim
  Physical Therapy Rehabilitation Science.2024; 13(1): 18.     CrossRef
• Development of a Patient Safety Simulation Program for New Nurses in the Intensive Care Unit
  Su Jin Jung, Jin-Hee Park
  Journal of Korean Academy of Fundamentals of Nursing.2024; 31(1): 100.     CrossRef
• SIMULAÇÃO NO ENSINO DE URGÊNCIA E EMERGÊNCIA PARA ENFERMAGEM
  Amanda Diniz Silva, Suzel Regina Ribeiro Chavaglia, Fabiana Cristina Pires, Caroline Bueno de Moraes Pereira, Ingrid Fidelix de Souza, Elizabeth Barichello, Rosali Isabel Barduchi Ohl
  Enfermagem em Foco.2022;[Epub]     CrossRef
• Effects of Peer-led Debriefing on Cognitive Load, Achievement Emotions, and Nursing Performance
  Yoon Hee Na, Young Sook Roh
  Clinical Simulation in Nursing.2021; 55: 1.     CrossRef
• The Effect of Team Debriefing-based Emergency Simulation Education
  Hwa Yeong Choi, Yeoungsuk Song
  Journal of Health Informatics and Statistics.2020; 45(2): 216.     CrossRef
• Learning Experience of Undergraduate Nursing Students in Simulation: A Meta-synthesis and Meta-ethnography Study
  Jihae Lee, Jieun Jeon, Sooyoung Kim
  Journal of Korean Academic Society of Nursing Education.2019; 25(3): 300.     CrossRef

PURPOSE
The purpose of this secondary data analysis study was to compare what factors influenced individual's satisfaction with emergency medical services (EMS).
METHODS
Data were obtained from the Korea Health Panel Survey 2013 with 20,641 participants. A total sample of emergency room (ER) users (n=1,709) aged 20 and over were selected and divided into two age groups, one for 1,046 adults and the other for 663 elderly. Participants' responses were analyzed using descriptive statistics, χ² test and logistic regression.
RESULTS
Among adults and elderly who were transferred to other hospitals instead of being admitted or returned to their homes reported less satisfaction (χ²=10.18, p=.006). Further, the adults who perceived their arrival to the ER as not delayed (χ²=3.74, p=.049) or visited the ER for treatment for illness (χ²=5.32, p=.021) reported more satisfaction than those who perceived their ER service being delayed or visited the ER for accident or poisoning. The elderly who visited ER by non-ambulance reported higher satisfaction than those who arrived by ambulance (χ²=14.15, p < .001).
CONCLUSION
In both adults and the elderly, satisfaction of EMS can be increased by avoiding transferring patients to other hospital. For adults to be satisfied with EMS, efficient and rapid EMS might be needed to avoid delay in ER arrival, especially for adults with accidents or poisoning.

Citations

• Factors Influencing Satisfaction with Medical Institutions according to Health Condition and Medical Use Condition of Single Elderly Households in Rural Areas: Using the Results of Survey on Rural Well-being 2021
  Min U Lee, Gi Chun Seo, Eun-Jung Hong
  The Korean Journal of Community Living Science.2023; 34(3): 457.     CrossRef

PURPOSE
The purpose of this study was to investigate predictors of violent behavior by patient or caregiver of patient in the emergency department.
METHODS
Subjects of the study were 447 residents who have visited the emergency department in community P Metropolitan City during the past year. The data collecting period was from June 1, 2012 to August 31, 2012. Data was collected using self-reported questionnaires.
RESULTS
Predictors of violent behavior in the emergency department were divided into personal and institutional factors. Personal factors included relationship with patients, presence of alcohol, reports of discontent during and past treatment and responses to deterioration in patient's conditions, institution factors included perceived attitudes toward medical workers' explanations and proficiency of medical workers, and delay in medical treatment hours.
CONCLUSION
Knowledge of personal and institutional factors may permit emergency staff to minimize or prevent potential violence in the emergency department.

Citations

• Predicting Workplace Violence in the Emergency Department Based on Electronic Health Record Data
  Hyungbok Lee, Heeje Yun, Minjin Choi, Hyeoneui Kim
  Journal of Emergency Nursing.2023; 49(3): 415.     CrossRef
• Experiences of traumatic events, knowledge and attitudes concerning post-traumatic stress disorder, and resilience among nurses and paramedics working in emergency department
  Sun-Woo Hong, Kyung-Sook Bang, Hwal Lan Bang, Hye Jin Hyun, Miyoung Lee, Yu Na Jung
  The Journal of Korean Academic Society of Nursing Education.2023; 29(1): 86.     CrossRef
• Relationships between Violence Experience, Resilience, and the Nursing Performance of Emergency Room Nurses in South Korea
  Sarang Kim, Minkyung Gu, Sohyune Sok
  International Journal of Environmental Research and Public Health.2022; 19(5): 2617.     CrossRef
• Factors Affecting on Turnover Intentions of Emergency Department Nurses who have Experienced Verbal Abuse
  Gyoo-Yeong CHO, Mi-Kyung SEO
  JOURNAL OF FISHRIES AND MARINE SCIENCES EDUCATION.2021; 33(2): 314.     CrossRef
• Usefulness of Korean Version of Behavioral Cue Checklist for Predicting of Patient Violence in Emergency Departments
  Jang Mi Kim, Eun Nam Lee
  Journal of Korean Academy of Nursing.2018; 48(3): 289.     CrossRef
• Mediating Effect of Resilience on the Association between Violence Experience and Violence Response among Nurses
  Cheol Jeong, Eun Nam Lee
  Korean Journal of Adult Nursing.2018; 30(1): 41.     CrossRef
• The Study of Preceptor Nurses’ Occupational Stress and Burden
  Joohee Han, Eun Kwang Yoo
  Korean Journal of Stress Research.2018; 26(1): 38.     CrossRef
• The relationship between intention to leave the hospital and coping methods of emergency nurses after workplace violence
  In‐Young Jeong, Ji‐Soo Kim
  Journal of Clinical Nursing.2018; 27(7-8): 1692.     CrossRef
• Hardiness Mediates Stress and Impact Level in ED Nurses Who Experienced a Violent Event
  Jin Hee Park, Eun Nam Lee, Kyung Ran Kong, Moon Jung Jang
  Journal of Emergency Nursing.2017; 43(6): 539.     CrossRef

PURPOSE
This study was conducted to test the impact of simulation-based education program for emergency airway management on self-efficacy and clinical performance ability.
METHODS
A quasi-experimental non-equivalent control group pre-post test design was used. A total of 60 nurses, 30 nurses assigned to the simulation-based education group and 30 nurses to a traditional lecture group. The treatment group received a lecture, small group workshop and team simulation whereas the comparison group received lectures.
RESULTS
The participants in the simulation-based education group reported significantly higher self-efficacy of emergency airway management compared to participants in the lecture only group (t=5.985, p<.001). The simulation-based education group showed significantly higher clinical performance ability of emergency airway management compared with the lecture group (t=5.532, p<.001).
CONCLUSION
Simulation-based education was verified to be an effective teaching method to improve the self-efficacy, clinical performance skills of nurses in the learning of emergency airway management.

Citations

• An Exploratory Study to Develop a Virtual Reality Based Simulation Training Program for Hypovolemic Shock Nursing Care: A Qualitative Study Using Focus Group Interview
  Jaehee Jeon, Sihyun Park
  Healthcare.2021; 9(4): 417.     CrossRef
• Simulation-based education program on postpartum hemorrhage for nursing students
  Miok Kim, Juyoung Ha
  Korean Journal of Women Health Nursing.2020; 26(1): 19.     CrossRef
• Development and Effects a Simulation-based Emergency Airway Management Education Program for Nurses in a Neonatal Intensive Care Unit
  Minjung Kim, Sunghee Kim
  Child Health Nursing Research.2019; 25(4): 518.     CrossRef
• Importance and Performance Analysis of Competency for Advanced Beginner-stage Nurses of Ward
  Inhee Hwang, Soyoung Yu
  Journal of Health Informatics and Statistics.2019; 44(3): 292.     CrossRef
• Effect of simulation-based emergency cardiac arrest education on nursing students' self-efficacy and critical thinking skills: Roleplay versus lecture
  Eunsook Kim
  Nurse Education Today.2018; 61: 258.     CrossRef
• Effects of a simulated emergency airway management education program on the self‐efficacy and clinical performance of intensive care unit nurses
  Myong‐Ja Han, Ju‐Ry Lee, Yu‐Jung Shin, Jeong‐Suk Son, Eun‐Joo Choi, Yun‐Hee Oh, Soon‐Haeng Lee, Hye‐Ran Choi
  Japan Journal of Nursing Science.2018; 15(3): 258.     CrossRef
• Effects of a Simulation-based Stroke Care Education on Nursing Performance Ability and Satisfaction in Nursing Students
  Kie In Jang, Young Sook Roh
  Journal of the Korea Academia-Industrial cooperation Society.2015; 16(1): 408.     CrossRef
• Effect of Attribution Disposition and Self-Efficacy on Clinical Practice Competence of Nursing Student
  Su Ol Kim, So Myeong Kim
  Journal of Korean Public Health Nursing.2015; 29(3): 452.     CrossRef

PURPOSE
The purpose of this study was to perform an economic analysis and estimate the fee for the practices that carried out by Emergency Nurse Practitioner (ENP) using relative value scale (RVS) and its conversion factor.
METHODS
First, we developed ENP's RVS for 25 advanced nursing services based on ENP's workload and its time spent by survey. A cost analysis was performed to evaluate the conversion factor of ENP's RVS. The share of ENP's contribution to fee-for-service in emergency setting was also analyzed.
RESULTS
Calculation of the RVS of 25 advanced nursing practices showed a range of points from 73.4 to 296.3 and an average of 145.1 points. The relevant conversion factor for advanced nursing practices among ENP was estimated at 12.2~15.9 won. The contribution rate of ENP's advanced nursing practices in the relative value scale of the national health insurance was estimated at 13.1~17.0%.
CONCLUSION
The practices of ENP are not compensated separately and its reimbursement is usually included in physician fee. An estimation of nursing fee and an independent fee related to ENP's services shows the contribution rate to total revenue. It suggests that emergency nurse practitioners be considered as a revenue source the in emergency room.

PURPOSE
This study was conducted to develop a Web-based learning program on cardiopulmonary emergency care for clinical nurses and to evaluate learners' responses.
METHODS
Based on the assessment of learning needs of clinical nurses, a total of three self-directed learning modules were developed according to the procedure of the ADDIE (assessment, design, development, implementation, & evaluation) model.
RESULTS
Each learning module included the emergency treatments and drugs used in the real patients' situations with cardiopulmonary crisis, which had been adopted from the emergency department of a C University hospital located in G-city. Real video clips for endotracheal intubation and ACLS (advanced cardiac life support) were developed with the help of the staff of the department of emergency medicine using a human simulator, SimMan(R). The program published on the Web was evaluated by 20 clinical nurses who are working in the emergency department and wards of a C-University hospital. About 80% of the respondents were satisfied with the program contents, design, and learning strategy.
CONCLUSION
Web-based learning programs on cardiopulmonary emergency care are needed for clinical nurses as educational material for staff education to increase their knowledge for making immediate clinical decisions and in giving skilled care in emergency situations.

PURPOSE
The purpose of this study was to examine the effects of music therapy on anxiety of patients in emergency room. METHODS: The study was designed using a noneqivalent control group nonsynchronized design. For 20 minutes, the experimental group(22 patients) had listened to music and the control group(23 patients) had bed rest. A six-item state anxiety scale developed by Marteau and Bekker, which was based on Spielberger's State-Trait Anxiety Inventory, blood pressure and pulse rate were measured to all study participants before and after the intervention. The data was analyzed by the SPSS 12.0 program. RESULTS: 1) The experimental group's state anxiety level were significantly lower than the control group's(t=2.220, p=.032). 2) There were no significant differences in both group's diastolic(t=-.495, p=.623) and systolic blood pressure(t=831, p=.411). 3) The experimental group's pulse rate was significantly lower than the control group's(t=2.363, p=.023). CONCLUSION: Music therapy may be applied as a nursing intervention to decrease anxiety in emergency room.

PURPOSE
The purpose of this study was to suggest the projected workforce of certified emergency nurses in Korea. METHOD: The methods used in this study are 1) demand & ratio model was used for the projected workforce of CEN, 2) Index functional formula was used for the suggestion of the number of general hospitals and hospitals, 3) Experts in Emergency care were contacted to get an opinion and information about the criteria of distribution and scope of CEN, 4) National and international internet data were collected. RESULT: The demand of CEN were analyzed by two ways; demand of Emergency centers only and demand of emergency centers including community centers. The number of CENs needed to meet the demands in 2002, 2005 and 2010 was estimated at minimum of 1,512 to maximum1,576, 1,640 to 1,704 and 1,892 to 1,956 respectively. The projected number of CENs for the 2002 was 1% total available nurses in Korea, and 3.2 CENs per 100,000 population. CONCLUSION: It is really desirable that CENs not only work for hospital emergency centers but also for emergency related centers in community.

The purpose of this study is to analyse and evaluate the characteristics of stroke patients and the causes of their spending time in arriving emergency room and the actual conditions of using alternative medicines before entering emergency room. The subject of this study four hundred seventy six patients who was hospitalized in Western Medical and Chinese Herb Medicine of D Hospital in Pusan within two weeks after attack. The collected data are analysed by the analysis method of narration statistics through SAS program and one-way analysis through ANOVA. The important results of this study are as followings: The spending time in arriving emergency room shows that under 3 hours is 19.5%, under 6 hours is 29.0%, under 24 hours is 55.1%. In the aspects of using alternative medicines before entering emergency room, the patients of 60.1% had used alternative medicines. Through the examination and analysis it can be seen that the geographical-environmental features and the clinical features for the acute stroke patients have more effect than the populational-sociological features on the spending time in arriving emergency room. For the aspects of using alternative medicines before entering emergency room, however, the charactericstics of clinical features have more effect than the populational-sociological features and the geographical-environmental features.