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학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 발행연도
- 2020.1
- 수록면
- 1 - 12 (12page)
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Background: Medical staff members are concentrated in the intensive care unit (ICU), and medical residents are essentially needed to operate the ICU. However, the recent trend has been to restrict resident working hours. This restriction may lead to a shortage of ICU staff, and there is a chance that regional academic hospitals will face running ICUs without residents in the near future. Methods: We performed a retrospective observational study (intensivist crossover design) of medical patients who were transferred to two ICUs from general wards between September 2017 and February 2019 at one academic hospital. We compared the ICU outcomes according to the ICU type (ICU with resident management under high-intensity intensivist staffing vs. ICU with direct management by intensivists without residents). Results: Of 314 enrolled patients, 70 were primarily managed by residents, and 244 were directly managed by intensivists. The latter patients showed better ICU mortality (29.9% vs. 42.9%, P = 0.042), lower cardiopulmonary resuscitation (CPR) (10.2% vs. 21.4%, P = 0.013), lower continuous renal replacement therapy (CRRT) (24.2% vs. 40.0%, P = 0.009), and more advanced care planning decisions before death (87.3% vs. 66.7%, P = 0.013) than the former patients. The better ICU mortality (hazard ratio, 1.641; P = 0.035), lower CPR (odds ratio [OR], 2.891; P = 0.009), lower CRRT (OR, 2.602; P = 0.005), and more advanced care planning decisions before death (OR, 4.978; P = 0.007) were also associated with intensivist direct management in the multivariate cox and logistic regression analysis. Conclusion: Intensivist direct management might be associated with better ICU outcomes than resident management under the supervision of an intensivist. Further large-scale prospective randomized trials are required to draw a definitive conclusion.
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참고문헌 (26)
참고문헌 신청
김새롬 / 2015 / 한국 전공의들의 근무환경, 건강, 인식된 환자안전: 2014 전공의 근무환경조사 / 보건사회연구 35(2):584~607
Ministry of Health & Welfare / Act on the improvement of training conditions and status of medical residents
Huh S / 2016 / Will the year 2016 augur well for better patient safety and health of residents in Korea according to the enactment of the Act for improving the resident training environment and enhancing resident's status? / J Educ Eval Health Prof 13:2
김재중 / 2011 / 우리나라에서 바람직한 진료지원 인력 제도 / 대한의사협회지 54(12):1240~1244
이원표 / 2015 / 내과 전공의 미달 사태로 본 우리나라 의료현실 / 대한의사협회지 58(5):368~371
Ministry of Health & Welfare / Act on the improvement of training conditions and status of medical residents
Huh S / 2016 / Will the year 2016 augur well for better patient safety and health of residents in Korea according to the enactment of the Act for improving the resident training environment and enhancing resident's status? / J Educ Eval Health Prof 13:2
김재중 / 2011 / 우리나라에서 바람직한 진료지원 인력 제도 / 대한의사협회지 54(12):1240~1244
이원표 / 2015 / 내과 전공의 미달 사태로 본 우리나라 의료현실 / 대한의사협회지 58(5):368~371
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