PURPOSE: Regional and local emergency medical centers are supported and evaluated by the government, but local emergency medical facilities have not done very well. This research was started to aid in the improvement of local emergency medical centers by examining the present condition of medical treatment at those facilities and to indentify problems with the primary emergency medical service. METHODS: This research targeted head nurses at the emergency rooms of 42 hospitals out of 48 local emergency medical facilities in Gwangju and Jeollanam-do, who answered our survey, asked them about the actual condition of day and night duty in the emergency rooms, the present conditions of the hospitals and plans for the future development and analyzed the results. RESULTS: 1)Questions about the present conditions of hospitals: An average of 8.2 nurses were working in emergency rooms, 11.9 patients per day visited during the day, and 18.3 at night. Only 5 hospitals had emergency medical specialists, and the most serious problem in the management of emergency rooms was a shortage of proper medical manpower. 2)Questions about day duty:In 34.7% of the cases, specialists on staff were in charge of day-time medical treatment in emergency rooms and 33.3% of the emergency rooms had no workers in charge. There were many cases for which rapid medical treatment was not done when emergency rooms were called out during the days. 3)Questions about night duty: As to the types of night time medical treatment at emergency rooms, general doctors worked with medical specialists on back-up duty in 54.7% of the emergency rooms, medical specialists worked alone in 31.0%, and general doctors worked alone in 14.3%. those in charge of night duty were public health doctors or army surgeons (23.9%), general doctors (28.6%) and physicians (47.5%) who belong to hospitals. 4)Questions about future plans: All of the respondents answered that the present working system in emergency rooms needed to be changed, and 85.7% of them answered that they needed medical specialists who majored in emergency medicine. CONCLUSION: In local emergency medical facilities, specialists on staff were for in charge of day-time medical treatment. There were many cases in which general doctors were on night duty with medical specialists on back-up duty or medical specialists were on duty. Many hospitals needed medical specialists who majored in emergency medical science and plan future improvement in manpower.
Surveys and Questionnaires ; Emergencies* ; Emergency Medical Services ; Emergency Medicine ; Emergency Service, Hospital ; Gwangju* ; Humans ; Jeollanam-do* ; Nursing, Supervisory ; Public Health ; Specialization

Background: Sterility and safety assurance of hematopoietic stem cell (HSC) products is critical in transplantation. Microbial contamination can lead to product disposal and increases the risk of unsuccessful clinical outcomes. Therefore, it is important to implement and maintain good practice guidelines and regulations for the HSC collection and processing unit in each hospital. We aimed to share our experiences and suggest strategies to improve the quality assurance of HSC processing. Methods: We retrospectively analyzed microbial culture results of 11,743 HSC products processed over a 25-year period (January 1996 to May 2021). Because of reorganization of the HSC management system in 2008, the 25-year period was divided into periods 1 (January 1996 to December 2007) and 2 (January 2008 to May 2021). We reviewed all culture results of the HSC products and stored aliquot samples and collected culture results for peripheral blood and catheter samples. Results: Of the 11,743 products in total, 35 (0.3%) were contaminated by microorganisms, including 19 (0.5%) of 3,861 products during period 1 and 16 (0.2%) of 7,882 products during period 2. Penicillium was the most commonly identified microorganism (15.8%) during period 1 and coagulase-negative Staphylococcus was the most commonly identified (31.3%) during period 2. HSC product contamination occurred most often during HSC collection and processing. Conclusions The contamination rate decreased significantly during period 2, when the HSC management system was reorganized. Our results imply that handling HSC products by trained personnel and adopting established protocols, including quality assurance programs, aid in decreasing the contamination risk.