Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi

Abdulkadir Atalan; Cem Çağrı Dönmez; Yasemin Ayaz Atalan

doi:10.7240/marufbd.395255

Research Article

Implementation of Simulation for the Improvement of Emergency Service Quality by High-Educated Specialist Nurses Employment: Turkish Health System

Year 2018, Volume: 30 Issue: 4, 318 - 338, 31.12.2018

Abdulkadir Atalan , Cem Çağrı Dönmez , Yasemin Ayaz Atalan

https://doi.org/10.7240/marufbd.395255

Cited By: 6

Abstract

Emergency departments
are the cornerstone of health care systems. In this study, the work of the
emergency services system in Turkey were examined. The intensities of the
emergency services are becoming immeasurable in the present situation. This is
mainly due to the fact that the majority of patients who come to emergency
services are not urgent in emergency departments. This study suggests that
patients who are not urgent or outpatient in emergency services should be
treated by highly-educated specialist nurses (YSN). In this case, it is
aimed to treat more patients, to reduce the waiting time of the patients and
therefore the duration of the patients' stay in the emergency services. It is
also aimed to increase the efficiency of the resources employed in emergency
services. According to the simulation example applied on 1/24 and 7/24 basis,
it was observed that the number of patients treated by providing employment of
YUH was increased by 26,71% on the basis of 1/24 and 15,13% on the basis of
7/24. The waiting time for treatment was reduced by 38.67% on 1/24 basis and
53.66% on 7/24 basis, respectively, from the time the patients were enrolled in
emergency services. Likewise, the time required for a patient to be treated in
emergency services for treatment was reduced from an average of 82.46 minutes
to 53.97 minutes. Among the findings, it has been seen that the efficiency of
the employment of YUH has provided a balance in the efficiency rates of the
resources by not getting the efficiency as high as the resources employed in
the emergency services. In addition, it has been found that the employment
intensity of physicians decreases with the employment of YUH.

Keywords

Turkey Emergency Service System, High Educated Specialist Nurses, Simulation, Resources of Emergency Service

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Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi

Year 2018, Volume: 30 Issue: 4, 318 - 338, 31.12.2018

Abdulkadir Atalan , Cem Çağrı Dönmez , Yasemin Ayaz Atalan

https://doi.org/10.7240/marufbd.395255

Cited By: 6

Abstract

Acil servisler sağlık sistemlerin
temel taşını oluşturmaktadırlar. Bu çalışmada, Türkiye’deki acil servislerin
çalışma sistemleri incelenmiştir. Mevcut durumdaki acil servislere ait
yoğunluklar ölçülemez hale gelmektedir. Bunun başlıca nedeni acil durumda
olmayan hastaların acil servisleri meşgul etmesidir. Bu çalışma ile acil servislerde acil olmayan
ya da ayakta tedavi edilebilecek olan hastaların yüksek-eğitimli uzman hemşireler
(YUH) tarafından tedavi edilmesi önerilmiştir. Bu durumda daha fazla hasta
tedavi edilmesi, hastaların bekleme sürelerinin ve dolayısıyla hastaların acil
servislerde kalma sürelerinin azaltılması amaçlanmıştır. Ayrıca acil
servislerde istihdam edilen kaynakların verimliliğinin arttırılması
hedeflenmiştir. 1/24 ve 7/24 esasına göre uygulanan simülasyon örneği ile YUH
istihdamı sağlanarak tedavi edilen hasta sayısında 1/24 esasına göre %26,71 ve
7/24 esasına göre %15,13 oranında artış sağlandığı görülmüştür. Hastaların acil
servise kayıt yaptıkları andan itibaren tedavi olmak için bekledikleri süre
1/24 esasına göre %38,67 ve 7/24 esasına göre %53,66 oranlarında iyileşme
sağlanarak bekleme zamanı düşürülmüştür. Aynı şekilde bir hastanın tedavi olmak
için acil servislerde geçirmesi gereken süre ortalama 82,46 dakikadan 53,97
dakikaya düşürülmüştür. Bulgular arasında, acil servislerde istihdam edilen
kaynaklardan yeteri kadar verim alınamamasıyla YUH istihdamı sayesinde
kaynaklara ait verimlilik oranlarında bir denge sağlandığı görülmüştür. Ek
olarak, YUH istihdamı ile doktorların çalışma yoğunluklarının azaldığı tespit
edilmiştir.

Keywords

Türkiye Acil Servis Sistemi, Yüksek Eğitimli Uzman Hemşire, Simülasyon, Acil Servis Kaynakları

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26. Durand, A.-C., Palazzolo, S., Tanti-Hardouin, N., Gerbeaux, P., Sambuc, R., & Gentile, S. (2012). Nonurgent patients in emergency departments: rational or irresponsible consumers? Perceptions of professionals and patients. BMC Research Notes, 5, 525-525. doi:10.1186/1756-0500-5-525.
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29. Fenton, J. J., Jerant, A. F., Bertakis, K. D., & Franks, P. (2012). The cost of satisfaction: a national study of patient satisfaction, health care utilization, expenditures, and mortality. Archives of internal medicine, 172(5), 405-411.
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36. Jun, J., Jacobson, S. H., & Swisher, J. R. (1999). Application of discrete-event simulation in health care clinics: A survey. Journal of the operational research society, 109-123.
37. Keck, M. (2003). Hospital emergency department resource utilization and optimization system. In: Google Patents.
38. Kim, S. E., Kim, C. W., Lee, S. J., Oh, J. H., Lee, D. H., Lim, T. H., . . . Jung, J. H. (2015). A questionnaire survey exploring healthcare professionals' attitudes towards teamwork and safety in acute care areas in South Korea. BMJ Open, 5(7).
39. Komashie, A., & Mousavi, A. (2005). Modeling emergency departments using discrete event simulation techniques. Paper presented at the Proceedings of the 37th conference on Winter simulation.
40. Köse, A., Köse, B., Öncü, M. R., & Tuğrul, F. (2010). Bir devlet hastanesi acil servisine başvuran hastaların profili ve başvurunun uygunluğu. Gaziantep Medical Journal, 17(2), 57-62.
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There are 63 citations in total.

Details

Primary Language	Turkish
Subjects	Engineering
Journal Section	Research Articles
Authors	Abdulkadir Atalan 0000-0003-0924-3685 Cem Çağrı Dönmez Yasemin Ayaz Atalan
Publication Date	December 31, 2018
Acceptance Date	December 11, 2018
Published in Issue	Year 2018 Volume: 30 Issue: 4

Cite

APA	Atalan, A., Dönmez, C. Ç., & Ayaz Atalan, Y. (2018). Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. Marmara Fen Bilimleri Dergisi, 30(4), 318-338. https://doi.org/10.7240/marufbd.395255
AMA	Atalan A, Dönmez CÇ, Ayaz Atalan Y. Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. MFBD. December 2018;30(4):318-338. doi:10.7240/marufbd.395255
Chicago	Atalan, Abdulkadir, Cem Çağrı Dönmez, and Yasemin Ayaz Atalan. “Yüksek-Eğitimli Uzman Hemşire İstihdamı Ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi”. Marmara Fen Bilimleri Dergisi 30, no. 4 (December 2018): 318-38. https://doi.org/10.7240/marufbd.395255.
EndNote	Atalan A, Dönmez CÇ, Ayaz Atalan Y (December 1, 2018) Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. Marmara Fen Bilimleri Dergisi 30 4 318–338.
IEEE	A. Atalan, C. Ç. Dönmez, and Y. Ayaz Atalan, “Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi”, MFBD, vol. 30, no. 4, pp. 318–338, 2018, doi: 10.7240/marufbd.395255.
ISNAD	Atalan, Abdulkadir et al. “Yüksek-Eğitimli Uzman Hemşire İstihdamı Ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi”. Marmara Fen Bilimleri Dergisi 30/4 (December 2018), 318-338. https://doi.org/10.7240/marufbd.395255.
JAMA	Atalan A, Dönmez CÇ, Ayaz Atalan Y. Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. MFBD. 2018;30:318–338.
MLA	Atalan, Abdulkadir et al. “Yüksek-Eğitimli Uzman Hemşire İstihdamı Ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi”. Marmara Fen Bilimleri Dergisi, vol. 30, no. 4, 2018, pp. 318-3, doi:10.7240/marufbd.395255.
Vancouver	Atalan A, Dönmez CÇ, Ayaz Atalan Y. Yüksek-Eğitimli Uzman Hemşire İstihdamı ile Acil Servis Kalitesinin Yükseltilmesi için Simülasyon Uygulaması: Türkiye Sağlık Sistemi. MFBD. 2018;30(4):318-3.