Publication: 17 Ağustos 1999 Marmara depremi sonrası İstanbul ilinde bulunan kamu hastaneleri acil ünitelerindeki gelişmelerin irdelenmesi
Abstract
Bu çalışma, İstanbul ilinde bulunan I. Seviye acil hizmeti veren tüm kamu hastanesi acil ünitelerinin, 17 Ağustos 1999 Marmara depremi sonrasında, insan gücü, fiziki yapı, yönetsel durum ve tıbbi donanım açısından nasıl bir gelişme sağladıklarını belirlemek amacıyla tanımlayıcı olarak yapıldı. Araştırma; İstanbul ilinde bulunan ve I. seviye acil hizmeti veren, 13 adet kamu hastanelerinin acil ünitelerinde 01 Ekim 2004-30 Ocak 2005 tarihleri arasında, yönetici ve sorumlu hekim, hemşire, sivil savunma uzmanları ile yüz yüze görüşülerek yapıldı. Acil ünitelerinin insan gücü, fiziki yapı, yönetsel durum ve tıbbi donanımını irdeleyen sorular yöneltildi, gözlem yapıldı. Araştırmanın verileri araştırmacı tarafından geliştirilen veri toplama formuna kayıt edildi. Sonuç olarak; araştırma yapılan acil ünitelerinde çalışan hemşirelerin deprem sonrası %23.9, hekimlerin %46.6, hizmetli personelin %13.9 oranında artış gösterdiği, deprem sonrasında görev alacak personellerin görev tanımlarının, afetler konusunda ki eğitimlerinin ve depremde uygulanacak acil durum planının %73 oranında yapıldığı belirlendi. Acil ünitelerinde ki triyaj uygulama eğitimlerinin deprem sonrası artış göstermesi istatistiksel açıdan da anlamlı bulundu (%53.8). Depremden sonra hasta nakil kriterlerinin oluşturulması (%76.9), hasta kayıt kriterlerinin belirlenmesi (%61.5), alternatif çıkışlar ve yönlendirici tabelalar konulması (%76.9), yaşamsal önem taşıyan tıbbi malzeme ve cihazların bulundurulması (%98), acil durum alarm ya da uyarı sisteminin geliştirilmesi (%84.6), hasar belirleme çalışmalarının yapılması (%69.2) istatistiksel açıdan anlamlı bulunurken, deprem bilgisi klavuzlarının oluşturulması, deprem tatbikatı yaptırılması, tıbbi sarf malzemelerin bulundurulması, acil ünitelerinin fiziki yapılarının düzenlenmesi, haberleşme yöntemlerinin geliştirilmesi, tanı ve tedavi bölümlerinin acil ünitesine yakın ya da ünitenin içinde yapılması, tıbbi cihaz, ekipman ve riskli malzemelerin sabitlenerek olası bir depreme karşı önlem alınmasının 17 Ağustos depremi öncesine göre anlamlı bir farklılık oluşturmadığı saptandı.
This descriptive study was conducted in Istanbul, to evaluate the changes in human resources, physical infrastructure, management status and medical equipment in the state hospitals having a first level emergency unit, after the August 17, 1999 Marmara earthquake. October 1st, 2004 and January 30th, 2005, general managers, medical directors, nurses, civil defence officers from 13 state hospitals having a first level emergency unit in Istanbul were interviewed face-to-face. In additon to the questions about human resources, physical infrastructure, management status and medical equipment, on site observations were made. All the collected data were recorded onto a data form developped by the reseacher. Since the earthquake, it was found that the numbers of nurses, physicians and other health staff were increased (23.9%, 46.6% and 13.9%, respectively). The preparation of mission statements, training for a possible disaster of the staff, and the existence of emergency plans were achieved at a rate of 73%. The increase in the triage application training after the earthquake was statistically significant (53.8%). Other significant findings were the preparation of patient trasport criteria (76.9% ), patient registration criteria (61.5%), alternative exits and installation of directional signs (76.9%), the preparedness of vital medical materials and machines (98%), installment of emergency alarms and warning systems (84.6%) and damage analysis studies (69.2%). But, no significant difference were found for those below, after the earthquake: preparation of earthquake information guides, earthquake readiness exercices, piling up medical materials, amelioration of physical infrastructure of the emergency units, development of uninterupted telecommunication tools, the closeness of diagnosis and treatment areas to the emergency units, stabilization of medical machines, equipment and risky materials to prevent potential injuries.
This descriptive study was conducted in Istanbul, to evaluate the changes in human resources, physical infrastructure, management status and medical equipment in the state hospitals having a first level emergency unit, after the August 17, 1999 Marmara earthquake. October 1st, 2004 and January 30th, 2005, general managers, medical directors, nurses, civil defence officers from 13 state hospitals having a first level emergency unit in Istanbul were interviewed face-to-face. In additon to the questions about human resources, physical infrastructure, management status and medical equipment, on site observations were made. All the collected data were recorded onto a data form developped by the reseacher. Since the earthquake, it was found that the numbers of nurses, physicians and other health staff were increased (23.9%, 46.6% and 13.9%, respectively). The preparation of mission statements, training for a possible disaster of the staff, and the existence of emergency plans were achieved at a rate of 73%. The increase in the triage application training after the earthquake was statistically significant (53.8%). Other significant findings were the preparation of patient trasport criteria (76.9% ), patient registration criteria (61.5%), alternative exits and installation of directional signs (76.9%), the preparedness of vital medical materials and machines (98%), installment of emergency alarms and warning systems (84.6%) and damage analysis studies (69.2%). But, no significant difference were found for those below, after the earthquake: preparation of earthquake information guides, earthquake readiness exercices, piling up medical materials, amelioration of physical infrastructure of the emergency units, development of uninterupted telecommunication tools, the closeness of diagnosis and treatment areas to the emergency units, stabilization of medical machines, equipment and risky materials to prevent potential injuries.