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Purpose: This study aimed to develop an algorithm-based simulation scenario for emergency measures for a high-risk newborn presenting apnea. Methods: A methodological study design was used to develop the algorithm-based simulation scenario. Expert evaluation was used to establish the developed algorithm’s content validity. Results: The simulation scenario was developed using several steps of algorithm development based on the Neonatal Resuscitation Program (NRP). The content validity was established. Based on the expert evaluation results, an eight-frame algorithm was selected for the final simulation scenario. The scenario courseware was composed of six major components: pre-learning activity simulation orientation, simulation operation, SBAR-format recording, watching the video-clip of their performance for self-evaluation and debriefing. After simulation, student’s clinical performance and communication skill were evaluated with the developed instrument. Conclusion: Considering that nursing students have limited access to high-risk newborns during their clinical experience and that newborns presenting apnea are common in the neonatal intensive care unit, the algorithm-based simulation scenario developed in this study can provide students with the opportunity to practice alternative emergency measures for high-risk newborns.

This study analyzed the characteristics of high PM2.5 episodes that meets the concentration criteria of Emergency Reduction Measures Plan (ERMP) in Busan during the 2015-2020, and compared with those in Seoul. As a first step, the CAPSS-2017 emission data was employed to analyze the emission differences between Busan and Seoul, and pointed out that Busan emission included the dominance of ship emissions (37.7%) among total PM2.5 city emissions, whereas fugitive PM2,5 emission was the highest in Seoul. These emission characteristics are indicating that the controlling action plan should be uniquely applied to cope with ERMP in each region. We selected extremely high PM2.5 episode days that meet the criteria of ERMP levels. In Busan, Ulsan, and Gyeongnam region, 15, 16, and 8 days of extremely high PM2.5 cases were found, respectively, whereas Seoul showed approximately doubling of occurrences with 37 cases. However, the occurrences in summer season indicated big differences between two cities: the proportion of summer-season occurrence was 13-25% in Busan, whereas no single case have occurred in Seoul. This is suggesting the needs of comprehensive summer emission reduction plan with focusing on sulfur reduction to effectively cope with the ERMP levels in summer in the southeastern region, including Busan.