Purpose: This study was to develop a factor-type patient classification system for general nursing unit based on nursing needs (KPCS; Korean patient classification system for nurses). Method: We reviewed workload management system for nurses(WMSN) of Walter Reed Medical Center, Korean patient classification system for ICU, and nursing activities in nursing records and developed the first version of KPCS. The final version KPCS was evaluated via validity and reliability verifications based on panel discussions and data from 800 patient classifications. Content validity was performed by Delphi method and concurrent validity was verified by the correlation of two tools (r=.71). Construct validity was also tested by medical department (p<.001), patient type (p<.001), and nurse intuition (p<.001). These verifications were performed from April to October, 2008. Results: The KPCS has 75 items in classifying 50 nursing activities, and categorized into 12 different nursing area (measuring vital sign, monitoring, respiratory treatment, hygiene, diet, excretion, movement, examination, medication, treatment, special treatment, and education/emotional support). Conclusion: The findings of the study showed sound reliability and validity of KPCS based on nursing needs. Further study is mandated to refine the system and to develop index score to estimate the necessary number of nurses for adequate care.

Purpose: The purpose of this study was to examine the effect of position change on discomfort and bleeding in patients undergone coronary angiography with a vascular device and required bed-rest. Method: This study utilized nonequivalent control group non-synchronized design. Data were collected from 118 inpatients after coronary angiography and stayed in general ward at Y hospital in Seoul, from June 5 to August 12, 2008. After coronary angiography, position change was performed to the experimental group who consisted of 59 patients. They stayed in supine position just after angiography and then head-up position with 15 degrees was applied 1 hour later. After that, they could change the position alternatively into lateral position with leg down and supine position. The control group was positioned keeping the affected leg immobile with supine position for 4 hours. Results: The experimental group reported significantly more comfortable than control group after position change. There were no significant differences in the grades of bleeding or hematoma at puncture site between the two groups. Conclusion: The position change in patients undergone angiography could be applied without any harm such as bleeding or hematoma, but effective in reducing back pain and subjective patients' discomforts.

Purpose: The purpose of this study was to evaluate the importance and the performance of intramural marketing in the hospital and to examine the effect of intramural marketing on nurses' job satisfaction and turnover intention. Method: The participants of this study were 203 nurses, who had worked over 3 months in the general or special units in C university hospital located in Seoul. Results: The participants' perceived performance of the intramural marketing was 2.35 on average. The importance of the intramural marketing recognized by the participants was 4.02. The score of the job satisfaction of the participants was 2.74 and that of the turnover intention was 3.67 on average. The intramural marketing demonstrates statistically significant correlations with job satisfaction and turnover intention. Conclusion: The findings of the study demonstrate the importance of the intramural marketing in the hospital for nurse retention. In order to increase nurses' job satisfaction and reducing their turnover intention, the intramural marketing activities should be expanded further.

Purpose: This study aimed to compare the moisturizing effect of cold water gargling, wet gauze application and humidification in reducing thirst and mouth dryness after nasal surgery. Method: Patients were randomly assigned into three groups of 19 subjects each. In the two intervention groups, each group was received hourly cold water gargling or wet gauze application for 4 hours postoperatively. In the control group, the subjects were received only humidification continuously on a bedside. We compared the thirst and oral condition at 0, 2, 4hours. after operation. Thirst was measured using VAS questionnaire, and oral condition(mouth dryness) by Oral Assessment Guide. Results: There was a significant difference among three groups in the level of thirst and mouth dryness. In the cold water gargling group, there was a significant decrease in thirst at 2, 4hours. In the wet gauze group, there was a significant decrease in thirst at 4hours. In the intervention group, there was a significant decrease in mouth dryness at 2, 4hours. In the control group, there was a significant decrease in mouth dryness at 4hours. Conclusion: The findings of this study suggest that the cold water gargling would be an effective nursing intervention to reduce thirst and mouth dryness postoperatively.

Purpose: The purpose of this study was to compare the 1% chlorhexidine gluconate/61% ethanol (CHG/ethanol), 45% ethanol/18% 1-propanol (ethanol/propanol) and 7.5% povidone-iodine (PVI) scrub with brush to evaluate their antimicrobial effect. Method: Utilizing repeated measures design, 9 nurses participated in the study. Glove juice sampling procedure was used to evaluate microbial hand counts before the surgical hand antisepsis, one minute after hand wash, and after the surgery. Results: Waterless rub using CHG and ethanol combination resulted in a 3.94 log reduction at 1 min and 2.78 log reduction at 3 hrs. Ethanol/propanol resulted in a 2.42 at 1 min and 2.22 at 3 hrs. The traditional scrub using PVI with brush resulted in a 0.94 at 1 min and 0.95 at 3 hrs (p=.003) and 3 hrs (p=.026) after the surgical hand antisepsis. Repeated measures ANOVA results showed that there was a statistically significant difference among group (p=.002). Duncan post hoc test result showed that the PVI was less effective (p<.05) in sterilizing microbials on hands than CHG/ethanol or ethanol/propanol. Conclusion: Both of the two alcohol-based antiseptic rubs are acceptable alternatives to the PVI with brush for surgical hand antisepsis.

Purpose: This study was aimed to investigate the effects of Lebed method exercise (LME) on nurses' depression, anxiety and stress. The LME is a therapeutic exercise and movement program developed by Sherry Lebed Davis and expected to lessen the stress level of nurses and enhance the nursing job's satisfaction and efficiency. This study was utilized a non equivalent control group pre-post test design. Method: The subjects were 36 nurses in total; 18 in experimental group and 18 in control group. The data were collected from March to August, 2008. For the experimental group, 8 hour-long lectures on stress management and LME were given for 12 weeks. For the control group, only lectures on stress management was given. Depression, anxiety, perceived stress, and heart rate variability were measured on the subjects in both groups as pre- and post tests. The data were analyzed by Kolmogrov-Smirov test and P-P plot, t-test and $x^2-test$ using the SPSS program. Results: As proposed in the hypothesis, the subjects in the experimental group experienced less depression (t=2.286, p=.029), less anxiety (t=3.319, p=.002) and less perceived stress(t=2.862, p=.007) than those in the control group. Conclusion: The LME is considered an effective exercise to improve depression, anxiety, and to lessen stress for the nurses. The LME program has potential to be one of the effective stress management interventions for nurses in the future.

Purpose: The purpose of this study was to describe the characteristics of children who visited the pediatric emergency department (PED) following an accident. Method: Data were obtained from the medical records of 4,010 children who visited the PED from January 1, 2004 through December 31, 2006. Data were analyzed using SPSS WIN 13.0 version. Results: The percentage of children who visited the PED for treatment following an accident was 14.9%. There were more boys (63.5%) than girls. The largest age group for children visiting the PED was preschool aged children. Slip downs were the most frequent accident (37.1%). The face was the most frequently injured area of the body (26.0%). Most (93.3%) of the children who visited the PED were classified as non-emergency, 6.5% as emergency and 0.2% as urgent. About 70.0% of children were examined and 50% of children were medicated. Fifty percent stayed in the PED department for less than 2 hours, and 88.0% of children were discharged to home. Nine percent were admitted, and 2.2% were transferred to other hospitals. Conclusion: The results of this study suggest the need for accident prevention education for parents, and the need to develop effective education for clinical nurses working in PED.

Purpose: The purpose of this study was to develop a valid and reliable instrument to explore and measure job satisfaction as perceived by perioperative nurses, specifically from the perspective of contemporary perioperative nursing in Korea. Method: Items (69) were developed from the responses to two open-ended questions by 168 perioperative nurses in one teaching hospital; (a) reasons that make work enjoyable, (b) reasons that make work unpleasant. Finally 55 items were selected, excluding items with lower correlation with the total scale. The instrument was completed by 885 perioperative nurses from 89 different hospitals nationwide who were attending the annual conference of the Korean Association Operating Room Nurses (KAORN), yielding a response rate of 95.6%. Results: Ten factors were extracted by factor analysis, which explained 60.0% of the total variance; Reliability and internal consistency were established (Cronbach's alpha=.95). A smaller sample of 39 perioperative nurses completed the instrument on two occasions, with a 2-week interval between. Mean scores were computed and two sets of scores were analyzed by Weighted Kappa (W-Kappa=0.680, p=.029). Conclusion: This instrument is a concise, highly practical and flexible tool, which can be used for the perioperative nurse in a wide range of hospital settings.

Purpose: The purpose of this study was to identify nursing interventions frequently used with cancer patients. Nursing records from 5 general hospitals for patients with stomach, liver, lung or colon cancer were analyzed. Method: A descriptive study methodology was used and nursing records for 15 patients in each disease category at each hospital, who were admitted and discharged during June 2007 were analyzed. Results: Five domains of NIC were found and the physiological(basic) domain was most frequent (31.52%). Twenty two classes of NIC were identified with risk management for safety being most frequent (22.49%). For the 119 nursing interventions identified, the most frequent was pain management with 7,827 (12.31%), followed by prevention of falls (11.76%), surveillance (6.79%) and wound care (5.12%). Nursing activities of pain management and prevention of falls were comparable to activities listed in literature on guidelines for evidence based and best practices in nursing care. Eight of the 17 nursing activities for pain management, and 9 of 14 for fall prevention were consistent with these guidelines. Conclusion: In this study, nursing interventions were found to be focused on physical care, monitoring patients' condition and education. We have to develop diverse nursing interventions and a convenient recording process.

Purpose: This study was conducted to identify the effects of provision of a cancer pain guideline and education for patients with cancer and their families on their knowledge and attitude toward cancer pain control. Method: A nonequivalent control group pre-post test design was used. The participants were selected according to a selection criteria from patients and their families on the medical ward at K university hospital in D city. Both the experimental group for patients with cancer and control group consisted of 16 patients and their families. Results: The first hypothesis, which assumed that there was a difference between the patients in the experimental group and the control group on knowledge (t=-20.006, p=.000) and attitude (t=-13.492, p=.000), was accepted. The second hypothesis, which assumed there was a difference between families in the experimental group and the control group on knowledge (t=-16.087, p=.000) and attitude (t=-10.262, p=.000), was supported. Conclusion: Education for cancer related pain control with a patient guideline had a positive effect on knowledge and attitude of patients with cancer patients and their families suggesting that there is a need to developed this type of guidelines.

Purpose: This study was conducted to construct evidence based clinical guidelines and to develop nursing process based performance measures for prevention and management of pressure ulcers, falls and pain. Method: Clinical guidelines were drafted through a comprehensive review of relevant literature, national guidelines and hospital protocols. The proposed guidelines were reviewed by a panel of experts and 90 hospital nurses, and refined on the basis of their suggestions. Nursing process based performance measures were developed based on the clinical guidelines and content validity was examined by surveys from 90 hospital nurses. Results: All items, except timetable for position change and pressure ulcer nursing record, in the guidelines for prevention and management of pressure ulcer were appropriate. Most items, except fall risk assessment tools, were appropriate for the guidelines of fall prevention. All other items, except the purpose of pain management, were appropriate for the guidelines of pain management. Performance measures developed in this study were acceptable as a tool to evaluate quality of nursing care. Conclusion: Nursing process based performance measures provide important indicators to monitor whether necessary nursing care is implemented and can be used as the primary resources to improve quality of nursing services.

Purpose: This study was done to identify the causes of turnover in nursing staff in small and medium‐size hospitals and prepare measures to decrease turnover. Nurses in these hospitals were surveyed focusing on their nursing activities, reasons for turnover, and content of their work. Method: A mail survey of hospitals with 300 beds or less was conducted using a questionnaire including items on the current state of nursing, performance of nursing tasks, turnover of nurses, working conditions, and supports and policies related to insufficient number of nurses. Results: The average number of nurses per 100 beds was 37.5, 3.3 less than the prescribed level of 40.8. The turnover rate was higher when the level of remuneration for nursing care was low, and the most frequent reason for nurses leaving was 'move to another hospital', showing that there is a continuous chain of moves for nurses. Other frequent reasons were situations related to working conditions such as childbirth, child care, irregular working hours, night work, and low wages. Conclusion: To guarantee adequate nursing coverage in these hospitals, working conditions for nurses should be improved, including higher wages, a more flexible work system, and installation and operation of 24-hour child care facilities.