Purpose: This study was aimed to modify and adapt the previously developed, high-quality enteral tube feeding guidelines for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by NECA (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The modified and adapted enteral tube feeding guidelines were consisted of 11 domains and 95 recommendations. The domains and numbers of recommendations in each domain were: 4 on general issues, 2 on enteral nutrition indication and discontinue, 6 on enteral nutrition device selection, 12 on enteral tube feeding device insertions, 3 on enteral nutrition formular and choices, 16 on enteral tube feeding start and progress, 20 on enteral tube feeding maintenance and management, 15 on monitoring enteral tube feeding administration, 10 on prevention of error, 5 on medication administration, and 2 on documentation and report. There were 16.1% of the recommendations marked as A grade, 17.8% of B grade, and 66.1% of C grade. Conclusion: The adapted enteral tube feeding nursing practice guideline is to be added to the evidence-based practice guidelines for fundamentals of nursing practice. The guideline is hoped to be disseminated to nurses nationwide in order to improve the efficiency of enteral tube feeding practice.

Purpose: The purpose of this study was to perform an operating room nursing activities analysis and estimate nursing intensity of each nursing activity based on the Relative Value Scale (RVS). Methods: The methodology for this study of RVS was based on the work of Hsiao et al. The first stage was to identify nursing activities and the second to measure intensity of nursing activities including technical skill, mental effort, and stress. Results: Calculation of the RVS for 99 nursing practices showed a score range from 300.00 to 1337.78. CS operation assistant, OS operation assistant, and obtaining certification had high nursing intensity. Surgical hand washing, putting on surgical gowns, surgical gloves and surgical caps and mask had low nursing intensity. Conclusion: The activities of operating room are not compensated separately but reimbursement is usually included in physician fees. In the future, an estimation of nursing cost should show the nursing contribution rate to total operation revenue.

Purpose: This study was conducted to identify factors influencing endoscopy nurses' protective behavior against radiation exposure. Methods: Data were collected using self-report questionnaires from 122 endoscopy nurses in 21 hospitals located in Seoul, Gyeonggi province and six metropolitan cities in Korea. Collected data were analyzed using SPSS 18.0 program and included multiple regression analysis. Results: 1) There were significant relationships between protective behavior and protective environment (r=.74, p<.001), number of education sessions on radiation protection (r=.32, p<.001), number of protective devices (r=.28, p=.002), number of fellow nurses (r=.27, p=.003), and protective attitude (r=.18, p=.048). 2) Protective environment (${\beta}=0.79$, p<.001), type of hospital foundation (${\beta}=0.18$, p=.011) and marital status (${\beta}=-0.13$, p=.040) significantly predicted endoscopy nurses' protective behavior against radiation exposure (adjusted R square=.58, p<.001). The most powerful predictor for protective behavior against radiation exposure was a protective environment. Conclusion: Effective protective behavior of endoscopy nurses from radiation exposure requires improvement in their protective environment. Hospital administrators and managers should make efforts to increase protective facilities in endoscopy departments and provide endoscopy nurses with regular education on radiation protection.

Purpose: The purpose of this study was to investigate job stress and job satisfaction among nurses in gastrointestinal endoscopy units, and factors related to their job stress and job satisfaction. Methods: The study participants were 153 nurses working in gastrointestinal endoscopy units at eleven general hospitals. Job stress and job satisfaction were measured using nurses's job stress scale and the index of work satisfaction respectively. Results: The average job stress was 3.67 (range 1~5) and job satisfaction was 2.90 (range 1~5). Gastrointestinal endoscopy unit nurses, who were full time worker, having more than 7 years of clinical experiences, having higher incomes, having high subjective work-intensity, and having an intention to change their working units, showed greater job stresses than those of the others. There were significant differences in job satisfaction according to subjective health status, the types of employment, subjective work-intensity, subjective aptitude, intention to change working units, major nursing tasks, and the numbers of major nursing tasks. Also, the subjects's job stress showed a negative correlation with job satisfaction. Conclusion: Findings suggest that management strategies should be developed to increase job satisfaction focusing on general and job characteristics associated with job stress.

Purpose: The main purpose of this study was to effect oral care methods between essential oil gargling and purified water gargling for postoperative patients who had general surgery or orthopedic surgery. Methods: The postoperative patients were assigned to one of two groups. One group gargled with essential oil and the other with purified water. All group gargled three times interval 2 hours. Each patients thirst, oral condition and halitosis were assessed four times. Results: After oral care was provided once, there were significant differences in thirst level between two groups. when oral care was provided once and three times, there were significant differences in oral condition between two groups. but there were no significant differences in halitosis between two groups. Conclusion: The results show that essential oil gargling is a more effective intervention than purified water gargling for post operative patients oral care in reducing the thirst level and improving the condition of the oral cavity.

Purpose: This study was done to identify the effects of Laughter therapy on recovery status from facial paralysis, pain, and stress in Bell's palsy patients. Methods: This research was a nonequivalent control group non-synchronized pre-posttest quasi-experimental research design. Data were collected from August 8, to October 15, 2013 at D university Oriental Medical Center in B city. Participants were 60 patients with Bell's palsy who were assigned to one of two groups: an experimental group of 30 patients and a control group of 30 patients. t-test, $x^2-test$, Fisher's exact test and Welth-Aspin test were used to test the homogeneity between the two groups and t-test, Welth-Aspin test and ANCOVA were used to test the research hypotheses. SPSS program was used for statistical analysis. Results: There were significant increases in recovery status from facial paralysis and decreases in stress after Laughter therapy in the experimental group. Conclusion: The results indicate that Laughter therapy is effective in facilitating recovery status from facial paralysis and decreasing stress. Therefore, Laughter therapy can be used as an effective nursing intervention for patients with facial paralysis and to relieve stress in these patients.

Purpose: Resuscitation rooms in emergency department are places for time-critical tasks. This study aimed 1) to develop a resuscitation protocol for dyspneic patients and 2) to evaluate the effect of the resuscitation protocol for dyspneic patients in improving clinical performances. Methods: A panel of experts including emergency physicians and nurses developed a resuscitation protocol for dyspneic patients which included a list of critical interventions and time-limits. The resuscitation protocol was implemented in a emergency medical center for two months. Clinical performances of health care providers were compared by analyzing video-recorded clinical performances. Results: The resuscitation protocol consisted of four steps: Initial treatments within 5 minutes, main treatments within 15 minutes, diagnostic tests within 30 minutes, and disposition within 60 minutes. A total of 43 dyspneic patients (23 patients experimental group, 20 patients control group) were included for the analysis of the clinical performance change. Clinical performance rates were improved significantly from control group (66.71%) to experimental group (82.41%) after implementing the resuscitation protocol (Z=-3.09, p=.004). Conclusion: The resuscitation protocol developed for dyspneic patients improved clinical performance rates of health care providers. Further development of clinical protocols for other emergent cases at resuscitation rooms are strongly recommended.

Purpose: Preventing frequent change and discontinuation of the nurses' carrier is one of major issues for human resource management in a health organization (HO). This study was conducted to get evidences for improvement nursing manpower management and career development of the clinical nurses through investigating affecting factors to their career withdrawal intention (CWI). Methods: A self-report questionnaire survey was conducted on the subjects of the 590 clinical nurses with more than one year tenure from the eight hospitals in Busan city during December, 2013. Data analysis was performed using SPSS program (ver 20.0) and AMOS program (ver 20.0) for structural modeling. Results: Career satisfaction (CS) showed positive(+) effects, and increased with higher job adequacy (${\beta}=.139$, t=2.676, p=.007), job autonomy (${\beta}=.260$, t=4.815, p<.001), and career planning (${\beta}=.301$, t=5.797, p<.001). Career commitment (CC) showed positive(+) effects, and increased with higher job adequacy (${\beta}=.107$, t=2.280, p=.023), job autonomy (${\beta}=.257$, t=5.035, p<.001), career planning (${\beta}=.232$, t=4.717, p<.001), and career satisfaction (CS)(${\beta}=.123$, t=2.293, p=.022). CWI showed negative(-) effects and increased with lower CC (${\beta}=-.906$, t=-15.72, p<.001). Conclusion: Results indicate that CC and CS have important mediating roles between job adequacy, job autonomy, career planning and CWI. As CC directly influenced CWI, there is a need to strengthen CC to prevent frequent changes and discontinuation of nurses' careers and to contribute to productivity HO's.

Purpose: Along the process of organ transplantation, coordinators perform complex professional roles, playing as a key person among recipients, donors, family members and medical staffs. The purpose was to analyze the tasks of organ transplantation coordinators using DACUM method and to establish the basis for standardizing them in accordance with relevant laws and systems. Methods: Participants were consisted of 78 transplantation coordinators working at the medical centers in Korea. The questionnaire was administered to analyze the criticality, difficulty and frequency of task elements. Results: The job of organ transplantation was classified into five duties, 13 tasks, and 84 task elements. The five duties were recipient management, donor management, organ donation activation management, organ transplantation administration, and professional capability development. On the four-point scale: donor management was the duty with the highest criticality (3.68), organ donation activation management was the duty of highest difficulty (2.96), and recipient management was the duty of the highest frequency (3.32). Conclusion: This study will be useful for developing an educational program and as a reference of nurse practitioner qualifying examination. It is necessary to develop a comprehensive educational program for transplantation coordinators in order to support them to take their complex roles successfully.

Purpose: This study was done to identify the level of knowledge on and stress from delirium among recovery room nurses, and correlations between these factors. Methods: In this study, 125 nurses agreed to participate in the study were surveyed from October 8 to October 28, 2013. Data were analyzed using t-test, ANOVA, $Scheff{\grave{e}}$ test and Pearson correlation. Results: Average percentage of correct answers to questions about delirium was 81.9% and the mean score was 26.22 (${\pm}5.01$). The mean score for recovery room nurses' work stress from emergency delirium was 3.86 (${\pm}0.99$). Extent of knowledge on delirium significantly differed by age (F=15.017, p<.001), length of clinical experience (F=22.132, p<.001), length of recovery room experience (F=10.538, p<.001), education (F=3.312, p =.040), and marital status (t=4.107, p<.001). Stress from ED was significantly related to age (F=9.185, p<.001), clinical experience (F=7.077, p=.001), and marital status (t=-2.027, p =.045). Knowledge on delirium had a negative relationship with stress from delirium (r=-.514, p<.001). Conclusion: Results show that nurses gained knowledge of delirium from their own clinical experience indicating a need to develop educational programs to improve knowledge on delirium and plans to reduce stress from delirium for recovery room nurses.