Purpose: This study aimed to determine the correlation between uncertainty, self efficacy, social support, and self-care performance among liver transplant recipients. Methods: Participants comprised 111 liver transplant recipients who visited the outpatient clinic at the hepatobiliary and pancreatic surgery department of a hospital in D city. Data were collected from September to October 2021 using self-report questionnaires, and were analyzed by the SPSS 23.0 program. Results: Self-care performance was correlated with uncertainty (r=-.31, p=.001), self efficacy (r=.22, p=.023), and social support (r=.38, p<.001). Conclusion: To improve self-care performance in liver transplant recipients, it is necessary to develop nursing interventions that can reduce uncertainty and enhance self efficacy and social support.

Purpose: This study aimed to identify the relationship between the experiences of workplace violence and post-traumatic stress disorder and the moderating effect of resilience and social support at work on the relationship in tertiary hospital nurses. Methods: This was a descriptive correlation study to confirm the moderating effect of resilience and social support at work on the factors affecting post-traumatic stress disorder for nurses who have experienced violence. A total of 146 registered nurses were recruited from a tertiary hospital from March to July 2020. The Participants who worked for more than one year and experienced violence at work completed self-reported questionnaires that measured the experiences of workplace violence and post-traumatic stress disorder, resilience, social support at work, and demographic information. The collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient, and hierarchical regression analysis. Results: The nurses experienced verbal abuse an average of 3.70±2.06 times a week, physical threat an average of 2.30±1.71 times a month, and physical assault an average of 0.76±0.82 times a year. The Experiences of workplace violence were significantly increased post-traumatic stress disorder. The result also showed that resilience moderated the relationship between the experience of verbal abuse and post-traumatic stress disorder in hospital nurses. However, there was no significant moderating effect of social support between workplace violence and post-traumatic stress disorder. Conclusion: The experiences of workplace violence influenced post-traumatic stress disorder in nurses and were moderated by resilience. Therefore, hospital administrators need to develop and provide a workplace violence prevention and resilience reinforcement program to reduce post-traumatic stress disorder in nurses. In addition, we suggest further research on the effect of social support in a workplace on the experiences of violence.

Purpose: This study aims to identify the effects of mobile web-based COVID-19 isolation hospitalization management training on patient's uncertainty, anxiety, and nursing education satisfaction. Methods: Patients hospitalized with COVID-19 isolation rooms from August to October 2021, in Medical Center B which is an infectious disease dedicated hospital located in metropolitan city B were included. The total number of subjects was 142, of which 71 were the experimental group and 71 the control group. As an experimental treatment, a total of 5 minutes and 35 seconds of mobile web-based education were provided to the experimental group three times, including the day of, the first day of, and the second day of hospitalization. Existing training conducted on the control group was provided by the nurses in charge of the ward through oral explanation using printed materials. The data were analysed using the IBM SPSS/WIN 26.0 program. Results: Significant differences were observed between the two groups in pre-and post-assessment of uncertainty scores (t=-22.92, p<.001), anxiety scores (t=-15.03, p<.001) and nursing education satisfaction score (t=11.61, p<.001). Conclusion: As a result of the above, mobile web-based education can be used as an effective educational medium in nursing practice to improve the work efficiency and quality of nursing care and contribute to improving the patient's educational satisfaction.

Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.

Purpose: This retrospective chart review study was conducted to examine the frequency of delirium and to identify the risk factors of delirium in elderly surgical patients. Methods: The subjects of this study were 394 patients aged 65 years or older who underwent surgery. The diagnosis of delirium was based on the nursing assessment records with scores from the day of surgery to the 4th day after surgery. The collected data were analyzed by binary logistic regression analysis. Results: The incidence of delirium was 4.3%, and delirium occurred most frequently on the first day of surgery and lasted for 2.16 days on average. Of delirium patients, 76.5% underwent gastrointestinal surgery, and the most common delirium pattern was disorientation. In terms of the characteristics of the subjects, the occurrence of delirium was statistically different by age (𝝌²=10.79, p=.005), systemic-specific disease (𝝌²=9.63, p=.047), use of delirium-inducing drug(benzodiazepine) before surgery (𝝌²=15.90, p<.001), walking ability before surgery (𝝌²=7.65, p=.006), history of delirium (𝝌²=35.92, p<.001), and emergency surgery (𝝌²=16.40, p<.001). As risk factors of delirium, gastrointestinal surgery was found to increase the risk of delirium by 12.57 times (95% CI=2.45~64.46, p=.002), and the use of benzodiazepines before surgery was shown to increase delirium by 10.07 times (95% CI=2.21~45.87, p=.003). Conclusion: It is necessary for nurses to actively evaluate delirium using screening tools for early detection and prevention of delirium in elderly surgical patients with delirium risk factors.

Purpose: The purpose of this study was to examine the influence of empowerment, infection control organizational culture, and infection control awareness on infection control performance among nurses in long-term care hospitals. Methods: A descriptive survey study was conducted with 125 nurses as subjects who had been working for at least six months in four long-term care hospitals located in Busan metropolitan city and Gyeongsangnam-do Province. Data were collected from September 30 to October 28, 2021 and analyzed using t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple regression with SPSS/WIN 26.0. Results: The results showed that infection control performance had significant correlations with empowerment (r=.36, p<.001), infection control organizational culture (r=.51, p<.001), and infection control awareness (r=.75, p<.001). Multiple regression analysis for infection control performance revealed that the most powerful predictor was infection control awareness (β=.70, p<.001). Empowerment, infection control awareness and awareness of infection control guidelines explained approximately 60.0% of the variance in infection control performance. Conclusion: Findings indicated that various factors are related to the infection control performance among nurses in long-term care hospital. Based on the results of this study, further development and application of the programs to enhance empowerment and infection control awareness are needed in order to improve the infection control performance of nurses in long-term care hospitals.

Purpose: The purpose of this study was to investigate hospital nurses' delirium screening for postoperative delirium, delirium knowledge, and delirium care using case scenarios at a tertiary hospital in Seoul. Methods: A total of 235 nurses working at surgical units participated in this questionnaire-based study. Five cases scenarios were developed based on diagnosed postoperative delirium cases. Data were collected from April 1 to May 1, 2021. Results: The delirium screening score was 4.20±1.17 out of 5. The delirium knowledge score was 34.35±4.57 out of 47. The delirium care score was 67.61±9.26 out of 92. The correlation between the delirium screening and delirium knowledge was statistically significant (r=.18, p=.005). The correlation between the delirium knowledge and delirium care was statistically significant (r=.25, p<.001). Conclusion: The findings showed that the continuing educations of delirium for hospital nurses and the development of a delirium education programs were important to improve delirium screening and care.

Purpose: Driveline infection (DLI) is one of the major adverse events of Left Ventricular Assist Device (LVAD). The purpose of this study was to explore the incidence of DLI according to the driveline dressing methods. Methods: This study was a retrospective cohort study that investigated the medical records of 75 patients who implanted LVAD from January 2015 to December 2020 at a hospital in Seoul, Korea. Traditionally, sandwich dressing method was applied until October 2019, after which newly winded dressing method was adopted for driveline dressing to LVAD patients. The outcome variables were compared between sandwich dressing method applied group (n=41) and winded dressing method applied group (n=34). The follow-up period for DLI was 1 year. Results: When compared participants' characteristics, there was no difference between the two groups, except the type of LVAD device. The incidence of DLI was 17.1% in sandwich dressing group, while no infection was found in winded dressing group (p=.011). Conclusion: Although there were difference in the LVAD devices, it is considered that winded dressing contributed to the reduction of DLI. Further research on standardized dressing methods was required for DLI prevention in Korea.

Purpose: The purpose of this study was to identify the relationships between variables and factors affecting the intention on retention of nurses in small and medium-sized hospitals. Methods: The participants of this study were 203 nurses working in six small and medium-sized hospitals, and data was collected from August 15 to August 30, 2019 using a structured questionnaire. The collected data were analyzed by t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using IBM SPSS/WIN 24.0. Results: As a result of the study, intention on retention was positively correlated with resilience (r=.40, p<.05) and followership (r=.38, p<.05). Affecting factors of the intention on retention were marital state (married) (β=.21, p=.001), resilience (β=.22, p=.016), and active engagement as a subcartegory of followership (β=.19, p=.034), and the variables explained 20.8% of the nurses' intention on retention. Conclusion: In order to increase the intention on retention of small and medium-sized hospitals nurses, it is necessary to provide an environment in which small and medium-sized hospital nurses are able to have active engagement and independent thinking and to develop a program to promote their resilience.

Purpose: This study was performed to verify reliability and validity of the Korean Pediatric Patient Classification System (KPPCS) and estimate nursing time conversion index. Methods: The study was conducted in 9 children's hospital which included various areas and size of bed settings. To verify intraclass correlation reliability and construct validity, staff nurses and nurse managers of 21 wards classified 575 patients according to KPPCS comparing differences by age, days of stay, type of stay and medical department. Direct and indirect nursing time of 575 patients were measured by 284 nursing staffs by stopwatch observation and self reports for 24 hours. Results: KPPCS has 12 categories, 55 nursing activities and 80 criterions. High agreement among nurses (r=.91, p<.001) suggested substantial reliability. Construct validity was verified by comparing differences in age, days of stay, type of stay and medical department (p<.05). The correlation of nursing time and classification score was also statistically significant (r=.59, p<.001). The nursing time conversion index was 10.78 minutes per 1 classification score. The entire patient group were classified to four groups using KPPCS. Conclusion: The findings suggest that KPPCS would be a useful tool for estimating nursing demands related to the complexity of pediatric patients.

Purpose: The purpose of the study was to shorten the KPCS-1 (Korean Patient Classification System-1) for predicting nursing care need level and to explore whether the patients can be clustered by their acuity and dependency. Methods: The participants were inpatients in two surgical wards and two internal medicine wards at a teritory hospital during 14 days investigations. The KPCS-1 was evaluated once a day for all inpatients and 2,082 cases of data from a total of 411 patients were analyzed. Results: The items were reducted from 50 items to 26 items by partial least squares analysis and expert review. Through factor analysis, it was confirmed that hygiene, diet, elimination, and exercise were categorized as dependence factors. Patients were clustered with low acuity/low dependency (average score: 7.68±2.81/1.05±1.33), high acuity/low dependency (average score: 17.20±4.15/1.94±2.40), medium acuity/high dependency (average score: 13.56±5.30/9.66±2.64) through cluster analysis. The total score of the three groups for their nursing care needs was 8.73±3.36, 19.14±5.74, and 23.24±6.31 in order, and the results showed a statistically significant difference (F=1712.12, p<.001). Conclusion: The shortening of the KPCS-1 and the new criteria for categorizing patients according to acuity and dependence will increase clinical utility and be useful for manpower assignment criteria in detail.