• Tuberculosis and Respiratory Diseases
• /
• v.80 no.2
• /
• pp.201-209
• /
• 2017

Background: Methicillin-resistant Staphylococcus aureus (MRSA) infection is a severe and life-threatening disease in patients with community-onset (CO) pneumonia. However, the current guidelines lack specificity for a screening test for MRSA infection. Methods: This study was retrospectively conducted in elderly patients aged ${\geq}65years$, who had contracted CO-pneumonia during hospitalization at the Jeju National University Hospital, between January 2012 and December 2014. We analyzed the risk factors of MRSA in these patients and developed a scoring system to predict MRSA infection. Results: A total of 762 patients were enrolled in this study, including 19 (2.4%) with MRSA infection. Healthcare-associated pneumonia (HCAP) showed more frequent MRSA infection compared to community-acquired pneumonia (4.4% vs. 1.5%, respectively; p=0.016). In a multivariate logistic regression analysis, admissions during the influenza season (odds ratio [OR], 2.896; 95% confidence interval [CI], 1.022-8.202; p=0.045), chronic kidney disease (OR, 3.555; 95% CI, 1.157-10.926; p=0.027), and intensive care unit admission (OR, 3.385; 95% CI, 1.035-11.075; p=0.044) were identified as predictive factors for MRSA infection. However, the presence of HCAP was not significantly associated with MRSA infection (OR, 1.991; 95% CI, 0.720-5.505; p=0.185). The scoring system consisted of three variables based on the multivariate analysis, and showed moderately accurate diagnostic prediction (area under curve, 0.790; 95% CI, 0.680-0.899; p<0.001). Conclusion: MRSA infection would be considered in elderly CO-pneumonia patients, with three risk factors identified herein. When managing elderly patients with pneumonia, clinicians might keep in mind that these risk factors are associated with MRSA infection, which may help in selecting appropriate antibiotics.

• Korean Journal of Adult Nursing
• /
• v.24 no.1
• /
• pp.74-84
• /
• 2012

Purpose: This study was designed to identify knowledge and performance level of infection control among oriental medical doctors and nurses and further to identify factors that may influence practice. Methods: Data were collected using the survey method. Two hundred and forty two healthcare workers (HCW) from five oriental medicine university hospitals in Korea (140 physicians and 102 nurses) completed a survey about infection control. The study was conducted from February 1 to 28, 2011. Results: The average knowledge level of infection control among HCW was $0.75{\pm}0.13$ (score range 0~1) and the average performance level of infection control was $3.16{\pm}1.05$ (score range 0~5). 'Disinfection and sterilization' were ranked the highest in both the knowledge and performance level. In the knowledge level, 'hand washing/hand hygiene' were ranked the lowest. 'Bloodstream infection prevention' was the lowest among the infection control categories in performance. Total average knowledge and performance level of nurses was significantly higher than that of the physicians. Conclusion: This study demonstrated the oriental medical doctors and nurses' knowledge and performance level of infection control differed. The education on infection control is required to oriental medical doctors and nurses and it would contribute to preventing healthcare associated infections in oriental medicine hospitals.

• Journal of Korean Academic Society of Home Health Care Nursing
• /
• v.24 no.3
• /
• pp.306-315
• /
• 2017

Purpose: This study was conducted to examine psychological empowerment and awareness and performance of Healthcare-Associated Infections(HAIs) control among Intensive Care Unit (ICU) nurses. Method: The data for this study were collected using structured questionnaires from 178 nurses working in the ICUs of four hospitals with more than 500 beds. Results: The subjects'psychological empowerment, awareness and performance of HAIs control were mean over. The subjects'psychological empowerment showed statistically significant differences depending on age, marital status, academic background, clinical career, ICU career, and position and experience in infection control among their general characteristics. Awareness of HAIs control showed statistically significant differences depending on age, gender, marital status, clinical career, and ICU career. Performance showed statistically significant differences depending on age, gender, marital status, and, ICU career. Regarding the subjects' performance of HAIs control, there was a statistically significant positive correlation between psychological empowerment and awareness. Conclusion: It was found that it is necessary to strengthen differential customized training according to the subjects'characteristics for effective HAIs control, and to strengthen the nurses'awareness of HAIs control through systematic evaluation, monitoring, and feedback, as well as continuous education and training.

• Korean Journal of Clinical Laboratory Science
• /
• v.45 no.1
• /
• pp.1-4
• /
• 2013

Vancomycin-resistant enterococci (VRE) have emerged as important healthcare-associated infection since last two decades. ChromID VRE agar (cIDVA) is useful for VRE rectal swab screening. We investigated all VRE were isolated on the cIDVA. A total of 363 rectal swabs of 85 patients to test VRE screening were inoculated into bile-esculin (B-E) broth with $6{\mu}g/mL$ vancomycin. After 24 hours incubation, we subcultured B-E broths were changed to black onto cIDVA. All isolates were identified by the MICROSCAN and VITEK2. The vanA gene and vancomycin minimal inhibition concentration (MIC) were detected by PCR and E-test respectively. 277 E. faecium (84.7%), 16 E. faecalis (4.9%), 25 E. avium (7.6%), 8 E. gallinarum (2.4%) and 1 E. raffinosus (0.3%) were isolated. 10.3% of VRE detected on cIDVA were other than E. faecium and E. faecalis that presented various color from colorless to pale violet. All isolates contained vanA and vancomycin MIC were > $256{\mu}g/mL$. VRE isolates other than E. faecium and E. faecalis should be objective to the contact precautions for healthcare-associated infection control if they possess vanA gene. Due to emerging enterococci carrying vanA such as E. avium, E. gallinarum, and E. raffinosus, VRE surveillance should be expanded to all isolates on chromogenic agar.

• Journal of the Korea Academia-Industrial cooperation Society
• /
• v.18 no.8
• /
• pp.72-83
• /
• 2017

This study was conducted to investigate nursing students' safety-climate: perception and performance of standard precautions for healthcare-associated infection control. We also identified actors influencing performance of standard precautions. Data were collected from 246 junior and senior nursing students at nine colleges in D city from July to September, 2016. The mean score of performance was significantly lower than that of perception in all areas of standard precautions. The biggest difference between perception and performance was in the usage of personal protective equipment and safe injection practices. We also detected significant positive correlations among safety-climate, perception, and performance of standard precautions. In the regression analysis, performance of standard precautions was influenced by safety-climate and grade accounting for 10.7% of variance. To improve healthcare-associated infection control among nursing students, safer and more supportive practical environments need to be provided, and new training strategies such as simulation education need to be expanded.

• Obstetrics & gynecology science
• /
• v.61 no.6
• /
• pp.662-668
• /
• 2018

Objective This study was to identify the risk factors for cytological progression in women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL). Methods We analyzed data from women infected with the human papillomavirus (HPV) who participated in the Korean HPV cohort study. The cohort recruited women aged 20-60 years with abnormal cervical cytology (ASC-US or LSIL) from April 2010. All women were followed-up at every 6-month intervals with cervical cytology and HPV DNA testing. Results Of the 1,158 women included, 654 (56.5%) and 504 (43.5%) women showed ASC-US and LSIL, respectively. At the time of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytology performed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% of the women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than that with infection caused by other HPV types (relative risk [RR], 1.75; 95% confidence interval [CI], 1.08-2.84; P=0.028). The cytological progression rate in women with persistent HPV 16 infection was higher than that in women with incidental or cleared infections (P<0.001). Logistic regression analysis showed a significant relationship between cigarette smoking and cytological progression (RR, 4.15; 95% CI, 1.01-17.00). Conclusion The cytological progression rate in HPV 16-positive women with ASC-US or LSIL is higher than that in women infected with other HPV types. Additionally, cigarette smoking may play a role in cytological progression.

• Journal of radiological science and technology
• /
• v.41 no.4
• /
• pp.297-304
• /
• 2018

This study proposes measures and methods to reduce healthcare associated infections by comparing and analyzing the bacterial contamination level before and after putting on personal protective equipment (PPE) on the test equipment and the contact infected patients getting chest PA projections. Among the 50 inpatients who were diagnosed with C. difficile, MRSA, and VRE, 28 patients who were instructed to undergo chest PA projection and follow-up were chosen, The 3 parts that come in contact with the detector, chin, chest, and hands, were designated for all, and the bacterial contamination level before and after disinfection and before and after putting PPE was determined. Statistical analysis was performed using Medcalc version 14, and quantitative analysis was performed using paired student t-test, with statistical significance being noted at p<0.05. Results for the comparison of the mean values before and after disinfection of the detector, chin (3.000), chest (2.000), and hands (3.430), showed that the number of bacteria after disinfection was lower than it was before disinfection. Analyzing for each part before and after disinfection, there were statistically significant differences for the chin, chest, and hands (p<0.01). Results for the comparison of the mean values before and after putting on PPE, chin (2.202), chest (2.140), and hands (4.213), showed that the number of bacteria after putting on PPE was lower than it was before putting on PPE. Analyzing for each part before and after putting on PPE, there were statistically significant differences for the chin, chest, and hands (p<0.03). As a result, it was confirmed that the number of bacteria after putting on PPE was lower than it was before putting it on. In the future, expanding the research scope for contact infected patients will establish standards for quarantine guidelines depending on the way it spreads, and contribute to the prevention of healthcare associated infections.

• Journal of Korean Biological Nursing Science
• /
• v.20 no.1
• /
• pp.38-46
• /
• 2018

Purpose: The aim of this study was to verify the effects of daily 2% chlorhexidine gluconate (CHG) bathing on the acquisition of multidrug-resistant organisms (MDRO) and healthcare-associated infection (HAI) in a medical intensive care unit (MICU). Methods: The study was a randomized controlled group posttest only design, involving 91 patients in MICU at a tertiary hospital (47 patients in the experimental group and 44 patients in the control group). The 2% CHG bathing was performed daily according to bathing protocol to the patients in the experimental group, and traditional bath was performed every three days to those in the control group. Fisher's exact test and x2 test were used to analyze the data. Results: MDRO were found in 6 patients of the experimental group and in 15 patients of the control group. The difference was statistically significant (p= .016). HAI occurred in 2 patients of the experimental group and in 7 patients of the control group. The difference was not statistically significant (p= .084). Conclusion: The results confirmed that daily bathing with CHG was effective in reducing the incidence of MDRO acquisition. Therefore, it is expected that daily bathing with CHG will be used as an effective nursing intervention to reduce the incidence of MDRO acquisition.

• Journal of Korean Critical Care Nursing
• /
• v.14 no.1
• /
• pp.63-75
• /
• 2021

Purpose : The purposes of this study were to examine the relationships between knowledge, awareness, safe environment, and performance of standard precautions and identify factors associated with performance of standard precautions. Methods : This study was a descriptive research. A structured questionnaire on knowledge, awareness, safe environment, and performance of standard precautions was used for the survey with a convenience sample of 150 caregivers. Data were collected from July to August 2019 and were analyzed using descriptive statistics, independent t-test, one way ANOVA, Pearson's correlation coefficient, and multiple regression with SPSS/WIN 25.0 program. Results : The mean scores on knowledge, awareness, safe environment, and performance of standard precautions were 15.77±3.34, 7.35±1.91, 4.55±2.05, and 55.20±10.11 respectively. Performance of standard precautions showed a statistically significant positive correlation with knowledge (r=.54, p<.001), awareness (r=.54, p<.001), and safe environment (r=.50, p<.001). Awareness (β=.24, p=.025) and safe environment (β=.35, p<.001) were significantly associated with factors of performance of standard precautions. Also, education level (high school and above college), affiliated institution (private association), and importance of infection control education (moderate) were significantly associated with factors of performance of standard precautions. Conclusion : The results of the study indicate that factors influencing the performance of standard precautions of caregivers were awareness and safe environment. Therefore, to improve implementation of the standard precautions among caregivers, a safe environment within the hospital must be supported, and appropriate infection management education needs to be provided to caregivers to improve their knowledge and awareness of the standard precautions.

• Journal of The Korea Institute of Healthcare Architecture
• /
• v.24 no.3
• /
• pp.49-57
• /
• 2018

Purpose: The increase in patients requiring hemodialysis has resulted in an increase dialysis-associated infections risk. but there are no Renal Dialysis unit design standard meet specified safety and quality standards. Therefore, appropriate Establish standards and legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Methods: Literature survey on the design guideline and standards of Renal Dialysis unit design in Korea, U.S, Germany, Singapore, Hongkong, Dubai. Results: There are no established standards for facilities in dialysis units in Korea. To prevent infections in dialysis patients, necessary establish standards. Considering the domestic and overseas Health-care facilities standards, the major factors to be considered in the medical environment for Renal Dialysis Unit are as follows. First, planning to separate Clean areas(treatment area) from contaminated areas(medical waste storage area). Second, ensure sufficient space and minimum separation distance. Although there may be differences depending on the circumstances of individual institutions, renal dialysis unit consider the space to prevent droplet transmission. Third, secure infrastructure of infection prevention such as sufficient amount of hand hygiene sinks. Hand washing facilities for staff within the Unit should be readily available. Hand hygiene sinks should be located to prevent water from splashing into the treatment area. Fourth, Heating, ventilation and air conditioning (HVAC) system for Renal Dialysis Unit is all about providing a safer environment for patients and staff. Implications: The results of this paper can be the basic data for the design of the Renal Dialysis Units and relevant regulations.