• 근관절건강학회지
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• 제26권3호
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• pp.241-250
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• 2019

Purpose: This study was conducted to identify influencing factors on the performance of healthcare-associated infection control and microbiological hand contamination among caregivers at a tertiary hospital. Methods: The participants of this study were 59 caregivers woring at a tertiary hospital. Data were collected from July 1 to 30, 2018. Data were analyzed using descriptive statistics, t-test, ANOVA, Scheffé test, Pearson's correlation coefficients and stepwise multiple regression by SPSS 23.0 Win program. Results: Multiple regression analysis revealed that factors influencing performance of healthcare-associated infection control were awareness (β=.63, p<.001) and the experience of infection-related education (β=-3.40, p=.042). Regression equations describing the performance of healthcare-related infection control were found to be appropriate (F=27.29, p<.001) and accounted for 68% of variance. Factors affecting the degree of microbiological hand contamination were work experience (β=-0.28, p=.026) and healthcare-related infection performance (β=-0.28, p=.029). A regression equation describing the microbiological hand contamination was appropriate (F=6.10, p=.004) and accounted for 42% of variance. Conclusion: The findings of this study suggest that it is necessary to increase performance of healthcare-associated infection control by caregivers. Also, educations for preventing healthcare-associated infection and guidelines for increasing compliance with healthcare-associated infection control are recommended to improve performance of healthcare-associated infection control.

• Journal of Korean Medical Science
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• 제33권45호
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• pp.280.1-280.9
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• 2018

Background: Surveillance and interventions of central line-associated bloodstream infections (CLABSIs) had mainly been targeted in intensive care units (ICUs). Central lines are increasingly used outside ICUs. Therefore, we performed a hospital-wide survey of CLABSIs to evaluate the current status and develop strategies to reduce CLBASI rates. Methods: All hospitalized patients with central venous catheters (CVCs) were screened for CLABSIs from January 2014 through December 2015 at a 1,328 bed tertiary care teaching hospital in Korea using an electronic data-collecting system. Clinical information including type of CVC was collected. CLABSI rates were calculated using the definitions of the National Health and Safety Network after excluding mucosal barrier injury laboratory-confirmed bloodstream infection (BSI). Results: A total of 154 CLABSIs were identified, of which 72 (46.8%) occurred in general wards and 82 (53.2%) in ICUs (0.81 and 2.71 per 1,000 catheter days), respectively. Nontunneled CVCs were most common (68.6%) among 70 CLABSI events diagnosed within one week of their maintenance. On the other hand, tunneled CVCs and peripherally inserted central catheters (PICCs) were more common (60.5%) among 114 CLABSI events diagnosed more than a week after maintenance. Whereas the majority (72.2%) of CLABSIs in ICUs were associated with non-tunneled CVCs, tunneled CVCs (38.9%) and PICCs (36.8%) were more common in general wards. Conclusion: CLABSIs are less common in general wards than in ICUs, but they are more often associated with long-term indwelling catheters. Therefore, interventions to prevent CLABSIs should be tailored according to the type of ward and type of catheter.

• 한국직업건강간호학회지
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• 제23권4호
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• pp.208-218
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• 2014

Purpose: The purpose of this study was to identify the factors influencing on practice of healthcare-associated infection control among clinical nurses. Methods: The subject of this study were 118 nurses who worked in medical surgical ward and ICU of 2 general hospital in Gwangju city. Data were collected with a questionnaire. Data were analysed using descriptive statistics, t-test, one-way ANOVA, Scheff$\acute{e}$ test, Pearson correlation and stepwise multiple regression analysis using SPSS/WIN 12.0. Results: The major findings of this study were as follow: There were significant positive correlation between knowledge, recognition, empowerment and practice of healthcare-associated infection control. The significant factors influencing practice of healthcare-associated infection control were recognition and empowerment, which explained 68.8% of the practice of healthcare-associated infection control. Conclusion: These results indicate that recognition on healthcare-associated infection control and empowerment among clinical nurses should be reinforcement via consistent education, administrative and organizational support at the level of hospital.

• International Journal of Advanced Culture Technology
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• 제7권3호
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• pp.35-45
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• 2019

The aims of the study to investigate the relationship between awareness, empowerment and performance of healthcare associated infections (HAIs) control and to identify factors influencing performance of HAIs among general hospital nurses. Data were collected from 230 nurses in two general hospitals in B city, with the questionnaire of an empowerment, awareness and performance of infection control tool. The data were analyzed by t-test, one-way ANOVA, Pearson's correlation coefficient and multiple regressions. The performance of infection control was significantly correlated with empowerment and awareness of infection control. The empowerment had a positive correlation with an awareness of infection control (r= .233, p <.001) respectively. The infection control performance was influenced by infection control awareness, empowerment and number of annual job training, which explained 42.2% of the performance of infection control. Infection management performance of general hospitals nurses is affected not only by infection awareness but also by empowerment and job education. Therefore, it suggests that HAIs management program could develop for the nurses and provide empowerment with job training to improve the management and performance of HAIs, also to reinforce via constant support by the hospital.

• Tuberculosis and Respiratory Diseases
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• 제80권2호
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• pp.201-209
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• 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.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제21권1호
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• pp.43-50
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• 2018

Purpose: Clostridium difficile colonization and infection are commonly associated with poor outcomes in patients with pediatric inflammatory bowel disease (PIBD). We aimed to investigate the prevalence of C. difficile colonization and infection at the time of diagnosis and to evaluate risk factors associated with the development of C. difficile infection during the course of PIBD treatment. Methods: We retrospectively enrolled a total of 59 children who were newly diagnosed with PIBD at the tertiary medical center. All patients underwent C. difficile toxin assays and cultures initially and at every follow-up during the disease course. Kaplan-Meier survival analysis and Cox regression test were used for statistical analysis. Results: Initial cultures for C. difficile were positive in 13 (22.0%) of 59 PIBD patients, whereas initial toxin assays were positive in 3 patients (5.1%). During treatment, C. difficile cultures converted to positive in 28 (47.5%) in addition to 13 patients who were initially culture-positive, and C. difficile toxins converted to positive in 13 (22.0%) in addition to 3 originally toxin-positive patients. Antibiotic usage alone was significantly associated with the development of C. difficile colonization (p=0.011), and the length of hospitalization was associated with the development of C. difficile infection (p=0.032). Conclusion: C. difficile colonization and infection occur frequently during the disease course of PIBD. Antibiotic usage and longer hospital stay were significant risks factors for the conversion of C. difficile status in PIBD patients undergoing treatment.

• Annals of Clinical Neurophysiology
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• 제13권2호
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• pp.97-100
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• 2011

Chronic inflammatory demyelinating polyneuropathy (CIDP) is an acquired immune-mediated polyneuropathy. Corticosteroids, intravenous immunoglobulin (IVIG) and plasmapheresis have been reported to be effective treatment. Rarely, CIDP can occur in the patients with HIV infection. The clinical features and electrophysiological findings of CIDP are known to be similar in patients with and without HIV infection. We report a 30-year-old male with HIV infection associated CIDP who improved after the administration of intravenous immunoglobulin and long term oral prednisone.

• Korean Journal of Radiology
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• 제21권5호
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• pp.526-536
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• 2020

Objective: This study aimed to evaluate the clinical benefits and risks of CT-guided percutaneous transthoracic needle lung biopsies (PTNBs) in patients with a suspected pulmonary infection. Materials and Methods: This study included 351 CT-guided PTNBs performed in 342 patients (mean age, 58.9 years [range, 17-91 years]) with suspected pulmonary infection from January 2010 to December 2016. The proportion of biopsies that revealed the causative organism for pulmonary infection and that influenced patient's treatment were measured. Multivariate analyses were performed to identify factors associated with PTNB that revealed the causative organism or affected the treatment. Finally, the complication rate was measured. Results: CT-guided PTNB revealed the causative organism in 32.5% of biopsies (114/351). The presence of necrotic components in the lesion (odds ratio [OR], 1.7; 95% confidence interval [CI], 1.1-2.7; p = 0.028), suspected pulmonary tuberculosis (OR, 2.0; 95% CI, 1.2-3.5; p = 0.010), and fine needle aspiration (OR, 2.5; 95% CI, 1.1-5.8; p = 0.037) were factors associated with biopsies that revealed the causative organism. PTNB influenced patient's treatment in 40.7% (143/351) of biopsies. The absence of leukocytosis (OR, 1.9; 95% CI, 1.0-3.7; p = 0.049), presence of a necrotic component in the lesion (OR, 2.4; 95% CI, 1.5-3.8; p < 0.001), and suspected tuberculosis (OR, 1.7; 95% CI, 1.0-2.8; p = 0.040) were factors associated with biopsies that influenced the treatment. The overall complication rate of PTNB was 19% (65/351). Conclusion: In patients with suspected pulmonary infection, approximately 30-40% of CT-guided PTNBs revealed the causative organism or affected the treatment. The complication rate of PTNB for suspected pulmonary infection was relatively low.

• The Journal of Korean Physical Therapy
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• 제28권2호
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• pp.155-163
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• 2016

Purpose: Infection management is important for physical therapists in order to protect patients and themselves since they often provide patient care and have physical contact with patients. This study examined the performance of infection control and associated factors among physical therapists. Methods: The study subjects were 174 physical therapists working in the G metropolitan city. The performance of infection control according to general characteristics, job-related characteristics, and infection-related characteristics were compared using t-test and ANOVA. Associations between awareness and performance of infection control were tested by correlation. Finally, multiple linear regression analyses were performed to examine the factors associated with performance of infection control. Results: Overall performance scores for personal and therapy room were $87.47{\pm}11.70$ and $70.08{\pm}13.68$, respectively. Both personal and therapy room infection control were lower for the degree of performance than the degree of awareness. In multiple linear regression analysis, the degree of performance at a personal level was related to current smoking status, type of charge therapy, supply of protection equipment, and awareness of personal infection control. The degree of performance of therapy room was related to injury experience in the workplace, supply of protection equipment, and awareness of therapy room infection control. Conclusion: Performance of therapy room infection control was lower than that of personal infection control. The performance was associated with the supply of protection equipment and awareness. Therefore, the degree of performance for infection control will be increased with proper supply of protection equipment in the hospital and increase the degree of awareness with adequate prevention education.

• 가정∙방문간호학회지
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• 제30권1호
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• pp.26-36
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• 2023

Purpose: This study investigated the organizational culture in hospital for infection control, moral sensitivity, and the degree of infection control among long-term care hospital nurses, and to identified the factors associated with infection control perfomance. Methods: 186 nurses who directly care for patients at seven Long-Term Care Hospitals in D Metropolitan City participated in the survey. Data were collected using self-reported questionnaires and analyzed using the IBM SPSS 26.0 software. Results: Moral sensitivity showed statistically significant differences in age (F=5.473, p=.065), clinical experience (F=8.890, p=.031), nursing hospital work experience (F=6.520, p=.038), religion (t=-2.01, p=.046) and position (t=-2.96, p=.003). Correlation analysis revealed that with moral sensitivity and effect of organizational culture on infection control, there was a positive correlation between infection control and patient-centered nursing (r=.201, p<.006), professionalism (r=.149, p<.042), benevolence (r=.303, p<.001), infection control organizational culture (r=.556, p<.001). Benevolence of moral sensitivity (β=.21, p=.001) and infection control organizational culture (β=.54, p<.001) were associated with infection control perfomance. Moral sensitivity (including patient-centered nursing, professionalism, and benevolence) and infection control organizational culture explained 33.8% of the variance in infection control (F=24.57, p<.001). Conclusion: It is important to improve the moral sensitivity of nurses and a positive organizational culture for better infection control. We need to develop intervention strategies and establish systematic and administrative support.