• Korean Journal of Clinical Pharmacy
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• v.25 no.4
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• pp.264-272
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• 2015

Background: The over-prescription of acid-suppressive therapy for the provision of stress ulcer prophylaxis (SUP) in hospitalized patients has been identified in a proceeding study. Objective: This study was conducted to evaluate clinicians' beliefs, knowledge and other factors that influence the over-prescribing of SUP in low-risk, non-intensive care unit (non-ICU) patients. Method: A cross-sectional survey consisting of multiple-choice queries and close-ended questions was distributed to healthcare personnel at a major teaching hospital in Korea. Results: More than half of total respondents reported that they would continue SUP following patients discharge from the ICU (77.8%, 43.5%, and 39.7% in the physician, pharmacist, and nurse groups, respectively). Over 55% of physicians would also initiate non-ICU patients on SUP upon hospital admission, and 42.6% of physicians would even continue prophylaxis post hospital discharge. The mean knowledge score regarding SUP indications and side effects was higher in pharmacists compared to physicians and nurses (12.44, 7.40, and 7.28, respectively; p<0.001). High-prescribing behavior was associated with a prescriber's belief that SUP is effective for preventing bleeding (odds ratio 7.40; 95% confidence interval 1.57 to 31.94; p=0.012). Low knowledge score and computerized order set also showed statistically significant association with the overutilization of SUP.

• Child Health Nursing Research
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• v.24 no.2
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• pp.208-219
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• 2018

Purpose: The purpose of this study was to explore nursing students' experiences of debriefing after simulation-based learning and to obtain fundamental data to support the development of effective teaching strategies. Methods: Sixty-seven nursing students participated in this study from April to May, 2017. This was a descriptive study analyzing the content of students' descriptions of structured questions in 3 stages (description, analysis, and application) based on recorded videos. Results: The description stage was classified into 3 categories for problem recognition, 4 categories for the nursing plan, and 6 categories for the nursing intervention. The analysis stage was classified into 6 categories for satisfactory practice, 3 categories for experience and 4 categories for what they learned through practice. The application stage was classified into 5 categories, that were to be mastered, and 6 categories, that were important to recognize. Conclusion: This study succeeded in charaterizing learners' experiences of debriefing. During the debriefing, students watched recorded videos, and we found that self-evaluation through structured questionnaires could be a very effective way to strengthen students' core competencies. Our content analysis of the debriefing is expected to contribute to the development of effective strategies in simulation-based education for students and nurses.

• The Journal of Korean Academic Society of Nursing Education
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• v.17 no.2
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• pp.168-177
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• 2011

Purpose: The purpose of this study was to investigate the attitude toward death in Korean nursing students. Method: The sample consisted of 365 baccalaureate nursing students. The questionnaires included questions on sociodemographics and death-related characteristics of the participants, and the Fear of Death and Dying Scale (FODS) to measure the attitude toward death. Result: The mean of the FODS score was 2.63 out of 4, so the participants had a slightly negative attitude toward death. There were statistically significant differences between gender, religion, religion activity, perceived health status, experience of parents' death, experience of friend's death, and overall FODS score. Among the four subscales of overall FODS, the score of the fear of death of self was significantly higher in the participants who experienced clinical practice and who experienced patient's death in the intensive care unit compared to the emergency room. Conclusion: Based on the study results, educational programs to change the attitude toward death are required before clinical practice. Programs need to consider nursing students' gender and religion, and give opportunity to share experiences and feelings about death of family or friend. In addition, using standardized patients and simulators is advised in the need for simulation training.

• Journal of Korean Biological Nursing Science
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• v.21 no.4
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• pp.249-258
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• 2019

Purpose: The purpose of this study was to assess the psychosocial status of candidates for deceased donor kidney transplantation (DDKT) in South Korea and identify factors associated with high-risk psychosocial status. Methods: The descriptive cross-sectional design included application of a standardized transplantation-specific assessment tool, the Psychosocial Assessment Candidacy Transplantation (PACT) instrument, and review of candidates' medical records. A total of 157 patients awaiting DDKT were recruited from a Korean organ transplantation center. The collected data were analyzed using descriptive statistics and binary logistic regression. Candidates were divided into high- and low-psychosocial risk groups using 3 as the cutoff point of PACT. Results: The mean score for the PACT final rating was 2.10, and the lowest average subscale score was 2.30 for understanding the processes of transplantation and follow up. Poor physical candidacy, especially due to comorbidities, and older age were associated with high psychosocial risk. Conclusion: The results of this study showed that the psychosocial status of Korean DDKT candidates was problematic. Development of systematic management programs for effective clinical strategies in the care of candidates is crucial to maintain their desirable psychosocial status in case of an emergency DDKT operation and improve post-transplantation outcomes. Continuous education is absolutely necessary to enhance understanding of the transplantation process for high-risk psychosocial candidates. Additionally, nurses and transplantation professionals should screen candidates with high-risk psychosocial status early in the process using transplantation-specific assessment tools and provide intensive interventions, particularly for poor physical candidacy patients and older candidates.

• Journal of Korean Clinical Nursing Research
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• v.25 no.3
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• pp.333-341
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• 2019

Purpose: The purpose of this study was to determine the most appropriate shelf life for sterilized products according to their packaging material. Methods: Samples were prepared to target six nursing units in one general hospital in Seoul. After steam and E.O gas sterilization, sterilized product, samples were supplied to wards. Data collection was conducted for 3 months, after the expiration date of 3 months had passed for samples packaged with crepe paper and nonwoven wraps. For samples packaged with paper-plastic pouches, data collection conducted for 3 months when the expiration date of 9 months had passed. The sterilized products were collected and tested for microbial contamination. Identification of the storage environment was done as samples were collected. Results: This study confirmed that the storage environment met international standards such as CDC, except for temperature. For steam sterilized crepe paper packaging samples and steam and E.O gas sterilized for nonwoven packaging samples no contamination in all products was found for 3 months past the expiration date. However, in the E.O gas sterilized paper-plastic pouch packaging sterile samples, Gram-positive bacilli were detected in one sample from a surgical intensive care unit at 45 weeks and another sample from an operating room at 47 weeks. Furthermore, the results did not show any microorganisms for up to 52 weeks in all products. Conclusion: According to the results of this study, sterilized product packaging made with crepe paper and nonwoven wraps is better able an extended shelf life from 3 months to 6 months, reducing unnecessary costs.

• Journal of Korean Clinical Nursing Research
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• v.30 no.1
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• pp.35-44
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• 2024

Purpose: The purpose of this study is to compare the predictive validity of pressure injury risk assessment, Braden, Braden Q and Braden QD for pediatric patients. Methods: Prospective observational study included patients under the age of 19 who were hospitalized to general wards, intensive care units of a children's hospital. Characteristics related to pressure injury were collected, and predicted validity was compared by calculating the areas under the curve (AUC) of the Braden, Braden Q, and Braden QD scales. Results: A total of 689 patients were included in the study. A total of 13 (1.9%) patients had pressure injuries, and the number of pressure injuries was 17. Factors related to the occurrence of pressure injuries were 9 (52.9%) immobility-related and 8 (47.1%) medical device-related. The AUC for each scale was .91 (95% CI .89~.94) for Braden, .92 (95% CI .90~.95) for Braden Q, and .94(95% CI .92~.96) for Braden QD. The optimal cut-off points were identified as 16 for Braden (sensitivity=88.8%, specificity=86.4%), 17 for Braden Q(sensitivity=63.6%, specificity=94.9%), and 12 for Braden QD (sensitivity=94.4%, specificity=88.7%). Conclusion: The Braden QD scale demonstrated the highest predictive validity for pressure injuries in pediatric patients and is expected to be valuable tool in preventing pediatrics pressure injuries.

• Neonatal Medicine
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• v.18 no.2
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• pp.345-352
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• 2011

Purpose: Nursing quality influences patient' outcomes in the neonatal intensive care unit (NICU). We compared differences in adverse events (AEs) by differences in the level of nursing experience at the NICU, developed guidelines to prevent AE, and then investigated the change in AE. Methods: AEs related to nursing were investigated from January 1, 2009 to December 31 2009 at the NICU of the newly established A hospital and B hospital that has been operating for 14 years. We also assessed the level of nursing experience. Guidelines to prevent nursing-related AEs were prepared at A hospital, and the change in the incidence of AE was investigated after 1 year. Results: Twenty nurses (80%) had <2 years experience at A hospital, whereas 13 nurses (65%) had 2 years or longer but less than 4 years experience at B hospital (P<0.001). The number of incidences of AE that occurred in 2009 in A hospital was higher (46) than that at B hospital (10). Intravenous (IV) injection-related incidents had the highest share in both hospitals: 24 incidents (52.2%) at hospital A and eight incidents (80%) at hospital B. After the guidelines were instituted in 2009, the number of nursing AEs decreased to 17, of which the number of IV incidents was the highest (6, 35%), athough its share decreased. Conclusion: Supervision and prevention guidelines should be in place to reduce nursing AEs, which would improve the quality of NICU service.

• Journal of Preventive Medicine and Public Health
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• v.11 no.1
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• pp.86-97
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• 1978

The mobile medical service has been operated for many years by a number of medical schools and hospitals as a most convenient means of medical service delivery to the people residing in such area where the geographical and socioeconomic conditions are not good enough to enjoy modern medical care. Despite of official appraisal showing off simply with numbers of outpatients treated and medical persons participated, however, as well recognized, the capability (in respect of budget, equipment and time) of those mobile medical teams is so limitted that it often discourages the recipients as well as medical participants themselves. In the midst of rising need to secure medical service of good quality to all parts of the country, and of developing concept of primary health care system, authors evaluated the effectiveness of and problems associated with mobile medical servies program through the community diagnosis of a village (Opo-myun, Kwangju-gun) to obtain the information which may be halpful for future improvement. 1. Owing to the nationwide Sae-Maul movement powerfully practiced during last several years, living environment of farm villages generally and remarkably improved including houses, water supply and wastes disposal etc. Neverthless, due to limitations in budget time and lack of knowledge (probably the most important), these improvements tend to keep up appearances only and are far from the goal which may being practical benefit in promoting the health of the community. 2. As a result of intensive population policy led by the government since 1962, there has been considerable advances in understanding and the rate of practicing family planning through out the villages and yet, one should see many things, especially education, to be done. Fifty eight per cent of mothers have not received prenatal check and the care for most (72%) delivery was offered by laymen at home. 3. Approximately seven per cent of the population was reported to have chronic illness but since only a few (practically none) of the people has had physical check up by doctors, the actual prevalence of chronic diseases may reach many times of the reported. The same fact was observed also in prevalence of tuberculosis; the patients registered at local health center totaled 31 comprising only 0.51% while the numbers in two neighboring villages (designated as demonstration area of tuberculosis control and mass examination was done recently) were 3.5 and 4.0% respectively. Prevalence rate of all dieseses and injuries expereinced during one month (July, 1977) was 15.8%. Only one tenth of those patients received treatment by physicians and one fifth was not treated at all. The situation was worse as for the chronic patients; 84% of all cases either have never been treated or discontinued therapy, and the main reasons were known to be financial difficulty and ignorance or indifference. 4. Among the patients treated by our mobile clinic, one third was chronic cases and 45% of all patients, by the opinion of doctors attended, were those who may be treated by specially trained nurses or other paramedics (objects of primary care). Besides, 20% of the cases required professional managements of level beyond the mobile team's capability and in this sense one may conclude that the effectiveness (performance) of present mobile medical team is quite limitted. According to above findings, the authors would like to suggest following for mobile medical service and overall medicare program for the people living in remote country side. 1. Establishment of primary health care system secured with effective communication and evacuation (between villages and local medical center) measures. 2. Nationwide enforcement of medical insurance system. 3. Simple outpatient care which now constitutes the main part of the most mobile medical services should largely be yielded up to primary health care unit of the village and the mobile team itself should be assigned on new and more urgent missions such as mass screening health examination of the villagers, health education with modern and effective audiovisual aids, professional training and consultant services for the primary health care organization.

• Journal of Hospice and Palliative Care
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• v.3 no.1
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• pp.4-17
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• 2000

Purpose : This study aimed to investigate and to evaluate the present conditions of hospice programs in Korea for supplying data useful in making policy in hospice, which is not institutionalized yet. Method : For this purpose we surveyed 59 hospice programs regarding the general characteristics, manpower, patients, services, financial conditions, and facilities. Thirty-seven hospice programs answered the questionnaires. Result : They were 11 tertiary hospitals, 11 other hospitals, 3 clinics, 12 home care hospice, and 1 freestanding hospice. Only 9 hospice programs have all of the essential professionals: physicians, nurses, social workers, clergies, and volunteers. In some hospice programs, volunteers who had not been trained for hospice provided services to terminal patients. More than half of the hospice said they provided services to the patients who lost their consciousness and were not suitable for hospice care. 16% of the hospice said they did not keep the patients' record. Some hospitals including tertiary hospitals provided such intensive care as radiotherapy, TPN, injections to hospice patients. Many hospice programs other than hospitals didn't charge patients for hospice care. 60% of the hospice said they suffered from financial problems. Most of the hospice wards were not built for hospice use at first. So they did not have such supplementary facilities as dayroom, waiting room, special bathing facilities etc. Conclusion : For improving the quality of terminal patients and promoting the cost effective use of health care resources, it is necessary to consider the institutionalization of hospice. The institutionalization of hospice programs can improve the quality of hospice care and the standardization of the hospice program can hasten its institutionalization.

• Tuberculosis and Respiratory Diseases
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• v.49 no.5
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• pp.624-632
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• 2000

Background : Home ventilation can decrease hospital-acquired infection, increase physical activity, improve nutritional status, enhance quality of life, and reduce medical costs. The number of patient using home ventilators has been increasing, particularly in Europe and United States. Although the number of patients with home ventilation has been increasing in Korea, the current status of these patients is not well known. This study was undertaken to obtain basic information upon these patients in addition to evaluating any problems related to patients' home care in our country. Methods : A register of 92 patients with home ventilators in Seoul and Kyunggi Province were obtained from commercial ventilator supply companies. The patients were contacted by phone and 29 of them accepted our visit. Information concerning education about home care before discharge, equipment cost, and problems related to home care were documented. The mode and preset variables of the home ventilator were checked; tidal volume (TV), peak airway pressure, and oxygen saturation were measured. Results : There were 26 males (90%) and their mean age was 48.0 (${\pm}20.1$) years. The underlying diseases were : 21 neuromuscular disorders, 2 spinal cord injuries, 6 chronic lung diseases. Among the caregivers, spouses (n=14) predominated. Education for home care before discharge was performed primarily by intensive care unit nurses and the education for ventilator management by commercial companies. Twenty-five of the 29 patients had tracheostomies. Volume targeted type (VTT ; n=20, 69%) was more frequently used than the pressure targeted type (PTT). Twenty-three of the 29 patients purchased a ventilator privately, which cost 7,450,000 (${\pm}$3,290,000) won for a PTT, and 14,280.000 (${\pm}$3,130,000) won for a VTT. Total cost for the equipment was 11,430,000 (${\pm}$634,000) won. The average cost required for home care per month was 1,120,000 (${\pm}$1,360, 000) won. Conclusion : The commonest underlying disease of the patients was neuromuscular disease. The VTT ventilator was primarily used with tracheostomy. Patients and their families considered the financial difficulties associated with purchasing and maintaining equipment for home care an urgent problem. Some patients were aided by a visiting nurse, however most patients were neglected and left without professional medical supervision.