• Pediatric Infection and Vaccine
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• v.26 no.3
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• pp.148-160
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• 2019

Purpose: This study aimed to investigate the molecular epidemiology of a methicillin-resistant Staphylococcus aureus (MRSA) outbreak at a newborn nursery and neonatal intensive care unit (NICU). Methods: During the outbreak, from August to September 2017, MRSA isolates collected from neonates and medical staff underwent genotyping and screened for virulence factors. Antibiotic susceptibilities were tested. Results: During the study period, 41 neonates were admitted at the nursery (n=27) and NICU (n=14). Of these, 7 had MRSA infections (skin infection [n=6] and sepsis [n=1]) and 4 were colonized with MRSA. Associated medical staff (n=32) were screened; three were nasal MRSA carriers. Staphylococcal chromosomal cassette mec (SCCmec) type II, sequence type (ST) 89, spa type t375 was found to be the skin infection outbreak causing strain, with multi-drug resistance including low-level mupirocin resistance. SCCmec type IVa, ST 72, and a novel spa type designated t17879, was the cause of MRSA sepsis. Many different types of MRSA were colonized on the neonates; however, SCCmec type IVa, ST 72, spa type t664 was colonized in both neonates and a NICU nurse. All MRSA isolates from colonized infants were positive for the Panton-Valentine leukocidin (PVL) toxin gene. Conclusions: The strain causing an outbreak of skin infections had multi-drug resistance. Also, MRSA colonized in the neonates were found to carry the PVL toxin gene. Because different strains are present during an outbreak, molecular epidemiologic studies are important to identify the outbreak strain and colonized strains which aid in effective control and prevention of future MRSA outbreaks.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.60-64
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• 2017

Purpose Westgard multi-rules application based on test quality improvement and commercialized international standard has been widely used in quality control. However, it is difficult to applicate the Westgard multi-rules in nuclear medicine in vitro tests due to the larger sample sizes and the simultaneous measurement of quality control material and patient sample. This study investigated the usefulness of Westgard multi-rules application in nuclear medicine in vitro tests. Materials and Methods A total of 282 systematic error multi-rules (22s, 101s) recorded in the samsung medical center computer system from January 2013 to June 2016 along with 117 cases of corrective measure record was analyzed. The Quality control implementation is recorded in Hospital information system were divided into 4 high-level areas including quality control material error, experimental procedural error, Kit lot number management error, and others. To prevent quality control material error, the existing method that each staff used their own method was changed. The staff who in charge of managing the quality control material was designated and daily consumption amount of every test was strictly controlled by one person. To prevent other errors, every test step was standardized so that the entire test procedures are identically implemented. Results The total quality control implementation was 117 cases; As a result, 62 quality control material errors were 62 cases, experimental process errors were 24 cases, Kit lot number control errors were 18 cases, and other errors were 13 cases. The quality control material error was corrected and could be used fresh materials within 2 days after thawing. The cases of systemic error were decreased to causes as quality control material error. The quality control materials were reduced above 10 vials to a monthly average. In addition, these errors of experimental processing and Kit lot number were improved by test standardization. Consequently, the cases of 101s and 22s in systematic error rules decreased at least 2 cases to a monthly average. Conclusion To confirm of systematic error through multi-rules application quickly, it is necessary to base on management of the QC material, target values and standard deviation. Moreover, in the event of a systematic error, it was found important to record measures based on test cause analysis. The experiment results are expected to contribute to internal quality control improvement and prompt and accurate result reporting through error recording and causal analysis based on Westgard multi-rules analysis.

• Health Policy and Management
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• v.14 no.1
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• pp.65-88
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• 2004

In general, empowerment is defined as the motivational concept of autonomy and self-efficacy. Recently, the concept of empowerment is applied to improve organizational staff's job satisfaction and organizational commitment in many organizations. Empower-ment in service organizations, i.e., hospitals, has certainly generated more publicity than any other organizations. The objectives of this study are, first, to measure the degree of hospital employees' empowerment using Spreitzer(1995)'s empowerment theory, second, to analyze the causal relationship of organizational and job characteristics, a degree of empowerment, and organizational performance(job satisfaction and organizational commitment), and third, to offer the strategy for the improvement of job satisfaction and organizational commitment. Spreitzer insists that the empowerment is composed of 4 dimensions(meaning, competence, self-determination, and impact). And he argues that various work-related characteristics is a direct cause of empowerment and the indirect cause of job satisfaction and organizational commitment, mediated by the empowerment latent variable. In order to perform this study, data were collected by self-administered questionnaires from hospital employees working in administrative department of 3 university hospitals in Inchon and Kyunggi-Do region. The number of cases is 181(response rate; 86%). The Collected data were analyzed with SPSS Ver. 10.0 and AMOSV Ver. 4.0. First, to test validity of variables, the factor analysis was used. Second, to test reliability, Cronbach's alpha coefficients was calculated. Cronbach's alpha of empowerment variable is 0.8323 showing that there's no problem in regard to the internal consistency. Also the Cronbach's alpha of other variables are 0.8301 of the degree of perceived control, 0.6705 of job characteristics, O.8787 of compensation, 0.9254 of job satisfaction, and 0.8389 of organizational commitment, respectively. Among the questions of job characteristics, two survey questions are deleted due to lowering the reliability. Third, to test multicollinearity and correlation of variables, the correlation analysis was performed. There was no problem of multicollinearity. Finally structural equation modelling (SEM) analysis was conducted to find the causal relationship of organizational and job Characteristics, empowerment, job satisfaction and organizational commitment. The 16 variables are included for the SEM analysis. The major results of this study are as follows: First, in the case of model fitness, the condition of x$^2$ statistic(92.187) is not fully satisfied, but the indices of GFI(0.912), AGFI(0.863), NFI(0.917) and CFI(0.928) are partially satisfied, which needs to upper 0.90. Second, in the result of hypotheses testing, all hypotheses are accepted and have a positive effect in 95% or 99% confidence interval(P<0.05 or P<0.001) except the effect of compensation variable on empowerment(P=0.082). Third, in regard to the direct, indirect, and total effect of variables, the direct effect of perceived control, task characteristics, and compensation on job satisfaction are 0.728, 2.264, 0.328 and on organizational commitment are 0.094, 1.411, 0.418, respectively. Also the indirect effect of perceived control, task characteristics, and compensation on job satisfaction are 0.311, 0.196, 0.028 and on organizational commitment are 0.210, 0.132, 0.019, respectively. Thus, these findings imply that various work-related factors are direct effect of empowerment and indirect effect of result variables, job satisfaction and organizational commitment. Also These results showed that the workplace empowerment is significant mediating factor of employee's job satisfaction and organizational commitment.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.8
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• pp.3769-3776
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• 2016

Background: Breast cancer is the leading cause of cancer deaths among women worldwide. High breast cancer mortality has been attributed to lack of public awareness of the disease. Little is known about the level of knowledge of breast cancer in Central African Republic. This study aimed to investigate the knowledge of health professionals on breast cancer. Materials and Methods: This cross-sectional study was conducted among 158 health professionals (27 medical; 131 paramedical) in 17 hospitals in Bangui using a self-administered questionnaire. Descriptive statistical analysis, Person's ${\chi}^2$ test and ANOVA were applied to examine associations between variables with p < 0.05 being considered significant. Results: Data analyzed using SPSS version 20 indicates that average knowledge about breast cancer perception of the entire population was 47.6%, diagnosis method 45.5%, treatment 34.3% and risk factors 23.8%. Most respondents (65.8%) agreed that breast cancer is important in Central African Republic and that family history is a risk factor (44.3%). Clinical assessments and mammography were considered most suitable diagnostic methods, and surgery as the best treatment. The knowledge level was significantly higher among medical than paramedical staff with regard to risk factors, diagnosis and treatment. However the trainee group had very high significant differences of knowledge compared with all other groups. Conclusions: There is a very urgent need to update the various training programs for these professionals, with recommendations of retraining. Health authorities must create suitable structures for the overall management of cancer observed as a serious public health problem.

• Journal of Korean Academy of Nursing Administration
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• v.6 no.2
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• pp.281-290
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• 2000

The purpose of this study was to identify the relationship between the head nurses' leadership style the and the autonomy perceived by nurses and to provide the basic data for developing strategies of the effective nurse staff management. The subjects were 177 nurses who were working at the 3 general hospitals in Seoul. The data were collected from December 1999 to January 2000 by the structured questionnaires. For data analysis, descriptive statistics, ANOVA, Pearson correlation coefficient, and stepwise multiple regression with $SPSS-PC^+$ version 8.0 were used. The results of this study were as follows : 1. The score of 'the head nurses' transformational leadership perceived by nurses' was highier than that of 'the head nurses' transactional leadership'. Among 5 subdimensions of 'the leadership styles perceived by nurse', the scores of the 'charisma' and 'intellectual stimulation' were highest and the lowest one was that of 'extra management'. 2. Only 'the head nurses' transformational leadership perceived nurses' and 'the situatuational reward' showed a significant difference according to the married status ; nurses who were married showed higher scores than who were not. 3. 'The autonomy perceived by nurses' showed a significant difference according to the educational background ; nurses who had master degree showed higher score than who had diploma. 4. 'Charisma' was positively related to 'intellectual stimulation', 'individual consideration', and 'situational reward'. 'Intellectual stimulation' was positively related to 'individual consideration' and 'situational reward'. 'Individual consideration' was positively related to 'situational reward'. But 'extra management' was negatively related to all of variables. 'Autonomy' was significantly related to 'individual consideration' and 'the transformational leadership'. 5. The determinents of 'the autonomy perceived by nurses' were 'individual consideration' and the educational background, and they explained 15.4% of the total variance of it. The key determinent variables was 'individual consideration'. It explained 11.5% of the total variance of the autonomy. According to the results of this study, the suggestions were as follows: 1. It is necessary to develop strategies for exercising the head nurses' transformational leadership in nursing department : It should to be considered the difference in the leadership style perceived by nurses according to demographic variables. 2. The further studys on the individual consideration of head nurses' transformational leadership and the opportunity of self-development such as education for enhancing nurses' autonomy is needed.

• Journal of dental hygiene science
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• v.10 no.1
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• pp.45-54
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• 2010

The purpose of this study was to offer the importance on factors of selecting dental institution according to general characteristics targeting general dental patients, and the information of having important influence upon choosing dental clinic and dental hospital. The survey was carried out from August 2009 to September. As a result of analyzing SAS(ver 9.1), the following conclusions were obtained. In the importance on factors of selecting dental institution according to general characteristics, it was thought to be important in convenience of movement or mobility such as distance, transportation, and parking convenience according to age level. According to final academic background, the importance in a factor of rumor in dental clinic was high(p < 0.05). According to job, the significant difference was shown in rumor of dentistry and parking convenience(p < 0.05). According to income, the factor in the appearance of training a medical specialist was indicated to be statistically higher in the group with over 5 million won than the group with under 2 million won(p < 0.05). Given seeing the distribution of opinion about dental hospitals (comparison with dental clinics), the excellence in the medical staff's ability was indicated to be the highest in all of the factor of influencing the use satisfaction(${\beta}=0.18$), the factor of influencing the recommendation level(${\beta}=0.21$), and the factor of influencing the re-use intention(OR=2.09).

• Management & Information Systems Review
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• v.36 no.1
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• pp.309-327
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• 2017

Recently the importance of emotional labor has increased so this study aims to prove the effects of emotional labor(surface acting and deep acting) on counterproductive work behaviors(deviate from organization and individual deviation) using burnout(emotional exhaustion, personality disorder, decrease in sense of accomplishment) as a medium. 350 surveys were sent to employees such as workers from call centers, salesperson from department store, financial worker, hospital staff, flight attendant and workers from customer center who and worked with emotional labor and 300 surveys excluding insincere ones were used for analysis. The result is as follows. First, surface acting which is a type of emotional labor chosen by customer workers had a positive effect on burnout such as personality disorder and decrease in sense of accomplishment. Second, deep acting had a negative effect on personality disorder and decrease in sense of accomplishment but did not show any effect on emotional exhaustion. Third, personality disorder and decrease in sense of accomplishment among burnout had effect on counterproductive work behaviors(deviate from organization, individual deviation) but emotional exhaustion did not show any effect on work behaviors(deviate from organization, individual deviation). Based on the result of analysis, implication of this study and direction of future research were suggested.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.111-132
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• 1970

An analysis of nursing activities in a in-patient ward and its management was observed in order to assess necessary number of nursing hands and find out reasonable work management with them. The study was performed with two wards of St. Mary′s Hospital, Catholic Medical Center, for the period from July to December 1970. The results and conclusions were as the following 1. The role of the nurses are determined by doctor′s order in 57.7% in kind, 80.0% in amount. and by nurses decision 20.0% in amount. 2. Works related to patient care are found to be 20.6% in the internal medicine ward and 20.4% in the surgical ward while works related to treatment are 4.7% in the former and 27.2% in the letter. Medication occupies 40.0% in the internal medical ward while 26.6% in the surgery ward, and observation occupies 34.7% in the former while 25.8% in the letter. These can be said to reflect characteristic differences bet ween the two wards. 3. When nursing functions were evaluated by importance "A" level in the amount of works to be done occupied 67.6% in the surgical ward and 62.8% in the internal medical ward. In the kind of the important works, "B"level is found to be most frequent with 50% while "A"level 43%. When evaluated by difficulty, "B"level was found to be most frequent in amount in both internal medicine and surgical wards (52.6%, 38.2%). 4. Works needing professional knowledge and skills occupied 92% in the both wards while unprofessional works 2.8% and 4.2% respectively. There are indications, however, that unprofessional works have an increasing tendency. 5. When evaluated by the amount of works, the surgical ward has 11 nurses less and the internal medicine ward 3 nurses less then the necessary number of nursing staffs. There are shortage of 12 and 6 nurses respectively when evaluated by the number of patients and 18 nurses in the both wards when evaluated by the medical regulations of the Government. 6. The ratio of the nursing staff to patient was found to be 1:11.5, 1:23.0 and 1:34.5 in the morning, evening and night turn in the surgical ward. In the medical word the ratio was 1:9.4, 1:22.0 and 1:33.0. 7. The deficiency of necessary equipment and tension accompanying management of those equipment were found to lower the effective functioning of the head nurse who is a junior manager of the ward. They also consume much of the time and energy of the nurses at work who are over burdened in most of the cases. 8. The high rate of the number of nurses who leave the job impairs the functioning of team work which is considered to be most important in the effective performance of nursing activities and thus contributes to lower the efficiency of nursing functions.

• Journal of Korean Academy of Nursing
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• v.4 no.3
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• pp.93-104
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• 1974

Regardless of a patient's diagnosis, the care of his skin has been a primary concern of nurses throughout the years. Nurses has washed, dried, and rubbed the skin and have changed his position so as to keep the patient's skin in good condition and to protect him from pressure sores. However, we still find many-patients suffering from the pressure sores which may take many mothers or years of treatment and cost a lot to be repaired. In view of expensive cost for treatment of the sores and low ratios of nursing staff per patient for intensive nursing care, prophylaxis of the bed sores with sufficient aids is extremely important both for patients and for nurses. Therefore, the unique purpose of this study was to determine whether sponge is good enough to treat and prevent the pressure sore as compared with gel pad and sheepskin. Sixty patients in the age range of 15 through 45 who were in unconscious status or have difficulty of mobility were chosen between January and March of 1974 at Seoul National University Hospital. They were randomly assigned to each treatment and observed on every 4th day with regard to level of consciousness, status of mobility, moisture or dryness of the bed, general skin condition, intake of nutrition, vital signs and intervals of position change in comparison with the changes of skin over the bony prominences. The study results were reviewed in a statistical method analysis of valiance-to obtain the following findings: 1. There was no significantly different changes of skin over the sanctum or the trochanter in each group using get pad, sheepskin or sponge. It means that we may substitute sponge for expensive gel pad or sheepskin. 2. There was no significant difference among mean changes of patient's skin in relation to sheepskin, gel pad and sponge. 3. There was no significant changes of patient's akin in relation to level of consciousness, status of mobility, intake of nutrition, general skin condition, temperature, blood pressure or interval of position change. 4. There were no meaningful interactions between each treatment and level of consciousness, moisture or dryness of the bed, intake of nutrition, general skin condition, temperature or blood pressure. 5. Sheepskin and gel pad had significantly better influence on patients with limited mobility than on patients with immobility, and sponge on patients with immobility on than patients with limited mobility, 6. Sheepskin and sponge had meaningfully totter influence on patients changing position at below 2-hour interval, gel pad at 2-4-hour interval, sheepskin at 4-6-hour interval, and three of them at above 6-hour interval.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.1
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• pp.25-36
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• 2004

Purpose: Nursing puts much weight en the organization of hospital. Therefore it is necessity to improve nursing care. One of the most important things is to secure confident nurses and to develop nurse' potentiality. It directs nurse evaluation system. The concept of "performance appraisal tools" is extremely important in evaluation system. Therefore, the purpose of this study aims to define performance appraisal process. Method: In order to do this, two main study has been observed interviewing appraisers and employees in-depth and analyzing performance appraisal tools of seven hospitals and analysed validity, reliability, acceptability and practicability. Result: The result of this study can be summarized as follows; Firstly, the result of analysis of performance appraisal tools. Regard to validity, Hospitals had a typical goal, but had not put to practice use. Regard to reliability, 1) Appraisal rule had been focused on appraiser's error, how to avoid. 2) 5 hospitals accessed nurses with relative rating and 2 hospitals with absolute rating both in practice. 3) 3 hospitals informed nurses the result of performance appraisal but 4 hospitals did not. 4) All hospitals in this study had conducted superiors rating. Regard to acceptability, 1)Rating scale method had been implemented by 6 hospitals and among those conducted beth ranking method and descriptive method. 2) Most hospitals had focused on personal traits in performance appraisal factors. Regard to practicality, The term of appraisal took $10{\sim}14$ days; performance appraisal happened 1 or 2 times per year; appraisal factors were based on 10 different items. Secondly, the result of in-depth interview with head nurses and staff nurses Regard to validity, head nurses and nurses wared that the goal of performance appraisal is to develop nurse's ability. Regard to reliability, head nurses pointed out that they were doubt of the justice of performance appraisal and they should have got training. Nurses insisted that raters should have been trained due to lack of qualification of appraiser; Head nurses and nurse proposed to convert form relative rating to absolute rating; to inform the result of appraisal; to implement peers rating. Regard to acceptability, One of the critical problems of performance appraisal tools was abstract of appraisal factors ; Lack of job analysis. Regard to practicality, Head nurses used to take overtime for appraisal. There was only a little respond despite of their efforts. Nurses questioned that appraisal tools exist for only appraisal; there was less cost-effectiveness. Conclusion: Based en these findings, it could be suggested to improve the performance appraisal tools for nurses evaluation. Firstly, it is necessary to describe goal of performance appraisal clearly set up, so that nurses could improve their positive word performance and develop their potentiality. Secondly, it is necessary to obtain various training on raters, implement absolute rating and inform the result of appraisal to nurses and use peers rating. Thirdly, it is necessary to convert from rating scale method to management by objectives or behaviorally anchored rating scale and take measurable appraisal factors based en job analysis. Finally, it is necessary to reduce the appraisal cost but increase effectiveness of performance appraisal.