BACKGROUND: The purpose of this study was to investigate nurses' clinical competence and its relationship with perception of and compliance with standard precautions. METHODS: From January 12 to January 20, 2011, a total of 134 nurses working at a university hospital in Gyeonggi province completed a structured questionnaire on clinical competence and perception of and compliance with standard precautions. The data were analyzed with independent t-test, one-way analysis of variance, and Pearson's correlation analysis. RESULTS: The mean score for clinical competence was 3.53, and showed significant differences according to age, gender, education level, marital status, monthly income, and years of experience. The mean scores for perception of and compliance with standard precautions were 4.67 and 4.00 respectively. Perception of standard precautions showed a significant difference according to years of experience. There were significant positive correlations among clinical competence and perception (r=0.234, P=0.007), clinical competence and compliance (r=0.363, P<0.001), and perception and compliance (r=0.406, P<0.001). CONCLUSIONS: To improve nurses' compliance with standard precautions educational and administrative policies to improve clinical competence should be considered.
Clinical Competence ; Compliance ; Infection Control ; Marital Status

No abstract available.
Arnold-Chiari Malformation* ; Diagnosis* ; Prenatal Diagnosis* ; Ultrasonography*

No abstract available.

PURPOSE: This study was conducted to examine the factors associated with work related injuries of nurses in small and medium sized hospitals. Method: A cross-sectional survey was conducted with nurses in eight hospitals from October 2007 to January 2008. A questionnaire was designed to collect information on nurses' work related injuries, and individual and job related characteristics. The response rate was 65.1%. Data from 294 nurses were analyzed. Multiple logistic regression analysis was performed to determine factors associated with work related injuries. Result: Of the 294 nurses, 19.1% (n=56) responded as having at least one injury during their job performance. The logistic regression analysis revealed that the significant factors influencing work related injuries were job satisfaction, stress recognition, and hospital's location. Nurses with a higher job satisfaction were less likely to experience work related injuries (OR=0.58). Nurses with a higher stress recognition (OR=2.57) and those working at hospitals in metropolitan cities (OR=3.28) were more likely to experience work related injuries. CONCLUSIONS: The result of this study indicated that a substantial proportion of nurses in small and medium sized hospitals had experienced injuries related to nursing job. Interventions to prevent work related injuries among nurses should take into account the job satisfaction, stress recognition, and hospital characteristics.
Cross-Sectional Studies ; Job Satisfaction ; Logistic Models ; Surveys and Questionnaires

PURPOSE: Alterations in cerebral blood flow are very important for understanding the neurological consequences of all varieties of perinatal asphyxia. The purpose of this study is to measure the change of cerebral blood flow velocity and resistance index (RI) of middle cerebral artery (MCA) according to the time in asphyxiated infants. METHODS: We studied 7 asphyxiated term infant and 27 normal term infant who were born at Ewha Womans University Hospital from January 1996 to August 1997. Using the Doppler ultrasound, we examined blood flow velocity and RI of the middle cerebral artery. RESULTS: Clinical characteristics were not significantly different in both groups. Peak systolic flow velocity (PSFV) in asphyxiated infants significantly decreased than control (P<0.05). End diastolic flow velocity (EDFV) was not significantly different in both groups. RI in asphyxiated infants significantly decreased for 24 hours (P<0.05). No control infant ever had a RI value of 0.55 or below, three (42.9%) asphyxiated infants had a RI value of 0.55 or below. The changes of the systemic BP and heart rate were not significant. Two (28.6%) asphyxiated infants were proven periventricular white matter ischemia by ultrasonography. CONCLUSION: It is therefore very important to monitor RI in asphyxiated infants even if the degree of asphyxia is mild.
Asphyxia ; Blood Flow Velocity* ; Female ; Heart Rate ; Humans ; Infant* ; Ischemia ; Middle Cerebral Artery ; Ultrasonography

PURPOSE: Alterations in cerebral blood flow are very important for understanding the neurological consequences of all varieties of perinatal asphyxia. The purpose of this study is to measure the change of cerebral blood flow velocity and resistance index (RI) of middle cerebral artery (MCA) according to the time in asphyxiated infants. METHODS: We studied 7 asphyxiated term infant and 27 normal term infant who were born at Ewha Womans University Hospital from January 1996 to August 1997. Using the Doppler ultrasound, we examined blood flow velocity and RI of the middle cerebral artery. RESULTS: Clinical characteristics were not significantly different in both groups. Peak systolic flow velocity (PSFV) in asphyxiated infants significantly decreased than control (P<0.05). End diastolic flow velocity (EDFV) was not significantly different in both groups. RI in asphyxiated infants significantly decreased for 24 hours (P<0.05). No control infant ever had a RI value of 0.55 or below, three (42.9%) asphyxiated infants had a RI value of 0.55 or below. The changes of the systemic BP and heart rate were not significant. Two (28.6%) asphyxiated infants were proven periventricular white matter ischemia by ultrasonography. CONCLUSION: It is therefore very important to monitor RI in asphyxiated infants even if the degree of asphyxia is mild.
Asphyxia ; Blood Flow Velocity* ; Female ; Heart Rate ; Humans ; Infant* ; Ischemia ; Middle Cerebral Artery ; Ultrasonography

PURPOSE: The purpose of this study is to investigate the perception of nursing students' on-site clinical experience at intensive care unit(ICU), which will help on developing fundamental tool to enhance the effect of their clinical practice. METHOD: Van Manens hermeneutic-phenomenological method has been used to analyze the data. Participants consisted of 74 third-year nursing students who performed the clinical practice at an ICU in C university hospital. The students got the group interviews and kept the clinical diaries. Data was collected from series of group interviews and contents of the students clinical diaries. RESULT: Major concerns related to students clinical practice were found as follows: [being nervous about unfamiliar machines and situations], [being frustrated about the patients], [feeling of helplessness], [being stupefied from witnessing a death], [realizing the importance of health], [realizing individual patient's precious value through family's love], [realizing the importance of treating a patient as human being], [realizing the differences between theory and practice], [modelizing two aspects of nursing: professional and personal], [readiness to become a capable nurse]. CONCLUSION: We are able to obtain in-depth understandings about the nursing students lived experience of clinical practice at the ICU. Based upon this, there is a need to develop a better nursing intervention enhance the effectiveness of the nursing students clinical practice.
Humans ; Intensive Care Units* ; Critical Care* ; Interviews as Topic ; Nursing* ; Students, Nursing

OBJECTIVES: The hospital standardized mortality ratio (HSMR) has been widely used because it allows for robust risk adjustment using administrative data and is important for improving the quality of patient care. METHODS: All inpatients discharged from hospitals with more than 700 beds (66 hospitals) in 2008 were eligible for inclusion. Using the claims data, 29 most responsible diagnosis (MRDx), accounting for 80% of all inpatient deaths among these hospitals, were identified, and inpatients with those MRDx were selected. The final study population included 703 571 inpatients including 27 718 (3.9% of all inpatients) in-hospital deaths. Using logistic regression, risk-adjusted models for predicting in-hospital mortality were created for each MRDx. The HSMR of individual hospitals was calculated for each MRDx using the model coefficients. The models included age, gender, income level, urgency of admission, diagnosis codes, disease-specific risk factors, and comorbidities. The Elixhauser comorbidity index was used to adjust for comorbidities. RESULTS: For 26 out of 29 MRDx, the c-statistics of these mortality prediction models were higher than 0.8 indicating excellent discriminative power. The HSMR greatly varied across hospitals and disease groups. The academic status of the hospital was the only factor significantly associated with the HSMR. CONCLUSIONS: We found a large variation in HSMR among hospitals; therefore, efforts to reduce these variations including continuous monitoring and regular disclosure of the HSMR are required.
*Hospital Mortality ; Hospitals/*statistics & numerical data ; Humans ; Logistic Models ; Outcome Assessment (Health Care)/standards ; Quality of Health Care/standards ; Republic of Korea

PURPOSE: The purpose of this study was to identify the effects of hand acupuncture therapy on sleep quality by means of a sleep questionnaire, polysomnography and a cerebral blood flow test in 30~59 year old adults. METHODS: The study was a sham controlled design. Twenty-two adults were assigned to the pellet stimulating group (11) or sham group (11). The pellet stimulating group received hand acupuncture therapy using New Seoam Press Pellets number 1 for 4 weeks. On the other hand, the sham group used the same Adhesive tape in terms of shape, size and quality as New Seoam Press Pellets number 1 for 4 weeks. A Transcranial Doppler Ultrasonography and Carotid Duplex Ultrasonography examination were used for evaluating cerebral blood flow. Data was analyzed using the SPSS 12.0 version program with Chi2-test, Fisher's exact test and Mann Whitney U-test. RESULTS: In the pellet stimulating group, subjective sleep quality significantly improved more than that of the sham group. Among the sleep indices of the polysomnography, total sleep time and sleep latency of the sham group significantly improved. The cerebral blood flow test didn't show any differences. CONCLUSION: These results suggest that hand acupuncture therapy is effective for subjective sleep improvement only, not polysomnographical sleep indices and cerebral blood flow.
*Acupuncture Therapy ; Adult ; *Cerebrovascular Circulation ; Demography ; Female ; Hand/*physiology ; Humans ; Male ; Middle Aged ; Polysomnography ; Research Design ; Sleep Disorders/*therapy ; Sleep Stages ; Ultrasonography, Doppler, Transcranial

BACKGROUND: Esmolol is a short acting sympathetic beta receptor antagonist, and it was successfully applied to induced hypotension. Esmolol lowers blood pressure by decreasing cardiac output, and does not cause vasodilation. This property of esmolol may help to decrease bleeding during induced hypotension. In this study, we tried to elucidate the effect of esmolol on induced hypotension for total hip arthroplasty. METHOD: Twenty patients receiving total hip arthroplasty were randomly divided to two groups. Esmolol group (10 patients) received esmolol as a hypotensive agent, and sodium nitroprusside (SNP) group (10 patients) received SNP as a hypotensive agent. We measured arterial blood gas analysis, vital sign, amounts of bleeding, amounts of transfusion and administered fluid, and various laboratory findings. RESULTS: Induced hypotension was successfully performed in either esmolol and SNP group. Heart rate increased by SNP, and decreased by esmolol. There were no statistically significant differences between the two groups in amounts of bleeding, amounts of transfusion or administered fluid, and laboratory findings. Arterial oxygen tension was relatively constant in esmolol group, but decreased in SNP group. CONCLUSION: Esmolol can be used as a single hypotensive agent during induced hypotension without significant side effects during total hip arthroplasty.
Arthroplasty, Replacement, Hip* ; Blood Gas Analysis ; Blood Pressure ; Cardiac Output ; Heart Rate ; Hemorrhage ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium* ; Vasodilation ; Vital Signs