PURPOSE: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. METHODS: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. RESULTS: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. CONCLUSION: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.
Continuity of Patient Care ; Counseling* ; Delivery of Health Care ; Electronic Health Records ; Fees and Charges ; Humans ; Nursing ; Patient Transfer* ; Referral and Consultation ; Seoul ; Tertiary Care Centers

Purpose: This study aimed to understand the non-contact nursing experiences of clinical nurses during the COVID-19 pandemic. Methods: A qualitative research design applying thematic analysis was used. The participants were purposive sampled from three institutes: a tertiary hospital, a general hospital, and a residential treatment center in Seoul. Data were collected between December 2021 and January 2022 through individual in-depth interviews with 12 clinical nurses. The data were analyzed using Braun and Clarke’s method to identify the meaning of the participants’ experiences. Results: During the COVID-19 pandemic, the fields where the participants performed non-contact nursing included intensive care units and isolation wards of hospitals, a residential treatment center, and home cares. Their tasks in non-contact nursing commonly involved remote monitoring using digital devices or equipment, consultation and education. From their experiences performing tasks in these fields, the four theme clusters and nine themes were derived. The four theme clusters are as follows:(1) Confusion of nursing role; (2) Conflict due to insufficient support system; (3) Concern about the quality of nursing; (4) Reflection on the establishment of nursing professionalism. Conclusion This study highlights the necessity for institutionalizing professional nursing areas, nursing education, and practical support by clarifying the purpose and goals of non-contact nursing and developing nursing knowledge through frameworks.

Purpose: This study aimed to understand the non-contact nursing experiences of clinical nurses during the COVID-19 pandemic. Methods: A qualitative research design applying thematic analysis was used. The participants were purposive sampled from three institutes: a tertiary hospital, a general hospital, and a residential treatment center in Seoul. Data were collected between December 2021 and January 2022 through individual in-depth interviews with 12 clinical nurses. The data were analyzed using Braun and Clarke’s method to identify the meaning of the participants’ experiences. Results: During the COVID-19 pandemic, the fields where the participants performed non-contact nursing included intensive care units and isolation wards of hospitals, a residential treatment center, and home cares. Their tasks in non-contact nursing commonly involved remote monitoring using digital devices or equipment, consultation and education. From their experiences performing tasks in these fields, the four theme clusters and nine themes were derived. The four theme clusters are as follows:(1) Confusion of nursing role; (2) Conflict due to insufficient support system; (3) Concern about the quality of nursing; (4) Reflection on the establishment of nursing professionalism. Conclusion This study highlights the necessity for institutionalizing professional nursing areas, nursing education, and practical support by clarifying the purpose and goals of non-contact nursing and developing nursing knowledge through frameworks.

Purpose: This study aimed to understand the non-contact nursing experiences of clinical nurses during the COVID-19 pandemic. Methods: A qualitative research design applying thematic analysis was used. The participants were purposive sampled from three institutes: a tertiary hospital, a general hospital, and a residential treatment center in Seoul. Data were collected between December 2021 and January 2022 through individual in-depth interviews with 12 clinical nurses. The data were analyzed using Braun and Clarke’s method to identify the meaning of the participants’ experiences. Results: During the COVID-19 pandemic, the fields where the participants performed non-contact nursing included intensive care units and isolation wards of hospitals, a residential treatment center, and home cares. Their tasks in non-contact nursing commonly involved remote monitoring using digital devices or equipment, consultation and education. From their experiences performing tasks in these fields, the four theme clusters and nine themes were derived. The four theme clusters are as follows:(1) Confusion of nursing role; (2) Conflict due to insufficient support system; (3) Concern about the quality of nursing; (4) Reflection on the establishment of nursing professionalism. Conclusion This study highlights the necessity for institutionalizing professional nursing areas, nursing education, and practical support by clarifying the purpose and goals of non-contact nursing and developing nursing knowledge through frameworks.

Purpose: This study aimed to understand the non-contact nursing experiences of clinical nurses during the COVID-19 pandemic. Methods: A qualitative research design applying thematic analysis was used. The participants were purposive sampled from three institutes: a tertiary hospital, a general hospital, and a residential treatment center in Seoul. Data were collected between December 2021 and January 2022 through individual in-depth interviews with 12 clinical nurses. The data were analyzed using Braun and Clarke’s method to identify the meaning of the participants’ experiences. Results: During the COVID-19 pandemic, the fields where the participants performed non-contact nursing included intensive care units and isolation wards of hospitals, a residential treatment center, and home cares. Their tasks in non-contact nursing commonly involved remote monitoring using digital devices or equipment, consultation and education. From their experiences performing tasks in these fields, the four theme clusters and nine themes were derived. The four theme clusters are as follows:(1) Confusion of nursing role; (2) Conflict due to insufficient support system; (3) Concern about the quality of nursing; (4) Reflection on the establishment of nursing professionalism. Conclusion This study highlights the necessity for institutionalizing professional nursing areas, nursing education, and practical support by clarifying the purpose and goals of non-contact nursing and developing nursing knowledge through frameworks.

BACKGROUND: Mivacurium is a nondepolarizing muscle relaxant and metabolized by pseudo-cholinesterase(pChe). Many reports show fall in pChe activity during pregnancy, so the metabolism of mivacurium may be delayed and muscle relaxation would be prolonged. METHODS: Muscle relaxation of full-term pregnant women(C group, n=10) and nopregnant women(Non-C group, n=10) was maintained by continuous infusion of mivacurium to keep 1st response of TOF at 5+/-1%. After discontinuance of infusion, recovery profiles were measured with accelerography. RESULTS: The Infusion rate of mivacurium to maintain 1st twich response of TOF at 5+/-1% was significantly low in C group comparing with Non-C group(P<0.05). There was no significant difference in pChe activity between two groups. There was no significant difference in recovery index, recovery time(T1 25%-T4 ratio, 0.75). There was a little correlation between the total infusion time and recovery profiles(recovery index: r2=0.37, recovery time: r2=0.28). Strong correlation existed between bolus-TS(time interval from the injection of mivacurium to recovery of 5% twitch hight) and infusion rate(r2=0.76). CONCLUSION: The mivacurium infusion rate of C group to maintain muscle relaxation was significantly lower than Non-C group. There would be many possible reasons including over-estimation of paturient body weight compared with lean body mass, decrease of blood volume due to hemorrhage.
Blood Volume ; Body Weight ; Cesarean Section* ; Female ; Hemorrhage ; Metabolism ; Muscle Relaxation ; Obstetrics ; Pregnancy ; Pseudocholinesterase

BACKGROUND: Mivacurium is a nondepolarizing muscle relaxant and metabolized by pseudo-cholinesterase(pChe). Many reports show fall in pChe activity during pregnancy, so the metabolism of mivacurium may be delayed and muscle relaxation would be prolonged. METHODS: Muscle relaxation of full-term pregnant women(C group, n=10) and nopregnant women(Non-C group, n=10) was maintained by continuous infusion of mivacurium to keep 1st response of TOF at 5+/-1%. After discontinuance of infusion, recovery profiles were measured with accelerography. RESULTS: The Infusion rate of mivacurium to maintain 1st twich response of TOF at 5+/-1% was significantly low in C group comparing with Non-C group(P<0.05). There was no significant difference in pChe activity between two groups. There was no significant difference in recovery index, recovery time(T1 25%-T4 ratio, 0.75). There was a little correlation between the total infusion time and recovery profiles(recovery index: r2=0.37, recovery time: r2=0.28). Strong correlation existed between bolus-TS(time interval from the injection of mivacurium to recovery of 5% twitch hight) and infusion rate(r2=0.76). CONCLUSION: The mivacurium infusion rate of C group to maintain muscle relaxation was significantly lower than Non-C group. There would be many possible reasons including over-estimation of paturient body weight compared with lean body mass, decrease of blood volume due to hemorrhage.
Blood Volume ; Body Weight ; Cesarean Section* ; Female ; Hemorrhage ; Metabolism ; Muscle Relaxation ; Obstetrics ; Pregnancy ; Pseudocholinesterase

Purpose: This study aimed to analyze the mass and social media contents and structures related to particulate matter before and after the policy enforcement of the comprehensive countermeasures for particulate matter, derive nursing implications, and provide a basis for designing health policies. Methods: After crawling online news articles and posts on social networking sites before and after policy enforcement with particulate matter as keywords, we conducted topic and semantic network analysis using TEXTOM, R, and UCINET 6. Results: In topic analysis, behavior tips was the common main topic in both media before and after the policy enforcement. After the policy enforcement, influence on health disappeared from the main topics due to increased reports about reduction measures and government in mass media, whereas influence on health appeared as the main topic in social media. However semantic network analysis confirmed that social media had much number of nodes and links and lower centrality than mass media, leaving substantial information that was not organically connected and unstructured. Conclusion Understanding of particulate matter policy and implications influence health, as well as gaps in the needs and use of health information, should be integrated with leadership and supports in the nurses’ care of vulnerable patients and public health promotion.

Purpose: This study was conducted to assess public awareness and policy challenges faced by practicing nurses. Methods: After collecting nurse-related news articles published before and after ‘the Thanks to You Challenge’ campaign (between December 31, 2019, and July 15, 2020), keywords were extracted via preprocessing. A three-step method keyword analysis, latent Dirichlet allocation topic modeling, and keyword network analysis was used to examine the text and the structure of the selected news articles. Results: Top 30 keywords with similar occurrences were collected before and after the campaign. The five dominant topics before the campaign were: pandemic, infection of medical staff, local transmission, medical resources, and return of overseas Koreans. After the campaign, the topics ‘infection of medical staff’ and ‘return of overseas Koreans’ disappeared, but ‘the Thanks to You Challenge’ emerged as a dominant topic. A keyword network analysis revealed that the word of nurse was linked with keywords like thanks and campaign, through the word of sacrifice. These words formed interrelated domains of ‘the Thanks to You Challenge’ topic. Conclusion The findings of this study can provide useful information for understanding various issues and social perspectives on COVID-19 nursing. The major themes of news reports lagged behind the real problems faced by nurses in COVID-19 crisis. While the press tends to focus on heroism and whole society, issues and policies mutually beneficial to public and nursing need to be further explored and enhanced by nurses.

Purpose: This study was conducted to assess public awareness and policy challenges faced by practicing nurses. Methods: After collecting nurse-related news articles published before and after ‘the Thanks to You Challenge’ campaign (between December 31, 2019, and July 15, 2020), keywords were extracted via preprocessing. A three-step method keyword analysis, latent Dirichlet allocation topic modeling, and keyword network analysis was used to examine the text and the structure of the selected news articles. Results: Top 30 keywords with similar occurrences were collected before and after the campaign. The five dominant topics before the campaign were: pandemic, infection of medical staff, local transmission, medical resources, and return of overseas Koreans. After the campaign, the topics ‘infection of medical staff’ and ‘return of overseas Koreans’ disappeared, but ‘the Thanks to You Challenge’ emerged as a dominant topic. A keyword network analysis revealed that the word of nurse was linked with keywords like thanks and campaign, through the word of sacrifice. These words formed interrelated domains of ‘the Thanks to You Challenge’ topic. Conclusion The findings of this study can provide useful information for understanding various issues and social perspectives on COVID-19 nursing. The major themes of news reports lagged behind the real problems faced by nurses in COVID-19 crisis. While the press tends to focus on heroism and whole society, issues and policies mutually beneficial to public and nursing need to be further explored and enhanced by nurses.