Purpose: The purpose of this study was to measure the influence of job stress, critical thinking disposition, and clinical decision-making ability on clinical nurses’ medication safety competence. Methods: A descriptive survey was conducted among 140 nurses with more than 6 months of work experience in 4 general hospitals in Busan metropolitan city. Data were collected from August 15 to October 30, 2021 and analyzed using the independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and stepwise multiple regression. Results: Medication safety competence had significant correlations with job stress (r=.20, p=.021), critical thinking disposition (r=.63, p<.001), and clinical decision-making ability (r=.54, p<.001). Multiple regression analysis for medication safety competence revealed that the most powerful predictor was critical thinking disposition. Job stress and critical thinking disposition explained approximately 45% of the variance in medication safety competence. Conclusion This study confirms the need to make systematic efforts in clinical settings to improve nurses’ medication safety competence, and seeks ways to do so. To enhance clinical nurses’ medication safety competence in the future, programs that manage job stress and improve critical thinking disposition within the nursing department in particular and the hospital in general should be developed and implemented.

No abstract available.
Skin Neoplasms* ; Skin*

No abstract available.
Folliculitis ; Herpes Zoster ; Herpesvirus 3, Human

PURPOSE: The most common cause of bronchiolitis and pneumonia in infants is respiratory syncytial virus (RSV). We evaluated the clinical characteristics according to RSV subgroup in infantile bronchiolitis and pneumonia. METHODS: This study enrolled infants with bronchiolitis or pneumonia infected by single virus. Virus infection was confirmed by respiratory virus reverse transcriptase polymerase chain reaction in two consecutive seasons (2010-2011, 2011-2012). They were divided into 3 groups: group 1 with RSV A, group 2 with RSV B, and group 3 with other virus. We retrospectively reviewed the medical charts to collect data on the hospitalized patients. RESULTS: Seventy four and 181 infants were included in the two seasons, respectively. The most common virus was RSV B in 2010-2011 and RSV A in 2011.2012. Among 255 infants, 55% (141/255) were group 1, 20% (49/255) group 2, 25% (65/255) group 3. Infants younger than 3 months were 55%. There were no significant age differences between groups. In comparison to group 3, group 1 and 2 showed frequent abnormal chest auscultation, high symptom severity score and need for systemic corticosteroid (P<0.05). In comparison to group 1 and 3, group 2 had longer hospitalization and time to need for normalization of lung sound (P<0.05). The recurrence rates within 6 months showed no significant differences between groups. CONCLUSION: The RSV subgroup changed from one year to another. Patients' clinical manifestations and symptom severity may vary according to infected virus subgroup.
Auscultation ; Bronchiolitis ; Hospitalization ; Humans ; Infant ; Pneumonia ; Recurrence ; Respiratory Sounds ; Respiratory Syncytial Viruses ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Seasons ; Thorax ; Viruses

A 9-month-old infant presented with cough, tachypnea, and grunting was admitted. The patient was revealed to have cardiomegaly, high NT-proBNP, and severe left ventricular dilation and dysfunction; she was subsequently diagnosed with acute myocarditis and congestive heart failure. Intravenous immunoglobulin, inotropics, diuretics, angiotensin converting enzyme inhibitors and beta blocker were used. However, left hemiparesis suddenly developed at 30-day after treatment. Brain MRI showed high signal intensity in the right middle cerebral arterial territory on diffusion weighted brain MRI and in the left parietal lobe with gyral enhancement. Echocardiogram revealed no definite intraventricular thrombus. The patient was started on an antiplatelet agent only without anticoagulant therapy for the treatment of cerebral infarct in respect of the risk to the infant. Four years after the cerebral ischemic stroke (CIS), she showed complete recovery from hemiparesis, with no more CIS. In conclusion, severe ventricular dilatation and dysfunction can lead to thromboembolic events in infants. We should keep in mind that anticoagulant or antiplatelet agents can be used in specific situations.
Angiotensin-Converting Enzyme Inhibitors ; Brain ; Cardiomegaly ; Cough ; Diffusion ; Dilatation ; Diuretics ; Heart Failure ; Humans ; Immunoglobulins ; Infant ; Myocarditis ; Natriuretic Peptide, Brain ; Paresis ; Parietal Lobe ; Peptide Fragments ; Platelet Aggregation Inhibitors ; Stroke ; Tachypnea ; Thrombosis

Purpose: : Using a descriptive survey design, this study investigated the relationship between the types of violence experienced, self-esteem, and organizational commitment among emergency room (ER) nurses. Methods: : A descriptive survey was conducted on 124 ER nurses working in two tertiary hospitals and three general hospitals in Busan Metropolitan City. Data were collected from October 15th to October 30th , 2019, and analyzed using independent t-tests, one-way ANOVA, and the Scheffé test. Results: : In the relationship between the types of violence experienced, self-esteem, and organizational commitment, a weak negative correlation (r=-.27, p=.002) was found between the type of violence experienced and organizational commitment. Conclusion : The study findings showed that it is necessary to reduce violent experiences to increase the organizational commitment of ER nurses. To this end, it is vital to create a safe working environment in emergency rooms, which are often exposed to violence, and to establish policies that prevent and protect ER in advance from various factors that cause violence.

No abstract available.
Carcinoma, Adenoid Cystic* ; Histiocytoma, Benign Fibrous*

Lamotrigine is an antiepileptic drug widely used to treat epileptic seizures. Using whole-cell voltage clamp recordings in combination with a fast drug application approach, we investigated the effects of lamotrigine on 5-hydroxytryptamine (5-HT)₃ receptors in NCB-20 neuroblastoma cells. Co-application of lamotrigine (1~300 µM) resulted in a concentration-dependent reduction in peak amplitude of currents induced by 3 µM of 5-HT for an IC₅₀ value of 28.2±3.6 µM with a Hill coefficient of 1.2±0.1. These peak amplitude decreases were accompanied by the rise slope reduction. In addition, 5-HT₃-mediated currents evoked by 1 mM dopamine, a partial 5-HT₃ receptor agonist, were inhibited by lamotrigine co-application. The EC₅₀ of 5-HT for 5-HT₃ receptor currents were shifted to the right by co-application of lamotrigine without a significant change of maximal effect. Currents activated by 5-HT and lamotrigine co-application in the presence of 1 min pretreatment of lamotrigine were similar to those activated by 5-HT and lamotrigine co-application alone. Moreover, subsequent application of lamotrigine in the presence of 5-HT and 5-hydroxyindole, known to attenuate 5-HT₃ receptor desensitization, inhibited 5-HT₃ receptor currents in a concentration-dependent manner. The deactivation of 5-HT₃ receptor was delayed by washing with an external solution containing lamotrigine. Lamotrigine accelerated the desensitization process of 5-HT₃ receptors. There was no voltage-dependency in the inhibitory effects of lamotrigine on the 5-HT3 receptor currents. These results indicate that lamotrigine inhibits 5-HT₃-activated currents in a competitive manner by binding to the open state of the channels and blocking channel activation or accelerating receptor desensitization.
Dopamine ; Epilepsy ; Neuroblastoma* ; Receptors, Serotonin, 5-HT3 ; Serotonin

Necrotizing fasciitis (NF) is a severe soft tissue infection, characterized by rapid and fulminant progression. Thus, early suspicion, and prompt medical and aggressive surgical management are important for the clinical outcomes of NF. Despite the rarity of NF in infants and group B streptococcus as its cause, a 2-month-old preterm girl presented with NF involving the suprapubic, inguinal, and lower lateral abdominal regions caused by group B streptococcus. The girl recovered after early medical and surgical management.

Background: Fresh frozen plasma (FFP) has been inappropriately using in spite of limited transfusion indications. Our institution applied the transfusion indication data-entry to a computerized order system in February 2018. Physicians should select the indication during transfusion order. In January 2019, the warning pop-up additionally applied for informing whether or not the coagulation test results correspond to FFP transfusion indications. We investigated the effects of a new applied program on the appropriateness of FFP transfusion. Methods: By comparing the appropriateness of transfusion before applying the transfusion indication data-entry, we investigated whether there were improvements of appropriateness after applying the transfusion indication data-entry and after applying the warning pop-up. We compared the percentages of performing pre-transfusion coagulation tests and transfusion among FFP requests before and after applying the warning pop-up. Results: After applying the transfusion indication data-entry, the appropriateness improved from 54.5% to 66.7%. The appropriateness of the surgery department was the lowest compared with that of the medical departments and emergency departments. The warning pop-up would be effective to induce pre-transfusion coagulation tests from surgery departments and emergency department. However, there was no further improvement in the appropriateness. Many requests from the surgery departments did not lead to transfusion. As the results of the analysis conducted by dividing each department that belonged to surgery departments, we could determine the wrong transfusion practice specific to each department. Conclusion The transfusion indication data-entry contributed to improving the appropriateness of FFP transfusion. Department-specific education and real-time auditing are needed for further improvement.