Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

Background: This study investigates changes in infection control organizations and the roles of infection control nurses in healthcare institutions during the prolonged COVID-19 pandemic. It aims to provide evidence for preparing effective responses to future emerging infectious diseases. Methods: A survey was conducted from August 9 to 27, 2021, targeting infection control nurses working in infection control departments of general hospitals in South Korea with more than 100 beds. Results: A total of 118 (38.3%) healthcare institutions responded, and 113 questionnaires ultimately analyzed. Changes in infection control organizations observed during the COVID-19 pandemic included alterations in infection control department staffing (34.5%), work arrangements (92.0%), IT systems development (45.1%), facilities and equipment (92.9%), and systems for responding to emerging infectious diseases (99.1%). Over 50% of infection control tasks were performed either frequently or daily during the pandemic, with the most significant workload increase observed in epidemiological investigations (77.9%). The most challenging task for infection control nurses was establishing and operating epidemic management systems (82.3%). Among personal factors hindering their work, a sense of responsibility for their duties scored the highest (mean 4.73/5 points). The primary structural and environmental barrier was insufficient staffing (mean 4.36/5 points). The most critical need for improving infection control efforts was increased staffing in infection control departments and enhanced administrative support (mean 4.63/5 points). Conclusion The COVID-19 pandemic brought significant changes to infection control organizations and the roles of infection control nurses. Based on the lessons learned, healthcare institutions must systematically restructure infection control organizations and enhance the expertise of infection control nurses to respond effectively to future outbreaks of emerging infectious diseases.

BACKGROUND: Liver transplantation (LT) is a complicated procedure with a high incidence of postoperative acute kidney injury (AKI). Previous studies indicate that even transient or mild post-LT AKI can result in critical conditions, including prolonged stays in hospitals and intensive care units and increased morbidity and mortality. The aim of this study was to investigate the association between body mass index (BMI) and occurrence of AKI in LT recipients. METHODS: Medical data from 203 patients who received LT surgery from January 2010 to August 2016 in a single university hospital setting were retrospectively collected and analyzed. Patients were classified as either underweight (BMI <20 kg/m²) or normal weight (20 ≤ BMI < 30 kg/m²). Demographic data, anesthetic methods, complications, and perioperative laboratory test values of each patient were assessed. Propensity analyses and logistic regression were performed to evaluate the association between BMI and post-LT AKI. RESULTS: There was no significant difference in occurrence of post-LT AKI between underweight and normal weight patients. The underweight patient group had significantly longer hospital stay compared with the normal weight patient group (P = 0.023). CONCLUSIONS: BMI classification was neither a positive nor negative predictor of postoperative AKI occurrence. However, patients with lower BMI had significantly longer hospital stay compared with their counterparts. Although our study was limited by its retrospective design, our observations suggest that lower BMI might play a role in post-LT AKI.
Acute Kidney Injury* ; Body Mass Index* ; Classification ; Humans ; Incidence ; Intensive Care Units ; Length of Stay ; Liver Transplantation* ; Liver* ; Logistic Models ; Mortality ; Retrospective Studies* ; Thinness

Narcissistic personality is an ego centric personality characterized by obsession with oneself, disregard for others, and lack of empathy. It forms a spectrum from normal to pathological levels. A narcissistic person unconsciously fears death because he/she pursues immortality and omnipotence. A narcissistic person does not consider others important. Thus, he/she does not mourn separation or loss. It might be a characteristic defense of narcissistic personality. The authors selected by Japanese author Yoko Sano as a text. Many people loved the cat and cried and mourned when the cat died. However, he was reborn immediately a million times. The cat loved only itself. The cat then met a white cat and fell in love for the first time. They lived to-gether. As time passed, the white cat died. For the first time, the cat cried out loud in sadness. After crying and crying, he stoppedmoving and dying. He was not reborn again. The authors viewed the cat as a narcissistic personality and interpreted its active avoidance and denial of separation, death, and mourning as a narcissistic defense. Repeating this only strengthened his narcissistic traits.However, the momentum of change was falling in love. Losing a loved one and going through the process of mourning the eternalseparation of death for the first time became the trigger for the change in narcissistic personality.

Placenta increta is a kind of placental adhesion which can cause severe postpartum hemorrhage and life-threatening condition. It might necessitate a hysterectomy, but conservative management can be considerable for preserving reproductive potential when possible. A 34-years-old woman in her 41st week of pregnancy had normal full term spontaneous delivery. Retained placenta after removal by placenta forceps resulted in mild bleeding. Placenta increta was clinically diagnosed on computerized tomography. Remnant placenta in situ was nearly disappeared 2 months later after five-time intramuscular injection of 50 mg methotrexate and three-times curettage was done for conservative management.
Curettage ; Female ; Hemorrhage ; Humans ; Hysterectomy ; Injections, Intramuscular ; Methotrexate ; Placenta ; Placenta Accreta ; Placenta, Retained ; Postpartum Hemorrhage ; Pregnancy ; Surgical Instruments

PURPOSE: This study tries to identify experience of verbal abuse, emotional response, and ways to deal with verbal abuse against nurses in hospitals. METHODS: This study was a descriptive research and conducted from April to July 2011. One hundred and seventeen nurses with over one-year experience in general wards were selected and evaluated. The data were analyzed using descriptive analysis, independent t-tests, and one-way ANOVA. RESULTS: The nurses' experience rate of verbal abuse during the entire period of work in hospitals was 98.3%. The majority of the nurses were verbally abused by patients (70.9%), followed by patients' relatives (65.8%), physicians (61.5%), and coworkers (58.1%). Overall negative emotional response score of nurses after verbal abuse was 38.82+/-8.28. Ways to deal with verbal abuse were as follows: suppression was 74.4%, complaining of an injustice to close people, 67.5%, and ignoring, 43.6%. CONCLUSION: Nurses have significantly been exposed to verbal abuse while working in hospitals. Therefore, hospital managers and nurse managers are required to inform other staff and visitors in hospitals the real condition of verbal abuse against nurses and provide a safe work environment by developing the report and disposal system of verbal abuse.
Humans ; Nurse Administrators ; Patients' Rooms

Recently, some cases of paradoxical bronchoconsthction with the use of nebulized antiasthmatic respirator solutions have been reported. This study was performed to determine whether benzalkonium chloride, contained in several antiasthmatic respirator solutions as a preservative, may cause paradoxical bronchoconstriction. This was accomplished by comparing the FEV(1) change after Ventolin (benzalkonium containing salbutamol) nebulization with the FEV(1) change after Respolin autohaler (benzalkonium free sa1butamol) inhalation within the same patient. This study consisted thirty patients with stable asthma who regularly attend the allergy clinic at Wallace Memorial Baptist Hospital. Patients were excluded from the study if they had respiratory disease or were taking any other medications. The results are as knows: 1) The baseline FEV(1) in the Ventolin group was 73+/-1O(% predicted) and 74+/-10(% predicted) in the Respolin autohaler group, showing no statistical difference in baseline FEV(1) between the two groups. 2) FEV(1) was decreased in 9 subjects(3096) after Ventolin nebu1ization and in 1 subject(3396) after Respolin autohaler inhalation, showing that the incidence of FEV(1) fall was higher in the Vento1in group than in the Respo1in autohaler group(p<0.OO5, one-tailed t-test). 3) Considering the cases with increased FEV(1) after inhalation, FEVl was increased by 9+/-7 (% predicted) in the Vento1in group and 7+/-5(% predicted) in the Respolin autohaIer group, suggesting that bronchodi1ator effects of both medications are similar. 4) Mild coughing occurred in 4 subjects(13396), and mild chest tightness in 1 subject(33%) in the Ventolin group. These symptoms resolved without any treatment. No side effects were reported by subjects in the Respolin autohaler group. In conclusion, these results strongly suggest that the paradoxical bron-choconstriction occurring with nebulized antiasthmatic respirator solutions is due to the ingredient benzalkonium chloride. Therefore we recommend that a benzalkoniulm free salbutamol product should be used for asthmatic patients, or if a product such as Ventolin which contains benza1konium chloride must be used, we recommend that it should be administered cautiously.
Albuterol ; Asthma ; Benzalkonium Compounds* ; Bronchoconstriction* ; Cough ; Humans ; Hypersensitivity ; Incidence ; Inhalation ; Protestantism ; Thorax ; Ventilators, Mechanical*

OBJECTIVES: When a patient who attempts suicide visits the emergency room, it is important that the departments of emergency medicine, internal medicine, and psychiatry communicate with each other and prioritize treatment. This study was conducted to verify the effectiveness of the multidisciplinary emergency consultation system (ECS) for drug intoxicated patients. METHODS: We retrospectively analyzed the data from medical records prior to the ECS, from July 2017 to May 2018, and after the ECS, from July 2018 to May 2019, to verify the effectiveness of the system. RESULTS: After the ECS, admission to open wards was significantly higher than to the intensive care units (χ²=8.567, p=0.014). In addition, the proportion of consultations to the department of psychiatry among patients admitted to other departments tended to increase (χ²=4.202, p=0.053), and the time required for consultation response decreased (Z=−2.031, p=0.042). As a result of the consultation, the proportion of the patients who had been transferred to the department of psychiatry was increased (χ²=4.692, p=0.043), and the time spent to transfer tended to decrease (Z=−1.941, p=0.052). CONCLUSIONS After implementing the ECS for drug intoxicated patients, unnecessary intensive care unit admissions, consultation response time, and the time spent to transfer were reduced, and the rate of consultation referrals and transfer rates increased. This means that the multidisciplinary consultation system rapidly provided essential medical services to patients at lower medical costs.