BACKGROUND: This study aimed to identify the effects of a multifaceted needlestick injury (NSI) prevention program on changes in knowledge about bloodborne infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting pre- and post-intervention among nurses. METHODS: A total of 429 and 420 nurses participated in the pre- and post-intervention periods, respectively. The intervention was performed from April to September 2007, comprising NSI guideline education, the use of containers with enhanced engineering, and the supply of safety devices. RESULTS: The average score of knowledge about bloodborne infectious diseases increased significantly from 8.3 to 8.9 out of 14 points (P<0.001), but the change in score of knowledge about postexposure coping was insignificant. The average score of attitude toward postexposure reporting increased significantly from 8.9 to 9.6 out of 12 points (P<0.001). Preventive measures such as "gloves are provided whenever needed" (P<0.001), "use one-hand technique" (P<0.001), and "needle containers are provided whenever needed" (P=0.031) increased significantly. The number of NSIs decreased by 40.4%, and the postexposure reporting rate increased by 552.8%. CONCLUSION: The multifaceted NSI prevention program positively affected knowledge about infectious diseases and postexposure coping, attitudes toward postexposure reporting, preventive measures, the number of NSIs, and postexposure reporting after intervention. Therefore, we recommend that this program be applied to various healthcare workers in hospitals.
Communicable Diseases ; Delivery of Health Care ; Incidence ; Needlestick Injuries ; Post-Exposure Prophylaxis

PURPOSE: To explore the usefulness of previous fall history as a triage variable for inpatients. METHODS: Medical records of 21,382 patients, admitted to medical units of one tertiary hospital, were analyzed retrospectively. Inpatient falls were identified from the hospital's self-report system. Non-falls in 1,125 patients were selected by a stratified matching sampling with 125 patients with falls (0.59%). A comparative and predictive accuracy analysis was conducted to describe differences between the two groups with and without a history of falls. Logistic regression was used to measure the effect size of the fall history. RESULTS: The fall history group showed higher prevalence by 9 fold than the non-fall history group. The relationships between falls and relevant variables which were significant in the non-fall history group, were not significant for the fall history group. Falls in the fall history group were 25 times more likely than in the non-fall group. Predictive accuracy of the risk assessment tool showed almost zero specificity in the fall history group. CONCLUSION: The presence of fall history, the fall prevalence, variables relevant to falls, and the accuracy of the risk tool were different, which support the usefulness of the fall history as a triage variable.
Accidental Falls ; Humans ; Inpatients ; Logistic Models ; Medical Records ; Predictive Value of Tests ; Prevalence ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity ; Tertiary Care Centers ; Triage

PURPOSE: The aim of this study was to identify the effect of an observation window (OW) at peripheral intravenous (IV) catheter sites on early detection of IV infiltration among hospitalized children. METHODS: This was a retrospective observational study with history control group design. Participants were children who had IV infiltration after peripheral catheterization when hospitalized from January to May, 2014 and January to May, 2015 at a children's hospital located in Yangsan city, Korea. The 193 patients, who were hospitalized from January to May, 2014 formed the control group and did not have OW, and the 167 patients, who were hospitalized from January to May, 2015 formed the window group and had OW. Data were analyzed using χ²-test, independent samples t-test and multiple logistic regression. RESULTS: First stage IV infiltration was 39.5% for the window group and 25.9% for the control group, which was significantly different (p=.007). The likelihood of 2nd stage and above IV infiltration decreased by 44% in the window group, which was significantly different (p=.014). CONCLUSION: OW at the peripheral IV catheter site was found to be an effective measure in early recognition of IV infiltration. Considering the effect of OW, we recommend that nurses should make an OW with transparent dressing during stabilization of the IV catheter site in hospitalized children in clinical settings.
Bandages ; Catheterization, Peripheral ; Catheters* ; Child ; Child, Hospitalized* ; Gyeongsangnam-do ; Humans ; Infusions, Intravenous ; Korea ; Logistic Models ; Observational Study ; Retrospective Studies

PURPOSE: This study aimed to validate instruments to classify the frailty of Korean elderly people in community. METHODS: For this study, 632 elders were selected from community-based elderly houses and home visiting registries, and data on frailty were collected using three instruments during November, 2008. The Korean Frail Scale (KFS) was composed of 10 domains with the maximum score of 20. The Edmonton Frail Scale (EFS) had 10 domains with the maximum score of 17. The 25_Japan Frail Scale (25_JFS) was composed of 6 domains with the maximum score of 25. Internal consistency was measured with Cronbach's alpha. Sensitivity, specificity and area under the curve (AUC) of ROC were measured to see validity with long-term care insurance grade as a gold standard. RESULTS: The Cronbach's alpha was .72 for KFS, .55 for EFS, and .80 for 25_JFS. Sensitivity, specificity, and AUC were 70.0%, 83.2%, and .83, respectively, at cutting point 10.5 for the KFS, 50.0%, 80.9%, and .66, respectively, at 8.5 for EFS, and 80.0%, 85.9%, and .86, respectively, at 12.5 for 25_JFS. CONCLUSION: KFS and three JFS showed favorable internal consistency and predictive validity. Further longitudinal studies are recommended to confirm predictive validity.
Aged* ; Area Under Curve ; Frail Elderly ; House Calls ; Humans ; Insurance, Long-Term Care ; Longitudinal Studies ; Registries ; Sensitivity and Specificity

PURPOSE: Cancer is the most frequent cause of death in Korea. Cancer screening can save lives through early detection. This study was to investigate major cancer screening rates and the reasons for not having been screening. METHOD: 210 participants of registered nurses from 5 general hospitals in Busan, Korea were completed a structured self-administered questionnaire. Data were analyzed using descriptive statistics with SPSS WIN 10.0. Results: The cancer screening rates of the subjects were 53.8% in Pap smear test for cervical cancer, 41.0% in gastroendoscopy for stomach cancer, 15.7% in mammograpy for breast cancer, and 3.8% in colonoscopy. And the higher proportions of having regular screening were 9,5% in Pap smear test and 2.9% in gastroendoscopy. The primary reason related to not having a screening test was 'seems to be healthy'. CONCLUSION: The findings showed the necessity of recognizing and educating Korean nurses to have a regular cancer screening for their health management.
Breast Neoplasms ; Busan* ; Cause of Death ; Colonoscopy ; Early Detection of Cancer* ; Hospitals, General* ; Korea ; Mass Screening ; Surveys and Questionnaires ; Stomach Neoplasms ; Uterine Cervical Neoplasms

PURPOSE: The differentiation properties of stem cells are not yet fully understood due to their close association with multiple environmental and extrinsic factors. This study investigates the differentiation properties of mesenchymal stem cells (MSCs) and correlates them with their intrinsic mechanical properties. METHODS: A total of 3 different types of MSCs, namely bone marrow-derived MSCs (BMSCs), umbilical cord-derived MSCs (UCSCs), and adipose-derived MSCs (ADSCs) were evaluated. These 3 MSCs were individually differentiated into adipocytes and osteoblasts for 3 weeks. The mechanical properties of the MSCs and differentiated cells were determined by atomic force microscopy. RESULTS: ADSCs showed the greatest ability to differentiate into adipocytes, followed by BMSCs and UCSCs. While UCSCs differentiated readily into osteoblasts, BMSCs and ADSCs were less likely to undergo this differentiation. UCSCs were the “hardest” cells, while ADSCs were the “softest.” The cells differentiated from “hard” MSCs were stiffer than the cells differentiated from “soft” MSCs, irrespective of lineage specification. CONCLUSIONS: The differentiation ability of MSCs and the mechanical properties of the differentiated cells were closely linked. However, there were no significant correlations regarding changes in the mechanical properties between the nuclear region and the cytoplasm during differentiation.
Adipocytes ; Adipogenesis ; Cytoplasm ; Mechanics ; Mesenchymal Stromal Cells* ; Microscopy, Atomic Force ; Osteoblasts ; Osteogenesis ; Stem Cells

PURPOSE: The purpose of this study was to compare and check the levels of cancer pain management knowledge and awareness between doctors and nurses in a tertiary hospital and to develop an intervention program. METHODS: Participants were 725 nurses and 95 doctors working in a hospital from May 2 to 29, 2009. Data were analyzed using t-tests, chi2-tests, and ANOVA with SPSS WIN 18.0. RESULTS: In a comparison of the pain management score, nurses showed significant results for age (p<.001), carrier (p<.001), education (p<.001), workplace (p<.001), and doctors showed significant results only for age (p=.032). Doctors' marks were significantly higher than nurses' in pain management scores (p<.001). Knowledge about analgesic medication (t=-5.38, p<.001) and analgesic drug effect (t=-8.59, p<.001) were significantly different in the pain management subcategory score between nurses and doctors. There were four items with different awareness levels related to analgesics between nurses and doctors. CONCLUSION: The findings of this study demonstrate that it is possible to develop pain education content for nurses and doctors. The findings of this study are useful when seeking to change the awareness level of a medical team regarding opioid analgesics.
Analgesics ; Analgesics, Opioid ; Pain Management ; Tertiary Care Centers

PURPOSE: The aims of study were; (1) to evaluate the validity and sensitivity of a fall-risk assessment tool, and (2) to establish continuous quality improvement (CQI) methods to monitor the effective use of the risk assessment tool. METHODS: A retrospective case-control cohort design was used. Analysis was conducted for 90 admissions as cases and 3,716 as controls during the 2006 and 2007 calendar years was conducted. Fallers were identified from the hospital's Accident Reporting System, and non-fallers were selected by randomized selection. Accuracy estimates, sensitivity analysis and logistic regression were used. RESULTS: At the lower cutoff score of one, sensitivity, specificity, and positive and negative predictive values were 82.2%, 19.3%, 0.03%, and 96.9%, respectively. The area under the ROC was 0.60 implying poor prediction. Logistic regression analysis showed that five out of nine constitutional items; age, history of falls, gait problems, and confusion were significantly associated with falls. Based on these results, we suggested a tailored falls CQI process with specific indexes. CONCLUSION: The fall-risk assessment tool was found to need considerable reviews for its validity and usage problems in practice. It is also necessary to develop protocols for use and identify strategies that reflect changes in patient conditions during hospital stay.
Accidental Falls ; Case-Control Studies ; Cohort Studies ; Gait ; Hospitalization ; Humans ; Length of Stay ; Logistic Models ; Organothiophosphorus Compounds ; Predictive Value of Tests ; Quality Improvement ; Retrospective Studies ; Risk Assessment ; Sensitivity and Specificity

The purposes of this study were to identify the effects of the Nursing Information System on time of the direct and indirect nursing activities, the frequencies of verbal and telephone order, the number of cases and patient's treatments fees before and after NIS. 10 nursing units in the S.N.U.H. were se lected. The data were colle cted for 6 month prior and pa st to NIS. The frequencies of verbal and telephone order were reported from staff nurses for 3 days. The numbers of cases and fees of patient's treatments were taken for 3 month before and after NIS. The results of this study were as follows: 1. 66.9% of participants said direct nursing activities were increased. Any changed nursing performances were patients education, nursing rounds, care of patient's hygiene, care for patient's movements, oral and tracheal suctioning, changing position, and feeding. 2. The difference of amount of time of dir ect and indirect nursing activities 1)There was 14 minutes increase indirect,4 minutes decrease in indirect. 2)NA's activities we re increased by 30minute in direct, decreased by 16 minute in indirect. 3. The frequency of telephone order decreased 16 and verbal order decreased 46 per day. 4. The difference of the number of patient treatment case before and after NIS was increased 9,907 per 3 months and of fees for patient treatment was increased 797,811,067 won per 3 months.
Education, Nursing ; Fees and Charges* ; Humans ; Hygiene ; Information Systems* ; Nursing* ; Suction ; Telephone

PURPOSE: The present survey was conducted to investigate the perceptions among nurses of neonatal pain and the associated use of pharmacologic measures (PMs) and nonpharmacologic comfort measures (CMs) in neonatal intensive care units (NICUs). Pain perception, the necessity and actual use of PMs and CMs, and their relationships were investigated and compared according to nurses' positions, educational levels, the existence of guidelines, and prior education on neonatal pain management. METHODS: Participants were 141 nurses from five NICUs at university hospitals. A questionnaire was developed by researchers based on previous studies of neonatal pain management and current practices in surveyed NICUs. Five-point Likert scales were used to assess nurses' perceptions of pain, the necessity of PMs and CMs, and their actual use in 29 painful procedures. RESULTS: The mean scores of perceived pain and the necessity of PMs and CMs were 3.68, 2.96, and 3.79 points, respectively. The actual use of PMs and CMs was 1.67 and 2.63 points, respectively. The perceived necessity of PMs correlated with the actual use of PMs (r = .316, p < .001), and CMs were performed (r = .390, p < .001). Keeping or reading guidelines, or receiving education on pain management resulted in a higher perception of the necessity of PMs. CONCLUSION: Korean nurses in NICUs often underestimate the necessity of pain relief measures and use few PMs or CMs. Therefore, systematic approaches to implement guidelines, such as adaptation of guidelines for each NICU, dissemination of guideline content to all NICU staff, and regular measurements of compliance with the guidelines, are recommended.
Adult ; *Attitude of Health Personnel ; Cross-Sectional Studies ; Female ; Humans ; Infant, Newborn ; *Intensive Care Units, Neonatal ; Intensive Care, Neonatal/*methods ; Nursing Staff, Hospital/*psychology ; Pain/nursing ; Pain Management/*methods/psychology/*utilization ; Questionnaires ; Republic of Korea ; Young Adult