PURPOSE: This study was conducted to develop an empowering education program for Maternal-Fetal Intensive Care Unit (MFICU) nurses who provide intensive care to high-risk mother and fetus at hospitals, to test effects of the education program on nursing care confidence and nursing knowledge, and to examine program satisfaction. METHODS: This study comprised of 2 phases: program development and evaluation. First, we have followed a process of program development to develop and refine an empowering education program for MFICU nurses through collaborative works among clinical obstetrics and gynecology doctors and nurses and academic nursing professors. Second, the empowering education program was provided to 49 nurses and evaluated from July 5 to 6, 2019. Levels of MFICU nursing care confidence and knowledge were measured. RESULTS: The empowering education program included 18 hours of lectures, discussion, and Q & A, which continued for 2 days. This program significantly improved high-risk maternal-fetal nursing care confidence and knowledge of nurses. The program was well met with nurses' education need and goals, and found to be highly satisfactory. CONCLUSION: The empowering education program was observed to be effective in terms of improve nursing care confidence and knowledge of nurses in MFICU. It is proposed that this program should be open regularly for nurses to obtain and improve their clinical knowledge, confidence, and competency. Further study is needed to develop and run 2-levels of education such as basic and advanced levels based on nurses' clinical background and competency.
Critical Care ; Education ; Fetus ; Gynecology ; Humans ; Intensive Care Units ; Lectures ; Mothers ; Nursing ; Nursing Care ; Obstetrics ; Pregnancy, High-Risk ; Program Development

OBJECTIVES: The usability of clinical information systems (CISs) is known to be an essential consideration in ensuring patient safety as well as integrating clinical flow. This study aimed to determine how usability and safety guidelines of CIS consider clinical workflow through a systematic review in terms of the target systems, methodology, and guideline components of relevant articles. METHODS: A literature search was conducted for articles published from 2000 to 2015 in PubMed, Cochrane, EMBASE, Web of Science, and CINAHL. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement method was employed. Articles containing recommendations, principles, and evaluation items for CIS usability and safety were included. The selected articles were classified according to article type, methodology, and target systems. Taking clinical workflow into consideration, the components of guidelines were extracted and classified. RESULTS: A total of 7,401 articles were identified by keyword search. From the 76 articles remaining after abstract screening, 15 were selected through full-text review. Literature review (n = 7) was the most common methodology, followed by expert opinions (n = 6). Computerized physician order entry (n = 6) was the most frequent system. Four articles considered the entire process of clinical tasks, and two articles considered the principles of the entire process of user interface affecting clinical workflow. Only two articles performed heuristic evaluations of CISs. CONCLUSIONS: The usability and safety guidelines of CISs need improvement in guideline development methodology and with consideration of clinical workflow.
Expert Testimony ; Heuristics ; Hospital Information Systems ; Information Systems* ; Mass Screening ; Medical Order Entry Systems ; Methods ; Patient Safety ; User-Computer Interface

PURPOSE: The purpose of this study was to investigate the occurrence of first onset of constipation during the rehabilitation stage and risk factors for constipation in patients with cerebral vascular disease (CVD). METHODS: Participants for this retrospective study were 214 CVD patients admitted to rehabilitation units. First onset of constipation and factors influencing constipation such as dependency level were recorded for 14 days during the rehabilitation stage. Survival analysis with Cox proportional hazard model and descriptive statistics were conducted. RESULTS: Age, patients'severity, types of diet, and dependency level were different between constipation and non-constipation groups. In survival analysis, 99% of participants developed constipation within 14 days after admission to rehabilitation units. Median constipation occurrence time was 7.4 days. Patients who were immobile and had tube feedings were more likely to develop constipation 4.07 times (95% CI: 1.018~16.301, p=.047) and 2.09 times (95% CI: 1.001~4.377, p=.050) respectively compared to patients who were independent and had a regular diet, respectively. CONCLUSION: Most CVD patients experienced constipation within 2 weeks after entering the rehabilitation stage. Constipation was linked to types of diet and dependency level. These factors associated with constipation should be considered when caring for patients in rehabilitation.
Constipation* ; Diet ; Humans ; Proportional Hazards Models ; Rehabilitation* ; Retrospective Studies ; Risk Factors ; Stroke ; Survival Analysis ; Vascular Diseases*

Background: Creutzfeldt-Jakob disease (CJD) is a rare and a rapidly progressive, invariably fatal neurodegenerative disorder believed to be caused by an abnormal isoform of a cellular glycoprotein known as the prion protein. The disease develops in very different ways, such as sporadic, genetic, and iatrogenic. We aim to identify the incidence of CJD genotypes registered in the statutory infectious disease surveillance system from 2017 to 2023 and analyze the types and characteristics of domestic pathogenic CJD genotypes to serve as a basis for preventing transmission. Methods: We analyzed the characteristics of hereditary CDJ among subjects reported through the Korean Centers for Disease Control and Prevention's statutory infectious disease surveillance system from 2017 to 2023. Results: In total, six pathogenic genotypes were identified in Korean patients, with P102L belonging to Gerstmann-Sträussler-Scheinker syndrome being the most common (16, 30.2%), followed by V180I (13, 24.5%), M232R (10, 18.9%), and E200K (seven, 18.9%), which are highly prevalent in Asia, and D178N (six, 11.3%) and V203I (one, 1.9%), which belong to fatal familial insomnia. Conclusions The significance of this study lies in the identification of P102L as the predominant genotype observed among individuals in their 30s and 40s in Korea. Moreover, it highlights that the occurrence of visual symptoms at an early stage is more prevalent in this age group compared to individuals over 50. Therefore, if a young individual reports a subjective decline in visual acuity not adequately accounted for by structural abnormalities of the eye, it becomes imperative to confirm the presence of CJD before undergoing ophthalmic procedures (such as corneal or retinal surgery), as these procedures involve high-risk organs for CJD transmission.

Background: Creutzfeldt-Jakob disease (CJD) is a rare and a rapidly progressive, invariably fatal neurodegenerative disorder believed to be caused by an abnormal isoform of a cellular glycoprotein known as the prion protein. The disease develops in very different ways, such as sporadic, genetic, and iatrogenic. We aim to identify the incidence of CJD genotypes registered in the statutory infectious disease surveillance system from 2017 to 2023 and analyze the types and characteristics of domestic pathogenic CJD genotypes to serve as a basis for preventing transmission. Methods: We analyzed the characteristics of hereditary CDJ among subjects reported through the Korean Centers for Disease Control and Prevention's statutory infectious disease surveillance system from 2017 to 2023. Results: In total, six pathogenic genotypes were identified in Korean patients, with P102L belonging to Gerstmann-Sträussler-Scheinker syndrome being the most common (16, 30.2%), followed by V180I (13, 24.5%), M232R (10, 18.9%), and E200K (seven, 18.9%), which are highly prevalent in Asia, and D178N (six, 11.3%) and V203I (one, 1.9%), which belong to fatal familial insomnia. Conclusions The significance of this study lies in the identification of P102L as the predominant genotype observed among individuals in their 30s and 40s in Korea. Moreover, it highlights that the occurrence of visual symptoms at an early stage is more prevalent in this age group compared to individuals over 50. Therefore, if a young individual reports a subjective decline in visual acuity not adequately accounted for by structural abnormalities of the eye, it becomes imperative to confirm the presence of CJD before undergoing ophthalmic procedures (such as corneal or retinal surgery), as these procedures involve high-risk organs for CJD transmission.

Background: Creutzfeldt-Jakob disease (CJD) is a rare and a rapidly progressive, invariably fatal neurodegenerative disorder believed to be caused by an abnormal isoform of a cellular glycoprotein known as the prion protein. The disease develops in very different ways, such as sporadic, genetic, and iatrogenic. We aim to identify the incidence of CJD genotypes registered in the statutory infectious disease surveillance system from 2017 to 2023 and analyze the types and characteristics of domestic pathogenic CJD genotypes to serve as a basis for preventing transmission. Methods: We analyzed the characteristics of hereditary CDJ among subjects reported through the Korean Centers for Disease Control and Prevention's statutory infectious disease surveillance system from 2017 to 2023. Results: In total, six pathogenic genotypes were identified in Korean patients, with P102L belonging to Gerstmann-Sträussler-Scheinker syndrome being the most common (16, 30.2%), followed by V180I (13, 24.5%), M232R (10, 18.9%), and E200K (seven, 18.9%), which are highly prevalent in Asia, and D178N (six, 11.3%) and V203I (one, 1.9%), which belong to fatal familial insomnia. Conclusions The significance of this study lies in the identification of P102L as the predominant genotype observed among individuals in their 30s and 40s in Korea. Moreover, it highlights that the occurrence of visual symptoms at an early stage is more prevalent in this age group compared to individuals over 50. Therefore, if a young individual reports a subjective decline in visual acuity not adequately accounted for by structural abnormalities of the eye, it becomes imperative to confirm the presence of CJD before undergoing ophthalmic procedures (such as corneal or retinal surgery), as these procedures involve high-risk organs for CJD transmission.

Purpose: The purpose of this study was to examine knowledge, attitudes, performance, and barriers to pain management of nurses working in oncology settings. Methods: This cross-sectional study was conducted on 222 nurses in five tertiary hospitals in Korea.The period of data collection was 1 September to 30 November 2018. Participants were surveyed using the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), a pain management performance, and barriers questionnaire. The data were analyzed through independent t-test and One-way ANOVA, and the post-hoc test was conducted with the Scheffé test using the SPSS 23 program. Results: According to the study, oncology nurses’ knowledge and attitudes to pain received a score of 26.4±3.77 (out of 41 points) and the performance received a score of 3.24±0.35 (out of 4 points). Among the barriers to pain management, time constraints were the most frequent medical staff-related factor, and reluctance to take opioids was the most frequent patient-related factor. In terms of factors related to the health care system, strict regulation of opioids was the most significant. There was a significant positive correlation between knowledge and attitude of pain management and performance of pain management. Conclusion Based on the findings of this study, it is recommended that structured education programs to be developed and implemented to enhance knowledge, attitudes, and performance on pain.

Purpose: The purpose of this study was to examine knowledge, attitudes, performance, and barriers to pain management of nurses working in oncology settings. Methods: This cross-sectional study was conducted on 222 nurses in five tertiary hospitals in Korea.The period of data collection was 1 September to 30 November 2018. Participants were surveyed using the Nurse Knowledge and Attitudes Survey Regarding Pain (NKASRP), a pain management performance, and barriers questionnaire. The data were analyzed through independent t-test and One-way ANOVA, and the post-hoc test was conducted with the Scheffé test using the SPSS 23 program. Results: According to the study, oncology nurses’ knowledge and attitudes to pain received a score of 26.4±3.77 (out of 41 points) and the performance received a score of 3.24±0.35 (out of 4 points). Among the barriers to pain management, time constraints were the most frequent medical staff-related factor, and reluctance to take opioids was the most frequent patient-related factor. In terms of factors related to the health care system, strict regulation of opioids was the most significant. There was a significant positive correlation between knowledge and attitude of pain management and performance of pain management. Conclusion Based on the findings of this study, it is recommended that structured education programs to be developed and implemented to enhance knowledge, attitudes, and performance on pain.

OBJECTIVES: The purpose of this study is to find the influential clinical and physical characteristics which affect apnea-hypopnea index (AHI) in suspected obstructive sleep apnea (OSA) patients. METHODS: We evaluated the comprehensive factors including sleep related symptoms, clinical scales, medical history, substance use, and anthropometric data of the 119 participants who complained of the symptoms of OSA. All the participants underwent attended-full night laboratory polysomnography. The correlation and multiple regression analysis were conducted to find the influential and predictive factors of AHI. RESULTS: A multiple linear regression model 1 showed that higher AHI was associated with higher body mass index (BMI)(p < 0.001) and higher frequency of observed apnea (p = 0.002). In multiple linear regression model 2, AHI was associated with higher BMI (p < 0.001) and loudness of snoring (p = 0.018). CONCLUSIONS: The present preliminary results suggest that BMI and observed apnea are most influential factors that affect AHI in suspected OSA patients. In the future study we will design the prediction formula for the OSA and AHI, which is useful in the clinical medical field.
Apnea ; Body Mass Index ; Humans ; Linear Models ; Polysomnography ; Sleep Apnea, Obstructive ; Snoring ; Weights and Measures

Rabbits are being increasingly used as companion animals, and in research; thus, the need for proper veterinary care for rabbits has increased. Surgical access is more challenging in rabbits under inhalation anesthesia compared to other animals, such as dogs and cats. Rabbits have a very narrow and deep oral cavity, large incisors, and a large tongue. Moreover, their temporomandibular joint has limited mobility, making it more difficult to approach the larynx. Various methods have been proposed to overcome this difficulty. The video laryngoscope was introduced in 1999 and is useful when airway intubation is unsuccessful using a conventional laryngoscope. We postulated that a video laryngoscope with a modified size 1 Macintosh blade (McGrath MAC Video Laryngoscope, Medtronic, USA) would facilitate the intubation of New Zealand White rabbits. Sixteen specific-pathogen-free male New Zealand White rabbits weighing 3.45–4.70 kg were studied. All rabbits were intubated using the video laryngoscope. Typically, a 3.0 mm endotracheal tube was used for rabbits weighing < 4 kg, while a 3.5 mm tube was used in those weighing > 4 kg. During surgery, anesthesia was well maintained, and there were no major abnormalities in the animals’ conditions. No rabbit developed breathing difficulties or anorexia after recovering from anesthesia. We established an intubation method using a video laryngoscope with a modified blade and stylet in the supine (ventrodorsal) position and successfully applied it in 16 rabbits. It is useful for training novices and for treating rabbits in veterinary hospitals with few staff members and animal research facilities where there are insufficient human resources.