BACKGROUND: Nurses are often exposed to needlestick and sharp-object injuries (NSIs). This study aimed to investigate the post-exposure reporting rate of NSIs among nurses. METHODS: The subjects were 84 nurses from 4 hospitals (3 hospitals with 300 or more beds and 1 hospital with less than 300 beds) who had experienced at least 1 NSI within a 6-month period. The instrument was a self-administered questionnaire, which was based on the EPINet report form and a questionnaire for NSIs among resident physicians, which was used by Choi et al. Data were collected between April 9 and June 15, 2009, and analyzed using descriptive statistics and the chi-square test, which was performed using SPSS with a significance level of 0.05. RESULTS: Among the 84 nurses who had experienced at least 1 NSI within 6 months, only 14.3% had reported the NSIs, and 58.4% of these subjects reported the NSI immediately after sustaining the injury. The most common reason for not reporting was "the patients were found out to be uninfectious" (81.9%) followed by "too busy" (65.3%). The incidence of post-exposure reporting was negatively related to the number of NSIs (chi-square=13.871, p<0.001) and positively related to assessments of infectivity of the patients (chi-square=4.248, P=0.039) and other persons' recommendations to report NSIs (chi-square=4.092, P=0.043). CONCLUSION: The post-exposure reporting rate was very low. The factors responsible for this low rate should be investigated in a more systematic manner, and more measures should be undertaken to increase the reporting rate among nurses.
Humans ; Incidence ; Needlestick Injuries ; Surveys and Questionnaires

Purpose: This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital. Methods: This retrospective cohort study included 613 patients (CRE group:69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness. Results: The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those ofCREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: - 0.16~0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63~.78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors’ cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively. Conclusion The CREP-model’s discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points.

No abstract available.
Gardner Syndrome*

Purpose: This study aimed to identify the risk factors of carbapenem-resistant Enterobacteriaceae (CRE) acquisition to build a nomogram for CRE acquisition risk prediction and evaluate its performance. Methods: This unmatched case-control study included 352 adult patients (55 patients and 297 controls) admitted to the intensive care unit (ICU) of a 453-bed secondary referral hospital between January 1, 2018, and September 31, 2019, in Busan, South Korea. The nomogram was built with the identified risk factors using multiple logistic regression analysis. Its performance was analyzed using calibration-in-the-large, the slope of the calibration plot, concordance statistic (c-statistic), and the sensitivity and specificity of the training set, subsets, and a new test set. Results: The risk factors of CRE acquisition among ICU patients at a secondary referral hospital were Acute Physiology and Chronic Health Evaluation II score at the time of admission, use of a central venous catheter and a nasogastric tube, as well as use of cephalosporin antibiotics. At 20.0% of the predicted CRE acquisition risk in the training set, the calibration-in-the-large was 0, slope of the calibration plot was 1, c-statistic was .93, sensitivity was 85.5%, and specificity was 84.8%. The performance was relatively good in the subsets and new test set. Conclusion The nomogram can be used to monitor the CRE acquisition risk for ICU patients who have a similar case mix to patients in the study hospitals. Future studies need to involve more rigorous methodology and larger samples.

Purpose: This study investigated the incidence of urinary tract infection (UTI) in community-dwelling adults and identified the association between obesity and UTI. Methods: The participants were 4,926 adults aged over 40 years who had no UTIs at the baseline survey of the Korean Genome Epidemiology Study. Obesity was defined according to the cirtieria of Korean Society for the Study of Obesity using body mass index (BMI) data. UTI was defined as those who had self-reported UTI or had either nitrite, or both leukocytes and blood in the urine dipstick test. Hazard ratio (HR) and 95% confidence interval (CI) were calculated using a multivariate Cox proportional hazards regression analysis to identify the association between the obesity and UTI. Results: The incidence proportion of UTI was 5.1%, and the incidence density per 1,000 person-years was 25.5. After controlling general characteristics, people with BMI ≥30.0 kg/m2 remained 1.66 times (HR = 1.66, 95% CI = 1.06~2.60; p < .05) more likely to have UTI than those with normal weight. This trend was also present in men or people aged ≥ 60 years. Among women aged ≥ 60 years, people with BMI ≥ 30.0 kg/m2 were 1.98 times (HR = 1.98, 95% CI = 1.01~3.86; p < .05) more likely to have UTI than those with normal weight. Conclusion The BMI ≥ 30.0 kg/m2 is a risk factor of UTIs in Korean adult men over 40 years and women aged ≥ 60 years. It is necessary to emphasize the importance of obesity management to men or women aged ≥ 60 years, specifically.

Purpose: This study aimed to identify the risk factors of carbapenem-resistant Enterobacteriaceae (CRE) acquisition to build a nomogram for CRE acquisition risk prediction and evaluate its performance. Methods: This unmatched case-control study included 352 adult patients (55 patients and 297 controls) admitted to the intensive care unit (ICU) of a 453-bed secondary referral hospital between January 1, 2018, and September 31, 2019, in Busan, South Korea. The nomogram was built with the identified risk factors using multiple logistic regression analysis. Its performance was analyzed using calibration-in-the-large, the slope of the calibration plot, concordance statistic (c-statistic), and the sensitivity and specificity of the training set, subsets, and a new test set. Results: The risk factors of CRE acquisition among ICU patients at a secondary referral hospital were Acute Physiology and Chronic Health Evaluation II score at the time of admission, use of a central venous catheter and a nasogastric tube, as well as use of cephalosporin antibiotics. At 20.0% of the predicted CRE acquisition risk in the training set, the calibration-in-the-large was 0, slope of the calibration plot was 1, c-statistic was .93, sensitivity was 85.5%, and specificity was 84.8%. The performance was relatively good in the subsets and new test set. Conclusion The nomogram can be used to monitor the CRE acquisition risk for ICU patients who have a similar case mix to patients in the study hospitals. Future studies need to involve more rigorous methodology and larger samples.

Purpose: This study investigated the incidence of urinary tract infection (UTI) in community-dwelling adults and identified the association between obesity and UTI. Methods: The participants were 4,926 adults aged over 40 years who had no UTIs at the baseline survey of the Korean Genome Epidemiology Study. Obesity was defined according to the cirtieria of Korean Society for the Study of Obesity using body mass index (BMI) data. UTI was defined as those who had self-reported UTI or had either nitrite, or both leukocytes and blood in the urine dipstick test. Hazard ratio (HR) and 95% confidence interval (CI) were calculated using a multivariate Cox proportional hazards regression analysis to identify the association between the obesity and UTI. Results: The incidence proportion of UTI was 5.1%, and the incidence density per 1,000 person-years was 25.5. After controlling general characteristics, people with BMI ≥30.0 kg/m2 remained 1.66 times (HR = 1.66, 95% CI = 1.06~2.60; p < .05) more likely to have UTI than those with normal weight. This trend was also present in men or people aged ≥ 60 years. Among women aged ≥ 60 years, people with BMI ≥ 30.0 kg/m2 were 1.98 times (HR = 1.98, 95% CI = 1.01~3.86; p < .05) more likely to have UTI than those with normal weight. Conclusion The BMI ≥ 30.0 kg/m2 is a risk factor of UTIs in Korean adult men over 40 years and women aged ≥ 60 years. It is necessary to emphasize the importance of obesity management to men or women aged ≥ 60 years, specifically.

BACKGROUND/AIMS: Renal dysfunction commonly develops in patients with established liver disease. The assessment of renal function is of clinical importance in patients with cirrhosis and ascites. Renal function indices such as glomerular filtration rate and the plasma renin activity (PRA) could be better predictors of survival than the parameters usually used to estimate liver function including Child-Pugh score. This study was designed to find whether renal function indices are useful in determining the prognosis concerned with the survival of patients with liver cirrhosis. METHODS: A total of 110 patients was selected and followed for 89 weeks. As indices reflecting renal function, creatinine clearance rate, PRA, aldosterone concentration, and the pulsatility index (PI) and resistive index (RI) by Doppler ultrasonography were measured. The prognostic values of these indices were determined by comparison and analysis according to survival or death of the patients. For the statistics, univariate and multivariate analysis was done. RESULTS: Child-Pugh score (> or =10), creatinine clearance rate (<80 mL/min), plasma alodosterone concentration (> or =15 ng/dL), PRA (> or =8 ng/mL/hr), renal PI (> or =1.15) and RI (> or =0.7) were prognostic indicators in univariate analysis (p<0.05). Multivariate analysis disclosed two independent survival predictors of creatinine clearance rate (<80 mL/min) (OR:5.37, 95% CI: 2.09-13.82) and plasma aldosterone concentration (> or =15 ng/dL) (OR: 3.65, 95% CI: 1.09-12.18). CONCLUSION: Various renal function indices are closely related to the survival of patients with liver cirrhosis. Creatinine clearance rate and plasma aldosterone concentration are especially important prognostic factors in predicting the survival of patients with liver cirrhosis.
Aldosterone ; Ascites ; Creatinine ; Fibrosis ; Glomerular Filtration Rate ; Humans ; Liver Cirrhosis* ; Liver Diseases ; Liver* ; Multivariate Analysis ; Plasma ; Prognosis* ; Renin ; Ultrasonography, Doppler

PURPOSE: The purpose of this study was to seek the direction of community health nursing practice education focus on the nursing education accreditation criteria. METHODS: We collected data through e-mail survey to all of 202 Korean nursing baccalaureate education institute in April, 2016. The 93 professors teaching community health nursing was responded about their affiliated institute (response rate 46.0%). RESULTS: The Korean nursing graduates in Feb. 2016 was practiced 3.01 credits, 131.6 hours in community health nursing course. Community health nursing practice agency was public health center (98.9%), Public health center post (43.0%), Public health center branch (32.3%) in order. The possibility to achieve the course objectives up to national examination was recognised Public health center (3.4), Public health center post (3.3), Public health center branch and school (3.2) from 5 score likert scale. A lot of nursing education institute have difficulty in clinical placement in community health nursing practice agency that meet eligibility of preceptor and space gaining for only nursing students. CONCLUSION: The nursing education accreditation criteria in 3rd cycle have to be considered real community health nursing practice situation and newly emerging community health nursing fields.
Accreditation* ; Community Health Nursing* ; Education* ; Education, Nursing* ; Electronic Mail ; Humans ; Nursing* ; Public Health ; Public Health Practice ; Students, Nursing

This paper describes a Q-methodological study on the perception of comfort in hospital inpatients. The participants completed a 37-item Q sort made up of statements which could be ranked in terms of their relevance to the subjective meaning of comfort. Three interpretable types of comfort were identified through this Q study: Type I, positive medical action style, feel secure and satisfied when medical staff show a positive attitude towards them as patients. They put a high value on prompt responses from medical staff and physical aspects of care like non-invasive procedures or comfortable position. Type II, social relation style, experience a state of comfort when they perceive support or concern from medical staff, relatives or other patients suffering from similar diseases. They feel safe and secure when medical staff are kind and have a good reputation or when the size of the hospital is big enough. Type III, emotional wellbeing style, feel that hope for a healthy life or maintaining self-care activities are highly valuable. They feel safe and comfortable when their privacy is protected. They put worth on independent thinking, strong will, and emotional or psychological comfort.The results of this study can be used as a basis to develop nursing measures for comfort. Further studies on factors which influence perception of comfort and intervention strategies according to the above types of comfort need to be done.
Hope ; Humans ; Inpatients ; Medical Staff ; Methods ; Nursing ; Privacy ; Q-Sort ; Self Care ; Thinking