1.Analysis of Medication Errors of Nurses by Patient Safety Accident Reports
Journal of Korean Clinical Nursing Research 2021;27(1):109-119
Purpose:
The purpose of this study was to identify and analyze the characteristics of nurses’ medication errors during three years.
Methods:
Retrospective survey study design was used to analyze medication errors by nurses among patient safety accidents. Data were collected for three years from January, 2017 to December, 2019. Data were analyzed using frequency, percentage, x2 -test, and logistic regression with SPSS 26.0 program.
Results:
Of a total 677 medication errors, 40.6% were caused by nurses. Among the medication errors, near miss (n=154, 56.0%), intravenous bolus injection (n=170, 61.8%), wrong dose (n=102, 37.1%) and carelessness for repetitive work (n=98, 35.6%) were the most common. Medication errors differed by department, and nurses’ career, and patient safety accident type. The results of the logistic regression analysis showed that the risk factors of adverse events were medication of fluids (OR=3.93, 95% CI: 1.26~12.27), insulin subcutaneous injection (OR=39.06, 95% CI: 4.58~333.18), and occurrence of extravasation/infiltration (OR=7.26, 95% CI: 1.85~28.53).
Conclusion
The simplest and most effective way to prevent medication errors is to keep 5 right, and a differentiated education program according to department and nurse career is needed rather than general education programs. Hospital-level integrated interventions such as a medication barcode system or a team nursing method are also necessary.
2.Factors Influencing Posttraumatic Growth in Patients with Lung Cancer
Young Suk KIM ; Jin Ha MOON ; Young Suk LEE ; Yeon Woo KIM ; Gyu Rim HEO ; Soon Keum OH
Journal of Korean Clinical Nursing Research 2021;27(1):98-108
Purpose:
This study was conducted to identify the factors influencing the posttraumatic growth (PTG) in patients with lung cancer and to provide basic data for nursing intervention development to improve PTG and adaptation.
Methods:
The study included 126 non-small cell lung cancer patients initially diagnosed at the Lung Cancer Center, C University Hospital in S city, Gyeonggi-do. Patients were asked to complete a questionnaire consisting of demographic characteristics, disease characteristics, posttraumatic growth, cancer coping, social support, and resilience. Data were analyzed using t-tests, ANOVA, and Pearson's correlation and multiple regression analysis.
Results:
The mean score for PTG in lung cancer patients was 56.39, cancer coping was 61.31, social support was 61.09, and resilience was 92.77. Significant positive correlations were found for PTG and cancer coping (r=.75, p<.001), social support (r=.52, p<.001) and resilience (r=.63, p<.001). Factors contributing to PTG of lung cancer patients were cancer coping (β=.53 p<.001), perceived health status(β=.20, p=.002), resilience (β=.21, p=.010) and importance of religion (β=.15, p=.013). This model explained about 64.0% of variances of PTG (F=29.58, p<.001).
Conclusion
It is necessary to develop new nursing intervention programs to improve PTG for patients with lung cancer based on strategies to enhance coping and resilience to recovery. Longitudinal studies examining temporal changes in PTG among patients with lung cancer are suggested for future studies in this regard.
3.Effects of a Video Education Program for Caregivers on the Maintenance of Peripheral Intravenous Catheter among Hospitalized Children
Journal of Korean Clinical Nursing Research 2021;27(1):85-97
Purpose:
The purpose of this study was to develop a video education program (VEP) for the caregivers and to verify its effectiveness on the maintenance of a peripheral intravenous catheter (PIVC) among hospitalized children.
Methods:
The VEP was developed through a literature review, educational need assessment of caregivers, and interviews with pediatric nurses, and validation of an expert group. The effectiveness of the VEP was tested on 102 caregivers and their children in a children’s hospital at D city. A nonequivalent control group pretest-posttest design was used in which different types of intervention were given to caregivers in intervention group (n=51) and control group (n=51). All caregivers received brief verbal information about the PIVC maintenance. The intervention group was additionally provided with VEP using a smartphone. Data were analyzed using SPSS/Win 21.0 program.
Results:
The caregivers’ knowledge score on PIVC maintenance in the intervention group was significantly higher than that of the control group. The numbers of flushing in case of blockage of PIVC and gauze dressing change of the intervention group was significantly lower than those of the control group.
Conclusion
These results suggest that the VEP developed in this study can be useful for the maintenance of PIVC among hospitalized children.
4.Risk Factors of Malnutrition by Age in Hospitalized Older Adults
Journal of Korean Clinical Nursing Research 2021;27(1):77-84
Purpose:
Malnutrition affects all age groups, but older adults are particularly more vulnerable to nutritional deficiencies. This study evaluated the age-specific factors affecting malnutrition in hospitalized older adults.
Methods:
A retrospective study was conducted on inpatient elderly people who received artificial nutrition from 2010 to 2017. Data of demographics, diagnosis, type of nutrition therapy, number of comorbidity, fall risk assessment, Acute Physiologic Assessment and Chronic Health Evaluation (APACHE) score, and intensive care unit admission were collected. Malnutrition was defined as a body mass index (BMI) of less than 18.5 kg/m2 . Patients were classified as the young-old (65~74 years old), the old-old (75~84 years old), or the oldest-old (85 years old or older).
Results:
A total of 7,130 older adults were included, and 4,028 patients were classified as the young-old, 2,506 into the old-old, and 596 into the oldest-old. Proportion of malnutrition was higher in the oldest-old compared to the other groups. In multivariate analysis, parenteral nutrition, alcohol, and high risk of falls were factors affecting malnutrition in all groups. Parenteral nutrition and alcohol in the young-old, high risk of falls in the old-old, and male sex in the oldest-old were the factors affecting malnutrition by the age group.
Conclusion
Older age was the most significant factor affecting malnutrition. Specific strategies by age are needed to improve nutritional status in hospitalized older adults as influencing factors for malnutrition vary among different age groups.
5.Performance, Perception, and Influencing Contexts of Intentional Rounding
Mi Young KIM ; Mi Soon KIM ; Ae Ran KIM ; Hee Sun KIM
Journal of Korean Clinical Nursing Research 2021;27(1):66-76
Purpose:
This descriptive study aimed to explore the performance, nurses' perception, and influencing contexts of intentional rounding (IR), and to identify the factors influencing the performance of IR.
Methods:
498 questionnaire responses were collected from clinical nurses with more than six months of work experiences in general wards performing IR in a general hospital.
Results:
The mean scores of the performance, nurses' perception, and influencing contexts of IR were 3.81(±0.68), 3.46(±0.42), and 3.79(±0.51) out of 5.00, respectively. There were significant differences in performance (F=20.51, p<.001) and nurses' perception (F=4.96, p=.001) based on the work department. There were significant differences in the influencing contexts based on age (F=6.02, p=.003) and the length of clinical experience in the ward (F=3.36, p=.010). Performance and nurses’ perception(r=.42, p<.001), performance and influencing contexts (r=.46, p<.001), and nurses' perception and influencing contexts (r=.58, p<.001) showed a statistically positive correlation. Work unit (F=10.45, p<.001), nurses' perception of the benefits to patients (F=-2.46, p=.014) and to nurses (F=4.34, p<.001), and influencing contexts at the individual (F=7.77, p<.001) and department levels (F=2.99, p=.003) were found to be significant factors on the performance of IR.
Conclusion
It is necessary to support the education programs and active participation of nurses in their role as leaders to raise their awareness regarding the benefits of IR. Furthermore, there is a need to adapt the IR protocol according to the unique characteristics of each unit and evaluate the effectiveness.
6.Factors Influencing on Vision-related Quality of Life in Patients with Retinal Diseases Receiving Intravitreal Injections
Journal of Korean Clinical Nursing Research 2021;27(1):54-65
Purpose:
The purpose of this study was to identify influencing factors on vision-related quality of life in patients with retinal diseases receiving intravitreal injections by examining relationships among anxiety, depression, coping, eye health behaviors and vision-related quality of life.
Methods:
One hundred and five outpatients who were diagnosed with macular degeneration and diabetic retinopathy were recruited from one university hospital during August 16, 2019 to March 25, 2020. Data were analyzed using descriptive statistics (frequency and percentage, mean, standard deviation), and t-tests, ANOVA, Scheffé test, Pearson’s correlations, and stepwise multiple regressions using the IBM SPSS Statistics 25.0.
Results:
The vision-related quality of life according to general characteristics of retinal disease patients with intravitreal injection showed significant differences in age (F=3.01, p=.034), subjective economic status (F=5.83, p=.004), types of retinal disease (t=2.62, p=.010), and disease in both eyes (t=-3.04, p=.003). The vision-related quality of life showed a significant positive correlation with age (r=.24, p=.012), and negative correlations with anxiety (r=-.66, p<.001), depression (r=-.48, p<.001), and emotion-focused coping (r=-.20, p=.036). The hierarchical regression analysis indicated that factors affecting vision-related quality of life in patients with retinal diseases were anxiety and subjective economic status, accounting for 47.0% of the variances of the vision-related quality of life.
Conclusion
Based on our results, health professionals need to pay attention to patients with low socioeconomic status due to frequent treatments. Also, a program needs to be developed to decrease anxiety for outpatients receiving intravitreal injections to improve their vision-related quality of life.
7.Factors Affecting Turnover Intention of Nurses Working in Neonatal Intensive Care Units
Sun Hwa JUN ; Mi Hyang LEE ; Moon Sook SHIM ; Hyo Nam LIM
Journal of Korean Clinical Nursing Research 2021;27(1):45-53
Purpose:
This study was conducted to assess the factors affecting turnover intention of the nurses working in neonatal intensive care units, including the extent of fatigue, work stresses, and work overload related to infection control.
Methods:
This was a descriptive correlational study to test factors affecting the turnover intention of the nurses working in neonatal intensive care units. Data was analyzed utilizing descriptive statistics, t-test, One-way ANOVA, Pearsons’ Correlation Coefficient, and multiple regressions by using the IBM SPSS Statistics 23.0 Program(IBM Corp., Armonk, NY).
Results:
The turnover intention of nurses had a positive correlation with the extent of fatigue (r=.54, p<.001), work stress (r=.40, p<.001), and with the work overload (r=.43, p<.001) related to infection control. In addition, factors affecting the turnover intention of nurses included the extent of fatigue (β=.52, p<.001) related to infection control and the number of pediatric patients assigned to each nurse (β=.26, p=.001) and the variances explained by the regression model was 37.0%.
Conclusion
It is necessary to establish and implement strategies to lower the extent of fatigue related to infection control by reducing the nurses’ workload. Securing additional nurses to ensure an appropriate number of pediatric patients assigned to each nurse, and providing efficient management and available resources to reduce the turnover intention of nurses working in neonatal intensive care units are suggested.
8.Factors Affecting the Individual Innovative Behaviors of Tertiary Hospitals' Nurses: Focusing on the Individual, Job and Organizational Factors
Journal of Korean Clinical Nursing Research 2021;27(1):35-44
Purpose:
The aim of this study was to identify the individual, job, and organizational factors affecting the individual innovative behaviors among tertiary care hospitals’ nurses.
Methods
The participants in this study were 230 nurses who have worked more than one year in tertiary care hospitals. Data were collected using self-administered questionnaires that included individual factors (self efficacy, and empowerment), job factors (knowledge and skills for evidence-based practice, and beliefs for evidence-based practice), organizational factors (perceived organizational support), and individual innovation behavior. The SPSS/WIN 25.0 program was used for data analysis which included descriptive analysis, t-test, ANOVA, Scheffé test, Pearson’s correlation coefficient, and hierarchical regression analysis. Results: Individual innovative behavior had significant positive correlations with all of individual, job, and organizational factors. The results of hierarchical regression analysis showed that knowledge and skills for evidence-based practice (β=.28, p<.001), self efficacy (β=.25, p=.002), gender (female, β=.23, p<.001), and beliefs for evidence-based practice (β=.17, p=.016) were significant factors influencing on individual innovative behavior. Conclusion: These findings suggest that knowledge, skills and beliefs for evidence-based practice, and self efficacy were linked to individual innovative behaviors.Therefore, education and human resource management improving self efficacy, knowledge, skills and beliefs for evidence-based practice are needed to increase nurses’ individual innovative behaviors in tertiary care hospitals.
9.Influences of Workplace Bullying, Social Support and Resilience on Retention Intention among Hospital Nurses: The Mediating Effect of Professional Quality of Life
Journal of Korean Clinical Nursing Research 2021;27(1):23-34
Purpose:
The purpose of this study is to examine the mediating effect of professional quality of life among hospital nurses in the effects of workplace bullying, social support and resilience on retention intention.
Methods:
A descriptive and cross-sectional study was conducted on 414 hospital nurses who worked for at least two months at a general hospital in the Seoul metropolitan area. The data were analyzed using IBM SPSS 23.0/AMOS 22.0 programs and employed reliability verification, descriptive statistics include frequency analysis, confirmatory factor analysis, structural equation modeling, and bootstrapping.
Results:
As a result of the study's structural modeling verification, workplace bullying had a negative effect, social support had a positive effect, resilience had a positive effect on professional quality of life, and professional quality of life had a positive effect on retention intention. Also, workplace bullying, social support, and resilience did not directly impact on retention intention. However, the professional quality of life had a complete mediating effect in the relationships between workplace bullying, social support, resilience and retention intention. The study results verified the mediating effect of professional quality of life affecting the retention intention.
Conclusion
In order to improve professional quality of life and retention intention, strategies to prevent workplace bullying and promote social support and resilience are needed.
10.The Effects of Organizational Commitment and Perceived Patient Safety Culture on Patient Safety Nursing Activities among Nurses in Comprehensive Nursing Care Units
Journal of Korean Clinical Nursing Research 2021;27(1):12-22
Purpose:
The purpose of this study is to identify the effects of organizational commitment (OC) and perceived patient safety culture (PPSC) on patient safety nursing activities (PSNA) among nurses in comprehensive nursing care units.
Methods:
Participants were 173 nurses working at five general hospitals in Chungcheong area. Data were analyzed using descriptive statistics, x2 test, t-test, ANOVA, Pearson’s correlation coefficient, and multiple regression analysis with SPSS/WIN 23.0 programs. Results: The mean scores of the OC and PPSC were 3.28±0.50 and 3.85±0.35, respectively. The mean score of PSNA was 4.55±0.41, and PSNA was significantly different by the experience of participating in hospital’s safety culture campaigns (t=2.70, p=.008). The results of the multiple regression analysis showed that ‘patient safety knowledge and attitudes’ (β=.27, p=.006) and ‘unpunished environment to error’ (β=.22, p=.004) as the sub-categories of PPSC were affecting factors on PSNA with an explanatory power of 26.0% (F=6.40, p<.001).
Conclusion
The results of this study suggest that in order to promote PSNA among nurses in comprehensive nursing care units, it is necessary to develop a program to enhance patient safety-related knowledge and attitudes. In addition, the hospital's organizational efforts such as operating safety campaigns and creating an unpunished environment to error should be needed.