BACKGROUND: The purpose of this study is to evaluate the evidence for the effectiveness of different isolation policies in reducing the incidence of methicillin-resistant Staphylococcus aureus (MRSA) infection in hospital in-patients. METHODS: We prospectively evaluated the effectiveness of an isolation policy on transmission of MRSA in the 745-beds hospital. First period, all patients with MRSA (March - July 2000) were not isolated Second period, strict isolation policies were performed (August 2000 - January 2002). All patients with MRSA were isolated in separated room, hand hygiene using alcohol handrub, gowning and g1oving, apply of MRSA notice sticker, criteria in isolation remove, separated disinfection and wastement. Third period, semi strict isolation policies were performed (February 2002 - August 2005). Some patients with MRSA were isolated in separated room and others were admitted in general ward for bed shortage. Only some practices were performed in hand washing and separated disinfection in general ward. RESULTS: The rates of MRSA nosocomial infection per patients during 1st, 2nd, and 3rd surveillance were reported 0.56, 0.23, and 0.42 (P<0.05). Patient-days rate of MRSA nosocomial infection during 1st, 2nd, and 3rd surveillance were reported 0.62, 0.27, and 0.38 (P<0.05). CONCLUSION: With many different isolation policies, it was possible to reduce nosocomial infection of MRSA. In this study, strict isolation policies (2nd period) were the most effective practices in reducing MRSA infection.
Cross Infection ; Disinfection ; Hand Disinfection ; Hand Hygiene ; Humans ; Incidence ; Infection Control ; Methicillin Resistance* ; Methicillin-Resistant Staphylococcus aureus* ; Patients' Rooms ; Prospective Studies

PURPOSE: To implement evidence-based nursing, it is important to know where and how to find the best available evidence. This study was conducted to identify the results of a search from Ovid MEDLINE and to compare the results from Ovid MEDLINE with those from PubMed MEDLINE. METHODS: Four different approaches via Ovid MEDLINE were used to search for guidelines on preventing catheter-associated urinary tract infections. Outcomes of this study were the number of records and relevant literature, and the sensitivity and precision of the search methods via Ovid MEDLINE. RESULTS: The number of retrieved items ranged 23 to 6,005 and that of relevant studies, 5 to 8 of 8. Simple searches resulted in the highest sensitivity of 100.0%. When using MeSH terms and limits feature, the precision was highest (21.7%) among four approaches for literature searches. Simple searches in Ovid had higher sensitivity and lower precision than those in PubMed. CONCLUSION: Simple searches in Ovid may be inefficient for busy clinicians compared to PubMed. However, to ensure a comprehensive and systematic literature search, using Ovid MEDLINE in addition to PubMed is recommended.
Evidence-Based Nursing ; Urinary Catheterization ; Urinary Tract Infections ; Urinary Tract*

PURPOSE: Effective literature searching is essential to support evidence-based nursing. The aim of this study was to present our recent systematic search experience to identify guidelines in PubMed for prevention of catheter-associated urinary tract infections. METHODS: Five approaches to the literature search via PubMed were employed. The searches were restricted to items published from 1980 to 2010, for patients admitted to hospital, and in the English language. The search results were compared using the number of records and relevant items, and the sensitivity and precision of each search strategy. RESULTS: The individual approaches retrieved 19-141 of records and 3-6 of relevant items. Sensitivity ranged from 37.5% to 75.0% with the highest values for simple searches and a search combining MeSH terms and free textwords with a methodological search filter. Precision varied from 4.3% to 21.7% and the highest precision was found for MeSH terms with limits feature. CONCLUSION: The simple search in PubMed is an appropriate way for nurses in a busy clinical practice to search the literature for evidence. However, several approaches using MeSH terms, free textwords, limits feature or methodological search filters are also required to have more efficient and better informed search results.
Evidence-Based Nursing ; Humans ; Methods ; Urinary Catheterization ; Urinary Tract Infections* ; Urinary Tract*

This study was carried out to find out the basic data required to plan and develop Rehabilitation Day Care Program for the stroke survivor's family in Korea. The subjects comprised of 92 stroke survivor's family who discharged from 4 hospitals in Seoul during the past 2 years. The data were collected from August 3. 1998 to September 18, 1998, through interviews with questionnaires about general characteristics, activities of daily living, depression and service need of rehabilitation day care program at the outpatient clinics by trained nursing graduates. Data were analyzed with descriptive analysis, Pearson's correlation analysis, and Stepwise multiple linear regression analysis using SPSS/WIN 10.0 program. The results obtained are as follows: 1. The mean score of the general need of rehabilitation day care program of stroke survivor's family was 3.10(range 1-4). The highest need among the service categories of the rehabilitation day care program was self-care and restorative activities category(3.30). and health services referral category, recreation category, psychosocial activities category in order. The needs of each category are as follows. In the health services referral category, the need for dental examination and medical examination were highest, followed by the need for physical therapy and occupational therapy. In the psychosocial activities category, the need for family counselling was highest. In the self-care and restorative activities category, the need for ROM exercise training was highest, followed by bowel training, and ambulation training. 2. The need of family for rehabilitation day care program service displayed a correlation with the level of education. ADL. and the level of depression. and a reverse correlation with age, illness intrusiveness, depression, knowledge. subject and object burden and relationship with stroke survivors. 3. The stepwise multiple linear regression analysis revealed following results. For the need for rehabilitation day care program service. 22.6% of the variance was initially explained by level of family's knowledge about caring method for stroke survivors, 8.8% was the level of subjective burden and 5.4% was relationship with stroke survivors. In conclusion, above characteristics should be considered to develop stroke survivors' rehabilitation day care program.
Activities of Daily Living ; Ambulatory Care Facilities ; Day Care, Medical* ; Depression ; Education ; Health Services ; Humans ; Korea ; Linear Models ; Nursing ; Occupational Therapy ; Surveys and Questionnaires ; Recreation ; Referral and Consultation ; Rehabilitation* ; Self Care ; Seoul ; Stroke* ; Survivors ; Walking

PURPOSE: The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing. METHOD: 70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station. RESULT: There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048). CONCLUSION: Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.
Administration, Inhalation ; Adult ; Education, Nursing, Baccalaureate/*standards ; Educational Measurement ; Female ; Humans ; Lung Neoplasms/nursing ; Male ; Medical History Taking ; Physical Examination ; Postoperative Care ; Reproducibility of Results ; Task Performance and Analysis

Patients with acute glomerulonephritis often are seen with signs suggesting heart failure. Whether these signs are due to fluid overload secondary to kidney damage only, or whether there is associated myocardial damage has not been elucidated. Twenty-two children with acute glomerulonephritis were studied by echocardiography during edematous phase of disease. Left ventricular function was normal in all childrem. The most consistent finding was enlargement of left atrium and left ventricle during the edematous phase. There was no correlation between blood pressure and the echocardiographic findings. This study suggest that signs of heart failure in acute glomerulonephritis are not due to myocardial damage but probably reflect fluid overload.
Blood Pressure ; Child ; Echocardiography* ; Glomerulonephritis* ; Heart Atria ; Heart Failure ; Heart Ventricles ; Heart* ; Humans ; Kidney ; Ventricular Function, Left

PURPOSE: The purpose of this study was to compare communication competence, nursing professionalism, work environment and job satisfaction between outpatient nurses and ward nurses, and to identify the correlation among variables.METHODS: The participants were 90 outpatient nurses and 98 ward nurses at the two general hospitals. Data were collected using self-administered questionnaires. Data were analyzed using descriptive statistics, χ2-test, independent t-test and Pearson's correlation coefficient.RESULTS: There were statistically significant differences between two groups in nursing professionalism, possibilities for development, commitment to the workplace, social support from colleagues, social community at work and job satisfaction, outpatient nurses showed higher level than ward nurses except commitment to the workplace. The work environment variables and nurses' job satisfaction were mostly correlated. Job satisfaction showed significant negatively correlated with quantitative demands, emotional demands and role conflicts in both groups nurses.CONCLUSION: These findings showed that nursing work environments were the most important factor for job satisfaction of both group nurses. Therefore, it is necessary to put efforts in improving nursing work environment and to develop diverse strategies for human resource management.
Hospitals, General ; Humans ; Job Satisfaction ; Mental Competency ; Nursing ; Outpatients ; Professionalism

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In Uremic condition, Secondary Hyperparathyroidism ensues due to phosphate retention, low level of calcitriol, decreased calcium absorption from intestine, skeletal resistance to the Parathyroid Hormone (PTH), hypocalcemia and eventually parathyroid hyperplasia. Theoretically, Reversal of hyperparathyroidism can be expected after successful kidney transplantation. However, Some patients show continuous increase of parathyroid function due to autonomous excretion of PTH, in which case, we could assume a tertiary hyperparathyroidism. There were sporadic reports for the treatment of tertiary hyperparathyroidism after successful kidney transplantation. And in some aspects, there remains a controvesrsy about the timing of parathyroidectomy. The occurrence of a single parathyroid adenoma after kidney transplantation is ever unusual finding. In our hospital, we have experienced a case of parathyroid adenoma who had taken successful kidney transplantation. The patient was 62 year old man who had a long duration of hemodialysis for 10 years. His hypercalcemic findings were managed medically for 1 year. As the patient's hypercalcemic symptom aggrevated, he was admitted and parathyroid adenoma was diagnosed by a CT scan and parathyroid scan. After excsion of the parathyroid adenoma, his general condition and kidney function improved. In our conclusion, there may be a debate for the timing of subtotal parathyroidectomy in the patient with tertiary hyperparathyroidism after kidney transplantation. But when the patient shows a hypercalcemic profile, the parathyroid scan, CT scan, Neck Ultrasonography must be considered to detect single parathyroid adenoma which is so simple to remove surgically.
Absorption ; Calcitriol ; Calcium ; Humans ; Hyperparathyroidism ; Hyperparathyroidism, Secondary ; Hyperplasia ; Hypocalcemia ; Intestines ; Kidney Transplantation* ; Kidney* ; Middle Aged ; Neck ; Parathyroid Hormone ; Parathyroid Neoplasms* ; Parathyroidectomy ; Renal Dialysis ; Tomography, X-Ray Computed ; Ultrasonography