No Abstract Available.

PURPOSE: This study aimed to identify the effect of role conflict, self-efficacy, and resilience on the nursing task performance of emergency department (ED) nurses. METHODS: Data were collected from 140 ED nurses working in 6 general hospitals, using self-reporting questionnaires. Data were analyzed using SPSS 23.0, and the analyses included descriptive statistics, a t-test, an ANOVA, the Pearson's correlation coefficient test, and a stepwise multiple regression. RESULTS: Nursing task performance differed significantly in terms of the following general characteristics of the participants: age, marital status, total clinical experience, clinical experience in the ED, and position at the hospital. Nursing task performance was positively correlated with role conflict, self-efficacy, and resilience. Self-efficacy, role conflict, clinical experience in the ED, and resilience were significant predictors of nursing performance, and they accounted for 36.9% of the variance. CONCLUSION: Self-efficacy was identified as the most significant factor affecting the nursing task performance of ED nurses. Therefore, it is necessary to develop programs to improve the self-efficacy of ED nurses.
Emergencies ; Emergency Service, Hospital ; Hospitals, General ; Marital Status ; Nursing ; Task Performance and Analysis

PURPOSE: This study aimed to identify the effect of role conflict, self-efficacy, and resilience on the nursing task performance of emergency department (ED) nurses. METHODS: Data were collected from 140 ED nurses working in 6 general hospitals, using self-reporting questionnaires. Data were analyzed using SPSS 23.0, and the analyses included descriptive statistics, a t-test, an ANOVA, the Pearson's correlation coefficient test, and a stepwise multiple regression. RESULTS: Nursing task performance differed significantly in terms of the following general characteristics of the participants: age, marital status, total clinical experience, clinical experience in the ED, and position at the hospital. Nursing task performance was positively correlated with role conflict, self-efficacy, and resilience. Self-efficacy, role conflict, clinical experience in the ED, and resilience were significant predictors of nursing performance, and they accounted for 36.9% of the variance. CONCLUSION Self-efficacy was identified as the most significant factor affecting the nursing task performance of ED nurses. Therefore, it is necessary to develop programs to improve the self-efficacy of ED nurses.

PURPOSE: The purpose of this study was to investigate the relation between satisfaction in major, career decision-making self-efficacy and career identity of nursing students. METHODS: Data were collected from 543 students by means of self reported questionnaires about satisfaction in major, career decision-making self-efficacy and career identity from November 26 to 30, 2012. RESULTS: The average score of satisfaction in major, career decision-making self-efficacy and career identity of nursing students was 3.56 on a 5 point-scale, 3.28 on a 5 point-scale, and 2.65 on a 4 point-scale respectively. There were significant correlation between satisfaction in major, career decision-making self-efficacy and career identity of nursing students. Career identity could be explained 26.2% by satisfaction in major, career decision-making self-efficacy, admission motivation, and school grade. CONCLUSION: Career identity was correlated with satisfaction in major and career decision-making self-efficacy in nursing students. Therefore, it is necessary to develop an effective intervention program to improve nursing students's satisfaction in major, career decision-making self-efficacy and career identity.
Humans ; Motivation ; Nursing ; Surveys and Questionnaires ; Self Report ; Students, Nursing*

PURPOSE: Bispectral index (BIS) is a non-invasive parameter that expresses the level of consciousness using a numerical value that ranges from 0-100. It can be easily conducted at the patient bed-side throughout a day. We studied whether BIS could be used as a predictive factor for neurological outcome in patients who undergo hypothermia after cardiopulmonary resuscitation. METHODS: The prospective study enrolled patients who underwent induced hypothermia with post-resuscitated state after cardiac arrest and presented to Chonnam National University Hospital from June, 2010 to October, 2010. BIS monitoring was conducted from admission at the intensive care unit until normal temperature was attained after the induction of hypothermia. The patients were divided into two groups based on neurological outcome at discharge and the values obtained from BIS monitoring were compared. RESULTS: Fourteen patients were included in this study. The mortality rate was 28.6% and five patients were discharged with Glasgow Pittsburgh Cerebral Performance Categories 1 or 2. The value of BIS at the start of rewarming was significantly different between the two groups according to neurological outcome, while the value of BIS upon reaching normal temperature did not differ statistically. The significant difference between the two groups was observed in the value of BIS from 19 hours after starting hypothermia. CONCLUSION: BIS can be used to predict the neurological outcome of patients who undergo resuscitation after cardiac arrest.
Consciousness ; Consciousness Monitors ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Intensive Care Units ; Prospective Studies ; Resuscitation ; Rewarming

PURPOSE: Bispectral index (BIS) is a non-invasive parameter that expresses the level of consciousness using a numerical value that ranges from 0-100. It can be easily conducted at the patient bed-side throughout a day. We studied whether BIS could be used as a predictive factor for neurological outcome in patients who undergo hypothermia after cardiopulmonary resuscitation. METHODS: The prospective study enrolled patients who underwent induced hypothermia with post-resuscitated state after cardiac arrest and presented to Chonnam National University Hospital from June, 2010 to October, 2010. BIS monitoring was conducted from admission at the intensive care unit until normal temperature was attained after the induction of hypothermia. The patients were divided into two groups based on neurological outcome at discharge and the values obtained from BIS monitoring were compared. RESULTS: Fourteen patients were included in this study. The mortality rate was 28.6% and five patients were discharged with Glasgow Pittsburgh Cerebral Performance Categories 1 or 2. The value of BIS at the start of rewarming was significantly different between the two groups according to neurological outcome, while the value of BIS upon reaching normal temperature did not differ statistically. The significant difference between the two groups was observed in the value of BIS from 19 hours after starting hypothermia. CONCLUSION: BIS can be used to predict the neurological outcome of patients who undergo resuscitation after cardiac arrest.
Consciousness ; Consciousness Monitors ; Heart Arrest ; Humans ; Hypothermia ; Hypothermia, Induced ; Intensive Care Units ; Prospective Studies ; Resuscitation ; Rewarming

PURPOSE: This study was performed to determine the usefulness of blood culture in the management of febrile immunocompetent patients presenting emergency department. METHODS: We prospectively analysed the medical characteristic and the result of blood culture of febrile immunocompetent patients who presented to Chonnam National University Hospital emergency center form April 2005 to October 2005. RESULTS: The study included 182 patients. The characteristic associated with the positive result of blood culture on multivariate analysis was the low initial level of albumin. Of the 182 culture, only 26 were true positive(14.3%). Of them, the result of blood culture influenced management in five patients (2.7%). CONCLUSION: The blood cultures has usually been ordered in febrile immunocompetent patients at emergency department has the limited usefulness. The emergency physician who initially treats them has to consider this limitation of it.
Emergencies* ; Emergency Service, Hospital* ; Fever ; Humans ; Jeollanam-do ; Multivariate Analysis ; Prospective Studies

Fentanyl is a selective and pure agonist to the micron receptor and is about 100 times more potent than morphine. It has been used through intravenously to control acute pain, such as postopreative pain, for a long time. A transdermal fentanyl system, a fentanyl patch, composed of four layers of functional reserviors of fentanyl and one protective layer, delivers a constant amount of fentanyl to systemic circulation thorough passive diffusion for up to 3 days after application on the skin. Due to its pharmacokinetic properties, including delayed onset, relatively constant effect for 3 days, and to the relatively short duration and variable change of acute pain, we recommend that the transdermal fentanyl system should be used to control chronic pain in patients who do not response to lower analgesic agents. However, because of misperception of health care providers, its noninvasive and simple method of administration, and the absence of laws to regulate its usage, abuses of the transdermal fentanyl system have been reported a lot. In conclusion, we reported the cases of two patient who experienced fatal effects after abuse of fentanyl patch, we analyse the pharmacokinetic properties of the fentanyl patch and previous reported cases. We also discuss the appropriate use and regulation of the transdermal fentanyl system by primary health care provider.
Acute Pain ; Analgesics ; Chronic Pain ; Diffusion ; Fentanyl* ; Health Personnel ; Humans ; Jurisprudence ; Morphine ; Primary Health Care ; Respiratory Insufficiency ; Skin

N-acetylcysteine (NAC) is widely recognized as the antidote of choice for acetaminophen overdose. Acetaminophen is a commonly used analgesic and antipyretic agent, and its use is one of the most common causes of poisoning worldwide. Acetaminophen toxicity may occur acutely when supratherapeutic amounts are ingested purposefully or unintentionally. Liver failure may occur in severe toxicity. However, if treated early, patients with acetaminophen poisoning generally recover uneventfully. Acetaminophen is metabolized to N-acetyl-p-benzoquinone imine (NAPQI), which is detoxified by conjugation with glutathione. In overdose, hepatic stores of glutathione are depleted and NAPQI binding to hepatocytes induces cell death and hepatic necrosis. NAC replenishes hepatic glutathione and may also act as a glutathione substitute, combining directly with the toxic metabolite. Intravenous NAC is indicated in patients who present with a history of acetaminophen overdose within the previous 8 to 10 hours, patients unable to tolerate oral NAC, and patients who present with evidence of fulminant hepatic failure. However, caution should be used in patients who have experienced previous hypersensitivity or anaphylactoid reactions to intravenous NAC, as well as in patients with asthma. The most common anaphylactoid reactions include rash, flushing, and bronchospasm. Adults should receive 150 mg/kg administered for 45 minutes, followed by 50 mg/kg administered for 4 hours, followed by 100 mg/kg administered for 16 hours. The total dose is 300 mg/kg delivered over 21 hours. Additionally, caution should always be used when intravenous NAC is prescribed and the amount of diluent is calculated. Monitoring of patients with a should include repeated neurologic and hemodynamic assessment.
Acetaminophen* ; Acetylcysteine* ; Adult ; Antidotes ; Asthma ; Benzoquinones ; Bronchial Spasm ; Cell Death ; Exanthema ; Flushing ; Glutathione ; Hemodynamics ; Hepatocytes ; Humans ; Hypersensitivity ; Imines ; Liver Failure ; Liver Failure, Acute ; Necrosis ; Poisoning*

BACKGROUND: The purpose of this study is to investigate the effects of volume and concentration in a constant dose of subarachnoid bupivacaine on the extent and duration of sensory and motor blocks. METHODS: Forty parturients scheduled for cesarean section were randomly assigned to two groups for spinal anesthesia. In group 1, 3.5 ml of hyperbaric 0.25% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected into the subarachnoid space; in group 2, 1.75 ml of hyperbaric 0.5% bupivacaine (8.75 mg) with 0.25 mg morphine and 10 microgram fentanyl were injected. Dural punctures were performed at the L3-L4 or L2-L3 interspaces with a 25 gauge needle in the sitting position after which the patients were turned to the supine horizontal position. The level and extent of the sensory and motor block were measured at 3, 5, 10, and 15 minutes. The onset, duration and regression of sensory and motor blocks were studied. RESULTS: There were no significant differences between two groups in the level and extent of sensory and motor blocks. From onset time to maximal sensory block took 12.1 +/- 3.0 min in group 1, and 13.3 +/- 3.7 min in group 2, and from onset time to complete motor block took 10.2 +/- 2.7 min in group 1 and 11.4 +/-2.6 min in group 2. There was no significant difference in the time taken to complete the regression of seosory block, and the complete resolution of the motor block. CONCLUSIONS: A constant 8.75 mg dose of subarachnoid hyperbaric bupivacaine produced, in all groups, a similar, statistically insisnificant, level and extent of sensory and motor block, in spite of different volumes and concentrations.
Anesthesia, Spinal* ; Bupivacaine* ; Cesarean Section ; Female ; Fentanyl ; Humans ; Morphine ; Needles ; Pregnancy ; Punctures ; Subarachnoid Space