To prevent the transmission of pathogens in hospitals, implementation of transmission-based precautions is essential, such as precautions to prevent airborne, droplet, and contact transmissions. However, it is impossible to identify all hidden asymptomatic carriers. Emphasis has therefore been placed on the use of standard precautions, including hand hygiene and cough etiquette. Recently, the possibility of the spread of imported emerging infectious diseases in medical institutions has also become an area of focus. Prevention of the spread of infections in hospitals should be a top priority to ensure the highest quality of care.
Communicable Diseases, Emerging ; Cough ; Hand Hygiene ; Patient Isolation

Clothing ; Infectious Disease Transmission, Professional-to-Patient ; Methicillin-Resistant Staphylococcus aureus/*isolation & purification ; Physician-Patient Relations ; Safety ; Staphylococcal Infections/*transmission

Isolation is a concept that includes all methods to prevent the transmission of infection and to ensure the safety of patients, family members, visitors, and healthcare workers in healthcare settings. There are two tiers of isolation precautions, standard precautions and transmission-based precautions. Standard precautions are intended to be applied to the care of all patients in all healthcare settings, regardless of the suspected or confirmed presence of an infectious agent. Implementation of standard precautions constitutes the primary strategy, including hand hygiene, respiratory hygiene/cough etiquette, use of personal protective equipment depending on the anticipated exposure, safe injection, patient placement, care of the environment and instruments, and worker safety, for the prevention of healthcare-associated transmission of infectious agents among patients and healthcare personnel. Transmission-based precautions are for patients who are known or suspected to be infected or colonized with infectious agents, including certain epidemiologically important pathogens, which require additional control measures to effectively prevent transmission. There are three categories of transmission-based precautions; contact precautions, droplet precautions, and airborne precautions. Transmission-based precautions are used when the routes of transmission are not completely interrupted using standard precautions alone. For some diseases that have multiple routes of transmission, more than one transmission-based precautions category may be used. When used either alone or in combination, they are always used in addition to standard precautions.
Colon ; Communicable Disease Control ; Delivery of Health Care ; Dietary Sucrose ; Hand Hygiene ; Humans ; Infection Control ; Patient Isolation

PURPOSE: The purpose of this study was to investigate the perception and performance of tuberculosis infection control measures among emergency department nurses. METHODS: A structured questionnaire was administered to a convenience sample of 227 emergency department nurses from 20 hospitals in B City. RESULTS: The mean perception score was 4.52 out of a possible 5, and the mean performance score was 3.31 out of a possible 5. There were big differences between the perception and performance score on the items regarding wearing a gown or mask, while there were small differences on the items regarding dealing with patients' articles or medication. CONCLUSION: Emergency nurses showed high perception and low performance score on the items related to facilities and regulation such as visitation restriction or patient isolation. There was a positive correlation between perception and performance score. CONCLUSION: For emergency nurses, perception is higher than performance of tuberculosis infection control measures. The findings indicate the importance of providing continuing education for emergency nurse professionals seeking to update and increase their knowledge and to develop evidence-based nursing protocols on tuberculosis infection control in emergency department.
Education, Continuing ; Emergencies ; Emergency Nursing ; Evidence-Based Nursing ; Infection Control ; Masks ; Patient Isolation ; Surveys and Questionnaires ; Tuberculosis

OBJECTIVES: This study was performed to build the predictive model of suicidal ideation of elderly men living alone. METHODS: As for the subject, 251 subjects suitable for the selection criteria were selected among elderly men living alone above 65 years old in one region in Gyeongnam and three regions in Gyeongbuk. The data were collected via questionnaires and analyzed using SPSS version 20.0 and Amos version 18.0. RESULTS: The goodness-of-fit test result of hypothetical model were suitable for recommended level: χ²/df=1.47, RMR=.04, GFI=.92, AGFI=.90, CFI=.95, IFI=.95, RMSEA=.04. Self-esteem, individual coping, family cohesion, social support, social activity, and depression explained 55% of the model of suicidal ideation. The most influential direct factor of suicidal ideation was self-esteem, and social isolation was the most influential indirect influence on suicidal ideation. CONCLUSION: To sum up the above results, if we promote the researched variables of self-esteem, family cohesion, social activity, individual coping and social support in addition to developing and utilizing an efficient customized suicidal prevention nursing intervention program thereby reducing depression and social isolation, suicidal ideation of elderly men living alone would be prevented.
Aged* ; Depression ; Ecosystem* ; Gyeongsangbuk-do ; Humans ; Male ; Nursing ; Patient Selection ; Self Concept ; Social Isolation ; Suicidal Ideation*

Hemorrhagic Fever, Ebola ; epidemiology ; Hospitals ; standards ; Humans ; Pandemics ; Patient Isolation ; organization & administration ; standards ; Patient Transfer ; organization & administration ; standards ; Simulation Training ; Singapore

OBJECTIVETo improve the respiratory isolation policy for patients with suspected pulmonary tuberculosis (TB).

METHODSAll consecutive patients with suspicion of having pulmonary TB when seeking health care at the County TB dispensary of the Center of Disease Control and Prevention received face to face interview.

RESULTSA Classification model was constructed with a sensitivity of 90.9% and specificity of 90.2%, while predictive factors of culture-proven pulmonary TB among smear negativecases were soakage in Chest X-ray exam (77.0% vs. 4.4%; P<0.0001), bilateral lung's abnormal (1.6% vs. 19.4%; P<0.0001) and reaction of tuberculin skin testing (0.0% vs. 2.6%; P=0.014).

CONCLUSIONSoakage, bilateral lung's abnormal and positive reaction of tuberculin skin testing were important predictors to prognosticate culture positive diagnosis. The model had been proved to have promising sensitivity and specificity in the rural population covered by NTP-DOTs.

Humans ; Models, Theoretical ; Patient Isolation ; Predictive Value of Tests ; Sensitivity and Specificity ; Tuberculin Test ; Tuberculosis, Pulmonary ; classification ; diagnosis ; epidemiology

PURPOSE: This purpose of this study was to develop evidence-based practice guideline for isolation in health care settings to prevent transmission of infectious diseases utilizing guideline adaption process. METHODS: The process of guideline adaptation was performed according to the Korean hospital nurses association's guideline adaptation manual which consisted of three main phases, 9 modules, and 24 steps. RESULTS: The adapted isolation guideline consisted of introduction, overview of isolation guideline, summary of recommendations, recommendations, references, and appendices. The guideline includes 224 recommendations in 4 sections which are organizational administration, standard precautions, transmission-based precautions, and education/counselling. CONCLUSION: The adapted isolation guideline is recommended to be disseminated and utilized by nurses and clinicians nationwide to improve the isolation practices for infected or colonized patients with communicable diseases and to decrease the transmission of infections in the healthcare settings.
Colon ; Communicable Diseases ; Delivery of Health Care ; Disease Transmission, Infectious ; Evidence-Based Nursing ; Evidence-Based Practice ; Humans ; Infection Control ; Patient Isolation

PURPOSE: The purpose of this study was to explore uncertainty, depression, and anxiety in isolated inpatients and to identify associations between them, with specific focus on state anxiety. METHODS: Data were collected using structured questionnaires and semi-structured interviews, administered to isolated inpatients at an acute care hospital (N=92). The structured questionnaires consisted of the State-Trait Anxiety Inventory, Mishel Uncertainty in Illness Scale, and the Center for Epidemiologic Studies Depression Scale. Multiple linear regression and content analysis were conducted. RESULTS: Isolated inpatients showed significant differences in uncertainty, depression, trait anxiety, and state anxiety according to gender, perception of sufficient information about isolation, and the type of isolation. State anxiety scores increased when sufficient information about isolation was not provided (β=.23, p=.005), with higher levels of depression (β=.24, p=.020) and trait anxiety (β=.49, p<.001). Through the content analysis, three themes were identified regarding patient's information needs about isolation specifically for disease, explanation, and environment. CONCLUSION: Based on the findings, it is crucial to improve the awareness of emotional responses of isolated patients experiencing uncertainty, depression, and anxiety. Our study findings are expected to support the development of nursing interventions to provide proper information and mental health support when caring for isolated inpatients.
Anxiety ; Depression ; Epidemiologic Studies ; Humans ; Information Seeking Behavior ; Inpatients ; Linear Models ; Mental Health ; Nursing ; Patient Isolation ; Uncertainty

PURPOSE: The aim of this study was to identify the present situation of hospital infection and route of infection by clarifying the transmission aspect of methicillin-resistant Staphylococcus aureus(MRSA) in a Neurosurgical Intensive Care Unit by analysing genotype. METHODS: MRSA was cultured from twenty five patients with a tracheostomy, twenty five health care workers, and environments in the Neurosurgical Intensive Care Unit of one hospital in D city. Data was collected from December 21, 2004 to November 5, 2005. MRSA isolates representing each genotype were analyzed by spaA typing and a multiplex PCR method capable of identifying the structural type of the staphylococcal cassette chromosome mec(SCCmec) carried by the bacteria. RESULTS: As the same genotype and gene sequence were found among health care workers, patients, and environments, it was assumed that there was cross transmission among them. CONCLUSION: This study suggests that first, as the hospital infection by MRSA between health care workers and patients in the Neurosurgical Intensive Care Unit was due to result of cross transmission and the relevance of transmission between them was verified, it is necessary to take preventive measures and conduct education. Secondly, development of nursing interventions and study of infection are needed. Thirdly, consistent investment in prevention against hospital infections and environmental renovation is needed.
Bacterial Proteins/genetics ; Drug Resistance, Bacterial ; Genotype ; Humans ; *Infectious Disease Transmission, Patient-to-Professional ; *Infectious Disease Transmission, Professional-to-Patient ; Intensive Care Units ; *Methicillin Resistance ; Neurosurgery ; Polymerase Chain Reaction ; Staphylococcal Infections/microbiology/*transmission ; Staphylococcus aureus/drug effects/genetics/*isolation & purification ; Tracheostomy