PURPOSE: The aim of this study was to evaluate nurses' knowledge of the law, consciousness, and will to practice and the relationships among factors affecting the will to practice. METHODS: A cross-sectional survey was conducted and data were analyzed using descriptive statistics, independent t-test, ANOVA, Pearson correlation coefficients and multiple regression. RESULTS: Most respondents were women (93.9%) and 75.6% of them had received basic education on law. The average score on knowledge of the law was 11.83±3.07 for general law and 10.42±3.32 for nursing law. The average score on consciousness of law and will to practice was 2.50±0.31 and 4.32±0.58, respectively. Differences were observed in knowledge of the law in terms of having taken a refresher course(F=5.87, p=.003); in consciousness of the law in terms of knowledge of the law (F=6.61, p<.002); and in will to practice according to age (F=7.30, p=.007) and educational level (F=13.08, p<.001). Factors influencing will to practice included behavioral and cognitive consciousness, general knowledge of law, and education. These factors explained 24% of the variance. CONCLUSION: Nurses knowledge and consciousness regarding law was relatively lower than their will to practice. Systematic law education for nurses and repetitive research are recommended to prevent nursing malpractice.
Consciousness* ; Cross-Sectional Studies ; Education ; Female ; Humans ; Jurisprudence* ; Malpractice ; Nursing ; Surveys and Questionnaires

BACKGROUND: A surveillance system for antibiotic resistance is well organized in both Japan and Korea; however, a comparative analysis by microorganism has not previously been conducted. METHODS: We compared the latest antibiotic resistance rates of medically important pathogens, such as Staphylococcus aureus, enterococci, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, and Acinetobacter baumannii, between Japan and Korea. Data were collected by JANIS (Japan Nosocomial Infections Surveillance) and KARMS (Korean Antimicrobial Resistance Monitoring System) from 2007-2012. RESULTS: In 2012, the proportions of oxacillin-resistant S. aureus, vancomycin-resistant Enterococcus faecium (VRE), cefotaxime-resistant E. coli, ceftazidime-resistant K. pneumoniae, imipenem-resistant P. aeruginosa, and imipenem-resistant A. baumannii were 53%, 0.4%, 16.6%, 2.9%, 18.5%, and 2% in Japan and 67%, 32%, 29%, 40%, 28%, and 70% in Korea, respectively. CONCLUSION: There were large differences in the frequencies of VRE, ceftazidime-resistant K. pneumoniae, and imipenem-resistant A. baumannii between Japan and Korea. A collaborative study to probe the differences in the antibiotic resistance rates between the two countries should be performed.
Acinetobacter baumannii ; Cross Infection ; Drug Resistance, Microbial* ; Enterococcus faecium ; Escherichia coli ; Japan* ; Klebsiella pneumoniae ; Korea* ; Methicillin-Resistant Staphylococcus aureus ; Pneumonia ; Pseudomonas aeruginosa ; Staphylococcus aureus

This study is designed to evaluate the immune status of schoolchildren with respect to Streptococcus pyogenes, and to ascertain the usefulness of antideoxyribonuclease B (ADNase B). Antistreptolysin O (ASO) and ADNase B concentrations were measured quantitatively in 266 serum samples from healthy elementary school children in Seoul. Simultaneously, throat cultures were taken in order to isolate S. pyogenes and other beta-hemolytic streptococci (BHS). The upper limits of the normal (ULN) concentration of ASO and ADNase B were 326 IU/mL, and 362 IU/mL, respectively. The correlation between ADNase B (y) and ASO (x) was y=0.4x+173 (r= 0.46). Mean ADNase B level (392 IU/mL) was significantly higher in children with S. pyogenes than in those with non-group A BHS (236 IU/mL) or no BHS (234 IU/ mL). Some schoolchildren were proven, via ASO and ADNase B tests, to be harboring asymptomatic S. pyogenes infections. The high ULN of ASO and ADNase B in schoolchildren should be carefully considered, in order to interpret the data collected from the patients. We could add the ADNase B test to our set of diagnostic tools, which would allow us to more accurately detect and diagnose streptococcal infections, as ADNase B was more specifically related to the results of throat cultures, and there was little correlation between ASO and ADNase B.
Antibodies, Bacterial/*blood ; Bacterial Proteins/immunology ; Child ; Deoxyribonucleases/*immunology ; Female ; Humans ; Korea ; Male ; Serologic Tests ; Streptococcal Infections/*diagnosis/*immunology ; Streptococcus pyogenes/enzymology/*immunology ; Streptolysins/immunology

A 60-year-old man visited our clinic with a sudden blurred vision and ocular pain in his right eye occurring 15 years after cataract surgery. The intraocular pressure (IOP) was 55 mmHg in the right eye and gonioscopy revealed a wide open angle with white cortical lens material in the inferior angle. Since the IOP was unable to be controlled with medical therapy, removal of the lens material was performed by irrigation and aspiration. Following surgery, the IOP was decreased to 18 mmHg without medication and the patient's vision recovered to 20/20. The pathology of the aqueous humor showed macrophages with engulfed lens particles.
Aqueous Humor/*cytology ; Case Report ; Cataract Extraction/*adverse effects ; Glaucoma/*etiology/*pathology ; Human ; Lens, Crystalline/*pathology ; Macrophages/pathology ; Male ; Middle Age

No abstract available.
Blood Volume

PURPOSE: This study was done to identify the relationships among nursing professionalism, nursing work environment, and patient safety activities, and to analyze the factors influencing nurses' patient safety nursing activities. METHODS: This descriptive study included 270 nurses from six general hospitals. Questionnaires were used to collect data between August 20 and September 21, 2018, using questionnaires. Analyses included descriptive statistics, t-test, analysis of variance, Pearson correlation coefficient, and stepwise multiple regression, conducted using IBM SPSS/WIN 21.0. RESULTS: Mean scores on nursing professionalism, nursing work environment, and patient safety nursing activities were 3.51±0.41, 2.44±0.45, and 4.39±0.50, respectively. The patient safety nursing activities score was positively correlated with subscales of nursing professionalism variable: professional self-concept (r=.15, p=.019), social recognition (r=.10, p=.036), professional identity in nursing (r=.24, p<.001), role of nursing practice (r=.16, p=.012), nursing foundation for quality of care (r=.19, p=.003), and nurse manager's ability (r=.14, p=.031). Patient safety nursing activities were influenced by professional identity in nursing (β=.22, p=.001) and nursing foundation for quality of care (β=.15, p=.001), which explained 8.0% of the variance. CONCLUSION: These results suggest that nurse managers should focus on creating an appropriate nursing environment and facilitating nursing professionalism to enhance hospital nurses' patient safety nursing activities.
Hospitals, General ; Humans ; Nurse Administrators ; Nursing ; Patient Safety ; Professionalism

Background: Sputum Gram stains and cultures are standard tests for thediagnosis of lower respiratory tract infections. Analysis reports of the sputumquality are scarce in relation to cultures as well as clinical diagnosis. Methods: A total of 1,523 sputum specimens, requested for culture, wereevaluated for their quality using the modified Murray–Washington (MW)grouping system in association with the culture results. The clinical diagnosiswas investigated for the culture positive cases. Results: There was a significant difference in bacterial growth (odds ratio,2.01; P =0.0164) and diagnosis of pneumonia (odds ratio, 4.18; P =0.002)between the acceptable groups (groups 4–5) and the unacceptable groups(groups 1–3). However, one-quarter did not belong to the current MW group.More than half of the sputum cultures were in group 6, with the lowestpositive rate (18.0%). Overall, 10% of the sputum cultures were related to aclinical diagnosis of pneumonia. Conclusions The MW grouping system should be revised, because onequarterdid not belong to the current group. Further evaluation of group 6will be needed. Improvement of sputum cultures is required to enhance thediagnosis of pneumonia.

Background: Group A streptococcus (GAS) is the most common cause of bacterial pharyngitis. This study aimed to characterize the molecular epidemiology of GAS infection using an emm-typing and emm-clustering approach. Methods: A total of 372 patients from Changwon who showed pharyngitis symptoms were recruited during the sampling period of 2018–2019 and throat cultures were obtained from them. emm typing was performed using polymerase chain reaction (PCR) and direct sequencing. emm genotypes and GAS clusters were classified based on a web-based database. Results: Of the 372 throat swab specimens, 101 (27.2%) were positive for GAS. emm typing analysis was performed on 59 GAS isolates. The most prevalent emm type was emm89 (20.3%), followed by emm12 (16.9%). Seven emm clusters were identified: E4 (emm89/ emm28, 32.2%), A-C4 (emm12, 16.9%), E1 (emm4, 13.6%), A-C5 (emm3, 10.2%), E6 (emm75, 8.5%), M6 (emm6, 8.5%), and A-C3 (emm1, 6.8%). Conclusion Diverse and temporal changes were observed in the distribution of emm types and clusters of GAS. Continuous surveillance based on emm genotyping is needed to monitor the epidemiological characteristics of GAS pharyngitis.

BACKGROUND: Antibiotic resistance of group A streptococci (GAS) is increasing nationwide. Pulsed-field gel electrophoresis (PFGE) is useful for investigating genetic relationship among outbreaks of bacterial infection. Erythromycin (EM) resistance is mediated by either ermB, ermTR, or mefA gene.The emm gene encodes M protein which is the most important virulence factor of GAS. METHODS: The clonal relationship among 56 EM resistant GAS isolated from the children with acute pharyngitis in Jinju was investigated by analysis of chromosomal DNA restriction pattern with SmaI enzyme. The ermB and mefA genes were amplified and emm genotype was identified with PCR and sequencing. Their relationship with PFGE pattern was investigated. RESULTS: The emm genotyes were identified as 2, 3, 12, 18, and 75. Mostly emm12 had ermB gene, while emm 3, 18 and 75 had mefA resistance gene. All strains with mefA gene were not restricted with SmaI. The emm12 strains showed 5 different PFGE patterns. CONCLUSIONS: The emm genotypes were closely related with resistance genes. Analysis of macrorestriction fragment patterns by PFGE showed that EM resistant GAS were polyclonal at least in Jinju. GAS strains with mefA gene were not restricted with SmaI suggesting mefA gene might inhibit chromosomal digestion with SmaI.
Bacterial Infections ; Child ; Digestion ; Disease Outbreaks ; DNA ; Drug Resistance, Microbial ; Electrophoresis, Gel, Pulsed-Field* ; Erythromycin* ; Genotype ; Gyeongsangnam-do ; Humans ; Pharyngitis ; Polymerase Chain Reaction ; Virulence

Background: Blood culture is essential for diagnosis of sepsis. However, usually the available blood volume is not sufficient to meet the guidelines. Thus, periodic monitoring and feedback are essential to improve the quality of blood cultures. Methods: We analyzed blood cultures requested between November 2018 and June 2019, and provided educational intervention and coaching for phlebotomists at the end of February 2019. Then, we evaluated the impact of education on blood cultures in a secondary­‑­care hospital. Blood volume, positive rate, contamination rate, and time to detection (TTD) were compared between the pre- (November 2018 to February, 2019) and post-intervention periods (March to June, 2019). Results: The average blood volume increased significantly from 5.4 mL to 7.1 mL (P < 0.0001) (35.2%) after intervention. Accordingly, the proportion of optimal blood volume (8–12 mL) increased from 9.1% to 37.8% (P < 0.0001). Before the intervention, the positivity rate was 9.6% and the contamination rate was 0.5%, whereas after the intervention, the positivity rate decreased to 9.1% and the contamination rate increased to 1.1%. TTD improved from 14.7 hours to 13.1 hours (P = 0.0420). Conclusion The educational intervention of the phlebotomy team improved the quality of blood cultures, especially blood volumes and TTD. However, the positivity rate did not increase, suggesting that it is affected not only by the blood volumes but also by the severity of the underlying illnesses of the patient in a secondary-care hospital.