PURPOSE: The purpose of this study was to study the effects of the reeducation of core fundamental nursing skills on clinical stress, critical thinking disposition, and self-confidence in nursing skills of senior nursing students. METHODS: A quasi-experimental study with a non-equivalent control group pretest-posttest design was used. Participants were recruited from two nursing colleges. The sample consisted of an intervention group (n=33) that participated in the educational program and a control group (n=32). The data were collected using self-administered questionnaires. Data analyses utilized χ²-test & t–test. RESULTS: After the reeducation of core fundamental nursing skills, senior nursing students had less clinical stress (t=-2.089, p=.041) and more self-confidence (t=1.008, p=.318) in nursing skills. However, it had no effect on critical thinking disposition (t=1.008, p=.318). CONCLUSION: Reeducation of core fundamental nursing skills is important to the nursing profession. Also, nurses who are self-confident in their nursing skills are less stressed about improving the quality of their work due to the reeducation of core fundamental nursing skills. Therefore, it is vital for nursing colleges to reeducate core fundamental nursing skills to their students before graduation.
Education ; Humans ; Non-Randomized Controlled Trials as Topic ; Nursing* ; Statistics as Topic ; Students, Nursing* ; Thinking*

From January 2007 to June 2012, 55 autopsy cases were reviewed, in which death occurred outside the hospital and the patients were declared dead on arrival at the emergency departments, in order to compare the clinical and postmortem examination diagnoses of death-on-arrival patients in tertiary hospitals in Busan, Yangsan and Ulsan city. Of 22 non-traumatic deaths, 21 occurred from natural causes and 1 from unknown cause (sudden infant death syndrome, SIDS). Clinical diagnoses were cardiovascular diseases or "non-traumatic" / "unknown" while autopsy diagnoses were majorly cardiovascular diseases, especially coronary artery diseases (72.7%). Of 33 unnatural deaths, the cause of death was blunt trauma in 4 patients, sharp-force injury in 6, falling in 10, gunshot injury in 1, traffic accidents in 3, asphyxia in 2, drowning in 2, fire-related death in 1, and intoxication in 4. There were no definite discrepancies between clinical and autopsy diagnoses, except for 5 non-traumatic deaths and 2 unnatural deaths. These results suggest that the role of the emergency department may be crucial in postmortem investigations.
Accidents, Traffic ; Asphyxia ; Autopsy ; Cardiovascular Diseases ; Cause of Death ; Coronary Artery Disease ; Drowning ; Emergencies ; Humans ; Infant ; Tertiary Care Centers

BACKGROUND: Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients. METHODS: A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher. RESULTS: Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients' mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016). CONCLUSIONS: This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.
Emergency Service, Hospital ; Factor VIIa* ; Female ; Humans ; Maternal Death ; Maternal Mortality ; Medical Records ; Organ Dysfunction Scores ; Postpartum Hemorrhage* ; Postpartum Period* ; Prognosis ; Recombinant Proteins ; Retrospective Studies

Purpose: The purpose of this study was to investigate factors affecting the quality of life of middle-aged women with urinary incontinence by using Wilson and Cleary (1995)'s health-related quality of life model and previous studies. This article was done to construct a model for the collection of data on women with urinary incontinence and verifying the suitability of the model and the hypotheses presented in the model. Methods: A total of 209 valid questionnaires which met the criteria of middle-aged women who experienced urinary incontinence was used for final analysis. The exogenous and endogenous variables of the hypothesis model consisted of age, number of delivery, menstrual status, self-esteem, social support, physical symptoms, depression, anxiety, self-care agency and quality of life. The data were analyzed using IBM SPSS/WINdow 25.0 and AMOS 18.0 program. Results: The fitness of the modified model, x2/df=1.675, RMR=0.047, RMAEA=0.057, GFI=0.900, AGFI=0.855, NFI=0.923, TLI=0.957, CFI=0.9674. In the modified model, self-esteem showed the strongest total impact including the direct and indirect impacts on the quality of life of women with incontinence. In the result of verification of the modified model, quality of life explained by 58.8% through self-esteem, social support, self-care agency. Conclusion Efforts are needed to improve self-esteem for middle-aged women with urinary incontinence, alleviate psychological symptoms, and develop self-care agency that they can manage themselves. Various aspects of physical, mental and psychological aspects can be comprehensively assessed and utilized to develop an interactive strategy system through individual programs and social support.

Objective: Urgent upper endoscopy is performed to achieve acute hemostasis in patients with high-risk bleeding sources. Emergency physicians must identify patients who require urgent endoscopic treatments. This study assessed the performance of blood urea nitrogen (BUN) for predicting severe bleeding that necessitates urgent endoscopic hemostasis compared to the risk assessment scores in patients with acute non-variceal upper gastrointestinal bleeding (ANVUGIB). Methods: The presumed ANVUGIB patients were classified into endoscopic and non-endoscopic hemostasis groups. Data including historical features, symptoms, signs, and routine laboratory tests were collected and compared. Results: Three hundred and ninety-one patients were analyzed, including 116 patients in the endoscopic hemostasis and 275 patients in the non-endoscopic hemostasis group. In the area under curve (AUC) of the receiver operator characteristic curve, BUN (AUC 0.733; 95% confidence interval [CI], 0.681-0.785) and BUN/creatinine (AUC, 0.727; 95% CI, 0.672-0.783) were superior to total protein, Glasgow-Blatchford score (GBS), modified GBS (AUC, 0.649, 0.623 and 0.646, respectively) for predicting endoscopic hemostasis. Pre-endoscopy Rockall score and AIMS65 were statistically insignificant. The same results were obtained when the patients with liver and chronic kidney diseases were excluded. Conclusion The current results suggest that BUN was an independent predictor of endoscopic hemostasis in patients with ANVUGIB. Further studies will be needed to determine if BUN can be used in clinical practice.

In this study, we investigated the molecular characteristics of extended-spectrum beta-lactamase (ESBL)-producing Klebsiella pneumoniae isolates that were recovered from an outbreak in a Korean hospital. A new multilocus sequence typing (MLST) scheme for K. pneumoniae based on five housekeeping genes was developed and was evaluated for 43 ESBL-producing isolates from an outbreak as well as 38 surveillance isolates from Korea and also a reference strain. Overall, a total of 37 sequence types (STs) and six clonal complexes (CCs) were identified among the 82 K. pneumoniae isolates. The result of MLST analysis was concordant with that of pulsedfield gel electrophoresis. Most of the outbreak isolates belonged to a certain clone (ST2), and they produced SHV-1 and CTX-M14 enzymes, which was a different feature from that of the K. pneumoniae isolates from other Korean hospitals (ST20 and SHV-12). We also found a different distribution of CCs between ESBL-producing and -nonproducing K. pneumoniae isolates. The MLST method we developed in this study could provide unambiguous and well-resolved data for the epidemiologic study of K. pneumoniae. The outbreak isolates showed different molecular characteristics from the other K. pneumoniae isolates from other Korean hospitals.
Electrophoresis, Gel, Pulsed-Field ; Hospitals ; Humans ; Klebsiella pneumoniae/*classification/enzymology/genetics/isolation & purification ; Sequence Analysis, DNA ; beta-Lactamases/*biosynthesis ; Mycobacteria, Atypical/*drug effects/genetics/isolation & purification