nursing home–acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER).METHODS: We performed a retrospective cohort study of 83 pneumonia patients with confirmed causative bacteria admitted to ICUs via ER March 2015–May 2017. We compared clinical parameters, between patients who received appropriate or inappropriate antibiotics using the Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests. We investigated independent factors associated with inappropriate antibiotic use in patients using multivariate logistic regression.RESULTS: Among 83 patients, 30 patients (36.1%) received inappropriate antibiotics. NHAP patients were more frequently treated with inappropriate antibiotics than with appropriate antibiotics (47.2% vs. 96.7%, p<0.001). Methicillin-resistant Staphylococcus aureus was more frequently isolated from individuals in the inappropriate antibiotics–treated group than in the appropriate antibiotics–treated group (7.5% vs. 70.0%, p<0.001). In multivariate analysis, NHAP was independently associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via ER.CONCLUSION: NHAP is a risk factor associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the ER.]]>
Anti-Bacterial Agents ; Bacteria ; Cohort Studies ; Critical Care ; Emergency Service, Hospital ; Hospitals, Teaching ; Humans ; Intensive Care Units ; Logistic Models ; Methicillin-Resistant Staphylococcus aureus ; Multivariate Analysis ; Nursing ; Pneumonia ; Retrospective Studies ; Risk Factors

PURPOSE: The purpose of this study was to explain a structural model of posttraumatic growth among psychiatric nurses based on existing models and a literature review and verify its effectiveness.METHODS: Data were collected from psychiatric nurses in one special city, four metropolitan cities, and three regional cities from February to March 2016. Exogenous variables included hardiness and distress perception, while endogenous variables included self-disclosure, social support, deliberate rumination, and posttraumatic growth. Data from 489 psychiatric nurses were analyzed using IBM SPSS Statistics 19.0 and AMOS 20.0.RESULTS: The modified model was a good fit for the data. Tests on significance of the pathways of the modified model showed that nine of the 14 paths were supported, and the explanatory power of posttraumatic growth by included variables in the model was 69.2%. For posttraumatic growth among psychiatric nurses, deliberate rumination had a direct effect as the variable that had the largest influence. Indirect effects were found in the order of hardiness, social support, and distress perception. Self-disclosure showed both direct and indirect effects.CONCLUSION: A strategy to improve deliberate rumination is necessary when seeking to improve posttraumatic growth among psychiatric nurses. Enhancing psychiatric nurses' hardiness before trauma would enable them to actively express negative emotions after trauma, allowing them to receive more social support. This would improve deliberate rumination and consequently help promote psychological growth among psychiatric nurses who have experienced trauma.
Models, Structural ; Psychiatric Nursing

PURPOSE: The purpose of this study was to identify factors affecting communication ability of nursing students.METHODS: The participants were 140 students in nursing college at the G city. The data were collected using online-questionnaires from July 4 to July 10 2018 and analyzed using descriptive statistics, t-test, Pearson correlation analysis and multiple linear regression analysis with SPSS 20.0 program.RESULTS: The results show that communication ability was statistically significant according to self-awareness, other-awareness, empathy. Multiple regression analysis found that the factors influencing communication ability of nursing students were empathy(β=.540), self-awareness(β=.429), other-awareness(β=.375). These variable factors explained community ability as 46.3%.CONCLUSIONS: This study suggests that empathy, self-awareness, other-awareness are significant factors of communication ability of nursing students. Therefore, strategies to improve communication ability of nursing students should be developed with consideration for empathy, self-awareness, other-awareness.
Communication ; Empathy ; Humans ; Linear Models ; Nursing ; Residence Characteristics ; Students, Nursing

PURPOSE: The purpose of this study was to identify the risk factors for falls in tertiary hospital inpatients and to suggest data for developing a nursing intervention program for preventing falls.METHODS: Data were collected between January 1, 2017, to December 31, 2017. Kaplan-Meier estimation was used to measure the survival rate, and the log-rank test was used for the differences between the fall group and the non-fall group. The Cox proportional hazards model was used to identify the risk factors for falls.RESULTS: The incidence rate of falls for the inpatients was 1.2 cases per 1,000 days of hospitalization. The risk factors for falls were more likely to be found among those who were aged ≥81, had not undergone surgery, had poor joint motion, had unsteady gait, needed help or supervision, used assistive devices, had comorbidity, and took at least two drugs.CONCLUSION: For the inpatients, the risk factors for falls included age, surgery, comorbidity, medication that could change mobility, joint motion, and use of patient care equipment. It is necessary to give special attention to inpatients who have any of these risk factors and to develop a falls risk assessment tool.
Accidental Falls ; Comorbidity ; Gait Disorders, Neurologic ; Hospitalization ; Humans ; Incidence ; Inpatients ; Joints ; Nursing ; Organization and Administration ; Patient Care ; Proportional Hazards Models ; Risk Assessment ; Risk Factors ; Self-Help Devices ; Survival Analysis ; Survival Rate ; Tertiary Care Centers

PURPOSE: The purpose of this study was to identify status and characteristics of patients who have been readmitted to ICU, and to analyze risk factors associated with the readmission to ICU within 48hours.METHODS: Data were collected from patient's electronic medical reports from one hospital in B city. Participants were 2,937 patients aged 18 years old or older admitted to the ICU. Data were analyzed using odd ratios (ORs) from multivariate logistic regressions.RESULTS: 2.2% of the 2,937 patients were early readmitted to ICU. Risk factors for early readmission to ICU were existence of respiratory disease, use of mechanical ventilator, and duration of hospitalization (longer).CONCLUSION: The assessment on the respiratory system of the patient who will be discharged from the ICU was identified as an important nursing activity. Therefore, the respiratory system management and education should be actively conducted. In addition, early ICU readmission may be prevented and decreased if a link was built to share the information on patient condition between the ICU and general wards.
Critical Care ; Education ; Hospitalization ; Humans ; Intensive Care Units ; Logistic Models ; Nursing ; Patient Readmission ; Patients' Rooms ; Respiratory System ; Risk Factors ; Ventilators, Mechanical

PURPOSE: The purpose of this study was to identify predictors of eating disorders in adolescents with type 1 diabetes, with the goal of providing data in support of nursing interventions to improve their health.METHODS: A total of 136 adolescents aged 13–18 years with type 1 diabetes completed the Diabetes Eating Problem Survey-Revised, Rosenberg Self-Esteem Scale, and the Beck Depression Inventory-II, using structured self-reported questionnaires. The collected data were analyzed using the t-test, χ² test, and binominal logistic regression with SPSS version 23.0 for Windows.RESULTS: The prevalence of eating disorders in adolescents with type 1 diabetes was 39%. Four significant predictors of eating disorders were identified; absence of body satisfaction (odds ratio [OR]=3.87, 95% confidence interval [CI]=1.55~9.65), depression (OR=2.87, 95% CI=1.13~7.28), female gender (OR=2.67, 95% CI=1.09~6.54), and glycosylated hemoglobin type A1c levels (OR=1.47, 95% CI=1.10~1.97).CONCLUSION: In order to prevent eating disorders among adolescents with type 1 diabetes, programs for managing adolescents' depression and improving their body satisfaction should be developed. Futhermore, more attention should be directed towards programs aiming to prevent eating disorders in female adolescents.
Adolescent ; Body Image ; Depression ; Diabetes Mellitus, Type 1 ; Eating ; Female ; Hemoglobin A, Glycosylated ; Humans ; Logistic Models ; Nursing ; Prevalence

PURPOSE: The aim of this study was to identify the effect of metacognition, communication skills, and confidence in the performance of core basic nursing skills on clinical competency in nursing students.METHODS: A total of 158 students were recruited from two nursing colleges in B metropolitan city. Data were collected by means of self-reported questionnaires from December 3–31, 2018 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and multiple linear regression with SPSS 21.0.RESULTS: Metacognition, communication skills, and confidence in the performance of core basic nursing skills were higher than normal and the relationship between the variables metacognition (r=.69, p=<.001), communication skills (r=.69, p=<.001), and confidence in the performance of core basic nursing skills (r=.59, p=<.001) were highly positively correlated with clinical performance. Factors influencing these three variables accounted for 64.4% of clinical competency.CONCLUSION: Further research on the development of the curriculum and intervention program, and the verification of the effect are needed.
Clinical Competence ; Curriculum ; Humans ; Linear Models ; Metacognition ; Nursing ; Students, Nursing

PURPOSE: The study was done to investigate the influence of voice behavior, self-esteem and sexual knowledge on sexual assertiveness of nursing college students.METHODS: A structured self-report questionnaire was used to measure voice behavior, self-esteem, sexual knowledge and sexual assertiveness. During March, 2019, data were collected from 133 nursing students in D city and G city. Data were analyzed using t-test, one-way ANOVA, Pearson's correlation coefficients, and stepwise multiple linear regression with the SPSS/WIN 25.0 program.RESULTS: Voice behavior and self-esteem were positively correlated with the sexual assertiveness of participants, while voice behavior was positively correlated with the self-esteem of participants. Also, self-esteem was a significant predictor of sexual assertiveness in nursing college students. The predictor explained 12% of their sexual assertiveness.CONCLUSION: The finding indicates that self-esteem is an important factor for sexual assertiveness of nursing students. It is also expected that self-esteem can further promote their sexual assertiveness.
Assertiveness ; Humans ; Linear Models ; Nursing ; Reproductive Health ; Students, Nursing ; Voice

PURPOSE: The purpose of this study was to examine the effects of perceptions of patient rounding, self-leadership and nursing organization culture on intentional rounding performance.METHODS: The participants for this study were 210 nurses who had the experience of patient rounding care in general hospitals in B and Y cities. Data were collected from February 5th to 22nd, 2018. Collected data were analyzed using descriptive statistics, χ² test, and independent t-test. Logistic regression analysis was performed to identify factors influencing intentional rounding performance.RESULTS: It was found that intentional rounding performance was carried out by 20.0% of the day shift nurses, 18.1% of the evening shift nurses, and 19.5% of the night shift nurses. The significant factors influencing intentional rounding performance were the recommended rounding time interval in wards and the use of rounding protocol in the wards (p < .050).CONCLUSION: It is expected that nurses will be able to provide more advanced and efficient patient rounding by promising a systematic patient rounding time for intentional rounding and developing appropriate protocols for each ward.
Hospitals, General ; Humans ; Logistic Models ; Nursing ; Practice Management ; Teaching Rounds

PURPOSE: This study was done to identify the factors involved in ageism in nurses.METHODS: The participants in this study were 178 general hospital nurses. Data were collected in March 2019 using self-report questionnaires, and were analyzed using descriptive statistics, independent t-test, Mann-Whitney U test, one-way ANOVA, Kruskal-Wallis test, and stepwise multiple linear regression.RESULTS: The total score for ageism was 39.75±5.44 out of a maximum of 72. Ageism had a statistically significant relationship with contact experience (r=-.47, p < .001), attitude (r=.40 p < .001), and aging anxiety (r=.35 p < .001). The determining factors affecting ageism were contact experience (β=-.45, p < .001), attitude(β=.20, p=.002), work place (β=.22, p < .001), marital status (β=.21, p < .001), geriatric nursing preference (β=.18, p=.006), geriatric education (β=.17, p=.006), and aging anxiety (β=.14, p=.041). The explanation power of these variables was 39%.CONCLUSION: The results suggest that contact experience with elders had the largest influence on ageism in nurses. Therefore, it is necessary to develop tailored education programs by hospital type to increase positive contact experience and promote understanding of older patients in acute care settings. Furthermore, the importance of the perception of ageism needs to be highlighted in nursing education and continuing education for nurses.
Ageism ; Aging ; Anxiety ; Education ; Education, Continuing ; Education, Nursing ; Geriatric Nursing ; Hospitals, General ; Humans ; Linear Models ; Marital Status ; Workplace