Purpose: This study aimed to examine the levels of clinical decision-making ability, role conflict, and nursing work performance ability and to identify factors influencing nursing work performance ability among emergency room nurses. Methods: This study emploved a descriptive correlational research design. A total of 137 emergency room nurses, were participated. Data were collected at three tertiary hospitals located in city B, from June 1 to August 25, 2024. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Scheffé test, Pearson’s correlation, and multiple regression analysis using IBM SPSS 29.0 program. Results: The average score of clinical decision-making ability was 3.31, while role conflict and nursing work performance ability both had an average score of 3.77. Factors influencing nursing work performance ability included clinical decision-making ability, role conflict, and annual salary, which explained 20.0% of the variance in nursing work performance ability. Conclusion Clinical decision-making ability and role conflict significantly impact nursing work performance among emergency room nurses. Strategies to enhance clinical decision-making skills and mitigate role conflict should be developed at the organizational level. Additionally, further research is needed to on appropriate compensation systems and institutional measures to enhance nursing work performance.

Purpose: This study aimed to examine changes in nurse staffing grades and nursing fee revenues in intensive care units (ICUs) following the third amendment of the resource-based relative value scale, which was implemented in January 2024. Methods: Changes in staffing grades from the fourth quarter of 2023 to the first quarter of 2024 were analyzed among 588 general ICUs, 94 neonatal ICUs, and 13 pediatric ICUs. Annual nursing fee revenues per nurse were estimated based on the new nursing fee structure for each grade. Results: In general ICUs, the highest grade (grade S) and the second-highest grade (grade A) accounted for 7.3% and 41.5%, respectively, in tertiary hospitals, whereas 3.8% were grade S and 11.5% were grade A in general hospitals. In neonatal ICUs, the proportion of higher grades (S, A, and 1) was greater in general hospitals (54.3%) than in tertiary hospitals (38.6%). In pediatric ICUs, 30.8% were grade S and 61.5% were grade A. When applying the same grading criteria (i.e., beds per nurse) across both quarters, staffing levels remained unchanged in most ICUs. Nursing fees and their revenues did not increase proportionally to staffing requirements (i.e., the number of nurses required per patient). Conclusion Revisions to staffing grade and nursing fee systems are necessary to induce medical institutions to improve their ICU staffing levels.

Purpose: This study aimed to identify the risk factors for peripheral intravenous catheter-related phlebitis in hospitalized neurosurgery patients. Methods: This study involved 443 neurosurgery patients who were admitted to a general hospital in Seoul. The analysis included 982 intravenous lines. Data were retrospectively extracted from electronic medical records for the period between November 1, 2022, and May 31, 2023. Data were analyzed using descriptive statistics, independent t-test, x 2 test, and logistic regression. Results: The incidence rate of phlebitis was 13.6%, with the majority of cases classified as grade 2. Gender, present diseases, length of hospital stay, needle gauge size, and cardiovascular drugs were identified as risk factors for phlebitis in neurosurgery patients. Conclusion This study is significant as it provides basic data for the prevention and management of peripheral phlebitis in hospitalized neurosurgery patients. The risk factors identified in this study should be incorporated into nursing education to implement a systematic peripheral intravenous management program, and appropriate peripheral intravenous catheter-related nursing interventions are necessary based on the characteristics of each patient.

Purpose: This study aimed to identify the mediating effect of organizational communication on the relationship between organizational justice and the work engagement of clinical nurses. Methods: This study included 186 nurses from 6 small and medium-sized hospitals. Data were collected from September 1 to October 31, 2023 using self-report questionnaires and were analyzed using IBM SPSS Statistics for Windows version 25.0. The data were analyzed using descriptive statistics, t-test, ANOVA, and Pearson's correlation coefficient. Multiple regression analysis based on the three-step mediation effect verification procedures proposed by Baron and Kenny, and the mediating effect was confirmed using bootstrapping and verified using the SPSS PROCESS macro model 4. Results: Organizational communication had perfect mediating effects on the relationship between organizational justice and work engagement (indirect effect=0.35). Conclusion Based on the results of this study, to improve the work engagement of clinical nurses, institutional efforts to improve the justice of nursing organizations and effective strategies are needed to develop and apply programs to enhance organizational communication competency.

Purpose: This study was conducted to update the practice guidelines for intravenous infusion therapy published in 2017, focusing on the most recent evidence for peripheral intravenous infusion therapy. Methods: The guideline update was conducted using the 22-step methodology. Results: The updated guidelines consist of 17 domains and 235 recommendations (including 284 sub-recommendations). The domains are as follows: general instructions (5 items), peripheral catheter selection (7), catheter insertion site selection (11), management during peripheral catheter insertion (10), post-insertion management (30), perfusion and locking (17), blood sampling via peripheral catheters(6), exchange and removal of peripheral catheters (6), infusion set management (14), add-on devices (32), complications (25), chemotherapy infusions (10), PCA infusions (7), parenteral nutrition (20), transfusion therapy (23), education (5), and documentation and reporting (7). The evidence levels for these recommendations are as follows: 27(9.5%) at level I, 3 (1.1%) at level I A/P, 118 (41.5%) at level II, and 136 (47.9%) at level III.Recommendation grades are categorized as follows: 30 (10.6%) at level A, 118 (41.5%) at level B, and 136(47.9%) at level C. Of these, 73 (25.7%) recommendations were newly developed, 49 (17.3%) underwent major revisions, and 147 (51.7%) underwent minor revisions. Conclusion The updated practice guideline, based on the latest evidence, is anticipated to enhance nursing practice related to peripheral intravenous infusion therapy.

Purpose: This study aimed to investigate the influence of perceptions and stress experienced during the end-of-life decision-making process on end-of-life care competence among intensive care unit (ICU) nurses. Methods: Data were collected from February 1 to March 1, 2023, and analyzed using the IBM SPSS/WIN 27.0 program. Results: Factors influencing end-of-life care competence among ICU nurses included role clarity in the end-of-life context (β=.34, p<.001), collaboration in the end-of-life context (β=.25, p=.002), and work-related interruptions of communication with families (β=-.15, p=.029). These factors, which were subdomains of perceptions and stress experienced during end-of-life decision making process, collectively explained 51.0% of the variance (F=13.09, p<.001). Conclusion Enhancing end-of-life care competence among ICU nurses requires targeted interventions. These measures should include the development of clear guidelines, the provision of education, and the implementation of institutional strategies aimed at clarifying nurses’ roles in end-of-life situations, fostering collaboration among nursing staff, and reducing work-related interruptions in communication with families.

Purpose: This study aimed to identify the most delirium assessment tool with high predictive validity for elderly patients with stroke. Methods: This was a prospective observational study. The subjects were 219 stroke patients aged 60 years or older admitted to the neurology ward of a general hospital and data collection was conducted from August 2022 to February 2023. The collected data were analyzed using descriptive statistics, x 2 -test, independent t-test, and Fisher's exact test. The predictive validity of the Delirium Observation Screening Scale (DOS), the Nursing Delirium Screening Scale(Nu-DESC), and the 4'A's test (4AT) were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC). Results: Of the 38 patients screened for delirium using delirium assessment tools, 32 (14.6%) were diagnosed with delirium by a neurologist. The sensitivity, specificity, positive predictive value, and negative predictive value were 84.4%, 91.1%, 71.1%, and 97.2% for DOS; 93.8%, 96.8%, 83.3%, and 98.9% for Nu-DESC; and 100.0%, 96.8%, 84.2%, and 100.0% for 4AT, respectively. The AUC was shown to be 0.89 for the DOS, 0.95 for the Nu-DESC, and 0.98 for the 4AT. Conclusion The results indicate that the 4AT was the most valid delirium assessment tool for elderly patients with stroke. Therefore, the active use of 4AT by nurses to screen for delirium of elderly stroke patients in clinical settings can contribute to the prevention and early management of delirium.

Purpose: This study aimed to establish a basis for minimizing readmission of patients with heart failure by comparing their demographic, clinical, psychosocial, and behavioral characteristics based on the presence or absence of readmission. Methods: This retrospective descriptive study included 160 elderly patients with heart failure aged 60 years and older, who regularly visited the cardiovascular outpatient clinic in K hospital in Daegu.Data were collected from April to December 2021 using self-report questionnaires including the Lubben Social Network Scale, the Scale of Positive and Negative Experience, and European Heart Failure Self-care Behaviour 9-Item Tools, which were translated in the Korean context. IBM SPSS Statistics 25 was used for analysis, and descriptive statistics, χ2 test, Fisher’s exact test, t-test, and logistic regression analysis were conducted. Results: The factors that significantly affected the readmission of elderly patients with heart failure were social network and the type of medications taken. The total explanatory power of the regression model was 22.7%. Social network (OR=0.93, p=.037) and the type of medication taken were 4~5 (OR=4.80, p=.014) and more than 6 medications (OR=7.84, p=.037) had a significant impact on readmission. Conclusion Social network was the most influential factor for readmission. Further studies are needed to minimize readmission by analyzing additional factors that show significant differences.

Purpose: This study aimed to examine the effects of a self-management education program on dietary self-care behaviors, patient role performance, self-efficacy, and physiological indicators in hemodialysis patients. Methods: A quasi-experimental study was conducted from February to May 2024 with 43 hemodialysis patients(22 experimental, 21 control at the artificial kidney units of Hospital A and Hospital Y in K region. Data were analyzed using descriptive statistics, independent t-test, achi-square test, and ANCOVA with SPSS/WIN 26.0. The reliability of the measurement tools was assessed using Cronbach’s ⍺. Results: The experimental group that participated in the self-management education program showed significant improvements in dietary self-care behavior (t=81.87, p=.011), patient role performance (t=27.86, p=.035), and self-efficacy (t=17.88, p=.003) compared to the control group. However, no significant differences were observed in serum potassium (F=0.06, p=.813) and phosphorus (F=0.02, p=.903) levels. In contrast, serum protein (F=6.94, p=.012) and albumin (F=8.05, p=.007) levels significantly increased in the experimental group. Conclusion The self-management education program was effective in improving dietary self-care behaviors, patient role performance, and self-efficacy among hemodialysis patients. However, its impact on physiological indicators was limited to specific parameters. Therefore, this program may be effectively implemented in clinical settings to enhance self-care adherence, improve patient role performance, and ultimately reduce complications in hemodialysis patients.

Purpose: The study aimed to examine the mediating effects of social support on the relationship between reality shock and turnover intention among new graduate nurses. Methods: This study included 146 new graduate nurses working in hospitals located in state G. Data were collected from August 9, 2023 to January 15, 2024.Data was collected through a survey. For data analysis, SPSS/WIN 25.0 program was used. The data were identified with frequency and percentage, mean, standard deviation, independent t-test and one-way ANOVA, Scheffé test, Pearson’s correlation coefficient, and Baron and Kenny’s 3-stage procedures. The statistical significance of the mediating effects was verified using the PROCESS macro model 4. Results: Social support exhibited a negative correlation with reality shock (r=-.47, p<.001) and turnover intention (r=-.61, p<.001). Additionally, there was a positive correlation (r=.67, p<.001) between reality shock and turnover intention. Notably, social support had a partial mediating effect on the relationship between reality shock and turnover intention (β=.49, p<.001). Conclusion This study demonstrated that social support serves as a partial mediator in the relationship between reality shock and turnover intention among new graduate nurses.Consequently, it is recommended that efforts be made to improve social support through institutional and legal improvement and the development and implementation of programs aimed at reducing turnover intention among new graduate nurses.