Background: Hand hygiene is considered the simplest and most cost-effective method of infection prevention. Regular observation and feedback on hand hygiene compliance are key strategies for its enhancement. This study evaluated the effectiveness of hand hygiene surveillance, including direct observation and feedback, by comprehensively analyzing the reported hand hygiene compliance within the Korean National Healthcare-Associated Infections Surveillance System from 2019 to 2022. Methods: Participating medical institutions included general hospitals and hospitals with infection control departments that consented to participate. Hand hygiene surveillance was conducted using direct observation. Collected data, including healthcare workers, clinical areas, hand hygiene moments, and hand hygiene compliance, were recorded to calculate hand hygiene compliance rates. Additionally, the volume of alcohol-based hand sanitizers used per patient per day was investigated as an indirect indicator of hand hygiene compliance. The study was conducted from July 2019 to December 2022. Results: Hand hygiene compliance increased from 87.2% in Q3 2019 to 89.9% in 2022. Nurses and medical technologists showed the highest compliance rates, whereas doctors showed the lowest compliance rates. Intensive care units excelled in compliance, whereas emergency de partments lagged. Compliance was highest after patient contact and lowest when the patient’s surroundings were touched. Larger hospitals consumed more alcohol-based hand sanitizers than smaller hospitals did. Conclusion This study confirmed an improvement in hand hygiene compliance through sustained surveillance, indicating its contribution not only to preventing infection transfer within healthcare facilities but also to fostering a culture of hand hygiene in the country.

PURPOSE: The purpose of this study was to describe the status of infection control nurses (ICNs) and their activities, and to identify the factors affecting the level of infection control activities. Methods: Data were collected from 199 hospitals from June 24 to July 26, 2016. The structured questionnaires included status of infection control nurses, type and level of infection control activities. METHODS: Data were collected from 199 hospitals from June 24 to July 26, 2016. The structured questionnaires included status of infection control nurses, type and level of infection control activities. RESULTS: Most participating hospital were advanced general hospital (20.1%) and general hospital (67.8%). Among the hospitals, 86.4% had an infection control department (ICD). The average hospital work experience of ICNs was 14.62 years, and their average infection control career was for 4.94 years. Among the ICNs, 85.6% worked in full time and the average number of beds per ICN was 311.21. There were significant differences in the existence of ICD, infection control activities including surveillance, outbreak investigation, negative pressure room, hand hygiene monitoring, disinfection, and sterilization according to hospital size. The level of infection control activities was higher with more number of ICNs, ICN employment as full time, and healthcare institution accreditation status. The explanatory power was 37.5%. CONCLUSION: These results of this study which reflect infection control status of healthcare facilities with more than 150 beds in 2016 will provide baseline data to establish infection control system in small to medium sized hospitals after the Middle East Respiratory Syndrome outbreak in 2015.
Accreditation ; Coronavirus Infections ; Delivery of Health Care ; Disinfection ; Employment ; Hand Hygiene ; Health Facility Size ; Hospitals, General ; Infection Control ; Korea ; Sterilization

BACKGROUND: This study was performed to improve the working competencies of novice infection control nurses (ICNs) and thereby prevent healthcare associated infection. We developed and implemented an education program and then evaluated its effectiveness. METHODS: The education program was developed by conducting a literature review and four expert group discussions. The program was implemented twice, and included 3 days of lectures and 1 day of practice in Seoul and Pusan, for 157 ICNs with less than 3 years of experience. The knowledge of the participants before and after the educational program and overall satisfaction were measured. Data were analyzed using the SPSS WIN 18.0 program. RESULTS: The education program consisted of 12 lectures and 2 practices in total. The post-program knowledge score increased to 77.99 compared to 45.91 prior to participating in the program (P<.001). The scores for overall satisfaction, knowledge acquirement, and usefulness in field practice were 9.05, 8.97, and 9.01, respectively. The overall satisfaction was higher for the practice component (9.37) than the lectures (9.00). There were significant differences in surveillance knowledge according to age (F=3.94, P=.021), hospital career (F=3.71, P=.027), hospital type (F=5.36, P=.006), and hospital size (F=6.19, P=.003); and there were significant differences in hand hygiene knowledge according to age (F=4.14, P=.018) and hospital type (F=4.84, P=.009). However, there was no difference in overall satisfaction with the program. CONCLUSION: To enhance working competencies and professionalism, education programs considering the characteristics and needs of the ICNs must be developed. Moreover, professional training courses are needed to nurture ICNs in small hospitals.
Busan ; Cross Infection ; Education* ; Hand Hygiene ; Health Facility Size ; Infection Control* ; Lectures ; Professionalism ; Seoul

PURPOSE: The neonatal (NMR) or infant mortality rate (IMR) in South Korea is lower than that in the United States. We aimed to investigate the contributing factors to this difference in mortality rates. METHODS: The study populations consisted of five groups, namely group A, comprising live births in South Korea during 2009-2011 (n=1,383,806), and groups B (live births to Korean parents, n=107,309), C (Caucasian births, n=31,588,183), D (African-origin, n=4,381,664), and E (all live births, n=49,384,187) comprising various US live births during 2000-2011. Maternal characteristics, birth outcomes, and mortality rates in these five groups were compared according to birth weight (BW) and gestational age (GA). RESULTS: Maternal characteristics such as BW distribution and very low and low BW rates among infants in South Korea and those in the United States were quite similar. Both rates were significantly lower among the Korean live births than among Caucasian and African-origin live births in the United States. However, the mortality rates of these small birth weight groups were significantly higher in the Korean infants born in South Korea than in those born in the United States, or in Caucasian and African-origin infants born in the United States. Similar results were noted when analyzed according to gestational age. CONCLUSIONS: The NMR or IMR in South Korea is lower than that in the United States, primarily due to the overwhelming favorable BW and GA distribution, despite the lower BW- and GA-specific survival rates in the live births in South Korea than in the United States.
Birth Weight ; Continental Population Groups ; Gestational Age ; Humans ; Infant ; Infant Mortality* ; Infant* ; Korea ; Live Birth ; Mortality ; Parents ; Parturition ; Survival Rate ; United States*

PURPOSE: This study was done to investigate the status of disinfection and sterilization in healthcare facilities. METHOD: A survey of 193 Korean healthcare facilities was conducted from February 8 to March 7, 2013. Data were analyzed using descriptive statistics, chi2 test, Fisher's exact test, one-way ANOVA, Scheffe with SPSS WIN 18.0. RESULTS: Of the healthcare facilities 93.2% had specific guidelines for disinfection/sterilization, but only 47.9% had a committee on disinfection/sterilization for decision-making, less than half (42.7%) conducted regular monitoring of actual practices, while 83.9% had established procedures for recovery in case of problems with the disinfection process and 89.0% kept records and archives of disinfection practices. Cleaning process, selection of chemical disinfectants and process of disinfection and sterilization were found to be inadequate in some healthcare facilities. Perception score for adequacy of medical instruments was 8.10, environmental disinfection was 7.20, and sterilizer management was 8.45 out of a possible 10. CONCLUSION: Compared to larger institutions, smaller healthcare facilities had less effective disinfection and sterilization management systems, while some facilities showed inadequate practices for medical equipment and general sterilization. Better academic and state-level support is recommended for smaller facilities in order to establish a better system-wide management system.
Delivery of Health Care* ; Disinfectants ; Disinfection* ; Sterilization*

PURPOSE: The purpose of this study is to investigate the predisposing factors for nipple confusion by using questionnaires. METHODS: From October, 2005 to October, 2006, we performed a survey on guardians of neonates who had been admitted to the nursery at Dongguk University Medical Center and were discharged 10 to 14 days before the survey. We reviewed their medical records retrospectively. The neonates were categorized into two groups; nipple-unconfused group and nipple- confused group. RESULTS: There were 71 neonates in the nipple-unconfused group and 29 neonates in the nipple-confused group. In the nipple-confused group, 12 neonates (41.4%) had nipple-suckling experience before admission, whereas in the nipple-unconfused group, 54 neonates (76.1%) had nipple-suckling experience before admission; showing a difference that was statistically significant (P=0.001). Regarding to breast-feeding experience before admission, 11 neonates (37.9%) had experience in the nipple-confused group, whereas 49 neonates (69.0%) had in the nipple-unconfused group. This also showed a statistically significant difference (P=0.004). However, the relationship between the duration of breast-feeding prior to hospitalization was not different (P=0.151). CONCLUSION: In this study, we believe that the suckling experience and the breast-feeding of neonates before admission may be factors affecting the development of nipple confusion. This study particularly revealed that neonates who had only nipple suckling experience, regardless of breast-feeding, had less nipple confusion. Thus, allowing neonates enough time to make an attempt at nipple suckling may be helpful to prevent nipple confusion.
Academic Medical Centers ; Breast Feeding ; Hospitalization ; Humans ; Infant, Newborn ; Medical Records ; Nipples ; Nurseries ; Retrospective Studies

BACKGROUND: Cost-benefit studies for hospital infection control and prevention (HICP) are often applied to improve the investment for infection control; however, an accurate cost measurement for HICP would be necessary before a cost benefit analysis and establishing a proper policy for HICP. The purpose of this study is to analyze the costs of HICP for the hospital in Korea. METHOD: The costs associated with HICP in the year 2004 were surveyed for 8 university-affiliated teaching hospitals in Seoul and Kyounggi province. The collected data included the costs for standard precaution materials including hand hygiene and personal protective equipments, hospital employee health service, maintenance of hospital facility and environmental control, and operating infection control office. RESULT: The average costs for HICP were estimated to be 785,115 won per one bed per year. Among the contributing factors to the total costs were the cost for patient isolation in private rooms (310,458 won), disinfectants (125,533), hand hygiene materials (99,007), maintenance of hospital environmental hygiene (90,773), operation of infection control office (65,811), personal protective equipment (58,099), and employee health care (35,434). CONCLUSION: We estimated the annual cost of HICP at a minimum of 96,723,000 won for a 100-bed hospital. This study contributes to establishing the basic and necessary data for a proper HICP compensation system by providing various HICP costs for the university hospital.
Compensation and Redress ; Cost-Benefit Analysis ; Cross Infection* ; Disinfectants ; Hand Hygiene ; Hospitals, Teaching ; Humans ; Hygiene ; Infection Control ; Investments ; Korea ; Occupational Health ; Occupational Health Services ; Patient Isolation ; Patients' Rooms ; Seoul

PURPOSE: The aim of study was to compare the differentiation capacity of mesenchymal stem cells (MSCs) obtained from human bone marrow (BM) according to the age of the donors. MATERIALS AND METHODS: MSCs were isolated from the BM of young (n=16, 12.5+/-5.8 years) and elder (n=4, 48.5+/-7.2 years) patients with the consent of them. We analyzed the cell morphology and the cell surface markers of the MSCs. In addition, we assessed the cell senescence with serial cultures from both age groups. Cell pluripotentiality was analyzed by osteogenic, chondrogenic, and adipogenic induction media. We performed RT-PCR, a measurement of expression of alkaline phosphatase, and staining with von Kossa, safranin O, and oil red O stain. RESULTS: All of the MSC samples tested, irrespective of the age of the donors, MSCs were all successfully isolated from twenty bone marrows. However, the number of cells of from the young donors was five times greater than that of the elderly donors. Senescence was observed over 10 passages in both age groups. The immunophenotypes of both age groups showed similar patterns. MSCs obtained from young and older donors showed the potential to differentiate into osteogenic, chondrogenic, and adipogenic lineages with no difference for both age groups. CONCLUSION: Our study supports that age does not influence the pluripotential capacity of human BM derived MSCs.
Aged ; Aging* ; Alkaline Phosphatase ; Bone Marrow* ; Cell Aging ; Humans* ; Mesenchymal Stromal Cells* ; Tissue Donors

Background: A clinician reported unusually high incidence of A. xylosoxidans isolation from aspirated tissues in outpatient clinic. Methods: A. xylosoxidans isolates from January 2002 to June 2002 were investigated. The infection control nurse reviewed medical records and observed the procedures of tissue aspiration and culture at the clinical microbiology laboratory. Specimens were obtained for investigational cultures from dye, aspiration gun, slide alcohol sponge, tray, sink. water of sink, buffer solution, microscope, computer, and telephone. Results: A. xyloxosidans was isolated from twenty-four patients during 6 months. None of 24 cases had any typical signs or symptoms of infections by A. xylosoxidans. Observation of tissue aspiration and culture procedure revealed that buffer solution was used for prevention of specimen drying after tissue aspiration. Culture of the buffer solution yielded a heavy growth of A. xylosoxidans from four out of ten specimens. A. xylosoxidans was not isolated from any other investigational specimens. Conclusions: This was supposed to represent pseudoepidemic. Contaminated buffer solution was documented as the cause of this pseudoepidemic. The usage of buffer solution was stopped. During the follow-up period of 2 months, no additional A. Xylosoxidans was cultured from aspirated tissues.
Alcaligenes* ; Ambulatory Care Facilities ; Follow-Up Studies ; Humans ; Incidence ; Infection Control ; Medical Records ; Methods ; Porifera ; Telephone ; Water

The purpose of this study is to identify the differences of zebrin II expression between ataxic pogo and normal Balb/C mouse cerebellum. Zebrin II is expressed by subsets of Purkinje cells that form an array of parasagittal bands that extend rostrocaudally throughout the cerebellar cortex, separated by similar bands of Purkinje cells that do not express zebrin II. Zebrin II immunoreactivity was localized in the perikarya of Purkinje cells, and the dendrites. Distribution of zebrin II-immunoreactive Purkinje cells were very similar pattern in pogo and Balb/C mouse cerebellum. But, in the lobule III, distribution of zebrin II expression was different between pogo and Balb/C mouse cerebellum. In lobule III of Balb/c mouse cerebellum, 10~15 zebrin II-immunoreactive Purkinje cells were observed and clustered to form a parasagittal bands. On the other hand, zebrin II expressions of lobule III in pogo mouse cerebellum showed a little different patterns. In lobule III of pogo mouse cerebellum, three bilateral zebrin II immunoreactive parasagittal band were observed. P1 band was almost same with lobule III of Balb/C mouse cerebellum. But, P2 bands were composed of 50~60 Purkinje cells which were immunoreactive with zebrin II. These kind of thickening in zebrin II expression of pogo mouse cerebellum may be due to the genetical difference. Furthermore, these results may provide useful information with further ataxic pogo mice cerebellum studies.
Animals ; Cerebellar Cortex ; Cerebellum* ; Dendrites ; Hand ; Immunohistochemistry ; Mice* ; Purkinje Cells