Objective: To understand the current situation of emergency department nurses' work engagement, and analyze the relationship between emergency department nurses' organizational climate perception, work-related acceptance actions and work engagement. Methods: In May 2021, 273 emergency department nurses from 6 class Ⅲ class a general hospitals in Tianjin were selected as the research objects by using the convenient sampling method, and the general information questionnaire, work input scale, nurses' organizational climate perception scale and work-related acceptance action questionnaire were used for questionnaire survey. The correlation between job involvement and nurses' organizational climate perception and job-related acceptance action was analyzed by pearson correlation, and the influencing factors of job involvement were analyzed by multiple linear regression. Results: The average score of job involvement was (3.57±0.45) , the average score of nurses' organizational climate perception was (3.29±0.69) , and the score of work-related acceptance action was 35.00 (29.00, 47.00) . The results of correlation analysis showed that there was a positive correlation between nurses' organizational climate perception, job acceptance action and job involvement in emergency department (r=0.435, 0.518, P<0.05) . Multiple stepwise regression analysis showed that job acceptance, nurses' perception of organizational climate, health status, specialist nurses, education and emergency work years were the influencing factors of emergency department nurses' job involvement (P<0.05) , accounting for 41.9% of the total variation. Conclusion: We should create a good organizational atmosphere, improve the acceptance of emergency department nurses to nursing work, and improve the level of nurses' work input.
Emergency Service, Hospital ; Humans ; Job Satisfaction ; Nurses ; Nursing Staff, Hospital ; Perception ; Surveys and Questionnaires ; Work Engagement

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: This study was conducted to investigate relationship between delirium, risk factors on delirium, and patient prognosis based on Donabedian's structure-process-outcome model.METHODS: This study utilized a path analysis design. We extracted data from the electronic medical records containing delirium screening data. Each five hundred data in a delirium and a non-delirium group were randomly selected from electronic medical records of medical and surgical intensive care patients. Data were analyzed using SPSS 20 and AMOS 24.RESULTS: In the final model, admission via emergency department (B=.06, p=.019), age over 65 years (B=.11, p=.001), unconsciousness (B=.18, p=.001), dependent activities (B=.12, p=.001), abnormal vital signs (B=.12, p=.001), pressure ulcer risk (B=.12, p=.001), enteral nutrition (B=.12, p=.001), and use of restraint (B=.30, p=.001) directly affecting delirium accounted for 56.0% of delirium cases. Delirium had a direct effect on hospital mortality (B=.06, p=.038), hospital length of stay (B=5.06, p=.010), and discharge to another facility (not home) (B=.12, p=.001), also risk factors on delirium indirectly affected patient prognosis through delirium.CONCLUSION: The use of interventions to reduce delirium may improve patient prognosis. To improve the dependency activities and risk of pressure ulcers that directly affect delirium, early ambulation is encouraged, and treatment and nursing interventions to remove the ventilator and drainage tube quickly must be provided to minimize the application of restraint. Further, delirium can be prevented and patient prognosis improved through continuous intervention to stimulate cognitive awareness and monitoring of the onset of delirium. This study also discussed the effects of delirium intervention on the prognosis of patients with delirium and future research in this area.
Critical Care ; Delirium ; Drainage ; Early Ambulation ; Electronic Health Records ; Emergency Service, Hospital ; Enteral Nutrition ; Hospital Mortality ; Humans ; Intensive Care Units ; Length of Stay ; Mass Screening ; Nursing ; Pressure Ulcer ; Prognosis ; Risk Factors ; Unconsciousness ; Ventilators, Mechanical ; Vital Signs

PURPOSE: The purpose of this study was to examine the frequency, perceived importance and competence of pediatric emergency nursing practice (PENP) in nurses who cared for pediatric patients in the emergency department. METHODS: This cross-sectional descriptive study analyzed 175 emergency department nurses caring for pediatric patients at 7 university hospitals with more than 500 beds, located in Seoul and Gyeonggi Province. The measurement tool was modified from the Classification of Standard Nursing Activities to measure the frequency, importance of PENP, and nursing competence. It comprised 143 items in 16 domains of PENP. RESULTS: The most frequent nursing practice was the domain of ‘nursing records and environmental management’ and the least frequent practice was the ‘research and consulting’ domain. The nursing care domain perceived to be most important by nurses was ‘specialized intensive nursing care’. The nursing care domain with the highest level of nursing competence was ‘hygiene care’, and the domain with the least level of nursing competence was the ‘research and consulting’. CONCLUSION: These results will be utilized as basic data for future pediatric emergency nursing education initiatives and for establishing priorities of nursing policy to improve health care for children admitted to the emergency department.
Child ; Child Care ; Classification ; Delivery of Health Care ; Education ; Emergencies ; Emergency Nursing ; Emergency Service, Hospital ; Gyeonggi-do ; Hospitals, University ; Humans ; Mental Competency ; Nurse's Role ; Nursing Care ; Nursing ; Professional Competence ; Seoul

PURPOSE: Epilepsy is the most common neurological disorder in childhood. Hospital nurses, who are the first to recognize seizures in epilepsy patients in the ward environment, possess expertise related to epilepsy and play a central role in epilepsy management. The purpose of this study was to develop an algorithm-based education program and to improve nurses' knowledge and self-efficacy related to providing nursing care to children with epilepsy. METHODS: The education program consisted of lectures on the definition, cause, classification, diagnosis, treatment, and nursing of epilepsy based on a booklet, as well as practice using an algorithm for nursing interventions when a child experiences a seizure. Twenty-seven nurses working at pediatric neurological wards and a pediatric emergency room participated in the education program. The data were analyzed using descriptive statistics and the paired t-test. RESULTS: Nurses' knowledge and self-efficacy showed a statistically significant improvement after participation in the education program on nursing care for children with epilepsy. CONCLUSION: The application of this education program for hospital setting is expected to improve nurses' capability to care for children with epilepsy, thereby contributing to a higher quality of nursing.
Child ; Classification ; Diagnosis ; Education ; Education, Nursing ; Emergency Service, Hospital ; Epilepsy ; Humans ; Lectures ; Nervous System Diseases ; Nursing Care ; Nursing ; Pamphlets ; Seizures

PURPOSE: The purpose of this study was to review the literature on intervention studies for abused children and adolescent in residential facilities in South Korea (ACARF-K). The goal was to understand the problems they experience, to evaluate the content and effectiveness of interventions applied to them, and to develop evidence-based nursing intervention programs. METHODS: We used four electronic databases to search for relevant articles. 18 studies according to Whittemore and Knafl's integrative review method to synthesize the literature. RESULTS: The ACARF-K experienced problems in biophysical, psychological, and sociocultural domains related to attachment impairment. Effective intervention strategies were building trust through empathy and fulfillment of needs, encouraging ACARF-K to express themselves and helping them to clarify emotions in an unthreatening environment, and improving their self-concept through activities in which they experienced achievement. CONCLUSION: Interventions are needed to help restore attachment damage among ACARF-K. The interventions in this study utilized emotional, cognitive, relational, and behavioral therapeutic tools to improve their psychological and social capacities. Future intervention programs for ACARF-K should include these key elements.
Adolescent ; Child Abuse ; Child Protective Services ; Child ; Domestic Violence ; Emergency Shelter ; Empathy ; Evidence-Based Nursing ; Group Homes ; Humans ; Korea ; Methods ; Residential Facilities

BACKGROUND AND OBJECTIVES: Noise levels and room acoustic parameters at a tertiary referral hospital, Seoul National University Hospital (SNUH) in Korea, are investigated. MATERIALS AND METHODS: Through a questionnaire, acoustically problematic rooms are identified. Noise levels in emergency rooms (ERs) and intensive care units (ICUs) are measured over about three days. Acoustically critical and problematic rooms in the otolaryngology department are measured including examination rooms, operating rooms, nurse stations, receptions, and patient rooms. RESULTS: The A-weighted equivalent noise level, L(Aeq), ranges from 54 to 56 dBA, which is at least 10 dB lower than the noise levels of 65 to 73 dBA measured in American ERs. In an ICU, the noise level for the first night was 66 dBA, which came down to 56 dBA for the next day. The noise levels during three different ear surgeries vary from 57 to 62 dBA, depending on the use of surgical drills and suctions. The noise levels in a patient room is found to be 47 dBA, while the nurse stations and the receptions have high noise levels up to 64 dBA. The reverberation times in an operation room, examination room, and single patient room are found to be below 0.6 s. CONCLUSIONS: At SNUH, the nurse stations and receptions were found to be quite noisy. The ERs were quieter than in the previous studies. The measured reverberation times seemed low enough but some other nurse stations and examination rooms were not satisfactory according to the questionnaire.
Acoustics ; Ear ; Emergency Service, Hospital ; Intensive Care Units ; Korea ; Noise ; Nursing Stations ; Operating Rooms ; Otolaryngology ; Patients' Rooms ; Seoul ; Suction ; Tertiary Care Centers

PURPOSE: This study focuses on investigating the effectiveness of simulation education on emergency management using a low-fidelity simulator as related to clinical skill performance, self-confidence, knowledge, learning satisfaction, and critical thinking disposition in new nurses. METHODS: A pre-post test experimental design of nonequivalent control group was applied. Fifty-five new nurses were recruited, 28 nurses for the experimental group and 27 nurses for the control group. A simulation education for emergency management comprising knowledge lecture, team learning, skill education, team simulation, and debriefing was developed and implemented from Feb. 14 to 27, 2015. Data were analyzed with percentage, average, and standard deviation, chi-square, and t-test using SPSS. RESULTS: The experimental group showed significantly higher knowledge (t=5.81, p<.001), clinical skill performance (t=10.08, p<.001), self-confidence (t=-6.24, p<.001), critical thinking disposition (t=2.42, p=.019), and learning satisfaction (t=4.21, p<.001) for emergency management compared with the control group who had traditional lecture education. CONCLUSION: The results indicate that a simulation education using a low-fidelity simulator is an efficient teaching method for new nurses to deepen their clinical skill performance, self-confidence, knowledge, learning satisfaction, and critical thinking disposition in learning emergency management.
Clinical Competence ; Education ; Emergencies ; Emergency Nursing ; Evaluation Studies as Topic ; Learning ; Patient Simulation ; Research Design ; Teaching ; Thinking

PURPOSE: The purpose of this study was to develop an informational leaflet on emergency care and to explore effects of facilitative nurse-patient interaction behavior using an informational leaflet on patient satisfaction with nurse-patient interaction behavior, patient anxiety, and patient satisfaction with use of emergency care. METHODS: This study was a quasi-experimental study that applied a nonequivalent control-group posttest-only design. The participants were 81 patients who visited the emergency department of a hospital in Korea; the experimental group (n=40) received facilitative nurse-patient interaction behavior using an informational leaflet, and the control group (n=41) received care under routine protocols without an information leaflet. The effects of the two groups were analyzed using an independent t-test with SPSS computer program. RESULTS: Patient satisfaction with nurse-patient interaction behavior and use of emergency care in the experimental group were significantly higher than in the control group. Patient anxiety related to using emergency care in the experimental group was significantly lower than the control group. CONCLUSION: Therefore, facilitative nurse-patient interaction behavior using an informational leaflet to the patient may be useful interventions that are easily implemented by nurses in emergency settings.
Anxiety ; Emergencies ; Emergency Medical Services ; Emergency Nursing ; Emergency Service, Hospital ; Humans ; Korea ; Non-Randomized Controlled Trials as Topic ; Nurse-Patient Relations ; Patient Satisfaction

PURPOSE: Although emergency care is one of the most important capabilities for novice nurses, many novice nurses have shown difficulty in emergency care in the clinical field. The purpose of this study was to provide evidence data for the future development of educational programs by analyzing the priorities in emergency care of novice nurses using the Importance-Performance Analysis. METHODS: This study was designed as a descriptive survey. The participants were 197 novice nurses who worked in general hospitals from August 1 to 31, 2018. The questionnaire consisted of ‘common emergency care’, ‘cardiovascular emergency care’, ‘nervous system emergency care’, ‘respiratory system emergency care’, ‘communication and teamwork competency’. RESULTS: As a result of this study, ‘communication and teamwork’ among emergency cares was evaluated as the most important capability in the clinical field. In the Importance-Performance Analysis, a total of 12 items were included in the quadrant A, including 5 items related to ‘cardiovascular emergency care’, 4 items to ‘respiratory system emergency care’, 2 items to ‘nervous system emergency care’ and 1 item to ‘common emergency care’. The results showed a need for intensive improvement in items included in quadrant A which are the high importance low performance items. CONCLUSION: In order to improve the emergency care of novice nurses, a variety of emergency care education programs on the nervous system and respiratory system care should be implemented as well as cardiovascular emergency care education.
Clinical Competence ; Education ; Emergencies ; Emergency Medical Services ; Emergency Nursing ; Hospitals, General ; Nervous System ; Respiratory System