Background: In 2023, we experienced an outbreak from a case of undiagnosed crusted scabies, resulting in a significant number of exposed individuals and secondary cases. In this report, we describe the outbreak control measures, the attack rate, and the risk factors for acquisition of scabies among healthcare workers (HCWs). Methods: This study was conducted in a 2,700-bed tertiary care hospital in Seoul, South Korea. The attack rate was defined both for microscopic proven cases per exposed individuals and as the sum of proven and probable cases per exposed individuals. Outbreak control measures included identifying and treating all potentially exposed individuals with or without symptoms, as well as environmental disinfection. Results: From the index, there was potential quinary transmission resulting in 63 proven cases, 142 probable cases, and a total of 1,820 exposed individuals, including 734 contacts from the index case. The attack rate from the index was 7% (50/734) based on proven cases and 19% (138/734) based on proven and probable cases. Among the 526 HCWs who received preemptive topical treatment with permethrin applied once, 21 (4%) were later diagnosed as scabies. In addition, 5 of 20 HCWs (25%) with initial proven scabies had a persistent positive microscopic exam after four permethrin treatments. In the case group, there were significantly more nurses (60% vs. 43%, P = 0.007) and nurse assistants (20% vs. 9%, P = 0.006). There were significantly more cases than controls involving direct contact with the index case (94% vs. 64%, P < 0.001). Conclusion Lowering the threshold for suspicion of crusted scabies is important, as a single missed case could lead to a large outbreak. Simultaneously applying preemptive permethrin cream to all potentially exposed individuals might have been effective in preventing further transmission. However, caution is needed because the development of scabies or persistent scabies is possible even with preemptive or therapeutic treatment.

Background: In 2023, we experienced an outbreak from a case of undiagnosed crusted scabies, resulting in a significant number of exposed individuals and secondary cases. In this report, we describe the outbreak control measures, the attack rate, and the risk factors for acquisition of scabies among healthcare workers (HCWs). Methods: This study was conducted in a 2,700-bed tertiary care hospital in Seoul, South Korea. The attack rate was defined both for microscopic proven cases per exposed individuals and as the sum of proven and probable cases per exposed individuals. Outbreak control measures included identifying and treating all potentially exposed individuals with or without symptoms, as well as environmental disinfection. Results: From the index, there was potential quinary transmission resulting in 63 proven cases, 142 probable cases, and a total of 1,820 exposed individuals, including 734 contacts from the index case. The attack rate from the index was 7% (50/734) based on proven cases and 19% (138/734) based on proven and probable cases. Among the 526 HCWs who received preemptive topical treatment with permethrin applied once, 21 (4%) were later diagnosed as scabies. In addition, 5 of 20 HCWs (25%) with initial proven scabies had a persistent positive microscopic exam after four permethrin treatments. In the case group, there were significantly more nurses (60% vs. 43%, P = 0.007) and nurse assistants (20% vs. 9%, P = 0.006). There were significantly more cases than controls involving direct contact with the index case (94% vs. 64%, P < 0.001). Conclusion Lowering the threshold for suspicion of crusted scabies is important, as a single missed case could lead to a large outbreak. Simultaneously applying preemptive permethrin cream to all potentially exposed individuals might have been effective in preventing further transmission. However, caution is needed because the development of scabies or persistent scabies is possible even with preemptive or therapeutic treatment.

Purpose: This study aimed to provide a theoretical basis for the handoff communication of operating room (OR) nurses by defining and organizing the concept behind it. Methods: For this study, we analyzed five articles found through a literature search using Walker and Avant’s conceptual analysis. Results: An analysis of OR nurses’ handoff communication shows that its antecedents include individual competencies, performance experience, improving interpersonal relationships, securing the OR environment, and the existence of relevant protocols. Additionally, effective handoff communication possesses attributes such as conciseness and accuracy of verbal communication, the ability to convey information concisely and accurately, OR resource availability and risk factors, timeliness of communication, and structured handoff communication protocols related to surgeries. These factors improve patient safety and result in the consistent communication of patient information, improved teamwork, and increased work efficiency. Conclusion This study can enhance the understanding of handoff communication among perioperative nurses and be used to help develop a systematic protocol. Additionally, it can serve as a foundation for constructing a theory of handoff communication and for formulating guidelines specific to the OR.

Purpose: This study aimed to provide a theoretical basis for the handoff communication of operating room (OR) nurses by defining and organizing the concept behind it. Methods: For this study, we analyzed five articles found through a literature search using Walker and Avant’s conceptual analysis. Results: An analysis of OR nurses’ handoff communication shows that its antecedents include individual competencies, performance experience, improving interpersonal relationships, securing the OR environment, and the existence of relevant protocols. Additionally, effective handoff communication possesses attributes such as conciseness and accuracy of verbal communication, the ability to convey information concisely and accurately, OR resource availability and risk factors, timeliness of communication, and structured handoff communication protocols related to surgeries. These factors improve patient safety and result in the consistent communication of patient information, improved teamwork, and increased work efficiency. Conclusion This study can enhance the understanding of handoff communication among perioperative nurses and be used to help develop a systematic protocol. Additionally, it can serve as a foundation for constructing a theory of handoff communication and for formulating guidelines specific to the OR.

Background: In 2023, we experienced an outbreak from a case of undiagnosed crusted scabies, resulting in a significant number of exposed individuals and secondary cases. In this report, we describe the outbreak control measures, the attack rate, and the risk factors for acquisition of scabies among healthcare workers (HCWs). Methods: This study was conducted in a 2,700-bed tertiary care hospital in Seoul, South Korea. The attack rate was defined both for microscopic proven cases per exposed individuals and as the sum of proven and probable cases per exposed individuals. Outbreak control measures included identifying and treating all potentially exposed individuals with or without symptoms, as well as environmental disinfection. Results: From the index, there was potential quinary transmission resulting in 63 proven cases, 142 probable cases, and a total of 1,820 exposed individuals, including 734 contacts from the index case. The attack rate from the index was 7% (50/734) based on proven cases and 19% (138/734) based on proven and probable cases. Among the 526 HCWs who received preemptive topical treatment with permethrin applied once, 21 (4%) were later diagnosed as scabies. In addition, 5 of 20 HCWs (25%) with initial proven scabies had a persistent positive microscopic exam after four permethrin treatments. In the case group, there were significantly more nurses (60% vs. 43%, P = 0.007) and nurse assistants (20% vs. 9%, P = 0.006). There were significantly more cases than controls involving direct contact with the index case (94% vs. 64%, P < 0.001). Conclusion Lowering the threshold for suspicion of crusted scabies is important, as a single missed case could lead to a large outbreak. Simultaneously applying preemptive permethrin cream to all potentially exposed individuals might have been effective in preventing further transmission. However, caution is needed because the development of scabies or persistent scabies is possible even with preemptive or therapeutic treatment.

Purpose: This study aimed to provide a theoretical basis for the handoff communication of operating room (OR) nurses by defining and organizing the concept behind it. Methods: For this study, we analyzed five articles found through a literature search using Walker and Avant’s conceptual analysis. Results: An analysis of OR nurses’ handoff communication shows that its antecedents include individual competencies, performance experience, improving interpersonal relationships, securing the OR environment, and the existence of relevant protocols. Additionally, effective handoff communication possesses attributes such as conciseness and accuracy of verbal communication, the ability to convey information concisely and accurately, OR resource availability and risk factors, timeliness of communication, and structured handoff communication protocols related to surgeries. These factors improve patient safety and result in the consistent communication of patient information, improved teamwork, and increased work efficiency. Conclusion This study can enhance the understanding of handoff communication among perioperative nurses and be used to help develop a systematic protocol. Additionally, it can serve as a foundation for constructing a theory of handoff communication and for formulating guidelines specific to the OR.

Background: In 2023, we experienced an outbreak from a case of undiagnosed crusted scabies, resulting in a significant number of exposed individuals and secondary cases. In this report, we describe the outbreak control measures, the attack rate, and the risk factors for acquisition of scabies among healthcare workers (HCWs). Methods: This study was conducted in a 2,700-bed tertiary care hospital in Seoul, South Korea. The attack rate was defined both for microscopic proven cases per exposed individuals and as the sum of proven and probable cases per exposed individuals. Outbreak control measures included identifying and treating all potentially exposed individuals with or without symptoms, as well as environmental disinfection. Results: From the index, there was potential quinary transmission resulting in 63 proven cases, 142 probable cases, and a total of 1,820 exposed individuals, including 734 contacts from the index case. The attack rate from the index was 7% (50/734) based on proven cases and 19% (138/734) based on proven and probable cases. Among the 526 HCWs who received preemptive topical treatment with permethrin applied once, 21 (4%) were later diagnosed as scabies. In addition, 5 of 20 HCWs (25%) with initial proven scabies had a persistent positive microscopic exam after four permethrin treatments. In the case group, there were significantly more nurses (60% vs. 43%, P = 0.007) and nurse assistants (20% vs. 9%, P = 0.006). There were significantly more cases than controls involving direct contact with the index case (94% vs. 64%, P < 0.001). Conclusion Lowering the threshold for suspicion of crusted scabies is important, as a single missed case could lead to a large outbreak. Simultaneously applying preemptive permethrin cream to all potentially exposed individuals might have been effective in preventing further transmission. However, caution is needed because the development of scabies or persistent scabies is possible even with preemptive or therapeutic treatment.

Purpose: This study aimed to determine the mediating effect of leader-member exchange (LMX) on the relationship between nursing unit managers’ethical leadership and nurses’turnover intentions. Methods: A cross-sectional nationwide survey was performed using structured questionnaires. A total of 225 clinical nurses working in general tertiary hospitals were recruited through proportional quota sampling; the quota used represented the location of working hospitals in South Korea. Data were collected through an online survey and snowball sampling from June to September 2022 and analyzed using the SPSS 25.0 program. A mediation analysis was performed using a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval. Results: In bootstrapping, the indirect effect (X→M→Y) was statistically significant (B=-0.77, 95% CI:-1.02 to -0.50). LMX showed a mediating effect on the relationship between nursing unit managers’ethical leadership and clinical nurses’ turnover intention. In this model, the total effect was B=-0.93 (p<.001). Conclusion These findings suggest that LMX must be considered when making a strategy for nursing retention in the hospital setting. Nursing unit managers with ethical leadership could decrease nurses’ turnover intention by improving the LMX.

Background: s/Aims: Artificial intelligence (AI) technology has been used to assess surgery quality, educate, and evaluate surgical performance using video recordings in the minimally invasive surgery era. Much attention has been paid to automating surgical workflow analysis from surgical videos for an effective evaluation to achieve the assessment and evaluation. This study aimed to design a deep learning model to automatically identify surgical phases using laparoscopic cholecystectomy videos and automatically assess the accuracy of recognizing surgical phases. Methods: One hundred and twenty cholecystectomy videos from a public dataset (Cholec80) and 40 laparoscopic cholecystectomy videos recorded between July 2022 and December 2022 at a single institution were collected. These datasets were split into training and testing datasets for the AI model at a 2:1 ratio. Test scenarios were constructed according to structural characteristics of the trained model. No pre- or post-processing of input data or inference output was performed to accurately analyze the effect of the label on model training. Results: A total of 98,234 frames were extracted from 40 cases as test data. The overall accuracy of the model was 91.2%. The most accurate phase was Calot’s triangle dissection (F1 score: 0.9421), whereas the least accurate phase was clipping and cutting (F1 score:0.7761). Conclusions Our AI model identified phases of laparoscopic cholecystectomy with a high accuracy.

Purpose: This study aimed to determine the mediating effect of leader-member exchange (LMX) on the relationship between nursing unit managers’ethical leadership and nurses’turnover intentions. Methods: A cross-sectional nationwide survey was performed using structured questionnaires. A total of 225 clinical nurses working in general tertiary hospitals were recruited through proportional quota sampling; the quota used represented the location of working hospitals in South Korea. Data were collected through an online survey and snowball sampling from June to September 2022 and analyzed using the SPSS 25.0 program. A mediation analysis was performed using a simple mediation model applying the PROCESS macro with 95% bias-corrected bootstrap confidence interval. Results: In bootstrapping, the indirect effect (X→M→Y) was statistically significant (B=-0.77, 95% CI:-1.02 to -0.50). LMX showed a mediating effect on the relationship between nursing unit managers’ethical leadership and clinical nurses’ turnover intention. In this model, the total effect was B=-0.93 (p<.001). Conclusion These findings suggest that LMX must be considered when making a strategy for nursing retention in the hospital setting. Nursing unit managers with ethical leadership could decrease nurses’ turnover intention by improving the LMX.