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

BACKGROUND: Healthcare-associated infection (HAI) affects the morbidity and mortality of inpatients worldwide. Nepal is a developing country in which HAIs pose a major problem in terms of patient safety. Therefore, this study was designed to assess the level of knowledge and attitude toward HAIs and compliance for infection control among nurses. METHODS: A cross-sectional survey was conducted using a self-administered questionnaire including general characteristics, and knowledge of, attitude toward, and compliance with HAI control practices, on a sample of 259 nurses from 11 hospitals in 3 cities in Nepal, from July 17 to August 5, 2014. RESULTS: The average score on knowledge of HAI was 6.56, on a 13-point scale. In total, 59 nurses had undergone HAI control training and 211 nurses reported that they were governed by some guidelines, but there were no significant differences. The overall level of compliance with HAI control guidelines was 79.2 points based on a 100-point scale, which did not differ in terms of age, exposure to infection control training, and the presence of any guidelines. CONCLUSION: The level of knowledge of HAI control among nurses was very low and a majority had never undergone any HAI control training. Evidently, there is an urgent need to provide HAI control training to nurses, and to develop infrastructure to provide training for them.
Compliance* ; Cross-Sectional Studies ; Developing Countries ; Humans ; Infection Control* ; Inpatients ; Mortality ; Nepal* ; Patient Safety

The recent trends and future of infection control are anticipated to be as follows: Most hospitals will develop a nationwide network and cooperate with governmental and public institutions for infection control. The importance of environmental hygiene will be reappraised. Universal decolonization will be a mainstream intervention for the pre-emptive eradication of various nosocomial pathogens. Molecular technology could become a routine practice in many clinical fields. Advances in information technology (IT) will have a profound impact on infection control. For example, applications of big data and tracking technology using wearable devices are already underway. Infection control in the future will be a coordinated system involving governmental regulation, IT and molecular technology.
Biotechnology ; Hygiene ; Infection Control* ; Republic of Korea*

BACKGROUND: Nursing students may be exposed to patients with infectious diseases such as hepatitis B and hepatitis A through needle stick injuries or close contact during their clinical practice. This study surveyed the presence of antihepatitis B virus (anti-HBV), anti-hepatitis A virus (anti-HAV), and anti-varicella zoster virus antibodies in nursing students before the initiation of their clinical practice to help prevent subsequent infections. METHODS: From 2009 to 2013, the junior students of a nursing college in Jeollabuk-do were tested for antibodies against the hepatitis B, hepatitis A, and varicella zoster viruses before the initiation of their clinical practice. RESULTS: The students tested positive for anti-HBV (46.2-57.1%), anti-HAV (0-10.5%), and anti-varicella zoster antibodies (80.2-90.2%). No significant differences in the positivity rates were observed with respect to the year of their enrollment. CONCLUSION: This study was a survey of the seroprevalence of anti-HBV, anti-HAV, and anti-varicella zoster antibodies in nursing students before they started their clinical practice. The positivity rate of anti-HAV was lower than 10%. In order to prevent infection, it is necessary to test nursing students for the presence of antibodies against hepatitis B, hepatitis A, varicella, measles, mumps, and rubella, and check their vaccination history as recommended in the adult immunization schedule. Vaccination must be recommended for students who test negative for the respective antibodies.
Adult ; Antibodies* ; Chickenpox ; Communicable Diseases ; Hepatitis A ; Hepatitis A Antibodies ; Hepatitis B ; Hepatitis B Antibodies ; Herpes Zoster* ; Herpesvirus 1, Cercopithecine* ; Herpesvirus 3, Human ; Humans ; Immunization Schedule ; Jeollabuk-do ; Measles ; Mumps ; Needlestick Injuries ; Nursing* ; Rubella ; Seroepidemiologic Studies* ; Students, Nursing* ; Vaccination

BACKGROUND: This study aimed to assess central supply room nurses' knowledge on and educational needs for the sterilization process. METHODS: The participants were 88 nurses working at central supply rooms of hospitals in Busan, Ulsan, and Gyeong-nam. From August to September 2014, knowledge and educational needs of the sterilization process were measured by using self-reported questionnaires. Data were analyzed by descriptive statistics, t test or analysis of variance (ANOVA), Scheffe test, and repeated-measures ANOVA with the SPSS 21.0 program. RESULTS: The mean score for knowledge on the sterilization process was 39.58 out of 50 points and was highest in keeping sterilization (8.94 out of 10 points) and lowest in packing sterilization (6.82 out of 10 points). The mean score for knowledge was significantly higher in the nurses with postgraduate studies (F=3.35, P=0.040), in those with internal training (t=2.03, P=0.045), with three or more internal trainings (F=9.72, P<0.001), with external training (t=3.48, P=.001), with two or more external trainings (F=8.40, P=0.001), and in those working in hospitals with 700 beds or more (F=15.88, P<0.001). The mean score for educational need was 4.06 out of 5 points, ranging from 3.99 to 4.12 points. It was significantly higher in nurses aged 40 years and older (F=4.28, P=0.017) and in those working in hospitals with 700 beds or more (F=4.82, P=0.010). CONCLUSION: Nurses working in central supply rooms need education on the sterilization process. We recommend the development of a standardized textbook and an educational program based on the results of this study.
Busan ; Education ; Sterilization* ; Ulsan

BACKGROUND: Prevention of respiratory infection among workers in geriatric facilities is important because the workers can transmit these infections to the elderly. Therefore, this study intended to assess the knowledge and compliance of preventive behavior against respiratory tract infection among these workers. METHODS: Data were collected from 202 workers in geriatric facilities via a questionnaire-based survey from July 19 to August 8, 2014. Data were analyzed using the SPSS 21.0 program. RESULTS: Among the workers, 44.6% experienced respiratory tract infection in the last 1 year. The score for knowledge of respiratory tract infection prevention among the workers was 10.6 points out of 12. The average score for compliance of the preventive behavior against respiratory tract infection was 34.6 points out of 48. The correlation between preventive knowledge and compliance of the preventive behavior against respiratory tract infection was not verified (r=0.00, P=0.967). CONCLUSION: In this study, the level of knowledge of respiratory infection prevention among the workers in the elderly care facility was high. However, the level of compliance was not sufficiently high. In addition, no correlation was found between their preventive knowledge and compliance. Therefore, a preventive program that focuses on the compliance of respiratory infection prevention rather than on its knowledge needs to be developed.
Aged ; Compliance* ; Humans ; Respiratory System* ; Respiratory Tract Infections*

BACKGROUND: In this report, we present the annual data of the intensive care unit (ICU) module of the Korean Nosocomial Infections Surveillance System (KONIS) from July 2013 through June 2014. METHODS: We performed a prospective surveillance of nosocomial urinary tract infections (UTIs), bloodstream infections (BSIs), and pneumonia (PNEU) in 166 ICUs of 94 hospitals using the KONIS. Nosocomial infection (NI) rate was defined as the number of infections per 1,000 patient-days or device-days. RESULTS: A total of 2,843 NIs were found during the study period: 861 UTIs (846 were urinary catheter-associated), 1,173 BSIs (1,021 were central line-associated), and 809 PNEUs (498 were ventilator-associated). The rate of urinary catheter-associated UTIs was 1.21 per 1,000 device-days (95% confidence interval [CI]=1.13-1.29), and the urinary catheter utilization ratio was 0.84 (95% CI=0.839-0.841). The rate of central line-associated BSIs was 2.33 per 1,000 device-days (95% CI=2.20-2.48), and the utilization ratio was 0.53 (95% CI=0.529-0.531). The rate of ventilatorassociated PNEUs (VAPs) was 1.46 per 1,000 device-days (95% CI=1.34-1.60), and the utilization ratio was 0.41 (95% CI=0.409-0.411). In hospitals with more than 900 beds, although the ventilator utilization ratio was highest, the rate of VAPs was lower than in hospitals with 300-699 or 700-899 beds. CONCLUSION: BSIs were the most commonly reported nosocomial infections. Although device utilization ratios had increased, nosocomial infection rates did not differ significantly from those during the previous period (July 2012 through June 2013).
Cross Infection* ; Intensive Care Units* ; Critical Care* ; Pneumonia ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections ; Ventilators, Mechanical

BACKGROUND: The Korean Society for Nosocomial Infection Control (KOSNIC) ran a surveillance system, called as Korean Nosocomial Infections Surveillance (KONIS), since July 2006. Here, we report the annual data of the intensive care unit (ICU) module of the system from July 2012 through June 2013. METHODS: This is a prospective surveillance of nosocomial urinary tract infections (UTI), bloodstream infections (BSI), and pneumonia (PNEU) at 161 ICUs in 91 hospitals using the KONIS system. The nosocomial infection (NI) rate was calculated as the number of infections per 1,000 patient days or device days. RESULTS: A total of 3,042 NIs were reported during the study period: 877 UTIs (854 cases were urinary catheter-associated), 1,272 BSIs (1,096 were central line-associated), and 893 PNEUs (526 cases were ventilator-associated). The rate of urinary catheter-associated UTIs (CAUTIs) was 1.26 cases per 1,000 device days (95% confidence interval; 1.18-1.34) and urinary catheter utilization ratio was 0.78 (0.779-0.781). The rate of central line-associated BSIs was 2.57 (2.42-2.72) and the utilization ratio was 0.49 (0.489-0.491). The rate of ventilator-associated PNEUs was 1.64 (1.50-1.78) and the utilization ratio was 0.37 (0.369-0.371). The urinary catheter utilization ratio was lower in the ICUs of hospitals with 400-699 beds than in those of hospitals with more than 900 beds; nevertheless, CAUTIs were more common in the hospitals with 400-699 beds. The central line-associated BSI (CLABSI) rate was lower in the study period than in the previous period of July 2011-June 2012 [2.57 (2.42-2.72) vs. 3.01 (2.84-3.19)]. CONCLUSION: The CLABSI rates were lower in the study period than those in the previous years. CAUTIs were more common in the ICUs of hospitals with 400-699 beds than in those of larger hospitals.
Cross Infection* ; Humans ; Intensive Care Units* ; Critical Care* ; Pneumonia ; Prospective Studies ; Urinary Catheters ; Urinary Tract Infections

BACKGROUND: Most studies on the incidence rate (IR) and post-exposure reporting rate (RR) of needle-stick injuries (NSIs) were performed using retrospective surveillance, which is vulnerable to recall bias. This study aimed to identify the agreement between IRs and RRs obtained from prospective and retrospective surveillance. METHODS: The prospective surveillance was performed with 716 nurses working at 3 hospitals from August to September in 2012. They prospectively reported when they experienced the NSIs, and the investigator retrospectively calculated the RR from records in the infection control unit or health care unit during the same periods when they reported the number of NSIs. The retrospective surveillance was carried out with 312 nurses who participated in the prospective surveillance. They retrospectively answered the question on the number of NSIs and post-exposure reporting after recalling the experienced NSI from August to September in 2012. RESULTS: The IR of NSIs was 9.8 per 100 nurses by the prospective surveillance and 36.4 per 100 nurses by the retrospective surveillance, which was statistically significantly different (P<0.001). The RR of NSIs was 14.3% by the prospective surveillance and 8.5% by the retrospective surveillance, which was not statistically significantly different. CONCLUSION: We recommend using a prospective approach for calculating the IR of NSIs to reduce the risk of recall bias. However, the RR of NSIs can be calculated using both prospective and retrospective approaches.
Bias (Epidemiology) ; Delivery of Health Care ; Humans ; Incidence* ; Infection Control ; Memory ; Needlestick Injuries* ; Prospective Studies* ; Research Personnel ; Retrospective Studies*

BACKGROUND: Patients infected with vancomycin-resistant enterococci (VRE) are kept in isolation to prevent the spread of VRE in medical facilities. However, decision-making regarding isolation can be challenging at the time of re-admission of previously VRE-colonized or infected patients who have not been examined for VRE infections for a long time. This study focused on providing guidelines for isolating VRE patients based on the analysis of risk factors for prolonged carriage and reacquisition of VRE. METHODS: A retrospective review was performed on medical records of patients who were diagnosed with VRE infections at a university hospital in 2009. Durations of colonization and negative conversion of VRE were estimated by Kaplan-Meier methods. Prolonged duration of VRE infections and risk factors for reacquisition were analyzed using Cox's proportional hazard model. RESULTS: Among 220 VRE-colonized patients, 132 were cleared, and 30 reacquired after negative conversion of VRE. The median duration of colonization was 33.1 weeks, and the median clearance period was 19.4 weeks. Patients who were admitted via the emergency department and treated with glycopeptides tended to have prolonged duration of VRE colonization. Prolonged hospitalization and metronidazole therapy increased the risk of reacquisition more rapidly. CONCLUSION: Treatment with glycopeptides, metronidazole antibiotic therapy, history of admission via the emergency department, and prolonged hospitalization can affect to prolonged carriage and reacquisition of VRE. Consider carefully the release of isolation of VRE patients with these risk factors.
Colon ; Emergency Service, Hospital ; Enterococcus ; Glycopeptides ; Hospitalization ; Humans ; Medical Records ; Metronidazole ; Patient Isolation ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors* ; Vancomycin Resistance