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 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 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 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 describe the desperate situation where the clinician should make decisions to further manage patients having experienced adverse drug reaction (ADR) to lamotrigine that is indicated to not easily controlled neuropsychiatric diseases. Methods: A descriptive analysis was done by thoroughly reviewing medical records of patients who were reported to have ADR to lamotrigine in a regional drug-safety center between 2010 and 2018. Results: Eighty-four cases of lamotrigine-related ADRs occurred in 80 patients. Skin lesions were most commonly observed in 70 cases (83.3%) and 14 cases (16.7%) had severe ADRs. Sixty-three subjects (78.8%) discontinued lamotrigine, while 17 (21.3%) continued it.At the time of discontinuation, 30.0% were prescribed aromatic antiepileptic drugs. Among 4 subjects who were eventually prescribed lamotrigine again after a period of discontinuation, 3 (75.0%) experienced its recurrence. Among patients who had taken alternative medications, the incidence of ADRs was higher in those being prescribed aromatic antiepileptic drugs than in the others being prescribed other than aromatic antiepileptic drugs (P = 0.013). Regarding the control of underlying diseases, as many as 65 (86.7%) and 68 (90.7%) failed to reach maintaining the resolved state from 6 months and 12 months after the substitution, respectively. Conclusion Patients can be easily trapped between the recurrence of ADRs and the treatment failure to a certain drug like lamotrigine, in which we can hardly find a reasonable alternative to manage them.

Objectives: This study aimed to analyze menu patterns and food group diversity in daycare centers managed by the Center for Children's Foodservice Management in South Korea. Methods: Data from 18 Center for Children's Foodservice Management centers across various provinces (excluding Jeju Island) were analyzed. We examined 8,796 meals served in February, May, August, and December 2021, focusing on seasonal lunch and snack menus for children aged 3-5. Foods were categorized into 19 groups for lunch and 21 for snacks. The frequency of food groups and dietary patterns were assessed using the Dietary Diversity Score. Analyses were conducted using Excel 2016 and IBM SPSS Statistics version 28. Results: Most lunch menus (89%) included five menu items, with a ratio of grain, meat, and vegetables at 88%. Snack menus typically had one item (57%), with significantly more items in the afternoon compared to the morning (P < 0.001). Regarding snack patterns, 75.2% of morning snacks and 61.1% of afternoon snacks contained only one solid food and drink (P < 0.001). Fruit and milk (22.4%) was the most prevalent pattern in morning snacks, while grain and milk (31%) dominated afternoon snacks (P < 0.001). Only 48% of daycare center menus (all snacks and lunch) included all five food groups (grain, meat, vegetables, fruit, and milk). Notably, only 83% included milk and 57% included fruit. Conclusions These findings highlight the need to improve food variety and diversity in the Center for Children’s Foodservice Management-managed daycare center menus.Developing more detailed guidelines for menu structure and food composition is crucial to ensure children receive balanced and diverse nutrition.

Background: There have been no health-related studies of pre-employed firefighters without firefighter-specific job-related factors (FSJRF). This study aimed to evaluate the sleep quality of pre-employed firefighters and to examine the relationship between sleep quality and psychosocial factors. Methods: We conducted a self-report questionnaire survey for 602 pre-employed firefighters at 3 Fire Service Academies after brief lecture about sleep. Sleep quality and psychosocial variables such as depression, anxiety, stress and social support were evaluated. The independent 2 sample t-test, χ2 test and multiple logistic regression analysis were used to evaluate the effect of the variables on the sleep quality of pre-employed firefighters. Results: Among a total of 602 people, 347 (57.6%) had good sleep quality and 255 (42.4%) had poor sleep quality. Pittsburgh Sleep Quality Index score of them was 3.29 ± 1.41) and 7.87 ± 2.20), respectively. 24 (4.0%) were evaluated to have insomnia by Insomnia Severity Index.Logistic regression analyses showed that the depression (adjusted odds ratio [aOR]: 5.940, 95% confidence interval [CI]: 3.124–11.292), anxiety (aOR: 4.233, 95% CI: 2.138–8.381), stress (aOR: 2.880, 95% CI: 1.915–4.330) and social support (aOR: 0.959, 95% CI: 0.939–0.980) have a significant effect on sleep quality after adjusted by sex, age, smoking status, drinking status, caffeine intake, past shift working and circadian rhythm type. Conclusions Depression, anxiety, stress and social support were associated with sleep quality among pre-employed firefighters. Repeated follow-up studies of pre-employed firefighters are needed to further assess their change of sleep quality and identify the FSJRF that may affect the sleep quality of firefighters.

Background: There have been no health-related studies of pre-employed firefighters without firefighter-specific job-related factors (FSJRF). This study aimed to evaluate the sleep quality of pre-employed firefighters and to examine the relationship between sleep quality and psychosocial factors. Methods: We conducted a self-report questionnaire survey for 602 pre-employed firefighters at 3 Fire Service Academies after brief lecture about sleep. Sleep quality and psychosocial variables such as depression, anxiety, stress and social support were evaluated. The independent 2 sample t-test, χ2 test and multiple logistic regression analysis were used to evaluate the effect of the variables on the sleep quality of pre-employed firefighters. Results: Among a total of 602 people, 347 (57.6%) had good sleep quality and 255 (42.4%) had poor sleep quality. Pittsburgh Sleep Quality Index score of them was 3.29 ± 1.41) and 7.87 ± 2.20), respectively. 24 (4.0%) were evaluated to have insomnia by Insomnia Severity Index.Logistic regression analyses showed that the depression (adjusted odds ratio [aOR]: 5.940, 95% confidence interval [CI]: 3.124–11.292), anxiety (aOR: 4.233, 95% CI: 2.138–8.381), stress (aOR: 2.880, 95% CI: 1.915–4.330) and social support (aOR: 0.959, 95% CI: 0.939–0.980) have a significant effect on sleep quality after adjusted by sex, age, smoking status, drinking status, caffeine intake, past shift working and circadian rhythm type. Conclusions Depression, anxiety, stress and social support were associated with sleep quality among pre-employed firefighters. Repeated follow-up studies of pre-employed firefighters are needed to further assess their change of sleep quality and identify the FSJRF that may affect the sleep quality of firefighters.

Purpose: The purpose of this study was to analyze nurse staffing according to patients' acuity and dependency by measuring nursing hours. Methods: The study sample included patients who visited the adult emergency departments (EDs) of three tertiary referral hospitals and nurses who worked on shifts for 48 hours from October 24 to 26, 2019. Hourly patient census and nurse staffing were analyzed. Patient acuity was measured using the Korean Triage and Acuity Scale (KTAS), ranging from Level 1 (highest) to Level 5 (lowest). Patient dependency was measured using six items (e.g., clinical attention and communication) and classified into four groups. Nursing activities were observed every 10 minutes and nursing hours per patient and nurse staffing were analyzed according to acuity and dependency. Results: Nurse-to-patient ratio ranged from 1:1.8 to 1:4.2 during the 48 hours of observation. The average work hours of nurses, excluding breaks and meals, was 8.57 hours; 42.5% of which was spent providing direct care. Higher acuity and dependency were associated with higher nursing hours and staffing level. Patients with KTAS Level 1 were provided 74.3 minutes per hour, 5.02 times higher than Level 5 (14.8 minutes). Patients in the highest dependency group were provided 87.4 minutes per hour, 5.75 times higher than the lowest group (15.2 minutes). Newly arrived patients received more nursing hours than continuously stayed patients within the same KTAS Levels. Conclusion Large variations were found in hourly patient census, acuity, and dependency. Nurse staffing in EDs should be determined based on patient acuity and dependency.

Background: The platelet aggregation test is widely used to measure antiplatelet therapy response and to detect platelet function disorders. CS-5100 (Sysmex Co., Japan) is a recently introduced coagulation analyzer that can also measure platelet aggregation. We evaluated the performance of CS-5100 in the platelet aggregation test for use in clinical laboratories. Methods: We investigated the precision, stability, dilution test, and correlation of CS-5100 with a traditional aggregometer. Precision was tested using normal and patient samples. Stability was assessed over 5 different time points for 8 hours. The dilution test was performed with normal samples using ADP agonists. We tested correlations between the results of Chrono-log aggregometer (Chrono-Log Co., USA) and CS-5100 using 10 samples with 5 agonists each. We also calculated the reference range of 5 agonists using 22-30 normal samples. Results: The coefficients of variation using normal samples were 7.45% and 3.27% for ADP and arachidonic acid, respectively. Stability was maintained for up to 2 hours in most samples. Dilution tests showed similar results until reaching a dilution factor of 2. Strong correlations of the results between Chrono-log and CS-5100 were found, except for ristocetin. The reference ranges of 5 reagents in CS-5100 were similar to those obtained with the Chrono-log aggregometer. Conclusions The performance of CS-5100 in platelet aggregation tests showed reliable results compared to a traditional aggregometer. CS-5100 can perform coagulation test and platelet aggregation test, simultaneously. Thus, CS-5100 can enable cost saving and reduce turn-around-time by reducing the inspection time.