Infection Control Education Programs for Nursing Students: A Systematic Review / 기본간호학회지

Purpose@#The purpose of this study was to use a systematic review to investigate how infection control education has been designed, implemented and evaluated in undergraduate programs in nursing. @*Methods@#This study was conducted base on the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). To search studies related to infection control education programs, Ovid-EMBASE, CINAHL, Pubmed, KoreaMed, KMBASE and KISS were used. A total of 2,306 studies were identified, and 13 studies were selected for final analysis. @*Results@#Ten studies out of 13 were designed as pre-post, no control group, quasi-experimental study designs. Nosocomial infection and standard precautions related infection control education were the most frequently selected topics and online was the most common teaching-learning method. The infection control education programs showed significant effect on knowledge and attitude. The mean difference of 7 studies for knowledge was 5.1 (95% CI: 2.36, 8.67, p<.001) and the mean difference of 4 studies for attitude was 3.34 (95% CI: 0.12, 6.55, p<.001). @*Conclusion@#The results of this study indicate that infection control education effectively improves the knowledge, attitude and compliance of nursing students. Therefore, it is necessary to develop more specific educational programs that can reflect the changes of the times and the demands of clinical nurses.

Factors Affecting Quality of Life in Patients with Unruptured Intracranial Aneurysm: A Systematic Review / 기본간호학회지

Purpose@#The purpose of this study was to comprehensively explore factors affecting quality of life in patients with unruptured intracranial aneurysm (UIA). @*Methods@#This study was conducted base on the National Evidence-based Healthcare Collaborating Agency (NECA) and Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA). To search studies related to quality of life in patients with UIA. KoreaMed, Kmbase, Kiss, Pubmed, EMBASE, Cochrane Central and CINAHL were used. Key words were 'unruptured intracranial aneurysm', 'quality of life' and 'well-being'. A total of 136 studies were identified. After confirming duplication and abstracts, 15 studies were selected for analysis. @*Results@#As a result, factors affecting the quality of life in patients with UIA were categorized into individual factors, disease related factors, symptom related factors, and functional related factors. The Short form-36 was one of the most frequently used measurements. @*Conclusion@#To improve the quality of life of patients with UIA, researchers need to explore the multiple factors affecting quality of life in patients with UIA, and consider application of tools that can reflect the disease specific quality of life in patients with UIA.

Common Scope of Practice for Advanced Practice Nurses in Korea Derived from Expert Agreement / 중환자간호학회지

PURPOSE: This study aimed to propose a common scope of practice (SOP) for 13 specialties of Advanced Practice Nurses (APNs) in Korea.METHODS: The first draft of a common SOP was extracted from domestic and international laws with a literature review by 17 experts from the Korean Association of Advanced Practice Nurses (KAAPN). Then, the common SOP was finalized after comparing the activities of APNs in clinical settings.RESULTS: A total of 70 duties were identified and six categories were suggested for the common SOP. The SOP proposed by the KAAPN featured the following: 1) identification of and discrimination between health problems; 2) prescription and implementation of diagnostic tests; 3) treatment of injuries and diseases while implementing measures to prevent exacerbation; 4) prescription of medicinal products in line with 1) to 3); 5) referral and consultation; and 6) education and counseling. It was then confirmed that the proposed six categories in the common SOP reflected all the duties performed by APNs in clinical practice, including all 40 activities.CONCLUSION: The results of this study can be used as evidence for the legalization of a common SOP for APNs. Given the increasing multidisciplinary team approach adopted in Korean hospitals, it may be desirable to establish a broader SOP to reflect the diverse duties of APNs.

Importance-Performance Analysis (IPA) to Improve Emergency Care for Novice Nurses / 기본간호학회지

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.

Role Ambiguity of Comprehensive Nursing Care Unit Nurses: A Concept Analysis / 보건행정학회지

BACKGROUND@#The purpose of this study was to identify role ambiguity of comprehensive nursing care unit nurses.@*METHODS@#A concept analysis method by Walker and Avant was used to understand role ambiguity of comprehensive nursing care unit nurses.@*RESULTS@#The antecedents of role ambiguity of nurses at comprehensive nursing units were shortage of nurses, unclear admission criteria, and demands for customized nursing care according to severity. Attributes include ambiguity in role delegation, patient placement ambiguity, and professional ambiguity among nursing staff. The consequences were diminished job satisfaction due to excessive workload, difficulty in resolving role ambiguity due to the lack of work analysis studies, and poor outcome of nursing indicators.@*CONCLUSION@#Improvement of nationwide awareness for comprehensive nursing care unit is required. Clear division at scope of practice for nursing staff in accordance of each medical institution's characteristics is essential. Nurses at comprehensive nursing care unit should understand nature of role ambiguity that occurs as they work in large groups. Nurses should promote communications between nursing staff and they must have volition to improve status quo. An additional research of comprehensive nursing care on the causes of role ambiguity in the practice of nursing care for ward nurses is needed, and management measures should be sought at the organizational level.

The Influence of Nurses' Emotional Intelligence and Communication within the Organization on Teamwork in Armed Forces Hospitals / 산업간호학회지

PURPOSE: The purpose of this study was to identify the influence of nurses' emotional intelligence and communication within the organization on teamwork in Armed Forces hospitals. METHODS: This study employed a cross-sectional design with a convenience sample of 195 nurses from five Armed Forces hospitals in Korea. Data were collected through a self-administered questionnaire from August 7 to 23, 2017 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression. The SPSS/WIN 21.0 program was used for all analyses. RESULTS: The degree of teamwork was 5.03±0.73, with scores ranging from 1 to 7. Emotional intelligence and communication within the organization were positively correlated with teamwork. Specifically, communication within the organization (β=.60, p < .001), the intensive care unit (β=.21, p=.001), and the medical general ward (β=.17, p=.010) were identified as factors influencing teamwork. This model explained 51% of the variance in teamwork, and it was statistically significant (F=35.09, p < .001). CONCLUSION: These results imply the need to develop an approach including communication within the organization to improve teamwork among nurses in Armed Forces hospitals.

Public Acceptance of a Health Information Exchange in Korea / 대한의료정보학회지

OBJECTIVES: We assessed the public acceptance of a health information exchange (HIE) and examined factors that influenced the acceptance and associations among constructs of the Technology Acceptance Model (TAM). METHODS: We collected data from a survey of 1,000 individuals in Korea, which was administered through a structured questionnaire. We assessed the validity and reliability of the survey instrument with exploratory factor analysis and Cronbach's alpha coefficients. We computed descriptive statistics to assess the acceptance and performed regression analyses with a structural equation model to estimate the magnitude and significance of influences among constructs of TAM. RESULTS: Eighty-seven percent of the respondents were willing to use the technology, and the average level of agreement with the need for the technology was 4.16 on a 5-point Likert scale. The perception of ease of use of the technology significantly influenced perceptions of usefulness and attitudes about the need for HIE. Perceptions of usefulness influenced attitude and behavioral intention to use HIE, and attitude influenced intention. Age showed a wide range of influences throughout the model, and experience with offline-based information exchange and health status also showed noteworthy influences. CONCLUSIONS: The public acceptance of HIE was high, and influences posited by TAM were mostly confirmed by the study results. The study findings indicated a need for an education and communication strategy tailored by population age, health status, and prior experience with offline-based exchange to gain public buy-in for a successful introduction of the technology.

Interprofessional Education Programs for Nursing Students: A Systematic Review / 한국간호교육학회지

PURPOSE: The purpose of this study was to investigate how interprofessional education has been designed, implemented, and evaluated in undergraduate programs in nursing through a systematic review. METHODS: The literature was searched using the PubMed, CINAHL, EMBASE, and Cochrane central databases to identify interventional studies including teaching-learning activities among nursing students and other disciplines in English between January 2000 and May 2017. Thirty studies were selected for the analysis. RESULTS: Twenty-four studies out of 30 were designed as a pre-post, no control group, quasi-experimental study design. Interprofessional education learners were primarily engaged in medicine, physical therapy, dentistry, occupational therapy, pharmacy, and respiratory therapy. Patient care related activity was the most frequently selected topic and simulation was the most common teaching-learning method. Evaluation of learning outcomes was mainly based on the aspects of teams and collaboration, professional identity, roles and responsibilities, patient care, and communication skills. Nursing students in 26 out of the 30 reviewed studies were found to benefit from interprofessional education, with outcome effects primarily related to changes in learning outcomes. CONCLUSION: The development and integration of interprofessional education with collaborative practices may offer opportunities in nursing education for training professional nurses of the future.

The Influence of Nurses' Emotional Intelligence and Communication within the Organization on Teamwork in Armed Forces Hospitals / 한국직업건강간호학회지

PURPOSE@#The purpose of this study was to identify the influence of nurses' emotional intelligence and communication within the organization on teamwork in Armed Forces hospitals.@*METHODS@#This study employed a cross-sectional design with a convenience sample of 195 nurses from five Armed Forces hospitals in Korea. Data were collected through a self-administered questionnaire from August 7 to 23, 2017 and analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple regression. The SPSS/WIN 21.0 program was used for all analyses.@*RESULTS@#The degree of teamwork was 5.03±0.73, with scores ranging from 1 to 7. Emotional intelligence and communication within the organization were positively correlated with teamwork. Specifically, communication within the organization (β=.60, p < .001), the intensive care unit (β=.21, p=.001), and the medical general ward (β=.17, p=.010) were identified as factors influencing teamwork. This model explained 51% of the variance in teamwork, and it was statistically significant (F=35.09, p < .001).@*CONCLUSION@#These results imply the need to develop an approach including communication within the organization to improve teamwork among nurses in Armed Forces hospitals.

Refinement and Evaluation of Korean Outpatient Groups for Visits with Multiple Procedures and Chemotherapy, and Medical Visit Indicators / 보건행정학회지

BACKGROUND: Issues concerning with the classification accuracy of Korean Outpatient Groups (KOPGs) have been raised by providers and researchers. The KOPG is an outpatient classification system used to measure casemix of outpatient visits and to adjust provider risk in charges by the Health Insurance Review & Assessment Service in managing insurance payments. The objective of this study were to refine KOPGs to improve the classification accuracy and to evaluate the refinement. METHODS: We refined the rules used to classify visits with multiple procedures, newly defined chemotherapy drug groups, and modified the medical visit indicators through reviews of other classification systems, data analyses, and consultations with experts. We assessed the improvement by measuring % of variation in case charges reduced by KOPGs and the refined system, Enhanced KOPGs (EKOPGs). We used claims data submitted by providers to the HIRA during the year 2012 in both refinement and evaluation. RESULTS: EKOPGs explicitly allowed additional payments for multiple procedures with exceptions of packaging of routine ancillary services and consolidation of related significant procedures, and discounts ranging from 30% to 70% were defined in additional payments. Thirteen chemotherapy drug KOPGs were added and medical visit indicators were streamlined to include codes for consultation fees for outpatient visits. The % of variance reduction achieved by EKOPGs was 48% for all patients whereas the figure was 40% for KOPGs, and the improvement was larger in data from tertiary and general hospitals than in data from clinics. CONCLUSION: A significant improvement in the performance of the KOPG was achieved by refining payments for visits with multiple procedures, defining groups for visits with chemotherapy, and revising medical visit indicators.

Stratified Sampling Design Based on Data Mining / 대한의료정보학회지

OBJECTIVES: To explore classification rules based on data mining methodologies which are to be used in defining strata in stratified sampling of healthcare providers with improved sampling efficiency. METHODS: We performed k-means clustering to group providers with similar characteristics, then, constructed decision trees on cluster labels to generate stratification rules. We assessed the variance explained by the stratification proposed in this study and by conventional stratification to evaluate the performance of the sampling design. We constructed a study database from health insurance claims data and providers' profile data made available to this study by the Health Insurance Review and Assessment Service of South Korea, and population data from Statistics Korea. From our database, we used the data for single specialty clinics or hospitals in two specialties, general surgery and ophthalmology, for the year 2011 in this study. RESULTS: Data mining resulted in five strata in general surgery with two stratification variables, the number of inpatients per specialist and population density of provider location, and five strata in ophthalmology with two stratification variables, the number of inpatients per specialist and number of beds. The percentages of variance in annual changes in the productivity of specialists explained by the stratification in general surgery and ophthalmology were 22% and 8%, respectively, whereas conventional stratification by the type of provider location and number of beds explained 2% and 0.2% of variance, respectively. CONCLUSIONS: This study demonstrated that data mining methods can be used in designing efficient stratified sampling with variables readily available to the insurer and government; it offers an alternative to the existing stratification method that is widely used in healthcare provider surveys in South Korea.

Effects of B2B E-Commerce in the Material Management of Hospitals / 대한의료정보학회지

The objectives of this study were to examine effects of B2B e-commerce on the material management by comparing the performance of B2B and non-B2B hospitals, and surveying the extent of the objective of B2B implementation was achieved and success and failure factors of the implementation. Managerial data from six hospitals, three B2B and three non-B2B, and survey data from 107 employees involved in the material management at the study hospitals were analyzed. The number of employees at the department of purchasing, time spent for placing order, cycle time from order to delivery were better at the B2B hospitals, and employees' satisfaction with the material management system was significantly higher in the B2B hospitals than in the non-B2B hospitals as well. However, intended effects of B2B e-commerce in wider areas of the material management such as inventory management and sharing of business information were not substantiated in this study. The study results indicated that B2B ecommerce in the study hospitals improved work efficiency and effectiveness in the area of procurement, and implied needs for an ERP-type system and process reengineering with the implementation of B2B e-commerce to obtain wider ranges of effects in the material management. Also the study results implied a need for communication with employees during the course of implementation for the system success.

Cost-Effectiveness of PACS Based on Medical Insurance Coverage / 대한의료정보학회지

The objective of this study was to analyze the cost effectiveness of PACS with the coverage of the medical insurance. Direct and indirect costs and benefits of PACS as well as indirect effects were included in the analyses. Cost and benefit data were obtained from two user and two non-user hospitals located in Seoul and Kyunggi Province. Radiology technologists and clerks were surveyed to obtain data for indirect effects of PACS. The present value of the direct net benefit of PACS during the study period of five years estimated for a 740-bed hospital was about 744 mill ion Won and the benefit to cost ratio for the direct effect was 1.07. and the total net benefit was about 4.110 million Won and the benefit to cost ratio for the total effect was 1.36. Clerks at the user hospitals had significantly higher job satisfaction than their counterpart at the non-user hospitals for speedy lending (p<0.05) and good relationship with radiologists (p<0.0l). These study results indicated that PACS was cost beneficial with the coverage of the medical insurance and was effective in limited measures of quality of care and job satisfaction of employees at radiology departments as well. The study results also guaranteed further research that extend the scope to the physicians in clinical and radiology departments and nurses.

Hospital Service-based Costing

No abstract available.

Variation in resource utilization for inpatients among university teaching hospitals in city / 예방의학회지

The variation in resource utilization for hospitalized patients who had a group of similar disease -- a Korean Diagnosis Related Group (KDRG) -- among the same type of hospitals was studied to assess the utilization variation due to the practice pattern of hospitals. Information about inpatients who were beneficiaries of the medical insurance for teachers and government officials discharged from 20 large university teaching hospitals in Seoul during 1986 and information about the hospitals were analyzed to achieve the study objective. A total of 20,223 non-outlier patients in 100 most frequent KDRGs were included in the analysis. Case charges after the review and length of stay (LOS) were used as measures of resource utilization during a hospitalization. A substantial variation among hospitals was found in most KDRGs: the ratio of the maximum and the minimum among the mean case charges of hospitals was greater than 2 in 83 KDRGs; the difference between the maximum and the minimum among the mean case charges of hospitals was greater than 100,000 Won in 94 KDRGs; the ratio of the maximum and the minimum among the mean LOS of hospitals was greater than 2 in 82 KDRGs; the difference between the maximum and the minimum among the mean LOS of hospitals was greater than 3 days in 94 KDRGs. The practice pattern of hospitals explained more than 20% of charge variation in 49 KDRGs and more than 20% of LOS variation in 43 KDRGs. The study results indicated need for a new health policy initiative for cost containment and quality assurance.