Effects of Infection Control Strategies for Vancomycin Resistant Enterococci in Intensive Care Units / 성인간호학회지

PURPOSE: This study was to examine whether VRE infection control strategies have an effect on the decrease in incidence rates for VRE acquisition and VRE nosocomial infection in ICU. METHODS: All the patients were examined for VRE carriers on ICU admission. Among them, patients hospitalized for over 48 hours were investigated for VRE acquisition rates and VRE nosocomial infection rate using VRE infection control strategies in ICU for the experimental group from September 2007 to April 2008. Before that, incidence of VRE acquisition and VRE nosocomial infection for the control group without Intervention were investigated from May to August 2007 retrospectively. RESULTS: VRE acquisition rate in clinical specimens was 0.6% in the experimental group, that was significantly lower when compared to the control group. VRE carrier rate at admission to ICU was 15.4%. Out of 182 VRE carriers, 180 patients were identified by the active surveillance culture. CONCLUSION: These results suggested that active surveillance culture at admission was considered to be an essential measure for detection of VRE carrier. But without strict isolation and adherence rating after each intervention, hand washing and contact isolation alone did not significantly decrease VRE nosocomial infection, although it did significantly decrease incidence of VRE acquired from clinical specimen.

The Effects of Individualized Cardiac Rehabilitation Education for Percutaneous Coronary Intervention (PCI) Patients / 기본간호학회지

PURPOSE: This study was done to evaluate the effectiveness of cardiac rehabilitation education individualized to PCI patients in order to improve their knowledge of these diseases and to lessen their anxiety. METHOD: A Quasi-experimental design with non-equivalent control group non-synchronized design was used. The experimental group had the PCI operation for ischemic heart disease and individualized cardiac rehabilitation education and counseling twice for 25 minutes each time using an educational booklet developed by the authors. The effects of the education were analyzed using a knowledge assessment tool, state anxiety inventory and anxiety visual analogue scale. RESULTS: The experimental group who received the individualized cardiac rehabilitation education showed a high level of knowledge about diseases compared to the control group and particularly showed a significant difference in knowledge about the drugs used for treatment. However, no significant difference was observed between the two groups in the level of state anxiety and anxiety visual analogue scale.

Effects on Nurses' Hand Washing Behavior and Reduction of Respiratory Isolation Rate of MRSA of the Hand Washing Education / 성인간호학회지

PURPOSE: This is a clinical experimental study aimed to provide basic data to ensure quality care. The purpose of this study is to increase nurses hand washing behavior and decrease respiratory isolation rate of MRSA. METHOD: This study was conducted in Kangnam St. Marys hospital. The subjects included 5 nurses working at the NS ICU and 165 specimen for nasal swabs and 46 specimen for sputum cultures from 106 patients admitted to the NS ICU. The data were collected from June to September 2000. RESULTS: 1.The percentage of the nurses hand washing was 15.6percent but was improved to 46.5 percent after the educational intervention. In particular, hand washing behavior was increased in situations such as after suctioning, before parenteral nutrition, and after providing hygiene care. 2. Results of nasal swab showed that MRSA isolation rate was reduced from 42.8 percent before the education to 18.6percent after the education. The sputum culture results also showed that the MRSA rate was reduced from 40.7percent before the education to 34.6percent after the education. CONCLUSION: The findings showed the nurses' strict hand washing behavior and use of disposable gloves and paper towers as well as use of hand sterilization spray by visitors or families can decrease the MRSA isolation rate in the NS ICU patients. Since the NS ICU patients may have respiratory complications due to long-term hospitalization, the nurses regular hand washing is important enough to be emphasized. Future research should be focused on the impact of nurses' hand washing behavior on the incidence of pneumonia, an iatrogenic infection.

Effects of Improved Methods of Endotracheal suction and Hand Washing on Incidence of Nosocomial Pneumonia in the Neurosurgical Intensive Care Unit / 병원감염관리

BACKGROUND: This study aimed at identifying the effects of improved methods of endotracheal suction and hand washing on incidence of nosocomial pneumonia (NP) in the neurosurgical ICU. METHOD: Repeated training of nurses about hand washing and adherence of the single use of suction catheter and sterile normal saline of endotracheal suction was provided. Then hand washing compliance of nurses before and after training was investigated. and the incidence of NP in all patients hospitalized for more than 72 hours in the neurosurgical ICU was investigated from Sep 1, 2000 to Jan 31, 2001 (2nd surveillance). The NP rate of that period was compared with the incidence of the 1st surveillance period, from Sep 1, 1999 to Jan 31, 2000. The data were analyzed with chi-square-test. Fisher's exact test and logistic regression analysis by SAS 8.0. RESULT: The proportion of hand washing performance increased from 15.6% to 46.8%. The rates of NP per patient during 1st surveillance and 2nd surveillance were 10.3%, 3.9%(p=0.01) patient-days rates of NP were 10.0 cases/1,000 patient days, 4.1 cases/1,000 patient days(p=0.04), and ventilator-days rates of NP were 67.6 cases/1.000 ventilator days, 16.2 cases/1,000 ventilator days(p=0.00) respectively. Out of 29 isolates, 18 were methicillin-resistant Staphylococcus aureus, which was the most frequently isolated microorganism. The risk factors associated with incidence of NP were age, length of stay, Glasgow coma scale, diabetes mellitus, duration of intubation, insertion of endotracheal tube, duration of tracheostomy, presence of tracheostomy, duration of ventilator, use of ventilator, and insertion of nasogastric tube. CONCLUSION: These results showed that single use of suction catheters and sterile normal saline and increased compliance of hand washing were important factors to decrease the incidence of NP.

A comparative study on the nurse and nurses aids' perception and performance level for nosocomial infection control / 성인간호학회지

This study was designed to compare the nurse and nurses aids on their perception and performance levels for nosocomial infection control and to evaluate the relevant variables. The study data were obtained from 246 nurses and 219 nurse aids working at two university hospitals in Seoul, by using a constructed questionnaire. The data was collected from March to April of 1998, and analyzed using the SAS program for t-test, two way ANOVA, Pearson's Correlation Coefficients. The results were as follows; 1. The mean score of the perception level for nosocomial infection control of the nurse(M= 4.72) was higher than that of the nurses aids(M= 4.56). 2. No significant association was found between the nurse and nurses aids on their performance level for nosocomial infection control. 3. The score of perception level showed significant interaction by age in all domains, by career in contaminated material and environmental management, and by department in sterile and environmental management. Regarding the performance levels, the score showed significant association between hand washing and clothing management by age and career. However, there was no significant difference by department. 4. A positive correlation was found in the perception and performance levels for nosocomial infection control between the nurse and nurse aids. In conclusion: the mean score of the perception level for nosocomial infection control in nurses was higher than that of their performance level. In the case of nurses aids, the mean scores of the perception and performance level for the nosocomial infection control were the same but lower than those of the nurses. It is suggested that appropriate hospital infection control programs should be developed by continuous systemic education and practice to improve the nurse and nurses aids' level of perception and performance for nosocomial infection control.