Influence of Infection Control Fatigue and Social Support on Nurses' Burnout During the Coronavirus Disease 2019 Pandemic / 임상간호연구

Purpose@#The purpose of this study was to understand the effects of infection control fatigue and social support on burnout among nurses during the Coronavirus Disease 2019 (COVID-19) pandemic. @*Methods@#This study is a descriptive survey study designed to confirm the effects of nurses' infection control fatigue and social support on burnout among nurses during the COVID-19 pandemic. The collected data were analyzed using frequency, percentage, mean, standard devia analyzed using frequency, percentage, mean, standard deviation, independent t-test, One-way ANOVA, Scheffé test, Pearson’s correlation coefficient, and stepwise multiple regression analysis using SPSS Statistics 26.0. @*Results@#An analysis of the correlations between fatigue from infection control, social support, and burnout showed a positive correlation between burnout and fatigue from infection control (r=.39, p<.001), and a negative correlation between burnout and social support (r=-.29, p<.001). Conflict and lack of support due to uncertain circumstances (β=.51, p<.001), support from supervisor's (β=-.22, p<.001), and experience of infection management education during the previous 1year (β=-.15, p=.007) were identified as the factors that influenced burnout among nurses, and explained 39.0% of the variance in burnout. @*Conclusion@#The results of this study demonstrate that fatigue from infection control and social support influence burnout levels among nurses, which suggests the need to establish a new kind of work culture. Additionally, the findings call for the development and implementation of interventional programs that can reduce fatigue from infection control and increase social support for nurses.

Factors Affecting Turnover Intention of Nurses Working in Neonatal Intensive Care Units / 임상간호연구

Purpose@#This study was conducted to assess the factors affecting turnover intention of the nurses working in neonatal intensive care units, including the extent of fatigue, work stresses, and work overload related to infection control. @*Methods@#This was a descriptive correlational study to test factors affecting the turnover intention of the nurses working in neonatal intensive care units. Data was analyzed utilizing descriptive statistics, t-test, One-way ANOVA, Pearsons’ Correlation Coefficient, and multiple regressions by using the IBM SPSS Statistics 23.0 Program(IBM Corp., Armonk, NY). @*Results@#The turnover intention of nurses had a positive correlation with the extent of fatigue (r=.54, p<.001), work stress (r=.40, p<.001), and with the work overload (r=.43, p<.001) related to infection control. In addition, factors affecting the turnover intention of nurses included the extent of fatigue (β=.52, p<.001) related to infection control and the number of pediatric patients assigned to each nurse (β=.26, p=.001) and the variances explained by the regression model was 37.0%. @*Conclusion@#It is necessary to establish and implement strategies to lower the extent of fatigue related to infection control by reducing the nurses’ workload. Securing additional nurses to ensure an appropriate number of pediatric patients assigned to each nurse, and providing efficient management and available resources to reduce the turnover intention of nurses working in neonatal intensive care units are suggested.

Factors Affecting Turnover Intention of Nurses Working in Neonatal Intensive Care Units / 임상간호연구

Purpose@#This study was conducted to assess the factors affecting turnover intention of the nurses working in neonatal intensive care units, including the extent of fatigue, work stresses, and work overload related to infection control. @*Methods@#This was a descriptive correlational study to test factors affecting the turnover intention of the nurses working in neonatal intensive care units. Data was analyzed utilizing descriptive statistics, t-test, One-way ANOVA, Pearsons’ Correlation Coefficient, and multiple regressions by using the IBM SPSS Statistics 23.0 Program(IBM Corp., Armonk, NY). @*Results@#The turnover intention of nurses had a positive correlation with the extent of fatigue (r=.54, p<.001), work stress (r=.40, p<.001), and with the work overload (r=.43, p<.001) related to infection control. In addition, factors affecting the turnover intention of nurses included the extent of fatigue (β=.52, p<.001) related to infection control and the number of pediatric patients assigned to each nurse (β=.26, p=.001) and the variances explained by the regression model was 37.0%. @*Conclusion@#It is necessary to establish and implement strategies to lower the extent of fatigue related to infection control by reducing the nurses’ workload. Securing additional nurses to ensure an appropriate number of pediatric patients assigned to each nurse, and providing efficient management and available resources to reduce the turnover intention of nurses working in neonatal intensive care units are suggested.

Integrated Literature Review of Infection Control of Nursing Care Workers in Long-term Care Facilities / 한국직업건강간호학회지

Purpose@#This study aims to conduct an integrated literature review of infection control studies conducted by nursing care workers in long-term care facilities in Korea. @*Methods@#Through the domestic search engines RISS and KISS, seven articles were selected by searching for theses and academic journals published in Korea from 2008 to January 2020. Results: In total, six research studies and one intervention study out of seven studies were analyzed. Measurement tools for examining the knowledge and performance of infection-related care workers consisted of skin infection, aspiration pneumonia, urinary tract infection, and hand hygiene. Factors affecting nursing care workers’ infection management performance were infection management knowledge, education level, health status, and importance awareness. Conclusion: This study showed it is necessary to develop a tool that can accurately measure nursing care workers’ infection management knowledge and performance. In addition, it is necessary to develop an intervention program for nursing care workers’ infection control.

Improvement of Infection Control System in Long-term Care Facilities after the Coronavirus Disease Outbreak / 한국직업건강간호학회지

Purpose@#COVID-19 infections have been erupting in places of worship, long-term care facilities, and call centers in Korea since January 2020. This study aims to diagnose and present an infection control system solution for long-term care facilities where at-risk elderly individuals are actively engaged in communal life. @*Methods@#We conducted comparative analyses of infection control systems between long-term care facilities and medical institutions respective of relevant laws and this study’s evaluation system. @*Results@#To prepare for future infectious diseases, it is necessary to establish a long-term care facility infection control system and strengthen the standards thereof, to strengthen long-term care facility evaluation standards and to newly establish medical charges for infection control. @*Conclusion@#Systematic procedure fortification and financial support provisions are necessary for infection control at long-term care facilities.

Serum Phospholipid Docosahexaenoic Acid Is Inversely Associated with Arterial Stiffness in Metabolically Healthy Men

We hypothesized that lower proportion of serum phospholipid docosahexaenoic acid (DHA) is inversely associated with increased cardiovascular risk and vascular function in metabolically healthy men. To elucidate it, we first compared serum phospholipid free fatty acid (FA) compositions and cardiovascular risk parameters between healthy men (n = 499) and male patients with coronary artery disease (CAD, n = 111) (30-69 years) without metabolic syndrome, and then further-analyzed the association of serum phospholipid DHA composition with arterial stiffness expressed by brachial-ankle pulse wave velocity (ba-PWV) in metabolically healthy men. Basic parameters, lipid profiles, fasting glycemic status, adiponectin, high sensitivity C-reactive protein (hs-CRP) and LDL particle size, and serum phospholipid FA compositions were significantly different between the two subject groups. Serum phospholipid DHA was highly correlated with most of long-chain FAs. Metabolically healthy men were subdivided into tertile groups according to serum phospholipid DHA proportion: lower ( 3.235%). Fasting glucose, insulin resistance, hs-CRP and ba-PWVs were significantly higher and adiponectin and LDL particle size were significantly lower in the lower-DHA group than the higher-DHA group after adjusted for confounding factors. In metabolically healthy men, multiple stepwise regression analysis revealed that serum phospholipid DHA mainly contributed to arterial stiffness (β'-coefficients = -0.127, p = 0.006) together with age, systolic blood pressure, triglyceride (r = 0.548, p = 0.023). Lower proportion of serum phospholipid DHA was associated with increased cardiovascular risk and arterial stiffness in metabolically healthy men. It suggests that maintaining higher proportion of serum phospholipid DHA may be beneficial for reducing cardiovascular risk including arterial stiffness in metabolically healthy men.

A Study on Failure Mode and Effect Analysis (FMEA) for Preoperative Risk Prevention / 간호행정학회지

PURPOSE: The purpose of this research was to provide patients with safe preoperative preparatory procedures by removing any risk factors from the preparatory procedures by using failure mode and effects analysis, which is a prospective risk-managing tool. METHODS: This was a research design in which before and after conditions of a single group were studied, Failure mode and effects analysis were applied for the preparatory procedures done before operations. RESULTS: The preparation omission rate before the operation decreased from 2.70% to 0.04%, and operation cancellation rate decreased from 0.48% to 0.08%. CONCLUSION: Failure mode and effects analysis which remove any risk factors for patients in advance of the operation is effective in preventing any negligent accidents.

Analysis of Effects of Chemotherapy using Failure Mode and Effect Analysis (FMEA) on Patient Safety and Safe Nursing / 간호행정학회지

PURPOSE: This study was done to apply failure mode & effect analysis (FMEA) to chemotherapy in order to reduce prescribing, dispensing and administering errors related to treatment and provide patients with a safe medical environment. METHODS: A one group pre-post test design was used to verify the effects using the tool for FMEA in chemotherapy. RESULTS: There was a statistically significant decrease in prescribing errors from 11.47% to 3.18%; administering errors decreased but they were not statistically significant. In a addition, there was no change in dispensing errors. CONCLUSION: The results show that FMEA removed risk factors that might occur during the process of chemotherapy and that it was an effective tool for prevention of negligent accident occurring in actual patients.

Clinical Nurses' HPV-related Knowledge and Perception of Cancer Causes: HPV Vaccinated vs. Not Vaccinated / 여성건강간호학회지

PURPOSE: The purpose of this study was to compare knowledge level of those clinical nurses who received HPV vaccine and those who did not and their perception of the relatedness of HPV vaccine to causes of cervical cancer. METHODS: A total of 249 clinical nurses were surveyed from June to July, 2009. The questionnaire originally developed by Kim & Ahn (2007) examined HPV-related knowledge originally and the tool for perception of the causes of cervical cancer was originally developed by Kim (1993). The total number of subjects equaled to: vaccination group of 52 (20.9%) and non-vaccination group of 197 (79.1%). RESULTS: Vaccination group showed significantly higher score of both knowledge of HPV vaccination and the perception of the cause of cervical cancer in comparison to the nonvaccination group at (p<.05). Among 4 subscales of the perception of causes of cervical cancer, destiny and constitution subscale scores were significantly different between the two groups at (p<.05). CONCLUSION: Clinical nurses need to constantly update with current knowledge of HPV and be prepared with currently changing cancer prevention strategies, especially in cervical cancer.

Evaluation of the Contaminant Bacteria Isolated from Humidifiers Used in the Intensive Care Unit / 병원감염관리

BACKGROUND: This study aims to obtain basic data regarding the proper maintenance and potential role of humidifiers in the development of nosocomial pneumonia. We investigated into a spectrum of bacteria that grew after disinfection in humidifiers that were used in intensive care units (ICUs). The bacteria were isolated at different time points after disinfection. METHODS: We randomly selected 6 humidifiers that were used in an ICU and conducted a series of bacterial culture studies at 24 hr, 48 hr, 72 hr and 168 hr after disinfecting the six humidifiers. The fluid from the humidifider was cultured in the same manner as the dialysate. RESULTS: No bacteria were isolated in most of the 6 humidifiers 24 hr after the disinfection of the instruments. Gram-negative bacilli such as Acinetobacter baumannii, Burkholderia cepacia, and Stenotrophomonas maltophilia were cultured at 48 hr after disinfection. CONCLUSION: Regular and thorough disinfection of humidifiers is necessary to prevent possible spread of infection via humidifiers in the ICU.

Cystic metastasis of the lateral neck mass: A case of occult thyroid adenocarcinoma

An Experimental Study on the Healing Process after the Implantation of Various Bone Substitutes in the Rats

The purpose of this study is to evaluate the tissue response in applying of various bone substitutes included toothash-plaster mixture, resorbable hydroxylapatite (HA) and demineralized freeze-dried bone and to show the clinical usefulness of toothash-plaster mixture for the repair of craniomaxillofacial bone defect. For this experiment, 100 Sprague-Dawley rats weighing 200gm or more were used. There were four experimental groups: group I, toothash-plaster mixture; group II, demineralized freeze-dried bone; group III, resorbable HA; and group IV, control group. A full thickness, round bone defect measuring 10mm in diameter was created in the midcranium, and the substitutes cited above were embedded in the experimental rats based on their group assignment. Blood clot was filled in the rats assigned to the control group. Experimental rats were sacrificed on the 1st, 3rd, 5th, 8th, 12th and 24th week after implantation and stained with the hematoxylin-eosin, Masson's Trichrome, using Van Gieson's stain method, and were examined under light microscope. The results were as follows: 1. In all the groups, prominent inflammatory reaction and the infiltration of multinucleated giant cells were noted during the early stage. Gradual healing decreased this reaction. 2. Among the rats in the experimental group II, which were given demineralized freeze-dried bone implants, active formation of new bone traveculae manifested. Chondroid tissues appeared, and it was suggested that the defect was filled with newly formed bone by virtue of osteoinductive activity. On the 12th week after the experiments, most of the defect was filled with newly formed bone trabeculae. 3. In experimental groups I and III, it was noted that HA manifested a healing process similar to that characterized by the toothash-plaster mixture, but inflammatory reaction was more prominent in experimental group I. Active osteoblasts were observed along the periphery of osteoid tissues, while newly formed bone trabeculae appeared adjacent to the implanted materials three weeks later. Formation increased to the extent that newly formed bone trabeculae fused directly with the host bone. Increase in new bone ingrowth into the filling materials was revealed by both experimental groups. 4. In the control group, new bone formation adjacent to the host bone was observed, but most of the defect was filled with mature connective tissue 24 weeks after the experiments.

Typological Study on Attitudes of Alternative Therapy Among Cancer Patients / 간호학회지

The purpose of this study is to identify and classify the different types of cancer patients who use alternative therapies, to understand their subjective frameworks in using such alternative therapies. The results of this study provided the subjective information on five types of attitudes towards alternative therapies and described characteristics of five types from 30 cancer patients. The "Dependent to Others" (the first type) decided to use alternative therapy because they were influenced by the experiences of others and invocations of the family (especially spouse) or close relatives. In general, they did not believe that it will cure the diseases but generally thought it was not harmful and it may be better than doing nothing. There were a group of patients who chose to use alternative therapy with vague hope and belief. These patients decided to try alternative methods with their own convictions and confidences because they have personally seen or heard about some people who had been cured miraculously. This group of patients was grouped as "Belief in Effects (second type)." Although, there is a very little chance for miracles, "Expecting for Effects (third type)" believed alternative therapy will strengthen immune systems, help with feces and urine, change physical constitutions, slow down the progression of cancerous cell, have no side-effects, and expects to have practical effects and uses. The fourth group of patients thought foods in alternative therapies were same as general foods, therefore, it was easy to take, did not expect miracles to happen but considered the alternative therapy as supplementary treatments. This "Supplementary for Effects (fourth type)" patients thought it was their duty to do everything possible. The last type was "Expecting for Miraculous Effects (fifth type)." The patients in this group were devastated and thought of alternative treatments as the last hope for miracles. They thought it would relieve their physical pains, reduce the chance of side effects from chemical treatments, help them for comfortable and painless death, and considered it as the last possible option with expecting for miracles. The result of this study has implications to provide practical and concrete guidelines for caring and nursing cancer patients using alternative therapies. It will be used as a tool to work on independent for nursing intervention. Furthermore, the result of study will provide practical guidelines to help develop better tools and nursing intervention strategies to nurse cancer patients.

Autogenous cancellous bone graft from the proximal tibial metaphysis

Many graft materials are available for surgical treatment of maxillofacial bony defect and deformity. Despite concerted efforts to gain comparable outcomes with allogenic bone, xenogenic bone, bone substitutes, and alloplasts, the results related to function, from and adaptibility remain superior with autogenous bone. The cancellous bone is relatively more osteogenic than cortical bone. The superior osteogenic properties of cancellous bone has been widely used an oral and maxillofacial surgery. Well-recognized donor sites of cancellous bone have included ilium, rib and calvarial bone, But the procurement of cancellous bone from any site should be no considered biologic insult to the patients. The proximal tibia as an alternative donor site has the potential to yield viable cancellous bone with a minimum of morbidity. We experienced several jaw defect treated with autogenous proximal tibial cancellous bone grafting. The harvested cancellous bone was soft and easily molded to fill defects and the recipient site showed a favorable result. Moreover, with uneventful healing process, the donor site showed the overall lack of morbidity. This report presents clinical applications of the autogenous cancellous bone graft from the proximal tibial metaphysis and satisfactory results to repair of the jaw defect.