Distribution and antimicrobial resistance of Acinetobacter baumannii in a geriatric hospital from 2013 to 2016 / 中国感染控制杂志

Objective To analyze the clinical distribution and antimicrobial resistance change trend of Acinetobacter baumannii(AB) from a geriatric hospital in 2013-2016.Methods Specimen source,department distribution,and antimicrobial resistance of AB isolated from all patients in the hospital from 2013 to 2016 were analyzed retrospectively.Results From 2013 to 2016,1 712 strains of AB were isolated,AB isolation rates in 2013,2014,2015,and 2016 decreased year by year,which were 17.92％,17.17％,15.10％,and 11.81％,respectively.AB were mainly isolated from sputum (n =1 524,89.02％),followed by urine (n =79,4.61％) and blood (n=37,2.16％).The main departments of AB isolation were intensive care unit (n =798,46.61％),department of respiratory medicine (n =507,29.62％),and neurology department (n =156,9.11％).Resistance rates of AB to most antimicrobial agents increased in 2013-2016,resistance rates to compound sulfamethoxazole were low (25.68 ％-65.89 ％),followed by resistance rates to cefoperazone/sulbactam (54.74％-68.00％),resistance rates to imipenem were 71.40％-77.42％,to the other antimicrobial agents were all＞60％;in 2013-2016,resistance rates of AB to cefepime,cefoperazone/sulbactam,gentamicin,tobramycin,and compound sulfamethoxazole were significantly different (all P＜0.05).Conclusion Antimicrobial resistance rates of AB in this hospital is increasing,it is necessary to strengthen the monitoring,promote the rational use of antimicrobial agents,and block the infection and transmission of AB in hospital.

Effect of Nursing Professionalism and Organizational Communication on Intent to Stay in Geriatric Hospital Nurses / 간호행정학회지

PURPOSE: This study was performed to measure nursing professionalism, organizational communication, and intent to stay, and investigate the relationship among these three variables in geriatric hospital nurses. METHODS: A cross-sectional survey was done with the participation of 195 nurses working at 23 geriatric hospitals in B city of Gyeongsangnam-do, Korea. Data were collected from January 19 to 25, 2018 using structured questionnaires and were analyzed using SPSS/WIN program. RESULTS: The geriatric hospital nurses' scores for nursing professionalism, organizational communication, and intent to stay were relatively lower than those of general hospital nurses. Each of these three variables was differently perceived according to participants' general characteristics but there was a positive correlation between them. The factors influencing intent to stay were organizational communication, age and through newspapers/advertising (one of motivations for working at geriatric hospitals). These three variables explained 47% of intent to stay. CONCLUSION: To increase intent to stay in geriatric hospital nurses, nursing or hospital managers must develop and apply programs that help improve nurses' professionalism and organizational communication. Especially geriatric hospital nursing managers should try to provide organizational communication enhancement programs for young and inexperienced nurses.

Analysis of the clinical distribution and drug resistance of the pathogenic bacteria in Zigong Geriatric Hospital from 2014 to 2016 / 国际检验医学杂志

Objective To investigate the distribution and drug resistance of common bacteria isolated from geriatric hospital for 2014 -2016 years,and to provide basis for the use of infection in elderly patients. Methods Bacterial identification and drug sensitivity test of isolates from January 2014 to December 2016 were performed by Microscan WalkAway 96 automatic microorganism analyzer.The drug resistance was ana-lyzed by Whonet5.6 software.Results In 2014-2016 a total of 2 133 strains of pathogens were isolated,in-cluding 1 668 strains of gram negative bacteria,accounting for 78.2%;318 strains of gram positive bacteria ac-counted for 14.9%;leather were the top 5 bacteria were Gram-negative bacteria,522 strains of Escherichia co-li,accounting for 24.5%,407 strains of Klebsiella pneumoniae,accounting for 19.1%,244 Pseudomonas aeruginosa,Proteus strains accounted for 11.4%,163 strains of proteus,accouuting for 7.6%;141 strains of Acinetobacter baumannii,accounting for 6.6%.No resistance to vancomycin,linezolid and daptomycin in Staphylococcus and Enterococcus,were not detected in carbapenem resistant Escherichia coli,Klebsiella pneu-moniae,Proteus drug.The detection rates of ESBLs producing Escherichia coli and Klebsiella pneumoniae were 26.7% and 13.6%,respectively.The detection rates of ESBLs producing Escherichia coli and Klebsiella pneu-moniae were 26.7% and 13.6%,respectively.The resistance rates of Pseudomonas aeruginosa and Acineto-bacter Bauman to imipenem w ere 8.6% and 32.6%,respectively.Conclusion T he bacterial resistance rate level is not high,the carbapenem resistant Enterobacteriaceae and non fermentive bacteria should be paid at-tention to,and the monitoring of bacterial multi drug resistant bacteria in the management and prevention of nosocomial spread and the restriction of the use of antibacterial drugs should be strengthened.We should refer to the drug resistance monitoring data of elderly population and select rational antibiotics according to the sen-sitivity test results.

Effect of Job Satisfaction and Self-Esteem on Psychological Burnout in Dietitians at Geriatric Hospital in Busan

This study aimed to investigate the effects of job satisfaction and self-esteem on psychological burnout in dietitians at a geriatric hospital in Busan. The survey was conducted from July 8 to August 31, 2014, and the data were analyzed using the SPSS program. The age group of over 36 years showed higher job satisfaction than the 'Under 25' group. Subjects that worked less than 2 years at their present jobs showed lower job satisfaction in job-itself than the 'Over 4 years' group did, and those who worked less than 1 year showed lower job satisfaction in terms of communication, appraisal compensation, and co-workers than did the other groups. Those who worked in '100approximately149 bed' hospitals showed higher job satisfaction than those in the 'Under 100 bed' group did. 'Over 200 bed' hospital dietitians showed higher satisfaction in supervision of superiors than did the other groups. Their experience of psychological burnout turned out to be 2.39 out of 5. Psychological burnout had a negative relationship with job satisfaction and self-esteem. Higher emotional exhaustion correlated with lower satisfaction in job-itself, less communication, and less supervision of superiors. Dehumanization correlated with lower satisfaction in job-itself, lower self-esteem, and worse communication, and while decreased personal achievement correlated with lower self-esteem, worse co-workers, lower satisfaction in job-itself, worse appraisal compensation, and worse communication. These results suggest that it would be effective for prevention and management of psychological burnout to mediate factors of job-itself, communication, supervision of superiors, co-worker, and appraisal compensation of dietitians in geriatric hospitals.

Bacteremia in a Multilevel Geriatric Hospital, Second Look 5 Years Later.

Aims: In a previous study (2004) we explored the clinical and microbiological aspects of bloodstream infections (BSI) in a multilevel geriatric hospital, and concluded that follow up and monitoring of these parameters is warranted. The purpose of this new study is to evaluate the current BSI status and compare these data to those obtained previously. Study Design and Methodology: We implemented the methodology developed for the initial study. Clinical features, microbiological characteristics and outcome of BSI over the year 2009 were investigated. Results: The rate of positive blood cultures was similar (10% versus 12%). The rate of BSI was 1.35 per 1000 patients in 2004 and 1.7 per 1000 in 2009. The mortality rate at 2 weeks decreased significantly (from 42% to 22.5%, p=.001). The most common isolate was Escherichia coli in both studies, followed by Proteus mirabilis. Interestingly, antibiotic susceptibility of common pathogens between 2004 and 2009 remained unchanged in 40% while increasing in 32% of cases. Conclusion: This second look at BSI and revision of BSI parameters provides updated information that may be beneficial for further follow up and antibiotic stewardship program.

Job Performance, Perception of Job Importance, and Job Satisfaction in Dietitians Working in Geriatric Hospitals in Busan

This study was carried out to investigate the job performance, perception of job importance, and job satisfaction in dietitians working in geriatric hospitals in Busan. A survey was conducted from April 28 to June 30, 2011, and the data were analyzed using the SPSS program. The age of over 41 group showed higher job performance in terms of sanitation and safety management than the age of under 25 group but showed lower job performance in terms of nutrition management than the age of 31~40 group. The subjects who worked for shorter than 2 years at their present jobs showed the lower job performance in terms of menu management and accounting management than the other groups, whereas those who worked in 'over 200 bed' hospitals showed the higher job performance in terms of sanitation and safety management than the others. The subjects who worked for longer than 6 years showed the higher job satisfaction in terms of communication and working environment than the others. Job performance showed a significant positive correlation with perception of job importance, whereas it showed no significant correlation with job satisfaction. More work experience correlated with a higher monthly income, and younger workers showed higher job performance. Younger age and more work experience at a present job correlated with a higher perception of job importance. More work experience at a present job, higher monthly income, and shorter work experience were correlated with higher job satisfaction. These results suggest that it would be effective to adopt training programs for appropriate nutrition service and provide continuous education programs for professional development.

A Study on Depression and Activities of Daily Living among Elderly Patients in Geriatric Hospitals / 성인간호학회지

PURPOSE: This study was conducted to examine the degrees of depression and activities of daily living (ADLs), and to identify factors that predict depression in elderly patients. METHODS: The sample was149 patients (80% female; mean age 79.1) from three geriatric hospitals located in small cities and who agreed to participate in the study. Data were collected by staff nurses involved in direct patient care from October to September 2009. The level of depression was measured on a daily basis for seven days using a 13-item scale. Patients' ADLs was measured using a modified 10-item Bathel ADLs scale. Data were analyzed using SPSS/WIN 17.0. RESULTS: Mean depression score was 10.05+/-4.77 out of 26 points and about 27% was assessed as depressed with more than 13 points. Multiple regression analysis showed that low educational level, absence of spouse and fewer family visits predict depression. In addition, low ADLs and sleep disturbance predict depression. CONCLUSION: Nursing care providers need to be concerned about ADLs of older patients and should develop nursing activity programs to increase their in-hospital physical activities. It is also important care for older patients' sleep and encourages family visits to decrease their depression.

Geriatric Hospital Pathogens of Lower Respiratory Tract Infection among Patients in ICU of a and Their Drug Resistance Analysis / 中华医院感染学杂志

OBJECTIVE To explore the pathogen distribution and their resistance in ICU of Geriatric hospital.METHODS 111 strains isolated from lower respiratory tract were collected from Sep 2006 to August 2007.The antibiotic resistance were tested.RESULTS Among 111 strains,G-strains accounted for 70.27%,in which Pseudomonas aeruginosa was the most common(20.72%).The G+bacteria were multi-resistant to most of the antibiotics except impenem.CONCLUSIONS The most common pathogens in ICU of geriatric hospital is G-bacteria with multi-resistance.The Antibiotics should be selected reasonably.

The Perspectives on Development of Korean Quality Measurement Tools for Geriatric Hospitals

The payment system such as national long term care insurance for the elderly and per diem rate for geriatric hospitals introduced in 2008 has greatly changed the Korean medical system for the elderly. Therefore, today it would be inevitable to discuss quality assessment of healthcare services provided by nursing facilities and geriatric hospitals in order to effectively establish and operate the introduced systems. Under these circumstances, in an effort to provide elderly people with high-quality medical services with limited resources, it is believed that the quality indicators need to include the following: (1) provision and management of medical services for major health problems; (2) assessment of quality of life for residents; (3) assessment of ADL and rehabilitation services so as to maintain and improve functions; (4) assessment of convenience of living facilities; and (5) assessment of rate of potential avoidable hospitalization in acute care hospitals. Moreover, along with an effort to define roles of nursing facilities and geriatric hospitals, it would be necessary to set up the feasible stepwise strategy through discussions with relevant institutions.

A Concept of the Foundation of Korean Hospital for the Elderly who have Neuropsychiatric Disorders

The population of the elderly and neuropsychiatric elderly patients increases radically, but realistic management in the welfare and medical dimensions are not adequate. Especially, the treatment and care for the neuropsychiatric geriatric patients have not been achieved properly for the lack of good medical facilities and heavy economic burden. Therefore, this paper will propose a model of specialized neuropsychiatric geriatric hospital suited to our reality for the welfare of the elderly themselves and their families. For this, we investigated the needs of medical consumers through surveys. Our subjects are 41 families of neuropsychiatric elderly patients in admission and 51 caregivers. In these surveys, patrons expect the establishment of specialized geriatric hospital proper to the characteristics of neuropsychiatric elderly patients. In addition, they hope patients adminssion fee to be reduced as difficulty and specialty of neuropsychiatric geriatric patient treatment are actively applied to the medical insurance fee and national support system. According to our examination of the caregeivers for the neuropsychiatric elderly patients, caregivers didn't receive systematized training, but only brief care-giving education. Their status is also unstable and their pay is low. These issues are very important for the quality of care-giving work. Therefore, specialized neuropsychiatric geriatric hospitals should be established properly to our social reality and request, and national and social supports for the training and education of medical staffs and quite necessary.