Factors influencing peripheral intravenous catheter practice of nurses in small and medium sized hospitals: a cross-sectional study.

BACKGROUND: The importance of the peripheral intravenous catheter (PIVC) practices on patient safety is increasing. Small and medium-sized hospitals play a central role in the provision of healthcare services in South Korea, but lack a system for quality improvement, leaving patient safety at risk. This study aimed to identify the extent to which the PIVC practice knowledge of nurses, the nursing working environment, and the patient safety-culture perception affect PIVC practices and thereby provide basic data for improving the PIVC practices in small and medium-sized hospitals. METHODS: This study had a cross-sectional descriptive design to identify the factors affecting PIVC nursing practices in small and medium-sized hospitals. Questionnaires returned by 149 nurses collected data on general characteristics, practical knowledge of PIVC nursing, nursing working environment, patient safety-culture perception, and PIVC practices. The questionnaire data were analysed using descriptive statistics, the independent t-test, one-way ANOVA, Scheffé's test, Pearson correlation, and hierarchical regression analysis. RESULTS: The mean score of PIVC practices was 4.60 out of 5. Length of clinical experience, practical knowledge of PIVC nursing and patient safety-culture perception were significant factors affecting the PIVC nursing practices, with these variables explaining 26.2% of the variance therein. CONCLUSIONS: The PIVC practices of nurses in small and medium-sized hospitals can be improved by providing education and training based on the latest standard or guideline to facilitate the acquisition of knowledge and skills. And campaigns and programs to strengthen patient safety culture perception specific to small and medium-sized hospital should be implemented. to ensure the safety of PIVC practice.

Status of Phlebitis in South Korean Hospitals: Focusing on Electronic Incident Reporting Systems.

Peripheral venous catheterization (PVC) is the most commonly used invasive technique, and its importance to patient safety is increasing. And phlebitis is a common complication which can lead to increased costs and extended hospital stays. This study attempted to characterize the current status of phlebitis based on incident reports in the Korea Patient Safety Reporting & Learning System. This retrospective descriptive study analysed 259 phlebitis cases reported in that system from 1 July 2017 to 31 December 2019. The analysis results were summarized using numbers and percentages or means with standard deviations. Among the reported phlebitis cases, antibiotics and high-osmolarity fluids comprised 48.2% of the intravenous inflammatory drugs used. All reported cases presented blood-flow infections. Insufficient observation or management was the most common cause of phlebitis. It was found that interventions for phlebitis were inconsistent with those recommended in evidence-based guidelines. Recommendations for nurses to alleviate complications in PVC must be promoted and educated. It is necessary to provide feedback from the incident reports analysis.

A Topic Modeling Analysis of the Crisis Response Stage during the COVID-19 Pandemic.

The core of disaster management is the ability to respond spontaneously and rapidly to unexpected situations and also to apply planned and adaptable responses that follow manuals and guidelines. This study aimed to observe the changes in information during the COVID-19 pandemic period by collecting and analyzing information announced on a hospital intranet by an infection control team. This study performed text mining of large amounts of data to investigate notices about in-hospital strategies towards COVID-19 to identify changes in the coping strategies during the pandemic. Notices announced within the infection control rooms of 12 university hospitals in South Korea from 1 January to 31 August 2020 were searched. Four representative topics were identified based on the stepwise keywords shown in the topic modeling analysis: (1) "Understanding the new infectious disease", (2) "Preparation of a patient care and management system", (3) "Prevention of spread and securing employee safety" and (4) "Improvement of the management system according to the revision of guidelines". Countries where an infectious disease emerges should provide accurate information on the disease and guidelines to determine how to respond. Medical institutions must revise and complement them while considering their specific circumstances. To efficiently respond to an infectious disease crisis, governments and medical institutions must cooperate closely, and implementing a systematic response is crucial.

Experiences of handovers between shifts among nurses in small and medium-sized hospitals: A focus-group study.

Nursing handovers represent an important and complex form of communication in healthcare organizations that involve the exchange of patient-related information between nurses. This qualitative descriptive study aimed to identify the intershift handover experiences among nurses working in small and medium-sized hospitals. Focus-group interviews were conducted with 30 nurses who directly participated in patient care in such hospitals in South Korea. The reporting of the study findings adhered to the Consolidated Criteria for Reporting Qualitative Research checklist. The data were analyzed using content analysis. Under the main theme of "baton touch in a relay," 6 categories, 17 subcategories, and 45 codes (concepts) were derived. The six categories were "procedural rituals for shifts," "nonstandardized handover training," "inconsistent handover style," "stress due to handovers," "coping strategies for handovers," and "interruptions of handovers." Nurses in small and medium-sized hospitals strive to improve the quality of handovers by preparing individual-level coping strategies under difficult conditions. This indicates that standardized handover education strategies need to be developed for nurses that are suitable for the personnel systems of small and medium-sized hospitals.

Patient handover education programme based on situated learning theory for nursing students in clinical practice.

AIM: If not conducted correctly, nursing handover can threaten patient safety, and so nursing students require good handover education. This study evaluated a handover education programme based on situated learning theory in a clinical practicum. METHODS: A quasi-experimental design and convenience sampling technique were used. The participants (fourth-grade nursing students recruited from a college in the C province of South Korea) were assigned to an intervention group (n = 38) or a control group (n = 39). A handover education programme that included lectures, expert observations, role playing, peer learning and reflection was received by the intervention group. The control group attended lectures and observed handovers. The handover skills of all participants were tested 2 weeks before and on the last day of the clinical practicum. Handover performance ability, handover clinical judgement ability and handover self-efficacy were outcome variables. RESULTS: Significant improvements in handover performance ability, handover clinical judgement ability and handover self-efficacy were observed in the intervention group compared with the control group. CONCLUSION: The significance of this study lies in the development and application of a programme based on situated learning theory for handover education. Application of theory-based handover education in clinical practicums is recommended to improve the handover capabilities of nursing students.

Systematic Review of Quality Improvement Projects Related to Intershift Nursing Handover.

BACKGROUND: Nursing handover is a real-time process in which patient-specific information is passed between nurses to ensure the continuity and safety of patient care. PURPOSE: The purpose of this study was to determine the effects of quality improvement (QI) projects in improving the intershift nursing handover process. METHODS: A computerized search was performed of electronic databases for articles published during 2009-2019 in English or Korean for which the full texts were available. The included studies involved QI projects, handover between nurses, and intershift handover. The QI-MQCS (Quality Improvement Minimum Quality Criteria Set) was used to appraise the quality of QI strategies. RESULTS: The handover methods used in the 22 QI projects could be broadly divided into 2 types: (1) using a standardized communication tool; and (2) involving patient-participation bedside handover. CONCLUSIONS: The published research on intershift handover-related QI projects employed standardized communication tools and the patient-participation bedside handover method to reduce adverse events and handover times and increase the satisfaction of patients and nurses. Future studies should measure the changes in patient safety-related outcomes.

A Topic Modeling Analysis of Nursing Handoff Studies.

This study used topic modeling to analyse key topics of nursing handoff research. Six topics were identified. The findings indicate that future studies should implement the standardization of handoff tools and the use of bedside handoff, and evaluate their effects on patient safety outcomes.

A Topic Modeling Analysis of the Crisis Response Stage for COVID-19 Pandemic.

After the COVID-19 pandemic occurred in South Korea in 2020, medical institutions have dealt with the epidemiological crisis. The institutions' strategies in response to the crisis were classified into four stages depending on the change of epidemic circumstances. Efficiently responding to the pandemic, close cooperation between the government and medical institutions is essential.

Patient safety culture and handoff evaluation of nurses in small and medium-sized hospitals.

OBJECTIVES: This study was conducted to investigate the current status of handoffs, perception of patient safety culture, and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that make a difference in handoff evaluation. METHODS: This is a descriptive study. 425 nurses who work at small and medium-sized hospitals in South Korea were included in our study. They completed a set of self-reporting questionnaires that evaluated demographic data, handoff-related characteristics, perception of patient safety culture, and handoff evaluation. RESULTS: Results showed that the overall score of awareness of a patient safety culture was 3.65 ± 0.45, the level was moderate. The score of handoff evaluation was 5.24 ± 0.85. Most nurses experienced errors in handoff and most nurses had no guidelines and checklist in the ward. Handoff evaluation differed significantly according to the level of education, work patterns, duration of hospital employment, handoff method, degree of satisfaction with the current handoff method, errors occurring at the time of handoff, handoff guidelines, and appropriateness of handoff education time (P < 0.05). CONCLUSION: For handoff improvement, guidelines and standards should be established. It is necessary to develop a structured handoff education system. And formal handoff education should be implemented to spread knowledge uniformly.

Korean nurses' perspectives regarding handoffs.

BACKGROUND: Nursing handoffs are communicative routines in most nursing units. The handoff is critical to the continuity and safety of patient care. Negative perceptions of handoffs could hinder efficient communication between nurses. AIMS: This study identified the perceptions of nurses' handoffs in Korea. DESIGN: A descriptive survey was employed. The population included nurses who worked in a general ward in 201 hospitals with more than 300 beds. RESULTS: 27.9% responded that the current handoff method needed to be changed and 75.8% had no handoff-related guideline. "Handoffs are frequently interrupted by outsiders' visits" was the most frequent problem expressed. Variables associated with a perceived need for change in handoff methods were age, handoff method, and preparation time for handoffs. CONCLUSION: Nurses recognized that handoffs were frequently interrupted by external factors and consumed too much time. Therefore, a standardized handoff method is needed to ensure the accuracy of information.

Kidney transplantation in sensitized recipients; a single center experience.

A successful transplantation, across a positive crossmatch barrier, is one of the most persistent long-standing problems in the field of kidney transplant medicine. The aim of this study was to describe seven consecutive living renal transplantations in recipients with positive crossmatch for donors or positive for donor specific antibodies (DSAs). A preconditioning regimen including plasmapheresis and intravenous immunoglobulin was delivered three times a week until the crossmatch and/or DSAs became negative. Mycophenolate mofetil and tacrolimus were started two days before the plasmapheresis. The protocol was modified to include administration of anti-CD 20 antibody (rituximab, 375 mg/m(2)) from the patient number 3 through the patient number 7. All seven patients achieved negative conversion of the crossmatch or DSAs, and the kidney transplantations were successfully performed in all cases. Acute cellular rejection occurred in two patients, which were subclinical and controlled with high dose steroid treatment. Antibody-mediated rejection occurred in one patient, which was easily reversed with plasmapheresis. All recipients attained normal graft function during the 7-24 months of follow up. Our study suggests that sensitized patients can be transplanted successfully with desensitization pretreatment.

Classification of nursing statements based on the ICNP, the HHCC, and the nursing process for use in electronic nursing records.

The purposes of this study were to identify nursing-phenomena-related statements and nursing-action- related statements for use in nursing records, to link nursing statements for the nursing process, to develop integrated nursing terms using the ICNP, to identify new terms for inclusion, and to group statements using the HHCC in a user interface. We extracted 5,133 nursing-phenomena-related statements and 3,844 nursing-action-related statements, with the former including 233 nursing diagnoses. A total of 2791 nursing terms were mapped and 287 new terms were developed. Synonyms of 827 standard nursing terms were extracted. We developed trees of nursing statements using the HHCC for the user interface in an electronic nursing record. The quality of nursing documentation and the nursing performance improved with the standardization process.

Mapping nursing statements with the ICNP and its practical use in electronic nursing records.

This study analyzed the usage of nursing statements and the frequencies of mapped nursing statements using the ICNP in electronic nursing records. A total of 9,200 statements were analyzed, comprising 5,135 related to nursing assessments, 215 related to nursing diagnoses, and 3,850 related to nursing interventions. Nurses used 3,744 (72.9%) of the respective statements in assessments, 149 (69.3%) in diagnoses, and 2,641 (68.6%) in interventions. There were 11,499 (56.8%) completely mapped nursing statements, 7,548 (37.3%) partially mapped statements, and 1,203 (5.9%) unmapped statements.