Potential Maneuvers for Providing Optimal Tidal Volume Using the One-Handed EC Technique.

Bag-valve-mask is a device that manually provides positive oxygen pressure. The grip technique of the character E and C shape is recommended to carry out this effectively. However, when applying this method, the hand in which the direction of the EC technique should be performed and the degree of adhesion pressure while performing the technique are unknown. This study aims to identify the factors influencing tidal volume and to determine the ideal sealing method between mask and face in the one-handed EC technique to optimize the Vt. A simulation study was conducted using a mechanical lung model in a scenario that resembled respiratory arrest. Multiple regression analyses identified high peak pressure, high left spot adhesion strength of the mask, and low right spot and bottom spot adhesion strength of the mask as significant factors. To provide an optimal Vt, it may be necessary to apply more strength to the left area of the mask when forming the "C" shape with the thumb and index finger of left hand using the one-handed EC technique.

Clinical Nurses' Intention to Use Defibrillators in South Korea: A Path Analysis.

This study aimed to investigate factors affecting behavioral intentions to use defibrillators among clinical nurses in South Korea, using a modified predictive technology acceptance model 2 (TAM 2) that facilitates understanding of what prompts apparent spontaneous actions. This descriptive, cross-sectional study included 467 clinical nurses with more than 6 months of clinical experience. The path analysis results showed that the variables directly affecting the intention to use a defibrillator among clinical nurses were the image, organizational support, perceived ease of use, and perceived usefulness. Moreover, job autonomy and total career indirectly affected the intention to use a defibrillator. Clinical nurses need to know how to use defibrillators and be able to act promptly on patients with in-hospital cardiac arrest (IHCA). Organizational managers need to improve the work environments of clinical nurses accordingly. Additionally, it is necessary to establish a policy foundation to ensure the development of competence and job autonomy that can lead to the use of defibrillators by improving various factors, including anxiety or reluctance of nurses to use defibrillators in acute cardiac arrest.

Tidal volume according to the 4-point sealing forces of a bag-valve-mask: an adult respiratory arrest simulator-based prospective, descriptive study.

BACKGROUND: For adequate ventilation during bag-valve-mask ventilation, rescuers should ensure a proper mask seal using the one-handed or two-handed technique. Little is known about the magnitude of sealing forces of a bag-valve-mask needed for adequate ventilation. This study aimed to explore the effect of the 4-point sealing forces of a bag-valve-mask on tidal volume while using the one-handed technique, focusing on the moderating effect of C length (the distance from the thumb to the index finger in the C shape of the one-hand EC grip). METHODS: A prospective, descriptive simulation study was conducted. A convenience sample of 125 undergraduate paramedic students from two universities was recruited. A self-reported questionnaire was used to collect subjective variables. Tidal volumes, 4-point sealing forces of the mask, peak pressure, and C length of the C shape in the one-hand EC grip were measured using the mechanical lung model under a simulated adult respiratory arrest. Hierarchical regression analysis was used to determine the moderating effect of C length on tidal volume in bag-valve-mask ventilation. RESULTS: The average C length, peak pressure, and tidal volume were 7.54 (± 1.85) cm, 11.62 (± 5.40) cmH2O, and 321.66 (± 135.18) mL, respectively. The average range of the 4-point sealing forces was 0.03-0.69 N. The apex sealing force was the weakest among the 4-point sealing forces. Hierarchical regression analysis demonstrated that tidal volume accounted for 62.7% of the variance by C length, peak pressure, and apex sealing force during bag-valve-mask ventilation (F = 9.676, p < 0.001). C length moderated the effect of the apex sealing force and peak pressure on the tidal volume, meaning the higher the peak pressure and apex sealing force, the more the tidal volume and the longer the C length. CONCLUSION: This first simulation study measuring the 4-point sealing forces during bag-valve-mask ventilation provides effective advice that can be adopted in clinical practice without side effects and underpins the importance of continuous retraining and assessment focused on individual physical characteristics, such as C length and bag-valve-mask sealing forces.

Factors Affecting Attitudes Toward Defibrillator Use Among Clinical Nurses in South Korea: A Cross-Sectional Study.

INTRODUCTION: Nurses are often first responders to in-hospital cardiac arrests. However, many nurses do not perform defibrillation even when required. Nurses' attitudes toward defibrillator use are influenced by social and psychological context. This descriptive, cross-sectional study explored factors affecting attitudes toward defibrillator use among nurses in South Korea. METHODS: A total of 280 nurses with a minimum of 6 months' clinical experience were included. The data were acquired through a self-administered questionnaire. Regression analysis was used to determine factors significantly associated with attitudes toward defibrillator use. RESULTS: Only 13.6% of the participating nurses had experience with defibrillator use in a cardiopulmonary resuscitation situation, whereas 94.6% of the nurses had received training on defibrillator use. Attitudes toward defibrillator use accounted for 37% of variance in measures of self-confidence, image, and job fit. DISCUSSION: To improve clinical nurses' attitudes toward defibrillator use, improving their self-confidence, image, and job fit through ongoing assessment and retraining on defibrillation is required. In addition, relevant institutional support and systematic guidelines should be provided.

Factors Affecting the Disaster Response Competency of Emergency Medical Technicians in South Korea.

PURPOSE: This study explored the factors influencing disaster response competency, that is, demographic and disaster-related characteristics, personal disaster (household and workplace) preparedness, disaster risk perception, and self-efficacy in handling disasters among emergency medical technicians in South Korea. METHODS: The study follows a descriptive, cross-sectional design and uses a self-reported questionnaire. Emergency medical technicians, amounting to 1,020 in all, currently working in firefighting organizations from four South Korean cities (Busan, Daegu, Daejeon, and Ulsan) participated in the study. RESULTS: Disaster risk perception, self-efficacy for disaster, participation experience in disaster education/training, and personal disaster (household and workplace) preparedness predicted the disaster response competency of emergency medical technicians in South Korea. CONCLUSION: There is a need for an antidisaster program to enhance the disaster risk perception, self-efficacy, personal disaster (household and workplace) preparedness, and the disaster education/training participation rate toward enhancing disaster response competency of emergency medical technicians in South Korea.

Disaster Preparedness of Child Care Teachers: A Cross-Sectional Study in South Korea.

OBJECTIVE: We aimed to identify the differences in personal disaster preparedness and disaster risk perception among child care and preschool teachers in South Korea by using demographic characteristics and disaster-related questions. METHODS: A cross-sectional self-reporting questionnaire was administered from February to October 2014. RESULTS: Of all the participants, 68.1% had received disaster preparedness education and training on 2 or more occasions per year; 13.2% had received no education or training. Personal disaster preparedness differed significantly by marital status (P<0.05), the number of disaster education and training sessions attended (P<0.05), and having purchased home insurance (P<0.001). Disaster risk perception differed significantly by children's age group under a teacher's care (P<0.05). The topic on which child care teachers wanted more training was "fractures and bleeding emergency care" (53.9%). The most probable disaster was considered to be a typhoon (66.0%). CONCLUSIONS: Disaster preparedness is important for both young children and their teachers. Field-based teacher disaster preparedness education and training should be provided so that they can respond effectively to disaster occurrence regardless of type, time, or location. (Disaster Med Public Health Preparedness. 2018; 12: 321-328).

Workplace Bullying, Job Stress, Intent to Leave, and Nurses' Perceptions of Patient Safety in South Korean Hospitals.

BACKGROUND: Negative work environments influence the ability of nurses to provide optimal patient care in a safe environment. AIM: The purpose of the study was to test a model linking workplace bullying (WPB) and lateral violence (LV) with job stress, intent to leave, and, subsequently, nurse-assessed patient adverse outcomes (safety issues). DESIGN: This descriptive-correlational study examined the relationships between study variables and used a structural equation model to test the validity of the proposed theoretical framework. METHODS: A convenience sample of 508 clinical nurses working in eight general hospitals in Daejeon, South Korea, completed a questionnaire on measures of WPB, LV, job stress, intent to leave, and nurse-assessed patient safety. Analysis of moment structures was used to estimate a set of three models with competing measurement structures for WPB and LV and the same structural model. Akaike Information Criterion was used for model selection. RESULTS: Among the three proposed models, the model with complex factor loadings was selected (WPB and LV were both associated with verbal abuse and physical threat). WPB directly and indirectly influenced nurse-assessed patient safety. Job stress directly influenced intent to leave, and intent to leave directly influenced nurse-assessed patient safety. CONCLUSIONS: The results of the study support the proposition that WPB, job stress, and intent to leave may be associated with nurse-perceived adverse outcomes (patient safety issues) in hospitals. Nurse perceptions of WPB were associated with nurse-assessed patient safety outcomes (adverse events) directly and through mediating job stress and intent to leave. LV was not associated with the mediators or nurse-assessed adverse outcomes (safety).

A comparative study of the effects of intra and extra circumoral exercise for older people on oral health at nursing homes: a non-equivalent trial.

AIMS: To investigate the effects of using intra and extra circumoral exercise on subjective and objective parameters of pre- and postoral health of older people living in nursing homes. BACKGROUND: Oral health problems, such as dry mouth and halitosis, are very common complaints for older people and might be the cause of a physiological, psychological or social handicap. In an ageing society, a simple and convenient nursing intervention is needed to resolve these oral health problems without side effects. DESIGN: The present study adopted a pre- and posttest non-equivalent control group in a quasi-experimental design. METHODS: A total of 41 older people (experimental group 21, control group 20) living in nursing homes participated in intra and extra circumoral exercise (25 min a day, six times per week for 4 weeks) to improve oral health in 2013. Chi-square test/Fisher's exact test, t-test/Mann-Whitney U-test and analysis of covariance were used for the data analysis. RESULTS: ancova was used to control the covariates (age and the basic values of dependent variables) to identify the effect of intra and extra circumoral exercise on the oral health between the two groups. Dry mouth symptoms decreased, oral motor function improved, salivary secretion and mouth opening size increased, salivary pH improved, halitosis decreased more in the experimental group than in the control group. However, the salivary IgA was not significantly different between the two groups. CONCLUSIONS: The intra and extra circumoral exercises as an independent nursing intervention can effectively promote oral health of older people.

Occupational exposure to infection risk and use of personal protective equipment by emergency medical personnel in the Republic of Korea.

BACKGROUND: Few studies of occupational exposure (OE) to infectious risk among emergency medical personnel (EMP) or their use of personal protective equipment (PPE) have been conducted in the Republic of Korea. OBJECTIVE: To determine the status of OE to infectious risks and use of PPE. METHODS: A convenience sample of 907 questionnaires (response rate, 88.5%) was collected from September 1, 2014, to January 31, 2015, in 5 metropolitan Korean cities. RESULTS: Respiratory diseases were significantly prevalent (44.5%) and influenza (29.5%) was the most frequently reported illness. An exposure report was only made in 19.5% of cases. The primary reason for OE report noncompletion was the complexity of the reporting process (23.9%). A total of 365 participants reported OE to body fluids and blood (40.2%) with needlestick injury being the most frequent OE type (17.6%). More than 5 years of job experience (47.8%) (P < .001) and region (city) (P = .003) significantly increased OE to body fluids and blood. Puncture-resistant containers (71.9%) and disposable gloves (68.9%) were used. Job training and education on infection risks and use of PPE were not uniformly conducted (77.5%). Anxiety about OE to risk of infection from patients was common among EMP (63.2%). CONCLUSIONS: EMP experienced significant OE to infectious risk and use PPE inadequately. Surveillance and education programs regarding OE should be developed.

[Effects on couples' communication, intimacy, conflict and quality of life by foot massage between immigrants].

PURPOSE: The purpose of this study was to evaluate the effects on immigrant couples' communication, intimacy, conflict and quality of life when using foot massage. METHODS: The research design consisted of pre-and-post test consecutive experimental design through a nonequivalent control group. Data were collected July 6, 2009 to February 27, 2010. The 36 couples were divided into two groups, experimental and control with 18 couples in each group. Foot massage was applied twice a week for 6 weeks by the couples in the experimental group. RESULTS: There were statistically significant increases in communication (p=.011), intimacy (p<.001), quality of life (p=.017) between the couples in the experimental group compared to the control group. There was also a statistically significant decrease in conflict (p=.003) between the couples in the experimental group compared to the control group. CONCLUSION: Foot massage can be applied as a nursing intervention for improvement of marital relationship in immigrant couples.