PURPOSE
The objective of this study was to examine the relationships between nurses' knowledge and performance for the prevention of intravascular catheter-related infections (ICRI) according to the strength of recommendations in evidence based guidelines (EBG).
METHODS
The total participants were 144 nurses working for medical.surgical unit and intensive care unit. Data were collected from July 12 to July 30, 2010 and analyzed by one way ANOVA and Pearson's correlation analysis.
RESULTS
The knowledge and performance mean scores were 0.80+/-0.17 and 3.04+/-0.31 for peripheral venous catheter (PVC) management, and 0.83+/-0.17 and 3.00+/-0.30 for central venous catheter (CVC) management respectively. The items of category IA had the highest knowledge score (F=44.70, p<.001) and the items of category II had the highest performance score (F=47.09, p<.001) in PVC management, while the items of category IA had the highest knowledge (F=20.04, p<.001) and performance scores (F=18.20, p<.001) in CVC management. Knowledge and performance scores were significantly correlated in CVC management (r=.24, p=.004), but not in PVC management (r=.03, p=.753).
CONCLUSION
EBG for the prevention of ICRI was not fully implemented in clinical settings. These findings emphasize that clinical professions need to develope strategies to enhance nursing practices with evidence based guideline.

PURPOSE
This study was conducted to develop Web-based multimedia contents for supporting student nurses' clinical practice on critical care, and to evaluate learners' responses.
METHODS
Based on the steps of Assessment, Design, Development, Implementation, & Evaluation(ADDIE) model, a total of 13 self-directed learning modules including live lectures and real video clips were developed through faculty collaboration of nine nursing colleges in Gwangju and Chonnam province. The finally developed multimedia contents were published on the Web of the learning management system at a local e-learning center.
RESULTS
The Web contents were evaluated after self-learning by 81 junior college nursing students who were encouraged to study it at their own pace during their two-week clinical practice at a medical or surgical intensive care unit of a university hospital and two hospitals. The knowledge (t = -27.66, p < .001) and self-evaluated clinical performance level(t = 7.54, p < .001) were significantly increased after learning of the Web contents and clinical practice, and satisfaction level that measured post-test only was 4.0 out of 5 point.
CONCLUSION
The use of Web contents for critical care need to be extended as a complimentary material in a class room lecture or clinical practice of students to increase their self-learning ability and understandings of clinical knowledge and situation.

PURPOSE
This study was conducted to develop a simulation-based education course and to evaluate the results after the application for second year nursing students. METHODS: This study was a non-equivalent control pre-post design. Based on the clinical situation scenarios about patients with COPD and MI, a total of two simulation-based learning modules was developed. Pretest and posttest was conducted to evaluate the difference in critical thinking disposition, problem solving, and clinical competence between two groups of 102 students for the experimental group, 2007 and 90 students for the control group, 2006. The experimental group conducted a clinical performance evaluation in the final test, on December 10, 2007. RESULTS: In the experimental group, knowledge related to learning objectives was significantly increased and core intervention was performed almost exactly, but the same result was not observed in domains of analysis of laboratory test, and nursing education for patients. Self-evaluated clinical competence and problem solving level were significantly more improved in the experimental group than control group, but critical thinking disposition level wasn't. CONCLUSION: In conclusion, a simulation-based education course needs to utilize self-directed learning module like computer-based learning through web contents and MicroSim and video productions for improving nursing students' critical thinking.

PURPOSE
S: The purpose of this study was to evaluate the extent of performance on activities in critical pathway (CP) according to eight domains and six admission days on nursing records of patients who received total hip replacement surgery.
METHODS
We reviewed 90 nursing records of patients who received total hip replacement surgery from June, 2004 to July, 2005 at C University Hospital. Data were collected using Hong's CP (2002) and were analyzed using ANOVA.
RESULTS
The domain of diet was valued the highest in CP performance scoring, followed by the domains of assessment, activities, and test. There were differences in the performance scores according to the period of admission in all of the domains. Among 132 activities in the CP, 18 activities were completely performed, of which most included activities belonging to the domain of assessment on the admission day. Twelve activities were never performed, of which most included activities belonging to the domain of treatment on the day of operation and the first day after operation.
CONCLUSIONS
Therefore, further studies on the development of a new system to increase CP utilization and on updating the contents of CP from the best practice based on evidence is recommended.

PURPOSE
The purpose of this study was to identify the effect of web-based learning for ventilator practice on the knowledge and clinical competence of nursing students.
METHOD
The research design was a non-equivalent control group pre-post non-synchronized design. Twenty five nursing students were collected for the experimental group from August 23 to November 26, 2004 and nineteen nursing students for the control group from August 22 to November 25, 2005. All subjects experienced clinical practices in an intensive care unit of a hospital in G city for 2 weeks. The web-based learning for ventilator practice was conducted in the experimental group only. The data were analyzed with t-test and ANCOVA using SPSS 10.1 program.
RESULT
The 2 week web-based clinical practice learning significantly improved the knowledge scores for the experimental group, however, there was no significant differences in the score for the clinical competence between experimental and control group.
CONCLUSION
These findings suggest that a self-directed web-based learning for ventilator practice of nursing students can facilitate the knowledge of care for a ventilated patient. Therefore, faculties should develop a variety of web-based multimedia content programs for clinical instruction based on clinical situation.

PURPOSE
The purpose of this study was to examine descriptors of dyspnea and clinical characteristics in patients with COPD at ED visit. METHOD: The study design was a descriptive survey, and 46 patients with COPD complaining of dyspnea were participated during their visits to the ED of C university hospital in G city, from October 1, 2004 to April 8, 2005. RESULT: The qualitative characteristics of dyspnea at the time of decision to the ED visit were short of breath (71.7%), tight (32.6%), hard to breathe (15.2%), smothering or suffocating (10.9%), gasping (8.7%), couldn't breathe (6.5%), constricted (2.2%), and hunger for air (2.2%). In the item of dyspnea checklists, My chest felt tight was the most common description among subjects. As the result of factor analysis of dyspnea checklists, the first factor was characterized rapid and shallow, the second was suffocating/smothering, the third was hunger for air, and the fourth was constricted. CONCLUSION: This study suggests that a checklist of dyspnea descriptors based on this findings would be utilized as a tool of initial and ongoing assessment for dyspneic patients with COPD in the ED after identifying the validity and reliability of the checklist.