PURPOSE
This study was undertaken to identify which delirium screening instrument would be more useful in clinical practice.
METHODS
Data were collected from 118 nurses from six hospitals in five provinces in Korea. For the delirium screening three instruments were compared: NEECHAM Confusion Scale (NEECHAM), Nursing Delirium Screening Scale (Nu-DESC), Delirium Observation Scale (DOS). The MMSE-K was used for concurrent validity. The nurse subjects were surveyed as to the practical clinical value of each instrument. Cronbach's alpha coefficient and Kuder-Richardson 20 were used to confirm the reliability.
RESULTS
The range of three scales reliability was .70~.82 and the range of correlation coefficient was .63~.82 with MMSE-K. For sensitivity of NEECHAM, Nu-DESC and DOS was 1.00, 1.00 and 0.81 respectively and specificity NEECHAM, Nu-DESC and DOS was 0.88, 0.89 and 0.89 respectively. Nurses rated the practical use of the DOS scale as significantly easier to use than the NEECHAM and Nu-DESC.
CONCLUSION
NEECHAM, Nu-DESC and DOS scales were acceptable in terms of reliability, validity, sensitivity and specificity. However, nurses rated the DOS scale as easier scale to use and had more relevance to their practice.

Citations

• Evaluation of Clinical Usefulness of Delirium Assessment Tools for Elderly Patients after Neurosurgery
  Su-Jung Kim, Jun-Ah Song
  Journal of Korean Gerontological Nursing.2015; 17(1): 38.     CrossRef

PURPOSE
This study was conducted to explore nursing education modality for facilitating undergraduate students' critical thinking within the Korean nursing education context.
METHODS
Data were collected from four group interviews from two focus groups, which were composed of six nursing professors in each group. Data were analyzed using qualitative content analysis.
RESULTS
Five themes with 13 sub-themes involving 10 categories were delineated. The five themes were managing shared resources, a supportive system in preparing qualified faculty, reflective thinking (self-directed learning), theory courses for understanding nursing resources, and clinical practicum for exercising critical thinking.
CONCLUSION
A nursing educational model for facilitating critical thinking within Korean context was suggested. This could be used as an accelerator in developing nursing undergraduate course programs for critical thinking in Korea.

PURPOSE
The purpose of this study was to investigate the effects of a walking and resistance exercise on body composition and lipid profile in obese women.
METHODS
Fourty three women were assigned to experimental group (n=21) or control group (n=22). The walking and resistance exercise using elastic band was provided three times a week for 12 weeks. Weight, height, body mass index, body fat percentage, abdominal fatness, skeletal muscle mass, body fatness, total cholesterol, triglyceride, HDL cholesterol, and LDL cholesterol were measured before and after the program. Paired and independent t-tests were performed using SAS program.
RESULTS
Weight (t=-5.35, p<.001), body mass index (t=-4.12, p<.001), body fat percentage (t=-2.33, p=.026), and body fatness (t=-4.32, p<.001) were significantly decreased and skeletal muscle mass (t=2.09, p=.044) was significantly increased after the walking and resistance exercise. Also, total cholesterol (t=-3.03, p=.006) and LDL cholesterol (t=-2.70, p=.011) were significantly decreased and HDL cholesterol (t=2.05, p=.046) was significantly increased after the exercise program.
CONCLUSION
According to the study result, exercise led a positive outcome on obese women in their 30~40s. The walking and resistance exercise will contribute to the improving body composition and lipid profile in this population.

PURPOSE
The purpose of this study was to examine the effect of maximal sterile barrier precaution on the central venous catheter-related infection and subsequent cost savings.
METHODS
Study subjects were 462 hospitalized patients with central venous, catheter of more than 48 hours duration. Data collection period was from April 2008 to February 2009 at a tertiary university hospital in Seoul. Subjects were randomly assigned to either the treatment or the usual care group. Patients in the treatment group (n=209) were treated by staff using maximal sterile barrier precautions and the comparison group(n=253) received traditional care.
RESULTS
Central venous catheter-days was2,821 in treatment group and 3,515 in comparison group. The incidence density of central venous catheter-related infection was 2.1 times higher in the comparison group (8.2 per 1,000 catheter-days) compared with the treatment group (3.9 per 1,000 catheter-days). The incidence density of central venous catheter-related bloodstream infection was 4.54 times higher than in the comparison group (3.2 per 1,000 catheter-days) compared with the treatment group (0.7 per 1,000 catheter-days). The attributable cost of central venous catheter-related infection in the treatment group was 10,174,197 won and that of the comparison group was 22,224,554 won. Attributable cost by area was also significantly lower compared with that of the comparisons.
CONCLUSION
The maximal sterile barrier precaution during central venous catheter insertion was an effective intervention to reduce central venous catheter-related infection rate and provides a significant cost savings.

PURPOSE
This study was object to the effects of a resistance exercise combined with relaxation therapy on blood pressure, frequency of exercise and physical fitness in elderly women.
METHODS
Seventy three elderly women participated in an exercise program for 12 months. The exercise program consisted of stretching, massage and resistance training using thera-bands twice a week and 50 minutes in every sessions each week. Repeated measures ANOVA were performed using SAS.
RESULTS
After the exercise program there was a significant difference in systolic blood pressure, frequency of exercise, body fat, sitting to standing, walking 2 minutes, sitting on a chair and reaching, and standing on one leg with eyes opened. After 6 months, there was a significant decrease in systolic blood pressure and significant increase in frequency of exercise, body fat, sitting to standing and standing on one leg with eyes opened. In 12 months, there was a significant increase in body fat, 2 minutes walking, and sitting in a chair and reaching.
CONCLUSION
Resistance exercise combined with muscle relaxation therapy would have a positive effect on elderly women. We found that it was helpful for the elderly women in terms of physical fitness.

PURPOSE
This study was to examine whether VRE infection control strategies have an effect on the decrease in incidence rates for VRE acquisition and VRE nosocomial infection in ICU.
METHODS
All the patients were examined for VRE carriers on ICU admission. Among them, patients hospitalized for over 48 hours were investigated for VRE acquisition rates and VRE nosocomial infection rate using VRE infection control strategies in ICU for the experimental group from September 2007 to April 2008. Before that, incidence of VRE acquisition and VRE nosocomial infection for the control group without Intervention were investigated from May to August 2007 retrospectively.
RESULTS
VRE acquisition rate in clinical specimens was 0.6% in the experimental group, that was significantly lower when compared to the control group. VRE carrier rate at admission to ICU was 15.4%. Out of 182 VRE carriers, 180 patients were identified by the active surveillance culture.
CONCLUSION
These results suggested that active surveillance culture at admission was considered to be an essential measure for detection of VRE carrier. But without strict isolation and adherence rating after each intervention, hand washing and contact isolation alone did not significantly decrease VRE nosocomial infection, although it did significantly decrease incidence of VRE acquired from clinical specimen.

PURPOSE
The purpose of this study was to examine the effects of hand massage on fatigue, sleep satisfaction and blood pressure of the aged in a long-term care facility.
METHODS
The data were collected from June to August 2008. The subjects were randomly recruited from a long-term care facility in Junnam Providence and were randomly assigned to the experimental group (n = 22) or control group (n = 22). Hand massage was carried out every other day in the evening for two weeks. Massage was administered to each forearm and hand for 10 minutes. Descriptive statistics, x2-test and t-test were performed using SAS program.
RESULTS
In the experimental group, the fatigue (p = .017) was significantly lower and the sleep satisfaction (p = .043) was significantly higher than for the control group.
CONCLUSION
On the basis of the results of the study, hand massage can be recommended for the elderly with sleep disturbance to reduce fatigue.

PURPOSE
To examine the effects of power walking exercise on fatigue and overweight in college students with Taeumin constitution. METHODS: According to results of the constitution diagnosis (QSCC II), 58 students who were identified as Taeumin, whose BMI was over 23 were assigned to one of three groups. The power walking group walked fast at a speed of 7,000 steps per hour using a pedometer, and the walking group walked at a speed of 5,000 steps per hour. There was no treatment with control group. Each group's fatigue level, blood lipids and body composition before and after the experiment were compared and analyzed. RESULTS: Total fatigue and total cholesterol decreased significantly in the power walking group compared to the walking group and the control group. Weight decreased significantly in the power walking group compared to the control group, and percentage of body fat decreased significantly in both the power walking group and the walking group compared to the control group. CONCLUSION: When power walking exercise was used with overweight Taeumin students, fatigue, blood lipid, weight and percentage of body fat decreased significantly.

PURPOSE
The present study is a quasi?experimental research for examining the effects of imagery on stress, anxiety and immune cells in acute leukemia patients receiving chemotherapy and utilizing the therapy for their self control and stress management.
METHODS
The subjects were 60 patients who were diagnosed with acute leukemia and scheduled to receive chemotherapy at A hospital in Seoul during the period from November 2006 to March 2007. After the start of chemotherapy, the experimental group received imagery for 4 weeks, three sessions a week, so a total of 12 sessions and 156 minutes.
RESULTS
The decrease of stress was larger in the experimental group than in the control group. Systolic blood pressure decreased significantly more in the experimental group than in the control group. In the experimental group, state anxiety decreased significantly in the 2nd week of the experiment and after the final stage of the experiment. The total number of white blood cells, and the absolute number of neutrophils and lymphocytes were showing significant differences between the time points.
CONCLUSION
Imagery is an effective intervention for reducing stress and state anxiety and stabilizing blood pressure in acute leukemia patients receiving chemotherapy.

PURPOSE
This study was conducted to examine the knowledge level and assessment experience of nurses in regards to delirium, and to utilize the study results as baseline data for planning delirium education programs for nurses.
METHODS
Subjects were 465 nurses who were working in a general hospital. A 'delirium related knowledge and assessment experience' questionnaire was used to collect data.
RESULTS
Knowledge levels regarding delirium averaged 70 out of 100, and at each domain, they scored 87 for etiology of delirium, 62 for symptoms, and 69 for nursing management. The knowledge level of delirium was significantly different according to educational level (F=3.851, p=.022), past education related to geriatrics(t=2.471, p=.014), and awareness of need for in-service education on geriatric nursing(F=2.663, p=.032). About 85% of nurses had past experience of dealing with delirious patients and only 7.7% of nurses used delirious state assessment tools.
CONCLUSION
According to the above results, it is necessary, not only to provide delirium related educational programs for nurses, but also to emphasize the usefulness of applying the assessment tool.

PURPOSE
The purpose of this study is to develop a set of standardized nursing interventions and their associated nursing activities according to the NIC system to guide home care nurses in performing nursing intervention activities for hospice patients.
METHOD
This study was a descriptive survey that first identified frequently used & specialized hospice nursing interventions based on the NIC systems and next validated a set of standardized nursing interventions and their associated nursing activities. One hundred chart records of home hospice patients were used to identify nursing interventions. Also, thirty-nine hospice specialized nurses participated twice using the Delphi technique to test the content validity of the standards.
RESULTS
Among the nursing interventions, 19 important nursing interventions and 418 associated nursing activities were selected after two rounds of Delphi technique by hospice specialized nurses. The mean content validity of the final nursing activities was 0.82. In this paper, only the 3 most frequently used nursing interventions and 3 hospice specialized nursing interventions with their associated nursing activities are presented since space is limited.
CONCLUSION
The nursing intervention standards will be a basis for home hospice nurses to improve quality of hospice care for hospice patients.

OBJECTIVE
The study was conducted by the Association of Korean College of Nursing in order to survey and analyze the current state of clinical practicum for adult health nursing at four-year nursing college in Korea and to suggest improvements in the contents and methods of clinical practicum and its future direction. METHOD: Data were collected using a survey by mail from July to November 2004 using a structured questionnaire on the general state of clinical practicum for adult health nursing. The questionnaires were sent to 53 nursing colleges throughout the country, and 47 recovered questionnaires were analyzed. RESULTS: The number of credits for adult health nursing practicum was 7~10(average range), and various nursing fields were used in clinical practicum. The number of students per team was 5~6 at general wards and 3~4 at intensive care units. Students also experienced practicum during daytime and in the evening. Clinical practicum for adult health nursing was led by full-time professors and field practicum directors. In clinical practicum for adult health nursing, almost every college evaluated students' attitude, skills, leadership, etc. in various forms. CONCLUSIONS: It is urgent to develope a standardized evaluation tool for clinical practicum.

PURPOSE
The study is to investigate the effects of tea tree oil gargling on oral cavity micro-organism growth and on the perceived discomfort of patients receiving chemotherapy. METHODS: A nonequivalent control group non-synchronized design was used to determine the effects of tea tree oil gargling on oral cavity for 20 second after using it for one week, twice a day. The sample consisted of two groups of patients receiving chemotherapy : 19 patients in experimental and 20 patients in control group. The instruments used in the study were Oral Assessment Guide(OAG), a measure of perceived symptoms on oral cavity, and a test of oral mucosal micro-organism culture. The data were analyzed using chi-square test, repeated measure of ANOVA, and Pearson correlation coefficient. RESULTS: There was no significant difference between the two groups in micro-organism culture test of oral mucosa. The experimental group showed a lower number and fewer kinds of micro-organisms than the control group. CONCLUSION: It is considered that use of tea tree oil is effective in infection control of the oral cavity.

PURPOSE
This study was designed to investigate the survey of analyzing nursing interventions and nursing outcomes of the patients with liver transplantation. METHOD: The subjects of this study consisted of 83 patients and fifteen nurses who took care of them. The methods of this study were retrospective and descriptive survey. RESULT: The mean age of patients was 42.7 years and the subjects were 62.7% males. 56.7% of these patients were diagnosed with liver cirrhosis of B type. The mean duration of hospitalization was 48.6 days. Ninety-five nursing interventions were performed at least daily. The most frequent used interventions were "environmental management: comfort", "medication administration: parenteral", "cough enhancement", and " oxygen therapy". Even though SGOT level to identify nursing outcomes was decreased, SGOT was not within normal limits. Therefore, even after discharge of patients, There is a need to take care of them carefully. CONCLUSION: Conclusion: These findings revealed the significance and need of nurse practitioners who performed professional nursing intervention for the patients with liver transplantation. Especially, it is necessary needs to develop the nursing intervention programs for comfort.

PURPOSE
This study was aimed at providing scientific evidence for minimizing ventilator-associated pneumonia(VAP) by identifying appropriate timing of exchange of circuit for mechanical ventilator that is well suitable for the medical environment of intensive care units of hospitals in Korea.
METHOD
This was a quasi-experimental study with a convenience sample of 19 adult subjects aged over 18 years who were admitted to the NS ICU of C university hospital, and placed on mechanical ventilator. The subjects were placed in two groups, compared on the incidence rate of VAP after they received exchange of circuit either at 1-week interval (N =10) or 2-week interval (N = 9).
RESULT
1) When considering 1000 days as the standard unit of analysis for incidence, the incidence rate of VAP was 7.19 cases at the 1-week cycle exchange group and 15.23 at the 2-week cycle exchange group, showing no statistically significant difference between the two groups. 2) There were a total of 3 types of bacteria isolated from the patients with VAP, including 2 cases with P. aeruginosa, 1 case with Streptococcus group F and A. baumannii.
CONCLUSION
With thorough hand washing and strict management of tracheal tube of mechanical ventilator as well as use of tracheal intubation techniques, exchange cycle of circuit of mechanical ventilator by nurses may be changed from 1-week to 2-week interval.

PUPPOSE: This study was to investigate the knowledge, attitudes, and educational needs for sexuality of the elderly.
METHOD
This was a descriptive study, in which data were collected from February to April 2002 from 354 elderly who were residing in Chung-Chung province.
RESULT
1. The level of knowledge regarding sexuality was below average. 2. The level of the attitudes toward sexuality of the elderly was neither positive nor negative. 3. The educational needs of the elderly were above average. 4. Higher level of knowledge on sexuality was significantly correlated with more positive attitudes and education needs for sexuality, and more positive attitudes toward sexuality was significantly correlated with more educational needs for sexuality.
CONCLUSION
Particularly men, with good health, and those who were in intimate relationships with their spouses and still engaged with active sexual life showed somewhat higher level of knowledge and positive attitudes as well as higher educational needs. Therefore, further development and applying of sexuality promotion programs for healthy elder couples should be considered in the future to enhance the quality of life of elder population. In addition, it is also suggested to develop an alternative intervention program on sexuality for elderly who are women, those with meager health, and the bereaved.

PURPOSE
This is a clinical experimental study aimed to provide basic data to ensure quality care. The purpose of this study is to increase nurses hand washing behavior and decrease respiratory isolation rate of MRSA.
METHOD
This study was conducted in Kangnam St. Marys hospital. The subjects included 5 nurses working at the NS ICU and 165 specimen for nasal swabs and 46 specimen for sputum cultures from 106 patients admitted to the NS ICU. The data were collected from June to September 2000.
RESULTS
1.The percentage of the nurses hand washing was 15.6percent but was improved to 46.5 percent after the educational intervention. In particular, hand washing behavior was increased in situations such as after suctioning, before parenteral nutrition, and after providing hygiene care. 2. Results of nasal swab showed that MRSA isolation rate was reduced from 42.8 percent before the education to 18.6percent after the education. The sputum culture results also showed that the MRSA rate was reduced from 40.7percent before the education to 34.6percent after the education.
CONCLUSION
The findings showed the nurses' strict hand washing behavior and use of disposable gloves and paper towers as well as use of hand sterilization spray by visitors or families can decrease the MRSA isolation rate in the NS ICU patients. Since the NS ICU patients may have respiratory complications due to long-term hospitalization, the nurses regular hand washing is important enough to be emphasized. Future research should be focused on the impact of nurses' hand washing behavior on the incidence of pneumonia, an iatrogenic infection.

The purpose of this study is to develop and evaluate the Self Efficacy Promotion and Exercise Program to prevent of obesity and cardiovascular diseases for the kidney transplant recipients. The subjects were selected randomly among the patients who underwent kidney transplantations at one major transplantation hospital in Seoul, Korea. This study ws carried out between November 23, 1999 and February 15, 2000. The subjects in this study consisted of 16 patients who had kidney transplantations between 1 month and 12 months ago prior to this study. They were all on steroids therapy and did not take any physical exercise regularly. The subjects received the self efficacy promotion and exercise program for 12 weeks which contained self efficacy promotion education and exercise program. The weight, body fat rate, exercise time and cardiopulmonary function were evaluated before the experiment and after the experiment. The results were as follows: 1. After the experiment, the weight was significantly decreased than that of before the experiment(p=.0001). 2. After the experiment, the body fat rate was significantly decreased than that of before the experiment(p=.0010). 3. After the experiment, the exercise time was significantly increased than that of before the experiment(p=.0002). 4. After the experiment, the absolute VO2 was significantly increased than that of before the experiment(p=.0008). 5. After the experiment, the relative VO2 was significantly increased than that of before the experiment(p=.0002). This study showed that the self efficacy promotion and exercise program was effective. So it would be expected that this self efficacy promotion and exercise program could be applied as an effective independent nursing intervention widely in prevention of obesity and cardiovascular diseases for kidney transplant recipients.

This study was designed to compare the nurse and nurses aids on their perception and performance levels for nosocomial infection control and to evaluate the relevant variables. The study data were obtained from 246 nurses and 219 nurse aids working at two university hospitals in Seoul, by using a constructed questionnaire. The data was collected from March to April of 1998, and analyzed using the SAS program for t-test, two way ANOVA, Pearson's Correlation Coefficients. The results were as follows; 1. The mean score of the perception level for nosocomial infection control of the nurse(M= 4.72) was higher than that of the nurses aids(M= 4.56). 2. No significant association was found between the nurse and nurses aids on their performance level for nosocomial infection control. 3. The score of perception level showed significant interaction by age in all domains, by career in contaminated material and environmental management, and by department in sterile and environmental management. Regarding the performance levels, the score showed significant association between hand washing and clothing management by age and career. However, there was no significant difference by department. 4. A positive correlation was found in the perception and performance levels for nosocomial infection control between the nurse and nurse aids. In conclusion: the mean score of the perception level for nosocomial infection control in nurses was higher than that of their performance level. In the case of nurses aids, the mean scores of the perception and performance level for the nosocomial infection control were the same but lower than those of the nurses. It is suggested that appropriate hospital infection control programs should be developed by continuous systemic education and practice to improve the nurse and nurses aids' level of perception and performance for nosocomial infection control.

The purpose of the study was to investigate two areas as a basis for providing an educational program for pulmonary rehabilitation. A) the learning needs about chronic obstructive pulmonary disease in patients with chronic obstructive pulmonary disease and B) the perception of nurses of the same learning needs. The subjects consisted of 57 patients, with chronic obstructive pulmonary disease, at the general hospital in Seoul and 71 nurses, who were working in the medical ward. Data was obtained from a "learning need" questionnaire between October 29 and November 19, '99. Data was analyzed using SAS program for t-test, ANOVA, Scheff test. The result were as follows: 1. The learning needs of the nurses(mean 4.36 +/- .38) were higher than those of the patients (mean 3.56 +/- .83). (t=6.78, P=.001) 2. The highest ranked patient education needs were as follows ; a)"how to control dyspnea", b)"cause for activating dyspnea", and c)"how to minimize the necessity of oxygen in daily living": and nurses' learning needs were ; a)"how to cope with the risk situation", b)"management after discharge", and c)"how to control dyspnea". 3. In the patient group, those who had a college degree or higher education and paid their own hospital expenses were higher in the learning needs. According to the above results, we should consider an educational program which is realistic and effective for patients by evaluating the items the patients really want to learn about and how much they know about the evaluated items.

A meta-analysis of 13 quasi-experimental studies was conducted to determine the effect of various nursing interventions applied to surgery patients. The studies were selected from dissertations done between 1982 to 1996 and had randomized or nonequivalent control groups in a pretest-post test design. The studies were classified according to three criteria : 1) types of surgery 2) types of nursing interventions 3) types of respondent variables. The following analysis was done : 1) Determination of usefulness of nursing interventions for surgery patients. 2) The magnitude of effect for each study was tested for different types of surgery, nursing interventions and outcome variables. 3) For a group of homogenious studies, the weighted mean effect size and standard error were estimated. Some findings are summarized as follows : Nursing interventions on relaxation effect applied to surgery patients have resulted in a significant effect size on pain, anxiety, and BP stabilization. Relaxation and music therapy were more effective on surgery patients than either education, heat therapy, or purposeful touch. It was impossible to identify which type of surgery was more effected by these interventions. On the basis of these findings, the following recommendations were made : 1) Many studies on the same kind of intervention applied to similar surgery patients should be accumulated continuously to identify factors that affect the effect size. 2) The detailed explanation of research process, such as, assignment method to experimental and control groups, starting points, duration and frequency of nursing interventions, and estimation of the outcome variables should be described in orther to be utilized for further research and practice.

The purpose of this study is to investigate th effect of the blood pressure self monitoring on the reduction of essential hypertension. This study had been conducted from March to July, 1995. Six persons who lived in Song-pa Gu, Seoul were selected for the experimental participants. They were consist of 5 males and 1 female. The samples measured their blood pressure by automated sphygmomanometer in supine position every morning(6-7AM) and night(10-11PM) for 6 weeks. The researcher measured blood pressure of samples in supine position by mercurial shpygmomanometer 2 times a week for 6 weeks. The samples' subjective stress was measured by VAS before and after the experiment. Results were as follows : 1. The average age of the samples was 53 (range from 49 to 60) and the average hypertension history of the samples was 56 months (range from 1 month to 10 years). 2. The self measuring samples' blood pressure of the morning showed the tendency of gradual reduction during the 2nd week and the 5th week. 3. The self measuring samples' blood pressure of the night showed no variation but systolic blood pressure showed slight reduction during the 5th week. 4. The blood pressure measured by researcher showed no variation but it showed the higher blood pressure than the self measuring samples' blood pressure. The conclusion is that the blood pressure self monitoring had effects on the reduction of essential hypertension, especially on the reduction of systolic blood pressure. 5. Generally blood pressure measured by researcher showed the higher blood pressure than the self measured samples' blood pressure. Therefore the medical persons who measure the blood pressure must be more careful when they measure blood pressure. I suggest that, first the client who want to know their real blood pressure should compare the blood pressure measured by clinic with the self monitoring method. 2nd the patient of essential hypertension who take anti-hypertensive agents should be selected in sampling. 3rd the experiment of the lasting duration of reduction of blood pressure self monitoring should be conducted.