PURPOSE
The purpose of this study was to compare the content of the falls prevention guideline developed by Korean Hospital Nurses' Association (KHNA) in 2008 with the seven guidelines recommended by The Joint Commission.
METHODS
The contents of the eight guidelines were categorized into eight assessment, eight intervention, and two outcome elements that were considered core concepts of individual nursing activities. Concept-level comparisons were conducted using the International Classification for Nursing Practice, and the Logical Observation Identifiers, Names, and Codes. Two researchers independently examined the content coverage of each guideline and assigned 1 point to included content, 0 to excluded content, and 0.5 to similar content that was ambiguous in terms of a broader expression. The scores were compared, with discordance among raters resolved through consensus-based discussions.
RESULTS
The communication element in the assessment area was missing from the KHNA guideline, while five elements of pathophysiologic, mental/cognitive, therapeutic, and post-fall assessments showed lack of content. Although there were no missing elements in the intervention area, the three elements of staff communication, risk-targeted, and post-fall interventions showed considerable lack of content compared to the other guidelines. In terms of outcomes, the severity of fall-related injury was omitted, and the facility's policy on falls prevention was not addressed.
CONCLUSION
Many nursing elements and key concepts were missing from the KHNA guideline, and its content was not comprehensive. This suggests that the current guideline needs to be revised urgently, and the points identified in this study should be considered a high priority.

Citations

• Evaluation of an approach to clinical decision support for preventing inpatient falls: a pragmatic trial
  Insook Cho, MiSoon Kim, Mi Ra Song, Patricia C Dykes
  JAMIA Open.2023;[Epub]     CrossRef
• Identifying Frequently Used NANDA-I Nursing Diagnoses, NOC Outcomes, NIC Interventions, and NNN Linkages for Nursing Home Residents in Korea
  Juh Hyun Shin, Gui Yun Choi, Jiyeon Lee
  International Journal of Environmental Research and Public Health.2021; 18(21): 11505.     CrossRef
• Development of ICNP‐based inpatient falls prevention catalogue
  I. Cho, J. Kim, J.S. Chae, M. Jung, Y.H. Kim
  International Nursing Review.2020; 67(2): 239.     CrossRef
• Evidence-based Clinical Nursing Practice Guideline for Management of Inpatient Falls: Adopting the Guideline Adaptation Process
  Insook Cho, Kyung Hee Park, Minhee Suh, Eun Man Kim
  Journal of Korean Academy of Fundamentals of Nursing.2020; 27(1): 40.     CrossRef

Oral mucositis continues to be a major complaint of patients who have chemotherapy for the acute leukemia. An innovative and inexpensive remedy which produces favorable results for those afficted is not yet introduced. So we tried to develop two oral care protocols for reducing the level of oral mucositis during cytotoxic therapy through literature review and our clinical experience. The one is sodium bicarbonate-normal saline gargling, and the other consists of chlorhexidine gargling. This quasi-experimental study was performed to compare the efficacy of these two different oral care protocols. Twenty subjects were assigned to one of the two specific diagnosis of leukemia, aim of the chemotherapy. The Oral Assessment Guide(OAG), the Beck's perception of oral comfort, WHO Grading system fot mucositis and the discomfort of oral gargling solution were used to assess oral status and subject's oral discomfort during chemotherapy. Each subjects were observed daily from the start of the chemotherapy until Absolute Neutrophil Count(ANC) reached 1,000. It continued about 2-4 weeks. The data analyzed by Mann-Whittney U test and ANCOVA. The result was follows as: The patient who used sodium bicarbonate-normal saline gargling showed significantly higher mean score of the discomfort of oral gargling solution than chlorhexidine gargling. The other scores were not significantly different between two groups. However the subjects using the sodium bicarbonate-normal saline gargling showed a lower level of oral mucositis. We concluded that oral using sodium bicarbonate-normal saline gargling was between to reduce the level of oral mucositis during chemotherapy and nursing assessments of the oral cavity seemed to promote patient's compliance with the oral care regimen.