Purpose This study aimed to explore the roles, facilitators, barriers, and future directions of rapid response teams (RRTs) in Korean hospitals from the perspectives of both RRT and ward nurses.
Methods Focus group interviews were conducted with 10 RRT nurses and 10 ward nurses across three hospitals that employed RRTs in Korea from August 2021 to February 2022. The interviews were recorded, transcribed, and analyzed using qualitative content analysis to identify themes relevant to RRT operations.
Results The analysis yielded 10 subtopics and 4 main themes: the exploration of RRT's essential roles, the facilitators and barriers impacting RRT operations, and the construction of a blueprint for future systems. Notable barriers included unclear job assignments without legal safeguards, conflict arising from hierarchical structures, and insufficient organizational support. The following facilitators were identified: transformed perceptions through collaborative efforts, organizational recognition and support, and self-reinforcement by demonstrating expertise.
Conclusion This study highlights the challenges and opportunities associated with implementing RRTs in Korean hospitals, including the need for clear role definitions, effective interprofessional collaboration, and organizational support. Based on these findings, future efforts should focus on establishing legal frameworks that define the scope of practice for RRT nurses.
Purpose The purpose of this study was to develop and validate a tool to evaluate slow nursing performance for older adults in long-term care hospitals. Methods The search period was set from March 2013, when the term "slow nursing" was first used in the literature, to October 2021. A slow nursing tool was developed in two phases: development and verification. In the tool development phase, 29 items were developed through an extensive literature review and in-depth interviews with seven long-term care hospital nurses. Construct validity testing was performed by a 10-member expert panel, and a pilot survey was conducted on long-term care hospital nurses. In the tool validation phase, the construct validity, criterion validity, and reliability of the tool were tested by applying it to 181 nurses in long-term care hospitals . Results The final tool comprised five factors and 23 items, with an overall explanatory power of 56.8%. Construct validity was examined using confirmatory factor analysis, and the model fit was good. Known-group validity was established by the observation of a significant difference in the slow nursing score between intensive care unit and long-term care hospital nurses, and criterion validity was established by a significant correlation between the slow nursing and person-centered assessment scores. Internal consistency reliability was shown by a Cronbach's ⍺ coefficient of .781. Conclusion The concept of slow nursing has been clarified, improving the understanding and implementation of slow nursing care by nurses in long-term care hospitals. The Slow Nursing Tool for Long-term Care Hospital Nurses (SNT-LCHN) is expected to increase interest in and contribute to the effectiveness of slow nursing practices. It will serve as a valuable tool for improving nursing performance in these settings.
Purpose The purpose of this study was to investigate the awareness and educational demand regarding Vancomycin-Resistant Enterococci (VRE) infection control among nurses in wards with cohort isolation rooms. Methods A mixed-methods design was applied. Quantitative data were collected via structured questionnaires and data from 61 nurses and analyzed using SPSS for Windows version 23.0. An Importance-Performance Analysis (IPA) was conducted. Qualitative data were collected through focus groups with 12 nurses who worked in wards with VRE cohort isolation rooms, and content analysis was conducted. Results All items had lower performance scores than their importance scores, with significant differences. In the qualitative/descriptive analysis, the barriers to implementing VRE infection control were a lack of awareness of infection control, increased work burden, and lack of resources. Conclusion The findings indicate that it is necessary to develop systematic education tailored to nurses in wards with cohort isolation rooms. Furthermore, adequate resource support, distinct from the general infection control practices in other wards, is necessary. This includes considering additional infection control tasks and procedures when staffing the ward, as well as supplying equipment in accordance with cohort isolation requirements.
Purpose We aimed to systematically review and synthesize qualitative evidence on the experiences of nurses caring for hemodialysis patients. Methods We used Noblit and Hare’s meta-ethnography. Seven databases (PubMed, EMBASE, CINAHL, Web of Science, RISS, KISS, National Assembly Electronic Library) were used for the literature search. There were no restrictions placed on publication dates. A total of 10 studies published in English and Korean up until July 2021 were finally selected for review. Results Three themes were identified from the literature review, which were then divided into six subthemes: acquiring the technical skills of hemodialysis, responsibility for prolonging patients’ lives, and maintaining stable hemodialysis in patients’ daily lives. Conclusion The results of this study provide basic data that emphasizes the specific role of nurses in the hemodialysis unit, a specialized area of nursing, and can be utilized as educational material for hemodialysis unit nurse education.
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Other variables, including the medical department, activation duration in minutes, total national early warning score, and respiratory distress as the reason for activation (compared to sepsis or septic shock) predicted unplanned ICU admissions. Conclusion Electronic medical record screening by RRT may facilitate the early detection and monitoring of physiological deterioration in patients in the general medical ward. This strategy may help prevent unplanned ICU admissions and potentially reduce mortality.
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PURPOSE Although the patient safety is the first priority in hospitals, the safety strategies and supportive programs for nurses in medium and small-sized hospitals are still insufficient. The purpose of this study was to identify the correlates of patient safety performance related to characteristics of nurses working at small-medium sized hospitals with less than 200 beds. METHODS The study design was a descriptive correlational design. Data were collected from 211 nurses of seven small-medium sized hospitals located in Seoul, Korea. Study variables measured by using survey questionnaires were patient safety performance, safety culture, job satisfaction, and general characteristics. Data were analyzed by multiple regression using SPSS/WIN 22.0 program. RESULTS The strongest factor associated with patient safety performance was communication process (β=.21, p=.002) followed by working environment (β=.21, p=.008), satisfaction on job contents (β=.16, p=.033), and safety management manual in hospital (β=.12, p=.041). Among general characteristics, nurses unmarried, working as staff nurses, having more than 10 years of clinical experience, and working at hospitals with the first nursing grade performed better patient safety performance. CONCLUSION The study findings suggest that the small-medium sized hospitals require strategies for nurses, supportive working environment, clear job contents, and qualitative safety management manuals.
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PURPOSE The purpose of this study was to evaluate the experience of hospital nurses regarding their intention to stay at hospital. METHODS Experiential data were collected from 10 experienced nurses through in-depth interviews. The main question was "Could you describe your experience and your work during your years at the hospital?" Qualitative data from the field and transcribed notes were analyzed using Strauss and Corbin's grounded theory methodology. RESULTS The core category of experience regarding hospital nurses' intention to stay was 'following a stable rather than a challenging path'. Participants used three interactional strategies: 'being encouraged via rapport with peers', 'accept reality', and 'find vitality in academic pursuits'. CONCLUSION The retention of experienced nurses is critical to human resource management in nursing departments. This study found that experienced nurses have a vague uncertainty about their future in the hospital. Therefore, nursing managers should support experienced nurses by providing them with the opportunities needed to develop their careers, by managing conflicts in nursing units, and by implementing new programs to increase confidence.
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PURPOSE The purpose of this study was to identify Compassion Fatigue (CF), Somatization, and Silencing Response (SR) among nurses and understand intermediate effects between the variables. METHODS The sample of 240 nurses who were working three shifts in medical and surgical wards, and emergency room were recruited in three hospitals with over 700 beds. A structured questionnaire was used which included CF, Somatization and SR scales. The data were analyzed using descriptive statistics, ANOVA, Pearson's correlation coefficients and stepwise multiple regression. RESULTS There were statistically significant differences in CF, Somatization and SR depending on perceived personal health condition, experience of turnover, co-worker support. There were significant correlations between those study variables. The result also indicated that burnout (beta=.81, p<.001) which is a part of Secondary Traumatic Stress and Somatization (beta=.79, p<.001) have the role of partial mediator in the relationship between Secondary Traumatic Stress and Silencing response. CONCLUSION The results of study show that an intermediary role by Burnout and Somatization in Silencing response of nurses is important for effective human resource management in hospital nursing staffs. Effective human resource management which includes mentoring and social support system can enhance the professional quality of life of nurses, which will eventually contribute to the quality of care by those care providers and counselors.
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PURPOSE During hospitalization, confusion occurs in 15~20% of older adults and persists in 5~10% of them. This study was designed to investigate effects of a five-day nursing intervention program designed to reduce confusion in hospitalized older adults. Subjects were inpatients over the age of 60 years old and were admitted in a surgical care unit. METHODS Data were collected from 111 patients. Subjects divided into one of two groups, 58 patients of the control group which received the usual nursing care; and 53 patients of the intervention group which received the usual nursing care plus nursing intervention program for reducing acute confusion. The Delirium Observation Screening Scale (DOS) and the Korean Mini-Mental Screening Examination (MMSE-K) were utilized. RESULTS 1) Acute delirium was significantly reduced in the intervention group compared to the control group (chi2=4.22, p=.034) as well as the duration of the delirious state was significantly shortened (F=56.62, p<.001). Cognitive function of the intervention group was improved (F=21.14, p<.001). CONCLUSION The nursing intervention program reduced the incidence and duration of acute delirium of the elderly inpatients, as well as it helps them keep better cognitive function than the control group.
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PURPOSE Clinical nurses are at high risk of incurring hospital violence during their working life. Hospital violence and its outcomes have an impact on the job satisfaction, the recruitment and retention of nurses as well as the quality of care delivered to patients. The purpose of this study was to identify coping styles toward hospital violence in clinical nurses using Q-methodology. METHODS Q-methodology, which analyzes the subjectivity of each type of attitude, and coping styles was used. The 40 selected Q-statements from each of 35 participants were classified into the shape of a normal distribution using a 9-point scale. The collected data were analyzed using the pc-QUANAL program. RESULTS The results revealed four discrete groups of clinical nurses toward hospital violence: take strong action and promote the recurrence prevention, appear psychosomatic symptoms, investigate the cause and focus on prevention, and request hospital assistance and keep up my duty. CONCLUSION The findings indicate that development of nursing intervention program based on the four types could beneficially contribute to the violence prevention in hospital.
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PURPOSE The purpose of this study was to examine the under-reporting rate and related factors after blood and body fluid (BBF) exposure among hospital employees. METHODS Fifteen hundred employees were conveniently sampled from ten university and acute care hospitals. The survey questionnaire consisted of 37 items. Data were collected from September 10 to November 30, 2008. RESULTS The survey response rate was 88.7%. The 47.9% (638/1,331) of hospital employees were exposed to BBF and the mean number of exposure was 4.7+/-5.942 within the previous year. Under-reporting rate after BBF exposure was 69.4% (443/638). By multi-variate logistic regression analysis, the exposure number, exposure type, infectious disease and hospital were independently related to the under-reporting of BBF among hospital employees. CONCLUSION The Under-reporting Rate After Being Exposed To Blood And Body Fluids Was Relatively High. To Address This Problem, Educational Programs Are Needed To Decrease The Under-reporting Rate For Healthcare Workers. Further, It Might Be Helpful If Other Factors Related To Under-reporting Be Investigated In Future Studies.
PURPOSE This study was conducted to examine the degrees of depression and activities of daily living (ADLs), and to identify factors that predict depression in elderly patients. METHODS The sample was149 patients (80% female; mean age 79.1) from three geriatric hospitals located in small cities and who agreed to participate in the study. Data were collected by staff nurses involved in direct patient care from October to September 2009. The level of depression was measured on a daily basis for seven days using a 13-item scale. Patients' ADLs was measured using a modified 10-item Bathel ADLs scale. Data were analyzed using SPSS/WIN 17.0. RESULTS Mean depression score was 10.05+/-4.77 out of 26 points and about 27% was assessed as depressed with more than 13 points. Multiple regression analysis showed that low educational level, absence of spouse and fewer family visits predict depression. In addition, low ADLs and sleep disturbance predict depression. CONCLUSION Nursing care providers need to be concerned about ADLs of older patients and should develop nursing activity programs to increase their in-hospital physical activities. It is also important care for older patients' sleep and encourages family visits to decrease their depression.
PURPOSE The purpose of this study was to develop an algorithm for preventing and managing of pressure ulcer and to verify the its appropriateness. METHODS: The first step was development of a pre-algorithm through a literature review and expert opinion. The second step was to establish content validity by submitting the algorithm questionnaires about the content to 12 experts. The third step was the revision of the algorithm. The fourth and last step was to establish the clinical validity of the algorithm with 25 experienced nurses. RESULTS: For the ease of the practitioner the algorithm for prevention and the management of pressure ulcers was confined to one page depicting the main algorithm pathway and seven stepwise guidelines. The guidelines included skin care of pressure ulcer prevention, mechanical loading care, support surface care , reposition care of pressure ulcer, and Stages II, III and IV explanations along with debridement/wound irrigation and infection control. Most of all algorithm courses chosen more than 80% of agreement by expert index of content validity. The usefulness, appropriateness, and convenience of the algorithm were demonstrated through clinical validity with intensive care unit and ward nurses. CONCLUSION: The algorithm will improve the quality of pressure ulcer nursing care as it provides a model for decision making for clinical nurses as well as providing consistent and integrated nursing care for patients with pressure ulcer throughout an institution.
PURPOSE The purpose of this study was to identify the factors affecting sleeping patterns among hospitalized elderly. METHODS: A descriptive correlational study was conducted. Participants were 121 hospitalized elderly in a hospital located in a county. A structured questionnaire was used for data collection. Collected data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson's correlation, and stepwise multiple regression. RESULTS: Almost a half of hospitalized elderly in this study suffer from sleep disturbances. As results of univariate analyses, physical symptoms, anxiety, depression, and environmental factors disturbed sleep among hospitalized elderly. However, the result of stepwise multiple regression analysis identified that anxiety and environmental factors were significant predictors of sleeping patterns for hospitalized elderly and these two factors accounted 32.5% of variance of sleeping patterns among hospitalized elderly. CONCLUSION: Sleep assessment should be conducted on admission to identify sleep difficulties and thereby to improve quality of nursing care. Nurses and other health care personnels should make efforts to decrease anxiety and to eliminate environmental barriers of sleep among hospitalized elderly. Educational programs for nursing staff that offer information about sleep and sleep promoting interventions for the elderly patients are critical. Moreover, sleep promotion intervention program should be developed, applied and evaluated.
PURPOSE The present study was intended to measure fatigue symptoms according to the quality of sleep among nurses working for an university hospital and to reveal its related factors. METHODS: The self-administered questionnaires were given to 397 nurses employed in an university hospital located in Daejeon City during the period from June 1st to July 31st, 2007. RESULTS: The group with higher quality of sleep accounted for 78.1% of all the subjects and the one with lower quality, 21.9%. According to qualities of sleep, the fatigue symptom was determined to be significantly higher in the group with lower quality of sleep than its counterpart. On adjustment for quality of sleep, the level of fatigue symptom was significantly higher in the groups, than in each respective counterparts, who don't take regular exercises, who have few leisure time, who have lower level of subjective health status, who range> or = 1 and < 10 years in job careers, who work in shifts, who reported that it is hard to get physical burden of work, who are satisfied with the job, who find themselves unfit to the job, who are considering quitting the job, who have higher job demand, who have lower job control, who have higher level of supervisor support, who have type A behavior pattern. CONCLUSION: The study results may explain that the fatigue symptom of nurses is highly associated with the quality of sleep independently of other variables and also with job-related characteristics independently of the sleep quality. In conclusion, to reduce the fatigue symptom of nurses, strategic efforts should be directed for programs to improve the quality of sleep and a proper job analysis.
PURPOSE This critical ethnography was performed to explore the experiences of nurses who are working with patients in an industrial disaster hospital. During the research process, I focused on the experiences of conflict in caring patients. METHODS Data for the study came from 13 informants with their corresponding patients through interview and observation from March 2002 to February 2004. The data was examined line by line; then compared and contrasted based on a critical discourse analysis. RESULTS Nurses' conflicts came from discrepancies of the world views from that of the patients. Such conflicts arose because of various issues as follows: Worker as an individual vs patients, nurse as young women vs the medical profession, hospital as an extended home vs health care setting, and hospitalization as a means to enhance work capacity vs a means of treatment. CONCLUSION We need more study on the development of adaptive strategy for the nurses to overcome conflicts during their nursing career. Developing a nurses' and patient role intervention program is needed.
PURPOSE This cross-sectional survey research was undertaken to identify the factors influencing time from onset to hospital arrival of stroke patients and to provide basic information for the development of intervention programs for stroke patients. METHODS The data were collected using a convenient sampling method from three hospitals in Inchon. The subjects were 78 patients who were diagnosed as stroke by doctor and they voluntarily participated in the study. RESULTS On the average, subjects arrived at the hospitals by 16.72 hours after the onset of stroke events with the range from 0.17 hours to 72 hours. Thirty-four(43.6%) subjects arrived within 3 hours which can maximize treatment effects. There was significant difference in hospital presentation time according to the level of knowledge(chi-square=18.629, p=.0003). A negative correlation was found between the hospital presentation time and self-efficacy (r= -.320, p=.004). Stepwise multiple regression analysis revealed that the most powerful predictor was self-efficacy. Self-efficacy, the level of knowledge and physical symptoms were significant factors and accounted for 21.7% of the variance of hospital presentation time in stroke patients. CONCLUSION According to the results, self-efficacy is a useful concept for reducing the hospital presentation time from onset of attack in stroke patients. Therefore, nurses should consider educational programs which include not only a knowledge of stroke and recurrence prevention but also the concept of self-efficacy.
PURPOSE The purpose of the study was to explore how hospital nurses decide to quit working as professional nurses using the grounded theory method. METHOD: The data was collected by individual in-depth interviews with 12 hospital nurses who recently resigned from work and it was analyzed using 'constant comparative analysis.' RESULT: The core category that emerged was "in search of new balance with self, work, and family". Three stages were identified: 1) "unconditionally accepting the working situation of itself," 2) "weighing advantages and disadvantages of working as a hospital nurse", and 3) "redesigning a future". Each stage contains three major strategies. The major strategies of the first stage are "maintaining a learning attitude", "enduring physical burnout," and "enduring unfair interpersonal relationships". The second stage contains "identifying advantages of working", "identifying disadvantages of working", and "comparing the advantages with the disadvantages". Lastly, the third stage includes "reassessing the aim of life", "beginning to construct an alternative life", and "deciding to quit working at a certain point". CONCLUSION: The results of the study will help nursing administrators in designing and implementing an effective turnover prevention program for nurses by understanding more deeply the process of turnover phenomenon among hospital nurses.
PURPOSE The purpose of this study was to identify the degree of perceived powerlessness in hospitalized elderly patients of the medical and surgical unit. METHOD The instrument for this study was the Powerlessness Behavioral Assessment Tool(Miller, 1983). The reliability of the instruments was .85. The data was analyzed by descriptive statistics, t-test, and ANOVA. RESULTS The results were as follows; 1. The mean score of powerlessness was 35.02(SD=+/-9.24) in a range of 19 to 64, and the mean of powerlessness was total 1.84. Among 4 subscales, the highest score was in the area of verbal response (M=1.98), and the lowest score for powerlessness was in the area of daily activities(M=1.74). In all items, 'verbal expression of fatalism' showed the highest score(M=2.78), and 'verbal expressions of giving up' showed the lowest score(M=1.38). 2. There were significant differences in the level of powerlessness according to hospitalization experience(t=-3.03, p=0.006), medical treatment experience(t=.291, p=.004). Especially, there was significant difference according to the hospitalization experience of the hospital in all sub-scales. CONCLUSION Based on these conclusions, nursing education for patient's diseases and treatment can be used for proper nursing intervention in reducing the level of powerlessness of hospitalized elderly.
The purpose of this study was to evaluate the knowledge level of pressure ulcer among hospital nurses through a cross-sectional survey by using the pressure ulcer knowledge assessment tool of Beitz et al.(1998). The total of subjects was 160 voluntary participants (60 were from Hospital A and 100 were from Hospital B) working at adult patients' units in two university hospitals located in the same city. None of the hospitals had expert nurses of pressure ulcer nor provided a regular pressure ulcer education program during the past one year. The survey tool consisted of 32 true-false items which were grouped into the risk factors knowledge category(13 items), the wound assessment knowledge category(4 items), and the treatment methods knowledge category(15 items). An internal consistency reliability test of the tool yielded an overall coefficient of 0.72; the coefficient for the risk factors knowledge category was 0.40, that for the wound assessment knowledge category was 0.33; that for the treatment knowledge category was 0.54. The main findings of the study are as follows. 1)Demographic characteristics of the two hospital nurses were similar except for the educational level(p=0.029) and the work units(p=0.001). These observations were maintained even if Hospital A and B were separately compared. 2)The knowledge level of the subjects about pressure ulcer in general was low as indicated by 53.3 points(of 100 possible points) on average. The knowledge level about treatment methods of pressure ulcer was the lowest as indicated by 47.0 points on average. 3)No correlation between the knowledge level of the pressure ulcer and the demographic characteristics of nurses was found except that the knowledge level of I.C.U. nurses was significantly higher(p=0.0003) than that of nurses in other units(p=0.2926) in the case of Hospital A. 4)The knowledge level of nurses in Hospital B was higher than for nurses in Hospital A. The reason was not identified, but it seems that it is related to the role of the I.C.U. or some other factors. The study results confirmed the existing literature that knowledge level of nurses about pressure ulcer is low regardless of age, educational level, or work experience. However, the working place(unit) affected the knowledge level. Further research on the exact reason for the differences in the knowledge level is needed in the future.
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