• Journal of Korean Academy of Dental Administration
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• v.8 no.1
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• pp.1-7
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• 2020

Dental settings have unique characteristics that warrant specific infection control considerations, including (1) prioritizing the most critical dental services and provide care in a way that minimizes harm to patients due to delayed care, or harm to personnel from potential exposure to persons infected with the COVID-19 disease, and (2) proactively communicate to both personnel and patients the need for them to stay at home if sick. For health care, an interim infection prevention and control recommendation (COVID-19) is recommended for patients suspected of having coronavirus or those whose status has been confirmed. SARS-CoV-2, which is the virus that causes COVID-19, is thought to be spread primarily between people who are in close contact with one another (within 6 feet) through respiratory droplets that are produced when an infected person coughs, sneezes, or talks. Airborne transmission from person-to-person over long distances is unlikely. However, COVID-19 is a new disease, and there remain uncertainties about its mode of spreads and the severity of illness it causes. The virus has been shown to persist in aerosols for several hours, and on some surfaces for days under laboratory conditions. COVID-19 may also be spread by people who are asymptomatic. The practice of dentistry involves the use of rotary dental and surgical instruments, such as handpieces or ultrasonic scalers, and air-water syringes. These instruments create a visible spray that can contain particle droplets of water, saliva, blood, microorganisms, and other debris. While KF 94 masks protect the mucous membranes of the mouth and nose from droplet spatter, they do not provide complete protection against the inhalation of airborne infectious agents. If the patient is afebrile (temperature <100.4°F)* and otherwise without symptoms consistent with COVID-19, then dental care may be provided using appropriate engineering and administrative controls, work practices, and infection control considerations. It is necessary to provide supplies for respiratory hygiene and cough etiquette, including alcohol-based hand rub (ABHR) with 60%~95% alcohol, tissues, and no-touch receptacles for disposal, at healthcare facility entrances, waiting rooms, and patient check-ins. There is also the need to install physical barriers (e.g., glass or plastic windows) in reception areas to limit close contact between triage personnel and potentially infectious patients. Ideally, dental treatment should be provided in individual rooms whenever possible, with a spacing of at least 6 feet between the patient chairs. Further, the use of easy-to-clean floor-to-ceiling barriers will enhance the effectiveness of portable HEPA air filtration systems. Before and after all patient contact, contact with potentially infectious material, and before putting on and after removing personal protective equipment, including gloves, hand hygiene after removal is particularly important to remove any pathogens that may have been transferred to the bare hands during the removal process. ABHR with 60~95% alcohol is to be used, or hands should be washed with soap and water for at least 20 s.

• Journal of Korean Clinical Nursing Research
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• v.29 no.1
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• pp.42-55
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• 2023

Purpose: This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. Methods: The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. Results: Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. Conclusion: The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

• Journal of Medicine and Life Science
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• v.17 no.1
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• pp.29-32
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• 2020

As respiratory syncytial virus(RSV) is transmitted either via directly contact with an infected case or via indirectly contaminated fomites or skin, the major preventive measures are strict hand hygiene, early detection of transmitted sources, and rapid isolation of RSV patients. Especially early detection of hidden cases is the most critical control measure when an index case was notified in a postpartum center. The Guideline of Korea Centers for Diseases Control and Prevention defines potential contacts in an epidemiologic survey as admitted newborns, parents of index cases, center's workers, and visitors for 10 days before the first diagnosis day of index case. However, it needs to classify potential contacts in more detail in order to conduct a successful survey. Authors conducted to search related literatures and appraise the evidences. Firstly, potential contacts would be classified into RSV-related symptomatic contacts(SxC) and asymptomatic contacts. And then, mother, caring workers, and visitors of the index cases among asymptomatic contacts would be defined as the asymptomatic close contacts(ASCC). Finally, the rest would be defined as the asymptomatic regular contacts(ASRC). The defined test using reverse transcription-PCR is applied to SxC and ASCC, and decision of isolation or regular activities are made according to the results. The rapid antigen detection test kits are applied to ASRC. These suggestions might be helpful to detect hidden cases earlier and prevent a further infection.

• Journal of Industrial Convergence
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• v.20 no.11
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• pp.205-211
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• 2022

This study is a descriptive research study to identify the knowledge and compliance of multidrug-resistant organisms of nursing students with clinical practice. Data were collected from 212 nursing students in two nursing schools in D city from 1 November 2020 to 10 March 2021. The collected data were statistically analyzed using the SPSS/WIN 25.0 program. Correlations were found between knowledge and compliance of multidrug-resistant organisms (r=.40, p<.001). Therefore, to enhance the compliance of multidrug-resistant organisms of nursing students, it is necessary to prepare detailed theoretical and practical guidelines for multidrug-resistant organisms in the curriculum and clinical practice and to increase knowledge through multidrug-resistant organisms infection control education.

• Journal of Environmental Health Sciences
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• v.46 no.5
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• pp.599-609
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• 2020

Objectives: Coronavirus disease 2019 (COVID-19) first emerged in December 2019 in Wuhan, China, and has rapidly become a global pandemic with over 26.4 million confirmed cases and approximately 871,000 fatalities worldwide as of this writing. In the Republic of Korea, disease clusters frequently occurred in long-term care hospitals where the majority of residents are elderly with underlying medical conditions. Despite the fact that public health authorities and local community health centers have put tremendous efforts into preventing the spread of disease, positive cases have continued to occur. Thus, the Korea Centers for Disease Control & Prevention rapid response team decided to conduct an environmental investigation of a long-term care hospital to identify whether environmental contamination has remained and contributed to the spread of COVID-19. Methods: An environmental investigation was conducted at Hospital A. The characteristics of the facility and its HVAC system were assessed by checking the layout and interviewing the people in charge. A total of 64 surface samples were collected from areas of concern, including patient rooms, toilets, elevators, and nurses' station. These samples were tested by a regional health and environmental research institute using real-time reverse transcription polymerase chain reaction. Results: All samples from Hospital A were confirmed to be negative. Through interviews with high-level personnel at the regional community health center, we found that extensive disinfection is frequently performed on potentially contaminated areas in Hospital A in accordance with government guidelines. Conclusion: The environmental control measures implemented in Hospital A had been sufficient for mitigating the risk of further infection, suggesting that such measures may also be effective for other long-term health care facilities.

• Archives of Craniofacial Surgery
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• v.25 no.2
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• pp.71-76
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• 2024

Background: The rising incidence of dialysis-dependent end-stage renal disease (ESRD) has underscored the need for collaboration between plastic surgeons and nephrologists, particularly concerning preoperative and postoperative management for facial reconstruction. This collaboration is essential due to a scarcity of comprehensive information in this domain. Methods: A study initiated in January 2015 involved 10 ESRD cases on dialysis undergoing Mohs micrographic surgery for facial skin cancer, followed by reconstructive surgery under general anesthesia. To ensure surgical safety, rigorous measures were enacted, encompassing laboratory testing, nephrology consultations, and preoperative dialysis admission. Throughout surgery, meticulous control was exercised over vital signs, electrolytes, bleeding risk, and pain management (excluding nonsteroidal anti-inflammatory drugs). Postoperative assessments included monitoring flap integrity, hematoma formation, infection, and cardiovascular risk through plasma creatinine levels. Results: Adherence to the proposed guidelines yielded a notable absence of postoperative wound complications. Postoperative plasma creatinine levels exhibited an average decrease of 1.10 mg/dL compared to preoperative levels, indicating improved renal function. Importantly, no cardiopulmonary complications or 30-day mortality were observed. In ESRD patients, creatinine levels decreased significantly postoperatively compared to the preoperative levels (p< 0.05), indicating favorable outcomes. Conclusion: The consistent application of guidelines for admission, anesthesia, and surgery yielded robust and stable outcomes across all patients. In particular, the findings support the importance of adjusting dialysis schedules. Despite the limited sample size in this study, these findings underscore the effectiveness of a collaborative and meticulous approach for plastic surgeons performing surgery on dialysis-dependent patients, ensuring successful outcomes.

• Journal of Venture Innovation
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• v.5 no.1
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• pp.145-154
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• 2022

This study briefly compares the first-cycle certification of nursing hospitals with the second-cycle certification, reviews the changes and achievements of the second-cycle certification and the third-cycle certification, and examples of challenges and solutions in the process of preparing the third-cycle certification. In this study, it is suggested as follows. First, in order to see the practical effect of certification intended by the government, the exhibition is prepared in a short period of time before certification. Second, after the implementation of the nursing hospital certification system, research on the hospital performance of the medical institution certification system is insufficient in terms of quality and quantity. Therefore, in order to see the effect on the certification system, various research support is also required so that research on this can be actively conducted. Third, design certification standard guidelines from a long-term perspective so that the standard guidelines for certification do not change significantly, and certify not only the guidelines but also individual standards and forms that can be used by medical institutions. Fourth, in the four-cycle certification, accurate and realistic guidelines for infection control and quarantine ward operation support should be developed. The importance of managing infectious diseases will be highlighted in the future due to COVID-19. Fifth, medical institutions can improve the quality of medical care in nursing hospitals and have competitiveness if their daily activities, not short-term certification preparation, are carried out in accordance with certification standards, which affects performance. Sixth, when preparing for certification, nursing hospital officials have problems in organizing documents or processing administratively in the short term as in the past. This is also based on the certification criteria for the usual business process.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.2
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• pp.31-38
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• 2022

Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.1
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• pp.15-25
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• 2019

The development of reliable and objective definitions as well as automated processes for the detection of health care-associated infections (HAIs) is crucial; however, transformation to an automated surveillance system remains a challenge. Early outbreak identification usually requires clinicians who can recognize abnormal events as well as ongoing disease surveillance to determine the baseline rate of cases. The system screens the laboratory information system (LIS) data daily to detect candidates for health care-associated bloodstream infection (HABSI) according to well-defined detection rules. The system detects and reserves professional autonomy by requiring further confirmation. In addition, web-based HABSI surveillance and classification systems use discrete data elements obtained from the LIS, and the LIS-provided data correlates strongly with the conventional infection-control personnel surveillance system. The system was timely, acceptable, useful, and sensitive according to the prevention guidelines. The surveillance system is useful because it can help health care professionals better understand when and where the transmission of a wide range of potential pathogens may be occurring in a hospital. A national plan is needed to strengthen the main structures in HAI prevention, Healthcare Associated Prevention and Control Committee (HAIPCC), sterilization service (SS), microbiology laboratories, and hand hygiene resources, considering their impact on HAI prevention.

• Pediatric Infection and Vaccine
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• v.14 no.2
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• pp.162-170
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• 2007

Purpose : While cases of vancomycin-resistant enterococci (VRE) have increasingly been reported worldwide since it was first reported in the late 1980s, there have been few systemic studies on the pediatric population. The purpose of this study is to contribute to the planning of VRE prevention by investigating the prevalence, risk factors and transmission of VRE infection. Methods : We studied 230 patients under age 15 years who were isolated VRE between January 2001 and December 2006 retrospectively. The patients were classified into the intensive care unit (ICU) and the non-ICU groups. We reviewed the procedures before VRE detection as well as antibiotic sensitivity of detected organisms. Results : The number of VRE-isolation cases was higher in the ICU group than the non-ICU group. Instances of VRE-isolation were also more prevalent in patients who underwent operations or active procedures while taking 3rd-generation cephalosporins or glycopeptides. Almost all antibiotics except tetracycline were resistant to VRE. The proportion of 3rd-generation cephalosporin use was higher than those of any other antibiotics before VRE detection. Additionally, the use of 3rd-generation cephalosporins has increased annually, but that of glycopeptides had decreased in 2006. Also, the rates of VRE isolation have been increasing since 1998. Conclusion : VRE infection is increasing in pediatric population. Strict adherence to appropriate infection control guidelines for the prevention of VRE transmission in hospitals, and tracking of VRE colonization through active surveillance in high risk units are recommended.