• Title/Summary/Keyword: Nosocomial

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Comparison of Nursing Needs as Perceived by Admitted Patients and Nurses in a General Hospital (입원환자와 간호사의 간호요구도 비교연구)

  • Kim Hyun-Sook;Won Jong-Soon
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.11 no.3
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    • pp.299-308
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    • 2004
  • Purpose: This study was done to compare the perceived nursing needs as reported by admitted patients and nurses in a general hospital. Method: The participants were 194 patients and 183 nurses in a general hospital in Seoul. The instruments were constructed based on a prior study review and revised after a pilot study with 3 patients. The questionnaire for nursing needs included questions on physical, therapeutic, emotional, educational and socioeconomic domains. Data were collected between February 29 and March 26 for patients and between February 19 and 26, 2002 for nurses. The data were analyzed with frequencies, percentiles, means and t-test. Results: The results were as follow: 1. The total score for perceived nursing needs by nurses was higher than that reported by patients except for socioeconomic needs. 2. There were significant differences between patients and nurses only in the emotional domain (t=3.50, p=.001). 3. The highest score was for therapeutic needs and the next was for educational needs. 4. Relatively higher scored items were for comfort care, prevention of nosocomial infections, immediate treatment, monitoring health condition, kindness, and explanation of tests and treatments. Conclusion: Nurses generally understand patients' nursing needs but have to be more interested in patients' needs in order to prevent nosocomial infections, to provide care in a good relationship with the doctors and to encourage the patients.

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Pattern of Methicillin-resistant Staphylococcus aureus in Dental and Medical Environments

  • Han, Seung-Ho;Song, In-Sook;Lee, Myeong-Jae;Jeong, Seung-Il;Kim, Shin-Moo;Kim, Kang-Ju
    • International Journal of Oral Biology
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    • v.35 no.4
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    • pp.185-190
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    • 2010
  • Methicillin-resistant Staphylococcus aureus (MRSA) is one of the most prevalent pathogens in hospitals. To investigate cross contamination by this bacterium in both dental and medical settings, the pathogens that cause acute pyogenic infection and one of the major microbes responsible for nosocomial infection were isolated from health care providers, nurses and patients. We used VITEK II to measure drug sensitivity, and we further performed biochemical testing, coagulase serotype testing and pulse-field gel electrophoresis (PFGE) for isolated MRSA colonies. The isolation rate of Staphylococcus aureus from nasal swabs was 75.0% from dental health care providers and 18.8% from the medical health care providers. A total of 10 MRSA strains were isolated from 40 health care providers and 2 patients and the prevalent coagulase serotype from patients and health care providers was VII. The antimicrobial drug resistance and partial PFGE types of the isolated MRSA strains showed a similar pattern. These results suggest that MRSA may be one of the principal causes of nosocomial infection in dental and medical hospitals.

The Reason of High Prevalence of Vancomycin-Resistant (VR) E. faecium in Nosocomial Infection

  • Jo, Hyun-Jung;Kim, Hee-Jeong;Lee, Hyo-Jin;Park, Gyu-Nam;Kim, Min-Ju;An, Dong-Jun;Chang, Kyung-Soo
    • Biomedical Science Letters
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    • v.18 no.1
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    • pp.83-85
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    • 2012
  • Vancomycin-resistant (VR)-E. faecium and VR-E. faecalis were isolated simultaneously from a rectal swab of a patient diagnosed with pneumonia in an intensive care unit (ICU). The patient was treated with various antibiotics including vancomycin. Only VR-E. faecium was continually isolated from the rectal swab at one and two weeks of the treatment. Identical vanA, IS1216V, and IS1542 genes were detected in both VR-E. faecium and VR-E. faecalis isolates which showed equal resistance against vancomycin and teicoplanin, but IS1251 was not detected. VR-E. faecium showed stronger multi-drug resistance than VE-E. faecalis. This result supports the reason why VR-E. faecium is one of the major pathogens in nosocomial infections.

Disinfection Effect of Film Cassettes by Ultraviolet Irradiation (자외선을 이용한 Film Cassette의 소독 효과)

  • Kweon, Dae-Cheol;Park, Peom
    • Journal of Radiation Protection and Research
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    • v.26 no.4
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    • pp.425-432
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    • 2001
  • A bacteria infection on film cassette contact surface was examined at the diagnostic radiology department. Studies have demonstrated a bactericidal effect of ultraviolet irradiation, and to assess the contamination level on film cassette contact surface as a predictor of patient prevent from nosocomial infection. The study showed that the laboratory result was identified non-pathologic and pathologic bacterial in the five different cassette size of the contact surface. Film cassettes were exposed to ultraviolet light for 1, 2 and 3 minutes. Ultraviolet light disinfection practices suitable for bacteria. The study concludes that presence of a bacterial infection will prevent a using antiseptic technique on film cassette contact surface. In conclusion, ultraviolet irradiate on film cassette over the surface more than 2 minutes. Ultraviolet dose of $1565 {\mu}W{\codt}s/cm^2$ Win in 30 second relative to ultraviolet dose in time.

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A Study on the Space Design for Nosocomial Infection Control in Intensive Care Unit (병원 감염관리를 위한 중환자부 공간계획에 관한 연구)

  • Lee, Hyunjin;Kim, Khilchae;Oh, Young-Hun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.22 no.4
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    • pp.87-95
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    • 2016
  • Purpose: Recently an experience in the MERS crisis focused on the importance of infection control in hospitals. According to Korean National healthcare-associated Infection Surveillance System (KONIS) of the KSICP, a great number of 498 people, 841 people, and 1021 people were infected by pneumonia, urinary tract infection, and bacteremia respectively from 94 hospital ICUs during the year of 2014. Therefore, the purpose of this study is to investigate the configuration and design guidelines for the ICU rooms to minimize the nosocominal infections. Methods: Based on the several infection control guidelines and revised Medical Law, consequent analyses which classified the planning and operational behavior in the ICUs of seven hospitals, were performed to reduce the cross-infection. Results: The results of this study are offering a space, configuration and design guidelines for effective infection control in the intensive care units through the unit-bed area, the bed-to-bed distance, the isolation room, etc. Implications: It is expected that this study propose the direction of architectural planning and guideline for the ICU room in order to realize the intension of revised Medical Law.

Relationship between Nursing Task Overload and Aseptic Technique Performance in Clinical Nursing Skills (임상 간호사의 역할과부담과 기본간호술 수행 시의 무균술 이행의 관계)

  • Lee, Sun-Ok;Park, Kyung-Yeon
    • Journal of East-West Nursing Research
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    • v.15 no.1
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    • pp.18-25
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    • 2009
  • Purpose: The study was investigated to identify the relationship between nursing workload and aseptic technique performance by clinical nurses, and to decrease the incidence rate of nosocomial infection. Methods: Participants (N=283) were recruited in B city from April to June 2007. The data were collected by a structured questionnaire and analyzed with descriptive statistics, t-test, ANOVA and Pearson's correlation coefficient. Results: Nursing workload was rated 9.85 out of a total score of 15. The level of aseptic technique performance as the basis for insertion of a Foley catheter was 42.72 out of a total score of 50, and as basis for insertion of intravenous catheter for fluid therapy was 40.11 out of a total score of 55. There was not a significant relationship between aseptic technique performance and nursing workload. There was a significant positive relationship between the aseptic technique performance in insertion of Foley catheter and that of intravenous catheter for fluid therapy (r=.279, p<.001). Conclusions: Attention to asepsis by nurses is crucial in nosocomial infection-related clinical nursing skills.

A Trial of Aerosolized Colistin for the Treatment of Nosocomial Pneumonia due to Multidrug-resistant Acinetobacter baumannii (다제내성 A. baumannii에 의한 병원획득폐렴에서 Colistin 분무치료의 시도)

  • Kim, Changhwan;Kim, Dong-Gyu;Kang, Hye-Ryun;Choi, Jeong-Hee;Lee, Chang Youl;Hwang, Yong Il;Shin, Tae Rim;Park, Sang Myeon;Park, Yong Bum;Lee, Jae Young;Jang, Seung Hun;Kim, Cheol Hong;Mo, Eun Kyung;Lee, Myung Goo;Hyun, In-Gyu;Jung, Ki-Suck;Choi, Young-Jin;Lee, Jae Woong
    • Tuberculosis and Respiratory Diseases
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    • v.64 no.2
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    • pp.102-108
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    • 2008
  • Background: Recently, multidrug-resistant (MDR) A. baumannii has been implicated for a significant proportion of nosocominal pneumonia in many intensive care units (ICUs), and its acquisition may increase mortality and the length of stay in the ICU. Aerosolized colistin has been successfully used in patients with cystic fibrosis, but there is a lack of data regarding the use of aerosolized colistin in patients with nosocomial pneumonia. Methods: We conducted the present study to assess the effectiveness of aerosolized colistin for the treatment of MDR A. baumannii nosocomial pneumonia. We retrospectively reviewed the medical records of 10 patients who had been hospitalized in the medical ICU and had received aerosolized colistin as a therapy for MDR A. baumannii pneumonia. Results: The mean duration of aerosolized colistin therapy was $12.7{\pm}2.4$ days. Nine (90%) of 10 patients showed a favorable response to the therapy. Follow-up cultures were available for all patients, and the responsible pathogen was completely eradicated. One patient suffered from bronchospasm, which resolved after treatment with nebulized salbutamol. Conclusion: Our results corroborate previous reports that aerosolized colistin may be an effective and safe choice for the treatment of nosocomial pneumonia caused by MDR A. baumannii. Larger prospective controlled clinical studies are warranted to validate further the effectiveness and safety of aerosolized colistin therapy.

Bronchoscopic Diagnosis in ICU Patient Accompanying Pneumonia (폐렴이 동반된 중환자실 환자에 대한 기관지내시경적 진단)

  • Chang, Jung Hyun
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.1
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    • pp.114-123
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    • 1997
  • Background : To assess the diagnostic role of bronchoscopic lavage for the evaluation of pneumonia in intensive care unit(ICU), the results were compared to blind endobronchial specimen. Method : From September 1993 to August 1996, twenty-eight ICU patients suspected pneumonia on the basis of clinical evidence and performed bronchoscopy under the diagnostic or therapeutic purpose were studied retrospectively for the clinical findings including culture of bronchoscopic and blind endobronchial specimen. Bronchoscopic specimen was got through small amount of bronchoalveolar lavage with 20-40ml saline, one or two times on the suspected site. Results : l. Main reasons of ICU admission were respiratory and impending respiratory failure Nosocomial pneumonia was most common with 16 cases; each for community acquired and immunocompromised type with 6 cases. Diagnostic purpose of bronchoscopy was performed in 20 cases as 71 percent in total, whereas therapeutic removal of secretion in 8 cases. The complication during bronchoscopic evaluation was trivial. 2. The agreement between blind endobronchial and bronchoscopic specimen on microbial culture was only 39.3 percent. However, 2 cases each for aspergillosis and tuberculosis were diagnosed under bronchoscopic evaluation. 3 The application of mechanical ventilation occured significantly frequently in multidrug resistant pneumonia compared with other pneumonia in terms of bronchoscopic specimen. 4. The application of mechanical ventilation was significantly common in nosocomial pneurmonia compared with other types of pneumonia. Conclusion : The selective bronchoalveolar lavage and therapeutic removal of bronchial secretion with bronchoscopy in ICU patient accompanying pneumonia is a very useful tool with safety. The multidrug resistant pneumonia or nosocomial pneumonia could be closely associated with the use of mechanical ventilation.

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A contact investigation after exposure to a child with disseminated tuberculosis mimicking inflammatory bowel disease

  • Kim, Dongsub;Lee, Sodam;Kang, Sang-Hee;Park, Mi-Sun;Yoo, So-Young;Jeon, Tae Yeon;Choi, JoonSik;Kim, Bora;Choi, Jong Rim;Cho, Sun Young;Chung, Doo Ryeon;Choe, Yon Ho;Kim, Yae-Jean
    • Clinical and Experimental Pediatrics
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    • v.61 no.11
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    • pp.366-370
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    • 2018
  • Purpose: Tuberculosis (TB) is one of the most important diseases that cause significant mortality and morbidity in young children. Data on TB transmission from an infected child are limited. Herein, we report a case of disseminated TB in a child and conducted a contact investigation among exposed individuals. Methods: A 4-year-old child without Bacille Calmette-$Gu{\acute{e}}rin$ vaccination was diagnosed as having culture-proven disseminated TB. The child initially presented with symptoms of inflammatory bowel disease, and nosocomial and kindergarten exposures were reported. The exposed individuals to the index case were divided into 3 groups, namely household, nosocomial, or kindergarten contacts. Evaluation was performed following the Korean guidelines for TB. Kindergarten contacts were further divided into close or casual contacts. Chest radiography and tuberculin skin test or interferon-gamma-releasing assay were performed for the contacts. Results: We examined 327 individuals (3 household, 10 nosocomial, and 314 kindergarten contacts), of whom 18 (5.5%), the brother of the index patient, and 17 kindergarten children were diagnosed as having latent TB infection (LTBI). LTBI diagnosis was more frequent in the children who had close kindergarten contact with the index case (17.1% vs. 4.4%, P=0.007). None of the cases had active TB. Conclusion: This is the first reported case of TB transmission among young children from a pediatric patient with disseminated TB in Korea. TB should be emphasized as a possible cause of chronic diarrhea and failure to thrive in children. A national TB control policy has been actively applied to identify Korean children with LTBI.

A Study on the Nosocomial Infection in One Burn Unit (일 화상 치료실에 입원한 화상환자의 감염실태조사)

  • 김정애
    • Journal of Korean Academy of Nursing
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    • v.17 no.3
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    • pp.227-240
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    • 1987
  • Infection has assumed increased importance as a cause of death among thermally injured individuals. Decreased treatment effectiveness and an increase in mortality are the hallmarks of nosocomial infection. Infection control is a monumental task that must be achieved to reduce mortalities. This was a retrospective study to survey the epidemiological features of nosocomial infections in a burn unit and to identify the possibilities for infection control. During the past 6 year 2 month period from July, 1981 to August, 1987, 306 burn patients were treated in the burn unit of university hospital. Among of these, 290 cases were the subjects of this study. The data were collected from the patients' records after discharge. All data collected were analyzed using percent, x$^2$-test, t-test with SPSS program. The results of this study are summariged as follows: 1) Infection rate was 40%. According to site, there were 67 cases of wound infection, 60 cases of post-operative skin graft infection, 20 cases of septicemia and 20 cases of donor site infection. As far as the burn size was concerned, the infection rate for patients whose burn size ranged 61 to 70%, was shown to be 100%, followed by the infection rate of 93.8%, for patients whose burn size ranged from 41~50%. As far as the period of time over which the infection developed, 5 to 7 days showed the highest frequency. Further infection was the main cause of deaths and complications. 2) Based upon the results obained by comparing the general characteristics, between a hospital infection-group and non-hospital infection group, there was a significant defference according to age, the time of the year when the accident happened, the place of accident or length of hospital-admission. And according to the result obtained by comparing the general characteristics of the burn, there was a significant difference according to burn size, burn depth, burn type, and burn site. And also based upon the result obtained by comparing the two groups according to method of treatment, there was a significant difference according to the use of antibiotics and to the type of wound-treatment, and for the 8 different binds of treatment related to infection, there was a significant difference for all. In conclusion, age, length of hospital-admission, burn size, burn type, burn site, burn depth, type of woundtreatment and the 8 different binds of treatment, which are related to burns, were shown to be the factors which affect the infection rate in burn patients.

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