Purpose: The purpose of this study was to identify the risk factors for a nosocomial urinary tract infection in intensive care units with a foley catheterization which showed a positive urine culture. Method: Three-hundred eighty-seven patients were included in the study. A retrospective review of the electrical medical record system's databases and medical record sheets in hospitalized patients from January 2003 to December 2003 was used. The collected data was analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis. Result: The frequency of the participants' nosocomial urinary tract infection was 72.9%. Significant risk factors for a nosocomial urinary tract infection were 'age', 'place of catheter insertion', 'frequency of catheter change', and 'duration of catheterization'. These variables explained 18.4% of variance in the experience of nosocomial urinary tract infection in intensive care units with foley catheterization. Conclusion: Medical personnel can decrease the incidence of a nosocomial urinary tract infection by recognizing and paying attention to the duration of catheterization, frequency of catheter change, and place of catheter insertion. As a result, specific and scrupulous strategies should be developed to reflect these factors for decreasing nosocomial urinary tract infections.
Journal of Korean Academy of Fundamentals of Nursing
/
v.11
no.1
/
pp.31-40
/
2004
Purpose: The purpose of this study was to describe nurses' recognition of, and practice level in management of general nosocomial infections, and methicillin resistant staphylococcus aureus (MRSA) and vancomycin resistant enterococci (VRE) infections. Method: A self-administered questionnaire was used to collect data. Data were collected on June, 2003 from 190 nurses in one university affiliated hospital located in Suwon. Result: The mean score for nurses' recognition of general nosocomial infection control was 3.57, MRSA control was 3.54, and VRE control was 3.86. The mean score on practice for control of general nosocomial infection was 3.19, for MRSA control, 3.20, and for VRE control, 3.63. There were statistically significant relationships between the recognition level and practice level for general nosocomial, MRSA, and VRE infection control. According to the general characteristics of the nurses, the mean scores for both recognition and practice were higher for those nurses who had had infection control education, for those who had worked longer in nursing, and for those who worked in the ICU. Conclusion: It is suggested that appropriate hospital infection control programs should be developed through continuous education and practice to improve nurses' level of the practice in general infection control, and especially in MRSA and VRE infection control.
Methicillin-resistant Staphylococcus aureus (MRSA), a leading cause of nosocomial infections, has been increasingly recognized in communities of the United States. This article will review the clinical spectrum and treatment of MRSA infections in children in the context of recent epidemiological changes of MRSA infections. In general, community-associated (CA) MRSA most frequently causes skin and soft tissue infections and has an increased association with invasive infections, particularly pneumonia and musculoskeletal infections. Hospital-associated (HA) MRSA strains tend to be associated with bloodstream infections, pneumonia, and surgical site infections. Different from the United States, CA-MRSA infections are not common in Korea (only 5.9%); however, there are some CA-MRSA clones that are different from HA-MRSA clones in Korea and from CA-MRSA clones in other countries. The treatment of MRSA infections should be guided by antimicrobial susceptibility testing, the site of infection, and the infection severity. Vancomycin is the treatment of choice for invasive MRSA infections. Other agents such as trimethoprim-sulfamethoxazole, clindamycin, linezolid, quinupristin-dalfopristin, and daptomycin have been used for some conditions.
Statistical methods to analyze and predict the related risk factors of nosocomial infection in lung cancer patients are various, but the results are inconsistent. A total of 609 patients with lung cancer were enrolled to allow factor comparison using Student's t-test or the Mann-Whitney test or the Chi-square test. Variables that were significantly related to the presence of nosocomial infection were selected as candidates for input into the final ANN model. The area under the receiver operating characteristic (ROC) curve (AUC) was used to evaluate the performance of the artificial neural network (ANN) model and logistic regression (LR) model. The prevalence of nosocomial infection from lung cancer in this entire study population was 20.1% (165/609), nosocomial infections occurring in sputum specimens (85.5%), followed by blood (6.73%), urine (6.0%) and pleural effusions (1.82%). It was shown that long term hospitalization (${\geq}22days$, P= 0.000), poor clinical stage (IIIb and IV stage, P=0.002), older age (${\geq}61days$ old, P=0.023), and use the hormones were linked to nosocomial infection and the ANN model consisted of these four factors. The artificial neural network model with variables consisting of age, clinical stage, time of hospitalization, and use of hormones should be useful for predicting nosocomial infection in lung cancer cases.
Hospitals accomodate patients who have a high risk of infection due to reduced immunity as well as people who require surgical, medical or other treatments. Consequently, the role of clinical nurses, who come into close contact with these patients is very important in the control of nosocomial infection. This study was done to investigate and compare the level of perception of the importance of the control of nosocomial infections as well as the level of actual performance, and the level of satisfaction with the control of nosocomial infection by the clinical nurses. Thus, the purpose of this study is to contribute basic data for improving policies and educational programs to control nosocomial infection. A summary of the survey results is as follows. 1) The means of scores on all categories of the inquiry were 4. 51 for awareness 4.42 for actual performance, and 3.20 for satisfaction, of a possible high score of 5.00. 2) Correlations of the level of perception of importance between characteristics of nurses and hospital control of nosocomial infection differed significantly according to the type of hospital establishment type (p=.005), age(p=.000), career(p=.000), position (p=.002), and regular conferences on infection control in working departments(p=.003), Correlation of the level of actual performance between characteristics of nurses and hospital control of nosocomial infection diffesed significantly according to type of hospital(p=.000), hospital size (p=.009), working department(p=.000), age(p=.000), career (p=.000), school career(p=.040), position (p=.000), education experience on nosocomial infection(p=.020), and regular conferences on infection control in working department(p=.000). Correlation of degree of satisfaction between characteristics of nurses and hospital control of nosocomial infection also differed significantly according to the type of hospital establishment (p=.003), working department(p=.000), age (p=.000), and regular conferences on infection control in working department (p=.000). 3) Correlation between clinical nurses, level of perception of importance and actual level of performance for the control of nosocomial infection was relatively positive (r=.57, p=.000). Correlation between clinical nurses degree of satisfaction and level of actual performance for control of nosocomial infection was relatively positive (r=.47, p=.000). Correlation between clinical nurses, level of perception of importance and degree of satisfaction degree with the control of nosocomial infection was also relatively positive (r=.27, p=.000).
Journal of Korean Academy of Fundamentals of Nursing
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v.11
no.3
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pp.299-308
/
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.
Journal of Korean Academy of Fundamentals of Nursing
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v.9
no.3
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pp.349-359
/
2002
Purpose: The purpose of this study was two-fold : to describe the level of recognition of nosocomial respiratory infections by ICU nurses and to compare self evaluation and objective evaluation of nosocomial respiratory infection control practices by ICU nurses. Method: Data were collected from 78 nurses in intensive care units in one university affiliated hospital in Kyung Ki Province. Data were collected from March 4 to March 18, 2002. The recognition and self evaluation data were collected through a self report questionnaire and an objective evaluation which was done by observing the actual behavior of the nurses. Result: The results of this study showed that there was a significant positive relationship between recognition scores and self evaluation scores. However, there was no significant relationship between level of recognition and objective evaluation, nor between self evaluation and objective evaluation of infection control Practices by ICU nurses. Conclusion: ICU nurses In this study gave higher scores on self evaluation of their practice than were shown in the observation evaluation of actual practice. Moreover, in the objective evaluation the nurses had the lowest score on the item, 'washing hands before taking care of patients'. The results indicate that it is necessary to develop a standardized practice manual on nosocomial respiratory infection control in the ICU. Also, it is necessary to have a program to transfer knowledge into actual practice.
Purpose: Surgical site infections (SSIs) are the third most frequently reported nosocomial infection. Of these SSIs, mostly were confined to the incision associated with underlying disease as diabetes, cigarette smoking, systemic steroid use, obesity, operating room environment, suture and surgical technique. This study has been planned to reduce the SSIs by using Vicryl $plus^{(R)}$ (Ethicon, USA) which contains triclosan, a broad-spectrum antibacterial agent, into the infected wound to evaluate whether or not Vicryl $plus^{(R)}$ (Ethicon, USA) is effective to nosocomial bacteria using a zone of inhibition assay. Methods: We did a comparison of Vicryl $plus^{(R)}$ suture (with triclosan) size 2-0, 5-0 with $Vicryl^{(R)}$ suture (without triclosan) size 4-0 each as treatment and control group, applied in Mueller-Hinton agar infected by following mircroorganisms: Methicillin-sensitive $Staphylococcus$$aureus$ (MSSA), Methicillin-resistant $Staphylococcus$$aureus$ (MRSA), Acinetobacter baumanii, $Escherichia$$coli$, Enterobacter faecalis, Pseudomonas aeruginosa, Candida albicans. Cultures were made of the selected mircroorganisms, seeding the study strain in agar plates for 24 and 48-hour period in an oven at $37^{\circ}C$ followed by zone of inhibition assay. Results: Vicryl $plus^{(R)}$ group has demonstrated to create a zone of inhibition against MRSA, MSSA and $A.$$baumanii$, but no effect on $E.$$faecalis$, $P.$$aeruginosa$, $C.$$albicans$. Vicryl $plus^{(R)}$ suture size 2-0 also had antibactericidal effect while Vicryl $plus^{(R)}$ suture size 5-0 did not. $Vicryl^{(R)}$ group had no zones of inhibition showing colonization at all mircroorganisms. Conclusion: Our results seem to warrant the use of Vicryl $plus^{(R)}$ as absorbable buried suture when concerning SSIs as a prophylaxis against surgical nosocomial infection.
Journal of Korean Academy of Fundamentals of Nursing
/
v.12
no.1
/
pp.113-120
/
2005
Purpose: To identify risk factors for surgical site infections in patients undergoing general surgery, to analyze the prolonged hospital stay and extra cost for antibiotics, and to provide basic data for control of surgical site infections. Method: Surgical site infection was defined using the definition of the CDC and the data were analyzed by $x^2$-test and unpaired t-test. Results: The prevalence of surgical site infections was 9.7%, and it was related to wound class, duration of operation, number of operations, whether the operation was an emergency, trauma, drains, preoperative stays, presence of remote infection during operative period, and previous history of recent surgery. The mean duration for post-operative stay when a surgical site infection occurred was 9.5 days and in 56.9 % of the patients the surgical site infection appeared 7 days after the operation. Post-operative stays for infected patients were 20.3 days longer than that of uninfected patients. The mean cost of antibiotics for infected patients was higher than that for uninfected patients by 561,067 won per person. Conclusion: Surgical site infection results in an increased length of stay and extra-cost, thus, hospitals need to create strategies to reduce nosocomial infections through effective infection surveillance and by considering factors related to surgical site infections.
Journal of the Korea Academia-Industrial cooperation Society
/
v.14
no.5
/
pp.2262-2270
/
2013
This study was to provide the basic data to raise the efficient practices that can reduce the Infection Prevention and Exposure by understanding the awareness, Performance degree of the Administrative Standard Guideline of Nosocomial Infection Control for Emergency Medical Technician students who are exposed to hospital infections while conducting clinical practice. After the study, the performance degree was lower than the awareness of the Performance degree of the Administrative Standard Guideline of Nosocomial Infection Control. And awareness and performance degree are have significant positive correlation, significant differences statistically(r=0.325, p=0.000). In the future, to improve the Performance degree of Nosocomial Infection Control for Emergency Medical Technician students, the continuing education programs and the curriculums should be performed in the practice agencies.
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