Purpose: The aim of this research was to determine knowledge and management of tracheal tube cuffs among nurses of ICU. Methods: This descriptive survey recruited 150 nurses working at 8 different adult ICUs within 2 tertiary hospitals in Seoul. A survey questionnaire was developed to measure cuff management. The internal reliability of the tool was examined by Cronbach's ${\alpha}$. Descriptive statistics and multiple regressions were used to analyze data. Results: Among the 150 nurses, 94.0% replied that they would measure the pressure themselves. With regard to nurses' knowledge about tracheal tube cuffs, only 6% answered that they knew 'the appropriate cuff pressure'. The existence of a measuring device (p < .001), a guideline (p < .001), the level of knowledge on its related complications(p = .003), and clinical experience (p < .001) together accounted for 35.0% of the total variation in cuff management. They pointed out that the lack of time and the lack of education were major barriers to appropriate management; whereas education update was the most imperative factor for good management. Conclusion: ICU nurses have inappropriate knowledge and practice in cuff management. Therefore continuing education is necessary for better practice of tracheal tube cuff management.
Ethylene oxide is a genotoxic carcinogen with widespread uses as industrial chemical intermediate and gaseous sterilant. 2-hydroxyethylated N-terminal valine in Hb is a good biomarker for biological monitoring of ethylene oxide exposure, because of its stability. We studied the determination method of (N-2-hydroxy-ethyl)valine in hemoglobin adduct by using GC/MS. PFPITC and TBMS were used as appropriate derivatives. Ethylene oxide formed Hb adducts as (N-2-hydroxy-ethyl)valine(HEV) in mouse with ethylene oxide inhalation exposure. Standard HEV can be synthesized with 2-amino-ethanol and 2-bromo-3-methylbutyric acid. GC/MS can measured them after derivatization with pentafluorophenylisothiocianate(PFPITC) and N-(tertiary butyl dimethylsiiyl)-N-methyl-trifluoroacetamide(TBDMS-TFA) by using Edman procedure. Concentrations of Hb adduct were proportionally increased with exposure levels. They were 230${\pm}$35(nmol g$^{-1}$ globin) and 410${\pm}$72(nmol $g^{-1}$ globin) at 200ppm and 400ppm ethylene oxide inhalation exposure, respectively.
Purpose: The purpose of this study was to explore the experiences of perception of nursing students' rights participating in clinical practice. Methods: This descriptive study carried out purposeful sampling. The participants were 17 nursing students, who had experience of participating in clinical practice for more than 12 weeks. Data were collected through focus group interviews. Twelve subjects were in their third year and five in their fourth year. All were practicing in secondary general and tertiary university hospitals. The data were analyzed using classical content analysis method. Results: The researchers extracted 23 codes representing the nursing students' rights of clinical practice, which were grouped into 4 categories and 11 subcategories. The 4 categories were 'deep disappointment as an alienated person in a clinical field', 'clinical practice experience that cannot be given up despite difficulties', 'need for a practice environment that takes care of nursing students', and 'hope for support, advocacy and respect'. Conclusion: Nursing students cannot claim rights at this time, but expressed the desire to build a support system so that these parts can be improved in the future. Therefore, nursing education institutions and clinical fields should maintain diverse efforts through reciprocal relationships.
Purpose: The aim of this project was to develop a patient safety-focused inservice education program for surgical nurse and to test the effects of this program. Methods: Methodological designs for instruments development, a pretest-posttest and a posttest design were employed. After the education, nurses' satisfaction, confidence, usefulness and application of 137 nurses were evaluated at 15 surgical units of a tertiary teaching hospital in Seoul, Korea. The education contents are 6 skill areas (infusion pump use, suction, chest tube drainage, oxygen administration, nebulizer use, insulin administration) and medication knowledge. Teaching methods were lecture, instructor demonstration, and 1:1 skill test. Descriptive statistics, Wilcoxon test, Spearman's correlation and Stepwise regression were used. Results: Satisfaction scores for skills and medication education were 4.00-4.21 (out of 5), The more performance frequency in 6 skills, the higher score in confidence as well as in usefulness and application, and the higher satisfaction with the program, the higher score in usefulness, application, confidence, and medication knowledge. Medication knowledge improved after the education (Z=-7,757, p<.001). Significant predictors of skill confidence were application of skills in job performance, medication confidence, and career in present unit. Conclusion: The results of this study suggest that systematic and continuous inservice education will improve patient safety by promoting nursing quality.
GAM-1 and GAM-2, two themostable glucoamylases from Aspergillus niger B-30, possess different molecular masses, glycosylation, and thermal stability. In the present study, the effects of additives on the thermal inactivation of GAM-1 and GAM-2 were investigated. The half-lives of GAM-1 and GAM-2 at 70℃ were 45 and 216 min, respectively. Data obtained from fluorescence spectroscopy, circular dichroism spectroscopy, UV absorption spectroscopy, and dynamic light scattering demonstrated that during the thermal inactivation progress, combined with the loss of the helical structure and a majority of the tertiary structure, tryptophan residues were partially exposed and further led to glucoamylases aggregating. The thermal stability of GAM-1 and GAM-2 was largely improved in the presence of sorbitol and trehalose. Results from spectroscopy and Native-PAGE confirmed that sorbitol and trehalose maintained the native state of glucoamylases and prevented their thermal aggregation. The loss of hydrophobic bonding and helical structure was responsible for the decrease of glucoamylase activity. Additionally, sorbitol and trehalose significantly increased the substrate affinity and catalytic efficiency of the two glucoamylases. Our results display an insight into the thermal inactivation of glucoamylases and provide an important base for industrial applications of the thermally stable glucoamylases.
Purpose: The purpose of this study was to investigate the effect of customer experience management on nursing service satisfaction of cancer patients and their intent to revisit the hospital and also to identify empathy ability of oncology nurses. Methods: Participants were 376 cancer patients and 190 oncology nurses from a tertiary hospital in Korea. Cancer patients' satisfaction with nursing care and intent to continue using the hospital were measured and empathy of oncology nurses was measured using Empathy Construct Rating Scale. Data were analyzed using descriptive statistics, ${\chi}^2$ test, t-test, one-way ANOVA and stepwise multiple regression analysis. Results: Patient satisfaction with nursing care and intent to continue using the hospital were higher in patients who received the customer experience management program than those who did not. Oncology nurses' ability to empathize was high. Clinical career, participate in customer experience management and education level together explained 20% of variance in empathy ability of oncology nurses. Conclusion: Findings from this study confirm that customer experience management affects patient satisfaction with nursing service and intent to continue using the hospital. Further research is necessary to reaffirm the empathy ability of the oncology nurses and to identify the related various factors.
Purpose: The aim of this study was to investigate the influence of nurses' awareness of healthcare accreditation on their job stress and turnover intention. Methods: Across-sectional correlation study design was used. Participants consisted of 143 nurses from two tertiary hospitals in Seoul and Gyunggido, South Korea. Data were collected in October 2016 using self-report questionnaires and analyzed using descriptive statistics, t-test, an ANOVA, Pearson's correlation coefficient, and multiple regression in SPSS/WIN 21.0. Results: Awareness of health care accreditation correlated negatively with job stress (r=-.63, p<.001) and turn over intention (r=-.50, p<.001). Awareness of health care accreditation was the factor that most influenced job stress, explaining 38% of the variance (F=23.10, p<.001). Awareness of health care accreditation and duty pattern were the factors that most influenced intention to leave, explaining 32% of the variance (F=10.35, p<.001). Conclusion: These findings suggest raising nurses' awareness of certification systems to reduce their job stress and turnover intentions. It will be necessary to provide support for the aggressive work nurses do and improve their work structure, highlighting the need for both manpower and institutional support. Accordingly, providing regular education programs and appropriate compensation schemes, by raising nurses' awareness of medical institutions' certification systems, is necessary.
Background: Successful implementation of pain management procedures and guidelines in an institution depends very much on the acceptance of many levels of healthcare providers. Aim: The main purpose of this study was to determine the level of knowledge and attitudes regarding pain among nurses working in tertiary care in a local setting and the factors that may be associated with this. Materials and Methods: This cross-sectional research study used a modified version of the Nurses' Knowledge and Attitudes Survey (NKAS) regarding pain. Basic demographic data were obtained for further correlation with the level of pain knowledge. Results: A total of 566 nurses, 34 male and 532 female, volunteered to participate in this study. The response rate (RR) was 76%, with an overall mean percentage score of $42.7{\pm}10.9$ (range: 5-92.5). The majority of participants were younger nurses below 40 years of age and more than 70% had worked for less than 10 years ($6.6{\pm}4.45$). Up to 92% had never had any formal education in pain management in general. The total mean score of correct answers was $58.6{\pm}9.58$, with oncology nursing staff scoring a higher percentage when compared with nurses from other general and critical care wards ($63.52{\pm}9.27$, p<0.045). Only 2.5% out of all participants obtained a score of 80% or greater. The majority of the oncology nurses achieved the expected competency level (p<0.03). Conclusions: The present findings give further support for the universal concern about poor knowledge and attitudes among nurses' related to the optimal management of pain. The results reflected that neither number of years working nor age influenced the level of knowledge or attitudes of the practising nurses. Oncology nursing staff consistently scored better than the rest of the cohort. This reflects that clinical experience helped to improve attitudes and knowledge concerning better pain management.
This study was to identify the utilization of home care service and home care nursing satisfaction for clients with cancer who had completed secondary and tertiary chemotherapy session. Raw data was collected by reviewing charts and questionnaire of 23 clients with cancer between September, 2002 and November 2002 at an university hospital located in Seoul. Korea. The result are as follows: 1. Characteristics in the use of home care: After applying for home care service, patients were visiting an average of 1.88 days later. The major purpose of using home care service was to help recovery after hospitalization or to maintain present health. The average period for home care service was 14.6 days, with 4 visits over this period, for 35.78 minutes per visit. 2. Content of home care service: A total of 47 items of service were provided - basic nursing care, education and counseling, and therapeutic nursing care. On every visit, an average of 19 items of home care service were provided, and the majority (7 items) were therapeutic nursing care. 3. Satisfaction with home care services: Satisfaction was very high, an average of 3.88 on a scale of 4 points. Both patients and families expressed high satisfaction with all sub-domains of nursing care: guidance by the home care nurses, knowledge, skill, attitude, interpersonal relationships, emotional support, and accessibility. In conclusion, home care served basic nursing care, teaching and counseling, and therapeutic nursing to clients with cancer going through secondary or tertiary chemotherapy. Therefore they changed knowledge and attitude to disease and treatment which were difficult to change.
Loho, Imelda M;Hasan, Irsan;Lesmana, C Rinaldi A;Dewiasty, Esthika;Gani, Rino A
Asian Pacific Journal of Cancer Prevention
/
제17권4호
/
pp.2165-2170
/
2016
Background: The survival of hepatocellular carcinoma (HCC) patients is usually low due to late diagnosis. Cipto Mangunkusumo Hospital as the largest tertiary referral hospital in Indonesia, has recently improved its modalities for advanced HCC management, but there has not been any evaluation on any improvement in HCC patient survival. Materials and Methods: A retrospective analysis on 114 HCC patients in 2013-2014 were conducted and compared with the database for 77 HCC patients in 1998-1999. Clinical characteristics and treatment received were recorded and the survival of both groups was analyzed using the Kaplan-Meier method and compared using the log-rank test. Results: The percentage of HBV positive patients had increased after fifteen years from 32.5% to 67.5%. Only two patients (1.8%) in 2013-2014 were diagnosed with HCC during surveillance program. Proportions of Barcelona Clinic Liver Cancer A, B, C, and D in 2013-2014 were 1.8%, 42%, 28.1%, and 28.1%, respectively. There was an increase in the use of potentially curative treatment, such as surgical resection or combination of loco-regional therapies. The one-year survival rate increased from 24.1% in 1998-1999 to 29.4% in 2013-2014, while the median survival decreased from 146 days to 138 days, but the difference was not statistically significant (p=0.913). Conclusions: There was no improvement in the median survival of HCC patients after fifteen years because most continued to present at late stages. There is an urgent need for a nationwide implementation of a hepatitis screening program and HCC surveillance education.
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