Comparing Pressure Injury Incidence Based on Repositioning Intervals and Support Surfaces in Acute Care Settings: A Quasi-Experimental Pragmatic Study.

OBJECTIVE: To compare pressure injury (PI) incidence based on repositioning intervals and support surfaces in acute care settings. METHODS: This pragmatic, quasi-experimental trial recruited a total of 251 critically ill patients who were at low or moderate risk for PI development. Participants were assigned to three interventions: a 2-hour repositioning interval using an air mattress, a 2-hour repositioning interval using a foam mattress, or a 3-hour repositioning interval using a foam mattress. Data were collected by nurses every shift over the course of 14 days. Pressure injury incidence was analyzed using a χ2 test. RESULTS: There were no statistically significant differences in PI incidence between the groups with a 2-hour repositioning interval. However, the PI incidence in the group using a foam mattress with a 3-hour repositioning interval was significantly lower than in the group using an air mattress with a 2-hour repositioning interval (odds ratio, 0.481; 95% confidence interval, 0.410-0.565). CONCLUSIONS: The findings showed that PIs decreased when the repositioning interval was extended from every 2 hours to every 3 hours while using foam mattresses. This study suggests that a 3-hour repositioning interval using a foam mattress could be applied to reduce the risk of PI development for patients at low or moderate risk.

Individual and organizational factors influencing workplace cyberbullying of nurses: A cross-sectional study.

Workplace cyberbullying has emerged as a new issue. This study aimed to explore individual and organizational factors that affect nurses' workplace cyberbullying in hospital settings. A multicenter, cross-sectional study was conducted using a self-report questionnaire. Three tertiary and 18 general hospitals were selected from one city in Korea. A total of 270 nurses with 6 months to 10 years of experience in the current department were enrolled. Multiple regression analysis was conducted to identify the factors associated with cyberbullying. Workplace cyberbullying was affected by self-labeled victimization due to face-to-face bullying, subjective health level, years of experience as a nurse (ß = 0.148, p = 0.009), and relation-oriented nursing organizational culture. Face-to-face bullying must be addressed to prevent workplace cyberbullying. It is important to assist nurses to maintain good health-considering that, new nurses with less than 1 year of experience are vulnerable to being victimized. Effective prevention strategies should be prepared to control workplace cyberbullying in clinical practice.

Cyberbullying, student nurses' ethical awareness and the Covid-19 pandemic.

BACKGROUND: The global COVID-19 pandemic has increased cyber communication, causing nursing students' clinical practice to be held in cyberspace. Thus, it is essential to ensure that nursing students develop comprehensive cyber ethics awareness. Moreover, cyberbullying is becoming more widespread and is an increasingly relevant new concept. OBJECTIVES: This study aimed to assess the experiences of cyberbullying among nursing students during clinical practice and determine the effects of cyberbullying victimization and cyber environments on their cyber ethics awareness. RESEARCH DESIGN: Data for this descriptive cross-sectional study were collected in July 2020 using a self-reported questionnaire and analyzed using hierarchical regression. PARTICIPANTS AND RESEARCH CONTEXT: The study included data from 291 nursing students with more than 6 months of clinical experience who were enrolled in two nursing universities in two cities in South Korea. ETHICAL CONSIDERATIONS: This study was conducted after obtaining approval from the Institutional Review Board of G University. Written, informed consent was obtained from all participants. RESULTS: Cyberbullying victimization experiences during clinical practice were few. The most common cyberbullies of work- and person-related cyberbullying were nurses and classmates, respectively. DISCUSSION: Cyber ethics awareness was affected by cyber anonymity and the perceived seriousness of cyberbullying; cyberbullying related to clinical practices was a new factor that significantly affected cyber ethics awareness. CONCLUSIONS: Hospitals and nursing universities should develop a multi-dimensional, comprehensive, and effective nursing intervention education program to be integrated into the nursing curriculum to enhance cyber ethics awareness and reduce cyberbullying of nursing students.

Female university students' menstrual-hygiene management and factors associated with genitourinary-tract infections in Korea.

This study examined female university students' menstrual-hygiene management and identified factors associated with genitourinary tract infections in this sample. This study was conducted as a descriptive survey. Participants were 383 female students from six universities in South Korea. Data were collected between April and June, 2017. Multiple logistic regression analysis was used to access the factors associated with genitourinary-tract infections. Multiple logistic regression revealed that genitourinary tract infections were significantly associated with low socioeconomic level, history of sexual intercourse, and vaginal douching during menstruation. We evaluated menstrual hygiene practices and their relation to genitourinary tract infections. Korean college students were relatively good at managing menstrual hygiene. However, some menstrual hygiene behaviors were improper. Therefore, school and community health agencies should provide education to maintain adequate menstrual hygiene and correct erroneous hygiene practices to prevent genitourinary tract infections.

Influencing factors on preventive health behaviours for Zika virus in pregnant women and their partners.

AIMS AND OBJECTIVES: To identify Zika virus-related knowledge, attitudes to Zika virus and health motivations of pregnant women, women preparing for pregnancy and their partners, and to identify factors that influence preventive health behaviours for Zika virus infection. BACKGROUND: Prevention of Zika virus infection is becoming a major worldwide public health effort. The high-risk group for Zika virus infection comprises women who are pregnant or preparing for pregnancy. Few studies have addressed preventive health behaviours for Zika virus infection by gender. DESIGN: This study was a descriptive cross-sectional survey. METHODS: Participants (112 males and 147 females) were selected by convenience sampling from three obstetric clinics located in South Korea. Women and their partners who visited obstetric clinics during pregnancy or preparing for pregnancy were included as subjects. RESULTS: Factors associated with preventive health behaviours for Zika virus were checking infection status of Zika virus on destinations when planning a trip and attitudes to Zika virus in males and age, educational level, intention to travel to Zika virus endemic countries, attitudes to Zika virus and health motivation in females. CONCLUSIONS: Factors that influence preventive health behaviours for Zika virus were different by gender. However, attitudes to Zika virus were influential to both genders. Gender differences should be considered in development of health policies to improve preventive health behaviours for Zika virus. Younger and less educated women are to be targeted, and health management programmes should be developed to promote health motivation. RELEVANCE TO CLINICAL PRACTICE: Pregnant women, women preparing for pregnancy and their partners need education and public health promotion to improve self-management during travel to places where Zika virus is endemic. Health policies and health management programmes considering age and educational background should be developed to promote health motivation in women of childbearing age.

Factors predicting young women's willingness to conduct vulvar self-examinations in Korea.

Vulvar self-examination (VSE) is an essential examination that all women should perform monthly, as it enables potential patients to discover vulvar cancer in early stage. In this study, a survey was conducted to identify the factors that affect Korean young women's willingness to conduct VSE. Willingness to conduct VSE was higher if the perceived benefit and the individual health motivation were higher. However, it was lower if the perceived barriers were higher. The systematic strategies should be included in VSE education programs to increase perceived benefits of, and health motivation for conducting VSE while reducing the perceived barriers to VSE.

Effects of workplace cyberbullying on nurses' symptom experience and turnover intention.

AIMS: The purpose of this study was to investigate the effect of workplace cyberbullying on nurses' symptom experience and turnover intention. BACKGROUND: While face-to-face workplace bullying occurs frequently in nursing organisations, workplace cyberbullying has rarely been studied. METHOD: This is a cross-sectional descriptive study using self-reporting surveys of 249 nurses from 20 hospitals. RESULTS: The prevalence of workplace cyberbullying was 8%, and the mean was 1.11 ± 0.31. Factors influencing symptom experience were workplace cyberbullying and perceived organisational support, while factors influencing turnover intention were workplace cyberbullying, perceived organisational support and educational level. CONCLUSIONS: Workplace cyberbullying and perceived organisational support are factors that significantly influenced both symptom experience and turnover intention in nurses working in hospital settings. Managing workplace cyberbullying can reduce the negative effects on nurses' symptom experience and turnover intention. This suggests that the management of workplace cyberbullying by a nursing organisation is essential. IMPLICATIONS FOR NURSING MANAGEMENT: Nursing managers need to focus on the control and prevention of workplace cyberbullying as well as traditional forms of bullying. Managing workplace cyberbullying can reduce negative effects on nurses' symptom experience. Interest in and prevention of workplace cyberbullying would decrease turnover intention and stabilize the nursing organisation and the workforce.

Prevention of Zika virus infection: Knowledge, attitudes, and practices of pregnant women in Korea.

This study was performed to investigate the association of knowledge, attitudes, and preventive practices for the prevention of Zika virus infection. The study sample consisted of 185 pregnant women in Korea. The Zika virus-related knowledge and attitude of pregnant women significantly affected preventive practices. The younger pregnant women and pregnant women who had not taken the influenza vaccine had lesser preventive practices of the Zika virus, thereby necessitating educating them and emphasizing good preventive practices. Our results suggest that systematic education and effective prevention programs for Zika virus will contribute to the prevention of infection.

Factors influencing emergency nurses' ethical problems during the outbreak of MERS-CoV.

BACKGROUND: Whenever there has been a worldwide contagious disease outbreak, there have been reports of infection and death of healthcare workers. Particularly because emergency nurses have contact with patients on the front line, they experience ethical problems in nursing while struggling with infectious diseases in an unfavorable environment. OBJECTIVE: The objective of this study was to explore emergency nurses' ethical problems and to identify factors influencing these problems during the outbreak of Middle East respiratory syndrome-coronavirus in Korea. DESIGN AND SAMPLE: For this cross-sectional study, a questionnaire survey was conducted with emergency nurses working in six hospitals selected through convenience sampling from the hospitals designated for Middle East respiratory syndrome-coronavirus patients in the capital area. METHODS: Data were collected from 169 emergency nurses in Korea during August 2015. Ethical considerations: This research was approved by the Institutional Review Board of G University in Korea. RESULTS: The findings of this study suggest that during the Middle East respiratory syndrome-coronavirus outbreak, emergency nurses experienced ethical problems tied to a mind-set of avoiding patients. Three factors were found to influence emergency nurses' ethical problems (in order of influence): cognition of social stigmatization, level of agreement with infection control measures, and perceived risk. CONCLUSION: Through this study, we obtained information on emergency nurses' ethical problems during the Middle East respiratory syndrome-coronavirus outbreak and identified the factors that influence them. As found in this study, nurses' ethical problems were influenced most by cognitions of social stigmatization. Accordingly, to support nurses confidently care for people during future health disasters, it is most urgent to promote appropriate public consciousness that encourages healthcare workers.

A Comparison of the Incidence of Post-Dural Puncture Headache and Backache After Spinal Anesthesia: A Pragmatic Randomized Controlled Trial.

BACKGROUND: Although bed rest is recommended after spinal anesthesia to prevent the occurrence of post-dural puncture headache, current literature suggests that periods of bed rest did not prevent headache as well as increase the risk of other complications such as backache. However, information is scarce regarding an appropriate period of bed rest following a dural puncture. AIM: The aim of this study was to compare the incidence of post-dural puncture headache and backache after different periods of bed rest following spinal anesthesia. METHODS: This study was a pragmatic, parallel-group, blinded, and randomized controlled trial (trial registration number KCT0001797). A total of 119 patients who underwent surgery under spinal anesthesia participated in this study from December 2013 to June 2014. The participants were randomly allocated to three groups: the immediate mobilization group (n = 45), 4-hour bed rest group (n = 40), and 6-hour bed rest group (n = 34). The severity of headache and backache was measured using the Dittmann scale and a visual analogue scale, respectively. Data were collected for 5 consecutive days postoperatively by one researcher blind to the group allocation. RESULTS: No significant difference in the incidence of headache among the three groups was detected. However, the incidence of backache in the 6-hour bed rest group was higher and was significantly more severe than the other groups. LINKING EVIDENCE TO ACTION: Bed rest after spinal anesthesia did not prevent the occurrence of headache and increased the incidence of patients experiencing a backache and, therefore, is not recommended. The findings provide information for establishing evidence-based nursing practices for patients after a dural puncture.

A study on the predictors of Korean male students' intention to receive human papillomavirus vaccination.

AIMS AND OBJECTIVES: The objective was to survey the current state of human papillomavirus (HPV) vaccination and the predictors of vaccination intention among Korean male students of high school (ages 15-19) and university (ages 17-27). BACKGROUND: Human papillomavirus is a sexually transmitted infectious agent causing uterine cervical, anal, and/or penile cancer and genital warts in males and females. Infection rate of human papillomavirus increases from the age when sexual intercourse first occurs. Therefore, motivation to receive human papillomavirus vaccination is needed to protect infection. DESIGN: Cross-sectional descriptive survey was performed only in male students. They are less aware of human papillomavirus than females, because human papillomavirus vaccination has been targeted on females for preventing cervical cancer in Korea. METHODS: Data were collected using a self-reporting questionnaire for male high school and university students sampled from a city in Korea. Human papillomavirus vaccine-related knowledge, health beliefs, demographic, and sexual history information variables relating to intentions to vaccinate were assessed. RESULTS: The human papillomavirus vaccination rate was very low and the levels of knowledge and health beliefs were low. The significant predictors that raised the intention of human papillomavirus vaccination were a university student, experience of sexual intercourse and perceiving the benefits of human papillomavirus vaccination. CONCLUSIONS: To promote human papillomavirus vaccination, educational programming targeting males should include health beliefs and knowledge, emphasising that vaccination is important to prevent uterine cervical cancer and to role as a preventative measure against common male diseases. RELEVANCE TO CLINICAL PRACTICE: Male high school students should be included as a major target population for school human papillomavirus education programmes, as they are at the age of commencing sexual intercourse. In addition, public health policies including human papillomavirus vaccination in the national immunisation programme are warranted.

Middle East respiratory syndrome-related knowledge, preventive behaviours and risk perception among nursing students during outbreak.

AIMS AND OBJECTIVES: The aim of this study was to survey nursing students' Middle East respiratory syndrome-related knowledge, preventive behaviours and risk perception to examine the correlations among the variables during a Middle East respiratory syndrome outbreak. BACKGROUND: Middle East respiratory syndrome is a new viral respiratory illness. Nursing students who engage in clinical practice at hospitals may have been exposed to Middle East respiratory syndrome infection during the Middle East respiratory syndrome outbreak. DESIGN: This study was a descriptive cross-sectional survey. METHODS: Participants (n = 249) were nursing students in their third or fourth year of the programme who were engaged in clinical practice for eight hours per day at the tertiary hospitals with Middle East respiratory syndrome patients. Knowledge, preventive behaviours and risk perception related to Middle East respiratory syndrome were measured using scales developed through a preliminary survey and validity testing. RESULTS: The subjects' knowledge level of Middle East respiratory syndrome was 84·4%; their practice of preventive behaviours was rated at 44·5%; and their risk perception rating was 2·4 out of 5. Middle East respiratory syndrome-related risk perception was significantly different according to gender and Middle East respiratory syndrome education. Middle East respiratory syndrome-related knowledge was significantly correlated with preventive behaviours and risk perception. CONCLUSION: Considering the low scores for items regarding knowledge and preventive behaviours, it is necessary to develop effective and systematic publicity and education programmes for nursing students. Enhancing Middle East respiratory syndrome-related knowledge by considering cooperation between hospitals and universities will sharpen nursing students' risk perception of the disease and effectively increase their preventive behaviours. RELEVANCE TO CLINICAL PRACTICE: Similar to other emerging infectious diseases, Middle East respiratory syndrome outbreaks may occur in other countries. The results of this study can be used to develop and apply efficient and feasible Middle East respiratory syndrome education programmes for nursing students during Middle East respiratory syndrome outbreaks.

Factors predicting clinical nurses' willingness to care for Ebola virus disease-infected patients: A cross-sectional, descriptive survey.

The purpose of this study was to identify factors predicting clinical nurses' willingness to care for Ebola virus disease (EVD)-infected patients. Data were collected from 179 nurses employed at 10 hospitals in Korea using self-reporting questionnaires. Only 26.8% of the participants were willing to care for EVD-infected patients. Factors predicting their willingness to provide care were their belief in public service, risk perception, and age. Nurses' willingness to provide care was high when their belief in public service was high, low when their risk perception was high, and low as their age increased. In order to strengthen nurses' willingness to care for EVD-infected patients, education that targets the enhancement of belief in public service should be included in nurse training. Efforts should be directed toward lowering EVD risk perception and developing systematic responses through government-led organized support.

Self-perceived competency of infection control nurses based on Benner's framework: a nationwide survey in Korea.

The aim of this study was to evaluate the competency level of Korean infection control nurses (ICNs) by comparing the self-perceived competency level based on Benner's framework and the core competency proposed by the Certification Board of Infection Control. Study subjects included 90 ICNs working in Korean hospitals with more than 300 beds. A questionnaire was used to measure self-perceived competency level and core competency level. Using descriptive analysis, the core competency level of ICNs was found to differ significantly according to self-perceived competency level, and core competency level showed a significant increase with the increase of self-perceived competency level. Self-perceived competency level could be useful in classifying the competency level of nursing specialties. These results illustrate the competency levels of Korean ICNs and could serve as a reference to evaluate and expand the application of competency measurement not only for ICNs but also other groups of nurse specialists.

Effects of organizational and individual factors on nurses' practice of central line-associated bloodstream infection prevention.

BACKGROUND: This study explored rarely investigated organizational factors (resource support and organizational culture) in conjunction with well-established individual factors (demographic characteristics, knowledge, and awareness) that impact nurses' practice of central line-associated bloodstream infection (CLABSI) prevention. METHODS: Self-reported questionnaire data were collected from 173 nurses recruited from departments that use central venous catheters (ie, intensive care units, emergency rooms, hemodialysis rooms, and oncology wards) in tertiary hospitals in South Korea. Multiple regression analyses were performed to examine the effects of individual and organizational factors. RESULTS: Organizational culture (ß = 0.350) had the greatest association with CLABSI prevention practice, followed by awareness (ß = 0.328) and department (ß = -0.217; all ps < 0.01). These variables explained 41.1% of the variance in CLABSI prevention practice (F = 20.996, P < .001). Higher self-reported CLABSI prevention practice was associated with a favorable organizational culture and higher awareness. Emergency room nurses' CLABSI prevention practice was notably inferior as compared to nurses in other departments. DISCUSSION: Organizational culture is the most significant factor affecting nurses' practice of CLABSI prevention. CONCLUSIONS: An organizational culture with environmental improvements and resource support as well as infection prevention education and awareness-building programs should be fostered.

Factors Affecting Nursing Students' Perception of Workplace Bullying.

Workplace bullying is a critical and prevalent issue that causes serious problems in healthcare settings. However, there is little research on the factors affecting nursing students' perception of workplace bullying despite their forthcoming transition into the nursing profession. Therefore, this study aimed to identify the factors related to nursing students' perception of workplace bullying in Korea. A cross-sectional study was conducted among 242 nursing students who had experienced clinical practice. The survey questionnaire included general characteristics, perceived susceptibility and severity of bullying, and perception of workplace bullying. Data were analyzed using multiple regression analysis. In this study, the significant factors affecting nursing students' perception of workplace bullying included bullying experience in clinical practice and the perceived severity of bullying. Therefore, it is crucial for nursing managers and instructors to have a clear understanding of the bullying situations experienced by nursing students during clinical practice. We should promote the perception of workplace bullying through indirect experiences such as systematic education about workplace bullying for nursing students, which may prevent workplace bullying in clinical practice and work environments. Furthermore, a comprehensive and multifaceted approach is necessary to effectively prevent workplace bullying in clinical practice and work environments. This study reveals that systemic and persistent education and intervention to bullying may improve nursing students' perception of workplace bullying and prevent workplace bullying in clinical practice and work environments. Furthermore, this study provides basic data on the prevention and management of bullying in nursing students' clinical practice.

Development and Implementation of a Mobile-Integrated Simulation for COVID-19 Nursing Practice: A Randomized Controlled Pretest-Posttest Experimental Design.

This study developed and evaluated the effects of a mobile-integrated simulation training program on infection prevention and nursing practices based on past experiences of coronavirus disease (COVID-19) care. We developed mobile videos for the experimental group and an educational booklet for the control group based on the Analysis, Design, Development, Implementation, and Evaluation (ADDIE) model. The effects of the simulation program with the use of mobile videos on knowledge of COVID-19 management, infection prevention practice confidence, and clinical decision-making anxiety and confidence were analyzed through a randomized controlled pretest-posttest experimental design. Data from 109 participants were analyzed. Five mobile videos were developed with a total duration of 43 min and 13 s. The experimental group showed significantly greater improvement in knowledge of COVID-19 management (p = 0.002) and infection prevention practice confidence (p < 0.001). Using the mobile-integrated COVID-19 nursing practice simulation program, nurses who have no experience with emerging infectious diseases can increase their infection control knowledge and infection prevention practice confidence. In conclusion, the mobile-integrated COVID-19 nursing practice simulation program was effective in increasing infection control knowledge and infection prevention practice confidence in nurses without COVID-19 care experience.

Awareness and practice of wound disinfection among wound care nurses in Korea.

PURPOSE: The aim of this study was to assess the awareness and practice of wound disinfection among Korean wound care nurses. SUBJECTS AND SETTING: The target sample comprised 100 members of the Korea Wound Ostomy Continence Nurse Association. Seventy-eight wound care nurses responded to the questionnaire, yielding a response rate of 78%. METHODS: Potential respondents were contacted via e-mail and asked to complete a questionnaire designed for this study. RESULTS: Pressure ulcers were the most common wound type managed by WOC nurses, followed by surgical wounds. The mean score of items measuring awareness of wound disinfection practice and reported wound disinfection practice were 3.38 on a scale of 0 to 4 scale, and 3.14 on a scale of 0 to 4, respectively. Scores among items that queried awareness and practice in various methods for disinfecting a chronic wound disinfection were highest (3.74 and 3.67 out of 4, respectively) and scores of items querying disinfection with sodium hypochlorite were lowest (2.80 and 2.05 out of 4, respectively). There were significant differences between all items of awareness and reported practice except for disinfection with alcohol. Awareness of wound disinfection significantly correlated with reported practice. CONCLUSIONS: Developing an effective educational program to enhance awareness is necessary to improve practice of wound disinfection.

Nurses' perceptions of career ladder systems, job satisfaction and turnover intention: A cross-sectional study.

AIM: This study aimed to compare nurses' perceptions of career ladder systems, job satisfaction and turnover intention in small- and medium-sized hospitals with and without a career ladder system. DESIGN: A cross-sectional, correlational, descriptive study was conducted. METHODS: Data were collected using self-report surveys from 130-144 participants in small- and medium-sized hospitals with and without a career ladder system, respectively. The data were collected from July 1, 2019-July 31, 2019. RESULTS: The perception of the career ladder system was positively correlated with job satisfaction in hospitals with and without a career ladder system but negatively correlated with turnover intention in those with a career ladder system only. A positive perception of the system is associated with increased job satisfaction and lowered turnover intention. Hospitals should implement a career ladder system and improve nurses' perception by addressing the specific categories identified in this study.

Development and Evaluation of a Workplace Bullying Cognitive Rehearsal-Based Nursing Simulation Education Program: A Mixed-Methods Study.

Bullying makes learning difficult for nursing students, and using real-life scenarios during training can improve the understanding of workplace bullying. Thus, to mitigate bullying experienced by nurses, this study developed and evaluated a cognitive rehearsal education program that constituted training nursing students through role-play simulations. A mixed-method research design was used to evaluate 39 nursing students from two universities. A quasi-experimental research design was applied to assess symptoms, knowledge, and perceptions of bullying, and a focus group interview was conducted with six participants. Quantitative analyses revealed that the program improved participants' knowledge and perceptions but not their symptoms. The focus group interview revealed that the program improved participants' coping skills and desire for education. This program could be effective in raising awareness of workplace bullying and increasing relevant coping skills. It can be further developed as part of an overall strategy to manage workplace bullying and its consequences in hospital settings.