Structural Topic Modeling Analysis of Patient Safety Interest among Health Consumers in Social Media

Purpose@#This study aimed to investigate healthcare consumers’ interest in patient safety on social media using structural topic modeling (STM) and to identify changes in interest over time. @*Methods@#Analyzing 105,727 posts from Naver news comments, blogs, internet cafés, and Twitter between 2010 and 2022, this study deployed a Python script for data collection and preprocessing. STM analysis was conducted using R, with the documents’ publication years serving as metadata to trace the evolution of discussions on patient safety. @*Results@#The analysis identified a total of 13 distinct topics, organized into three primary communities: (1) “Demand for systemic improvement of medical accidents,” underscoring the need for legal and regulatory reform to enhance accountability; (2) “Efforts of the government and organizations for safety management,” highlighting proactive risk mitigation strategies; and (3) “Medical accidents exposed in the media,” reflecting widespread concerns over medical negligence and its repercussions. These findings indicate pervasive concerns regarding medical accountability and transparency among healthcare consumers. @*Conclusion@#The findings emphasize the importance of transparent healthcare policies and practices that openly address patient safety incidents. There is clear advocacy for policy reforms aimed at increasing the accountability and transparency of healthcare providers. Moreover, this study highlights the significance of educational and engagement initiatives involving healthcare consumers in fostering a culture of patient safety. Integrating consumer perspectives into patient safety strategies is crucial for developing a robust safety culture in healthcare.

Comparison of the Predictive Validity of the Pressure Injury Risk Assessment in Pediatric Patients: Braden, Braden Q and Braden QD Scale / 임상간호연구

Purpose@#The purpose of this study is to compare the predictive validity of pressure injury risk assessment, Braden, Braden Q and Braden QD for pediatric patients. @*Methods@#Prospective observational study included patients under the age of 19 who were hospitalized to general wards, intensive care units of a children’s hospital.Characteristics related to pressure injury were collected, and predicted validity was compared by calculating the areas under the curve (AUC) of the Braden, Braden Q, and Braden QD scales. @*Results@#A total of 689 patients were included in the study. A total of 13 (1.9%) patients had pressure injuries, and the number of pressure injuries was 17. Factors related to the occurrence of pressure injuries were 9 (52.9%) immobility-related and 8 (47.1%) medical device-related. The AUC for each scale was .91 (95% CI .89~.94) for Braden, .92 (95% CI .90~.95) for Braden Q, and .94(95% CI .92~.96) for Braden QD. The optimal cut-off points were identified as 16 for Braden (sensitivity=88.8%, specificity=86.4%), 17 for Braden Q(sensitivity=63.6%, specificity=94.9%), and 12 for Braden QD (sensitivity=94.4%, specificity=88.7%). @*Conclusion@#The Braden QD scale demonstrated the highest predictive validity for pressure injuries in pediatric patients and is expected to be valuable tool in preventing pediatrics pressure injuries.

Psychological Impact of Quarantine on Caregivers at a Children's Hospital for Contact with Case of COVID-19

Quarantine often provokes negative psychological consequences. Thus, we aimed to identify the psychological and behavioral responses and stressors of caregivers quarantined with young patients after a close contact to a coronavirus disease 2019 case at a children's hospital. More than 90% of the caregivers reported feelings of worry and nervousness, while some of them reported suicidal ideations (4.2%), and/or homicidal ideations (1.4%). Fear of infection of the patient (91.7%) and/or oneself (86.1%) were most frequently reported stressors. A multidisciplinary team including infection control team, pediatrician, psychiatrist, nursing staff and legal department provided supplies and services to reduce caregiver's psychological distress. Psychotropic medication was needed in five (6.9%), one of whom was admitted to the psychiatry department due to suicidality. Quarantine at a children's hospital makes notable psychological impacts on the caregivers and a multidisciplinary approach is required.

Development and Evaluation of an Informatics System for Nursing Faculty to Improve Patient Safety Teaching Competency / 간호행정학회지

Purpose@#This study aimed to develop an educational informatics system for nursing faculty to improve their competencies in teaching patient safety and to evaluate the effectiveness of the system. @*Methods@#We developed a system called, ‘Resource to Enhance Safety Competency and Utilize for Education’ (RESCUE) based on the World Health Organization Multi-professional Patient Safety Curriculum Guide, and it was implemented with full-time nursing faculty in 4-year nursing schools. A one-group pretest-posttest design was used for evaluation. A total of 46 nursing faculty members used the system during a 3-month period. The effects of the RESCUE were measured using a survey including patient safety teaching competency, system usability and user satisfaction. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. @*Results@#After using the RESCUE, participants showed a significant increase in self-confidence in teaching patient safety during lectures (Z=-3.61, p<.001) and practica (Z=-3.14, p=.002). @*Conclusion@#The developed informatics system was shown to be effective in improving the self-confidence of nursing faculty in teaching patient safety. To effectively integrate patient safety topics into the curriculum, it can be helpful to utilize the educational materials provided in this study with various clinical cases.

Impact of Lifestyle and Health Examination Results on Sick Leave in Commercial Airline Pilots / 한국직업건강간호학회지

Purpose@#This study aims to compare the general characteristics, life-style, health examination results, and sick leave days by airmen medical examination decision and to investigate factors affecting sick leave days. @*Methods@#We obtained data from 2,361 Korean pilots who worked for a commercial airline. Comparison of the results by airmen medical examination decision (Fit or waver) was conducted using the x 2 test or Fisher’s exact test. Factors affecting sick leave days were analyzed using logistic regression. @*Results@#Age, smoking history, blood pressure, obesity, and fasting blood sugar level were significantly different between the Fit and Waver groups. Rate of using sick leave long-term was higher in the Waver than in the Fit. Sick leave days were significantly associated with age, habits of drinking, and smoking in the Fit group. @*Conclusion@#This study demonstrated the health risk factors that affect the number of sick leave days. By providing basic data for the health care of workers, it is expected to be applicable to the provision of health promotion and disease prevention programs for workers.

Development and Evaluation of an Informatics System for Nursing Faculty to Improve Patient Safety Teaching Competency / 간호행정학회지

Purpose@#This study aimed to develop an educational informatics system for nursing faculty to improve their competencies in teaching patient safety and to evaluate the effectiveness of the system. @*Methods@#We developed a system called, ‘Resource to Enhance Safety Competency and Utilize for Education’ (RESCUE) based on the World Health Organization Multi-professional Patient Safety Curriculum Guide, and it was implemented with full-time nursing faculty in 4-year nursing schools. A one-group pretest-posttest design was used for evaluation. A total of 46 nursing faculty members used the system during a 3-month period. The effects of the RESCUE were measured using a survey including patient safety teaching competency, system usability and user satisfaction. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. @*Results@#After using the RESCUE, participants showed a significant increase in self-confidence in teaching patient safety during lectures (Z=-3.61, p<.001) and practica (Z=-3.14, p=.002). @*Conclusion@#The developed informatics system was shown to be effective in improving the self-confidence of nursing faculty in teaching patient safety. To effectively integrate patient safety topics into the curriculum, it can be helpful to utilize the educational materials provided in this study with various clinical cases.

Experience of Communication for Patient Safety by Perioperative Nurses / 간호행정학회지

PURPOSE: The purpose of this study was to explore perioperative nurses' communication experience within the surgical team with regard to patient safety. METHODS: Data were collected from December 2015 to September 2016, through in-depth individual interviews with 14 perioperative nurses. Individual interviews, once or twice, lasted from 40 minutes to one hour for each session. The main interview question was “How do you describe your communication experience with surgical team members as a perioperative nurse?” Collected data were analyzed using a conventional content analysis. RESULTS: Two categories of the perioperative nurses' experience of communication were identified: communication contributing to patient safety, communication hindering patient safety. Communication in the surgical team reflected on the unique features of the operating room, such as urgency and a hierarchical organizational culture. However, the nurses recognized ineffective communication could impact on patient safety, and endeavored to overcome communication failures. CONCLUSION: The results indicate that sharing responsibility, open communication, assertiveness on safety issues, and interprofessional collaboration in the operating room are necessary to ensure effective communication. Thus, respectful culture and an open communication climate based on interprofessional understanding are required to improve communication. Training programs to enhance communication skills should be implemented.

Patient Safety Teaching Competency of Nursing Faculty

PURPOSE: The purpose of this study was to investigate patient safety teaching competency of nursing faculty and the extent of teaching patient safety topics in the nursing curriculum. METHODS: A national survey was conducted with full-time nursing faculty in 4-year nursing schools. Regional quota sampling method was used. An online survey was sent to 1,028 nursing faculty and 207 of them were completed. Among the 207, we analyzed data from 184 participants. The revised Health Professional Education in Patient Safety Survey was used. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation analysis, and multiple linear regression analyses. RESULTS: The faculty's self-confidence was lower than their perceived importance of patient safety education. The mean score of teaching patient safety was 3.52±0.67 out of 5, and the contents were mostly delivered through lectures. The extent of faculty's teaching varied depending on faculty's clinical career, teaching subjects, participation in practicum courses, and previous experience of patient safety education. The significant predictors of the extent of teaching patient safety were the faculty's self-confidence in teaching patient safety (β=.39) during clinical practicum, their perceived importance of patient safety education during lectures (β=.23), and the teaching subject (β=.15). CONCLUSION: To enhance the competency of nursing faculty for effective patient safety education, a patient safety education program tailored to faculty characteristics should be developed and continuously provided for faculty. In addition, it is necessary to improve patient safety curriculum, strengthen clinical and school linkages, and utilize various education methods in patient safety education.

Applying the Flipped Learning Model to an English-Medium Nursing Course

PURPOSE: An emerging trend in Asian higher education is English-medium instruction (EMI), which uses English as the primary instructional language. EMI prepares domestic students for international leadership; however, students report difficulty in learning, and educators have raised questions concerning the effectiveness of EMI. The flipped learning model (FLM), in which lecture and homework activities for a course are reversed, was applied to an English-medium course offered by a college of nursing in Korea. The aims of this study were to: 1) revise an existing English-medium nursing course using the FLM; 2) explore students' learning experiences and their acceptance of the FLM; and 3) identify key factors in the success of FLM. METHODS: We used a descriptive, cross-sectional, mixed-methods design and the participants were students at one nursing school in Korea. A series of course development meetings with faculties from the nursing school and the center for teaching and learning were used to develop the course format and content. We conducted course evaluations using the Flipped Course Evaluation Questionnaire with open-ended questions and focus group interviews. RESULTS: Students (N=75) in a 15-week nursing course responded to a survey after completing the course. Among them, seven students participated in one of two focus groups. Overall, students accepted and favored the flipped learning strategy, and indicated that the method enhanced lecture content and their understanding of it. Factors associated with effective instruction included structured monitoring systems and motivational environments. CONCLUSION: The FLM requires sufficient preparation to facilitate student motivation and maximize learning outcomes.

Perioperative Nurse's Experience of Nursing Errors and Emotional Distress, Coping Strategies, and Changes in Practice / 간호행정학회지

PURPOSE: This study was done to examine perioperative nurses' perception of the definitions and causes of nursing errors; the relationships among emotional distress, coping strategies, and changes in practice as a result of errors. METHODS: A descriptive, correlative design was used with a sample of 146 nurses working in the operating room of a university hospital. Data were collected using a self-report questionnaire with 4 point Likert scales. For the analysis, t-test, ANOVA, Scheffe's post hoc test and multiple regression analysis were used. RESULTS: Most nurses recognized themajority of the items as perioperative nursing errors. Job overload was perceived as the cause of errors. Emotional distress was significantly related with nurses' age, position and years of work experience. The coping strategies used most frequently were 'accepting responsibility' and 'planful problem solving'. The coping strategies of 'accepting responsibility', 'planful problem solving', 'seeking social support', and 'using self-control' were significant predictors in constructive practice change. Defensive changes were related to the strategy of escape/avoidance and emotional distress. CONCLUSION: The results of this study suggest that intervention strategies should be developed to decrease perioperative nurses'distress and improve their coping strategies resulting in constructive change in practice after committing an error.

Construct Validity and Reliability of the Korean Version of the Practice Environment Scale of Nursing Work Index for Korean Nurses

PURPOSE: To develop and test the validity and reliability of the Korean version of PES-NWI measuring nursing work environments in hospitals. METHODS: The Korean version of the PES-NWI was developed through forward-backward translation techniques, and revision based on feedback from focus groups. An internal consistency reliability and construct validity using confirmatory factor analysis were conducted using SPSS WIN (16.0) and AMOS (18.0). Survey data were collected from 733 nurses who worked in three acute care hospitals in Seoul, South Korea. RESULTS: The Korean version of PES-NWI showed reliable internal consistency with a Cronbach's alpha for the total scale of .93. Factor loadings of the 29 items on the five subscales ranged from .28 to .85. The five subscales model was validated by confirmatory factor analysis (RMR.9). CONCLUSION: The findings of this study demonstrate that the Korean version of PES-NWI has satisfactory construct validity and reliability to measure nursing work environments of hospitals in Korea.

Identification of Hypertension Management-related Errors in a Personal Digital Assistant-based Clinical Log for Nurses in Advanced Practice Nurse Training

PURPOSE: The purposes of this study were to develop a taxonomy for detection of errors related to hypertension management and to apply the taxonomy to retrospectively analyze the documentation of nurses in Advanced Practice Nurse (APN) training. Method: We developed the Hypertension Diagnosis and Management Error Taxonomy and applied it in a sample of adult patient encounters (N = 15,862) that were documented in a personal digital assistantbased clinical log by registered nurses in APN training. We used Standard Query Language queries to retrieve hypertension-related data from the central database. The data were summarized using descriptive statistics. Result: Blood pressure was documented in 77.5% (n = 12,297) of encounters; 21% had high blood pressure values. Missed diagnosis, incomplete diagnosis and misdiagnosis rates were 63.7%, 6.8% and 7.5% respectively. In terms of treatment, the omission rates were 17.9% for essential medications and 69.9% for essential patient teaching. Contraindicated anti-hypertensive medications were documented in 12% of encounters with co-occurring diagnoses of hypertension and asthma. CONCLUSION: The Hypertension Diagnosis and Management Error Taxonomy was useful for identifying errors based on documentation in a clinical log. The results provide an initial understanding of the nature of errors associated with hypertension diagnosis and management of nurses in APN training. The information gained from this study can contribute to educational interventions that promote APN competencies in identification and management of hypertension as well as overall patient safety and informatics competencies.

Focal Sparing of the Fatty Liver Caused by a Nontumorous Arterioportal Shunt

We present two cases of focal fatty sparing caused by a nontumorous arterioportal shunt. Two patients underwent ultrasonography (US) as a part of routine medical screening, which revealed a hypoechoic lesion in the diffuse fatty liver. Each lesion appeared to be an arterioportal shunt on triphasic mutidetector computed tomography (CT) and was seen as being slightly hyperdense on noncontrast CT. No tumors were delineated around or within the arterioportal shunt. Both lesions remained unchanged on six-month follow-up US.

Change of Radiologic Indicators during Putting Foot Orthosis on Flatfoot in Children with Cerebral Palsy

OBJECTIVE: To identify change of the radiologic indicators known to reflect height of medial longitudinal arch between with and without foot orthosis on flatfoot in children with cerebral palsy. METHOD: 15 children with cerebral palsy, which were diagnosed as pes planus by bio-mechanical examination and foot print test, were participated in this study. Initial radiologic study (foot anteroposterior and lateral view with standing position) had been done with shoe only and then second radiologic study with shoe and foot orthosis as same method. 3 months after, third radiologic study were performed with shoe only. Radiologic indicators were measured at each radiologic studies. Radiologic indicators measured at intial study were compared with both second and third study. RESULTS: In comparing initial radiologic study with second, consistently changed radiologic indicators toward corrective direction were calcaneometatarsal angle, navicular height, arch height ratio, arch height angle, talometatarsal angle in anteroposterior view. The other five indicators were variable in increase or decrease of change. There were no interval changes of radiologic indicators comparing at initial study with third study. CONCLUSION: Calcaneometatarsal angle, arch height ratio, arch height angle, and talometatarsal angle were consistently changed, simply measurable radiologic indicators for evaluation of pes planus in children with cerebral palsy.

Breast Arterial Calcification on Mammogram: Correlation with Carotid Arterial Atherosclerosis on Ultrasonogram

PURPOSE: To investigate the incidence of breast arterial calcification in Korean women, and to determine its association with systemic diseases and carotid arterial atherosclerosis. MATERIALS AND METHODS: One thousand seven hundred and thirteen female subjects who underwent mammography at a health care center between May 1999 and May 2000 were included in this study. Of the total, 172 were found to have breast arterial calcification, and were classified according to age. The coincidence of hypertension, diabetes mellitus and hyperlipidemia was examined in both the subject group and the control group selected on the same age basis. To investigate the presence and degree of carotid atherosclerosis, sonographic maging was performed and the findings were compared between the two groups. RESULTS: The incidence of breast arterial calcification showed statistically significant differences according to age, with a higher incidence in older patients (p<0.05). However, there was no statistical difference in the incidence of hypertension, hyperlipidemia, and diabetes mellitus between groups. Carotid atherosclerosis was subjects more prevalent among subjects than in the control group (p<0.05), though there was no statistically significant difference in the degree of luminal stenosis. CONCLUSION: The most common pathologic cause of breast arterial calcification is arteriosclerosis. Breast arterial calcification is demonstrated at mammography, along with other clinical risk factors for atherosclerosis or coincidental neurologic symptoms. We stress that further evaluation of the carotid artery is necessary.

Giant Renal Stone accompanied the Squamous Cell Carcinoma / 대한비뇨기과학회지

No abstract available.