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Purpose@#This study was conducted to update nursing practice guidelines for intravenous infusion published in 2017. @*Methods@#The guideline update process was carried out using 22 steps developed by NICE and SIGN. It was agreed to update domains related to central venous infusion therapy. Contents related to peripheral infusion would be updated later. @*Results@#Updated guidelines for central venous infusion therapy consisted of 6 domains and 195 recommendations. The number of recommendations by domain was 11 for general instruction, 14 for central vascular access devices (CVAD) and add-on devices, 13 for nursing management before insertion of CVAD, 30 for management during insertion of CVAD, 51 for management after insertion of CVAD, and 76 for complications. A grade was 29 (14.9%), B grade was 87 (44.6%), and C grade was 79 (40.5%) in the strength of recommendations. A total of 37 (19.0%) recommendations were newly developed and 23 (12.3%) previous recommendations have been modified. The newly developed recommendations were mainly related to the infection control methods. @*Conclusion@#The updated guideline is focused on safe maintenance of central venous infusion therapy. Through this guideline, it is hoped to minimize the occurrence of complications and improve the standardization and efficiency of nursing practice.

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Purpose@#This study was conducted to update the existing evidence-based nursing clinical practice guideline for indwelling urinary catheterization (IUC). @*Methods@#The guideline have been revised in 22 steps based on international standards. The quality of the practice guidelines to be used for revision was evaluated using the Appraisal of Guidelines for Research and Evaluation II. The evaluation of the content appropriateness and applicability of the draft recommendations of the revised practice guidelines was performed using the RAND/UCLA Appropriateness Method, a decision-making method developed by the RAND Corporation. Four guidelines were used for the revision. @*Results@#The updated nursing practice guideline for IUC consisted of 9 domains and 134 recommendations. The numbers of recommendations in each domain were: 4 Assessment, 20 Equipment, 11 Catheter insertion, 52 Catheter maintenance, 4 Catheter and drainage bag change, 9 Catheter removal, 22 Complications management, 5 Education and consult, and 7 Hospital support. The recommended grade was 8.2% for A, 38.1% for B, and 53.7% for C. Among these, the major revision was done in 11 recommendations (8.2%). A total of 29 recommendations (21.6%) were newly added. 30 (22.4%) recommendations had minor revisions such as changes or addition for some words or sentences, and 13 (9.7%) recommendations were deleted. @*Conclusion@#Revised nursing practice guideline is expected to serve as an evidence-based practice guideline for IUC in Korea. This guideline will provide health care providers, patients, and caregivers with information to help manage IUC, leading to improved patient outcomes.

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Purpose@#This study aimed to explore factors influencing on the preventive behaviors of dementia in older Koreans enrolled in senior welfare centers to provide basic information on dementia prevention. @*Methods@#A total of 182 older Koreans participated in this study, which employed a cross-sectional design. Data were collected using questionnaires with items related to general characteristics, depression, self-esteem, knowledge and attitudes about dementia, preventive behaviors of dementia, dementia management self-efficacy, and anxiety about dementia. Using SPSS WIN 23.0, data were analyzed by descriptive statistics, t-test, ANOVA, Scheffé test, Pearson's correlation coefficient, and multiple regression. @*Results@#Living with a spouse (p=.013), a higher monthly income (p=.018), better nutrition (p=.010), not having a sleep disorder (p<.001), and higher number of participating programs (p=.001) were associated with better dementia prevention behaviors. Attitudes about dementia (β=.18, p=.006) and the number of programs older Koreans were participating in (β=.17, p=.006) influenced positively on the preventive behaviors of dementia, while depression (β=-.41, p<.001) and sleep disorders (β=-.17, p=.006) influenced negatively on dementia preventive behaviors. Overall, approximately 35% of the variability in dementia preventive behaviors was explained by these four variables in this study (F=24.97, p<.001). @*Conclusion@#The findings of this study suggest that depression reduction, good attitudes about dementia, program participation, and good sleep should be encouraged to promote dementia prevention. In addition, effective and structured educational programs should be developed for older Koreans to encourage dementia preventive behaviors to reduce the risk of dementia.

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PURPOSE: This study aimed to explore influencing factors on care burden among family caregivers for elders with dementia living at home. METHODS: Participants in this study were 211 family caregivers who were taking care of elders registered at a support center for dementia located in S-gu, Seoul. Data were collected using a structured questionnaire. Data were analyzed with descriptive statistics, t-test, ANOVA, Pearson correlation coefficients, and multiple regression in SPSS WIN 23.0. RESULTS: The care burden of family caregivers was mild to moderate (40.31±21.50) in this study. The factors influencing care burden among family caregivers for elders with dementia were the age, behavioral problems, and dependency in instrumental activities of daily living of demented elderly, in addition to the perceived health status and resting hours of family caregivers. Overall, these factors explained 46.5% of the total variability in care burden in this sample (F=13.01, p < .001). CONCLUSION: Findings from this study suggest that the characteristics of demented elderly and family caregivers can influence care burden differently. Individually tailored strategies based on the various caregiving contexts need to be developed to reduce the level of care burden among family caregivers for elders with dementia.

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PURPOSE: This study aimed to identify the incidence and risks for pressure ulcer among older patients with hip fracture. METHODS: The subject were 215 older patients suffering from hip fracture who were admitted for surgical operation from January 1, 2012 to April 30, 2016 in a university-affiliated hospital. The incidence of pressure ulcer was collected retrospectively through medical record review and the risk factors were analyzed using Cox's proportional hazard model. RESULTS: Out of the total, 32 patients (14.9%) developed pressure ulcer with the average occurrence period being 4.72 (±3.81) days. Stage II pressure ulcer was the most common at 72.0%. Risk factors included ambulation status before injury (p=.039), spinal anesthesia (p=.029), and stay at intensive care unit after operation (p=.009). CONCLUSION: Despite pressure ulcer prevention efforts, the incidence remained relatively high. Considering the identified risk factors, more efforts is needed for early detection and prevention of pressure ulcers in such patients.

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PURPOSE: This study aimed to propose a common scope of practice (SOP) for 13 specialties of Advanced Practice Nurses (APNs) in Korea.METHODS: The first draft of a common SOP was extracted from domestic and international laws with a literature review by 17 experts from the Korean Association of Advanced Practice Nurses (KAAPN). Then, the common SOP was finalized after comparing the activities of APNs in clinical settings.RESULTS: A total of 70 duties were identified and six categories were suggested for the common SOP. The SOP proposed by the KAAPN featured the following: 1) identification of and discrimination between health problems; 2) prescription and implementation of diagnostic tests; 3) treatment of injuries and diseases while implementing measures to prevent exacerbation; 4) prescription of medicinal products in line with 1) to 3); 5) referral and consultation; and 6) education and counseling. It was then confirmed that the proposed six categories in the common SOP reflected all the duties performed by APNs in clinical practice, including all 40 activities.CONCLUSION: The results of this study can be used as evidence for the legalization of a common SOP for APNs. Given the increasing multidisciplinary team approach adopted in Korean hospitals, it may be desirable to establish a broader SOP to reflect the diverse duties of APNs.

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PURPOSE: This study aimed to investigate the influence of health status and types of health management on depression in middle-aged women. METHODS: A convenience sample of 188 participants was recruited from health centers in S city. Using a structured questionnaire, data was collected and analyzed by t-test, ANOVA, Pearson's correlation, and linear regression using SPSS/WIN 23 program. RESULTS: Results of the regression analysis showed that perceived current health status (β=−0.55, p < .001), no caregiver (β=0.47, p < .001), chronic diseases lasting more than three months (β=0.36, p < .001), perceived health status compared to peer group (β=0.32, p < .001), walking for health (β=−0.20, p=.002), caregiver except family (β=0.18, p=.001), and gastrointestinal disease (β=0.10, p=.022) influenced depression in middle-aged women. Overall, approximately 69.7% of total variance explained this model (adjusted R2=0.678, F=57.21, p < .001). CONCLUSION: This study suggests that it is more important to understand the level of perceived health status in middle-aged women. Furthermore, it is necessary to develop programs that include various health management methods and strengthen the health care with the help of families and neighbors in order to manage depression in middle-aged women.

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BACKGROUND: This study was conducted to develop a pre-discharge group education program for liver transplant patients, and to contribute to improving the knowledge and performance of self-management after discharge. METHODS: This investigation was a methodological study consisting of analysis, design, development, operation, and evaluation stages. RESULTS: The constituent items of the pre-discharge group education program for liver transplant patients include medication management, infection management, emergency management, outpatient management, complication management, nutrition management, exercise management, wound and drainage management, disability registration, and sex life. The pre-discharge group education program for liver transplant patients was conducted once a week, 30 minutes for the coordinator, 40 minutes for the clinical nurse specialist (including 10 minutes for wound and drainage management), 30 minutes for pharmacists, 20 minutes for the nutritionist, and 20 minutes for social workers. Additionally, the contents of the lecture announced by PowerPoint were made the same as the booklet. The overall knowledge level before and 3 months after the pre-discharge group education program for liver transplantation patients increased significantly from 17.32±1.53 to 19.74±0.89. At the 3-month time point, the overall compliance was 77.39±3.04 out of 80. Overall satisfaction was 9.32±0.93 on a scale of 10. Finally, the need for medication was the highest at 3 months. CONCLUSIONS: It is expected that this program can be utilized in the clinical field as an effective nursing education intervention.

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PURPOSE: This study was conducted to explore the relationship between simulation-based clinical judgment and performance ability for tracheal suction in nursing students. METHODS: With a convenience sampling, 207 nursing students participated in this descriptive study. Lasater clinical judgment rubric was used for self-reported clinical judgment in addition to observe the skill of tracheal suction using a checklist. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficients using the SPSS/WIN 22. RESULTS: A scenario with pneumonia patient was developed to observe the skill of tracheal suction during simulation-based practices. Then self-reported clinical judgment was scored. The mean score of total sum of clinical judgment, total mean of clinical judgment, and performance skill were 36.44±4.82, 13.44±1.71, and 42.32±5.05, respectively. Statistically, students having good skills in suction showed significant differences in clinical judgment of interpreting (p=.031) compared to students having fair skills. CONCLUSION: The results of this study show that a structured debriefing method utilizing Lasater clinical judgment rubric is helpful. Also, simulation-based practice related to adult nursing in the respiratory system was useful for increasing the core basic skills among nursing students.

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PURPOSE: This study aimed to verify the relationship between human rights sensitivity, advocacy attitudes, and advocacy interventions for mentally disabled people in psychiatric nurses and nursing students. METHODS: This is a descriptive study. Using questionnaires, data were collected from 206 participants who were recruited from one mental health institute, one general hospital, and one university in S city. Data were analyzed by t-test, ANOVA, Pearson's correlation coefficient using SPSS/WIN 22. RESULTS: The mean age was 33.8±12.89. The mean scores of human rights sensitivity, advocacy attitudes, and advocacy intervention was 37.7±18.09, 53.7±5.67, and 47.4±7.08, respectively. Human rights sensitivity correlated significantly with advocacy attitudes (r=.25, p=.020) and advocacy intervention (r=.17, p=.015). Also, there was a significant positive correlation between advocacy attitudes and advocacy intervention (r=.44, p<.001). CONCLUSION: These findings highlight that advocacy attitudes and advocacy interventions for mentally disabled people could be improved by increasing human rights sensitivity. Tailored education programs will be effective in the field of mental health care services to increase human rights sensitivity.

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OBJECTIVE: The purpose of this study was to explore the effects of a senior functional game (Rejuvenescent village) on cognitive function, instrumental activities of daily living (IADL), depression, and life satisfaction in Korea. METHODS: An one-group pretest-posttest design was used in this study. Data were collected twice (at the beginning and the end) from 100 elderly adults in S city who played “Rejuvenescent village” 8 times (twice per week, one hour per session) for a month. Also they completed questionnaires on their cognitive function, IADL, depression, life satisfaction, and general characteristics. The data were analyzed using SPSS 20.0 programs. RESULTS: The mean age was 70.06(±3.77) years, with a range of 65-80 years old. Among 100 subjects, 21% were male and 85% were young old. There were statistically significant differences in cognitive function (t=-3.32, p=.001), IADL (t=1.98, p=.049), and life satisfaction (t=-2.15, p=.034). Although there was no statistically significant difference in mean depression score (t=1.06, p=.292), categorized depression was statistically significant (χ²=62.97, p<.001). CONCLUSION: The findings in this study show that the serious game (Rejuvenescent village) was effective for older Koreans' cognitive function, IADL, depression, and life satisfaction. Thus, we need to consider senior functional games to get health benefits by making elderly adults active with enjoyment.

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PURPOSE: The purpose of this study was to identify the effects of health status and health management on activities of daily living (ADL) in older, urban-dwelling Koreans. METHODS: A total of 206 subjects were recruited from one senior welfare center, six senior citizen centers, and subjects' home in two cities. Data was collected with self-reported questionnaires in order to measure health management, health status, and ADL. Data was analyzed by t-test, ANOVA, and stepwise multiple linear regression using SPSS/WIN 22.0. RESULTS: ADL in this subject were different depending on their age, education, marital status, type of family, and average monthly living expenses. Multivariate analysis showed that age (beta=-0.35, p<.001), exercise ability (beta=0.20, p<.001), diabetes (beta =-0.17, p<.001), osteoarthritis (beta=-0.15, p<.001), caregiver (beta=0.14, p=.005), frequency of health management (beta =-0.13, p=.006), smoking (beta=-0.11, p=.019), hypertension (beta=-0.10, p=.027), and type of family (beta=-0.10, p=.036) were significantly associated with ADL. Overall, approximately 60.2% of total variability in ADL could be explained by the 11 variables in this model (R2=0.602, F=32.06, p<.001). CONCLUSION: This study suggests that individualized health care should be continued for older, community-dwelling Koreans in order to improve their ADL. Moreover, we need to develop self-care programs and encourage them to participate in those programs.

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PURPOSE: This study was conducted to plan and apply simulation-based practice for raising the achievement of program outcomes (POs) in nursing students. METHODS: Using convenience sampling, 95 nursing students participated in this descriptive study. A self-reported questionnaire was used to measure the achievement of POs (self-directed learning, problem-solving ability, critical thinking) and usefulness of curriculum in addition to observing tracheal suction skills using a checklist. RESULTS: A scenario with a pneumonia patient was developed to observe tracheal suction skills during simulation-based practices. Self-directed learning, problem-solving ability, and critical thinking were then scored. The mean scores of performance skill, self-directed learning, problem-solving ability, critical thinking were 37.82+/-6.03. 3.61+/-0.38, 3.61+/-0.33, and 3.73+/-0.32, respectively. All students passed the simulation-based practice in terms of performance ability and met the required achievement level for the POs at this university. Students with good suction skills showed significant differences in problem identification (p=.044) and alternative development (p=.019), which are components of problem-solving ability, compared to students with only fair skills. CONCLUSION: These findings indicate that simulation-based practice related to an adult nursing respiratory course was useful for evaluating the achievement of POs in nursing students. Further study is needed to develop a universal method of outcome measurement.

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PURPOSE: The purpose of this study was to identify health status and the use of complementary and alternative therapies in the community dwelling pre-elderly and elderly. METHODS: A total of 193 subjects participated in this study. They were recruited from one senior welfare center, four senior citizen centers and subjects' home in two cities. Data were collected with self-reported questionnaires to measure health status and the use of complementary and alternative therapies. Data were analyzed by t-test, ANOVA using SPSS/WIN 22.0. RESULTS: Health status in this subjects was different depending on their age, sex, education, religion, type of family, and average monthly living expenses. Most used items as complementary and alternative medicine are diet therapy, herbal medicine such as health supplement food therapy, vitamin therapy, and Korean folk remedies. There were statistically significant differences in using complementary and alternative therapies according to one's current health status (F=7.09, p<.001), comparing health status to peers (F=3.67, p=.013), and chronic disease having more than three months (t=-2.50, p=.013). CONCLUSION: This study suggest that individualized health care should be continued for the pre-elderly and elderly. Moreover, we need to prepare long term care plans such as educations for applying complementary and alternative therapies.

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PURPOSE: The purpose of this study was to explore the correlates of body mass index (BMI), perceived health status (PHS), and the needs of functional games for the elderly in Korea. METHODS: This is a descriptive study with convenience sampling. The data were collected from 363 older adults in S city who completed questionnaires asking about their BMI, PHS, needs for functional games, and general characteristics. Using the SPSS 20.0 program, data were analyzed. RESULTS: The mean age was 65.4(+/-4.75), ranging between 60-83 years old. Among the 363 subjects, 75.2% who were male, 55.9% chose "functional games are necessary," and 25.3% selected "functional games are absolutely necessary" for the elderly. There were statistically significant correlations between current PHS and comparing health to others (r=.827, p<.001), depression (r=-.330, p<.001), age (r=-.113, p=.032), respectively. In addition, there was a statistically significant correlation between comparing health to others and depression (r=-.292, p<.001). CONCLUSION: The study findings show that older adults have distinct needs and interests for functional games. Thus, we need to develop senior functional games to help make older adults more active with greater enjoyment to gain more health benefits. Interdisciplinary team approaches would work well for developing functional games in Korean considering the preferences of older people are similar.

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PURPOSE: The purpose of this study was to review the relationship between physical activity and cardiovascular outcomes in the Korean elderly. METHODS: Experimental studies were located using PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed. The selected studies for analysis were 20 articles of cardiovascular outcomes (total cholesterol, triglyceride, high density lipoprotein (HDL), low density lipoprotein (LDL), blood pressure, and pulse rate) from 515 articles. RESULTS: One-group pretest-posttest design was the most common. The main physical activity was an aerobic exercise. Five of 14 studies reported a significant improvement of total cholesterol. Four of 14 studies found relationship between exercise and triglyceride. Eight of 12 studies reported a significant improvement of HDL, whereas 3 of 9 studies reported a significant improvement of LDL. In over 60% of selected studies, reported significant improvement of blood pressure. CONCLUSION: Based on the review, it suggests that regular physical activity of the elderly may improve cardiovascular outcomes.

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PURPOSE: The purpose of this study was to review the effects of physical activity on musculoskeletal outcomes in older Koreans. METHODS: Experimental studies were retrieved from the search engines (PubMed, CINAHL, PsycINFO, Cochrane, RISS, KISS, and KoreaMed). The selected studies for analysis were 27 articles of musculoskeletal outcomes (gait, muscle strength, flexibility, balance, grip strength, endurance, body fat, and weight) from 515 articles. RESULTS: The most common type of physical activity was a resistance exercise. There were significant improvements in gait (71.4%), muscle strength (86.7%), flexibility (63.6%), balance (72.2%), grip strength (71.4%), endurance (71.4%), body fat (57.1%), and weight (28.6%). The activity programs that apply over 150 minutes a week showed greater improvement of 69.5% than 65.0% from those did not meet the guidelines totally. CONCLUSION: Based on the review, we conclude that regular physical activity in the elderly may improve the musculoskeletal outcomes. To be more effective programs, it is necessary to meet the guidelines of 150 minutes a week or 30 minutes of moderate-intensity activities on 5 days per week for the elderly.

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PURPOSE: This study was conducted to investigate the prevalence and correlates of depression among community-dwelling older adults (young-old vs old-old) in Korea. METHODS: Data on 11,250 older adults aged 65 or above, from the 2008 National Elderly Survey, were analyzed. RESULTS: Prevalence rate for depression was greater in old-old people (47.2%) than young-old people (24.7%). The logistic regression analysis revealed that gender, education, socioeconomic status (SES), living place, spouse, regular exercise, perceived health status, number of chronic disease, activity of daily living (ADL), instrumental activity of daily living (IADL), and cognitive function were significantly associated with depression in the young-old. However, in old-old people, education, SES, living status, religion, regular exercise, perceived health status, number of chronic disease, pain, ADL, IADL, and cognitive function were associated with depression. CONCLUSION: The findings indicate that there are age differences in prevalence and correlates of depression in older Koreans. Therefore, age differences should be considered in studying and developing interventions for depression in older adults.

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BACKGROUND: This study aimed to examine the underreporting rate and related factors after needlestick injuries among healthcare workers (HCWs) in small- or medium-sized hospitals. METHODS: Convenience sampling was conducted for 1,100 HCWs in 12 small- or medium-sized hospitals with less than 500 beds. From October 1 to November 30, 2010, data were collected using self-report questionnaire that was developed by researcher. The response rate for the study was 98.3% (982 HCWs). Data were analyzed using Statistical Package for the Social Sciences (SPSS) Win 12.0. RESULTS: The reports showed that 239 HCWs (24.3%) sustained needlestick injuries within the last year. The under-reporting rate after a needlestick injury was 67.4% (161/239), and underreporting rates varied across the hospitals and ranged from 46.2% to 85.7%. The major reasons for underreporting after needlestick injuries were the assumption that no blood-borne pathogens existed in the source patient (62.8%), annoyance (17.9%), and no knowledge about the reporting procedure (6.0%). Multiple logistic regression analysis showed that the suggestion by colleagues to report the injury, the number of needlestick injuries, and the needle type were independently related to the underreporting of needlestick injuries. CONCLUSION: The underreporting rate of needlestick injuries in small- or medium-sized hospitals was similar to that in large-sized hospitals, and this finding confirmed that the suggestion by colleagues to report the injury was the most significant factor influencing the injury-report rate. Thus, creating an environment that encourages HCWs to report injuries is considered the most important method to decrease the underreporting rate of needlestick injuries in small- and medium-sized hospitals.

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PURPOSE: This study was to identify the health status and reported resilience according to acculturation type among Chinese students in Korea. METHODS: The subjects were 386 Chinese students studying in three universities in Chungnam province. The data were collected by standardized questionnaires and SPSS/WIN 15.0 program was used to analyze the data with descriptive statistics, Chi-square, t-test, and ANOVA. RESULTS: Subjects reported the following Acculturation type: integration (26.7%), assimilation (28.5%), separation (32.4%), and marginalization (12.4%). The reported resilience was significantly different according to economic status. The health status was significantly different according to religion and economic status. Acculturation type was significantly different according to age, educational level, length of stay, type of residency and economic status working style. The health status and resilience were significantly different according to acculturation type. CONCLUSION: The findings suggest that integration of acculturation type is most useful to health status and resilience among Chinese students in Korea. Future studies need to examine acculturation type as coping strategy for foreign students' adaptation.

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