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This study was conducted to increase the frequency and level of thoroughness of hand hygiene practice by nurses, and to assess the influence of the methicillin-resistant Staphylococcus aureus (MRSA) acquired incidence rate and the MRSA colonization pressure in a medical intensive care unit (MICU). A total of 24 MICU nurses received hand hygiene education and individual feedback of hand hygiene frequency and method after a session of education, and two posteducation evaluations were followed. The frequency of hand hygiene (P = 0.001) and the methodology score of hand hygiene increased significantly (P = 0.001). The MRSA acquisition rate decreased significantly, from 11.1% before the education to 0% after (P = 0.014). The MRSA colonization pressure decreased significantly from 39.5% to 8.6% after the education sessions (P = 0.001). This indicates that providing individual feedback after hand hygiene education was very effective in increasing nurses' hand hygiene frequency and improving hand hygiene method; furthermore, it was expected to decrease health care-associated infections.

This study was aimed to test the association between schizophrenia and a functional serotonin polymorphism (5-HTTLPR) in the upstream regulatory region. Genomic DNA analysis with polymerase chain reaction was used for 5-HTTLPR genotyping. One hundred and eleven patients with schizophrenia and 208 healthy individuals participated in this study. There were significant differences in the negative score and general psychopathology score of the positive and negative syndrome scale according to 5-HTTLPR genotypes and alleles, although no significant differences in allele or genotype frequencies between the two groups were found. These results suggest that 5-HTTLPR may contribute to the susceptibility to the symptomatology of schizophrenia but not to the development of the disorder itself, at least in the Korean population.

Purpose: This study was conducted to identify endotracheal colonization and the incidence of ventilator-associated pneumonia related to the type of endotracheal suction system. Methods: The participants in this study were ICU patients hospitalized between October 2009 to March 2010 who used ventilators for over 48 hr with closed (CSS, n= 30) or open (OSS, n= 32) suction systems. To standardize the pre-intervention suction system, a suctioning protocol was taught to the ICU nurses. Collected data were analyzed using χ 2 -test, Fisher's exact test, Wilcoxon rank sums test, Wilcoxon test, Log-rank test and Poisson regression. Results: Endotracheal colonization was higher in OSS than CSS from day 1 to day 8 while using a ventilator and there was a significant difference between the two groups. The CSS reached 50% of endotracheal colonization by the 4th day, whereas for the OSS, it was the 2nd day (p= .04). The incidence of ventilator-associated pneumonia showed no significant difference. Conclusion: For patients with a high risk of pneumonia, CSS must be used to lower endotracheal colonization.

Aims: The purpose of this study was to report on the development of evidence-based practice guidelines.Design: Developmental research for practice guidelines. Methods:The guidelines developmental process was designed according to a procedure provided by Scottish Intercollegiate Guidelines Network (SIGN). A first step, key clinical questions were selected. Next, 74 studies were selected from studies of 719 according to a search strategy, and then methodological quality of those studies was evaluated using assessment tool of SIGN. After the evaluation of draft guidelines including recommendations and their grades, the contents were modified. Last, definitive guidelines were evaluated using Appraisal of Guidelines for Research and Evaluation (AGREE) tool. Result:The guidelines consist of three categories and 64 recommendations, i.e. nine recommendations for user before peripheral intravenous catheterization (PIVC), 26 recommendations during PIVC, and 29 recommendations after PIVC. Content validity was revealed to 70-78% by experts' agreement. Conclusion:These guidelines were completed throughout systematic reviews and evaluations by clinical experts. Their contents are also included about overall managements for PIV therapy. Therefore these guidelines could help PIV practitioners to make evidence based decision. Relevance to clinical practice:The method and result of this study are described specifically in figures, tables and appendix, which could give guidance to nurses who develop guidelines regarding other subjects.

The objective of this study was to estimate the peripherally inserted central catheter (PICC) insertion depth in newborns. We retrospectively reviewed the records of 790 neonates who underwent PICC insertion for intravenous injections administered for 6 days or more following neonatal intensive care unit admission at our institution between January 2011 and October 2015. We analyzed patients' electronic medical records and chest standard radiographs. PICC insertion depths were calculated using the following equation: Insertion depth = Section + (β 1 × Body weight). The predicted equation was checked for accuracy using Bland-Altman plots. Of 835 included neonates, 790 (94.6%) had properly positioned PICCs. Forty-three of 45 unsuitable

The study was conducted to explore the parenting experience of mothers who have defected from North Korean. Methods: Nineteen mothers who defected from North Korean were recruited in Hanawon and data were collected through face-to-face interviews. Grounded theory methodology developed by Strauss and Corbin (1998) was adapted for theoretical sampling and analysis. Interviews were recorded with consent and transcribed verbatim. Results: The core category was discovered to be 'pursuing positive parenting'. Phenomenon was identified as 'acting out of frustration' and this series of processes was categorized as having four stages: 'harsh reality', 'moving forward', 'seeking transition', and 'internalization'. Conclusion: The results indicate that their parenting experiences were in a transition process and, thus, it is critical to develop positive parenting intervention programs as a way to promote the empowerment of these mothers in parenting to help them support themselves and their children.

Purpose: This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU).Methods: In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4.Results: The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had significantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/ restless behavior (t=2.70, p=.008).Conclusion: Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles.