Aims This study identified clinical nurses' awareness of emergency codes and disaster nursing competencies and investigated the relationships between these variables. Background Nurses are on the front lines of disaster and emergency response; however, they report not feeling confident about their disaster preparedness. Methods Participants included 234 nurses working at a general hospital in Korea. Emergency code awareness was measured by recognition of and self‐confidence in eight emergency codes, and disaster nursing competencies were measured using the Disaster Nursing Preparedness Response Competency Scale. Data were collected from 17 to 23 October 2019. Results The recognition rate of emergency codes was 87.4%, whereas the level of self‐confidence was 3.30 out of 5. Nurses scored 2.98 out of 5 on disaster preparedness competencies and 3.37 out of 5 on disaster response competencies. Emergency code recognition was positively correlated with self‐confidence and disaster nursing competencies (p < .05). Conclusion Higher recognition of emergency codes among clinical nurses was associated with higher self‐confidence and disaster nursing competencies. Further studies need to develop strategies to improve nurses' awareness and confidence concerning emergency codes. Implications for Nursing Management Nurse managers should pay attention to provide more opportunities for disaster education to improve nurses' self‐confidence and disaster nursing competencies.

Personal protective equipment (PPE) is critical to protect healthcare workers from pandemic outbreaks. This study was designed to identify nurses' knowledge, attitude and perceptions on PPE. Methods: Data were collected from 154 nurses working at a tertiary general hospital, where positively diagnosed and suspected patients were accepted and admitted during the Middle East Respiratory Syndrome Coronavirus outbreak in 2015. The PPE tool consists of 20 items for knowledge, and 5 each for attitudes and perceptions. Results: Overall, knowledge for PPE was higher than moderate (76.95/100), but there was a lack for items related to powered air purifying respirator (PAPR). For attitudes, willingness to work in pandemic outbreaks was the most positive (4.04/5.00). Goggles and PAPR were perceived as the most uncomfortable barriers to work. There was no correlation between knowledge, attitude and perceptions, despite a strong positive correlation between attitude and perceptions. PPE training was identified as a factor to improve knowledge and attitudes on PPE. Conclusion: To respond to pandemic influenza, nurses need to expand their knowledge on PPE up to Level C, and be updated through regular training. Study findings suggest that repetitive studies targeting nurses and other healthcare workers at various hospital settings are necessary.

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(2002), revised for use in China, and 9 general characteristics. Data were analyzed using SPSS Win 13.0 program. Results: Total level of health literacy was relatively high (68.7%). Elders had high scores for taking medicines according to doctor's instruction, but lower ones for full comprehension through communication with doctors. Health status was high for emotional, physical, and social function in that order. There were significant differences between general characteristics and health status for gender, age, marital status, education, family, smoking, and alcohol consumption in that order. Results of multiple regression analysis for factors influencing health status showed that self-report health level was the most influential, followed by health literacy, age, gender. Conclusion: Health literacy is the main factor affecting health promotion among minority elders indicating a need to develop health promotion programs for elders who have low health literacy.

a b s t r a c tPurpose: This study aimed to identify the differences in interventional effects on hand hygiene compliance (HHC) among families and visitors in pediatric wards. Design & methods: A total of 2787 family and non-family visitors entering through the glass sliding door of 6 pediatric wards at a university children's hospital were observed for 4 h, respectively, before and after interventions between April 27 and May 20, 2018. In the first intervention, a visual stimulus emphasized the location of the hand sanitizer. In the second intervention, an additional auditory stimulus transmitted a cue through a motion sensor speaker. Results: During the preliminary observation, the HHC rates of family and non-family visitors were 0.0% and 1.5%, respectively; after the visual stimulus, they were 0.6% and 5.4%, and after the audio-visual stimulus, 1.8% and 8.2%. There was a significant increase in the overall HHC with the visual (OR, 5.22; 95% CI, 1.76-20.90) and audio-visual (OR, 8.67; 95% CI, 3.08-33.70) stimuli (Fisher's exact test, p b .05). Conclusions: The HHC of family and non-family visitors entering pediatric wards was very low and the audiovisual stimulus was found to be more effective than was the visual stimulus alone. Practice implications: To reduce healthcare-associated infection, pediatric wards must actively implement effective interventions. Using audio-visual stimulation to increase HHC among visitors will provide advantages. Follow-up research should examine the current state of HHC among visitors in various locations and conditions.

Aim: To develop a multimodality simulation program for hospital nurses to enhance their disaster competency and evaluate the effect of the program.Methods: The program implementation started in October 2016 and ended in December 2016. It was developed using the ADDIE model (analysis, design, development, implementation, and evaluation). Evaluation consisted of formative assessment and summative assessment. Formative assessment was performed during triage, crisis management, and problem‐solving simulation programs through direct feedback and debriefing from the teacher. Summative assessment was performed using the Kirkpatrick curriculum evaluation framework.Results: Needs assessment using the modified Delphi survey resulted in these competencies for hospital disaster nursing: triage, incident command, surge capacity, life‐saving procedures, and special situations. Each competency was matched with the appropriate simulation modalities. A total of 40 emergency nurses participated in the study program. The evaluation of the program resulted in improvement in perception, crisis management, problem solving, and technical skills in disaster nursing.Conclusion: Multimodality simulation training program was developed to enhance the competency of hospital nurses in disaster response. All participants improved their disaster response competencies significantly. The program that was developed in this study could be used as a fundamental tool in future research in disaster curriculum development.