Background Nursing students’ practical training should begin when students can apply core knowledge, skills, and attitudes related to patient safety. This necessitates an integrated curriculum in nursing education that links practice to the theory concerning patient safety to enhance patient safety competencies and quality in nursing care. This study aimed to develop an integrated curriculum that incorporates patient safety factors in the existing curriculum to increase patient safety competencies in nursing students. Method A case study approach was adopted to explain the development processes of a new curriculum integrating patient safety in the existing outcome-based curriculum of a nursing college. Based on the existing outcome-based curriculum of a nursing college, a four-step process was performed to integrate patient safety component, including quality improvement, into the curriculum: 1) literature review, 2) analysis of course syllabus, 3) selection of courses related to patient safety topics, and 4) development of evaluation tool. Results The integrated patient safety curriculum was based on six topics: patient safety principles, teamwork, communication, patient engagement, risk management and, quality improvement, and International Patient Safety Goals. Based on the characteristics of the course according to the level of students in each year, the curriculum was integrated to address patient safety topics in seven courses (four theoretical and three practical). A Patient safety Competency self-assessment checklist was developed for students to naturally acquire patient safety competencies in clinical settings. Conclusions This study demonstrated that patient safety topics should be addressed in both theoretical and practical settings across the entire nursing curriculum per the continuity and sequence of education principles.
Multimorbidity has become a global concern for an aging society. It has been reported to be associated with increased health service utilization, leading to poor health outcomes including quality of life. However, the incidence of multimorbidity and its related factors are poorly understood. The aim of this study was to determine the socioeconomic and health-related factors predicting the incidence of multimorbidity in Korean older adults using longitudinal secondary data from the Korean Longitudinal Study of Aging (KLoSA) dataset from 2008 to 2018. The KLoSA aimed to collect basic data to be used for developing socioeconomic policy for the aging society in Korea. The sample included 3,019 older adults aged 65 years and over who had 0-2 chronic diseases at baseline in 2008. Multimorbidity was measured with the incidence of co-existence of three or more chronic diseases using Cox’s proportional-hazards model. Among 3,019 respondents (female 57.6%, mean age 73.07±6.30 years), 586 (19.4%) incidents of multimorbidity were reported after 10 years of follow-up. Low participation in social activities, being overweight or obesity, more depressive symptoms, current or past drinkers, and lower life satisfaction were identified as significant predictors of multimorbidity among Korean older adults. This study identified high risk groups with overlapping senility and multimorbidity, who require more attention from health care providers in the course of chronic disease monitoring and management. This longitudinal approach will contribute to the development of preventive strategies to reduce the incidence of multimorbidity among older adults.
Cognitive frailty is a condition where physical frailty and mild cognitive impairment (MCI) co-exist without dementia. It occurs in 1.8%-8.9% of the general older population, and older people with depression have a higher risk of frailty. However, the relationship between cognitive frailty and depression is still unclear. This study aimed to determine the relationship between cognitive frailty and depression of older adults by time using comparative group analysis. A secondary analysis was conducted using the Korean Longitudinal Study of Aging (KLoSA) dataset from 2010 to 2018. A sample was 981 older adults who were 65 years old and without dementia over residing in the community. Cognitive frailty was defined as having a mini-mental state examination score of 18-23 and 3 or more of the Fried frailty indexes. Generalized Estimating Equation model and chi-square test were employed. Of the 981 subjects, the cognitive frailty(CF) was 28.5%, followed by robust (37.7%), physical frailty (PF, 29.4%), mild cognitive impairment (MCI, 4.4%) at baseline. The group differences on depression measured by the Center for Epidemiological Studies Depression (CESD) were statistically significant in the PF (F=4.70, p<.001) and the CF (F=4.95, p<.001) group compared to the robust group. The time difference effect (F=.09, p=.05) and a group-by-time interaction effect were observed (p<.001). This study confirmed that cognitive frailty is strongly associated with depression. Effective approaches to managing psychological wellbeing, including dementia, are essential for older adults with cognitive frailty.
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