병원감염관리 프로그램

정재심,Jeong, Jae-Sim 대한병원협회 1998 대한병원협회지 Vol.27 No.4

Coronavirus Disease (COVID-19) 범세계적 유행 관련 근거 고찰

정재심(Jeong, Jae Sim) 한국근거기반간호학회 2020 근거와 간호 Vol.8 No.1

Purpose: To identify epidemiological and disease-related characteristics by searching related literature in the pandemic situation caused by COVID-19. Methods: This is a narrative review that has been searched previous studies, national and international guidelines and practice manuals, and related website. Results: COVID-19-related literature and data were numerous and were being updated in real time. In this review, the pathogens of COVID-19, transmission mechanisms, diagnosis and treatment, prevention, and infection control methods were summarized. Conclusion: The data in this review are highly limited in time. It is limited to the literature search so far, and among the selected literatures related to COVID-19, some aspects of the researcher’s interests are more emphasized and considered. In the future, with the hope that COVID-19 will end or be reduced to a small endemic situation, we look forward to a more comprehensive and valid literature review.

임상기반 간호학 실험논문의 질 평가

정재심(Jeong, Jae Sim),임경춘(Lim, Kyung Choon),권정순(Kwon, Jeong Soon),곽찬영(Kwak, Chan Yeong),김경희(Kim, Kyung Hee),김성재(Kim, Sung Jae),이경숙(Lee, Kyung-Sook),박광옥(Park, Kwang Ok),김주현(Kim, Joo Hun),김금순(Kim, Keum So 한국근거기반간호학회 2018 근거와 간호 Vol.6 No.1

Purpose: This study was conducted in order to explore quality assessment tools applicable to research in the nursing area and to suggest the results of applying such tools in assessing the quality of experimental studies in nursing. Methods: We selected three experimental and 119 quasi-experimental studies with control groups in the Journal of Korean Clinical Nursing Research. We applied Cochran collaboration’s tool for assessing the quality of randomized controlled studies. Also, items developed by researchers were applied for assessing the quality of experimental studies in nursing. Results: Three studies (2.5%) used an adequate randomized sequence generation and two of them concealed the allocation sequence. The 63.1% of the studies applied blinding and 51% of the studies did not have missing values, or had insignificant missing values. In addition, 85.2% were not likely to report selectively, and 36.1% were assessed to have raised the risk of bias. Conclusion: Many studies had too a high risk of bias to be used as evidence-based data in the designs and methods of experimental studies. We found that it is necessary to inquire into research designs, methods, and quality assessment tools desirable for evidence-based practice in nursing.

전 국민의 손씻기 이행 및 인식 실태

정재심,최준길,정인숙,인혜경,박기동,백경란,Jeong, Jae-Sim,Choi, Jun-Kil,Jeong, Ihn-Sook,In, Hye-Kyung,Park, Ki-Dong,Paek, Kyong-Ran 대한예방의학회 2007 예방의학회지 Vol.40 No.3

Objectives : This study was conducted to evaluate the public's awareness of the importance of hand washing and to compare perceptions on the habit of hand washing with actual hand washing behavior. Methods : Data were collected by observing 2,800 participants washing their hands after using public restrooms in seven cities nationwide and by surveying 1,000 respondents (age > 14 years) through telephone interviews using a structured questionnaire. Results : Although 94% of the survey respondents claimed to mostly or always wash their hands after using public restrooms, only 63.4% of the observed participants did wash their hands after using public restrooms. Significant factors related to increased adherence to hand washing were female gender, approximate ages of 20 to 39 years by their appearance, and the presence of other people from the observation. About 79% of the survey respondents always washed their hands after using bathrooms at home, 73% washed their hands before handling food, and 67% washed their hands upon returning to their home. However, 93.2% and 86.3% of the survey respondents did not wash their hands after coughing or sneezing and after handling money, respectively. Although most of the survey respondents (77.6%) were aware that hand washing is helpful in preventing communicable diseases, 39.6% of the survey respondents did not do so because they were 'not accustomed' to washing their hands and 30.2% thought that washing their hands is 'annoying'. Conclusions : This is the first comprehensive report on hand washing behavior and awareness of the general population in Korea. The result of this study in terms of individual behavior and awareness of hand washing are comparable with similar studies conducted in other countries. However adherence to hand washing is still low and needs to be increased. The results of this study can be used as a baseline in setting up strategies and activities to promote adherence to hand washing.

의료종사자의 환자안전문화와 표준주의 인식과 상관관계

권혜경,정재심,이복임,김장한,Kwon, Hye-kyung,Jeong, Jae-sim,Lee, Bok-im,Kim, Jang-han 한국의료질향상학회 2015 한국의료질향상학회지 Vol.21 No.2

Objectives: This study was conducted as descriptive correlation research in order to survey healthcare personnel(HCP)'s awareness of patient safety culture and their recognition of standard precautions, and to examine the correlation between the two factors. Methods: The subjects were 400 HCPs including 80 doctors, 240 nurses, and 80 medical technicians from two general hospitals. The questionnaire used in the survey consisted of 9 questions on general characteristics, 44 on the perception of patient safety culture, and 21 on the recognition of standard precautions. Results: According to the subjects' general characteristics, the score was significantly higher in those aged over 40 than in those aged 30-39. In addition, it was significantly higher in managers than in practitioners, in those with work experience of less than a year than in those with 5-9 years. The score was also significantly higher in those working 8 hours a day than in those working over 10 hour a day. The number of medical accident reports according to the subjects' general characteristics was significantly larger in nurses than in doctors, in managers than in practitioners, and in those with 10 years' or longer experiences than in those with less than a year. In the awareness of standard precautions according to the subjects' general characteristics, the score was significantly higher in female workers than in male workers, and in managers than in practitioners. As a whole, the subjects' awareness of patient safety culture and their recognition of standard precautions showed a significant correlation with each other. Conclusion: From the result of this study, sufficient work force and the promotion of organizational culture for safety is needed in order to guarantee patient safety. Likewise, these results suggest that experience, job skill, and adequate working hours have a positive effect on the awareness of patient safety culture and the recognition of standard precautions.

신생아 중환자실에서 extended spectrum β-lactamase를 생성하는 Klebsiella pneumoniae 집단 보균 발생의 분자 역학적 조사 및 추적관찰

전누리,김미나,정재심,김양수,김애란,김기수,피수영,Jun, Nu-Lee,Kim, Mi-Na,Jeong, Jae-Sim,Kim, Yang-Soo,Kim, Ellen Ai-Rhan,Kim, Ki-Soo,Pi, Soo-Young 대한소아청소년과학회 2006 Clinical and Experimental Pediatrics (CEP) Vol.49 No.2

목 적 : 2000년 6월과 7월에 본원 신생아 중환자실에서는 ESBL 생성 K. pneumoniae에 의한 패혈증이 집단 발생하여 전체 환아에 대한 보균 상태를 파악하고 감염관리를 위해 감시배양을 실시하였다. 당시 집단 보균 상태임을 발견하여 보균자에 대한 격리를 실시한 결과 집단보균을 해결할 수 있었으나 대부분의 환아가 보균 상태로 퇴원하였다. ESBL 생성 K. pneumoniae는 대변 내 균이 장착되어서 입원 환아들간에 집단 감염을 일으킬 수 있으며, 이러한 균주에 의한 집단감염은 치료와 예후에 중요한 인자로 작용될 것으로 생각된다. 이에 저자들은 집단보균 발생시 분리된 ESBL 생성 K. pneumoniae의 분자 역학적 특징과 보균환아들의 추적관찰 결과를 알아보고자 본 연구를 시행하였다. 방 법 : 2000년 7월 28일부터 12월 30일까지 입원환아를 대상으로 직장내 도말법으로 감시배양검사를 시행하였다. 감시배양검사는 재원환아들에서 1주 간격으로 시행하였고, 신환은 입원 당일에 시행하였다. 균주의 형별 검사를 위해서 Pulsed-field gel electrophoresis(PFGE)를 시행하였고, 보균 상태로 퇴원했던 환아들은 외래에서 대변 배양검사로 추적 관찰하였다. 결 과 : 감시 배양기간 중 총 80명(28.5%)의 환아에서 보균이 확인되었고, 퇴원시 5명(6.3%)에서 음성이 확인되었다. PFGE를 시행한 65명의 타이핑 결과, 일회의 PFGE를 시행한 53명에서 분리된 균주의 염색체 유전자 분획양상은 집단클론 6가지, 단독클론 10가지형으로 분류되었고, 집단 클론 중 A형이 28명(52.8%)으로 가장 많았고, B형이 11명(20.8%), C, D, F, G형이 각각 1명(1.9%)이었다. 2회 이상 검사를 시행한 12명 중 초기검사에서는 A형이 10명(83.3%)으로 월등히 많았고 B형은 2명(16.7%)이었으며, 추적검사에서 분획 양상이 변화된 경우는 6명(50%)이었고, 이들은 A나 B로 변화된 경우가 각각 2명(33.3%)이었다. 변화되지 않은 6명(50%)은 모두 A형으로 남아 있었다. 월별 PFGE 양상은 처음 배양시 집단클론 A, B, C, D형 4가지와 단독클론 세 가지형이었으나 감염 관리를 하면서 11월부터 집단클론 A, B 두 가지형으로 나타나는 양상을 보였고, A형이 더 우세하였다. 보균된 상태로 퇴원한 75명 중 외래 추적관찰이 가능했던 30명을 대상으로 대변 배양검사를 시행한 결과 모두 음성이 확인되었다. 결 론 : 다양한 클론의 균주에 의한 집단보균 상태는 감염 관리를 하면서 단일 클론으로 변화하는 양상을 보였고, A형이 우세한 것으로 보아 집단 보균을 일으킨 유형 중 주 집단 클론은 A형이었음을 알 수 있었다. ESBL 생성 K. pneumoniae 보균 상태는 중환자실내에 입원기간 중에는 거의 지속되지만, 지역사회로 복귀하면 전부 해제되는 것으로 보인다. Purpose : The aims of this study included assessment of molecular-epidemiologic features during an outbreak of colonization of extended spectrum ${\beta}$-lactamase producing Klebsiella pneumoniae(ESBL-KPN) and re-evaluation of their colonized status one year later. Methods : Rectal swab cultures for ESBL-KPN from all hospitalized infants and newly admitted infants were obtained during the outbreak of colonization from July to December, 2000. The pattern of XbaI-digested chromosomal DNA of isolates were analyzed by pulsed-field gel electrophoresis. Weekly rectal swab cultures were obtained during the outbreak until patients were either discharged or decolonized. Patients discharged after being colonized had follow up stool cultures a year later. Results : A total of 80 patients(28.5 percent) were colonized. Of those, 53 whose pulsed-field gel electrophoresis(PFGE) was possible only once, were ESBL-KPN grouped into six cluster clones and 10 single clones : 28 patients(52.8 percent) were colonized with type A, the most common clone, followed by type B in 11 patients(20.8 percent). Of those 12 patients in whom serial PFGE was done more than twice, type A was predominant. Narrowed-down in strains occurred from types A, B, C, D and three single clones at initiation of the study into types A and type B after three months of strict infection control. Among 75 patients(93.7 percent) who were sent home after being colonized, 30 patients were re-called for stool cultures a year later : All of them were decolonized. Conclusion : This study demonstrates the importance of infection control as the diversity of ESBL-KPN strains could be narrowed into fewer strains. Colonization of ESBL-KPN could be reversed upon return to the community.

국내 종합병원 간호부의 근거기반간호 수행 현황

권정순(Kwon, Jeong Soon),정재심(Jeong, Jae Sim),김경숙(Kim, Kyeong Sug),김선경(Kim, Sun Kyung),김신미(Kim, Shin Mi),김은현(Kim, Eun Hyeon),서현주(Seo, Hyun Ju),이선희(Lee, Seon Heui),정영선(Jeong, Young Sun),정인숙(Jeong, Ihn Sook 한국근거기반간호학회 2016 근거와 간호 Vol.4 No.1

Purpose: This study was performed to identify the current status of organization and education for evidence-based nursing (EBN) among acute care hospitals in Korea. Methods: Using a questionnaire, the data were collected from 60 acute general hospitals selected conveniently from October to November in 2016. Results: The response rate was 83.3% and the mean number of beds for responded hospitals were 977.83. Responded hospitals appeared to perceive the importance of EBN, though approximately 50% of hospitals showed insufficient status for EBN. EBN project implemented in accordance with institutional support. EBN education courses have operated within hospitals and also have attended at outside courses. Conclusion: The current status of EBN organization and education have identified and it is needed to monitor continuously to activate and expand EBN in clinical settings.

병동 간호사 대상의 다각적 중재가 배양검사 검체의 보관과 상태 및 운송에 미치는 영향

조민정(Cho, Min Jung),정재심(Jeong, Jae Sim),김윤희(Kim, Yoon Hee) 한국기초간호학회 2022 Journal of korean biological nursing science Vol.24 No.2

Purpose: The purpose of this study was to provide multifaceted interventions for nurses and to confirm changes in their knowledge, perception, and actual practice on the adequate storage, conditions, and transportation of culture specimens. Methods: A one-group pretest-posttest experimental design was conducted with 41 nurses in two general wards of a tertiary acute care hospital in Seoul. Multifaceted interventions including education, feedback, posting guidelines and reminders, and improvement in specimen management accessibility were provided from May 2019 to January 2020. Outcomes were measured before and after the interventions. Knowledge and perception of the nurses were evaluated using self-reported questionnaires and actual practice by observation. Results: After the interventions, the average knowledge score on transportation time was significantly increased (Z=-4.89, p<.001). However, the knowledge score on storage methods was not significantly increased. The perception score was significantly increased (t=-3.19, p=.003). The proportion of specimen storage times, places, and conditions managed properly was significantly increased from 43.0% (46/107) to 77.1% (84/109) (p<.001). The average transportation time of blood samples to the laboratory significantly decreased from 3 hours 36 minutes (±1 hour 52 minutes) to 3 hours 1 minute (±1 hour 41 minutes) (t=2.51, p=.013). The percentage of blood culture specimens arriving within 2 hours was increased significantly from 22.9% to 39.2% (χ2=6.90, p=.009). Conclusion: The interventions were effective. However, some specimens remained in the ward longer than expected after the interventions. This requires further interventions.

병원 내 결핵 고위험부서 의료기사와 간호보조인력의 결핵 예방행위에 영향을 미치는 요인

김보라(Kim, Bo Ra),정재심(Jeong, Jae Sim),김연희(Kim, Yeon Hee),김미나(Kim, Mi Na) 한국근거기반간호학회 2019 근거와 간호 Vol.7 No.1

Purpose: The purpose of this study was to investigate knowledge, awareness, and compliance on tuberculosis prevention behavior among medical technicians and nursing assistants working in a hospital department with an increased risk of TB. Method: From February 11 to February 28, 2019, 149 medical technicians and nursing assistants working in departments at high risk of TB in a hospital in Seoul, Korea, were surveyed. Result: Knowledge score for TB was 7.66 on average for out of 10 points, awareness and compliance score for TB prevention was 37.56, and 36.86 for out of 40 points respectively. Analysis of the correlation between awareness of prevention behavior and compliance with that behavior showed a significant positive relationship. In multiple regression analysis, factors influencing TB prevention behavior were occupation ( p=.032) and compliance of tuberculosis prevention behavior (p <.001). The result was 34.1% explanatory power. Conclusion: In order to enhance the compliance of TB prevention behavior, it is necessary to develop active public relations and education programs that recognize the importance of employees themselves and bring about change in behavior, as opposed to educational approaches that convey simple knowledge.

국내 병원의 근거기반간호 수행 현황과 한국근거기반간호학회의 역할

박경희(Park, Kyung Hee),정재심(Jeong, Jae Sim),김주현(Kim, Joo-Hyun),권정순(Kwon, Jeong Soon),김경숙(Kim, Kyeong Sug),홍은영(Hong, Eun-Young),이현희(Lee, Hyun Hee),정영선(Jung, Young Sun),류재금(Ryu, Jae Geum),정인숙(Jeong, Ihn So 한국근거기반간호학회 2018 근거와 간호 Vol.6 No.1

Purpose: This qualitative study was done to identify the current status for evidence-based nursing (EBN) and the roles of the Korean Society of EBN (KEBN) for facilitating EBN. Methods: The participants were 7 female nurses who have worked in the acute care hospitals. Data were collected through focused group interviews. Collected data were analyzed with content analysis method. Results: The findings can be categorized into five main themes. 1) Background for introducing of EBN. 2) Facilitators to spread EBN. 3) Barriers to spread EBN. 4) Changes after introducing EBN into clinical practice. 5) Roles of the KEBN. Conclusion: The current status of EBN is that awareness about the importance of EBN is high and knowledge with skills are improving gradually. However, it is necessary to acquire solid knowledge and skills to facilitate their own EBN within the institutions. Therefore, we expect the roles of the KEBN in sharing and standardizing information of EBN with other organizations. The KEBN specifically may consider to operate a EBN program for mentors and it is necessary to seek strategies to plan a platform that can build a standardized system through cooperation with department of nursing to share and spread EBN related research.