Journal of Korean Academy of Nursing

Original Articles

External Validation of Carbapenem-Resistant Enterobacteriaceae Acquisition Risk Prediction Model in a Medium Sized Hospital: Seo, Su Min , Jeong, Ihn Sook; J Korean Acad Nurs 2020;50(4):621-630. Published online August 31, 2020; DOI: https://doi.org/10.4040/jkan.20137

Purpose
This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital.
Methods
This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness.
Results
The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those of CREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: - 0.16~0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63~.78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors’ cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively.
Conclusion
The CREP-model’s discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points.

Citations

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Risk factors for the colonization of carbapenem-resistant Enterobacteriaceae in patients transferred to a small/medium-size hospital in Korea: a retrospective study
Misun Lee, Hyunjung Kim
Journal of Korean Biological Nursing Science.2023; 25(4): 285. CrossRef
Improving the Rapidity and Accuracy of Carbapenem-Resistant Enterobacteriaceae Detection by Shortening the Enrichment Duration
Miyoung Lee
Microbiology and Biotechnology Letters.2022; 50(4): 584. CrossRef
Validation Study of the Estimated Glycemic Load Model Using Commercially Available Fast Foods
Miran Lee, Haejin Kang, Sang-Jin Chung, Kisun Nam, Yoo Kyoung Park
Frontiers in Nutrition.2022;[Epub] CrossRef
Development of a Nomogram for Carbapenem-Resistant Enterobacteriaceae Acquisition Risk Prediction Among Patients in the Intensive Care Unit of a Secondary Referral Hospital
Su Min Seo, Ihn Sook Jeong, Ju Yeoun Song, Sangjin Lee
Asian Nursing Research.2021; 15(3): 174. CrossRef

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Evaluation of Validity of the Korean Triage and Acuity Scale: Heejung Choi, Jong Sun Ok, Soo Young An; J Korean Acad Nurs 2019;49(1):26-35. Published online February 28, 2019; DOI: https://doi.org/10.4040/jkan.2019.49.1.26

Abstract PDF

Purpose

The aim of this study was to identify the predictive validity of the Korean Triage and Acuity Scale (KTAS).

Methods

This methodological study used data from National Emergency Department Information System for 2016. The KTAS disposition and emergency treatment results for emergency patients aged 15 years and older were analyzed to evaluate its predictive validity through its sensitivity, specificity, positive predictive value, and negative predictive value.

Results

In case of death in the emergency department, or where the intensive care unit admission was considered an emergency, the sensitivity, specificity, positive predictive value, and negative predictive value of the KTAS were 0.916, 0.581, 0.097, and 0.993, respectively. In case of death in the emergency department, or where the intensive or non-intensive care unit admission was considered an emergency, the sensitivity, specificity, and positive predictive value, and negative predictive value were 0.700, 0.642, 0.391, and 0.867, respectively.

Conclusion

The results of this study showed that the KTAS had high sensitivity but low specificity. It is necessary to constantly review and revise the KTAS level classification because it still results in a few errors of under and over-triage. Nevertheless, this study is meaningful in that it was an evaluation of the KTAS for the total cases of adult patients who sought help at regional and local emergency medical centers in 2016.

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Predictive validity of resource-adjusted Korean Triage and Acuity Scale in pediatric gastrointestinal tract foreign body patients
Jin Hee Lee, Jin Hee Jung, Hyun Noh, Mi Jin Kim
Scientific Reports.2024;[Epub] CrossRef
Effect of storage duration on outcome of patients receiving red blood cell in emergency department
Yu-Kyung Koo, Sol Ji Choi, Soon Sung Kwon, Jinwoo Myung, Sinyoung Kim, Incheol Park, Hyun Soo Chung
Scientific Reports.2024;[Epub] CrossRef
Inter hospital external validation of interpretable machine learning based triage score for the emergency department using common data model
Jae Yong Yu, Doyeop Kim, Sunyoung Yoon, Taerim Kim, SeJin Heo, Hansol Chang, Gab Soo Han, Kyung Won Jeong, Rae Woong Park, Jun Myung Gwon, Feng Xie, Marcus Eng Hock Ong, Yih Yng Ng, Hyung Joon Joo, Won Chul Cha
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Scientific Reports.2024;[Epub] CrossRef
Validity of the Korean triage and acuity scale in older patients compared to the adult group
Ho Sub Chung, Myeong Namgung, Dong Hoon Lee, Yoon Hee Choi, Sung Jin Bae
Experimental Gerontology.2023; 175: 112136. CrossRef
Predictive indicators for determining red blood cell transfusion strategies in the emergency department
Junhyup Song, Sinyoung Kim, Hyun Soo Chung, Incheol Park, Soon Sung Kwon, Jinwoo Myung
European Journal of Emergency Medicine.2023; 30(4): 260. CrossRef
Development and Validation of Simple Age-Adjusted Objectified Korean Triage and Acuity Scale for Adult Patients Visiting the Emergency Department
Seung Wook Kim, Yong Won Kim, Yong Hun Min, Kui Ja Lee, Hyo Ju Choi, Dong Won Kim, You Hwan Jo, Dong Keon Lee
Yonsei Medical Journal.2022; 63(3): 272. CrossRef
Baseline and clinical characteristics of older adults admitted to the intensive care unit through the emergency room: Analysis based on age groups
Ye Lim Lee, Sang Ook Ha, Young Sun Park, Jeong Hyeon Yi, Sun Beom Hur, Ki Ho Lee, Ki Yong Hong, Ju Young Sin, Duk Hwan Kim, Jun Kwon Cha, Jin Hyuck Kim
Hong Kong Journal of Emergency Medicine.2021; 28(2): 85. CrossRef
Long-term impact of coronavirus disease 2019 pandemic on emergency department utilization in a metropolitan emergency department in Korea
Seung Yeon Hwang, Jae Kwang Lee, Hyun Sik Ryu, Seong Soo Park, Jun Young Choi, Hye Ji Lee, Seung Ho Hur, Yeong Geun Park, Hyun Soo Choi
Pediatric Emergency Medicine Journal.2021; 8(2): 57. CrossRef
Modification and Validation of a Complaint-Oriented Emergency Department Triage System: A Multicenter Observational Study
Dong Hyun Choi, Won Pyo Hong, Kyoung Jun Song, Tae Han Kim, Sang Do Shin, Ki Jeong Hong, Jeong Ho Park, Joo Jeong
Yonsei Medical Journal.2021; 62(12): 1145. CrossRef
Pediatric Emergency Department Utilization and Coronavirus Disease in Daegu, Korea
Kyung Mi Jang, Ji Young Ahn, Hee Joung Choi, Sukhee Lee, Dongsub Kim, Dong Won Lee, Jae Young Choe
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Jaehee Yoon, Heesook Son
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Characteristics of children with trauma compared to those with disease in the emergency department: a Korean single regional emergency medical center study
Yosub Hwang, Ha Young Jo, Hye Won Yoo, Young Mi Kim, Hye-Young Kim
Pediatric Emergency Medicine Journal.2020; 7(2): 108. CrossRef
Alert Override Patterns With a Medication Clinical Decision Support System in an Academic Emergency Department: Retrospective Descriptive Study
Junsang Yoo, Jeonghoon Lee, Poong-Lyul Rhee, Dong Kyung Chang, Mira Kang, Jong Soo Choi, David W Bates, Won Chul Cha
JMIR Medical Informatics.2020; 8(11): e23351. CrossRef

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Nurse Managers' Moral Self Concept and Ethical Sensitivity: Yong Soon Kim, Jee Won Park, Youn Jung Son, Sung Suk Han; Journal of Korean Academy of Nursing 2002;32(7):1072-1078. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2002.32.7.1072

Abstract PDF

PURPOSE: This descriptive study was designed to find out the relationship between moral self concept and ethical sensitivity of nurse managers.
METHODS
Study data were collected from Aug 6, 2001 to Aug 24, 2001. Study subjects were 283 nurse managers working in university hospitals. Moral self concept was measured with questionnaire developed by Chung (1965) and ethical sensitivity was measured with the questionnaire developed by the researchers.
RESULTS
1. The score for degree of nurse managers' moral self concept was shown to be an average of 3.06 out of 4.00, which is relatively high. The score for degree of nurse managers' ethical sensitivity was shown to be an average of 2.84 out of 4.00 2. Analysis of correlation between moral self concept and ethical sensitivity showed a statistically significant positive correlation (r= .34, p=.00). 3. In general characteristics, a variable that caused significant difference in moral self concept was the total period of experience as a nurse (F=3.52, p=.02). A variable that caused significant difference in ethical sensitivity was the current working department (F=3.91, p=.01). 4. Nurse administrator's moral self concept was significantly related to ethical sensitivity (r= .34, p= .00).
CONCLUSION
It is important to intensify individual moral self concept in order to improve ethical sensitivity of nurse managers. Also, it is recommended that investigate variables affected moral self concept and develop a nursing education program to promote moral self concept in nurse administrators.

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Compassion fatigue and moral sensitivity in midwives in COVID-19
Reyhan Aydin Dogan, Sebahat Huseyinoglu, Saadet Yazici
Nursing Ethics.2023; 30(6): 776. CrossRef
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Pervin ŞAHİNER, Belgin BABADAĞLI, Nermin ERSOY
Kocaeli Üniversitesi Sağlık Bilimleri Dergisi.2019; 5(2): 86. CrossRef
Chinese insurance agents in “bad barrels”: a multilevel analysis of the relationship between ethical leadership, ethical climate and business ethical sensitivity
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Moral sensitivity and critical thinking disposition of nursing students in Korea
Sung‐Hee Ahn, Hye‐A Yeom
International Journal of Nursing Practice.2014; 20(5): 482. CrossRef
Sensitivity to Ethical Issues Confronted by Korean Hospital Staff Nurses
Yong-Soon Kim, Jee-Won Park, Mi-Ae You, Ye-Suk Seo, Sung-Suk Han
Nursing Ethics.2005; 12(6): 595. CrossRef

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Review Article

Predictive Validity of the Braden Scale for Pressure Ulcer Risk: A Meta-analysis: Seong-Hi Park, Yu-Sun Park; J Korean Acad Nurs 2014;44(6):595-607. Published online December 31, 2014; DOI: https://doi.org/10.4040/jkan.2014.44.6.595

Abstract PDF

Purpose

The Braden Scale is one of the most intensively studied risk assessment scales used in identifying the risk of developing pressure sore. However, not all studies show that the predictive validity of this scale is sufficient. The purpose of this study was to evaluate the Braden Scale for predicting pressure ulcer development.

Methods

Articles published 1946 and 2013 from periodicals indexed in Ovid Medline, Embase, CINAHL, KoreaMed, NDSL and other databases were selected, using the following keywords: 'pressure ulcer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4.

Results

Thirty-eight diagnostic studies with high methodological quality, involving 17,934 patients, were included. Results of the meta-analysis showed that the pooled sensitivity and specificity of the Braden Scale were 0.74 (95% CI: 0.72-0.76), 0.75 (95% CI: 0.74-0.76) respectively. However the predictive validity of the Braden Scale has limitation because there was high heterogeneity between studies.

Conclusion

The Braden Scale's predictive validity of risk for pressure ulcer is interpreted as at a moderate level. However there is a limitation to the interpretation of the results, because of high heterogeneity among the studies.

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Development of a Pressure Injury Machine Learning Prediction Model and Integration into Clinical Practice: A Prediction Model Development and Validation Study
Ju Hee Lee, Jae Yong Yu, So Yun Shim, Kyung Mi Yeom, Hyun A Ha, Se Yong Jekal, Ki Tae Moon, Joo Hee Park, Sook Hyun Park, Jeong Hee Hong, Mi Ra Song, Won Chul Cha
Korean Journal of Adult Nursing.2024; 36(3): 191. CrossRef
The Interrater Agreement for the Assessment of Pressure Ulcer Risk Using the Braden Scale and the Classification of Pressure Ulcers by Nurses in A Medium-Sized Hospital
Hyung-Ju Na, Sung-Hee Yoo, Young-Ran Kwon, Min-Jeng Ahn
Korean Journal of Adult Nursing.2020; 32(1): 35. CrossRef
A prediction tool for hospital‐acquired pressure ulcers among surgical patients: Surgical pressure ulcer risk score
Fazila Aloweni, Shin Yuh Ang, Stephanie Fook‐Chong, Nurliyana Agus, Patricia Yong, Meh Meh Goh, Lisa Tucker‐Kellogg, Rick Chai Soh
International Wound Journal.2019; 16(1): 164. CrossRef
Predictive Validity of Pressure Ulcer Risk Assessment Scales among Patients in a Trauma Intensive Care Unit
Ja Eun Choi, Sun-Kyung Hwang
Journal of Korean Critical Care Nursing.2019; 12(2): 26. CrossRef
A Phenomenological Study on Illness Experience of Patients with Pressure Ulcer
Misoo Yoo, Myungsun Yi
Korean Journal of Adult Nursing.2015; 27(5): 515. CrossRef

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Original Articles

Systematic Review and Meta-Analyses of Diagnostic Accuracy of Infrared Thermometer when Identifying Fever in Children: Young Joo Park, Seong-Hi Park, Chang-Bum Kang; J Korean Acad Nurs 2013;43(6):746-759. Published online December 31, 2013; DOI: https://doi.org/10.4040/jkan.2013.43.6.746

Abstract PDF

Purpose

Infrared thermometers are increasingly used as a convenient, non-invasive assessment method for febrile children. However, the diagnostic accuracy of the infrared thermometer for children has been questioned, particularly in relation to sensitivity and specificity. The aim of this study was to evaluate diagnostic accuracy of infrared thermometers in febrile children.

Methods

Articles published between 1966 and 2012 from periodicals indexed in the Ovid Medline, Embase, CINAHL, Cochrane, KoreaMed, NDSL, KERIS and other databases were selected, using the following keywords: 'infrared thermometer'. The QUADAS-II was applied to assess the internal validity of the diagnostic studies. Selected studies were analyzed using meta-analysis with MetaDisc 1.4.

Results

Nineteen diagnostic studies with high methodological quality, involving 4,304 children, were included. The results of meta-analysis showed that the pooled sensitivity, specificity and AUC (Area Under the Curve) of infrared tympanic thermometers in children over 1 year were 0.80 (95% CI 0.78, 0.81), 0.94 (95% CI 0.93, 0.95) and 0.95 respectively. However the diagnostic accuracy of infrared tympanic thermometers in children with hyperthermia was low.

Conclusion

The diagnostic accuracy of infrared tympanic thermometer was similar to axillary and rectal thermometers indicating a need for further research to substantiate these findings in children with hyperthermia.

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Clinical Accuracy of Non-Contact Forehead Infrared Thermometer Measurement in Children: An Observational Study
Yeon-Mi Kim, Myung-Roul Jang, Ju-Ryoung Moon, Goeun Park, Ye-Jin An, Jeong-Meen Seo
Children.2022; 9(9): 1389. CrossRef
Axillary temperature measurements based on smart wearable thermometers in South Korean children: comparison with tympanic temperature measurements
Younglee Choi, Hye Young Ahn
Child Health Nursing Research.2022; 28(1): 62. CrossRef
Smart Patch for Skin Temperature: Preliminary Study to Evaluate Psychometrics and Feasibility
Heejung Kim, Sunkook Kim, Mingoo Lee, Yumie Rhee, Sungho Lee, Yi-Rang Jeong, Sunju Kang, Muhammad Naqi, Soyun Hong
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Force protection in contingency operations: an evaluation of temperature monitoring in Sierra Leone
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Journal of the Royal Army Medical Corps.2016; 162(3): 176. CrossRef

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Effects of a Breast Feeding Promotion Program for Working Women: Ji-Won Yoon, Young-Joo Park; J Korean Acad Nurs 2008;38(6):843-852. Published online December 31, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.6.843

Abstract PDF

Purpose

The purpose of this study was to measure the effects of a breast feeding promotion program for working women on breast feeding continuation, mother-infant attachment, and maternal sensitivity.

Methods

The design of this study is nonequivalent control group design with repeated measures.

Results

There were significant differences in breast feeding continuation between two groups at each time point except 2 days and 1 week after delivery. The scores of mother-infant attachment and maternal sensitivity of experimental group were higher than those of the control group, but there were no significant differences between two groups.

Conclusion

Although some modifications in contents and administration will be required to increase the effectiveness of the program, breast feeding promotion program for working women can be an effective nursing intervention which can facilitate breast feeding continuation and mother-infant relationships.

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Maternal sensitivity, its relationship with child outcomes, and interventions that address it: a systematic literature review
Carolyn L. Deans
Early Child Development and Care.2020; 190(2): 252. CrossRef
Breastfeeding Support for Mothers in Workplace Employment or Educational Settings: Summary Statement
Kathleen A. Marinelli, Kathleen Moren, Julie Scott Taylor, and The Academy of Breastfe
Breastfeeding Medicine.2013; 8(1): 137. CrossRef
A Study on the Experience of Breastfeeding Education for Women with Children 24 Months of Age and Younger
Ji-Eun Kim, Dong-Yean Park
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Effects of a Breast-Feeding Empowerment Program on Exclusive Breast-Feeding
Yunmi Kim
Journal of Korean Academy of Nursing.2009; 39(2): 279. CrossRef

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Development and Psychometric Evaluation of a Quality of Life Scale for Korean Patients with Cancer (C-QOL): Eun Hyun Lee; Journal of Korean Academy of Nursing 2007;37(3):324-333. Published online April 30, 2007; DOI: https://doi.org/10.4040/jkan.2007.37.3.324

Abstract PDF

Purpose

The purpose of this study was to develop and evaluate a quality of life scale for Korean patients with cancer (C-QOL).

Methods

The C-QOL was developed and validated as follows; item generation, pilot study, and psychometric tests. A total of 337 patients diagnosed with stomach, liver, lung, colon, breast, or cervix cancer were recruited. The patients were asked to complete the preliminary questionnaire comprising the content-validated items, the SF-36, and the ECOG performance status. The obtained data was analyzed using descriptive statistics, factor analysis, multidimensional scaling (MDS), multitrait/multi-item matrix, ANOVA, t-test, and Cronbach's alpha.

Results

Preliminarily twenty-six items were generated through content validity and a pilot study. Factor analysis and MDS extracted a total of 21 items with a 5-point Likert-type scale (C-QOL). The C-QOL included five subscales: physical status (6 items), emotional status (6 items), social function (3 items), concern status (2 items), and coping function (4 items). The C-QOL established content validity, construct validity, item convergent and discriminant validity, known-groups validity, reliability, and sensitivity.

Conclusion

The Newly developed C-QOL is an easily applicable instrument which established psychometric properties and reflected Korean culture. It is recommended for further study to examine the responsiveness of the C-QOL using a longitudinal research design.

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