Purpose: This study aimed to compare the length of stay (LOS) and treatment outcomes based on the application and achievement of a newly developed emergency department (ED) LOS management system for severely ill patients. Methods: Data were retrospectively collected from electronic medical records (EMRs) for the system evaluation and research purpose. The study subjects are severely ill patients whose diagnosis codes are designated by the Ministry of Health and Welfare and who visited the ED of a tertiary hospital from January to December 2019. The control group (Group 1) refers to those who have neither applied nor achieved the goal (5 hours or less) of the ED LOS management system even after it was applied, and the experimental group (Group 2) refers to those who have achieved the 5-hour goal after applying the system. Results: A total of 2034 severely ill patients applied the ED LOS management system. Group 1 included 837 patients and Group 2 included 1197 patients. Thirty days in-hospital mortality corresponded to 10.6% in Group 1 and 6.6% in Group 2 (χ2 = 10.58, p = .001). The total duration of hospitalization was 14.66 ± 18.26 days in Group 1 and 10.19 ± 16.00 days in Group 2 (t = 9.03, p < .001). Six hundred forty-two patients (76.6%) in Group 1 were discharged to their home (normal discharge) and 979 patients (81.7%) were discharged to their home in Group 2, but the discharge-as-death rate was 14.1% in Group 1 and 7.5% in Group 2 (χ2 = 29.80, p < .001). Conclusion: With the application and attainment of the ED LOS management system for severely ill patients, we have concluded the new system produced a lower LOS in the ED, 30 days in-hospital mortality, length of the hospitalization, mortality rate, and a higher rate of normal discharge.

This study aimed to examine the process of establishing a telenursing service for COVID-19 patients with mild or no symptoms admitted to a community treatment center (CTC). The process of establishing the service was reviewed, and the degree of satisfaction with the provided service was investigated based on the medical records the patients submitted at their discharge from the CTC. A total of 113 patients were admitted; the patients themselves entered the self-measured vital signs and symptoms of COVID-19 infection to the electronic questionnaires and mobile application. The nurses implemented remote nursing based on the patients’ input data. The educational materials, including the video for self-measuring vital signs and the living guidelines, were prepared and arranged in advance. The telenursing protocol regarding the whole process from the patients’ admission to their discharge was used and applied to five other CTCs. The non-contact counseling service’s satisfaction and convenience scores were 4.65 points and 4.62 points, respectively, out of 5 points. The non-contact nursing counseling service played an important role in monitoring patients’ medical conditions during the spread of COVID-19. This experience of establishing telenursing services to the CTC provides a clear direction to innovate healthcare services in future disasters.

Background: The Long-Term Care Insurance Act in the Republic of Korea has enabled the elderly population to receive benefits through the long-term care system since July 2008. Because one nurse or nursing assistant is assigned to 25 elderly persons and one care worker is assigned to 2.5 elderly persons in long-term care facilities, registered nurses should educate care workers to participate in pressure ulcer prevention activities. This descriptive study investigated the effect of the knowledge and attitude related to pressure ulcer prevention on care performance. Methods: Data were collected from February 20 to December 15, 2021 using a structured questionnaire targeting 165 care workers in four long-term care facilities located in I-city and Y-gun, Gyeongsangbuk-do. The questionnaires of the knowledge, attitude, and care performance developed for nurses were modified to survey the care workers. The content validity was verified on a 4-point scale by 10 clinical experts. A preliminary survey was conducted for 30 care workers, and the contents of the modified questionnaire were further revised. Data analyses were performed by t-test, one-way ANOVA, Scheffé test, Pearson’s correlation coefficient, and a multiple linear regression modeling using the SPSS/WIN 25.0 program. Results: Care performance on pressure ulcer prevention had a significant positive correlation with knowledge (r = 0.692, p < .001), attitude (r = 0.426, p < .001), work experience (r = 0.760, p < .001), amount of experience (r = 0.712, p < .001), and the number of training sessions received (r = 0.551, p < .001). In multiple regression modeling, work experience (β [standardized coefficient beta] = 0.534, p = .000), knowledge (β = 0.323, p = .000), and attitude (β = 0.103, p = .049) related to pressure ulcer prevention were identified as variables significantly affecting care performance. The regression model explained 65.4% with 5 independent variables. Conclusion: To prevent bedsores in long-term care facilities, it is necessary to educate care workers regularly about pressure ulcer prevention. In addition, clinical guidelines could help standardize the pressure ulcer prevention work of caregivers, strongly regulating their practice in all long-term care facilities and monitoring bedsore prevention regularly.

The fastest aging society with the lowest fertility rate can be buffered by support for healthy pregnancies using sociocultural approaches. We aimed to address adult perceptions of a healthy pregnancy and explored their needs and concerns about childbirth across the lifespan. We conducted a qualitative study using content analysis to investigate general perceptions of a healthy pregnancy after focus-group interviews with adult men and women. We interviewed 60 participants in nine group sessions of 5 to 8 people per group. Three major themes emerged that affect healthy pregnancies: Taking responsibility for a prepared pregnancy, factors that interfere with a healthy pregnancy, and improving strategies for a healthy pregnancy. For the first theme, the two main concerns were financial and parenthood preparation. Factors interfering with a healthy pregnancy had direct and indirect causes, considering personal, social, and cultural changes. Strategies for a healthy pregnancy included family and workplace support, systematic education, and governmental support for financial preparation and health screening. Participants averred that various kinds of support (financial, healthcare, and career) are needed for a healthy pregnancy and childbirth. This public awareness could promote better decisions toward healthy pregnancy with more sociocultural approaches in the various settings of home, school, and the workplace.

Lee HY, et al. J Korean Acad Nurs. 2019 Apr;49(2):161-170. https://doi.org/10.4040/jkan.2019.49.2.161