Nurses In University Hospital Research Articles

Association between non‐atopic hand eczema and interleukin‐13 gene polymorphism in Taiwanese nursing population

Chronic hand eczema is an important occupational skin disease with atopic dermatitis (AD) and wet work being the most important risk factors. This study was launched to analyse the potential association between AD-related inflammation genes and development of non-atopic hand eczema among nurses in University Hospital. Atopic eczema, non-atopic hand dermatitis and control groups were identified. The association between occurrence of non-atopic hand eczema and interleukin (IL)-13, IL-4 and IL-5 gene variants was analysed. IL13 rs20541 A allele [assuming recessive model; odds ratio (OR) = 3.38, 95% CI: (1.63-7.00)] showed association with development of non-atopic hand eczema. Additive score analyses showed combination of this gene variant with previously identified risk factors including certain SPINK5 polymorphism and more than 10 years of work experience conferred highest risk for development of non-atopic hand eczema. As non-atopic hand eczema made up significant portion of occupational skin diseases, further studies should be focused on this commonly encountered skin condition.

Effects of Nurse's Organizational Conflict on Organizational Commitment and Labor Union Commitment in University Hospitals

Abstract Purpose: This study was done to investigate the effects of university hospital nurses' organizational conflict between organizational commitment and labor union commitment, so as to provide data on prevention of conflict with the hospital and to improve work achievement with commitment of two different groups: hospital and labor union commitment. Methods: Data collection was conducted from May 15 to 31, 2011 for nurses registered in the labor union of a university hospital. The collected data were analyzed using t-test, ANOVA, Scheffe test and multiple regression. Results: Organizational commitment of the nurses showed significant differences according to age, position and work experience, and degree of labor union commitment according to academic achievement. The factors affecting labor union commitment were organizational conflict and recognition of need for labor union, which accounted for 19% of the variance. Factors affecting organizational commitment were organizational conflict, recognition of need for labor union, participation in organizational events, and renewal of membership in the union, which accounted for 33% of the variance. Conclusion: The results of this study indicate that there is a need to improve work achievement by minimizing conflict and preventing labor disputes for better organizational commitment and labor union commitment of nurses.

Knowledge about standard precautions among university hospital nurses in the United Arab Emirates

Standard/universal precautions reduce the risk of transmission of bloodborne infections among patients and health care workers. This study was conducted to assess the awareness and knowledge of standard precautions among nurses in a university teaching hospital in Ajman, United Arab Emirates. All nurses working in the hospital were given a structured, self-administered, anonymous questionnaire: 101 nurses participated (range of experience from < 1 to 22 years). Overall 97.0% of respondents were familiar with the concept of standard precautions. Of these 61.2% believed that the blood and body fluids of all patients are potentially infectious irrespective of their diagnostic status, while 27.6% thought only diagnosed patients and 11.2% only suspected cases are potentially infectious. Less than half agreed that standard precautions aimed to protect both health care workers as well as patients (45.9%). The study highlights a need to implement a programme to improve knowledge on standard precautions.

Prevalence of Low Back Symptom and Impact of Job Stress among Working Women as Clinical Nurses in University Hospitals.

This study was aimed to investigate the impact of job stress on low back symptoms among Clinical nurses (CNs) in university hospital. A total of 322 CNs employed in a hospital in Seoul were interviewed by a well-trained interviewer using the structured questionnaire. Data collected for this study includes demographics, social and work characteristics, low back symptoms, and job stress. To test the impact of job stress on low back symptoms, we used multiple logistic regression analysis. The prevalence of low back symptoms was 25.8% in this study. Low back symptoms differed significantly by factors, such as physical work burden, past history of injury and work duration. Also low back symptoms differed significantly by organizational system among independent variables of job stress. In a multiple logistic regression analysis, the odds ratio of organizational system to low back symptoms was 2.07 after an adjustment. This study showed that organizational system among job stress was a significant variable in explaining low back symptoms. We suggest the improvement of organizational system category as a preventive strategy for low back pain in CNs working in hospital.

일개 대학병원 간호사의 무선정보기술 사용의도 영향 요인

The purpose of this study is to investigate determinants of intent to use a wireless information technology(WIT) of University Hospital Nurses. The independent variables used in the study are usefulness, compatibility, social environment, perceived readiness, technical readiness, organizational readiness and socio-demographic characteristics. The dependent variable is the intent to use a wireless information technology(WIT). The sample used in this study consisted of 297 nurses selected from a university hospital located in Wonju, Gangwon-do, Korea Data were collected with self-administered questionnaires and analyzed using multiple regression analysis. The results of the study revealed that 5 independent variables of usefulness, compatibility, perceived readiness, technical readiness, and organizational readiness were found to have significant effects on the nurses' intent to use a WIT. As a conclusion, it is important to make organizational, clinical, and technical environment WIT-friendly prior to applying WIT to hospital nurses. In addition, it is also important to provide an education and training for nurses to improve their skill of using WIT and to make the new WIT compatible with the existing nursing information system.

임상 간호사의 혈액매개감염 주의지침에 대한 수행정도

Purpose: This study was conducted to investigate the cognition level and the performance level of universal precautions on blood-borne infections and to analyze related-factors on the performance level for universal precautions among the nurses. Method: A total of 166 nurses participated in the survey. We performed multiple linear regression to assess the related-factors on the performance level for universal precautions. Result: The mean scores of cognition and performance level for universal precautions were 65.61(<TEX>${\pm}8.74$</TEX>) and 53.98(<TEX>${\pm}8.42$</TEX>) respectively. The mean score of the cognition level was significantly lower than the performance level in all items. The cognition level was associated with the working field. The performance level was highest for nurses working over 36 years, nurses in university hospitals, and nurses in the operating room. The cognitive level for universal precautions, education level, exposure to blood-borne infection, family's income, and marital status significantly predicted the performance level for universal precautions in the multiple linear regression model (Adjusted <TEX>$R^2=0.42$</TEX>). Conclusion: The cognition level for universal precautions is the strongest predictor on the performance level for universal precautions. An integrated approach should incorporate training experiences to improve cognition and perception of risk on universal precautions for preventing blood-borne infections.

Factors affecting turnover of Japanese novice nurses in university hospitals in early and later periods of employment

To explore the factors affecting turnover of novice nurses during the 10th-15th months of employment in comparison with those during the preceding 6 months. The early turnover of novice nurses is a serious issue. Our previous study showed that 4.0% (37/923) of novice nurses quit their jobs in the initial 3rd-9th months of employment. The major determinants of their turnover were education (i.e. graduation from vocational nursing schools), undesired ward assignment and lack of peer support. The cohort of 762 novice nurses from our previous study was followed up during the next 10th-15th months of employment. Their turnover in this period was predicted using variables from baseline data such as demographic attributes, burnout (J-MBI), assertiveness (J-RAS) and perceptions about the workplace. The findings showed that 4.6% (35/762) of novice nurses quitted their jobs during the first 15-month period. The factors affecting the turnover were: burnout, dissatisfaction with the workplace and hospital location being in Tokyo. All these factors were different from those observed for the preceding follow-up period. Burnout was revealed to be the most significant factor affecting the turnover of novice nurses. Implications for nursing management Nurse managers should be vigilant and exercise care in the prevention of burnout among novice nurses.

Evaluation of the clinical efficacy of a critical care outreach service for facilitated ICU discharge and ward-based care

An on-line survey was conducted. 20 countries, with 20 ICUs in each, and six nurses from each ICU were sampled. A 100-item knowledge questionnaire, developed originally by Australian nurses, was modified for European use and translated into sixteen languages. Data were collected during 2009. The sample was mainly female (80%), aged 40 (24%). Most nurses (97%) worked in public/state hospitals. The mean knowledge score was 66% (range 23—89%). Older nurses scored higher than younger nurses (p<0.001) and scores increased significantly with experience (p < 0.001). The lowest mean score (56.0%) was in the ventilation/respiration knowledge sub-set, with the highest score (80.7%) in the endocrine subset. The mean score (65.9%) of university hospital nurses was not significantly different to those in other hospitals (66.5%). In conclusion, results indicate variations in nurses’ knowledge levels; mean scores by country ranged from 51 to 78%. With a 50% pass mark, 8.3% would have failed. Generally, nurses from NW European countries had a stronger knowledge base.

The knowledge and attitudes of cancer pain management of residents and nurses in university hospital in Daegu city, Korea

20701 Background: Pain is the most feared symptom in cancer patient. In general, pain is under-treated. Barriers to effective pain management of health care professionals includes inadequate training in pain management, poor assessment of pain, concern about side effect management, fear of addiction, low priority given to pain treatment, and inadequate reimbursement. The importance of education in improving treatment of pain is well recognized. Methods: The purpose of this study is to evaluate the knowledge and attitude of cancer pain management of residents and nurses in University hospital in Daegu city, and the Korean medical oncologists. A total of 48 residents and 51 registered nurses in Dongsan Medical Center, Keimyung University in Daegu and 183 nationwide medical oncologists were surveyed. Self-administered questionnaire covered 2 domains of 40 items; knowledge of general principles of cancer pain management and opioid use, were used. Results: With compare to medical oncologists, resident and nurses had statistically significant mis-knowledge in 5 items in general principles of cancer pain management (effective cancer pain management rate, VAS, the 5th vital sign, character of neuropathic pain, WHO ladder step) and 7 items about opioid use (addiction, tolerance, efficacy of strong opioids, knowledge about opioids, education rate, efficacy of parenteral opioids, ceiling effect). With compare to resident, nurses had statistically significant mis-knowledge in 4 items in general principles of cancer pain management (effective cancer pain management rate, poor assessment of health care professionals, VAS, WHO ladder step) and 14 items about opioid use (addiction, tolerance, effect on survival, opioid use to herself, incidence of side effect, knowledge about opioids, education rate, efficacy of parenteral opioids, patients’ refusal rate, seriousness of side effects, treatment of tolerance, by the clock, ceiling effect, reserves of opioid for intractable pain). Conclusions: The knowledge of cancer pain management of residents and especially nurses should be improved. No significant financial relationships to disclose.

Nursing competency and organizational climate as perceived by staff nurses in a Chinese university hospital

Nursing competency is important to ensure patient safety and improve the quality of nursing care. Based on competency-based human resource management strategies, the organizational climate can positively influence nursing competency. However, a review of the literature indicated that there were no studies about the relationship between nursing competency and organizational climate in the People's Republic of China. This descriptive, correlational study examined the relationship between nursing competency and the organizational climate. The sample consisted of 243 staff nurses who completed the questionnaire worked at one university hospital in Liao Ning Province. The findings showed that there was a significantly moderate positive relationship between nursing competency and organizational climate. The study results suggested that Chinese nurse managers should maintain and provide a positive organizational climate to improve nursing competency.

Factors Affecting Occupational Commitment among Novice Nurses in University Hospitals

Factors Affecting Occupational Commitment among Novice Nurses in University Hospitals

Relationship between Job Stress Contents, Psychosocial Factors and Mental Health Status among University Hospital Nurses in Korea

The present study was intended to assess the mental health of nurses working for university hospitals and to establish which factors determine their mental health. Self-administered questionnaires were given to 1,486 nurses employed in six participating hospitals located in Daejeon City and Chungnam Province between July 1st and August 31st, 2006. The questionnaire items included sociodemographic, job-related, and psychosocial factors, with job stress factors (JCQ) as independent variables and indices of mental health status (PWI, SDS and MFS) as dependent variables. For statistical analysis, the Chi-square test was used for categorical variables, with hierarchical multiple regression used for determining the factors effecting mental health. The influence of psychosocial and job-related factors on mental health status was assessed by covariance structure analysis. The statistical significance was set at p<0.05. The factors influencing mental health status among subject nurses included sociodemographic characteristics such as age, number of hours of sleep, number of hours of leisure, and subjective health status; job-related characteristics such as status, job satisfaction, job suitability, stresses such as demands of the job, autonomy, and coworker support; and psychosocial factors such as self-esteem, locus of control and type A behavior patterns. Psychosocial factors had the greatest impact on mental health. Covariance structure analysis determined that psychosocial factors affected job stress levels and mental health status, and that the lower job stress levels were associated with better mental health. Based on the study results, improvement of mental health status among nurses requires the development and application of programs to manage job stress factors and/or psychosocial factors as well as sociodemographic and job-related characteristics.

The Relations between Shiftwork and Sleep Disturbance in a University Hospital Nurses

Objectives: Nurses working in a hospital operate in a special environment where patients require a 24hour day service. In order to meet the need for manpower, nurses in the wards, ICU, and ER work in 3 shifts per day. This study was designed to evaluate their sleeping patterns and the factors that influence them. Methods: The subjects were 114 female nurses working at a University Hospital in Kyungi-do. To evaluate their sleeping pattern, a survey containing 11 questions was used. Their were differentiated into insomnia, sleep deprivation, daytime sleepiness, and snoring. Statistical analysis was conducted with independent t test, chi square test and analysis of covariance. Results: A statistical difference was found between shiftworkers and nonshiftworkers, in terms of sleep initiation time (p<0.05). The occurrences of insomnia, sleep deprivation, daytime sleepiness and snoring differed between the two groups, but not significantly. Conclusions: Of the numerous factors affecting sleeping patterns, shiftwork has the most deteriorative effect.

Factors Affecting Rapid Turnover of Novice Nurses in University Hospitals

Rapid turnover of novice nurses eventually results in a shortage of veteran nurses. This study aimed to clarify the factors affecting rapid turnover of novice nurses in a prospective manner. We carried out an investigation in 20 university hospitals whose directors of nursing service departments accepted our request to cooperate with our research program. These hospitals were selected from all of the 102 university hospitals listed in The Hospital Catalog of Japan. The subjects were 1,203 novice hospital nurses who gave their informed consent for participation in our study. The questionnaires, which dealt with burnout, assertiveness, stressful life events, reality shock, ward assignment preference, transfer preference, job satisfaction (workplace, salary, workload, and overtime), social support and coping mechanisms were completed by 923 novice nurses in June 2003. Then, their turnover was investigated in December 2003. Thirty-seven novice nurses (4.0%) quit during this period. Multiple logistic regression analysis showed that the factors affecting rapid turnover were 1) graduation from vocational nursing schools, 2) dissatisfaction with assignment to a ward contrary to their desire, and 3) no peers for support. Assignment of novice nurses to wards they choose as far as possible, avoidance of assigning novice nurses to wards alone, and establishment of a support system for nurses who graduate from vocational nursing schools seem to be important for preventing rapid turnover of novice nurses.

Workplace Environment, Assertiveness and Burnout risk among Novice Nurses in University Hospitals

Workplace Environment, Assertiveness and Burnout risk among Novice Nurses in University Hospitals

Educational intervention together with an on-line quality control program achieve recommended analytical goals for bedside blood glucose monitoring in a 1200-bed university hospital

Portable meters for blood glucose concentrations are used at the patients bedside, as well as by patients for self-monitoring of blood glucose. Even though most devices have important technological advances that decrease operator error, the analytical goals proposed for the performance of glucose meters have been recently changed by the American Diabetes Association (ADA) to reach <5% analytical error and <7.9% total error. We studied 80 meters throughout the Virgen Macarena Hospital and we found most devices with performance error higher than 10%. The aim of the present study was to establish a new system to control portable glucose meters together with an educational program for nurses in a 1200-bed University Hospital to achieve recommended analytical goals, so that we could improve the quality of diabetes care. We used portable glucose meters connected on-line to the laboratory after an educational program for nurses with responsibilities in point-of-care testing. We evaluated the system by assessing total error of the glucometers using high- and low-level glucose control solutions. In a period of 6 months, we collected data from 5642 control samples obtained by 14 devices (Precision PCx) directly from the control program (QC manager). The average total error for the low-level glucose control (2.77 mmol/l) was 6.3% (range 5.5-7.6%), and even lower for the high-level glucose control (16.66 mmol/l), at 4.8% (range 4.1-6.5%). In conclusion, the performance of glucose meters used in our University Hospital with more than 1000 beds not only improved after the intervention, but the meters achieved the analytical goals of the suggested ADA/National Academy of Clinical Biochemistry criteria for total error (<7.9% in the range 2.77-16.66 mmol/l glucose) and optimal total error for high glucose concentrations of <5%, which will improve the quality of care of our patients.

Nursing activities and outcomes of care in the assessment, management, and documentation of children's pain.

This study describes how assessment and documentation of children's acute postoperative pain is managed by nurses in university hospitals in Finland. A survey was conducted of 303 nurses working in children's wards of university-affiliated hospitals, and at the same time a retrospective chart review of 50 consecutive cases of operation of acute appendicitis was carried out. Charts were analyzed by content analysis, and the results of the survey are reported with percentage distribution and nonparametric statistical calculations. The results indicate that nurses assess pain mainly by observing the child's behavior and changes in physiology. Pain measurement instruments are rarely used, and nurses do not recognize them. The documentation of pain care is unsystematic and does not support the continuity of care. There is a clear need for development of assessment and documentation practices in the studied hospitals. Future research should look at the postoperative care of pain at home as well as care in non-university-affiliated hospitals.

Prevalence of hepatitis C antibodies in health care personnel.

To determine the prevalence of hepatitis C virus (HCV) infection in health care personnel in an HCV endemic area, we conducted a seroprevalence study of 1638 Kurume University Hospital physicians, nurses, laboratory staff, and clerical staff (560 men, 1078 women). Antibody to HCV (anti-HCV) was found in 2.8% (46) of subjects and hepatitis B surface antigen was found in 1.1% (18). The anti-HCV positive rate in health care personnel was no higher than reported in the general population of Fukuoka prefecture in Kyushu, Japan. There were no significant differences in anti-HCV positive rate by occupation. However, the prevalence of anti-HCV positive individuals increased significantly as age and length of time in an occupation increased. Anti-HCV positive rate in health care personnel was probably not related to length of time in an occupation. The data suggest that HCV infection is not easily transmitted to health care personnel in an HCV endemic area.

Epidemiology of back injury in university hospital nurses from review of workers' compensation records and a case-control survey : L. J. Fuortes, Y. Shi, M. Zhang, C. Zwerling, M. Schootman, Journal of Occupational Medicine, vol. 36, no. 9, 1022–1026

Reviewing Workers' Compensation records for back injury from a large university hospital for a 2-year period, we found a yearly incidence of lost work time back injury among nurses of 2.0% per year, exceeded only by physical plant staff, who had a rate of 3.5%. Nurses' aides had an injury rate 3.3-fold higher than registered nurses and licensed practical nurses and higher than any other occupational group. We compared 100 cases of nurses with back injury in the previous 2 years with 197 noninjured control subjects using a mailed 40-item questionnaire. Multivariate logistic modelling showed that prior nonback injury and performing combined lifting activities were statistically significant risk factors for back injury, and being overweight approached significance, after adjusting for the effects of age, gender, and each of the evaluated risk factors.

Exposure to blood during various procedures: Results of two surveys before and after the implementation of universal precautions

In an attempt to define better situations involving exposure to blood, we surveyed nurses (N = 565) in a 1000-bed university hospital to determine the following for the last working shift: the rate of cutaneous exposure to blood for different procedures, the rate of needlestick injury, and the prevalence of hand lesions. Among nurses who had performed at least one of the specified procedures, 42% had been exposed to blood with unprotected skin. Direct examination of 100 pairs of hands revealed that 57% of the nurses had either acute or chronic skin lesions. Universal precautions were introduced, and a similar survey (N = 541) was carried out 1 year later to assess compliance. Exposure of unprotected skin to blood had been reduced to 27%, although 46% of nurses had not used gloves for any of the procedures they had performed. The main reason given by nurses for not wearing gloves was that they did not consider the patient to be at risk for carrying a blood-borne infection. The rate of needlestick injuries was high and had remained stable at approximately 2.8 needlesticks/nurse per year, as determined by information from the last working shifts. We conclude that compliance of nursing personnel with universal precautions was insufficient, despite an informational campaign throughout the hospital. Repeated instruction on barrier precautions and the prevention of needlestick injury (including the correct use of disposable containers) is necessary to ensure optimal protection.