Jee-In Hwang

Nurses’ perception of ethical climate, medical error experience and intent-to-leave

We examined nurses’ perceptions of the ethical climate of their workplace and the relationships among the perceptions, medical error experience and intent to leave through a cross-sectional survey of 1826 nurses in 33 Korean public hospitals. Ethical climate was measured using the Hospital Ethical Climate Survey. Although the sampled nurses perceived their workplace ethical climate positively, 19% reported making at least one medical error during the previous year, and 25% intended to leave their jobs in the near future. Controlling for individual and organizational characteristics, we found that nurses with a more positive perception of the ‘patient’ dimension of ethical climate were less likely to have made medical errors. Nurses with a more positive perception of the ‘patient’, ‘manager’, ‘hospital’ and ‘physician’ dimensions of ethical climate were less likely to leave their current job. Enhancing workplace ethical climate could reduce medical errors and improve nurses’ retention in public hospitals.

Inappropriate hospitalization days in Korean Oriental Medicine hospitals

OBJECTIVE To examine the extent of inappropriate hospitalization days in Korean oriental medicine (OM) hospitals and to determine the factors associated with inappropriate stays. DESIGN Cross-sectional study design using concurrent and retrospective medical record reviews. SETTING Two teaching OM hospitals in Korea. PARTICIPANTS Patients (n = 256) consecutively discharged from general care units in two OM hospitals in 1 month. INTERVENTION The appropriateness of each hospitalization day was assessed using a modified appropriateness evaluation protocol. Patient and healthcare use characteristics were also reviewed. Multiple regression analyses were performed to determine factors associated with inappropriate stay. MAIN OUTCOME MEASURE Rate of inappropriate hospitalization days. RESULTS Overall, 14.9% (691/4644) of hospitalization days reviewed were judged inappropriate with a mean of 18.3% (95% confidence interval = 14.6-22.0) per patient. Approximately half of patients (n = 126, 49.2%) had at least 1 inappropriate hospitalization day. Factors associated with inappropriate hospitalization days were admission method and number of types of OM therapies. Patients admitted to hospitals on foot without assistance had more inappropriate hospitalization days than those admitted by stretcher cart. Those who underwent several types of OM therapies during hospitalization had fewer inappropriate hospitalization days. CONCLUSIONS A substantial proportion of hospitalization days were evaluated as inappropriate. Patient condition at admission and types of OM therapies required should be taken into account to reduce unnecessary stays in OM hospitals. Additionally, availability of OM services, especially for patients with limited motor functions, needs to be improved outside hospitals.

Prevalence of adverse reactions to latex gloves in Korean operating room nurses

This study was conducted to determine the prevalence rate of adverse reactions to latex gloves. Among hospital personnel working in operating rooms, 41.4% reported adverse reactions to latex. Especially among OR nurses, the prevalence rate of adverse reactions was 80.3%, and that of latex allergy was 9.8%. Common symptoms were rash, skin itching, dizziness, and eye itching. Atopics had more latex allergy than the non-atopics. There was no difference in the incidence rate of latex allergy among the five gloves by the prick test. But with the exposure test, ordinary gloves had a higher latex allergy incidence than hypoallergenic gloves.

Nurses’ systems thinking competency, medical error reporting, and the occurrence of adverse events: a cross-sectional study

Background: Healthcare professionals’ systems thinking is emphasized for patient safety. Aims: To report nurses’ systems thinking competency, and its relationship with medical error reporting and the occurrence of adverse events. Design: A cross-sectional survey using a previously validated Systems Thinking Scale (STS), was conducted. Methods: Nurses from two teaching hospitals were invited to participate in the survey. There were 407 (60.3%) completed surveys. Results: The mean STS score was 54.5 (SD 7.3) out of 80. Nurses with higher STS scores were more likely to report medical errors (odds ratio (OR) = 1.05; 95% confidence interval (CI) = 1.02–1.08) and were less likely to be involved in the occurrence of adverse events (OR = 0.96; 95% CI = 0.93–0.98). Conclusions: Nurses showed moderate systems thinking competency. Systems thinking was a significant factor associated with patient safety. Impact Statement: The findings of this study highlight the importance of enhancing nurses’ systems thinking capacity to promote patient safety.

Adverse Events in Korean Traditional Medicine Hospitals: A Retrospective Medical Record Review.

Objectives Traditional medicine has been used worldwide in recent decades. The aim of this study was to determine the incidence of adverse events (AEs) in traditional medicine hospitals and investigate patient and health-care utilization factors associated with AE occurrence. Methods A 2-stage review of 1152 randomly sampled charts in 2 teaching Korean traditional medicine hospitals was conducted. Three physicians and a quality improvement specialist identified AE occurrence, severity, and preventability using the Global Trigger Tool (Appendix 1, Supplemental Digital Content, http://links.lww.com/JPS/A19). Two traditional Korean medicine professors validated the findings. Logistic regression analysis was performed to determine factors associated with AE occurrence. Results One hundred twenty-two admissions (10.6%) had at least one AE (7.39 events per 1000 patient days and 14.5 events per 100 admissions). Among 167 AEs, 73.7% were mild and 70.7% were judged preventable. Procedure-related AEs were most common. After considering other patient and health-care utilization characteristics, factors associated with AE occurrence were altered mental status on admission (OR, 3.86; 95% confidence interval [CI], 1.20–12.44), use of various traditional medicine therapies (OR, 1.69; 95% CI, 1.32–2.15), length of stay (OR, 1.02; 95% CI, 1.01–1.03), and number of unique triggers (OR, 6.35; 95% CI, 4.54–8.89). Conclusions Approximately 11% of inpatients in traditional medicine hospitals experienced AEs. Because patients have a higher risk of AEs, special attention should be paid to those with altered mental status on admission, receiving various traditional medicine therapies, staying for a longer period, and having various positive triggers.