Journal of Preventive Medicine and Public Health

Original Article

Knowledge, Perceptions, and Self-reported Performance of Hand Hygiene Among Registered Nurses at Community-based Hospitals in the Republic of Korea: A Cross-sectional Multi-center Study: Hyang Soon Oh; J Prev Med Public Health. 2018;51(3):121-129. Published online May 14, 2018; DOI: https://doi.org/10.3961/jpmph.17.188

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Objectives
To assess the nurses’ hand hygiene (HH) knowledge, perception, attitude, and self-reported performance in small- and medium-sized hospitals after Middle East Respiratory Syndrome outbreak.
Methods
The structured questionnaire was adapted from the World Health Organization’s survey. Data were collected between June 26 and July 14, 2017.
Results
Nurses showed scores on knowledge (17.6±2.5), perception (69.3±0.8), self-reported HH performance of non-self (86.0±11.0), self-reported performance of self (88.2±11.0), and attitude (50.5±5.5). HH performance rate of non-self was Y₁=36.678+ 0.555X₁ (HH performance rate of self) (adjusted R²=0.280, p<0.001). The regression model for performance was Y₄=18.302+0.247X₄₁ (peception)+0.232X₄₂ (attitude)+0.875X₄₂ (role model); coefficients were significant statistically except attitude, and this model significant statistically (adjusted R²=0.191, p<0.001).
Conclusions
Advanced HH education program would be developed and operated continuously. Perception, attitude, role model was found to be a significant predictors of HH performance of self. So these findings could be used in future HH promotion strategies for nurses.

Summary

Citations

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Special Articles

Lessons From Healthcare Providers' Attitudes Toward Pay-for-performance: What Should Purchasers Consider in Designing and Implementing a Successful Program?: Jin Yong Lee, Sang-Il Lee, Min-Woo Jo; J Prev Med Public Health. 2012;45(3):137-147. Published online May 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.3.137

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Abstract PDF

We conducted a systematic review to summarize providers' attitudes toward pay-for-performance (P4P), focusing on their general attitudes, the effects of P4P, their favorable design and implementation methods, and concerns. An electronic search was performed in PubMed and Scopus using selected keywords including P4P. Two reviewers screened target articles using titles and abstract review and then read the full version of the screened articles for the final selections. In addition, one reference of screened articles and one unpublished report were also included. Therefore, 14 articles were included in this study. Healthcare providers' attitudes on P4P were summarized in two ways. First, we gathered their general attitudes and opinions regarding the effects of P4P. Second, we rearranged their opinions regarding desirable P4P design and implementation methods, as well as their concerns. This study showed the possibility that some healthcare providers still have a low level of awareness about P4P and might prefer voluntary participation in P4P. In addition, they felt that adequate quality indicators and additional support for implementation of P4P would be needed. Most healthcare providers also had serious concerns that P4P would induce unintended consequences. In order to conduct successful implementation of P4P, purchaser should make more efforts such as increasing providers' level of awareness about P4P, providing technical and educational support, reducing their burden, developing a cooperative relationship with providers, developing more accurate quality measures, and minimizing the unintended consequences.

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Designing an Effective Pay-for-performance System in the Korean National Health Insurance: Hyoung-Sun Jeong; J Prev Med Public Health. 2012;45(3):127-136. Published online May 31, 2012; DOI: https://doi.org/10.3961/jpmph.2012.45.3.127

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Abstract PDF

The challenge facing the Korean National Health Insurance includes what to spend money on in order to elevate the 'value for money.' This article reviewed the changing issues associated with quality of care in the Korean health insurance system and envisioned a picture of an effective pay-for-performance (P4P) system in Korea taking into consideration quality of care and P4P systems in other countries. A review was made of existing systematic reviews and a recent Organization for Economic Cooperation and Development survey. An effective P4P in Korea was envisioned as containing three features: measures, basis for reward, and reward. The first priority is to develop proper measures for both efficiency and quality. For further improvement of quality indicators, an electronic system for patient history records should be built in the near future. A change in the level or the relative ranking seems more desirable than using absolute level alone for incentives. To stimulate medium- and small-scale hospitals to join the program in the next phase, it is suggested that the scope of application be expanded and the level of incentives adjusted. High-quality indicators of clinical care quality should be mapped out by combining information from medical claims and information from patient registries.

Summary

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English Abstract

The Change in Readmission Rate, Length of Stay and Hospital Charge after Performance Reporting of Hip Hemiarthroplasty.: Won Mo Jang, Sang Jun Eun, Pilyoung Sagong, Chae Eun Lee, Moo Kyung Oh, Juhwan Oh, Yoon Kim; J Prev Med Public Health. 2010;43(6):523-534.; DOI: https://doi.org/10.3961/jpmph.2010.43.6.523

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Abstract PDF

OBJECTIVES
We assessed impact of performance reporting information about the readmission rate, length of stay and cost of hip hemiarthroplasty. METHODS: The data are from a nationwide claims database, National Quality Improvement Project database, of Health Insurance Review & Assessment Service in Korea. From January 2006 to April 2008, we received information of length of stay, readmission within 30 days, cost of 22 851 hip hemiarthroplasty episodes. Each episodes has retained the diagnoses of comorbidities and demographics. We used time-series analysis to assess the shifting of patients selections, between high volume(over 16 operations in a year) and low volume institutions, after performance reporting (december 2007). The changes of quality (readmission, length of stay) and cost were evaluated by multilevel analysis with adjustment of patient's factors and institutional factors after performance reporting. RESULTS: As compared with the before performance reporting, the proportion of patients who choose the high volume institution, increased 3.45% and the trends continued 4 months at marginal significance (p=0.059). After performance reporting, national average readmission rate, length of stay were decreased by 0.49 OR (95% CI=0.25-0.95) and 10% (beta=-0.102 p<0.01) and cost was not changed (beta=-0.01, p<0.27). The high volume institutions were more decreased than low volume in length of stay. CONCLUSIONS: After performance reporting, readmission rate, length of stay were decreased and the patient selections were marginal shifted from low volume institutions to high volume institutions.

Summary

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Original Articles

Performance Evaluation of Emergency Medical Center.: Chul Hwan Kang, Yoon Kim, Pyung Soo Lee, Young Dae Kwon, Chang Yup Kim, Young Soo Shin; Korean J Prev Med. 1997;30(4):884-892.

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Abstract PDF: Currently, there are 100 community emergency centers which expect to provide professional emergency care like Level 1 trauma centers in U.S.A. To evaluate Performance of emergency center, most studies have been widely adopted death rate based methods such as Trauma and Injury Severity Score(TRISS) and A Severity Characterization of Trauma(ASCOT). However, these methods are only applicable in situation where registration process of trauma patients is well established. Therefore, an alternative method should be applied to evaluate performance of emergency centers in Korea which does not have well-developed registration scheme. This study aims to develop new performance measures which are applicable to Korea and evaluate performance of 35 community emergency centers through new measures. The new measures are included that 'W-statistic' ; death rate calculated on the basis of International Classification based Injury Severity Score(ICISS), and 'the degree of severity' ; rate of severe trauma patients of each emergency medical centers. The study results can be summarized as follows. First, about 34% of sample emergency centers show they provide proper care in terms of their function. Second, tertiary hospitals, university hospitals, and hospitals located in Seoul show higher severity degree of patients and lower severity-adjusted death rate.; Summary

The Assessment of Stress between White and Blue Collar Workers by using Psychosocial Well-being Index.: Seong Ouk Hur, Seong Sil Chang, Jung Wan Koo, Chung Yill Park; Korean J Prev Med. 1996;29(3):609-616.

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Abstract PDF: This study was conducted to evaluate the degree of stress state and the risk factors related to in 967 white collar workers and 275 blue collar workers buy using Psycosocial Well-being Index. The results obtained were as follows: 1. In the white collar workers and blue collar workers, young age, low education and low income groups had high scores of stress, while in white collar workers, female had high scores of stress but in blue collar workers male had high scores of stress. 2. According to psychosocial well-being index, mild stress state were 73.9% and 53.1%, high risk stress state were 8.9% and 44.4%, and healthy state were 17.2 and 2.6% in white collar and blue collar workers respectively. 3. The total stress score was highly associated with the factors of depression, social performance and self-confidence, general well-being and vitality, and sleeping disturbance and anxiety in order. 4. In reliability test of stress factors, Cronbach's coefficients of depression, social performance and self-confidence, general well-being and vitality, and sleeping disturbance and anxiety were 0.89, 0.81, 0.79, and 0.74 respectively. In conclusion, it suggested that age, sex, marital status, income, education, sleeping time, smoking and exercise habit were associated with stress score, all of above factors should considered to occupational health.; Summary

Performance Ranges of the Neurobehavioral Core Test Battery among Female Workers Occupationally Not Exposed to Neurotoxic Agents in Manufacturing Industries.: Kyung Jae Lee, Se Hoon Lee, Hyoung Ah Kim, Won Chul Lee, Seong Sil Chang, Chung Yill Park, Chee Kyung Chung; Korean J Prev Med. 1995;28(4):911-923.

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Abstract PDF: With increased use of neurotoxic agents in manufacturing industries, hazardous effects of neurotoxic agents pose significant problems in protecting health of workers who work in these industries. A normal range of neurobehavioral performance is required 10 study hazardous effects of neurotoxic agents among workers. However, such reference for Korean population is not available yet. The objective of this study is to estimate a normal range of neurobehuvioral test performance of female workers in Korea. Data for neurobehavioral test performance developed by the world Health organization were obtained from 165 female workers. Study Subjects, 140 production workers and 25 clerks, who voluntarily participated in this study were not occupationally exposed to neurotoxic agents. The mean age and the mean education years of them were 32 years and 10.9 years, respectively. Santa Ana dexterity, pursuit aiming, digit symbol, simple reaction time, and Benton visual retention tests among the Neurobehavioral Core Test Battery(NCTB) were included in the evaluation. Subjects were interviewed by a trained interviewer for their detailed occupational history. Mean(+/-SD) performance of the participants were: 45.7+/-7.1 and 41.9+/-6.4 in the Santa Ana dexterity test of the preferred and non-preferred hands; 191.9+/-38.6 in correct dot of the pursuit aiming test; 57.7+/-16.0 in the digit symbol test; 274.8+/-44.6 msec in the mean simple reaction time and 70.5+/-69.0 msec in the mean standard deviation of it; and 7.8+/-1.7 in the Benton visual retention test. Most neurobehavioral performance scores were correlated significantly with age and educational level. Educational level was found to be a significant independent variable which was associated with all test scores. Age was significantly associated with scores of pursuit aiming and digit symbol tests.; Summary

Factors related to poor school performance of elementary school children.: Jung Han Park, Gui Yeon Kim, Kyu Sook Her, Ju Young Lee, Doo Hie Kim; Korean J Prev Med. 1993;26(4):628-649.

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Abstract PDF: This study was conducted to investigate the factors related to the poor school performance of the elementary school children. Two schools in Taegu, one in the affluent area and the other in the poor area, were selected and a total of 175 children whose school performance was within low 10 percentile(poor performers) and 97 children whose school performance were within high 5 percentile(good performers) in each class of 2nd, 4th and 6th grades were tested for the physical health, behavioral problem and family background. Each child had gone through a battery of tests including visual and hearing acuity, anthropometry(body weight, height, head circumference), intelligence(Kodae Stanford-Binet test), test anxiety(TAI-K), neurologic examination by a developmental pediatrician and heavy metal content(Pb, Cd, Zn) in hair by atomic absorption spectrophotometry. A questionnaire was administered to the mothers for prenatal and perinatal courses of the child, family environment, child's developmental history, and child's behavioral and learning problems. Another questionnaire was administered to the teachers of the children for the child's family background, arithmatic and language abilities and behavioral problem. The poor school performance had a significant correlation with male gender, high birth order, broken home, low educational and occupational levels of parents, visual problem, high test anxiety score, attention deficit hyperactivity disorder(ADHD), poor physical growth(weight, height, head circumference) and low I.Q. score. The factors that had a significant correlation with the poor school performance in multiple logistic regression analysis were child's birth order(odds ratio=2.06), male gender(odds ratio=5.91), broken home(odds ratio=9.29), test anxiety score(odds ratio=1.07), ADHD(odds ratio=9.67), I.Q. score(odds ratio=0.85) and height less than Korean standard mean-1 S. D.(odds ratio=11.12). The heavy metal contents in hair did not show any significant correlation with poor school performance. However the lead and cadmium contents were high in males than in females. The lead content was negatively correlated with child's grade(p<0.05) and zinc was positively correlated with grade(p<0.05). Among the factors that showed a significant correlation with the poor school performance, high birth order, short stature and ADHD may be modified by a good family planning, good feeding practice for infant and child, and early detection and treatment of ADHD. Also, teacher and parents should restrain themselves from inducing excessive test anxiety by forcing the child to study and over-expecting beyond the child's intellectual capability.; Summary

Factors Associated with Performance of National Cancer Screening Program in Korea.: Kui Son Choi, Jeong Hee Yang, Su Yeon Kye, Sun Hee Lee, Eun Cheol Park, Hai Rim Shin, Chang Min Kim; J Prev Med Public Health. 2004;37(3):246-252.

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Abstract PDF: OBJECTIVES
Cancer is the leading cause of death in Korea. Therefore, a National Cancer Screening Program (NCSP) was launched in 1999. This study planned to evaluate the performance of the NCSP to identifying the influencing factors in relation to characteristic public health centers. METHODS: To analyze the performance, the database of the NCSP records for 2002 was used. The performance index was measured by the goal achievement rate, which was defined by the real number of screenees against the expected number of screenees. Also, a survey was conducted by a self-administered questionnaire to identify the factors associated with the goal achievement rate. The questionnaire was divided into two sections. In the first section, the individual characteristics of the program coordinator in each public health center were measured, and second section was comprised of questions about the organizational characteristics associated with the NCSP. A total of 121 subjects from 241 public health centers completed the questionnaire. RESULTS: Of the 121 public health centers (50.2% response rate), the average goal achievement rate was 72.8%. The results of the regression model showed that public health centers located in rural area (parameter estimates=38.2) and had great support from a head of center or province (parameter estimates=0.20) and tended to have higher goal achievement rates. However, the characteristics of the program coordinator, especially their knowledge of and attitude toward cancer screening, were not significantly related to the goal achievement rates. CONCLUSIONS: It appears that the most important associated factors to the goal achievement rate in the NSCP were the location of the public health center and the support for the NCSP from the head of the center or province.; Summary

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