Su Hyun Kim

Purpose: This study aimed to identify key infection control elements and analyze intervention strategies across the stages of the chain of infection framework in long-term care facilities in South Korea.Methods: An integrative review was conducted of 25 domestic studies published between 2008 and 2024, including quantitative, qualitative, and mixed-methods research. The selected studies were analyzed according to the six stages of the chain of infection and were categorized into eight major infection control factors.Results: The stages of “mode of transmission” and “susceptible host” were most frequently addressed in the reviewed studies, whereas the “infectious agent,” “reservoir,” “portal of exit,” and “portal of entry” stages received comparatively less attention. Notably, studies focusing on the prevention and management of chronic infections, such as multidrug-resistant organisms, were scarce. Among the eight infection control factors, “education” and “guidelines” consistently emerged as core interventions across all stages. In addition, the findings underscored the importance of deploying dedicated personnel, improving facility, environments, implementing simulation-based training, and strengthening education on aseptic techniques.Conclusion: By applying the chain of infection model, this study reconstructed infection control strategies in long-term care facilities and identified stage-specific gaps in existing interventions. The findings provide practical implications for strengthening infection prevention systems and offer foundational evidence to support policy initiatives, including the deployment of infection control nurses, development of tailored training programs, and reinforcement of national-level infection control guidelines.

Background: Shift work is essential for continuous patient care but disrupts circadian rhythms, leading to increased fatigue, burnout, and the risk of errors. Existing guidelines for managing nurse fatigue remain broad and often lack actionable strategies for roster design and staffing. Aim: This study aimed to identify optimal shift patterns and sleep–wake schedules that minimize fatigue among rotating night‐shift nurses, using mathematical modeling to provide actionable recommendations for nursing management. Methods: A quantitative observational study was conducted with 273 nurses working 8‐h rotating three‐shift systems in three Korean hospitals. Sleep was monitored over 14 days using wearable devices, supplemented with survey data. Fatigue was estimated using a validated mathematical model based on the two‐process model of sleep regulation, and simulations were applied to evaluate alternative shift sequences and sleep–wake strategies. Results: Night shifts resulted in the shortest sleep (mean 5.0 h) and the highest fatigue, with over half of work hours predicted to be spent in a fatigued state. Three consecutive day or evening shifts yielded the most favorable outcomes, with cumulative sleep exceeding 26 h and fatigue limited to less than 1 hour. Conversely, three consecutive night shifts resulted in the poorest outcomes, with fatigue affecting 34.7% of work hours. Quick return patterns (< 11 h between shifts) significantly increased fatigue despite comparable sleep durations. Model‐derived recommendations—such as immediate postshift sleep following night duty—improved recovery and reduced cumulative fatigue. Conclusions: Limiting consecutive night duties, avoiding quick returns, and supporting tailored sleep routines may reduce fatigue among rotating night‐shift nurses. Implications for Nursing Management: These findings provide managers with practical, evidence‐based guidance for roster design, policy development, and staff education. Incorporating fatigue modeling into workforce planning can enhance nurse well‐being, reduce error risks, and promote sustainable healthcare delivery.

Purpose: This study explored how Generation Z characteristics—specifically work–life balance, growth needs, and individualism—along with work environment, emotional labor, and interpersonal skills, affect job embeddedness among newly graduated nurses. It also examined whether job embeddedness mediates the relationship between these factors and turnover intention. Methods: A correlational descriptive study was conducted by analyzing survey data collected from 131 clinical nurses born between 1995 and 2000, who had less than three years of nursing work experience in South Korea. Hierarchical multiple regression analysis was employed to identify the independent effects of Generation Z characteristics on job embeddedness, over and above the effects of work environment, emotional labor, and interpersonal skills. Path analysis using bootstrapping method was conducted to examine the mediating role of job embeddedness in turnover intention. Results: Needs for growth and work environment were significant predictors of job embeddedness among newly graduated nurses. Furthermore, the effects of needs for growth and work environment on turnover intention were significantly mediated by job embeddedness. Conclusion: Understanding the characteristics of Generation Z, particularly their needs for growth, along with the work environment, is essential for enhancing job embeddedness among newly graduated nurses. Strengthening job embeddedness can effectively reduce their turnover intention.

Understanding the experiences and coping strategies employed by nurses working night shifts is essential for developing effective interventions to mitigate sleep disturbances. However, actionable and reliable strategies for improving sleep quality remain elusive. This study aimed to explore the sleep experiences and coping strategies of nurses working rotating night shifts. This qualitative descriptive study utilized semi-structured individual interviews with 15 nurses working rotating night shifts at three hospitals in South Korea. Data were collected between October 2022 and February 2023 and analyzed using qualitative content analysis. Four key themes emerged, including difficulty sleeping due to night shifts, distress due to difficulty sleeping, strategies to improve sleep quality, and desire for organizational change. Participants reported a range of coping strategies to enhance sleep quality while managing the challenges of shift work. These strategies included creating behaviors and environments to promote sleep, finding a balance between sleep and activity time, embracing irregular sleep patterns, and asking others for help. Despite employing various coping strategies, nurses working night shifts continued to face persistent sleep difficulties. While they recognized night shifts as an inherent aspect of their profession and demonstrated adaptability, they still sought to overcome their sleep challenges. These findings highlight the urgent need for organizational and institutional measures to address sleep-related issues among night shift nurses.

Background: Night shift work disrupts sleep and physiological recovery, leading to adverse health outcomes among nurses. While both work and nonwork factors are known to influence sleep and fatigue, few studies have examined their simultaneous and multiple mediating effects on health in night shift nurses. Aim: This study tested a comprehensive model to investigate the relationships among work factors (emotional demands, night shift rotation intervals, and social support), nonwork factors (exercise and work–life interference), sleep disturbance, fatigue, and health in night shift nurses. Methods: A cross‐sectional study was conducted with 289 nurses working rotating night shifts at three hospitals in South Korea. Structural equation modeling (SEM) was employed to assess the direct and indirect effects between variables. Data were collected using validated instruments for sleep disturbance, fatigue, emotional demands, social support, exercise, work–life interference, and health. Results: Work–life interference had the most significant effect on health, both directly and indirectly through sleep disturbance and fatigue. Emotional demands negatively influenced health via sleep disturbance and fatigue. Exercise indirectly improved health by reducing fatigue, but showed no direct effects. Sleep disturbance was a significant predictor of both fatigue and health. Social support did not demonstrate significant direct or indirect effects on health. The final model explained 51.8% of the variance in health outcomes and exhibited strong model fit indices. Conclusion: Maintaining a work–life balance is critical for improving the health of night shift nurses, as work–life interference directly and indirectly exacerbates health risks through sleep disturbance and fatigue. Implications for Nursing Management: These findings highlight the importance of implementing strategies to manage work–life balance, address emotional demands, promote physical activity, and ensure recovery from shift work to support the health of night shift nurses.

The ability to adapt to night shift work varies greatly among individuals, but little is known about how personal traits and coping strategies interact to affect shift-work tolerance. This study aimed to identify how certain personal traits (e.g., flexibility, languidness, chronotype, and neuroticism) and behavioral and coping strategies influence shift-work tolerance. Additionally, it explored whether behavioral and coping strategies moderate the association between neuroticism and shift-work tolerance. In this cross-sectional study, nurses (N=297) working rotating shifts consisting of either three 8-hour shifts or two 12-hour shifts at two university hospitals and one training hospital in South Korea completed a survey on shift work. Data were analyzed using hierarchical multiple linear regression analysis. Nurses with personal traits of lower flexibility, higher languidness, evening-oriented chronotypes, and higher neuroticism had less shift-work tolerance. Engagement-coping decreased fatigue, whereas disengagement-coping increased insomnia. Among those with higher levels of neuroticism, disengagement-coping further reduced alertness, while engagement-coping aggravated insomnia. Addressing the complex interplay between personal traits and coping strategies is essential to enhance adaptations to shift work without adverse consequences.

Summary Statement: This systematic review and meta-analysis aimed to thoroughly examine the effectiveness of simulation-based education in the management of emerging infectious diseases, focusing on educational content and methods. Studies published between 2000 and 2022 were identified, and a meta-analysis was conducted using a random-effects model. The findings revealed that simulation-based education significantly enhances various competencies related to managing emerging infectious diseases, encompassing cognitive, negative-affective, positive-affective, and psychomotor outcomes. Subgroup analysis indicated that methods effective in improving competencies include the use of equipment with limited or full patient interaction, simulated or in situ settings, and scenarios involving some interruptions by educators or independent participation of trainees. This review underscores the importance of appropriate methodological considerations in simulation-based education, including equipment, settings, and scenario designs, to optimize educational outcomes in the management of emerging infectious diseases.

Objectives: This study aimed to identify global trends and themes in health literacy research through topic modeling of the comprehensive literature, thereby suggesting future directions for health literacy research. Methods: Research papers on health literacy published from 2012 to 2021 were analyzed using a text mining technique called Bidirectional Encoder Representations from Transformers was applied for topic modeling. Results: Of the 12,842 retrieved papers on health literacy, the highest proportion was based on the themes of ‘mental health’ (1,161 papers, 9.04%) and ‘cancer prevention and screening’ (1,146 papers, 8.92%). These were followed by the themes of ‘digital healthcare’ (952 papers, 7.41%), ‘health information education’ (826 papers, 6.43%), and ‘older people’ (801 papers, 6.24%). The number of research papers on health literacy has increased constantly across all topics. Particularly, the topics of ‘infection prevention’ and ‘digital healthcare’ have grown rapidly since 2019. Conclusion: This study showed that health literacy research has expanded from healthcare at the individual level to disease prevention and health promotion at the population level throughout the life course. Future studies should develop a health literacy scale for national monitoring indices as well as optimal communication strategies for disease prevention and health promotion within low health literacy groups.

Background: Sleep disturbance is a common issue among rotating night shift workers and is closely related to health risks. The present study aimed to determine the effectiveness of pharmacological and non-pharmacological sleep interventions for the management of sleep disturbance among rotating night shift workers.Methods: For this systematic review and meta-analysis, we searched six electronic databases—EMBASE, CINAHL, Cochrane Library, PubMed, Scopus, and Web of Science—for randomized controlled trials and clinical trials published from January 1990 to June 2022. The quality of eligible studies was independently assessed by three authors using the Joanna Briggs Institute Critical Appraisal Checklist for randomized controlled trials and quasi-experimental studies. The meta-analysis was performed based on the random effects model using the Comprehensive Meta-Analysis software. The study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Results: Of the 1019 studies retrieved, 30 met the inclusion criteria for the systematic review; 25 were selected for the meta-analysis. Sleep interventions were categorized as follows: pharmacological approach (n = 7), light therapy (n = 9), cognitive behavioral approach (n = 7), aroma or alternative therapy (n = 4), and shift schedule modification (n = 3). The overall mean effect size of the interventions was moderate (Hedges' g = 0.59; 95% confidence interval = 0.33–0.84, z = 4.50, p < 0.001).Conclusion: Sleep interventions were effective in promoting sleep or reducing sleep disturbance among rotating night shift workers. These findings provide evidence of the effectiveness of various pharmacological and non-pharmacological sleep interventions for managing sleep health in the work environment of rotating night shift workers.