• Clinical and Experimental Pediatrics
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• v.49 no.12
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• pp.1287-1295
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• 2006

Purpose : The importance of staphylococcal infections in NICU has been emphasized in terms of increased resistant strains and increased incidence of morbidity and mortality. In this study, we inrestignted the clinical characteristics and risk factors for staphylococcal infections, and looked into sensitivity trends of antibiotics in the era of a high rate of methicillin-resistant staphylococcus aureus (MRSA) in our society. Methods : This study included 240 neonates with positive blood, urine and other sites cultures for staphylococci who were admitted to NICU of Hanil General Hospital and Kyunghee University Hospital from January 2000 to December 2004. The analyses included clinical characteristics of staphylococcal infections and the relationship of incidence rate among various factors, including invasive procedures. Results : For 5 years, 3,593 patients were hospitalized in the NICU and 7,481 specimens were cultured from blood, urine, and other sites. During the study period, staphylococci were isolated from 240 patients, of whom 88 patients had MRSA, 41 patients methcillin sensitive staphylococcus aureus (MSSA), 63 patients S. epidermidis, 48 patients coagulase-negative staphylococcus (CNS) except S. epidermidis infections. The risk factors associated with staphylococcal infections were less than 37 weeks of gestational age, less than 7 on a 5 minutes Apgar score, receiving TPN, applied mechanical ventilation, use of central venous catheters and other tubes. The sensitivity to vancomycin was 100 percent. A relatively high sensitivity against teicoplanin, trimethoprim-sulfamethoxazole, chloramphenicol, clindamycin and low sensitivity against gentamicin and erythromycin were shown. Conclusion : To reduce staphylococcal infections in NICU, we need to monitor and manage premature neonates from the beginning of the birth process and to avoid as many invasive procedures as possible in NICU. Considering MRSA, control of preceding factors and early use of appropriate antibiotics is expected to reduce the morbidity and mortality caused by MRSA infections.

• Journal of The Korean Society of Integrative Medicine
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• v.2 no.4
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• pp.19-27
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• 2014

Purpose : The purpose of this study was to provide some basic information about current status of occupational therapy in Korean University Hospital NICUs. Method : This study was conducted by mail and by analyzing 61 survey questionnaires sent out pediatric occupational therapist in 39 university hospitals. Result : 23 people of the current pediatric occupational therapists worked in NICU under many constraints. Some reasons for not providing occupational therapy services in the NICU were lack of pediatric occupational therapists(55.3%), funding difficulties(42.1%) and problem in the hospital system(42.1%). Conclusion : The results of this study can be used as a basis to increase the provision of occupational therapy in the NICU. Further research is needed to improve the role of occupational therapy in the NICU.

• Child Health Nursing Research
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• v.23 no.2
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• pp.179-189
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• 2017

Purpose: The purpose of this study was to investigate NICU nurses' nursing interventions for pain and factors affecting nursing interventions for pain. Methods: Participants were 120 NICU nurses from 5 university hospitals located in Daejeon Metropolitan City and Chungcheong Province. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA and Duncan test, Pearson correlation coefficients and multiple regression analysis with SPSS Windows 23.0 IBM program. Results: The factors affecting nursing interventions for pain included knowledge about non-pharmacological nursing interventions for pain and self-efficacy about nursing interventions for pain. These variables explained 28.3% of nursing interventions for pain. Conclusion: The results of this study suggest that it is necessary to develop education programs in which effective nursing interventions for neonatal pain are considered. The programs should be made available to NICU nurses.

• Clinical and Experimental Pediatrics
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• v.49 no.11
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• pp.1158-1166
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• 2006

Purpose : The purpose of this study is to make a diagnostic classification and discuss a diagnostic strategy of floppy infants by investigating clinical, neurological, electrophysiological, and genetic analysis of infants admitted to intensive care units with the complaint of hypotonia. Methods : A retrospective study was performed from Jan. 1993 to Dec. 2005 in neonatal and pediatric intensive care units of Seoul National University Children's Hospital. Clinical features and all tests related to hypotonia were investigated. Results : There were 21 cases of floppy infants admitted to intensive care units. Final diagnosis was classified as centra (7 cases[33.3 percent]), peripheral (11 cases [52.4 percent]), and unspecified (3 cases [14.3 percent]). Among the central group, three patients were diagnosed as hypoxic ischemic encephalopathy, two patients as Prader-Willi syndrome, one patient as chromosomal disorder, and one patient as transient hypotonia. Among the peripheral group, four patients were diagnosed as myotubular myopathy, three patients as SMA type 1, two patients as congenital myotonic dystrophy, one patient as congenital muscular dystrophy, and one as unspecified motor-neuron disease. Motor power was above grade 3 on average, and deep tendon reflex was brisk in the central group. Among investigations, electromyography showed 66 percent sensitivity in the peripheral group, and muscle biopsy was all diagnostic in the peripheral group. Brain image was diagnostic in the central group, and Prader-Willi FISH or karyotyping was helpful in diagnosis in central group. Morbidity and mortality was more severe in the peripheral group Conclusion : Classification of diagnosis by clinical characteristics in this study, and application of investigations step by step, may provide an effective diagnostic strategy.

• Clinical and Experimental Pediatrics
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• v.45 no.8
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• pp.961-966
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• 2002

Purpose : We compared the underlying or associated diseases according to the frequency of platelet transfusions in neonates with thrombocytopenia to know the factors predicting which patients will require multiple platelet transfusions. We also compared mortality. Methods : A retrospective study was performed in 72 neonates who received the platelet transfusions in neonatal intensive care unit(NICU) between August 1996 and July 2001. Group I received one platelet transfusion and group II received two or more. We compared the frequency of underlying or assodiated diseases such as sepsis/disseminated intravascular coagulopathy(DIC), respiratory distress syndrome(RDS), intraventricular hemorrhage(IVH), patent ductus arteriosus (PDA), necrotizing enterocolitis(NEC), liver or renal disease, and mortality between two groups. Results : Of the 72 patients, 29(40.2%) received one and 43(59.7%) received two or more transfusions; 16(22.2%) received four or more. There were no statistically significant differences in gestational age, birth weight, sex, and maternal history between two groups. C-section rate was higher in group II(20.7% vs. 55.8%, P<0.05) and the incidence of PDA was higher in group I (55.2% vs. 30.2%, P<0.05). Otherwise, there were no statistically significant differences in the incidence of sepsis/DIC, RDS, IVH, RDS, CLD, NEC, liver or renal disease, pulmonary hemorrhage and hypoxic ischemic encephalopathy, and mortality between group I and group II. Conclusion : There was no significant difference in clinical morbidity and mortality according to the frequency of platelet transfusion in neonates with thrombocytopenia. Further study is needed to know the predicting factor for multiple platelet transfusions in neonates with thrombocytopenia.

• Child Health Nursing Research
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• v.20 no.3
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• pp.185-195
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• 2014

Purpose: The purpose of this study was to identify whether hearing a recording of mother's voice affected physiological reactions, behavioral state related to sleep and weight of very low birth weight (VLBW) infants. Methods: This was a nonequivalent control group pre-post test quasiexperimental design. The participants were 11 VLBW infants in the experimental group and 11 in the control group. In the experimental group, a recording of mother's voice was played to her infant by voice recorder four times each day for five minutes over 10 consecutive days in the incubator. Results: For physiological response (heart rate, respiration rate, oxygen saturation), there were statistically significant differences between the experimental and control groups. Behavioral state during sleep was more very quiet and quiet in the experimental group. In the daily weight change, there was no significant difference between the experimental and control groups. Conclusion: The findings suggest that, for VLBW infants, the intervention of hearing a recording of mother's voice had some significance as a nursing intervention having a positive impact. Such interventions can help pediatric nurses to stabilize the physiological response and maintenance more very quiet sleep state and improve VLBW infants' growth.

• Child Health Nursing Research
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• v.20 no.2
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• pp.87-95
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• 2014

Purpose: This study was done to investigate the point prevalence of postpartum depression and its predictors during early postpartum in mother of preterm infants. Methods: Participants were 101 women, 2-3 weeks after delivery whose preterm babies were hospitalized in a neonatal intensive care unit. Data were collected from June 2010 to January 2011. The instruments included 'Edinburgh Postnatal Depression Scale', 'Prenatal depression', 'Subjective health status of infant', 'Medical staff support', and 'Husband support'. Collected data were analyzed using t-test, ${\chi}^2$-test, and multiple logistic regression with SPSS/WIN version 18.0. Results: The point prevalence was 86.1% that postpartum depression occurred during the early postpartum period in mothers of preterm infants. Three significant predictors of postpartum depression in mothers of preterm infants were identified; 'Type of delivery (OR, 5.57; 95% CI, 1.25-24.77)', 'Subjective health status of infant (OR, 0.34; 95% CI, 0.16-0.70)', and 'Medical staff support (OR, 0.52; 95% CI, 0.28-0.97)'. Conclusion: The results indicate that postpartum mothers should be screened for postpartum depression early in the postpartum period and that, medical personnel should pay particular attention to mothers with a caesarean section and should help mothers of preterm babies to develop positive perceptions of their babies.

• Child Health Nursing Research
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• v.22 no.3
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• pp.190-198
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• 2016

Purpose: The purpose of this study was to examine the paternal stress and nursing support as perceived by fathers of high risk infants admitted to Neonatal Intensive Care Units (NICU). Methods: The study participants included 88 fathers of high risk infants in NICUs. Their parental stress and nursing support were measured using a self-report questionnaire. Results: The parental stress level of the fathers was 3.57 of a possible 5. Among the parental stress items, 'Relationship with infant and parental role' had the highest scores. The perceived nursing support level was a relatively high, 3.90 on a 5-point scale. The lowest score was for the item 'showed concern about my well-being.' The parental stress was lower in fathers with low income, higher in fathers in nuclear families and when the infants' condition was serious. Conclusion: The findings indicate that fathers of high risk infants experience intense parental stress. Thus when designing care to provide support for these fathers and their infants, it is necessary to encourage the fathers' engagement, provide information on how to respond to the baby, and include supportive care to the fathers.

• Journal of The Korea Institute of Healthcare Architecture
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• v.30 no.3
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• pp.35-44
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• 2024

Purpose: The purpose of this study is to present basic data on installation location, functional connection, and arrangement to be considered when planning a neonatal intensive care unit in a certified tertiary general hospital. Method: Review the facility standards related to the neonatal intensive care unit, such as laws and guidelines, and select a Certified Tertiary General Hospital as a case hospital among the Neonatal Intensive Care Regional Centers designated by the Ministry of Health and Welfare to analyze the placement characteristics of major NICU components such as the location of the NICU installation, the connection of movement between adjacent facilities and functions, and the treatment room and accessory room. Results and Implications: NICU is a facility for critically ill babies among newborns and needs to consider more about infection and patient management compared to adult intensive care units, which not only install close to delivery-related facilities to enable immediate action after childbirth, but also divide the treatment room into open rooms and allow access to the attached rooms through dedicated corridors to minimize movement in the treatment room.

• Journal of Korean Critical Care Nursing
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• v.15 no.3
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• pp.37-50
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• 2022

Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory. Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability. Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents. Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the "recall of experience" subscale, and reduction of the scale response level.