• 중환자간호학회지
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• 제4권2호
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• pp.1-14
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• 2011

Purpose: This study was aimed to understand and describe the Korean critical care advanced practice nurses' work experience. Methods: Data was collected through 2 focus group interviews that were held in two different university hospitals in Seoul, Korea. All interviews were recorded and transcribed, and data were analysed using modified qualitative content analysis. Results: Ten themes were drawn from data analysis. They are "Various and complex tasks", "Excellency of advanced nursing practice", "Pressure and responsibility accompanied with pride", "Role identity confusion", "Role conflict", "Leaping and evolving role", "Gap between role and outcome evaluation", "Underestimated outcomes", "Where are my outcomes?" "Searching for outcomes: publicize the role". Conclusion: The results of this study help to understand the role of Korean critical care advanced practice nurses and to guide to outcome evaluation of their role effectiveness. Developing qualitative outcome indicators, cost-effectiveness ananlysis of Korean critical care advanced practice nurses' role, and accumulation of evidences through researches on outcome evaluation will be needed to successfully settle down advanced practice nursing in Korea.

• 중환자간호학회지
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• 제11권3호
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• pp.12-22
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• 2018

Purpose : This methodological study develops an oral health assessment tool for critically ill patients. Method : From February 15 to April 30, 2014, this study was conducted to test the validity and reliability of the tool at two general hospitals and three medical and surgical intensive care units (ICUs) in Seoul, Korea. Results : The result of the intraclass correlation coefficient to test the between-observer reliability by analyzing the oral health assessment scores before and after oral nursing care showed that .93 of before oral care and .90 of after oral care. The correlation coefficient values of .68 (p<.001) and .71 (p<.001) before and after providing oral nursing care, respectively, indicated the presence of a statistically significant correlation between the tool and the criterion. Using the paired t-test, the differentiated validity of the tool was tested in patients who had developed pneumonia after entering the ICU. A statistically significant difference in scores was found between the time of entering the ICU and that of developing pneumonia (t=-8.73, p<.001), which provided evidence for the differentiated validity of the tool. Conclusions : Since the validity and reliability of the tool developed in this study were verified, this tool can be used to assess the oral health conditions of critically ill patients.

• 대한간호학회지
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• 제35권1호
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• pp.47-55
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• 2005

Purpose: This study was to evaluate the validity of the Pediatric Index of Mortality Ⅱ(PIM Ⅱ). Method: The first values on PIM Ⅱ variables following ICU admission were collected from the patient's charts of 548 admissions retrospectively in three ICUs(medical, surgical, and neurosurgical) at P University Hospital and a cardiac ICU at D University Hospital in Busan from January 1, 2002 to December 31, 2003. Data was analyzed with the SPSSWIN 10.0 program for the descriptive statistics, correlation coefficient, standardized mortality ratio(SMR), validity index(sensitivity, specificity, positive predictive value, negative predictive value), and AUC of ROC curve. Result: The mortality rate was 10.9% (60 cases) and the predicted death rate was 9.5%. The correlation coefficient(r) between observed and expected death rates was .929(p<.01) and SMR was 1.15. Se, Sp, pPv, nPv, and the correct classification rate were .80, .96, .70, .98, and 94.0% respectively. In addition, areas under the curve (AUC) of the receiver operating characteristic(ROC) was 0.954 (95% CI=0.919～0.989). According to demographic characteristics, mortality was underestimated in the medical group and overestimated in the surgical group. In addition, the AUCs of ROC curve were generally high in all subgroups. Conclusion: The PIM Ⅱ showed a good, so it can be utilized for the subject hospital. better.

• 대한간호학회지
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• 제42권3호
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• pp.396-404
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• 2012

Purpose: The purpose of this study was to identify the features, risk scores and risk factors for deep vein thrombosis in critically ill patients who developed deep vein thrombosis in their lower extremities. Methods: The participants in this prospective descriptive study were 175 adult patients who did not receive any prophylactic medication or mechanical therapy during their admission in the intensive care unit. Results: The mean age was 62.24 (${\pm}17.28$) years. Men made up 54.9% of the participating patients. There were significant differences in age, body mass index, and leg swelling between patients who developed deep vein thrombosis and those who did not have deep vein thrombosis. The mean risk score was 6.71(${\pm}2.94$) and they had on average 4.01(${\pm}1.35$) risk factors. In the multiple logistic regression, body mass index (odds ratio=1.14) and leg swelling (odds ratio=6.05) were significant predictors of deep vein thrombosis. Conclusion: Most critically ill patients are in the potentially high risk group for deep vein thrombosis. However, patients who are elderly, obese or have leg edema should be closely assessed and more than one type of active prophylactic intervention should be provided.

• 한국콘텐츠학회논문지
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• 제17권8호
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• pp.241-249
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• 2017

본 연구는 인공호흡기 적용 환자들의 구강간호에 있어 클로르헥시딘의 적용에 대한 효과성을 분석하고, 이를 토대로 임상에서 실질적으로 구강간호 시행에 있어 명확한 근거를 제시 하고자 시도 되었다. 주요 검색어는 Ventilator associated pneumonia AND (Oral care OR Dental care OR Chlorhexidine*)으로 검색원으로는 국내 RISS, Koreamed, KISS와 국외 MEDLINE, Cochrane Central, CINAHL, Pub Med를 활용하여 2017년 5월까지의 문헌을 대상으로 검색하였다. 총 19편의 연구가 최종 선정되었고, Revman 5.3 프로그램으로 분석 하였으며, RoB (The Cochrane's Risk of Bias)도구를 이용해 문헌의 질을 평가하였다. 연구결과 중환자의 인공호흡기 관련 폐렴 예방에 있어 클로르헥시딘의 적용은 통계적으로 유의한 효과가 있었음이 나타났다.

• 성인간호학회지
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• 제24권5호
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• pp.509-519
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• 2012

Purpose: This retrospective study was designed to examine the frequency of unplanned extubation, and to identify the related factors of unplanned extubation in medical intensive care unit patients. Methods: Data were collected from medical records of patients who received intubation in a medical intensive care unit. One hundred eighteen patient charts were selected for the study. The Patient Severity Classification Scale and unplanned extubation risk factors were examined. Data were analyzed with descriptive statistics, $x^2$-test, Fisher's exact test and Mann-Whitney U test. Results: The incidence of unplanned extubation was 11 (9.32%) out of 118 patients who had undergone intubation. There were statistically significant differences between the unplanned extubation and work shift ($x^2$=61.52, p=.001), ventilation mode (p=.001), number of days of ventilator application (U=366.00, p=.038) and administration of sedatives (p=.025). Conclusion: Unplanned extubation is affected by the following variables: a) whether a nurse is in night shift, b) whether ventilation is mandatory, c) duration of ventilation use and d) administration of sedatives.

• 대한간호학회지
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• 제32권5호
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• pp.654-664
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• 2002

The purpose of this study was to identify the burden, health promotion behavior and health status and to describe the relationship of the burden, health promotion behavior and health status of the family caregivers of intensive care unit patients. Method: The subjects were 48 family caregivers of ICU patients in a University Hospital. Data were collected between June, 1 and July, 31, 2000 using structured questionnaires. Research tools used were Suh and Oh's Burden Scale, Revised Walker, Sechrist, & Pender's HPLP(1987) ; Revised Nam's Health State Scale(1965). Result: The mean score of burden of family caregiver was 3.01(full score was 5). The mean score of health promotion behavior of family caregiver was 2.52(full score was 4). And the mean score of health status of family caregiver was 0.68(full score was 1.00). The score of psychological health state was a little higher than the physiological one. In correlational analysis, the burden and the health status of caregivers were reversely correlated . The correlation between the burden and the health promotion behavior, and the health behavior and health status were not significant. Conclusion: The more burden caregivers of ICU patients felt, the worse their health status. So nurses need to understand the family caregiver's burden and apply nursing care that can reduce burden, in order to improve the health status of family caregivers.

• 기본간호학회지
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• 제16권1호
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• pp.21-29
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• 2009

Purpose: The purpose of this study was to identify the nutritional status and to compare nutritional indicators by caloric intake for intensive care unit patients, Methods: The participants for this descriptive investigation were 62 patients who were admitted to medical and surgical ICUs and started on enteral feeding. Data were collected in a tertiary hospital and the patients were followed for 7 days after enteral feeding was initiated. For analysis, patients who received 80% less calories than their required level were categorized as the underfed group and patients who received more than 80% to their required level, as the adequately fed group. Results: Compared to daily requirements, the prescribed calories and protein for patients overall were 77.39% and 64.75% respectively. The level of calories and protein given was less than their prescription. However, a comparison of the underfed group and the adequately fed group, showed that there was no significantly difference in albumin, prealbumin and transferrin. Only body weight was significantly different between the groups. C-reactive protein had a significant correlation with prealbumin and transferrin. Conclusion: Underfeeding is a common phenomenon among ICU patients. Nutritional indicators such as prealbumin, albumin and transferrin may not sensitive indicators to assess nutritional status of ICU patients.

• 중환자간호학회지
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• 제12권2호
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• pp.26-38
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• 2019

Purpose : The aims of this study were to identify the incidence of pressure ulcers and to compare the predictive validities of pressure ulcer risk assessment scales among trauma patients. Methods : This was a prospective observational study. A total of 155 patients admitted to a trauma intensive care unit in a university hospital were enrolled. The predictive validity of the Braden, Cubbin & Jackson, and Waterlow scales were assessed based on the sensitivity, specificity, positive and negative predictive values, and area under the receiver operating characteristic curve (AUC). Results : Of the patients, 14 (9.0%) subsequently developed pressure ulcers. The sensitivity, specificity, positive predictive values, and negative predictive values were 78.6%, 75.9%, 24.4%, and 97.3%, respectively, for the Braden scale (cut-off point of 12); 85.7%, 68.8%, 21.4%, and 98.0%, respectively, for the Cubbin & Jackson scale (cut-off point of 26); and 71.4%, 87.2%, 35.7%, and 96.9%, respectively, for the Waterlow scale (cut-off point of 18). The AUCs were 0.88 (Waterlow), 0.86 (Braden), and 0.85 (Cubbin & Jackson). Conclusion : The findings indicate that the predictive validity values of the Waterlow, Braden, and Cubbin & Jackson scales were similarly high. However, further studies need to also consider clinical usefulness of the scales.

• 중환자간호학회지
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• 제17권1호
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• pp.57-67
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• 2024

Purpose : The purpose of this study was to identify factors influencing the clinical competence of nursing students. Methods : The participants of this study were 209 nursing students who were in 3rd and 4th grade. The collected data were analyzed using one-way ANOVA, Kruskal-Wallis test, Mann-Whitney test, Pearson's correlation coefficients, and stepwise multiple regression. Results : Clinical competence had positive relationships with self-leadership (r=.59, p <.001) and resilience (r=.64, p <.001). Clinical competence was influenced by resilience (𝛽=.45), self-leadership (𝛽=.20), and grade (𝛽=.20), with an explanatory power of 44.9%. Conclusions : Based on these results, it is suggested that future nursing education should develop a curriculum that enhances students' personal abilities such as self-leadership and resilience, rather than only teaching knowledge and skills.