• Journal of Nutrition and Health
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• v.54 no.5
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• pp.489-500
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• 2021

Purpose: This study aimed at investigating the nutritional status, nutritional support, and nutritional indicators of critically ill patients on extracorporeal membrane oxygen (ECMO) in intensive care units (ICU). Methods: This descriptive study obtained data from the medical records of 37 patients who were treated using ECMO at a university hospital in Korea. The patients were admitted to the Korea University Anam Hospital ICU with acute or serious damage to vital organs from January 1, 2014 to June 30, 2016. Results: Although 32 patients (86.5%) were at a high risk of malnutrition, 26 patients (70.3%) were considered normal in terms of nutritional status by the nutritionist at the beginning of their ICU stay. However, after two weeks, nine patients had passed away and only one patient maintained normal status. Parenteral nutrition was started first but took 4.25 ± 6.95 days till initiation. Only eight patients (21.6%) were able to meet their requirement for both calories and protein. The group provided with adequate calorie and protein showed significantly longer use of the ECMO and respirator and longer ICU and total hospital stay than their counterparts. Normal levels of serum albumin and protein of the group at low-risk for malnutrition on the day of initiation of ECMO, which were significantly higher than the high-risk group, declined by the last day of ECMO leading to a lack of significant differences between the two groups. Conclusion: Considering that the nutritional indicators of patients deteriorated as the days on ECMO increased, more aggressive nutritional management to ensure adequate nutritional support should be emphasized from the beginning and throughout the ICU stay.

• Journal of Korean Academy of Nursing
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• v.42 no.1
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• pp.76-84
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• 2012

Purpose: The purpose of this methodological study was to examine the reliability and validity of a translated Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: A cross-sectional study design was used. Data were collected from a convenience sample of 202 critically ill patients admitted to a university hospital. Upon establishment of content and translation equivalence between the English and Korean version of CPOT, psychometric properties were evaluated. Results: The interrater reliability was found to be acceptable with the weighted kappa coefficients of .81-.88. Significant high correlations between the CPOT and the Checklist of Nonverbal Pain Indicators were found indicating good concurrent validity (r=.72-.83, p<.001). Data showed the area under the ROC curve of 0.86 with a cut-off point of 1, which resulted in 76.9% sensitivity and 88.6% specificity. The mean score of CPOT during suctioning was significantly different from that of before (t= -14.16, p<.001) or 20 minutes after suctioning (t=16.31, p<.001). Conclusion: Results of this study suggest that the CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal patients.

• Korean Journal of Adult Nursing
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• v.15 no.2
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• pp.267-277
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• 2003

Purpose: The purpose of this study was to evaluate the applicability of braden scale to assess pressure ulcer risk patients and to identify additional risk factors of pressure sores in an neurologic intensive care unit. Method: The subjects of this study were 66 patients in neurologic intensive care units. Data was prospectively collected from Sep. to Dec., 2002. Data were analyzed by mean, percentage, t-test, chi-square, discriminant analysis using Spss pc+. Result: The results of this study were as follows: 1) There was a significant difference between scoring of braden scale and pressure ulcer development. The subscales that predicted pressure ulcer development using braden scale only were sensory perception, moisture, mobility, friction & shear. By using these subscales, sensitivity was 86.7%, and specificity was 61.1%, and total hit ratio was 72.7%. 2) Additional pressure ulcer risk factors which showed significance for discriminating two group were protein, albumin, gender, level of consciousness, pattern of bowel elimination. By using the combination of these additional risk factors in addition to the braden scale, total hit ratio increased to 84.8%. Conclusion: This data suggest that albumin, protein, gender, level of consciousness, pattern of bowel elimination in addition to the braden scale should be included in the pressure sore assessment tool.

• Korean Journal of Adult Nursing
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• v.25 no.4
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• pp.444-453
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• 2013

Purpose: The purpose of this study was to describe the differences between early and delayed enteral nutrition on nutritional intake. Methods: A pilot cohort study was conducted with 45 critically ill adult patients who had a primary medical diagnosis. Energy prescribed and received were collected during the four days after initiation of enteral nutrition. Adequate feeding was defined as the energy intake more than 90% of required energy. Results: A total of 23 patients (52%) were received early enteral nutrition (within 48 hours of admission). Energy intake of early enteral nutrition was less than intake of delayed enteral nutrition during the four days of the study. Although the difference on day one was significantly greater than the differences on day two, the differences on day two were not different from days three or four. No statistical differences in the adequacy of nutritional intake were found between patients in the early and the delayed group. Conclusion: In critically ill patients receiving early enteral nutrition, more aggressive administration from the beginning will improve the nutritional intake. Additional studies including a large multi-centre, randomized clinical trial are recommended.

• Journal of Korean Critical Care Nursing
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• v.10 no.3
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• pp.53-64
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• 2017

Purpose : This study investigated the effects of active warming using a Warm Touch warming system or a cotton blanket in postoperative patients after general anesthesia for abdominal surgery. Methods : This quasi-experimental study utilized two experimental groups and one control group: a cotton-blanket group (n = 25) were warmed with a cotton blanket and a sheet; a forced-air warming group (n = 24) were warmed with a Warm Touch warming system, a cotton blanket, and a sheet; and a control group (n = 25) were warmed with a sheet. Measurement variables were postoperative pain, body temperature, and thermal discomfort. Data were analyzed using a one-way ANOVA, ${\chi}^2-tests$, Fisher's exact test, and a repeated measures ANOVA. Results : The effects of active warming using a Warm Touch warming system and a cotton blanket on postoperative patients was significant in reducing pain (F = 13.91, p < .001) and increasing body temperature (F = 12.49, p < .001). Conclusion : Active warming made a significant difference in pain and body temperature changes. Active warming methods may help patients' postoperative recovery and prevent complications. Further research is needed to explore the effects and side effects of active warming on recovering normothermia.

• Journal of muscle and joint health
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• v.19 no.2
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• pp.173-183
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• 2012

Purpose: The purpose of this study was to analyze nursing records for pain management in intensive care unit (ICU) patients. Methods: Nursing process for pain management were analyzed retrospectively by 180 ICU patients' nursing records. Instruments consisted of 3 questionnaires (pain assessment, intervention, and evaluation). Results: For assessment, there was different pain intensity between cancer patients (7.95) and non-cancer patients (7.20). Also pain intensity was lower in PCA group (5.08) than in PCA with PRN group (8.27). Common pain site was surgical areas, along with 17 kinds of words expressed for pain, and mean of pain intensity was 7.47 by numeric rating scales (NRS). For intervention, the patients received pharmacologic interventions (99.4%) such as narcotic analgesics (38.3%) intermittently (70.5%) without side effects (94.4%). For evaluation, mean of pain intensity was decreased to 3.14, but a few patients (12.8%) experienced pain over 5 points despite the intervention. Nurses evaluated the degree of pain relief after the intervention in 87.2% of patients. Conclusion: Nurses do assess patients' pain by using objective tool, intervene, and evaluate for effective pain management. Nurses should make an individual approach and record all nursing activities for pain management.

• Journal of Korean Academy of Nursing
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• v.42 no.5
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• pp.730-737
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• 2012

Purpose: This study was done to identify the time interval to pressure ulcer and to determine the optimal time interval for position change depending on pressure ulcer risk in patients using foam mattress in intensive care units. Methods: The Braden scale score, occurrence of pressure ulcers and position change intervals were assessed with 56 patients admitted to an intensive care unit from April to November, 2011. The time to pressure ulcer occurrence by Braden scale risk group was analyzed with Kaplan-Meier survival analysis and log rank test. Then, the optimal time interval for position change was calculated with ROC curve. Results: The median time to pressure ulcer occurrence was 5 hours at mild or moderate risk, 3.5 hours at high risk and 3 hours at very high risk on the Braden scale. The optimal time interval for position change was 3 hours at mild and moderate risk, 2 hours at high and very high risk of Braden scale. Conclusion: When foam mattresses are used a slight extension of the time interval for position change can be considered for the patients with mild or moderate pressure ulcer risk but not for patients with high or very high pressure ulcer risk by Braden scale.

• Korean Journal of Adult Nursing
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• v.26 no.6
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• pp.621-629
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• 2014

Purpose: The purpose of this study was to investigate the nutritional support, gastric residual volume, and nutritional status of the intensive care unit (ICU) patients on enteral feeding. Methods: A descriptive longitudinal design was used to collect 5 day data on enteral nutrition of 52 ICU patients in an university hospital. Nutritional support was calculated with actual caloric intake compared to individual caloric requirement. Residual volumes were measured prior to routine feedings, and the serum albumin levels and the total lymphocyte counts were checked to evaluate nutritional status. The data were analyzed using one group repeated measures ANOVA, paired t-test, and Spearman's bivariate correlation analysis. Results: The subjects received their first enteral feeding on the $5.75^{th}$ day of ICU admission. The mean nutritional support rate was 49.1% of the requirement, however prescription rate and support rate were increased as time goes by. Gastric residual volumes were less than 10 cc in 95% cases. A significant negative correlation was found between nutritional support and nutritional status. Conclusion: The nutritional support for ICU patient was low compared to the requirement, and their nutritional status was worse than at the time of ICU admission. Further studies are necessary to develop nursing interventions for improving nutritional support for ICU patients.

• Journal of Korean Critical Care Nursing
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• v.6 no.1
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• pp.11-20
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• 2013

Purpose: This study to describe experiences of nurses who work in intensive care units (ICUs) where they frequently encounter patients with attempted suicide by drug ingestion. Methods: Data were collected by 2 focus group interviews with 9 ICU nurses. The interview were recorded and transcribed, and data were analyzed using qualitative content analysis. Results: The results of data analysis, five themes were drawn: 'Confusion about for the attempted suicidal patient care', 'Helplessness for dying with attempted suicidal patients', 'Guilty for insufficient care', 'Ambivalence for the attempted suicidal patients', 'Recognition of need for professional approach'. Conclusion: The results of this study help us to understand patients who attempted suicide through the ICU nurses' experience. It would be useful to develop effective education programs for ICU nurses to preventive strategies for patients who are high risk of recurrence of suicidal crisis situation.

• Journal of Korean Critical Care Nursing
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• v.8 no.1
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• pp.1-10
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• 2015

This study was conducted to examine the relationship among the error risk of high-alert medication, attitudes to single-person checking of medication, and medication safety activities. The participants were 60 nurses working in the intensive care unit. Data were analyzed using descriptive analysis, t-test, analysis of variance, and Pearson's correlation coefficient. The mean scores of the knowledge and certainty of high-alert medication were $0.71{\pm}0.11$ and $2.74{\pm}0.59$, respectively. The mean score of the error risk of high-alert medication was $1.63{\pm}0.24$ and that of attitudes to single checking medication was $3.32{\pm}0.49$. The error risk of high-alert medication had a positive correlation with nurses' attitudes to single checking medication (r = .258, p = .047), which is correlated with the scores for certainty of knowledge (r = .284, p = .028). Based on the results of this study, continuing education for high-alert medication and the development of an accurate protocol for single checking medication are needed to improve the stability of high-alert medication.