• Journal of Korean Critical Care Nursing
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• v.4 no.1
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• pp.11-24
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• 2011

Purpose: The purpose of this study was to grasp the subjectivity of the nurses toward DNR (Do not resuscitation) order. Methods: Q methodology was employed to explore the nurses' subjectivity. Q population consisted of 292 statements that were obtained through individual in-depth interviews targeting 30 employees(nurses, doctors, staff members) and literature review. Finally, 30 nurses classified 34 statements using a 9 point scale. Results: The current survey that probed into the subjectivity of the nurses relative to DNR order abstracted four categories. The first type (restrictive acceptance type) perceived the determinants of DNR as the patient's hopeless state. The second type (evidence-based type) emphasized the decision based on the guideline. The third type (medical personnel-centered type) showed the characteristic that depends passively on the professional judgement. The fourth type (rationalistic type) emphasized rational characteristic that DNR decision needs to be made by considering several situations such as economic and psychological burden of family and the quality of life. Conclusion: These types of nurse's perception need to be considered in the nurses' continuing educational program in order to confront affirmatively and positively with ethical dilemma.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.77-90
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• 2010

Purpose: The aim of this study is to carry out research on nurses regarding end of life decision and advance directives (ADs) and their attitude, experience and confidence towards them in order to define the role of nurses. Methods: In this research, questionnaire was distributed and data were collected and analyzed after receiving a written consent from 332 nurses. The survey was conducted from the $14^{th}$ to $30^{th}$ of September, 2009. The instrument used for conducting the study was revised version of KAESAD (The Knowledge, Attitudinal, Experiential Survey on Advance Directives). Results: We have come to a conclusion that nurses have positive attitude towards ADs. However, they hardly had any experience regarding them which leads to low confidence in assisting preparing ADs. Also, attitude towards ADs had no correlation with experience and confidence. Conclusion: In order to bring about the confidence level from positive attitude that nurses have, there needs to be a systematic change in nursing education. For that, it requires an education system that emphasizes the role of nurses which incorporates Korean culture and characteristics regarding death issue.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.49-59
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• 2010

Purpose: The purpose of this study was to investigate in-service education needs in order to develop clinical competence of critical care nurses', and to identify contents which have to include in-service education according to nurses' characteristics. Methods: Data was collected using Critical Care Nurse Job Analysis Tool that was modified by professional team. Collected data was analyzed using the SPSS program. Results: Total 148 critical care nurses, who had worked at adult intensive care unit of one tertiary hospital in Seoul, filled out questionnaire. The results showed the participants highly needed education about cardiological nursing practices such as ECMO, pacemaker, cardiac tamponade. And there were significant correlations among in-service educational needs and ICU careers, preceptors experience, and charge nurse experience. Conclusion: It will be necessary for better nursing to develop in-service education is based on critical care nurse's need and their characteristics. Especially, it is important to develop and provide in-service education programs, which consider ICU nurse's differences for their career ladder and nursing preceptors.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.13-22
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• 2010

Purpose: This study was intended to examine the effects of educating the Ventilator-Associated Pneumonia (VAP) control for the nurses working in the intensive care unit (ICU). Methods: The study was conducted using one group pre-post test research design. The education on infection control was provided to 31 nurses working at the medical and surgical ICUs. A comparison was then made in terms of the degree of performing infection control a month before, two weeks after, and three months after the education respectively. The incidences of VAP at the medical and surgical ICUs were compared for 3 months before and after the education. Results: The average performance scores between before and after the education showed statistically significant differences. Compared to three months before, the incidence of VAP after the education was decreased slightly from 5.48 to 1.88 per 1,000 ventilator days. Conclusion: It is necessary to continue the VAP education, specifically on infection prevention and control methods and the consistent evaluation of its effects as well as the development of standardized educational program should be approached extensively in further studies.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.1-11
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• 2010

Purpose: This study was designed to identify the factors affecting healing of Stage 2 pressure ulcer in an acute care facility in Korea. Methods: 286 Stage 2 pressure ulcers of 145 patients were examined. Data were collected in the period between October $1^{st}$, 2006 and September $30^{th}$, 2007. Data were analyzed with Kaplan-Meier survival analysis for cumulative recovery rate of Stage 2 pressure ulcers. Cox proportional hazard model was used to examine effects of multiple variables simultaneously. Results: Out of 286 initial Stage 2 pressure ulcers, 204 (71.3%) pressure ulcers healed completely. The median time to heal was 15 days according to Kaplan-Meier survival analysis. Cox proportional hazard model showed that the Stage 2 pressure ulcers healed more quickly when pressure redistribution surfaces were used (p<.001, HR=2.184), patients were administered with vitamins (p= .038, HR=1.451), and the size of the pressure ulcers were small (${\leq}3.0cm^2$, p= .006, HR=1.765). Conclusion: The factors contributing to the healing of Stage 2 pressure ulcer in an acute care setting were the application of pressure redistribution surface, small ulcer size (${\leq}3.0cm^2$), and the administration of vitamins.

• Journal of Korean Critical Care Nursing
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• v.1 no.1
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• pp.19-31
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• 2008

Purpose: This study was conducted to exam the effects of the Abbreviated Cognitive Behavioral Therapy(ACBT) on chronic insomnia. Methods: Study was one-group interrupted time series study that involved 13 adults(mean age=51.7, aged 25-77 years) with chronic primary insomnia who visited sleep disorder clinic of S Hospital from November 2004 to October 2005. The subjects received 2-session individual ACBT with 2 week-interval($1^{st}$: 1.5- 2hrs, $2^{nd}$: 20-30min). To measure the subjective insomnia severity and sleep patterns, 3 times of insomnia severity index and sleep logs were completed(before ACBT, after ACBT, and 3-month after ACBT). The main outcomes were subjective insomnia severity and sleep patterns(sleep onset latency, waking after sleep onset, and total sleep time, sleep efficiency). The data were analyzed with SPSS 10.0 version program by Friedman test, Wilcoxon signed rank test with Bonferroni correction. Results: There were statistically significant decrease in insomnia severity index, sleep onset latency, and waking after sleep onset, and increase total sleep time and sleep efficiency. Conclusion: ACBT was effective in reducing subjective insomnia severity and improving sleep patterns. Sleep improvement was better sustained over time with ACBT.

• Journal of Korean Critical Care Nursing
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• v.1 no.1
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• pp.33-45
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• 2008

Purpose: Patients who underwent a coronary artery bypass graft surgery(CABG) experienced the unpleasant emotions and discomfort when their chest tube was removed. The purpose of this study was to evaluate the effects of cold therapy on pain related to chest tube removal(CTR) in CABG patients. Methods: Fifty adult patients undergoing CABG were recruited in a prospective, double blinded study. Subjects were divided into the experimental group and the control group considering their sex and age. The pretest data were obtained 20 minutes before CTR. Patients in the experimental group, received cold therapy for 10 minutes before CTR. Pain sense and intensity were determined immediately after CTR and at 10 minutes after CTR. Results: The total score of pain sense immediately after CTR of the experimental group was significantly lower than that of the control group(t=-3.703, p=.003). And scores of pain intensity immediately after CTR in the experimental group were significantly lower than that of the control group(t=-3.073, p=.001). But, there was no significant difference in the score of pain intensity 10 minutes after CTR between the experimental and the control group(t=1.759, p=.085). Conclusion: The cold therapy would be recommended as an effective and nonpharmacologic nursing intervention for relieving pain in patients undergoing CTR.

• Journal of Korean Critical Care Nursing
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• v.1 no.1
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• pp.59-71
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• 2008

Purpose: This study was to identify the effects of simulation-based training for advanced cardic life support on the competence of nurses in critical care settings. Methods: In this study, a nonequivalent control pretest-post test quasi-experimental design was used. Data were collected from May 1 to June 1, 2006 at one general hospital in W city. Among 40 nurses in critical care settings, twenty were assigned to the experimental group and twenty to the control group. Nurses in the experimental group received simulation-based training for advanced cardiac life support. Measurement tool were ACLS related knowledge and skills developed by AHA & Mega Code (2005) and some items were modified. The collected data were statistically processed using SPSS version 12.0 for Windows, and analyzed using descriptive statistics, $X^2$test, t-test, paired ttest, Pearson correlation coefficients. Results: 1) Hypothesis 1“: Nurses who received simulationbased training would have more knowledge of advanced cardiac life support than nurses who received traditional training”, was supported (t=11.51, p=.00). 2) Hypothesis 2: “Nurses who received simulation-based training would have better advanced cardiac life support skills than nurses who received traditional training”, was supported (t=2.38, p=.00). Conclusion: Simulation-based training for advanced cardiac life support is an effective strategy for increasing the competence of nurses in advanced cardiac life support in critical care settings.

• Journal of Korean Critical Care Nursing
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• v.1 no.1
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• pp.85-97
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• 2008

Purpose: This study was done to identify the level of knowledge and competence of nurses with regard to cardiopulmonary resuscitation. Methods: The participants were 360 nurses who worked in 3 general hospitals affiliated with universities in K-province. The study was done in May and June, 2005. Analysis was done using SPSS 12.0 and descriptive statistics, t test, ANOVA, Pearson’s correlation coefficients, and multiple regression were used to analyze the data. Results: The results showed that nurses’knowledge and competence levels vary. Mean scores for knowledge were 19.64. Using a score of 1, the mean was 0.65. Mean scores for competence were 96.29. Using a score of 5, the mean was 3.57. Correlation between total knowledge and total competence was r=.49 (p=.00). Conclusion: Lack of knowledge and low competence in nurses should be addressed in cardiopulmonary resuscitation education programs. For more effective education, the type of education should not be limited to lectures only, but should include both lectures and practice. As knowledge and competence were affected by work experience, it is important to provide nurses not only with knowledge but with work experience to increase levels of knowledge and competence in cardiopulmonary resuscitation.

• Journal of Korean Critical Care Nursing
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• v.7 no.1
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• pp.1-10
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• 2014

Purpose: The purpose of this study was developing a nasogastric tube feeding algorithm to prevent aspiration pneumonia. Methods: The algorithm was developed through a methodological design. First, a pilot study was performed to determine the incidence of pneumonia. The second step was development of a preliminary algorithm through a literature review and collection of nurse opinions. The third step was to establish content validity using a panel of 12 experts. The fourth step was revision of the algorithm. Next, 20 intensive care unit nurses applied the revised algorithm for six months to their actual treatment, and the practical feasibility was verified after that. Results: In the patients for whom this algorithm was applied, no cases of pneumonia occurred. The algorithm that was developed by the present author was suitable for clinical application. Conclusion: The effect and practical feasibility of the algorithm was tested with a few patients in this study. The effect of this algorithm should be examined by applying it to more patients on an ongoing basis.