• Journal of Korean Critical Care Nursing
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• v.2 no.1
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• pp.26-35
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• 2009

Purpose: This paper reviews current diagnostic evaluation, treatment, nursing considerations, and the nurse practitioner’s (NP) role in acute ischemic stroke care. Methods: National guidelines and extensive literature on acute stroke care were reviewed and a relevant clinical case was introduced. Results: Computerized tomography (CT) of the head without contrast is the initial brain imaging procedure for patients with an acute stroke. Magnetic resonance imaging (MRI) can be an alternative test. Restoration of cerebral perfusion to the affected area is a key therapeutic strategy for ischemic stroke. A number of treatment strategies such as thrombolysis, anticoagulation, antiplatelet, and surgical treatment can be selected to improve blood flow to the ischemic region. The NP on the stroke team is involved with immediate stroke management including neurological assessment, ensuring adequate oxygenation, blood pressure management, activity, and diet. Discharge planning with the patient, family teaching and coordination of follow up care should also be implemented early in the hospitalization. Conclusion: The nurse practitioner is one of the cardinal members on the stroke team, and must be updated with current treatment and management guidelines.

• Journal of Korean Critical Care Nursing
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• v.7 no.2
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• pp.14-23
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• 2014

Purpose: The purpose of this study was to provide basic information to develop appropriate nursing guidelines for cardiac telemetry. Methods: This retrospective research was conducted to identify the current usage of cardiac telemetry and considered 1,000 patients hospitalized for telemetry. The collected data were analyzed using IBM (SPSS Statistics for Windows 21.0). Results: Four-hundred and ninety-two patients (49.2%) were diagnosed with arrhythmia and 209 (20.9%) with heart failure. Electrocardiogram (ECG) rhythm changes were detected via telemetry in 464 cases. Major arrhythmias were ventricular tachycardia (183, 39.4%) and bradycardia (99, 21.3%). Interventions after detecting arrhythmia were cardioversion (16, 3.4%), defibrillation (1, 0.2%), and cardiopulmonary cerebral resuscitation (5, 1.1%); other patients were treated conservatively with close observation (381, 82.1%). Conclusion: There was appropriate intervention in 46.4% of the considered cases with the detection of ECG changes before patient notification, which implied that cardiac telemetry could be considered for application to patients with hemodynamic instability. Clear standards and guidelines are required to determine who requires telemetry and when to end the telemetry monitoring.

• Journal of Korean Critical Care Nursing
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• v.7 no.2
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• pp.1-13
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• 2014

Purpose: The purpose of this study was to determine the difference in reported discharge learning needs between nurses and liver transplantation (LT) patients. Methods: The participants of this study were 40 patients discharged after LT at P University Hospital in Y City and 42 nurses in intensive care units and the ward. The data were collected for two months from December 1, 2012, to January 31, 2013, and were analyzed using descriptive statistics, Student's t-test and analysis of variance (ANOVA). Results: Patients earning a low income (p=.041), having no experience of hospitalization after LT (p=.023), and receiving information about LT from nurses (p=.003) indicated higher discharge learning needs. Among the items evaluated regarding discharge learning needs, "rejection symptoms or signs" were regarded to be more important by nurses than LT patients (p=.038). However, "management of other diseases after LT" (p=.003), "risk of recurrence" (p=.001), "food choices" (p<.001), "obesity prevention" (p=.020), "amount of exercise" (p=.007), and "ways to receive financial help"(p=.033), were thought to be more important by LT patients than nurses. Conclusion: There exist differences between LT patients and nurses with respect to their perceptions of LT discharge learning needs. Therefore, an individualized education program reflecting patients' conditions and learning needs rather than providing information uniformly needs to be developed.

• Journal of Korean Critical Care Nursing
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• v.7 no.2
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• pp.34-44
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• 2014

Purpose: The purpose of this study was to determine the factors related to airway failure during endotracheal intubation among patients with and without predicted airway difficulty. Methods: Medical records were examined retrospectively. 329 patients who were admitted to the general ward and underwent endotracheal intubation were included. The incidence of airway failure in the two groups was investigated. Results: The group predicted to have airway difficulty consisted of 79 patients (24.0%) and the group without airway difficulty, 250 (76.0%). The number of cases of airway failure was 50 (15.2%). The factors that were associated with airway failure in the group with predicted airway difficulty were the jaw relaxation score, Cormack-Lehane score, and the device of the first endotracheal intubation attempt. The factors that were associated with the airway failure in the group predicted not to have airway difficulty were the induction agent, jaw relaxation score, Cormack-Lehane score, level of training of the personnel with the first endotracheal intubation success, and the device of the first endotracheal intubation attempt. Conclusion: The prediction of airway difficulty during endotracheal intubation was not effective; however, it was meaningful from the perspective of patient safety.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.31-40
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• 2017

Purpose: The purpose of this study was to identify the factors influencing on burnout in operating room nurses. Methods: Using a cross-sectional design, a total of 109 operating room nurses working at 7 general hospitals with 300 beds or more in B city were analyzed. The instruments used for this study assessed job stress, resilience, professional identity, and burnout. Data was analyzed using descriptive statistics, a t-test, an ANOVA, a Pearson's correlation coefficient and a multiple regression analysis. Results: There was a statistically significant correlation between burnout and job stress (r=.53, p<.001), resilience (r=-.59, p<.001), and professional identity (r=-.47, p<.001). The factors influencing burnout include job stress (${\beta}=.27$, p<.001), resilience(${\beta}=-.37$, p<.001), dissatisfaction with the nursing job (${\beta}=.32$, p<.001), and moderate satisfaction with the nursing job (${\beta}=.19$, p=.014), and the explanatory power was 53.0%. Conclusions: The results suggest that intervention to reduce job stress and to improve resilience, which were the factors influencing burnout in operating room nurses, is necessary.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.41-50
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• 2017

Purpose: The purpose of this study was to describe what critical care nurses perceived about life-sustaining treatment at end of life. Methods: A qualitative content analysis method was utilized. The unit of analysis was interview text obtained from fifty critical care nurses of a general hospital. Results: Seven categories in two content areas were abstracted. In the negative perception area, the following five categories were abstracted: patients' suffering, dying with damaged dignity, patients' isolation from family members, regret about choosing life-sustaining treatment, and family members' burden. In the positive perception area, the following two categories were abstracted: willingness to sustain life and duty as family members. Conclusions: Nurses have better competencies pertaining to understanding patients' responses and suffering than any other health care professions do. Nurses should play an important role in advocating for patients and their family in the process of end-of-life care decision making.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.63-74
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• 2017

Purpose: The purpose of this study was to examine the effect of professional autonomy, organizational commitment, and perceived patient safety culture on patient safety management activities of nurses in medium and small-sized hospitals. Methods: A cross-sectional design was employed. Self-reported questionnaires were completed by 121 nurses with at least 3 months of working experience in medium and small-sized hospitals located in B city. Data were analyzed using descriptive statistics, a t-test, a one-way ANOVA, Pearson correlation coefficients, and a multiple regression analysis. Results: Professional autonomy (r=.22, p=.016), organizational commitment (r=.34, p<.001), and perceived patient safety culture (r=.55, p<.001) had a statistically significant positive correlation with patient safety management activities. The factors that might affect patient safety management activities were professional autonomy (${\beta}=.23$, p=.003) and perceived patient safety culture (${\beta}=.55$, p<.001). The explanatory power of these factors for patient safety management activities was 33.5% (F=21.19, p<.001). Conclusions: The development of repetitive and continuous education programs is needed to improve a nurse's professional autonomy and perceived patient safety culture.

• Journal of Korean Critical Care Nursing
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• v.10 no.2
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• pp.1-13
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• 2017

Purpose: This study investigated the effects that the use of a booklet for intensive care unit nurses had on radiation safety management education (knowledge about and behaviors in radiation safety management, and awareness of anxiety caused by radiation hazards). Methods: A randomized control group pretest-posttest design was used. A booklet about radiation safety management developed by the authors was used as educational material. Participants (N=42) were intensive care unit nurses of P hospital in B city. Training was provided to the experimental group (N=21). Knowledge about and behaviors in radiation safety management and awareness of anxiety caused by radiation hazards were measured by questionnaires before and after the intervention. Data was analyzed by an $X^2$-test, non-paired t-test, and paired t-test. Results: There was a significant difference between groups in knowledge of (t=-14.932, p<.001) and behaviors in (t=-8.297, p<.001) radiation safety management and awareness of anxiety caused by radiation hazards (t=9.378, p<.001). Conclusion: The levels of knowledge about and behaviors in radiation safety management and awareness of anxiety generated by radiation hazards of intensive care unit nurses increased after receiving one session of radiation safety management education using the booklet. Therefore, providing radiation safety management training is suggested as an effective strategy for improving radiation safety management.

• Journal of Korean Critical Care Nursing
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• v.10 no.2
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• pp.45-55
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• 2017

Purpose: This study was intended to standardize the Kangaroo care protocol for fathers, and to determine the effect of fathers' Kangaroo care experience on paternal attachment. Methods: The data was collected from February to April, 2013. The study subjects were 34 fathers (17 experimental group subjects, 17 control group subjects) of premature babies, bornatatertiaryhospitalinSeoul, who agreed to participate . The standardized Kangaroo care protocol, which consisted of at least three 60-minutes sessions during the hospitalization period in a neonatal intensive care unit, was carried out with the experimental group. The data was analyzed by a $x^2$-test and Mann-Whitney U test. Results: The results were as follows: 1) There were no between-group differences in the general characteristics of babies and their fathers. 2) The Kangaroo care fathers showed higher scores of paternal attachment than the control group (Z=-3.657, p=0.008). Conclusion: Fathers who attended the Kangaroo care sessions showed stronger paternal attachment than those who did not. Therefore, use of a Kangaroo care program for fathers of premature babies at neonatal intensive care units is recommended.

• Journal of Korean Critical Care Nursing
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• v.10 no.2
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• pp.14-23
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• 2017

Purpose: The purpose of this study was to evaluate the effectiveness of a ventilator-associated pneumonia (VAP) bundle. Methods: This was a retrospective study that was carried out between June 2010 and October 2015. In this study, 3,224 intubated patients were included. The VAP bundle which was applied to Group 1 patients (n=470) included head-of-bed elevation to 30 degrees, cuff pressure monitorization, prophylaxis of peptic ulcer, and prophylaxis of deep vein thrombosis. The VAP bundle for Group 2 patients (n=1,914) included all the elements of the VAP bundle for Group 1 patients and one additional element which was oral care with 0.12% chlorhexidine. The VAP bundle for Group 3 patients (n=870) added sedative interruption and assessment of readiness to extubate to the VAP bundle for Group 2. Results: The numbers and incidences of VAP were significantly different among the three groups. Moreover, there were significant differences among groups in ICU length of stay and mortality. Conclusion: Three different VAP prevention bundles made different effects in patient outcomes.