• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권3호
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• pp.37-45
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• 2015

Purpose: The main objective of this paper is, to evaluate the unit design for patient-centered care and to draw lessons-learned for further improvement. Methods: This study conducted a case study of the intensive care unit, designed to fulfill patient-centered care in the US. It evaluated the effectiveness of the unit by incorporating several study methods such as plan analyses, direct observations through nursing tracking and behavior mapping, and focus group interviews. Results: The major design decision made in this patient-centered unit was the use of patient rooms with designated family areas and distributed nursing stations. Both design features appeared to be a success on a variety of research metrics and outcomes. The study identified that the patient rooms ultimately help family members to spent more time with their loved ones, which leads to increased satisfaction of family members and nurses also report that they generally enjoy the distributed nurses' stations, which provide a comfortable environment to complete their regular lines of work such as charting, monitoring patients, and collaborating with their colleagues. Implications: Certain design features in intensive care units such as patient rooms with designated family areas and distributed nursing stations could appropriately support hospitals to fulfill patient-centered care.

• 한국콘텐츠학회논문지
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• 제16권12호
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• pp.468-479
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• 2016

본 연구는 중환자 첫 발열 평가 가이드라인에 대한 간호사의 지식과 수행 정도를 확인하고자 수행된 연구이다. 대상자는 2개 병원 내 외과병동 및 중환자실에서 근무하는 총 145명의 간호사를 대상으로 하였다. 자료 분석은 SPSS 19.0 프로그램을 활용하여 분석하였고, 중환자 첫 발열 평가 가이드라인의 지식과 수행의 평균 평점은 각각 0.70점과 3.08점이다. 가이드라인의 근거수준 1영역은 지식과 수행 상위군에서 하위군보다 유의하게 높은 수행 점수를 나타냈고, 근거수준 3영역은 지식 상위군보다 지식 하위군이 더 높은 수행 점수를 나타냈다. 대상자의 가이드라인에 대한 지식과 수행은 유의한 상관관계를 나타냈다. 결론적으로 본 연구는 중환자 첫 발열 평가 가이드라인에 대한 간호사의 지식과 수행력을 향상시키고 근거기반실무를 개선시킬 필요가 있음을 제시하였다.

• 중환자간호학회지
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• 제7권2호
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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.

• 중환자간호학회지
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• 제7권2호
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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.

• 중환자간호학회지
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• 제11권3호
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• pp.1-11
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• 2018

Purpose : This study compares experiences of ethical dilemma between nurses working in intensive care units and those in general units under specific situations of treatment decisions and confidentiality. Method : This cross-sectional descriptive study utilizes the self-report survey method. The survey questionnaires were completed by 50 and 52 nurses working in intensive care units and general units, respectively. The instrument, which consisted of 16 items of ethical dilemma situations about treatment decision and confidentiality, was used. The mean scores for each item were compared between the two groups. Results : The study found no differences in terms of age, gender, education level, clinical experience in years, and being educated on healthcare ethics. For 9 out of 16 items, the mean scores of nurses in intensive care units were significantly higher than those of nurses in general units. Conclusions : Nurses in intensive care units experienced ethical dilemmas regarding treatment decisions and confidentiality more often than those in general units. This study emphasizes the need to establish strategies for improving the ethical competence of critical care nurses.

• 중환자간호학회지
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• 제11권3호
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• pp.71-84
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• 2018

Purpose : This study develop a Video Recording-Based Standardized Handoff (VRSH) program at shift change for ward nurses. Methods : The study was conducted in five medical, three surgical, and one comprehensive nursing care service wards affiliated with a secondary general hospital. In this methodological study, the VRSH program was developed between April and December, 2017. It is noted that 65 nurses who were involved in the VRSH program participated in this study. Results : In line with the modified Situation, Background, Assessment, Recommendation tool, the VRSH program consisted of three phases. In the VRSH program, the average time for handoff duration was 3-5 minutes per patient. More than 90% of the ward nurses were satisfied with the VRSH program since it benefited them by reducing overtime work and improving the performance, as well as effective communication, of nurses. The content analysis of nurses' VRSH program experience, revealed three categories and eight sub-categories. Conclusions : This study provides evidence that the VRSH program improves effective nursing performance and, the handoff communication and relationships between nurses. Future studies on large sample sizes and multiple settings are required to substantially evaluate the impact of the VRSH program on clinical outcomes.

• 중환자간호학회지
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• 제14권3호
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• pp.50-61
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• 2021

Purpose : This study aimed to identify the moderating and mediating effects of resilience on the relationship between role conflict and job satisfaction among nurses working in a comprehensive nursing care service ward. Methods : Participants were 130 comprehensive nursing care service ward nurses from four hospitals. Data were collected using structured questionnaires and analyzed by t-test, ANOVA, Scheffe test, Pearson correlation coefficients, and hierarchical multiple regression analysis, using SPSS 25.0. The mediating effect of resilience on the relationship between role conflict and job satisfaction was analyzed using multiple regression analysis according to Baron and Kenny's procedure. Results : Statistically significant negative correlations were found between role conflict and resilience (r=-.25, p<.007) and between role conflict and job satisfaction (r=-.38, p<.001). A significant positive correlation was found between resilience and job satisfaction (r=.54, p<.001). A partial mediating effect of resilience was found between role conflict and job satisfaction (Z=-2.53, p=.012) but no moderating effect was found. Conclusion : To improve the job satisfaction of comprehensive nursing care service ward nurses, interventions for alleviating role conflict and improving resilience as well as evaluations of the two variables are necessary.

• 중환자간호학회지
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• 제14권3호
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• pp.87-98
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• 2021

Purpose : This study aimed to examine the effects of the awareness of patient safety culture, emotional labor, and job stress on patient safety nursing activities by comprehensive nursing care medical service ward nurses. Methods : The participants were 112 nurses from the comprehensive nursing care service wards from six hospitals. Data were collected using structured questionnaires and analyzed using a t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis using SPSS version 20.0. Results : The factors that significantly influenced patient safety nursing activities in the comprehensive nursing care medical service ward nurses included job stress (𝛽=-0.18, p<.032) and awareness of patient safety culture (𝛽=0.54, p<.001). The explanatory power of these factors was 31.0% (F=13.43, p<.001). Conclusion : This study showed that the factors that influenced patient safety management activities of comprehensive nursing care medical service ward nurses included job stress and awareness of patient safety culture.

• 중환자간호학회지
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• 제16권1호
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• pp.44-55
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• 2023

Purpose : This study aims to identify job stress, emotional intelligence, and exhaustion of the nurses in comprehensive nursing service units and then verify the moderating and mediating effects of emotional intelligence on the relationship between job stress and exhaustion. Methods : Participants are 118 nurses working in two general hospitals. The collected data are analyzed using the SPSS WIN 27.0 and AMOS 18.0 programs by assessing frequency and percentage, mean and standard deviation, independent t-test and one-way ANOVA, Scheffé test, Pearson correlation coefficient, and hierarchical multiple regression analysis and bootstrapping. Results : Exhaustion has a statistically significant positive correlation with job stress (r=.40, p <.001) and a statistically significant negative correlation with emotional intelligence (r=-.26, p =.004). A partial mediating effect of emotional intelligence is found between job stress and exhaustion, however, there is no moderating effect. Conclusion : It is expected that to reduce the exhaustion of nurses in comprehensive nursing service units, it is necessary to assess job stress and emotional intelligence, and strengthen emotional intelligence along with job stress intervention.

• Tuberculosis and Respiratory Diseases
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• 제54권3호
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• pp.311-319
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• 2003

연구배경 : B-type natriuretic peptide(BNP)는 주로 심장의 심실에서 분비되는 호르몬으로서 심부전의 진단, 중증도 및 예후와도 연관이 있다고 알려져 있다. 중환자의 경우 급성병색시 심부전이 올수 있는 것으로 알려져있고 이는 환자의 예후와 연관이 있을 가능성이 있다. 그래서 저자들은 우선 이전 심질환의 병력이 없는 중환자들에서 BNP를 측정하여 증가여부를 살펴보고, BNP와 중환자의 중등도 및 예후와의 관련성 여부를 살펴보기로 하였다. 방 법 : 2002년 6월부터 10월까지 본원 중환자실에 입원하였던 환자 중 환자의 중증도와는 관련이 없이 BNP가 증가될 수 있는 울혈성 심부전, 심방 세동, 허혈성 심질환, 신부전 등을 제외한 32명을 대상으로 하였고, 대조군으로는 일반 병동 및 외래 환자 32명을 무작위로 추출하였다. BNP는 Triage B-Type Natriuretic Peptide test를 이용하여 fluorescence immunoassay를 통해 측정하였다. APACHE II score와 APACHE III score 및 중환자실 사망 여부를 추적하였다. 결 과 : 남녀비는 16 : 16이었고, 연령은 $59.2{\pm}20.6$세 였다. BNP는 $186.7{\pm}274.1$ pg/mL으로 정상 대조군의 $19.9{\pm}21.3$ pg/mL 보다 유의하게 높았다. 중환자군에서 BNP 100 pg/mL이상은 14명으로 43.8%였다. APACHE II score는 $16.5{\pm}7.6$이었고, 11명이 사망하였다. BNP값은 APACHE II score및 사망과 유의한 상관 관계를 보였고(r=0.443, p=0.011, r=0.530, p=0.002), 생존군과 사망군 BNP값은 유의한 차이를 보였으나($83.2{\pm}55.8$ pg/mL vs. $384.1{\pm}401.7$ pg/mL ; p=0.033), $PaO_2/FiO_2$와는 상관 관계를 보이지 않았다. 결 론 : BNP는 이전 심질환병력이 없었던 중환자에서 증가되어 있었고, 사망률 및 중증도 점수와도 유의한 상관 관계가 있었다. 따라서 중환자들의 예후를 예측하는데 비침습적이고 빠른 방법으로 도움이 될 가능성이 있다.