• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.14 no.1
• /
• pp.53-61
• /
• 2007

Purpose: The purpose of this study was to investigate the effects of an information protocol for anxiety and nursing satisfaction of family caregivers. The caregivers were caring for a family member who had a CVA (cerebrovascular accident) and who had been admitted to the ICU (intensive care unit). Method: The research design was a non-equivalent control group non-synchronized design. Data were collected from April 1 to October 31, 2005 at D hospital in Busan City The participants were 40 family caregivers of patients with a CVA admitted to the ICU. Caregivers in the experimental group participated in the information protocol for 30 min. Both groups were pre-tested before the intervention for two variables, anxiety and nursing needs. The post-test of both groups included anxiety and nursing satisfaction. The instruments used in this study were the Spielberger's state anxiety inventory (1976) and the nursing satisfaction scale developed by Molter (1979). Results: Anxiety scores were significantly lower and nursing satisfaction scores were significantly higher for caregivers in the experimental group compared to those in the control group. Conclusion: The information protocol was effective in reducing anxiety and increasing the level of nursing satisfaction of family caregivers caring for an ICU patients with a CVA.

• Journal of Korean Critical Care Nursing
• /
• v.14 no.3
• /
• pp.128-140
• /
• 2021

Purpose : This study aimed to identify the incidence of peripheral cyanosis and the characteristics and clinical results of patients with therapeutic hypothermia after a cardiac arrest. Methods : Data were collected from April to June 2021 via the electrical medical records of 95 patients with therapeutic hypothermia for 72 hours after a cardiac arrest admitted to an acute care unit at a tertiary hospital between January 1, 2016, and December 31, 2019. The data were analyzed using descriptive statistics and a t-test, Mann-Whitney U test, Chi-squared test, Fisher's exact test, and logistic regression using SPSS/WIN. Results : The incidence of peripheral cyanosis was 20%. In the peripheral cyanosis group, peripheral vascular disease, fibrinogen, vasopressor, infection, disseminated intravascular coagulation, acute physiology, chronic health evaluation II score on the second hospital day, nursing intervention, and mortality on the seventh hospital day were higher. The level of fibrinogen and use of vasopressors affected the occurrence of peripheral cyanosis. Conclusion : Considering the influencing variables, careful observation is necessary for patients with high fibrinogen levels and vasopressor use. These results provide basic data to recognize the need for nursing intervention for peripheral cyanosis and encourage nurses to deliver them during therapeutic hypothermia.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.15 no.1
• /
• pp.34-44
• /
• 2008

Purpose: The purpose of this study was to develop an eye care protocol for intensive care unit (ICU) patients. Method: A systematic review was conducted to develop an eye care protocol for ICU patients. Searches were performed using computerized databases (CINAHL, MEDLINE, EBM Review) and citation search from 1996 to January 2007. For the keywords, "eye care", and "randomized controlled trial" were used to identify experimental studies regarding eye care for ICU patients. After reviewing the collected studies, a preliminary eye care protocol algorithm was created. Then, content validity was examined with ophthalmologists and ICU nurses. Results: Six studies were included to serve as a basis for framing of the preliminary algorithm. The final eye care protocol was completed after verifying the preliminary algorithm's content validity. The final eye care protocol was organized in the following manner: 3 items in the assessment stage, 7 items in the no-risk stage, 4 items in the low-risk stage, and 5 items in the high-risk stage. Conclusion: The results indicate that, for ICU patients, nurses can broaden their knowledge regarding ocular diseases, as well as improve their practice-based eye care nursing performance.

• Korean Journal of Biological Psychiatry
• /
• v.24 no.1
• /
• pp.26-31
• /
• 2017

Objectives A normal circadian rhythm of autonomic nervous system function stands for the daily change of sympathetic and parasympathetic modulation, which can be measured by heart rate variability (HRV). Generally, patients in the intensive care unit (ICU) are prone to sleep-wake cycle dysregulation, therefore, it may have an influence on the circadian rhythm of autonomic nervous system. This study was designed to interpret possible dysregulation of autonomic nervous system in ICU patients by using HRV. Methods HRV was assessed every 3 hours in 21 ICU patients during a 7-minute period. The statistical differences of HRV features between the morning (AM 6 : 00-PM 12 : 00), and the afternoon (PM 12 : 00-PM 18 : 00) periods were evaluated in time domain and frequency domain. Results Patients showed significantly increased normalized power of low frequencey (nLF), absolute power of low frequencey (LF)/absolute power of high frequencey (HF) in the afternoon period as compared to the morning period. However, normalized power of high frequency (nHF) was significantly decreased in the afternoon period. There was no statistically significant difference between the morning period and the afternoon period in the time domain analysis. Conclusions The increased sympathetic tone in the afternoon period supports possible dysregulation in the circadian rhythm of autonomic nervous system in ICU patients. Future studies can help to interpret the association between autonomic dysregulation and negative outcomes of ICU patients.

• Perspectives in Nursing Science
• /
• v.10 no.1
• /
• pp.12-23
• /
• 2013

Purpose: This study was conducted to investigate ICU nurses' perceptions of communication difficulties, the importance of and satisfaction with communication with doctors, other nurses, patients, and family, as well as to explore communication barrier with patient families. Methods: Investigators developed a 15-item communication perception questionnaire and 58-item communication barrier questionnaire. Communication barrier included 4 domains: nurses, family, environment, and patient condition. A total of 151 ICU nurses with a minimum of one year of ICU experience participated. Results: ICU patients ($3.38{\pm}0.73$) were the most difficult group to communicate with, followed by family ($3.32{\pm}0.72$), senior nurses ($3.25{\pm}0.74$), doctors ($3.21{\pm}0.68$), and nurse colleagues ($2.64{\pm}0.73$). Doctors ($4.61{\pm}0.53$) were the most important group to communicate with, followed by nurse colleagues ($4.52{\pm}0.54$), patients ($4.49{\pm}0.58$), senior nurses ($4.44{\pm}0.55$), and family ($4.43{\pm}0.61$). Satisfaction with communication was the highest with colleague nurses ($3.60{\pm}0.68$), then senior nurses ($3.37{\pm}0.74$), family ($3.18{\pm}0.71$), patients ($3.09{\pm}0.75$), and doctors ($3.06{\pm}0.83$).The total score of the communication barrier was $2.83{\pm}0.52$, where each domain was scored as follows: patient condition $3.13{\pm}0.74$, nurses $2.83{\pm}0.60$, environment $2.81{\pm}0.66$, and family $2.76{\pm}0.57$. The ICU nurses reported that communication was difficult due to 'sudden deterioration in the patient's condition', 'being too busy', 'a noisy environment', and 'information not being shared between family members.' Significant differences were noted by age, clinical experience, and marital status of nurse respondents. Conclusion: The findings indicated that development of a protocol on communication between nurses and doctors as well as development of an educational program on communication skills are necessary.

• Journal of the Korean Dietetic Association
• /
• v.15 no.4
• /
• pp.335-342
• /
• 2009

Forty-two percent of the patients with renal failure that requires continuous renal replacement therapy (CRRT) have been reported to have severe malnutrition, and preexisting malnutrition is a statistically significant and independent predictor of negative hospital outcomes. We performed this study to evaluate the appropriateness of the calorie and protein provided for the critically ill patients who require CRRT. One hundred forty-nine patients who received CRRT were enrolled. The demographic data, the length of the ICU stay and the mortality were recorded. The calorie/protein intake and the blood urea nitrogen (BUN), albumin and creatinine levels were used as nutritional parameters. The mean daily calorie intake during CRRT was 16.1${\pm}$7.4 kcal/kg, which was 64% of the recommended intake. Only 10% of the patients received the recommended caloric intake and the ratio of the enteral and parenteral calories was 26%/74%. The mean protein intake was 0.58${\pm}$0.34 g/kg, which was 38% of the recommended intake. The calorie and protein intakes at the termination of CRRT were significantly increased compared to the initial day of treatment, but they stayed under the recommended intake. The BUN, creatinine and albumin levels were significantly increased in the survival group (odds ratio for albumin: 2.73; creatinine: 2.43). A strategy to increase the nutrition provision is needed to improve the nutritional statuses and clinical outcomes of the critically ill patients who require CRRT.

• Journal of Korean Clinical Nursing Research
• /
• v.26 no.2
• /
• pp.207-216
• /
• 2020

Purpose: The purpose of this study was to investigate the motor subtypes of delirium in patients in a Surgical Intensive Care Unit (SICU), and identify the factors related to the characteristics of patients according to the motor subtypes of delirium. Methods: Data were collected in the SICU of a tertiary hospital in ^⁎ city from October 2018 to June 2019. Delirium was detected using the Confusion Assessment Method for the ICU (CAM-ICU) and motor subtypes of delirium were measured with the Delirium Motor Subtype Scale (DMSS)-4. Patients' characteristics were obtained by using the electronic medical records. Descriptive statistics were used to analyze the data. Results: Among 1,112 patients, 172 patients showed delirium (15.5%). After excluding dementia patients and patients refusing to participate in the study, 126 patients included in the final analysis. Delirium patients were classified as hyperactive delirium (32.5%), hypoactive delirium (42.9%), mixed delirium (11.9%), and non-motor subtype delirium (12.7%). Conclusion: The study results suggest that hypoactive delirium is the most prevalent motor subtype of delirium in SICU. More application of ventilators, more administration of sedatives, more use of catheters, and higher nursing severity were reported for hypoactive delirium cases than hyperactive ones. Therefore, it is necessary to assess early the motor subtypes of delirium using structured tools and develop appropriate nursing interventions suitable for each subtype of delirium.

• Journal of Korean Academy of Nursing
• /
• v.47 no.6
• /
• pp.794-805
• /
• 2017

Purpose: Interface pressure is a factor that contributes to the occurrence of pressure injuries. This study aimed to investigate interface pressure at common sites of pressure injury (occipital, gluteal and peritrochanteric areas), to explore the relationships among risk factors, skin condition and interface pressure, and to identify risk factors influencing interface pressure. Methods: A total of 100 patients admitted to the intensive care unit were enrolled at a tertiary teaching hospital in Korea. Interface pressure was recorded by a scanning aid device (PalmQ). Patient data regarding age, pulmonary disease, Braden Scale score, body mass index, serum albumin, hemoglobin, mean blood pressure, body temperature, and oxygen saturation were included as risk factors. Data collected from July to September 2016 were analyzed using binary logistic regression. Results: The mean interface pressure of the occipital, gluteal, and right and left peritrochanteric areas were 37.96 (${\pm}14.90$), 41.15 (${\pm}16.04$), 53.44(${\pm}24.67$), and 54.33 (${\pm}22.80$) mmHg, respectively. Predictive factors for pressure injuries in the occipital area were age ${\geq}70$ years (OR 3.45, 95% confidence interval [CI]: 1.19~9.98), serum albumin deficit (OR 2.88, 95% CI: 1.00~8.26) and body temperature ${\geq}36.5^{\circ}C$ (OR 3.12, 95% CI: 1.17~8.17); age ${\geq}70$ years (OR 2.81, 95% CI: 1.10~7.15) in the right peritrochanteric area; and body temperature ${\geq}36.5^{\circ}C$ (OR 2.86, 95% CI: 1.17~6.98) in the left peritrochanteric area. Conclusion: Our findings suggest that old age, hypoalbuminemia, and high body temperature may be contributory factors to increasing interface pressure; therefore, careful assessment and nursing care of these patients are needed to prevent pressure injury. Further studies are needed to establish cutoff values of interface pressure for patients with pressure ulcers.

• Childhood Kidney Diseases
• /
• v.15 no.2
• /
• pp.107-115
• /
• 2011

Acute kidney injury (AKI) is associated with mortality and may lead to increased medical expense. A modified criteria (pediatric RIFLE [pRIFLE]: Risk, Injury, Failure, Loss, and End-stage renal disease) has been proposed to standardize the definition of AKI. The common causes of AKI are renal ischemia, nephrotoxic medications, and sepsis. A majority of critically ill children develop AKI by the pRIFLE criteria and need to receive intensive care early in the course of AKI. Factors influencing patient survival (pediatric intensive care unit discharge) are known to be low blood pressure at the onset of renal replacement therapy (RRT), the use of vasoactive pressors during RRT, and the degrees of fluid overload at the initiation of RRT. Early intervention of continuous RRT (CRRT) has been introduced to reduce mortality and fluid overload that affects poor prognosis in patients with AKI. Here, we briefly review the practical prescription of pediatric CRRT and literatures on the outcomes of patients with AKI receiving CRRT and associations among AKI, fluid overload, and CRRT. In conclusion, we suggest that an increased emphasis should be placed on the early initiation of CRRT and fluid overload in the management of pediatric AKI.

• Journal of Chest Surgery
• /
• v.32 no.1
• /
• pp.53-57
• /
• 1999

We describe a case of successful extracorporeal membrane oxygenation(ECMO) in a small infant with cardiopulmonary resuscitation(CPR) failure after an open heart surgery. A 35-day-old male infant weighing 4.4 kg who had congestive heart failure and pulmonary hypertension underwent patch closure of ventricular septal defect without any intraoperative event. Postoperative course was unremarkable in the intensive care uint for about 5 hours before the junctional ectopic tachycardia developed. Sudden cardiac decompensation with bradycardia occurred about 50 minutes after the development of junctional ectopic tachycardia. He was put on ECMO by arterial cannulation at the ascending aorta and by venous cannulation at the right atrial appendage after 4 hours' CPR. The hemodynamics were stable with enough urine output during ECMO. He was weaned from ECMO 38.5 hours after initiation. Delayed sternal closure was attempted. He was extubated on postoperative day 7 and discharged home on postoperative day 21 without any neurologic sequelae.