• Journal of Hospice and Palliative Care
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• v.22 no.2
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• pp.87-99
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• 2019

Purpose: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. Methods: Mixed methods were used to survey ICU nurses at a university hospital. Quantitative data (N=106) were collected through a questionnaire and analyzed using an independent samples t-test, ANOVA, Mann-Whitney U test and $Scheff{\acute{e}}$ test. Qualitative data (N=19) were collected through focus group interviews and analyzed through qualitative content analysis. Results: The mean score on the difficulty of EOLC was 3.41 out of 5. The education needs derived from the qualitative analysis was categorized into four themes: 1) guidelines on professional EOLC, 2) spiritual care, 3) a program to take care of feelings of patients, families and nurses, and 4) activities to think about death. Conclusion: This study confirmed that ICU nurses were experiencing an extreme difficulty in providing EOLC. In addition, a qualitative analysis confirmed that they needed an EOL nursing program. To mitigate the difficulties experienced by nurses involved in EOLC, there is an urgent need to develop an education program for EOLC tailored to nurses' needs.

• Journal of Industrial Convergence
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• v.21 no.10
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• pp.103-110
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• 2023

This study is a descriptive comparative study to identify personal characteristics and nursing work characteristics according to the presence or absence of back pain of nurses in intensive care units in general hospitals and to explore major factors that affect back pain induction. A survey was conducted on nurses in the intensive care unit of a general hospital located in D City, and a total of 100 copies were used for analysis. For data analysis, descriptive statistics, chi-square test, Fisher accurate test, and logistic regression analysis were performed using IBM SPSS 24.0. The study found that 69% of intensive care unit nurses had back pain, 65.2% of which experienced back pain for more than three months in the past year, and 84.1% had back pain after working in the intensive care unit. In the back pain intensity score measured by NRS, 49% answered that they experienced 4 or more points. As factors related to back pain, gender (p=.03) were significant variables in personal characteristics, in the characteristics of nursing work, the number of patient assistance (p=.03) and the number of patient exchanges (p=.01), heavy lifting (p=.04), satisfaction with the condition of the shoes (p=<.001) was found to be a significant variable affecting back pain induction. It is considered that hospital organization and national policies are needed to prevent and manage low back pain in intensive care unit nurses.

• Journal of Korean Critical Care Nursing
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• v.12 no.1
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• pp.22-35
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• 2019

Purpose : This study was to determine the levels of environmental stressor, posttraumatic stress disorder, and quality of life in intensive care units (ICU) survivors after intensive care, and to explore the factors affecting posttraumatic stress disorder and quality of life. Methods: With a longitudinal survey design, data were collected from 116 patients who were discharged from the ICU of a university hospital. The environmental stressor, posttraumatic stress disorder, and quality of life were measured immediately following and 1 month after the ICU discharge. Results: Of all the subjects, 16.4% experienced posttraumatic stress disorder after discharge. Multiple regression analysis revealed that ICU environmental stressors, experience of ICU readmission, using psychotropic drugs and narcotic analgesics, and ICU admission after surgery or cardiac intervention accounted for 22.2% of posttraumatic stress disorder. Posttraumatic stress disorder and sedation status when entering ICU accounted for 28.3% of the quality of life 1 month after ICU discharge. Conclusion: Nursing interventions focused on ICU environmental stressors would not only reduce environmental stress but also contribute to the reduction of posttraumatic stress disorder and later improvement of quality of life.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.51-62
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• 2017

Purpose: This study aimed to understand the essence of experiences of patients and family members during flexible visiting in an intensive care unit (ICU). Methods: This is a qualitative study using interviews with open ended questions. We used Colaizzi's method of phenomenological interpretation. Results: Flexible visiting in the ICU impacted the patients and their families in various ways. The following categories were extracted from the patients' experiences with flexible visiting: 1) the opportunity to feel the presence of the family and 2) the burden of unrestricted visiting. The following categories were extracted from the families' experiences with flexible visiting: 1) psychological comfort by convenience 2) being aware of health care professionals and critical care nursing in the intensive care unit, and 3) double trouble. Conclusions: These results showed that flexible visiting in the ICU affected the patients and their families positively and negatively. Therefore, nursing staff need to design psychological and social interventions that address the needs of patients and their families.

• Quality Improvement in Health Care
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• v.15 no.2
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• pp.93-103
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• 2009

문제: 억제대 적용에 대한 구체적 적용 지침 없이 의례적으로 억제대를 사용함으로 인해 환자들의 신체적 또는 정신적 안전을 위협할 수 있다. 목적: 완전 진정 상태 이거나 근력이 약하여 발관 능력이 없는 환자에 대한 예방적 적용, 바빠서 환자를 볼 수 없는 경우, 간호사 본인의 판단이 없이 타인의 요구에 따르는 등의 불필요한 억제대 적용이 증가하는 원인을 파악하여 중환자실의 특수성에 맞는 억제대 적용 및 제거 지침을 마련하고자한다. 의료기관: 인천광역시에 소재한 의과대학 소속병원의 집중치료실 질 향상 활동: 불필요한 억제대 적용에 영향을 미치는 요인을 선정하여 개선활동 수행. 개선효과: 억제대 적용에 대한 중환자실 간호사에게 미치는 영향을 보면 태도 정도 p=0.09(p<0.1), 올바른 수행 능력은 p=0.005(p<0.05)로 통계적으로 유의한 것으로 나타났다. 지식 정도 p=0.172(p<0.05) 통계적으로 유의 하지는 않지만 모든 항목이 개선 활동 전 에 비해 2,3차 개선 활동 후에 향상 한 것으로 나타났다. 개선 활동 전에 8.1%였던 간호 기록, 0.7%였던 간호 중재, 0%였던 의사 처방율이 3차 개선 활동 후 3가지 모두 100% 달성되었다. 이는 억제대 적용율 감소 및 부적절한 억제대 적용율은 유의하게 감소 하였다. 교훈: 중환자실 간호사의 억제대 적용에 대한 태도, 지식, 올바른 간호 수행 능력은 지속적으로 재평가 되어지고, 교육내용은 좀 더 나은 간호 제공을 위하여 개발되어져야 할 것이다. 억제대 적용 기준과 제거 기준을 Check List 하여 객관성의 유지를 위한 개선 활동은 계속적으로 Feedback 되어야 할 것이다.

• Journal of Digital Convergence
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• v.19 no.12
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• pp.649-660
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• 2021

The purposes of this study were to examine the effects of carebidet robot during defecation on incontinence associated dermatitis, pressure ulcer risk and biological markers in critical care patients. Data were analyzed using t-test, Chi-square test, Fisher's exact test, Mann-Whitney U-test and Repeated measures ANOVA. There was a significant difference in incontinence associated dermatitis, pressure ulcer risk, and improving biological markers between the two groups, and there were significant changes over time and the group by time interactions. The findings of the study demonstrated that carebidet robot during defecation was more effective than the current usual care in reducing incontinence associated dermatitis, pressure ulcer risk, and improving biological markers in critical care patients.

• Korean Journal of Psychosomatic Medicine
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• v.27 no.2
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• pp.101-110
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• 2019

Objectives : It is not clear which clinical variables are most closely associated with delirium in the Intensive Care Unit (ICU). By comparing clinical data of ICU delirium and non-delirium patients, we sought to identify variables that most effectively differentiate delirium from non-delirium. Methods : Medical records of 6,386 ICU patients were reviewed. Random Subset Feature Selection and Principal Component Analysis were utilized to select a set of clinical variables with the highest discriminatory capacity. Statistical analyses were employed to determine the separation capacity of two models-one using just the selected few clinical variables and the other using all clinical variables associated with delirium. Results : There was a significant difference between delirium and non-delirium individuals across 32 clinical variables. Richmond Agitation Sedation Scale (RASS), urinary catheterization, vascular catheterization, Hamilton Anxiety Rating Scale (HAM-A), Blood urea nitrogen, and Acute Physiology and Chronic Health Examination II most effectively differentiated delirium from non-delirium. Multivariable logistic regression analysis showed that, with the exception of vascular catheterization, these clinical variables were independent risk factors associated with delirium. Separation capacity of the logistic regression model using just 6 clinical variables was measured with Receiver Operating Characteristic curve, with Area Under the Curve (AUC) of 0.818. Same analyses were performed using all 32 clinical variables;the AUC was 0.881, denoting a very high separation capacity. Conclusions : The six aforementioned variables most effectively separate delirium from non-delirium. This highlights the importance of close monitoring of patients who received invasive medical procedures and were rated with very low RASS and HAM-A scores.

• Tuberculosis and Respiratory Diseases
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• v.55 no.6
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• pp.579-588
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• 2003

Background : The hospital-acquired pneumonia is the most common nosocomial infection. Recently, the Acinetobacter baummannii infections are rapidly increasing, especially the frequency of Multi-drug resistant A. baumannii. Therefore we assessed clinical features and prognosis of patients in the ICU with Multi-drug resistant A. baumannii from the sputum culture using the Clinical Pulmonary Infection Score(CPIS). Method : The medical records of 43 patients with Multi-drug resistant A. baumannii from sputum culture who were suspected had clinically pneumonia and admitted to the ICU from January 2000 to July 2002 were retrospectively analyzed. Results : 19 patients were CPIS greater than 6 and 24 patients were CPIS less than or equal to 6. Mean age for the former was $71{\pm}11$ years old, and the latter was $61{\pm}19$ years old. The mean APACHE II score on admission and on sputum study was not different between two groups($17.4{\pm}5.7$ vs $18.5{\pm}6.1$, p=0.553, $20{\pm}6$ vs $17{\pm}8$, p=0.078). But the mortality rate was 73.7% for the former, and 16.7% for the latter(p<0.001). Conclusion : In ICU patients who had clinically suspected pneumonia with sputum culture positive for Multi-drug resistant A. baumannii, the mortality was significantly higher if CPIS was greater than 6.

• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.143-155
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• 2009

Purpose: This study was conducted to develop and evaluate the collaborate transitional care program for improving continuity of care in patients transferred to general wards from ICUs. Methods: 18 years and older who were hospitalized in adult intensive care units at A university affiliated medical center was recruited for the study. The experimental group for patients transferred from an ICU consisted of 33 patients and family caregivers; 34 patients and family caregivers for the control group. This study was utilized a quasi-experimental research design. The collaborative transitional care program was administered in transfer process. Data were collected two times by interviews, medical records, and telephone using questionnaires. Results: There were statistically significant differences between the two groups on relocation stress (p<.001), perceived health status (p<.001), satisfaction of caring (p=.011), physical domain (p=.022) and mental domain (p<.001) of the QOL. There were significant differences between the families of the two groups on burden (p<.001) and satisfaction of caring (p<.001). Conclusion: The collaborative transitional care programs administered in transfer process to general wards from an ICU have positive effects on patients and families' intrinsic and extrinsic factors. This program will be able to be utilized in clinical fields to improve continuity of care for patients and families between ICUs and general wards.

• Journal of Korean Critical Care Nursing
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• v.15 no.3
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• pp.115-127
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• 2022

Purpose : This study aimed to investigate sleep parameters and to identify differences according to respiratory support therapy, sedation, and pain medication in intensive care unit (ICU) patients. Methods : In this observational study, sleep parameters were measured using actigraphy. We observed 45 sleep events in 30 ICU patients receiving respiratory support therapy. We measured the sleep parameters, time, efficiency, and wakefulness after sleep onset (WASO). The differences in sleep parameters according to the respiratory support therapy were analyzed using the Mann-Whitney U test. Results : The average daily sleep time of the participants was 776.66±276.71 minutes, of which more than 60% accounted for daytime sleep. During night sleep, the duration of WASO was 156.93±107.91 minutes, and the frequency of WASO was 26.02±25.82 times. The high flow nasal cannula (HFNC) group had a significantly shorter night sleep time (𝑥²=7.86, p =.049), a greater number of WASO (𝑥²=5.69, p =.128), and a longer WASO duration (𝑥²=8.75, p =.033) than groups of other respiratory therapies. Conclusion : ICU patients on respiratory support therapy experienced sleep disturbances such as disrupted circadian rhythm and sleep fragmentation. Among respiratory support regimens, HFNC was associated with poor sleep parameters, which appears to be associated with the insufficient use of analgesics. The results of this study warrant the development of interventions that can improve sleep in ICU patients receiving respiratory support, including HFNC.