• Journal of Digital Convergence
• /
• v.20 no.1
• /
• pp.379-389
• /
• 2022

This study was aimed to identify importance and satisfaction of intensive care unit health care providers for Intensive Care Unit Clinical Nurse Expert (ICU CNE) roles. A questionnaire survey was performed with 138 intensive care unit health care providers between May 3 to 29, 2021. Data were analyzed using descriptive statistics. t-test and Importance-Performance Analysis (IPA). There were statistically significant differences in importance(t=2.33, p=.024) and satisfaction(t=5.43, p<.001) between physicians and nurses. The importance and satisfaction of intensive care unit health care providers were ranked in the order of advanced clinical practice, professional activity, coordination and cooperation, education and counseling and research. In the 'concentrate' area, it was found that 'Professional activity' and 'Education' should be improved. A strategy is needed to strengthen the expertise of ICU CNE and to enhance the competency in areas that need improvement.

• Journal of Digital Convergence
• /
• v.20 no.3
• /
• pp.497-505
• /
• 2022

This study aimed to investigate the effect of Grit and positive psychological capital on job engagement in general hospital nurses. Participants were 159 nurses working at General Hospital in Gangwondo Province and data were collected from April 9 to 21, 2020. Data were analyzed by t-test, one-way ANOVA, Pearson's correlation coefficient, and hierarchical multiple regression using SPSS version 24.0. Job engagement was correlated with perseverance efforts and positive psychological capital. The factors influencing job engagement were self-efficacy (β=.23, p=.029) and optimism (β=.28, p=.001) with 41.8% explanatory power (F=12.34, p<.001). Therefore, in order to improve job enthusiasm, further study is necessary to develop and apply the positive psychological capital improvement program and identify its effect.

• Journal of Korean Academy of Nursing
• /
• v.53 no.1
• /
• pp.39-54
• /
• 2023

Purpose: This study aimed to investigate the nationwide intention to delegate clinical practice of medical specialists in accordance with the enactment of the scope of practice for advanced practice nurses (APNs). Methods: Data were collected from October to December 2021 using Google Surveys. In total, 147 medical specialists from 12 provinces responded to the survey. The survey questionnaire was categorized into four legislative draft duties, according to the scope of practice (a total of 41 tasks): Twenty-nine tasks on treatments, injects, etc., performed under the guidance of a physician and other activities necessary for medical treatment (treatment domain); two tasks on collaboration and coordination; six tasks on education, counseling, and quality improvement; four regarding other necessary tasks. Participants were asked whether they were willing to delegate the tasks to APN. Results: The intention to delegate tasks to APN was higher for non-invasive tasks such as blood sampling (97.3%) or simple dressing (96.6%). Invasive tasks such as endotracheal tube insertion (10.2%), sampling: bone marrow biopsy & aspiration (23.8%) showed low intention to delegate in the treatment domain. Participants who were older, male, and had more work careers with APN, showed a higher intention to delegate tasks. Conclusion: To prevent confusion in the clinical setting, a clear agreement on the scope of APN practice as APN delegated by physicians should be established. Based on this study, legal practices that APN can perform legally should be established.

• Journal of Korean Critical Care Nursing
• /
• v.16 no.2
• /
• pp.1-14
• /
• 2023

Purpose : Sleep disturbances in patients in the intensive care unit (ICU) are related to health problems after discharge. Therefore, active prevention and management are required. Hence, identification of the factors that affect sleep in patients who are critically ill is necessary. Methods : The PubMed, Cochrane Library, CINAHL, EMBASE, and Web of Science databases were searched. Selection criteria were observational and experimental studies that assessed sleep as an outcome, included adult patients admitted to the ICU, and published between November 2015 and April 2022. Results : A total of 21,136 articles were identified through search engines and manual searches, and 42 articles were selected. From these, 22 influencing factors and 11 interventions were identified. Individual factors included disease severity, age, pain, delirium, comorbidities, alcohol consumption, sex, sleep disturbance before hospitalization, chronic obstructive pulmonary disease (COPD), cardiovascular disease, and high diastolic blood pressure (DBP), low hemoglobin (Hb), and low respiratory rate (RR). Environmental factors included light level, noise level, and temperature. Furthermore, treatment-related factors included use of sedatives, melatonin administration, sleep management guidelines, ventilator application, nursing treatment, and length of ICU stay. Regarding sleep interventions, massage, eye mask and earplugs, quiet time and multicomponent protocols, aromatherapy, acupressure, sounds of the sea, adaptive intervention, circulation lighting, and single occupation in a room were identified. Conclusion : Based on these results, we propose the development and application of various interventions to improve sleep quality in patients who are critically ill.

• Journal of Korean Critical Care Nursing
• /
• v.16 no.2
• /
• pp.15-27
• /
• 2023

Purpose : This study aimed to examine the relationship between sleep quality and its influencing factors in patients with coronary artery disease (CAD). Methods : This descriptive correlational study included 130 patients with CAD admitted to the cardiology department of a general hospital in B City between September 2019 and February 2020. Data were collected using structured questionnaires and research instruments to measure sleep quality, anxiety, depression, chronotype, and daytime sleepiness. Results : The mean scores for sleep quality, daytime sleepiness, anxiety, and depression were 7.59±3.45, 6.45±3.46, 6.58±3.88, and 7.74±4.05, respectively. In terms of chronotypes, 10.8%, 48.5%, and 40.7% of the participants had evening-, intermediate-, and morning-type patterns, respectively. Sleep quality was significantly correlated with anxiety (r=0.38, p<.001), depression (r=.37, p<.001), and daytime sleepiness (r=.26, p =.002). Factors associated with sleep quality in patients with CAD included anxiety (β=.29), heart failure (β=.22), daytime sleepiness(β=.21), and sleeping alone (β=.19). Collectively, these factors had an explanatory power of 23.1% for sleep quality variance. Conclusion: Patients with CAD often experience poor sleep quality owing to various factors such as anxiety, daytime sleepiness, heart failure, and sleeping alone. It is recommended that healthcare providers objectively evaluate sleep and identify factors that influence sleep quality. This will enable the development of effective methods for sleep management as part of nursing care.

• Journal of Korean Critical Care Nursing
• /
• v.16 no.2
• /
• pp.28-41
• /
• 2023

Purpose : This study aimed to investigate the characteristics and risk factors associated with pressure injuries related to medical devices among patients admitted to the intensive care unit (ICU). Method : A retrospective study analyzed data from 462 ICU patients. Statistical analyses, including independent t-tests, Fisher's exact tests, and logistic regression were performed to analyze the data. Results : Among the 154 subjects, there were a total of 198 medical device-related pressure injuries (MDRPI). Stage 2 and deep tissue pressure injuries were the most frequent. MDRPI occurred most frequently on the face, with nasogastric tubes being its leading cause, followed by endotracheal tubes. The risk factors for MDRPI included male sex (odds ratio [OR]=1.78, 95% confidence interval [CI]=1.12-2.83), department at the time of ICU admission (OR=4.29, 95% CI=2.01-9.15), post-surgery ICU admission (OR=0.43, 95% CI=0.25-0.73), application of extracorporeal membrane oxygenation machines (OR=2.72, 95% CI=1.06-6.95), number of medical devices (OR=1.16, 95% CI=1.05-1.30), inotropic drug administration (OR=2.33, 95% CI=1.19-4.60), and sedative use (OR=2.53, 95% CI=1.17-5.45). Conclusion : These results enable the determination of the characteristics and risk factors associated with MDRPI. It is crucial to acknowledge the risk factors for MDRPI in ICU patients and establish a prevention strategy.

• Journal of Korean Critical Care Nursing
• /
• v.16 no.2
• /
• pp.42-53
• /
• 2023

Purpose : This retrospective mixed-methods study aimed to explore key considerations for designing effective simulated education in nursing, focusing specifically on the recognition and response to deteriorating patients. Methods : Quantitative and qualitative data were analyzed to assess the clinical judgment and performance of the nursing students. Descriptive statistics were used to analyze quantitative data related to prior knowledge, simulation satisfaction, clinical judgment, and nursing performance during deteriorating patient simulations. Qualitative content analysis was conducted for the reflective journal entries of the participants. Results : Quantitative analysis showed that most participants demonstrated a "being skillful" level of clinical judgment (33.1%) in effective response. At the beginner level, clinical judgment varied across effective noticing(39.7-82.8%), effective interpretating(77.6-82.8%), effective responding(3.4-86.2%), and effective reflecting(90.0-95.4%). Nursing performance in assessing patient respiration or SpO2 after request from a physician ranged from 46.6-48.3%. Qualitative analysis indicated that 48.5% of the participants anticipated a deteriorating condition and initiated appropriate actions, while 70% noticed patient unresponsiveness for the first time. Conclusion : To design an effective simulation program for identifying and addressing deteriorating patient care, a framework for observation and interpretation is essential, along with regular simulated training. It is important to design and assess simulation programs and to conduct thorough interviews with nursing students to gain insight into their clinical decision-making.

• Journal of Korean Critical Care Nursing
• /
• v.16 no.2
• /
• pp.67-80
• /
• 2023

Purpose : The 2020 Dietary Guidelines Advisory Committee specifically noted that meal frequency is associated with risks for cardiovascular disease, type 2 diabetes, and all-cause mortality, although the current evidence on meal frequency is conflicting. As meal frequency itself is affected by various factors, the aim of the study was not only to examine its relationships with cardiometabolic risk but also to identify the mediating effects of dietary quality. Methods : This study used a descriptive correlational design. In all 8,141 healthy adults participated in the study. Measurements included meal frequency, cardiometabolic risk, and diet quality. Data were analyzed using descriptive statistics, Pearson's correlation coefficient analysis, and process macro bootstrapping model 4. Results : The meal frequency was 3.52±0.61 times per day, the risk of cardiovascular metabolic diseases was 0.01±0.61 points, and the diet quality was 62.08±13.87 points. In mediation analysis, the effect of meal frequency on cardiometabolic risk score was completely mediated by diet quality. Conclusion : Improved diet quality in healthy adults should be considered when designing meal frequency interventions aimed at reducing their cardiometabolic risk, as the effect of meal frequency support on cardiometabolic risk was found to be mediated by diet quality.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.29 no.4
• /
• pp.352-361
• /
• 2023

Purpose: The purpose of this study was to construct the education applying the Havruta method for nursing students and to investigate the effects on self-directed learning ability, critical thinking, and learning commitment. Methods: A nonequivalent control group pre-posttest design was used. The participants were 63 nursing students (experimental group, n=31; control group, n=32) at two universities. The experimental group received education applying the Havruta method for five weeks. The study was conducted from September 1 to November 30, 2022. The data were analyzed using IBM SPSS 27.0 for an χ² test, Fisher's exact test, independent t-test, and Mann-Whitney U-test. Results: The experimental group had a significant increase in self-directed learning ability (z=-2.13, p=.033). However, there was no significant difference in critical thinking competency (t=0.64, p=.524) and learning commitment (t=0.04, p=.969) between the two groups. Conclusion: The Havruta method is an effective nursing education tool for self-directed learning ability. The result of this study could be a guide for nursing professors in designing and implementing educational programs that apply the Havruta method. In the future, research that applies the Havruta method and evaluates its effectiveness in nursing education programs should be continued.

• Journal of Korean Critical Care Nursing
• /
• v.16 no.3
• /
• pp.11-23
• /
• 2023

Purpose : This study investigates the experiences of patients in intensive care units (ICUs), and the factors influencing these experiences. Method : We used a cross-sectional survey design to analyze previously collected cohort data from 891 patients who spent over 24 hours in 19 ICUs across four university hospitals in Busan, South Korea between June 2019 and July 2020. Within a week of ICU discharge, participants completed the Korean version of the Intensive Care Experience Questionnaire, covering four areas: "awareness of surroundings," "frightening experiences," "satisfaction with care," and "recall of experiences." We used multiple linear regression to identify factors associated with the ICU experience. Results : Low income (𝛽 = -.08, p = .016), unplanned hospitalization (𝛽 = -.09, p = .006), sedation (𝛽 = -.16, p < .001), and delirium (𝛽 = -.15, p < .001) reduce patients' awareness of their surroundings. Frightening experiences are associated with being female (𝛽 = -.07, p = .027), experiencing delirium(𝛽= -.15, p<.001), and longer stays in the ICU (𝛽= -.14, p <.001). Using sedatives decreases satisfaction with care (𝛽 = -.08, p = .048). Living alone (𝛽 = -.08, p = .013) and using painkillers (𝛽 = -.08, p = .020) reduces recall of experiences. Conclusion : Negative ICU experiences are significantly associated with being female, living alone, lower income, unplanned admission, using sedatives and painkillers, delirium, and longer stays in the ICU. Thus, improving ICU experiences requires interventions that address modifiable factors, such as delirium, medication, and length of ICU stays.