• The Journal of Korean Academic Society of Nursing Education
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• v.23 no.3
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• pp.330-340
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• 2017

Purpose: This study was conducted to explore the relationship between simulation-based clinical judgment and performance ability for tracheal suction in nursing students. Methods: With a convenience sampling, 207 nursing students participated in this descriptive study. Lasater clinical judgment rubric was used for self-reported clinical judgment in addition to observe the skill of tracheal suction using a checklist. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficients using the SPSS/WIN 22. Results: A scenario with pneumonia patient was developed to observe the skill of tracheal suction during simulation-based practices. Then self-reported clinical judgment was scored. The mean score of total sum of clinical judgment, total mean of clinical judgment, and performance skill were $36.44{\pm}4.82$, $13.44{\pm}1.71$, and $42.32{\pm}5.05$, respectively. Statistically, students having good skills in suction showed significant differences in clinical judgment of interpreting (p=.031) compared to students having fair skills. Conclusion: The results of this study show that a structured debriefing method utilizing Lasater clinical judgment rubric is helpful. Also, simulation-based practice related to adult nursing in the respiratory system was useful for increasing the core basic skills among nursing students.

• Journal of Digital Convergence
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• v.14 no.6
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• pp.285-294
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• 2016

The purpose of this study was to examine the effectiveness(knowledge of core fundamental nursing skills, clinical competency, self-efficacy and learning motivation) of education program for core fundamental nursing skills focusing on endotracheal suctioning using recording video with smartphone and formative feedback for nursing school students. Subjects consisted of 54 sophomore nursing students, an experimental group(n=27) and a control group(n=27). The education for core fundamental nursing skills using recording video to smartphone and individual formative feedback was provided to students in an experimental group. The traditional method with self-directed practice for 4 hours was offered to a control group. The education program for core fundamental nursing skills using recording video with smartphone and formative feedback was effective in promoting knowledge of core fundamental nursing skills, clinical competency, self-efficacy and learning motivation. Based on our results, this program can be recommended as an effective educational program for the nursing students to improve their core fundamental nursing skills.

• Journal of the Korean Data and Information Science Society
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• v.25 no.6
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• pp.1353-1360
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• 2014

This study aimed to evaluate the effects of the nursing skills program, which offers online access to evidence-based skills and procedures. The nursing skills tested in this study was tracheostomy suctioning in the Mosby's Nursing Skills. The design of the study was a control group non-synchronized pre-posttest quasi-experimental research. The experimental group who utilized the Mosby's Nursing Skills had significantly higher level of knowledge and skills of trachosotmy suctioning, but not of self-efficacy. Online accessible nursing skills program was shown to be effective in improving nursing skills of students, and it is suggested to utilize the program in nursing practicum.

• Journal of Korean Academy of Nursing
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• v.34 no.7
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• pp.1215-1223
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• 2004

Purpose: This study was performed to test the clinical usefulness of the glucose test strip method for early detection of pulmonary aspiration in tube fed patients. Method: The subjects for the study were 36 patients who were receiving enteral feedings and 39 patients who were not given enteral feedings. For the analysis, the tube fed patients were divided into two groups (clinically significant aspiration and no aspiration) according to criteria. Result: The mean glucose concentration of tracheal secretions from non enteral fed patients was 26.35mg/dl and were lower than those concentrations found in tube fed patients (32.75mg/dl). The mean glucose concentration of the aspiration group was 45.60mg/dl and the glucose concentration of the non aspiration group was 19.93mg/dl. The difference was statistically significant (t=2.163, p=.038). More subjects in the no aspiration group ($73\%$) than the aspiration group ($56\%$) had glucose concentrations below 20mg/dl. After deleting the cases that had samples containing blood, glucose concentrations of tracheal aspirates were lower in both groups. Conclusion: The glucose level of the aspiration group was significantly lower than the no aspiration group and more subjects in the aspiration group had a glucose level higher than 101mg/dl. Therefore, the glucose test of tracheal secretions in tube fed patients could be a desirable test for screening for tracheal aspiration. Especially the patient who is showing repeatedly high glucose levels should not be given feedings until reassessment is completed.

• Journal of Korean Academy of Nursing
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• v.23 no.2
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• pp.245-254
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• 1993

The purpose of this study was to identify effective methods to minimize increases in intracranial pressure(IICP ) during endotracheal suction by means of comparing two methods of hyperventilation and oxygen supply before and after endotracheal suction. In order to evaluate the effects of these two methods, the ICP during suctioning and the sustained time of IICP were measured. For hyperventilation, ambu-bagging was done 10 times for 30 seconds with a tidal volume of 800-900m1. For oxygen supply, 100 percent oxygen was supplied for 2 minutes before and after suction. The subjects for this study were 12 neurosurgical patients who had had a subarachnoid bolt inserted for ICP monitoring and they were all on mechanical ventilatory support in a surgical intensive care unit of Seoul National University Hospital from July 1, 1991 to March 31, 1992. In each patient hyperventilation was performed five times and oxygen supply was given five times and intracranial pressures were measured immediately before and every 30 seconds for 15 minutes after suction. For case assignments counterbalancing and repeated measure designs were combined. And so the total number of experiments were sixty for each group. The effects of hyperventilation and oxygen supply on the IICP and the sustained time of IICP after suction were analyzed by t-test. The results of study were as follows 1. There was a significant difference between the two groups in the increased ICP during suction (t=2.49, p=.014). 2. The sustained time of IICP after suctioning in the oxygen supply group was shorter than that in the hyperventilation group(t=2.35, p=.020) In summary, the Increase in the ICP during suction was lower and the time for the ICP to return to the presuction level was shorter in the oxygen supply group as compared to the hyperventilation group. Therefore, oxygen supply can be re commended before and after endotracheal suction.

• Journal of Korean Academy of Nursing
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• v.40 no.3
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• pp.359-366
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• 2010

Purpose: The purpose of this study was to determine the significant factors for risk estimate of aspiration and to evaluate the efficiency of the dysphagia assessment tool. Methods: A consecutive series of 210 stroke patients with aspiration symptoms such as cough and dysphagia who had soft or regular diet without tube feeding were examined. The dysphagia assessment tool for aspiration was compared with videofluoroscopy using Classification and Regression Tree (CART) analysis. Results: In CART analysis, of 34 factors, the significant factors for estimating risk of aspiration were cough during swallowing, oral stasis, facial symmetry, salivary drooling, and cough after swallowing. The risk estimate error of the revised dysphagia assessment tool was 25.2%, equal to that of videofluoroscopy. Conclusion: The results indicate that the dysphagia assessment tool developed and examined in this study was potentially useful in the clinical field and the primary risk estimating factor was cough during swallowing. Oral stasis, facial symmetry, salivary drooling, cough after swallowing were other significant factors, and based on these results, the dysphagia assessment tool for aspiration was revised and complemented.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.8 no.3
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• pp.379-390
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• 2001

The purpose of this study was to survey the ability of nurses to perform endotracheal suction to provide basic data on correct endotracheal suction. The participants in this study were 181 intensive care unit nurses in two university hospitals and one general hospital located in Daegu, one university hospital and two general hospitals located in Pohang, one university hospital located in Gyeongju. These data were collected from February 1, 2001 to March 10, 2001 using self reported questionnaires. The study instrument, which was developed by these investigators, included questions on general characteristics and performance of endotracheal suction. The results of this study are as follows : 1. Of the Participants 71.3% recognized correct endotracheal suctioning and 23.2% did not. 2. The greatest number, 57.5%, acquired knowledge about endotracheal suctioning at conferences on practice or education for staff. 3 There were significant differences in scores on performance of endotracheal suction according to department (F=2.60, P=.05) and hospitals (F=3.24, p=.01) among the general characteristics. 4. Slightly less than half of the participants, 47.8%, averaged correct scores for endotracheal suctioning procedures. Ventilator $O_2$ supply had the highest score (84.0%), normal saline exchange time, the lowest (14.4%) From the results, we suggest that education is needed to increase the knowledge and correct performance of endotracheal suction. Further study including direct observation of Performance of endotracheal suction is also needed.

• Korean Journal of Adult Nursing
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• v.20 no.2
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• pp.209-218
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• 2008

Purpose: Regarding the respiratory function of patients with an artificial airway, this study compared the effects between normal saline with chest vibration and normal saline with expectorant mixture, administered before endotracheal suction. Methods: The study was conducted in the ICUs of one university hospital located in Incheon. The experimental group I received normal saline with chest vibration administered before endotracheal suction while the experimental group II received normal saline with expectorant mixture administered before endotracheal suction. For respiratory function, $PaO_2$, $PaCO_2$, and $O_2$ saturation were measured by ABGA at 3 minutes after endotracheal suction for both pre-test and post-test. Results: The two groups were not different significantly regarding $PaO_2$ level and $O_2$ saturation after the treatments, while, the experimental group II had lower $PaCO_2$ level than the experimental group I after the treatments (t = 2.075, p = .042). For experimental group II, post-test score of $PaCO_2$ level was significantly lower than that of the pre-test score (t = 1.842, p = .075). Conclusion: The administration of normal saline with expectorant mixture before endotracheal suction reduced $PaCO_2$ level and improved the respiratory function.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.21 no.3
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• pp.226-234
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• 2014

Purpose: This study was done to present guidelines for deciding appropriate times for measuring blood pressure (BP) in patients with neurological disorders who had surgery due to brain damage. Method: It was a repeated measures-experimental research on time variants in BP after nursing care. SBP (Systolic BP) and DBP (Diastolic) were measured every 2 minutes up to 5 times using an EKG patient monitor. Measured data were analyzed using repeated measures ANOVA and paired t-test. Results: For suctioning, there were significantly higher differences for SBP averages after 2 min. (138mmHg, p<0.01) and 4 min. (133mmHg, p<0.01) compared to before suctioning (120mmHg). For position change, there were significant differences in SBP averages after 2 min. (136mmHg, p<0.01) and 4 min. (130mmHg, p=0.01) compared to before changing position (121mmHg). For position change followed by suctioning there were significant differences in SBP averages after 2 min. (136mmHg, p<0.01), 4 min. (136mmHg, p<0.01) and 6 min. (125mmHg, p=0.003) compared to before the interventions (121mmHg). Conclusions: Results indicate that there are significant differences in SBP and DBP over time during nursing interventions, suggesting clinical measurement of BP after 6 min. or 8 min. be done for patients with neurological disorders in neurosurgery clinics.

• Child Health Nursing Research
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• v.16 no.2
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• pp.128-135
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• 2010

Purpose: This study aimed to confirm the effect of routine suctioning at a nursery for healthy newborns who have undergone immediate oronasopharyngeal bulb suctioning after birth in a delivery room through the observation of their oxygen saturation level, heart rate, respiration rate, the vomiting sign, and the number of instances of vomiting. Methods: Data were collected for 62 days from March 15 to May 15, 2009 at the nursery of a hospital located in Seoul. One hundred forty newborns were assigned to one of three groups: a no suction group, an oropharyngeal suction group, or a orogastric suction group. Collected data were analyzed with the SPSS WIN 15.0 program using ANOVA, cross tabulations and an independent 2-sample t-test. Results: Routine suctioning to healthy newborns resulted in decreasing oxygen saturation levels and increasing the heart and respiration rate regardless of the kind of suctioning. Stabilization of the oxygen saturation level and vital signs was also observed without suctioning. Conclusion: To prevent healthy newborns from the side effect of suctioning, selective suctioning is recommended.