• Title/Summary/Keyword: 흡인간호

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Development of a Nasogastric Tube Feeding Algorithm to Prevent Aspiration Pneumonia (흡인성 폐렴 예방을 위한 비위관 영양 알고리즘 개발)

  • Lee, Hye Jin;Kim, Dong-Hee
    • Journal of Korean Critical Care Nursing
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    • v.7 no.1
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    • pp.1-10
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    • 2014
  • Purpose: The purpose of this study was developing a nasogastric tube feeding algorithm to prevent aspiration pneumonia. Methods: The algorithm was developed through a methodological design. First, a pilot study was performed to determine the incidence of pneumonia. The second step was development of a preliminary algorithm through a literature review and collection of nurse opinions. The third step was to establish content validity using a panel of 12 experts. The fourth step was revision of the algorithm. Next, 20 intensive care unit nurses applied the revised algorithm for six months to their actual treatment, and the practical feasibility was verified after that. Results: In the patients for whom this algorithm was applied, no cases of pneumonia occurred. The algorithm that was developed by the present author was suitable for clinical application. Conclusion: The effect and practical feasibility of the algorithm was tested with a few patients in this study. The effect of this algorithm should be examined by applying it to more patients on an ongoing basis.

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Development and Evaluation of a Dysphagia Nursing Intervention Program for Patients with a Stroke (뇌졸중 환자에게 제공한 연하곤란 간호중재 프로그램 효과)

  • Song, Young Ae;Beom, Ji Hyun;Ham, Young Sun;Kim, Sang Hee
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.3
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    • pp.340-348
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    • 2011
  • Purpose: The purpose of this study was to develop and provide a standardized nursing intervention program for stroke patients with dysphagia and evaluate the effectiveness of the program. Methods: Data on the number of tube feedings, incidence of aspiration pneumonia and length of stay were collected from 42 patients in the control group and 51 patients in the experimental group over the 6 months of this study. The data were analyzed using $x^2$-test and t-test. Results: The number of tube feedings in the experimental group was significantly lower than control group (p=.002). The incidence of aspiration pneumonia in the experimental group was not significantly lower than the control group (p=.097). Length of stay in the experimental group was significantly shorter than the control group (p<.001). Conclusion: The results of this study indicate that a standardized nursing intervention program for stroke patients with dysphagia could be useful to decrease tube feedings and length of stay.

Nursing Activities Identified through Pediatric Nursing Simulation (간호활동을 중심으로 한 아동간호시뮬레이션 실습 분석)

  • Shin, Hyun-Sook;Shim, Ka-Ka;Lee, Yu-Na
    • Child Health Nursing Research
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    • v.19 no.2
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    • pp.111-119
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    • 2013
  • Purpose: This research was a descriptive study of nursing activities observed in nursing simulation during a senior nursing student practicum. Content and frequencies of nursing activities during the simulation practice were identified. Methods: Thirty-six episodes of pediatric nursing simulation were videotaped. Both verbalizations and descriptions of nonverbal behaviors were recorded from the videotapes. The data were coded and analyzed. The coded nursing activities were evaluated for frequency and purpose of interaction. Results: Average time per simulation episodes was 27 minutes and ranged from 3.30 to 32.54 minutes. Nursing activities in these simulation episodes included nursing assessments such as vital sign measurement, associated symptom assessment, and check of patient condition, nursing interventions such as medication, tepid water massage, fluid therapy, provision of oxygen, suctioning, hyperglycemia and hypoglycemia management, communication such as parent education, procedure guidance, and communication among providers. Activities in assessment were most frequent, and among them, vital sign measurement and check of patient condition were more frequent than others. Conclusion: Students showed enhanced nursing activities such as more frequent nursing assessment, communication and interventions in their simulation experience. Therefore simulation experience can be considered as one strategies to provide nursing students with better and more intense practicum experience.

The Effects of Chest Vibration Prior to Endotracheal Suctioning on Oxygen Saturation, Heart Rate and Lung Secretions in Premature Infants (미숙아의 기관지흡인 전 흉곽진동 간호중재가 산소포화도, 심박동수와 기도분비물의 양에 미치는 영향)

  • Ahn Young Mee
    • Child Health Nursing Research
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    • v.4 no.2
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    • pp.245-254
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    • 1998
  • Prematurity is the main cause for respiratory disorders in neonates. The goal in respiratory management is to maintain respiration with adequate oxygenation. Chest vibration(CV) prior to on dotracheal suctioning(ETS) has been arbitrarily applied to ventilated premature infants without the scientific evaluation of its safety and efficacy. A repeated measure within subjects experimental study was conducted to investigate the effects of CV prior to 875 on oxygenation and lung secretions in twenty-one ventilated premature infants. The independent variable was the type of research protocol, the control type (275 without C.V) and t he intervention(ETS with CV). The dependent variables were oxygen saturation(SpO₂), heart rate (HR), measured by pulse oximeter, and the amount of lung secretions measured in gram. The results showed there was no difference in SpO₂ responses regardless CV employed before ETS. But there was a significant difference in HR responses between the control and the intervention, even without clinical significance. There was a significant difference in the amount of lung secretions retrieved during ETS with CV, compared to ETS without CV. This study suggested the safety of CV by demonstrating no clinically significant changes in SpO₂ and HR in premature infants. The efficacy of CV could be supported by the increases in the amount of sputum during ETS with CV compared to ETS without CV in premature infants.

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Effect of Oropharyngeal Sensory Stimulation Using Capsaicin in Acute Stroke Patients with Dysphagia (연하장애를 가진 급성기 뇌졸중환자의 캡사이신을 이용한 구인두 감각 자극의 효과)

  • Bae, Hansol;Lee, Eunnam
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.73-86
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    • 2021
  • Purpose : This study aimed to investigate the effects of oropharyngeal sensory stimulation using low-temperature capsaicin on dysphagia, dietary level, aspiration pneumonia, and nutritional status in acute stroke patients with dysphagia admitted to a stroke intensive care unit. Methods : This study used a randomized controlled trial design and 43 participants were randomly assigned to the experimental group (n=21) or control group (n=22). An oropharyngeal sensory stimulation intervention program was constructed based on previous studies. The intervention was provided before meals twice a day for seven days and started with the first meal after hospitalization. In the control group, a solution was made using only bottled water without adding capsaicin solution, and the intervention was provided at the same time, method, and number of times as the experimental group. Results : As a result of the study, dysphagia and dietary level improved in the experimental group that received oropharyngeal sensory stimulation using capsaicin. There were no effects on the nutritional status or aspiration pneumonia. Conclusion : This study provides basic data for the development of an intervention program for patients with dysphagia by presenting a theoretical basis that oropharyngeal sensory stimulation intervention using capsaicin improves dysphagia and dietary levels.

Oral Hygiene Care for Elderly in Care Facility (노인요양시설에서의 구강위생관리)

  • Ko, Sok-Min;Lim, Soon-Ryun
    • The Journal of the Korean dental association
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    • v.53 no.10
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    • pp.678-687
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    • 2015
  • In order to prevent aspiration pneumonia, oral hygiene care is important; thus proper tips for oral hygiene care should be distributed among hospitals and care facilities for elderly. Malpractice of oral hygiene itself may cause aspiration pneumonia. For efficient and effective oral hygiene care, engagement of professionals such as dentists or dental hygienists is essential. At the point where necessity of systemized dental $professionals^{\circ}{\phi}$ involvement at care facilities for elderly is being emerged, it is important to determine less risky approaches for oral health care tailored to elderly. Among many approaches, oral health care practice without usage of water is considered safe, reducing risk of possibility of aspiration. Since this practice is quite easy to implement, many dental professionals may utilize it when practiced at care facilities for elderly.

National-Wide Survey on Endotracheal Suctioning in High-Risk Infants (고위험신생아를 위한 기관지흡인에 대한 실태조사)

  • Ahn Youngmee
    • Child Health Nursing Research
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    • v.5 no.2
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    • pp.198-210
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    • 1999
  • The goal of respiratory management in high risk infants is to maintain proper oxygenation by supporting respiration, therefore to minimize the secondary complications and to promote the maximum growth and development. While on artificial ventilator to achieve this goal, the infants require endotracheal suctioning(ETS) to remove lung secretions. However, the negative effects of ETS in neoates have been documented and include hypoxia, bradycardia, mucosal damage, increased intracranial pressure, and death result. The purpose of the study was to investigate how ETS is currently performed in NICU, which would be beneficial to develop the standardized ETS protocol and to apply it to these population. A national-wide survey on clinical protocol of ETS was performed to 149 neonatal nurses with the average of 3 years and 6 months experience in neonatal nursing, 34.2% of whom was bachelor in nursing. The results showed that about 89% of the nurses initiate En primarily based on the need of the subjects. The aseptic regulation on ETS was used in 83.9% of the subjects. There was no regulation on the length of catheter in 32.9% and on ID/OD ratio in 17.4%. Many nurses administered hyperoygenation/hyperinflation/hyperventilation based on personal knowhow, rather than scientific rationals (77.2%, 40.9%, 75.2%, retrospectively). About 41% of the nurse regulate subjectively the suction power, while 73.8% of them rotate the sub ject's head during suctioning and the half of the nurses was favorable in adapting the closed-suctioning protocol. With the findings of the study, the current clinical application of E% in neonates appears to be based on adult care practices, or personal preference, rather than scientific validation of the safety and effectiveness of the procedure. This study support the needs for developing and applying the standardized ETS protocolin conjunction with the consideration given to the physiologic characteristics of the neonates in respiratory distress.

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Importance-Performance Analysis about Early Mobilization after Abdominal Surgery Patients in Surgical Ward Nurses (복부수술 환자의 조기운동에 대한 외과병동 간호사의 중요도-수행도 분석)

  • Kim, Bo Eun;Choi, Hye-Ran
    • Journal of Digital Convergence
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    • v.19 no.12
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    • pp.567-575
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    • 2021
  • This study was aimed to identify surgical ward nurses' importance-performance awareness toward early mobilization after abdominal surgery patients. The date were collected from 162 nurses and the importance and performance of early mobilization were analyzed by the IPA method. The collected data were analyzed using the SPSS/WIN 25.0 by implementing descriptive statistics, independent t-test, paired t-test, and ANOVA. Early mobilization was divided into exercise of pulmonary complications and early ambulation. As a result of the study, the areas requiring concentration were 'check risk of aspiration', and areas requiring improvement were 'oral care', 'check lung sound', 'percussion/vibration', 'suction', and 'reinforcement exercise in bed'. Therefore, each item of early mobilization is recommended to reduce the gap between importance and performance in clinical care.

Effects of a Ventilator-associated Pneumonia Prevention Program on Incidence Rate and Endotracheal Colonization (인공호흡기 관련 폐렴 예방 프로그램이 폐렴 발생률과 기관내 균집락화에 미치는 효과)

  • Song, Ui Rim;Kim, Sook Young
    • Korean Journal of Adult Nursing
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    • v.28 no.6
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    • pp.628-636
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    • 2016
  • Purpose: This study examined the effects of a program designed to prevent ventilator-associated pneumonia (VAP) on VAP rate and endotracheal colonization. The program focused on aspiration prevention and oral care. Methods: A nonequivalent control group post-test only design was utilized. One hundred patients admitted to a medical intensive care unit (MICU) or coronary care unit (CCU) were assigned to either a experimental group (n=50) or a control group (n=50). The participants were selected 48 hours following an endotracheal intubation. VAP prevention program given to the experimental group includes keeping the head of the bed to $30^{\circ}{\sim}45^{\circ}$ high, maintaining continuous endotracheal cuff pressure at 25 cm $H_2O$, performing endotracheal suction before change position, and providing oral care with 0.1% chlorhexidine every four hours. The control group received usual care. Data were analyzed using t-test, $x^2$ test, Mantel-Haenszel $x^2$ and Cox proportional harzard regression model. Results: The experimental group showed a lower VAP rate than the control group although the difference was not statistically significant ($x^2=0.79$, p=.375). The experimental group showed lower colonization in tracheal secretion than the control group ($x^2=14.59$, p<.001). Conclusion: Results showed that a VAP prevention program is effective in reducing colonization of tracheal secretion. Therefore, VAP prevention programs are recommended as an ICU nursing intervention.

Effects of Tracheal Suction and Method of Bronchodilator Inhalation on Vital Signs and Pulmonary functions in Patients with Open Heart Surgery(OHS) (심장수술 환아에게 기도흡인과 기관지 확장제의 투여 방법이 활력징후 및 폐기능에 미치는 효과)

  • Song Hyo-Sook;Jun Tae-Gook;Park Pyo-Won;Kim Kyoung-Eun;Chung Ji-Hye
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.10 no.1
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    • pp.96-107
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    • 2003
  • Objective: The purpose of this study was to identify the effects of tracheal suction and the effects of different methods of bronchodilator inhalation (Ultrasonic nebulizer: MDI puff, MDI puff with spacer) in VSD surgery patients. Material & Method: From June 2001 to March 2002, sixty consecutive patients were randomly assigned to a control group (n= 15), ultrasonic nebulizer group (n=15), metered dose inhalation (MDI) puff group (n=15) and MDI with spacer group (n=15). Vital signs (HR, BP, CVP), ABGA and pulmonary functions were measured before suction (baseline for suction), after suction, 15 minutes after suction (base of bronchodilator inhalation), 30 minutes after bronchodilator inhalation, and 2 hours after bronchodilator inhalation. Stastistical analysis was performed using SPSS software. Repeated measure ANOVA was used to examine the effects of tracheal suction. One way ANOVA with Bonferroni's correction and multiple range test (the least significant difference test) were used to examine the effects of albuterol inhalation. Result: 1. Heart .ate increased significantly immediately after suction (p<.01) and recovered 15 minutes after suction. 2. $PaO_2$ and PH decreased significantly immediately after suction (p<.05) and $PaO_2$ recovered 15 minutes after suction. $PaCO_2$ increased immediately after suction and significantly 15 minutes after suction (p<.01). But changes in vital signs and ABGA were within the normal range. 3. Tidal volume decreased significantly 15 minutes after suction (p<.05). 4. Changes of HR and tidal volume were greater in the nebuizer group compared to the other groups (p<.05) 30 minutes after bronchodilator inhalation and recovered 2 hours after bronchodilator inhalation. 5. Changes of airway deadspace was greater in the nebulizer group compared to the control group and MDI puff group 30 minutes after albuterol inhalation (p<.05) and at 2 hours (p<.01). Conclusion: Tracheal suction did not have significant effect on vital signs and pulmonary functions after OHS. Although the methods of bronchodilator inhalation did not showed any significant difference on pulmonary function, the nebulizer method increased $PaO_2$ (20%) and tidal volume transiently. If the patient needs bronchodilator inhalation with bronchospasm after OHS, the nebulizer method is the best choice. More study on the effects of bronchodilator inhalation in bronchospasm group is needed.

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