• Journal of Korean Critical Care Nursing
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• v.2 no.1
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• pp.36-47
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• 2009

Purpose: This study was to determine ICU nurses noncompliance of critical care nursing standards in order to provide basic data for education aimed at improvement in practice and evaluation of quality of nursing care in ICU. Methods: Data was collected from 150 nurses who work for three educational hospitals which have more than 800 beds and located in Gyeonggi province using questionnaires from September 2007 to October 2007. Results: The highest categories of noncompliance of critical care nursing standards were admission care($2.71\pm.60$) and infection control($2.31\pm.70$). The main causes of noncompliance critical care nursing standards that nurses regarded as causes were lack of attention(80.7%). ICU nurses mainly reported their noncompliance to charge nurses(89.3%) within 30minutes (84.7%). The reasons they reported were to solve problems rapidly and correctly, to reduce a harm to patients, and to prevent making noncompliance again. The reasons they didn't report were that they thought it might be not a problem and there was no change of patients conditions. Conclusion: ICU nurses noncompliance of critical care nursing standards was determined, therefore it can be used for prevention of further noncompliance.

• The Journal of Korean Academic Society of Nursing Education
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• v.29 no.3
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• pp.272-280
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• 2023

Purpose: This study was conducted to identify the level of senior nursing students' knowledge about palliative care, meaning of life, and willingness to palliative care and to identify factors affecting their willingness to palliative care. Methods: Data were collected from 192 senior nursing students at six nursing schools in four cities in Korea from December 8, 2022 to January 5, 2023. Descriptive statistics, an independent t-test, Pearson's correlation, and multiple linear regression test were used to analyze the data. Results: The mean±standard deviation score of knowledge about palliative care and meaning of life were 8.44±2.20 and 146.48±19.32. Factors affecting senior nursing students' willingness to palliative care were the knowledge about palliative care (β=.18, p=.005), meaning of life (β=.36, p<.001), and motivation for admission into a nursing school based on aptitude and interest (β=.16, p=.020). Conclusion: It is necessary to develop a nursing education program for enhancing knowledge about palliative care and meaning of life to prepare the palliative care competency of nursing students.

• Acute and Critical Care
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• v.33 no.4
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• pp.197-205
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• 2018

Lung transplantation is widely accepted as the only viable treatment option for patients with end-stage lung disease. However, the imbalance between the number of suitable donor lungs available and the number of possible candidates often results in intensive care unit (ICU) admission for the latter. In the ICU setting, critical care is essential to keep these patients alive and to successfully bridge to lung transplantation. Proper management in the ICU is also one of the key factors supporting long-term success following transplantation. Critical care includes the provision of respiratory support such as mechanical ventilation (MV) and extracorporeal life support (ECLS). Accordingly, a working knowledge of the common critical care issues related to these unique patients and the early recognition and management of problems that arise before and after transplantation in the ICU setting are crucial for long-term success. In this review, we discuss the management and selection of candidates for lung transplantation as well as existing respiratory support strategies that involve MV and ECLS in the ICU setting.

• Journal of Trauma and Injury
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• v.26 no.2
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• pp.47-52
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• 2013

Purpose: Injury severity score (ISS), a widely used scoring system, is used to define the severity of trauma in multiple-trauma patients. Nevertheless, ISS cut-off value for predicting the outcome of multiple-trauma patients has not been confirmed. Thus, this study was performed to determine the more useful method for predicting the outcome for multiple-trauma patients: the ISS or the number of anatomical Abbreviated injury scale (AIS) injury regions. Methods: for 195 consecutive patients who a regional emergency medical center, we analyzed the ISS and the number of anatomical AIS injury region. The patients were divided into four groups based on the ISS and the number of anatomical AIS regions. We compared intensive-care-unit (ICU) admission days and hospitalization days and ICU stay ratio (ICU admission days/hospitalization days) between the four groups. Results: In the groups with an ISS more than 17, the results were not significantly different statistically the group with 2 anatomical AIS injury regions and more than 3 anatomical AIS injury regions. Also, in the group with an ISS of 17 or less, the results were the same as those for patients with an ISS more than 17 (p>0.05). Among the patients with 2 anatomical AIS injury regions, patients with an ISS more than 17 patients had more ICU admission days and a higher ICU stay ratio than patients with an ISS 17 or less. Also, Among the patients with 3 anatomical AIS injury regions, the results were the same as those for patients with 2 anatomical AIS injury regions. Conclusion: Patients with high ISS, regardless of the number of anatomical AIS injury regions had significantly longer ICU stays and higher ICU admission ratio. Thus, the ISS may be a better method than the number of anatomical AIS injury regions for predicting the outcomes for multiple-trauma patients.

• Tuberculosis and Respiratory Diseases
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• v.73 no.1
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• pp.38-47
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• 2012

Background: The prevalence rate of pulmonary tuberculosis (PTB) is steadily decreasing in South Korea. However, PTB is a disease with relatively high mortality and morbidity rates throughout Korea. Although there are many studies and statistics about the risk factors of PTB mortality in many countries, there are only a limited number of domestic papers on this topic. The aim of this study is to determine predictive factors for mortality among in-hospital patients associated with PTB. Methods: From December 2006 to January 2011, we reviewed medical records of 2,122 adult patients diagnosed with tuberculosis at a single tertiary hospital in a suburban area. In this study period, 960 patients were diagnosed with PTB by positive Acid fast bacilli smear and/or mycobacterial culture of the respiratory specimen. We compared the groups of patients deceased and patients discharged alive with PTB. The number of dead patients was 82 (47 males, 35 females). Results: Mortality was significantly associated with increased values of white blood cells (WBC), blood urine nitrogen (BUN), creatinine, C-reactive protein (CRP), numbers of involved lung field, and length of hospitalization. Also, it was associated with the decreased values of hemoglobin, lymphocyte, sodium, albumin, and cholesterol. Furthermore, admission through the emergency department, initial intensive care unit admission, and drug resistant PTB affected mortality in PTB patients. Independent predictors associated with PTB mortality are BUN, initial intensive care unit care, and admission during treatment of tuberculosis. Conclusion: In our study, mortality of pulmonary tuberculosis was related with parameters associated with nutritional status, disease severity at the time of admission, and drug resistance.

• Nutrition Research and Practice
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• v.14 no.1
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• pp.12-19
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• 2020

BACKGROUND/OBJECTIVES: Vitamin D is a pleiotropic hormone that affects various body organ systems. We evaluated the prevalence of a vitamin D deficiency (VDD) and its potential role in the clinical condition of critically ill Korean children. SUBJECTS/METHODS: Patients under 18 years old with a 25(OH) vitamin D measurement on the first day of PICU admission were included from among the children admitted to the pediatric intensive care unit (PICU) of our tertiary children's hospital between October 2017 and January 2019. RESULTS: A total of 172 pediatric patients were enrolled. The mean 25(OH) vitamin D level was 17.5 ± 12.8 ng/mL. There was a 65.1% prevalence of VDD (25(OH) vitamin D level < 20 ng/mL). VDD was associated with age at PICU admission, gastrointestinal/hepatobiliary disorders, International Society of Thrombosis and Hemostasis disseminated intravascular coagulation (ISTH DIC) score, pediatric multiple organ dysfunction syndrome (pMODS) score and with several laboratory test findings including hemoglobin, platelet, C-reactive protein, serum albumin, total bilirubin, prothrombin time, and anti-thrombin III levels. Most of these parameters also showed significant linear correlations with the 25(OH) vitamin D level (P < 0.05). However, no statistically meaningful association was found between VDD and other clinical conditions such as the need for a mechanical ventilator, requirement for vasoactive drugs, duration of the PICU and hospital stays, or PICU mortality. CONCLUSION: There is a high prevalence of VDD in critically ill Korean children. There were significant associations between the 25(OH) vitamin D level and gastrointestinal/hepatobiliary disorders, the pMODS score and with coagulation related factors. Further large-scale studies with more specific subgroup analyses are required to more precisely assess the clinical implications of VDD in critically ill pediatric patients.

• Physical Therapy Rehabilitation Science
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• v.8 no.3
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• pp.134-140
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• 2019

Objective: The purpose of this study was to investigate the effect of exercise therapy and bedside ergometer exercise on muscle strength, function level, and quality of life of persons in intensive care. Design: Randomized Controlled Trial Methods: Sixteen patients in the ICU were randomly assigned to either the exercise group (n=8) or the bedside cycle ergometer group (n=8). Activities in the ICU exercise group (rolling, sitting at the edge of the bed, transfer from sitting to standing, standing balance training, ambulation) and bedside cycle ergometer group were performed 5 times a week for 30 minutes during the ICU admission period. Medical Research Council (MRC) and Functional Status Scale-Intensive Care Unit (FSS-ICU) parameters were assessed at the time of admission to the ICU, and reevaluation was assessed on the day of ICU discharge. The Short Form-36 (SF-36) was assessed at the time of discharge from the ICU. Results: MRC and FSS-ICU were significantly increased before and after intervention in both the experimental and control groups (p<0.05). There was a significant difference between MRC and FSS-ICU in the comparison of the changes before and after the intervention (p<0.05). SF-36 was compared between groups after intervention and there was a significant difference between the experimental and the control group (p<0.05). Conclusions: Muscle strength and functional levels improved after intervention in both the experimental and control groups. The ICU exercise group was more effective than the bedside cycle ergometer group to improve muscle strength, functional level, and quality of life performance of persons in the ICU.

• Health Policy and Management
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• v.10 no.4
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• pp.20-56
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• 2000

The purpose of this article was to evaluate the effects of reimbursement system on the basis of diagnosis-related groups(DRGs). We searched articles which was published from 1970 to 2000 using MEDLINE ； Key words "diagnosis-related groups, DRGs, prospective payment system, PPS. Then we reviewed 97 articles on classifying them into several categories of contents. It seems that the effects of DRGs in controlling hospitals cost in the U.S. was not clear cut. The U.S. Medicare PPS using DRGs remains vulnerable to compensatory increases in ambulatory care and long-term care facilities utilization despite cost per case and cost per admission being reduced. Also some research indicated the possibilities of deterioration in health care service quality. So putting theses results together, much more consideration is needed before the application of DRGs reimbursement system in Korea. Particularly there is the crucial difference between U.S. health care system and Korean, we must be aware of the limitations of DRGs and revise the DRG system to applicable in Korea.orea.

• Journal of Hospice and Palliative Care
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• v.23 no.1
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• pp.1-4
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• 2020

To deliver holistic and person-centered palliative care (PC), the spiritual dimension must also be assessed. However, many nurses do not screen for or assess patient spirituality. This article presents five things that PC nurses can consider in order to improve their spiritual screening and assessment practices. These points are as follows: (1) Understand that spirituality is manifest in a myriad of ways and is not the same thing as religiosity. (2) Screen for spiritual distress, and then later conduct a spiritual history or assessment. (3) Remember that spirituality is not just something to assess upon admission. (4) Know that there are many ways to assess spirituality (it is not merely how a patient verbally responds to a question about spirituality or religiosity). (5) Remember that assessment can also be therapeutic.

• Korean Journal of Community Nutrition
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• v.8 no.4
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• pp.574-583
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• 2003

The purpose of this study was to investigate the anthropometry, biochemical parameters and electrolytes concentrations of the Total Parenteral Nutrition (TPN) patients according to their nutritional status at the time of admission. Thirty-three patients in the Intensive Care Unit at S University Hospital were the subjects of this study. Their nutritional status was classified as At-risk I (Mild PCM, n = 13), At - risk II (Moderate PCM, n = 9) and At-risk III (Marasmus + kwashiorkor + severe PCM, n = 11) . Anthropometeric, biochemical and dietary assessments were performed. The Patients intake of calories (75.02%) and protein (53.15%) was insufficient compare with Korean RDA requirements. The body weight and the Body Mass Index (BMI) in the At-risk III group were significantly lower than in the other groups. The percentage of body weight loss and change of body weight (kg) were significantly higher than in the other groups. The subjects were malnourished as indicated by nutritional related parameters such as serum total protein, albumin, total lymphocyte count (TLC), hemoglobin and hematocrit. Serum total protein, albumin and TLC levels were lower at the time of admission before TPN administration. But after TPN administration, they increased. The electrolyte concentrations did not show any differences following TPN administration. The nutritional status of the patients could be affect by the duration of TPN administration and the number of days of the patients hospitalization. The patients who require nutritional support need the continuous follow-up care and monitoring by a nutritional support team. (Korean J Community Nutrition 8(4) : 574-583, 2003)