• 중환자간호학회지
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• 제17권2호
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• pp.25-41
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• 2024

Purpose : This study aimed to investigate changes in critical nursing activities from 2009 to 2020 and explore the relationship between nurse staffing and such activities in intensive care units. Methods : A total of 446,445 adult patients admitted to intensive care units in tertiary and general hospitals from 2009 to 2020 were identified using the National Health Insurance claims database. The Critical Nursing Activities Index was calculated based on the following critical nursing activities: ventilator, extracorporeal membrane oxygenation (ECMO), and continuous renal replacement therapy (CRRT). Trend analysis was performed to analyze changes in critical nursing activities over 12 years and to assess linear trends across different staffing levels. Results : The annual utilization days for ventilators, ECMO, and CRRT, as well as the Critical Nursing Activities Index significantly increased over the study period (p-for-trend<.001) in tertiary and general hospitals, except for ventilator use in general hospitals. Ventilator, ECMO, and CRRT utilization exhibited a significant upward trend with higher nurse staffing levels (Bonferroni adjusted p-for-trend<.001). The Critical Nursing Activities Index was significantly higher in hospitals with higher staffing levels compared to those with lower staffing levels (Bonferroni adjusted p <.05). Conclusion : The findings underscore the need for improved nurse staffing levels in intensive care units. Government policies should ensure that staffing levels align with critical nursing activities among critically ill patients to uphold the quality of care.

• 중환자간호학회지
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• 제11권2호
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• pp.75-85
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• 2018

Purpose : The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies. Method : Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program. Results : The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased. Conclusion : Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically.

• 중환자간호학회지
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• 제5권1호
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• pp.56-66
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• 2012

Purpose: The purpose of this study was to investigate the knowledge and educational needs of nurses and physicians on home ventilator. Methods: The participants were 140 nurses and 47 physicians working at departments using home ventilators. The data were collected from January 30 to February 12, 2012 through a self-administered questionnaire with 32 items of the knowledge and educational needs on home ventilator. Results: The mean scores of nurses' and physicians' knowledge were 2.52 and 2.56 respectively. The mean scores of nurses' and physicians' educational needs were 3.16 and 3.06 respectively. Nurses' knowledge was associated with their experience using and receiving education about home ventilator and willingness to receive education about home ventilator education. Nurses' educational needs were associated with their present working department and experience using home ventilator. Nurses with high knowledge were more likely to have high educational needs. Physicians' knowledge and educational needs were not associated with any their general characteristics. Conclusion: Nurses' and physicians' knowledge of home ventilator were low and their educational needs on home ventilator were high. To provide high quality of care for home ventilators, it is necessary to provide nurses and physicians with education and to develop a more specific educational program for them.

• 중환자간호학회지
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• 제11권2호
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• pp.21-33
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• 2018

Purpose : To explore the person-centered care (PCC) experienced by critical patients. Method : This qualitative study deductively examined the attributes of the PCC model proposed by Jakimowicz and Perry. The participants were 16 patients who were recently discharged from intensive care units at a university hospital. Data were collected through in-depth interviews and were analyzed using the deductive method of content analysis. Results : A total of 4 categories, 16 subcategories, and 33 codes were generated from 171 meaningful statements. The final 4 categories were "compassionate presence," "professional interaction," "outstanding competency," and "patient identity." These were consistent with the main attributes of Jakimowicz and Perry's model. However, most of the codes belonged to the "compassionate presence" and "patient identity" categories. Among the attributes of the model, "continuity of nursing," "therapeutic relationship," "expert knowledge," "clinical knowledge," "evidence-based intervention," and "patient's rights" were not derived as codes. Conclusion : These findings deepen the understanding of the PCC model from the patient's point of view. The main attributes of PCC identified in the current study can be applied to the development of practical guidelines for intensive care nursing. In addition, we recommend the development of a PCC measurement tool for critical care patients.

• 중환자간호학회지
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• 제6권1호
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• pp.1-10
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• 2013

Purpose: The purpose of this study was to examine the reliability and validity of a Korean version of the Critical Care Pain Observation Tool (CPOT) developed for assessment of pain in critically ill nonverbal patients. Methods: Data were collected from a convenience sample of 30 critically ill patients admitted to a medical ICU in a hospital. The CPOT was tested at before, during and 20 minutes after changing a position and suction. Upon establishment of content and translation equivalence between the English and Korean version of CPOT. Results: The interrater reliability was found to be acceptable with the kappa coefficients of .76-1. The construct validity of the pain scores were increased from 0.43 to 2.5 in changing a position (t=-8.60, p<.001)and 0.1 to 3.23 (t=-9.36, p<.001) in suctioning. The pain scores were decreased from 6.06 to 4.01 in changing a position (t=-10.19, p<.001) and 6.45 to 4.13 (t=-10.39, p<.001) in suctioning. The concurrent validity the correlations between pain scores and physiological indicators, and a increased in Heart rate before and after changing a position (r=.65, p<.001). Conclusion: The CPOT can be used as a reliable and valid measure to assess pain in critically ill nonverbal a medical ICU patients.

• 대한간호학회지
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• 제41권6호
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• pp.768-779
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• 2011

Purpose: This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. Methods: This study used, the 'ADAPTE process', an international clinical practice guideline development method. The -'Bonnie Sue wound care algorithm' - was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. Results: A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ${\leq}$.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. Conclusion: The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

• 대한간호학회지
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• 제48권3호
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• pp.323-334
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• 2018

Purpose: The purpose of this study was to develop a scale to measure person-centered critical care nursing and verify its reliability and validity. Methods: A total of 38 preliminary items on person-centered critical care nursing were selected using content validity analysis of and expert opinion on 72 candidate items derived through literature review and qualitative interviews. We conducted a questionnaire survey with 477 nurses who worked in intensive care units. The collected data were analyzed using exploratory factor analysis (EFA) and confirmative factor analysis (CFA) with SPSS and AMOS 24.0 program. Results: EFA was performed with principal axis factor analysis and Varimax rotation. The 15 items in 4 factors that accounted for 50.8% of the total variance were identified by deleting the items that were not meet the condition that the commonality should be .30 or more and the factor loading over .40. We named the factors as compassion, individuality, respect, and comfort, respectively. The correlation coefficient between this scale and the Caring Perception Scale was r=.57 (p<.001), which determined concurrent validity. The item-total correlation values ranged from .39 to .63, and the internal consistency for the scale was Cronbach's ${\alpha}=.84$. Conclusion: The reliability and validity of the 15 item person-centered critical care nursing scale were verified. It is expected that the use of this scale would expand person-centered care in critical care nursing.

• 중환자간호학회지
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• 제11권2호
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• pp.1-10
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• 2018

Purpose : This study aimed to develop an in-depth and comprehensive understanding of the experiences of critical care nurses caring for dying patients. Method : Eleven critical care nurses with experience in caring for dying patients were recruited from four tertiary hospitals. Semi-structured face-to-face interviews were conducted between November 2016 and March 2017. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of critical care nurses. Results : The following six themes, and twelve sub-themes, were identified: (1) the gap between expectation and reality, (2) a distorted meaning of death, (3) repeated emotional pain and stress, (4) finding a solution alone, (5) sublimation into mission and calling, and (6) integration into one's own life. Conclusion : This study found that critical care nurses experience various psychological difficulties while caring for dying patients, and they made efforts on their own to overcome them. These findings are expected to inform the development of specialized programs to support critical care nurses to tackle these challenges, create guidelines on caring for dying patients, and help promote death education.

• 중환자간호학회지
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• 제4권2호
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• pp.1-14
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• 2011

Purpose: This study was aimed to understand and describe the Korean critical care advanced practice nurses' work experience. Methods: Data was collected through 2 focus group interviews that were held in two different university hospitals in Seoul, Korea. All interviews were recorded and transcribed, and data were analysed using modified qualitative content analysis. Results: Ten themes were drawn from data analysis. They are "Various and complex tasks", "Excellency of advanced nursing practice", "Pressure and responsibility accompanied with pride", "Role identity confusion", "Role conflict", "Leaping and evolving role", "Gap between role and outcome evaluation", "Underestimated outcomes", "Where are my outcomes?" "Searching for outcomes: publicize the role". Conclusion: The results of this study help to understand the role of Korean critical care advanced practice nurses and to guide to outcome evaluation of their role effectiveness. Developing qualitative outcome indicators, cost-effectiveness ananlysis of Korean critical care advanced practice nurses' role, and accumulation of evidences through researches on outcome evaluation will be needed to successfully settle down advanced practice nursing in Korea.

• 중환자간호학회지
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• 제2권2호
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• pp.79-91
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• 2009