• 기본간호학회지
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• 제10권2호
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• pp.145-153
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• 2003

Purpose: Related factors for 24 nursing diagnoses frequently used in the emergency care unit were validated in this study. Method: A convenience sample of 65 registered nurses who had worked for 2 years or more in emergency care units and received instruction on nursing diagnosis was used for the study. The classification of nursing diagnoses was based on NANDA (1996) and validation, on Fehring (1987)'s DCV model. Result: Differences were found between emergency and general care units for related factors for nursing diagnosis. Newly reported related factors were not found for emergency care units. Conclusion: It is helpful for nurses who work in emergency care to be able to apply the nursing diagnosis validated in this study. These findings can be used as the database to provide a nursing diagnosis system appropriate to improving the emergency nursing practice.

• Child Health Nursing Research
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• 제25권4호
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• pp.518-527
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• 2019

Purpose: The purpose of this study was to identify the effects of an educational intervention by evaluating neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance after developing and operating a simulation-based neonatal emergency airway management education program for nurses in a neonatal intensive care unit. Methods: The participants were 30 nurses in a neonatal intensive care unit. Data were collected from June 6 to 15, 2018 and analyzed using IBM SPSS version 22.0. Results: The results of the pretest and posttest for each educational group showed statistically significant improvements in neonatal emergency airway management knowledge, critical thinking, problem-solving ability, and confidence in clinical performance. Conclusion: The simulation-based neonatal emergency airway management training program was an effective educational program that enhanced neonatal emergency airway management knowledge, critical thinking disposition, problem-solving ability, and confidence in clinical performance among nurses in a neonatal intensive care unit. Therefore, it is suggested that the program described in this study can contribute to improving nursing quality by enhancing the ability of nurses to cope with emergencies in practice. It can also be used for education for new nurses and contribute to the development of nurses' practices.

• Archives of Plastic Surgery
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• 제50권5호
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• pp.501-506
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• 2023

This article portrays the authors' experience with a complex lower limb bone and soft tissue defect, following chronic osteomyelitis and pathological fracture, which was managed by the multidisciplinary orthoplastic team. The decision for functional amputation versus limb salvage was deemed necessary, enhanced by the principles of "spare parts" in reconstructive microsurgery. This case describes the successful use of the osteocutaneous distal tibia turn-up fillet flap that allowed "lowering the level of the amputation" from a through knee to a below-knee amputation (BKA) to preserve the knee joint function. We comprehensibly review reports of turn-up flaps which effectively lower the level of amputation, also applying "spare-parts" surgery principles and explore how these concepts refine complex orthoplastic approaches when limb salvage is not possible to enhance function. The osteocutaneous distal tibia turn-up fillet flap is a robust technique for modified BKA reconstructions that provides sufficient bone length to achieve a tough, sensate stump and functional knee joint.

• 중환자간호학회지
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• 제14권1호
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• pp.40-49
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• 2021

Purpose : This study identified the factors affecting the clinical competence of emergency unit nurses caring for foreign patients. Methods : This study utilized a descriptive correlation design. Participants were 112 emergency unit nurses working in different hospitals designated as the government's emergency medical centers and agencies in 2018. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficients, and multiple linear regression analysis. Results : Subjects' clinical competence showed positive relationships with cultural competency (r=.45, p<.001) and intercultural communication (r=.53, p<.001). Factors that affect the clinical competence of subjects showed intercultural communication (β=0.38, p=.001). Conclusion : It is necessary to develop programs to improve intercultural communication, factors that influence clinical competence of emergency unit nurses, and apply them to practical fields.

• 중환자간호학회지
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• 제6권1호
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• pp.11-20
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• 2013

Purpose: This study to describe experiences of nurses who work in intensive care units (ICUs) where they frequently encounter patients with attempted suicide by drug ingestion. Methods: Data were collected by 2 focus group interviews with 9 ICU nurses. The interview were recorded and transcribed, and data were analyzed using qualitative content analysis. Results: The results of data analysis, five themes were drawn: 'Confusion about for the attempted suicidal patient care', 'Helplessness for dying with attempted suicidal patients', 'Guilty for insufficient care', 'Ambivalence for the attempted suicidal patients', 'Recognition of need for professional approach'. Conclusion: The results of this study help us to understand patients who attempted suicide through the ICU nurses' experience. It would be useful to develop effective education programs for ICU nurses to preventive strategies for patients who are high risk of recurrence of suicidal crisis situation.

• 중환자간호학회지
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• 제11권1호
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• pp.89-100
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• 2018

Purpose : The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO). Method : Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized. Results : The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %. Conclusion : The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.

• Journal of Trauma and Injury
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• 제24권2호
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• pp.98-104
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• 2011

Purpose: The aim of this study was to evaluate the quality of the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency intensive care unit (ICU) in consultation with intervention radiologists and surgeons. Methods: This was a retrospective observational study conducted in an emergency ICU of a tertiary referral hospital. We enrolled consecutive patients who had been admitted to our emergency ICU with major trauma from March 2007 to September 2010. We collected data with respect to demographic findings, mechanisms of injury, the trauma and injury severity score (TRISS), emergency surgery, angiographic intervention, and 6-month mortality. Then, we compared the observed and predicted survivals of the patients. The Hosmer-Lemeshow test and calibration plots by using 10 groups, one for each decile, of predicted mortality were used to evaluate the fitness of TRISS. P-values of greater than 0.05 represent a fair calibration. Results: Among 116 patients, 12 (10.34%) were dead within 6 months after admission to the ICU, and 29 (25.00%) and 38 (32.80%) patients received emergency surgery and angiographic intervention, respectively. The mean injury severity score and revised trauma score were $36.97{\pm}17.73$ and $7.84{\pm}6.75$, respectively. The observed survival and the predicted survival of the TRISS were 89.66% (95% confidence interval [CI]: 84.03~95.28%) and 69.85% (95% CI: 63.80~75.91%), respectively. The calibration plots showed that the observed survival of our patients was consistently higher than the predicted survival of the TRISS ($p$ <0.001). Conclusion: The observed survival for the trauma care system of our hospital, in which emergency physicians care for major trauma patients in the emergency ICU in consultation with intervention radiologists and surgeons, was higher than the predicted survival of the TRISS.

• 대한임상독성학회지
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• 제18권2호
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• pp.94-101
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• 2020

Purpose: This study examined the clinical and epidemiological characteristics of intensive care unit (ICU) patients admitted or died in the emergency medical center with acute-poisoning to investigate the variables related to the prognosis. Methods: The data were collected from poisoning patients admitted or died in the emergency medical center of a general hospital located in Seoul, from January 2014 to February 2020. The subjects of this study were 190 patients. The medical records were screened retrospectively, and the clinical and epidemiological characteristics of the patients in the emergency room (ER) and ICU were examined to investigate the contributing factors that influence the poor prognosis. Results: The study analyzed 182 patients who survived after being admitted to the intensive care unit (ICU). The results are as follows. The mental change (87.4%) was the most common symptom. Sedative poisoning (49.5%) was the commonest cause. For most patients, pneumonia (26.9%) was the most common complication. Hypotension (23.7%), tachycardia (42.1%), fever (15.8%), seizures (10.5%), dyspnea (2.6%), high poisoning severity score (PSS), type of toxic material, mechanical ventilator application (39.5%), inotropes application (39.5%), and pneumonia (55.3%) were correlated the LOS over 5 days in the ICU. 8 patients died. In the case of death pesticides and carbon monoxide were the main toxic materials; tachycardia, bradycardia, and hypotension were the main symptoms, and a mechanical ventilator and inotropes were applied. Conclusion: Patients with unstable vital signs, high PSS, and non-pharmaceutical poisoning had a prolonged LOS in the ICU and a poor prognosis.

• 기본간호학회지
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• 제18권3호
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• pp.373-382
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• 2011

Purpose: The purpose of this study was to assess the educational needs of ICU nurses based on an analysis of importance, frequency, and difficulty for ICU nursing practice. Method: A cross-sectional survey was conducted using a questionnaire with 80 questions in 14 ICU nursing categories. Data were collected from August to October 2009. A total of 295 ICU nurses from five hospitals who had minimum of one year clinical experience participated. Data were analyzed with using descriptive statistics. Results: For importance, emergency care had the highest score, followed by physical assessment, communication, cardiovascular care, and ICU basic nursing. Regarding the frequency, physical assessment had the highest score, followed by communication, medication, ICU basic nursing, and respiratory care. Cardiovascular care was the most difficult task, followed by neurological care, emergency care, other ICU related nursing care, diagnostic test, and communication. Conclusion: The findings indicate a high educational need in the areas of communication, medication, physical assessment, diagnostic test, emergency care, and cardiovascular care. Thus the development of educational programs on communication, medication, physical assessment, diagnostic test, emergency care, and cardiovascular care are needed for ICU nurses.

• 한국의료질향상학회지
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• 제10권1호
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• pp.42-56
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• 2003

Background : The purpose of this study is to investigate the influencing factors on the length of emergency department stay of patients with acute myocardial infraction. Methods : we reviewed medical records of all patients who were Hospitalized with acute myocardial infraction from March 1, 2002 to February 28, 2003. Results : The average length of stay in the emergency room of the subjects was 182.74 minutes. After the emergency room treatment, 48.1% of the subjects were transferred to intensive care unit. The hospitalization through emergency room mostly took place in the office hours. There were more patients on Monday. The influencing factors on the length of stay in the emergency room of patients with acute myocardial infraction were emergency room arrival time which was classified in seasons, treatment hours of specialized doctors, medical care insurance and required time of radiologic examination. Conclusion : In order to reduce the length of emergency room stay, it might be an available solution secure enough spaces, facility, and staff of the radiologic test only for the patients of the emergency room. And the effective use of emergency facility and space, establishment of standardized treatment guideline, and provision of emergency treatment support system are also needed.