• Journal of Korean Clinical Nursing Research
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• v.16 no.3
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• pp.175-186
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• 2010

Purpose: Delirium can be a highly prevalent symptom in intensive care units but it may still be under-recognized despite its relation with inclined morbidity, mortality, cost, and readmission. Therefore, this study aimed to develop a protocol that covers risk factors and non-pharmacological interventions to prevent delirium in ICU patients. Methods: This study was conducted using methodological design, and it followed the Scottish Intercollegiate Guideline Network (SIGN) guideline development steps: 1) the scope of protocol was decided (population, intervention, comparison, and outcomes); 2) guidelines, systematic reviews, and protocols were reviewed and checked using methodology checklist; 3) the level of evidence and recommendation grades was assigned; 4) the appropriateness of recommendations was scored by experts; 5) the final protocol & algorithm was modified and complemented. Results: The evidence-based delirium prevention protocol was completed that includes predisposing factors, precipitating factors and recommendations with evidenced grades. Conclusion: This protocol can be used as a guide nurses in screening patients with high risk factors of delirium as well as in intervening the patients non-pharmacologically to prevent delirium.

• Korean Journal of Adult Nursing
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• v.12 no.2
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• pp.175-183
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• 2000

The study was done by applying a phenomenological study, which is qualitative research methods, in order to understand the meaning of the lived experiences, to confirm and describe the meaning structure, and to prepare nursing interventive strategies centering around the meanings of the inpatients' families in the intensive care units. In the study, the family members were the main important nursing providers for in the inpatients' who were admitted in the neurosurgical intensive care unit in K-university hospital and who agreed to participate in the study after being given on explanation about the purpose of the study. The data were collected from the seven participants who had feelings of trust and intimacy favorable toward the researcher as they were families of patients who had been cared for by the researcher in the ICU where the researcher has been assigned. The data were collected from April to October, 1999. The participants described their experiences as candidly as possible. The researcher described closely the lived experiences with their own words and the observations of the researcher. A tape recorder was used with the consent of the participants to prevent nursing information and communication. The analysis of the data was made through the phenomenological analytic method suggested by Giorgi; as an unit of description, which include the participants' expressions and the researcher's observations, the analysis was used based on the data described from the expressions of the participants and the details of observations of the researcher. The conclusions of the study were as follows : The meanings of the lived experience of the inpatients' families in the ICU was confirmed by indepth interviews and observations including these of the participatants : (1) Psychological impact: confusion, impatience, surprise, insensibility; (2) Physical suffering: fatigue, discomfort, indigestion; (3) Psychological suffering: heartbreaking emotion, anxiety, annoyance, fear, compassion, grief; (4) Economical suffering: economical difficulties; (5) Psychological disagreement: escape from reality, personnel avoidance, grudge, powerlessness, carefulness, transposition of life-tract, abandonment, role-crisis, hope, lack of understanding, regret, feeling of ambivalence(progressive process, medical personnel interest); (6) Psychological dependency; self-reliance group support, family support, religious support; (7) Psychological acceptance; acquaintance, gratitude, reassurance; The study will offer better understanding of experiences therefore, based on the experiences confirmed by the study, it may facilitate more appropriate nursing interventive strategies for health maintenance and to prevent occurrence of possible problems with the inpatients' families in the ICUs.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.5
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• pp.1699-1705
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• 2015

Background: Medication errors in oncology may cause severe clinical problems due to low therapeutic indices and high toxicity of chemotherapeutic agents. We aimed to investigate unintentional medication errors and underlying factors during chemotherapy preparation and administration based on a systematic survey conducted to reflect oncology nurses experience. Materials and Methods: This study was conducted in 18 adult chemotherapy units with volunteer participation of 206 nurses. A survey developed by primary investigators and medication errors (MAEs) defined preventable errors during prescription of medication, ordering, preparation or administration. The survey consisted of 4 parts: demographic features of nurses; workload of chemotherapy units; errors and their estimated monthly number during chemotherapy preparation and administration; and evaluation of the possible factors responsible from ME. The survey was conducted by face to face interview and data analyses were performed with descriptive statistics. Chi-square or Fisher exact tests were used for a comparative analysis of categorical data. Results: Some 83.4% of the 210 nurses reported one or more than one error during chemotherapy preparation and administration. Prescribing or ordering wrong doses by physicians (65.7%) and noncompliance with administration sequences during chemotherapy administration (50.5%) were the most common errors. The most common estimated average monthly error was not following the administration sequence of the chemotherapeutic agents (4.1 times/month, range 1-20). The most important underlying reasons for medication errors were heavy workload (49.7%) and insufficient number of staff (36.5%). Conclusions: Our findings suggest that the probability of medication error is very high during chemotherapy preparation and administration, the most common involving prescribing and ordering errors. Further studies must address the strategies to minimize medication error in chemotherapy receiving patients, determine sufficient protective measures and establishing multistep control mechanisms.

• Journal of Korean Academy of Nursing Administration
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• v.5 no.1
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• pp.63-76
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• 1999

The main objective of this study was to develop a concept of service marketing promotion in nursing that is derived from the concepts of service marketing theory. This research was a descriptive study, at the factor isolation level. The principle of concept derivation suggested by Walker and Avant (1988) and the Hybrid model suggested by Schwarz-Barcott and Kim (1993) were employed as the research method. The data were collected from December, 1997 to April. 1998 at a large general hospital located in Seoul. The procedures of this study were as follows: First. at the theoretical phase: the meaning, attributes, and definition of service marketing promotion were identified through an extensive review of the literature. Second, at the empirical phase: fieldwork was done to identify the promotional activities and events in nursing. Top nurse managers from 4 units (Director of Nursing, Head nurses of inpatient nursing unit, outpatient nursing unit. and home care nursing unit) were interviewed and the content of the interview was analyzed to identify the meaning and attributes of promotion in nursing. Other methods such as brochures and other audio-visual materials which were relevant to nursing promotion were used to supplement the interviews. Finally, the results of the theoretical and empirical analyses were intergrated to develop a concept of service marketing in nursing practice. A final definition of service marketing promotion in nursing was identified as follows. 1. Promotion as a marketing function in nursing service is concerned with communication to target markets on all information related to nursing service in order to satisfy the objectives of both a nursing service organization and the target markets. 2. The goals of nursing service promotion include: 1) increasing visibility of nursing services and delivering the information on nursing services, 2) affirming the value of nursing services, so it can contribute to formulation of reimbursement policy for nursing services. 3) advancing the general image of the nursing profession and nursing services. 4) achieving and attaining a desirable positioning for nurses among health care professionals. and 5) creating and stimulating the demand for nursing services. 3. In order to obtain these goals it is necessary to provide information on nursing services, to persuade target markets. to remind them about nursing services. and to establish a collaborative relationship with related departments. 4. The tools used to carry out the above functions of promotion in nursing are the providing nursing services, public relations and publicity. QA of nursing, advertising, and sales promotion. 5. The target markets of nursing service include the nursing customer markets. the internal markets, the influence markets. the recruitment markets. the supplier markets. and the nursing referral markets. In conclusion, the concept of promotion in other service marketing areas can be applied to the promotion of nursing service marketing. The promotion of nursing service is more than just effective communication in nursing service. it is the effective use of the concepts of service marketing promotion. Promotion of nursing service will contribute to create and expand nursing services.

• Journal of Korean Clinical Nursing Research
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• v.14 no.2
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• pp.127-138
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• 2008

Purpose: To examine the effects of the environmental nursing intervention using eye-shields and earplugs on the incidence of delirium, environmental stress and sleep among the patients with open-heart surgery in the post-cardiac ICU(intensive care units). Method: This study was a non-equivalent control group non-synchronized design. The subjects consisted of 93 patients who received ICU care after the cardiac surgery. Among those, 32 subjects was assigned in one experimental group with eye-shields, 31 in the other experimental group with earplugs, and 30 in the control group. ICU delirium was measured by CAM-ICU, environmental stress by ICUESS, and sleep by two sleep scales developed by Oh, et al. and Kim. The data were analyzed by the SPSS 13.0 program including frequency, percentage, t-test, $x^2$ test, ANOVA and ANCOVA. Results: There are no statistically significant differences in the incidence of delirium among three groups (p=.139). The ICU environmental stress scores from the subjects of two experimental groups demonstrated lower (F=6.731, p=.002) than the control group. Also, the degrees of sleep pattern (p=.000, p=.000) and sleep satisfaction (p=.000, p=.000) were greater than those of the control group. Conclusion: Although the environmental nursing intervention using eye-shields and earplugs did not demonstrate the effects in decreasing the incidence of ICU delirium, it has affirmative effects in decreasing environmental stress and improving the quality sleep among the patients with open-heart surgery while they stay in ICU. Further nursing implications are discussed.

• Journal of Korean Critical Care Nursing
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• v.6 no.1
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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.

• Journal of Korean Critical Care Nursing
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• v.12 no.3
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• pp.1-12
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• 2019

Purpose : This study aims to identify the relationship between person-centered critical care nursing (PCCN) and family satisfaction for intensive care unit (ICU) nurses. Methods : This research used a cross-sectional survey. The participants were 142 nurses and 121 family members from 8 ICUs in 4 hospitals in B city. The questionnaire survey was conducted between December 2018 and March 2019. The eight ICUs were divided into those that scored high and those that scored low for person-centered care relative to the average score for PCCN, and the difference in family satisfaction between the ICUs with high and low scores was compared using t-test. Results : The mean score of PCCN was $3.68{\pm}0.40$ out of 5. In the subcategories of PCCN, "comfort"was the highest at $3.95{\pm}0.49$, followed by "respect" at $3.73{\pm}0.57$, "compassion" at $3.59{\pm}0.57$, and "individuality" at $3.47{\pm}0.54$. The average score of family satisfaction with the ICUs was $3.45{\pm}0.67$ out of 5. In its subcategories, "emotion" was the highest at $3.69{\pm}0.72$, followed by "information" at $3.61{\pm}0.75$, "participation" at $3.30{\pm}0.79$, and "resources" at $3.20{\pm}0.80$. The family satisfaction ($3.75{\pm}0.54$) with the ICU of the highest-scoring PCCN was significantly higher than the family satisfaction ($3.25{\pm}0.53$) with the ICU with the lowest-scoring PCCN (t=4.97, p<.001). Conclusion: The results suggest that the PCCN scores of ICU nurses should be promoted to improve family satisfaction. It is necessary to pursue a variety of ways to secure the provision of person-centered nursing practice in ICUs.

• Journal of muscle and joint health
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• v.29 no.1
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• pp.41-49
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• 2022

Purpose: The purpose of this study was to assess the influence of nurses staffing level on patient health outcomes in intensive care units (ICUs) in Korea. Methods: The study was retrospective in nature. Information on patients and their outcomes, as well as nurse cohort data, were obtained from Korea's National Health Insurance Service Database. The observation period was from January 1, 2008 to December 31, 2018, and data for 2,964,991 patients were analyzed. Independent variables included patient' age and sex and hospital type, intensivist, and nurses staffing level. Results: The mortality rate in ICUs was significantly higher at tertiary hospitals with a level 3~4 (HR, 1.21; 95% confidence interval, 1.19~1.22) or level 5~9 nurse staffing (HR, 1.31; 95% confidence interval, 1.27~1.34) compare to that of tertiary hospitals with a 1~2 level. 28-day mortality rate was also higher at general hospitals with a level 3~4 (HR, 1.13; 95% confidence interval, 1.12~1.14), level 5~6 (HR. 1.34; 95% confidence interval, 1.32~1.36), level 7~9 nurse staffing (HR, 1.38; 95% confidence interval, 1.38~1.42), using level 1~2 as reference. Conclusion: Nurses staffing level is a key determinant of healthcare-associated mortality in critically ICUs patients. Policies to achieve adequate nurse staffing levels are therefore required to enhance patient outcomes.

• Korean Journal of Adult Nursing
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• v.25 no.3
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• pp.344-355
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• 2013

Purpose: The purpose of this study was to identify on the perceptions of family care-givers toward use of physical restraints according to their values, beliefs, and perceptions using Q methodology. Methods: Thirty-three family care-givers classified 41 selected Q-statements into 9 points standard. The obtained data were analyzed by using a pc QUANL program. Results: Principal component analysis identified 4types of the perceptions of family care-givers toward the use of physical restraints. Type I is 'Rational accepted', which means that they perceived the restraints are essential therapeutic devices and had cooperative attitude to use of medical staffs' restraints. Type II is 'Sardonic sensibility', which means that they have a negative and a cynical attitude to use of physical restraints. Type III is 'Ambivalent', which means that they have conflicts between rationality and emotion, and type IV is 'Practical claim of a right', which means they insist that patients and their family members must be provided with a detailed explanation regarding the application of physical restraints. Conclusion: The findings of this study suggest that perceptions toward the use of physical restraints among family care-givers should be understood for patients' safety and dignity in medical circumstance. Based on the results, this study will be useful in developing the customized nursing intervention for supporting family care-givers' subjectivity considering the Korean context.

• Child Health Nursing Research
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• v.24 no.2
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• pp.252-261
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• 2018

Purpose: This study aimed to evaluate the effects of an empowerment program on maternal stress, anxiety, depression and parenting confidence. Methods: A total of 44 mothers of preterm infants were assigned into an experimental or a control group (n=22 each). The experimental group received the usual nursing care and 7 sessions of an empowerment program. The control group only received the usual care. The program was implemented from June to December, 2016 in the neonatal intensive care unit of K university-affiliated hospital in Daegu, Korea. The outcome variables measured were parental stress (PSS: NICU), anxiety (STAI), depression (CES-D) and parenting confidence. Data were analyzed using t-test or repeated measures ANOVA. Results: Scores for both parental stress (t=3.07 p=.004) and depression (F=3.76, p=.26) were significantly lower in the experimental group than in the control group. However, there were no significant differences in anxiety between the groups (F=0.79, p=.505). Parenting confidence scores (F=9.05, p=.001) were significantly higher in the experimental group than in the control group. Conclusion: A maternal empowerment program can be an effective means of reducing parental stress and depression as well as enhancing parenting confidence, for mothers of preterm infants.