• 임상간호연구
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• 제19권1호
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• pp.33-44
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• 2013

Purpose: This study was done to develop a valid and reliable Classification System for Critical Care Nursing (CSCCN) to be used in Intensive Care Units (ICUs). Methods: Head nurses and staff nurses of 17 ICUs in 6 hospitals classified 307 patients to verify interrater reliability. To verify construct validity, the staff nurses classified 404 patients according to CSCCN comparing difference in medical department and type of stay in ICU. For conversion index, 78 patients from 4 ICUs of 'S' hospital were classified and nursing time was measured by 107 nurses and 18 nurse aids using stopwatches. Results: The developed CSCCN has 11 categories, 76 nursing activities and 101 criteria. The reliability was verified as having high agreement (r=.946). The construct validity was verified comparing differences in medical department and type of stay in ICU. According to scores, four groups in the CSCCN classification were identified. According to the conversion index, one score on the CSCCN means 7.2 minutes of nursing time. Conclusion: CSCCN can be used to measure diverse and complex nursing demands including psycho-social aspects of ICU patients and convert nursing demands to numbers.

• 임상간호연구
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• 제20권3호
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• pp.406-416
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• 2014

Purpose: Screening of delirium using delirium assessment tools could promote delirium detection, however, there is lack of report about regular delirium assessment in Korea. This study was intended to describe the prevalence and related risk factors of delirium in intensive care unit (ICU). Methods: The Confusion Assessment Method for the ICU (CAM-ICU) data which were evaluated by nurses in ICUs was obtained through retrospective chart review. Data were analyzed using descriptive statistics, Chi-square test, t-test, Mann-Whitney U test, and stepwise logistic regression. Results: Delirium was evaluated in 125 patients. The incidence rate of delirium was 27.2% with a high prevalence of hypoactive delirium compared to hyperactive delirium (61.8 vs. 38.2%). Those with delirium were older, had hypertension, stayed longer in hospital, receiving ventilator support, had more number of catheters, had low serum protein and albumin level. Delirium incidence also varied according to diagnosis. Age, diagnosis of gastrointestinal disease, and application of ventilator were the significant risk factors for the incidence of delirium. Conclusion: Routine delirium screening is important for early detection of delirium. Identification of high-risk group and running delirium prevention programs could improve early recognition of delirium in ICU.

• 중환자간호학회지
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• 제12권1호
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• pp.22-35
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• 2019

Purpose : This study was to determine the levels of environmental stressor, posttraumatic stress disorder, and quality of life in intensive care units (ICU) survivors after intensive care, and to explore the factors affecting posttraumatic stress disorder and quality of life. Methods: With a longitudinal survey design, data were collected from 116 patients who were discharged from the ICU of a university hospital. The environmental stressor, posttraumatic stress disorder, and quality of life were measured immediately following and 1 month after the ICU discharge. Results: Of all the subjects, 16.4% experienced posttraumatic stress disorder after discharge. Multiple regression analysis revealed that ICU environmental stressors, experience of ICU readmission, using psychotropic drugs and narcotic analgesics, and ICU admission after surgery or cardiac intervention accounted for 22.2% of posttraumatic stress disorder. Posttraumatic stress disorder and sedation status when entering ICU accounted for 28.3% of the quality of life 1 month after ICU discharge. Conclusion: Nursing interventions focused on ICU environmental stressors would not only reduce environmental stress but also contribute to the reduction of posttraumatic stress disorder and later improvement of quality of life.

• Journal of Korean Biological Nursing Science
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• 제20권4호
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• pp.228-235
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• 2018

Purpose: This study aimed to investigate the clinical alarm occurrence and management of nurses toward clinical alarms in the intensive care unit (ICU). Methods: This observational study was conducted with 40 patients and nurses cases in two ICUs of a university hospital. This study divided 24 hours into the unit of an hour and conducted two times of direct observation per unit hour for 48 hours targeting the medical devices applied to 40 patients. Data were analyzed using IBM SPSS Statistics 23. Results: On average, 3.8 units of medical devices were applied for each patient and the ranges of alarm settings were wide. During 48 hours, 184 cases of clinical alarm were occurred by four types of medical devices including physiological monitors, mechanical ventilators, infusion pumps, and continuous renal replacement therapy. Among them, false alarm was 110 cases (59.8%). As for the alarm management by ICU nurses, two-minute alarm mute took up most at 38.0% (70 cases), and no response was second most at 32.6% (60 cases). When valid alarm sounded, nurses showed no response at 43.2%. Conclusion: The findings suggest that a standard protocol for alarm management should be developed for Korean ICU settings. Based on the protocol, continuous training and education should be provided to nurses for appropriate alarm management.

• Journal of Korean Biological Nursing Science
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• 제15권4호
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• pp.247-256
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• 2013

Purpose: This study aimed to determine the effects of listening to music on pain and vital signs of critically ill patients with ventilatory support in intensive care units during nursing treatment (changes of posture and tracheal suction). Methods: The experimental treatment was to use an mp3 player and a speaker to let them listen to classical music by Mozart during nursing treatment. To determine the effects of music intervention, pain (Critical-Care Pain Observation Tool-K) was used. The data analysis was carried out by using PASW Statistics 20.0. Results: Hypothesis "The scores for pain would differ between the experimental group provided with music intervention during nursing treatment, and the control group" was supported. Conclusion: Application of music intervention during nursing treatment for critically ill patients with ventilatory support in intensive care units was found to be effective in reducing pain. Therefore, music intervention during nursing treatment for critically ill patients with ventilatory support can be used as non-pharmaceutical nursing intervention to reduce pain for the patients.

• 간호행정학회지
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• 제18권2호
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• pp.234-243
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• 2012

Purpose: This study was done to: (a) examine relationships between creative nursing practice and job satisfaction, and organizational commitment that nurses perceive in a hospital, and (b) identify creative nursing practice factors affecting job satisfaction and organizational commitment. Method: Using self-report questionnaires including 25 items of the Creative Nursing Practice Index, a descriptive study was conducted with a sample of 387 nurses working in the nursing care units of a general hospital in Seoul, Korea. Data were analyzed, using independent t-test, ANOVA, Pearson correlation, and hierarchical multiple regression analysis. Result: The mean score for nurses performance of creative practice was $2.29{\pm}0.46$ (range 1 to 4). Creative nursing practice had positive correlation with nurses' job satisfaction (r=.427, p<.001) and organizational commitment (r=.433, p<.001). Creative nursing practice factors influencing job satisfaction were implementing customized care (${\beta}$=.158, p=.010), making new knowledge (${\beta}$=.257, p<.001), and searching ideas (${\beta}$=.209, p<.001). Nurses' organizational commitment was influenced by implementing customized care (${\beta}$=.192, p=.002), making new knowledge (${\beta}$=.158, p=.028), searching ideas (${\beta}$=.254, p<.001), sharing ideas (${\beta}$=.250, p=.003), and validating ideas (${\beta}$=.189, p=.036). Conclusions: The results indicate a need to develop nurses' creative competency to pursue quality care as well as increase nurses' job satisfaction and organizational commitment.

• 임상간호연구
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• 제17권3호
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• pp.363-374
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• 2011

Purpose: The purpose of this study was to identify the types and causes of non-value-added (NVA) activities in nursing practice, and to determine the frequency of each NVA type and causes of NVA in clinical area. Methods: This study was conducted using Delphi technique. First, in order to identify NVA and their causes, 24 nurses with 7 years or more of clinical experience were recruited from medical/surgical units in six general hospitals in Korea. Then the NVA types and causes were tested using a larger sample of 130 nurses with more than 3 years of clinical experience at two general hospitals in Korea. Results: NVA was categorized into 6 different types, which are repeating, duplicating, waiting, reverse-proxy working, reworking, and searching. The most prevalent NVAs were repeating and duplicating works. Reworking and searching were less frequent types than others. The causes of NVA were classified into personnel-related, supporting departments, records, regulations, information, materials or instruments, and others. Among them, personnel-related and supporting departments were reported with the highest scores. Conclusion: NVA leads to waste cost and time. These results demonstrated the situations and causes of NVA occurred in nursing practice. Further studies on the typology and moderation of NVA activities are warranted to improve the efficiency and quality of nursing care in day-to-day practice.

• 중환자간호학회지
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• 제15권3호
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• pp.12-22
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• 2022

Purpose : This study aimed to examine the relationships of burnout and compassion competency with job satisfaction among nurses working in the intensive care units and emergency rooms. Methods : A correlational survey was conducted from August 1 to August 14, 2018 and involved in 102 nurses working at four university hospitals for more than 1 year. A structured questionnaire was used to measure burnout, compassion competency, and job satisfaction, and data were analyzed using hierarchical multiple regression and mediation effect analysis. Results : The mean scores of burnout, compassion competency, and job satisfaction were 2.58, 4.35, and 2.95, respectively. Burnout and compassion competency along with working night shifts and a wish to transfer explained 35.3% of variance in job satisfaction. Compassion competency showed a small but significant mediating effect in the relationship between burnout and job satisfaction (indirect effect -.0446, 95% CI -.1133, -.0075). Conclusion : Burnout and compassion competency were the significant influencing factors of job satisfaction among nurses working in intensive care units and emergency rooms. Since compassion competency showed a significant mediating effect, further studies should focus on intervention strategies for compassion competency to improve job satisfaction in this population.

• 기본간호학회지
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• 제25권2호
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• pp.109-119
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• 2018

Purpose: The purpose of this study was to investigate the effects of a delirium prevention intervention for patients in neurology and neurosurgery intensive care units (ICUs). Methods: This study was a quasi-experimental study. Participants were 87 patients. The experimental group was provided with nonpharmacologic and multicomponent delirium prevention interventions, consisting of regular delirium assessment, improvement in orientation, early therapeutic intervention, and environmental interventions. The control group was provided with routine intensive care. Data were analyzed using $x^2$ test, Fisher's exact test, and t-test. Results: Both groups were homogeneous. The incidence of delirium and length of hospitalization were significantly lower in the experimental group compared to the control group. ICU stay, mortality and unplanned extubation were lower in the experimental group compared to the control group, but there was no significant difference. Conclusion: Findings indicate that the delirium prevention intervention is effective in reducing incidence of delirium and length of hospitalization. Therefore, this intervention should be helpful in preventing delirium in neurology and neurosurgery ICUs and can be used as a guide in the prevention of delirium in neurological diseases's patients.

• 대한간호학회지
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• 제33권6호
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• pp.802-811
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• 2003

Purpose: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. Method: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. Result: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. Conclusion: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.