• Journal of Korean Academy of Fundamentals of Nursing
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• v.14 no.3
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• pp.297-305
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• 2007

Purpose: The purpose of this study was to evaluate knowledge, attitude, and compliance regarding hand hygiene according to the profession of ICU health care providers. Method: Data were collected by questionnaires and by recording of direct observations of 143 health care providers in 4 intensive care units. With SPSS/WIN 12.0 t-test, ANOVA, and ${\chi}^2-test$ were used to analyze the data. Results: The level of knowledge regarding handwashing among the nurses was higher and a more positive attitude was shown compared to physicians. Overall handwashing compliance was low among all ICU health care providers, but nurses had better compliance than any other health care providers and significantly higher frequency for handwashing before care and after care activities. All of professions had lower scores on the appropriate length of time for handwashing and areas that need to be scrubbed. The level for nurses was medium and for physicians, the lowest of all professions. The appropriate agent for handwashing and the method of drying for handwashing compliance was high in all professions. Conclusion: The results suggest that multidisciplinary interventions are needed to develop an environment for appropriate handwashing as well as to reinforce importance of handwashing compliance for health care providers.

• Journal of Korean Critical Care Nursing
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• v.11 no.2
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• pp.63-74
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• 2018

Purpose : This study aimed to identify the factors influencing job satisfaction in intensive care unit (ICU) nurses. Method : Using a cross-sectional design, data collected from 145 ICU nurses working at two university hospitals with more than 1,200 beds located in B and Y city were analyzed. The instruments used for this study assessed autonomy, communication satisfaction, resilience, and job satisfaction. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient, and multiple linear regression analysis. Results : Job satisfaction was significantly correlated with communication satisfaction (r=.60, p < .001) and resilience (r=.34, p < .001). Further, job satisfaction was influenced by communication satisfaction (${\beta}=.48$, p < .001), working at a surgery ICU (${\beta}=.21$, p =.008), and dissatisfaction with nursing (${\beta}=-.24$, p =.005). The explanatory power of this model was 44.7%. Conclusion : These results suggest the need for programs to improve communication satisfaction and nursing satisfaction.

• Journal of Korean Academy of Nursing
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• v.37 no.3
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• pp.373-380
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• 2007

Purpose: The objective of our study was to figure out costs of nursing services in ICU based on the PCS in order to determine an appropriate nursing fee schedule. Method: Data was collected from 2 hospitals from April 15-16 to April 22-23, 2003. The costs of nursing services in the ICU were analyzed by nursing time based on the nursing intensity. The inpatients in the ICU were classified by a PCS tool developed by the Korean Clinical Nurses Association(2000). Results: The distribution of patients by PCS in the ICU ranged from class IV to Class VI. The higher PCS in ICU consumed more nursing time. As a result, the higher nursing intensity, the more the daily average nursing costs in the ICU. Conclusion: Our study provides evidence to refine the current nursing fee schedule that does not differentiate from the volume of nursing services based on nursing time. We strongly recommend that the current reimbursement system for nursing services should be applied not only to the general nursing units but also to the ICU or other special nursing units.

• Journal of Korean Clinical Nursing Research
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• v.19 no.2
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• pp.265-274
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• 2013

Purpose: The aim of this study was to determine the risk factors contributed to unplanned readmission to intensive care unit (ICU) and to investigate the prediction model of unplanned readmission. Methods: We retrospectively reviewed the electronic medical records which included the data of 3,903 patients who had discharged from ICUs in a university hospital in Seoul from January 2011 to April 2012. Results: The unplanned readmission rate was 4.8% (n=186). The nine variables were significantly different between the unplanned readmission and no readmission groups: age, clinical department, length of stay at 1st ICU, operation, use of ventilator during 24 hours a day, APACHE II score at ICU admission and discharge, direct nursing care hours and Glasgow coma scale total score at 1st ICU discharge. The clinical department, length of stay at 1st ICU, operation and APACHE II score at ICU admission were the significant predictors of unplanned ICU readmission. The predictive model's area under the curve was .802 (p<.001). Conclusion: We identified the risk factors and the prediction model associated with unplanned ICU readmission. Better patient assessment tools and knowledge about risk factors could contribute to reduce unplanned ICU readmission rate and mortality.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.1-10
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• 2020

Purpose : This study aims to investigate the differences in fatigue, sleepiness, and near-miss according to sleep disturbance among shift nurses in intensive care units (ICUs). Methods : A cross-sectional study in a tertiary hospital was performed. A total of 122 shift nurses working in the six ICUs were recruited. They completed self-reported questionnaires about sleep disturbance, fatigue, sleepiness, and near-miss in the past two weeks. Results : The prevalence of reported sleep disturbance was 30.3% (37 out of 122 subjects). Compared to the non-sleep disturbance group, the sleep disturbance group reported significantly more sleepiness (11.46 vs. 8.86) and higher fatigue (82.62 vs. 69.39). The sleep disturbance group showed higher rates of near-miss (78.4 vs. 57.6%) and a higher frequency of them (4.49 vs. 2.11/2weeks) compared to the non-sleep disturbance group. Medication error was the most common type of near-miss. Conclusions : This study suggests that sleep disturbances could increase fatigue, sleepiness, and near-miss among ICU shift nurses. Personal and organizational programs should be developed to support the sleep of ICU nurses.

• Journal of Korean Academy of Nursing
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• v.37 no.6
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• pp.924-931
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• 2007

Purpose: The purpose of this study was to describe the essence of the experiences of patients in an ICU, and to understand them from the patients' point of view. Methods: Participants in this study were six patients in P hospital. Data collection consisted of in-depth interviews and an observation method done from January to April in 2005. The method was analysis using the phenomenological method proposed by Colaizzi(1978). Results: The themes were classified into eight theme clusters. The eight theme clusters were finally grouped into four categories, 'shock', 'pain', 'gratefulness' and 'pleasure of revival'. Conclusion: The ICU patients had negative experiences in physical mental critical situations, but also positive experiences in consolation and nurses and families' encouragement. Therefore, ICU nurses must support patients and their families to minimize the negative experiences and maximize the positive experiences.

• Journal of Korean Academy of Nursing
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• v.30 no.5
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• pp.1230-1242
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• 2000

The purpose of this research was to uncover the expertise of ICU nursing in Korea, and to describe nurses' practice based on the degree of skill acquisition. A total of 18 ICU nurses participated in the study. The data was collected through individual in-depth interviews and it was managed using the NUDIST 4.0 software program. The data was analyzed using interpretive phenomenology suggested by Benner. Four properties of expertise of ICU nursing were identified. These are 1) concern and love toward patients; 2) knowledge; 3) skill, and 4) abilities in interpersonal relationships. And the characterisitcs of four levels of skill acquisition, that is advanced beginner, competent, proficient, and expert, were described with exemplars. The results of this study might help nurse researchers clarify and elaborate on the concept of expertise in ICU nursing, and enable them to understand how the process of skill acquisition occurs in the ICU setting. They might also help nurse managers establish educational goals for ICU nursing for student or novice nurses.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.75-85
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• 2020

Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU). Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation. Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65~30.33, p<.001), education < high school graduation (OR=2.53, 95% CI=1.07~6.01, p=.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p=.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p=.038). Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.3
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• pp.359-367
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• 2006

Purpose: This study was a within subject repeated pretest-posttest design done to compare the effect of disinfection and the degree of MRSA(Methicillin- resistant staphylococcus aureus) isolation from hand disinfectant in ICU nurses. Method: Out of the total internal medicine/surgery ICU nurses at a university hospital in Seoul, 29 female nurses who were participating in direct patient care were participants in this study. After collection of samples, Staphylococcus aureus and MRSA were isolated from the palms, nails and nasal cavities of the nurses according to disinfectants (soap and beta-scrub). Results: The effect of disinfection was greater in the beta-scrub group than in the soap group, and the effect of disinfection on palms was higher in the beta-scrub group than in the soap group. As for the degree of MRSA isolation, there was more isolation in palms in the soap group than in the beta-scrub group but there was no difference in the degree of MRSA isolation from the hand disinfectant in nails and nasal cavities. Conclusion: Beta-scrub showed a superior prolonged effect against transient bacteria compared with soap. Further, to reduce MRSA infection, we recommend interventions focused on these aspects.

• Journal of Korean Academy of Nursing
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• v.31 no.5
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• pp.770-780
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• 2001

This quasi-experimental study was to explore the effects of back massage with Lavender essence oil on the stress response of the ICU nurses. Method: Twenty nurses were selected as an experimental group and twenty nurses were in the control group. Lavender essence oil mixed with Jojova carrier oil was used to massage the neck, shoulder, back, and low back. Massage was done three times a week for 20 minutes for 2 weeks by the massage therapist. The stress response was measured with a subjective stress score, Cortisol and IgA level in saliva. The cortisol level in saliva was analyzed by an radioimmunoassay before and after back massage. The level of IgA in saliva was analyzed by an immunoturbidimeter assay and subjective stress scores was measured by Visual Analogue Scale. The data was analyzed using SPSS 8.0 and the hypotheses were tested by ANCOVA and the Pearson coefficient correlation. Result: 1) Score of subjective stress decreased significantly after the use of back massage with Lavender essence oil. 2) Level of Cortisol in saliva did not change significantly after the use of back massage with Lavender essence oil. 3) Level of IgA in saliva increased significantly after the use of back massage with Lavender essence oil. 4) After the use of back massage with Lavender essence oil, there was significant negative correlation between subjective stress and level of IgA in saliva. Conclusion: Back massage with Lavender essence oil is an effective intervention to reduce the stress response in the ICU nurses.