• Korean Journal of Adult Nursing
• /
• v.19 no.4
• /
• pp.583-592
• /
• 2007

Purpose: The purposes of this study were to explore and describe the use of restraint on patients and to generate a grounded theory of how the use of restraint affects patients who have been restrained. Methods: Interview data from seven patients with physical restraint was analyzed using the Strauss and Corbin's grounded theory method. Data were collected and analyzed simultaneously. Unstructured and in-depth interviews were conducted retrospectively with patients recalling their memories of ICU following their transfer to general unit. Results: 'Safety belt' was emerged as a core category and it reflected that physical restraint provided a sense of security to patients. On the basis of core category, a model of the experience process of restrained patients in ICU was developed. The experience process were categorized into four stages: resistance, fear, resignation, and agreement. Stages of these proceeds appeared to have been influenced by the nurses' attitude and caring behavior such as the frequency of nurse-patient interaction, repetition of explanation, and empathetic understanding. Conclusion: These findings indicate that patients have mixed feelings towards restraint use, although negative feelings were stronger than positive ones. The result of this study will help nurses make effective nursing intervention.

• Korean Journal of Adult Nursing
• /
• v.21 no.2
• /
• pp.155-166
• /
• 2009

Purpose: This study developed and evaluated a systematic intervention among medical ICU nurses for preventing ventilator-associated pneumonia (hereafter VAP). Methods: A VAP prevention program was proposed based on a literature review, revised to fit the target situation, and validated. It was composed of one-time interventions including education, pamphlets, hand cultures, and a quiz event, as well as repeated interventions such as posters, reminders, posting hand culture results, and performance feedback. A simulated control group pretest-posttest design was used to verify the effectiveness of the VAP control program. The incidence of VAP among ICU patients was measured both during 3 months before (n=80) and during 3 months after (n=75) intervention. Results: The VAP prevention program's effectiveness, with a pre-intervention VAP rate of 17.38 and post-intervention rate of 11.04 per 1,000 ventilator days, showed a clinical tendency to decrease, but the difference was not statistically significant (p=.750). Conclusion: A VAP prevention program of multiple interventions can be useful in decreasing the VAP rate. Given that the monthly decrease in the VAP rate was not considered statistically significant, long-term research needs to be done. Additionally, since this study targeted only nurses, it is suggested that future research targets other health care workers who can influence VAP rates.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.17 no.2
• /
• pp.177-186
• /
• 2010

Purpose: The purpose of this descriptive study was to investigate the application of physical restraints in ICUs of a university hospital. Method: Data were collected from August 1 to October 1 2009, using a recording tool from Electric Nursing Records and an observation tool for physical restraints and related factors. Frequency, percentage, and paired t-test with the SPSS/WIN 16.0 program were used to analyze the data. Results: The application rate for physical restraints in 5 ICUs was 34.3%, the highest application rate was 48.4% in the neurosurgical ICU. The mean frequency for physical restraint application per patient was 1.14, and the mean hours of restraint application per incident was 113.01 hours. The most common complications of physical restraints were bruising and edema. Conclusion: Many ICU nurses use physical restraints when caring for patients who are at high risk for falls, including patients have high levels of acuity, decreased level of consciousness or increased irritability. When physical restraints are applied, patients show resistance against the use resulting in side effects of bruising and edema. Therefore, nurses should observe changes in restrain sites, perform nursing interventions to prevent complications, and minimize the use of physical restraints.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.18 no.1
• /
• pp.28-36
• /
• 2011

Purpose: The purpose of this study were to develop a new restraint for the intensive care units (ICU) and to investigate the application effect in comparison with a control group using existing restraints. Method: A non-equivalent control group non-synchronized quasi-experimental research design was used. The participants were 40 (control 20, experimental 20) patients who were recruited by convenience sampling the ICU of a university hospital. To avoid contamination of the experiment, data for the control group were collected prior to the experimental group. Measurement variables were edema and skin damage (redness and abrasion) at the application site, and nurses' perceived convenience in applying restraints. Results: Three days after applying the restraint, amount of edema at the application site was small and incidence of skin damage decreased in the experimental group in comparison with the control group. Also, score for application convenience measured by the nurses was higher in for the newly developed restraint than for existing restraints. Conclusion: Results indicate that the newly developed restraint has lower effects such as edema and skin damage and is more convenient compared with existing restraints, and is therefore recommended for patients in the ICU.

• Journal of Korean Clinical Nursing Research
• /
• v.17 no.3
• /
• pp.421-432
• /
• 2011

Purpose: The purpose of this study was to investigate the sleep patterns and the factors related to sleep disturbance in mechanically ventilated patients in intensive care units (ICUs). Sleep patterns in this study included both quality and quantity of sleep. Methods: Forty-four subjects were recruited in ICUs at a tertiary university hospital in D city. Data were collected using questionnaires, observation, and medical record from June, 2008 to May, 2009. Results: The total mean of sleep quality was $1.99{\pm}1.68$. The mean of total sleep time per 24-hour period was $3.75{\pm}1.94$hour (range 1-7.25) in mechanically ventilated ICU patients. The main sleep disturbance factors were listed as frequent nursing activities, attachment of medical appliances, and noise. All these factors were also significantly related to the sleep quality. Conclusion: These results indicated that mechanically ventilated patients were both qualitatively and quantitatively deprived of sleep far more than other ICU patients. In summary, a deeper understanding of sleep characteristics in mechanically ventilated ICU patients could help nurses to improve sleep derangements and patient outcome.

• Journal of Hospice and Palliative Care
• /
• v.22 no.2
• /
• pp.87-99
• /
• 2019

Purpose: This study aimed to identify the difficulties with end-of-life care (EOLC) experienced by intensive care unit (ICU) nurses and to investigate their educational needs for EOLC. Methods: Mixed methods were used to survey ICU nurses at a university hospital. Quantitative data (N=106) were collected through a questionnaire and analyzed using an independent samples t-test, ANOVA, Mann-Whitney U test and $Scheff{\acute{e}}$ test. Qualitative data (N=19) were collected through focus group interviews and analyzed through qualitative content analysis. Results: The mean score on the difficulty of EOLC was 3.41 out of 5. The education needs derived from the qualitative analysis was categorized into four themes: 1) guidelines on professional EOLC, 2) spiritual care, 3) a program to take care of feelings of patients, families and nurses, and 4) activities to think about death. Conclusion: This study confirmed that ICU nurses were experiencing an extreme difficulty in providing EOLC. In addition, a qualitative analysis confirmed that they needed an EOL nursing program. To mitigate the difficulties experienced by nurses involved in EOLC, there is an urgent need to develop an education program for EOLC tailored to nurses' needs.

• Journal of Korean Biological Nursing Science
• /
• v.26 no.1
• /
• pp.16-25
• /
• 2024

Purpose: This study aimed to investigate the effect of a video-based enteral nutrition education program using QR codes on the perception, knowledge, and performance of enteral nutrition for intensive care unit (ICU) nurses. Methods: This was a quasi-experimental study with a nonequivalent control group pre- and post-test design. The participants were nurses working at six ICUs within a single university hospital, with 55 nurses in the experimental group and 55 nurses in the control group. The video-based enteral nutrition education program using QR codes was repeated three times to the experimental group. Results: There was a statistically significant pre-post difference in perceptions between the two groups (Z = -4.04, p < .001) with 2.00 points (± 5.57) for the control group and 7.89 points (± 7.95) for the experimental group, in knowledge (Z = -7.48, p < .001) with 0.02 points (± 1.91) for the control and 4.18 points (± 2.33) for the experimental, and in performance (Z = -2.20, p = .028) with 0.06 points (± 3.96) for the control and 2.00 points (± 5.14) for the experimental. Conclusion: The video-based enteral nutrition education program using QR codes was effective in improving the perceptions, knowledge, and performance of enteral nutrition among ICU nurses. This enteral nutrition education program using QR codes in clinical education can contribute to evidence-based nursing practice by improving perceptions and knowledge of enteral nutrition.

• Journal of Korean Critical Care Nursing
• /
• v.13 no.3
• /
• pp.62-74
• /
• 2020

Purpose : This study aimed to investigate the prevalence and risk factors of mental health problems in patients discharged from the intensive care unit (ICU). Methods : This was a secondary analysis study using data from a multicenter prospective cohort of post-ICU patients. We analyzed data of 311 patients enrolled in the primary cohort study who responded to the mental health questionnaire three months after the discharge. Anxiety and depression were measured on the Hospital Anxiety-Depression Scale, and post-traumatic stress disorder (PTSD) was measured on the Posttraumatic Diagnostic Scale. Results : The prevalence of anxiety, depression, and PTSD in patients at three months after ICU discharge were 25.7%, 17.4%, and 18.0%, respectively, and 7.7% of them experienced all three problems. Unemployment (OR=1.99, p=.033) and unplanned ICU admission (OR=2.28, p=.017) were risk factors for depression, while women gender (OR=2.34, p=.009), comorbid diseases (OR=2.88, p=.004), non-surgical ICUs (trauma ICU: OR=7.31, p=.002, medical ICU: OR=3.72, p=.007, neurological ICU: OR=2.95, p=.019) and delirium (OR=2.89, p=.009) were risk factors for PTSD. Conclusion : ICU nurses should proactively monitor risk factors for post-ICU mental health problems. In particular, guidelines on the detection and management of delirium in critically ill patients should be observed.

• Journal of Korean Clinical Nursing Research
• /
• v.15 no.3
• /
• pp.27-38
• /
• 2009

Purpose: The purpose of this study was to develop a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The blood glucose control protocol was developed through the following process: selection of preliminary protocols, clinical application, and evaluation. The clinical validity of the protocol was measured by application, along with examination of the effects of the Yale and the Mayo blood glucose protocols. Seventeen medical ICU adults patients whose blood glucose levels exceeded 200 mg/dL consecutively participated in the study. The development protocol was evaluated by an expert group. Results: Incidence of normal blood glucose levels (p=.041) increased significantly in the Yale protocol application group. Also, incidence of severe hyperglycemia (p=.029) decreased significantly and time to target range of glucose (p=.023) decreased significantly after application of the Yale protocol. However, there was no significant difference in incidence of hypoglycemia (p=.666) between three groups. Conclusion: Using the developed protocol as a basis for the modified Yale protocol was found to be effective in improving the state of blood glucose control for medical ICU patients and is expected to be used for nursing intervention in critical care.

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