• Journal of Korean Clinical Nursing Research
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• v.17 no.2
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• pp.150-162
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• 2011

Purpose: Multi-drug resistant (MR) infections among intensive care unit (ICU) patients with oral intubation and a ventilator are serious nosocomial infections. This study was done to compare the effects of oral care and ventilator circuit on reduction of MR infections. Methods: A total of 92 participants were recruited from an ICU at C University Hospital in G-city, Korea, assigned to one of 4 groups and evaluated: group I received oral care with sponge and reusable circuit; group II received oral care with tooth brush and reusable circuit; group III received oral care with sponge and disposable circuit; group IV received oral care with tooth brush and disposable circuit. Results: Prevalence rate of MR infections was highest in group I (47.8%), followed by group II (30.4%), group IV (19.0%), and group III (13.6%). Of the four groups, group III showed a significantly decreased MR infections (p=.035) and higher possibility of survival rate as time passes according to survival analysis (p=.019). Conclusion: Results of this study indicate that using disposable ventilator circuit significantly decreases MR infections and raises the possibility of a higher survival rate as time passes. According to this study, the use of disposable ventilator circuit is useful in prevention of MR infections.

• Journal of Digital Convergence
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• v.20 no.1
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• pp.379-389
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• 2022

This study was aimed to identify importance and satisfaction of intensive care unit health care providers for Intensive Care Unit Clinical Nurse Expert (ICU CNE) roles. A questionnaire survey was performed with 138 intensive care unit health care providers between May 3 to 29, 2021. Data were analyzed using descriptive statistics. t-test and Importance-Performance Analysis (IPA). There were statistically significant differences in importance(t=2.33, p=.024) and satisfaction(t=5.43, p<.001) between physicians and nurses. The importance and satisfaction of intensive care unit health care providers were ranked in the order of advanced clinical practice, professional activity, coordination and cooperation, education and counseling and research. In the 'concentrate' area, it was found that 'Professional activity' and 'Education' should be improved. A strategy is needed to strengthen the expertise of ICU CNE and to enhance the competency in areas that need improvement.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.3
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• pp.364-375
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• 2018

This study was a descriptive investigation to identify the influence of nurses' moral sensitivity and safety of their environment on compliance with standard precautions. Participants consisted of 214 nurses in one general hospital and data were collected using a questionnaire that consisted of moral sensitivity, safety of environment and compliance with standard precautions from 1-15 August 2017. Data were evaluated by the independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis. The mean scores of moral sensitivity, safety of environment and compliance with standard precautions were 5.05, 5.76 and 4.50, respectively. Moreover, compliance with standard precautions was significantly positively correlated with moral sensitivity and safety of environment. Additionally, multiple regression revealed an $R^2$ of 0.253 with the department (ER, ICU), age and safety environment serving as the major predictor variables for compliance with standard precautions. However, the influence of moral sensitivity on compliance was not identified. Therefore, to increase compliance with standard precautions among nurses, it is necessary to provide continuous educational programs for new nurses, customized programs considering departmental characteristics and administrative support of institutions to enhance safety of the environment.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.156-171
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• 1996

Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.

• Journal of The Korea Institute of Healthcare Architecture
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• v.21 no.3
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• pp.37-45
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• 2015

Purpose: The main objective of this paper is, to evaluate the unit design for patient-centered care and to draw lessons-learned for further improvement. Methods: This study conducted a case study of the intensive care unit, designed to fulfill patient-centered care in the US. It evaluated the effectiveness of the unit by incorporating several study methods such as plan analyses, direct observations through nursing tracking and behavior mapping, and focus group interviews. Results: The major design decision made in this patient-centered unit was the use of patient rooms with designated family areas and distributed nursing stations. Both design features appeared to be a success on a variety of research metrics and outcomes. The study identified that the patient rooms ultimately help family members to spent more time with their loved ones, which leads to increased satisfaction of family members and nurses also report that they generally enjoy the distributed nurses' stations, which provide a comfortable environment to complete their regular lines of work such as charting, monitoring patients, and collaborating with their colleagues. Implications: Certain design features in intensive care units such as patient rooms with designated family areas and distributed nursing stations could appropriately support hospitals to fulfill patient-centered care.

• Korean Journal of Adult Nursing
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• v.18 no.4
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• pp.543-552
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• 2006

Purpose: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. Method: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characteristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. Results: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was $36.76{\pm}55.7$ hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. Conclusion: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.

• The Journal of Korean Academic Society of Nursing Education
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• v.21 no.1
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• pp.95-107
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• 2015

Purpose: The purpose of this study was to develop a tailored simulation learning (SL) program and to evaluate the effects of the program on the clinical competency, clinical decision-making competency, and communicative competency of new nursing staffs in intensive care units (ICU) and emergency rooms (ER). Methods: In this quasi-experimental study, fifteen nurses were assigned to the experimental group and fifteen to the control group. The experimental group was given the SL program of four sessions, whereas the lectures of four sessions were given to the control group. Data were analyzed using a $x^2$-test, Mann-Whitney U test, and Kruskal-Wallis test with an SPSS program. Analysis of covariance was used to treat the covariate of pre communicative competency between the experimental and control groups. Results: Based on the education needs of new nursing staffs in ICUs and ERs, three learning scenarios and one evaluating scenario were developed for the SL program. The score for clinical competency, clinical decision-making competency, and communicative competency were significantly higher in the experimental group compared with the control group. Conclusion: The SL program is an effective learning strategy for new nursing staffs in ICUs and ERs. These findings suggest that an SL program be offered as an alternative for new nurse orientation and continuing nurse education.

• Journal of Korean Clinical Nursing Research
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• v.18 no.2
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• pp.296-306
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• 2012

Purpose: This study was done to compare the physical injury, emotional response and unplanned self-removal of medical devices in patients with physical restraints and patients not restrained. Methods: Eighty patients admitted to the intensive care unit (ICU) of a university hospital in Seoul participated in this study. Forty patients made up each group and the group not restrained was matched with the restraint group for age and history of smoking and alcohol consumption. Data on occurrence of physical injury, intensity of anxiety, stage of agitation and unplanned self-removal of medical devices were collected by observation and medical chart review using a structured instrument. Statistical processing of collected data was done with the SPSS WIN 17.0 program. Results: The physically restrained group experienced more physical injuries and recorded significantly higher levels of anxiety and agitation than the unrestrained group. However, there were no significant differences between the groups in occurrence of unplanned self-removal of medical devices. Conclusion: Results indicate a need for critical care nurses to carefully monitor physical injuries and emotional responses of physically restrained patients and to develop nursing interventions to prevent adverse effects associated with restraint use. There is also a need to develop patient safety guidelines when using physical restraints.

• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.157-170
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• 2009

Purpose: This quasi-experimental study was conducted to investigate the effects of supportive nursing management on postpartum depression in the mothers with premature infants. Methods: The subjects were 21 mothers who delivered premature babies in a university hospital. The experimental group of 10 mothers was provided with supportive nursing management program by nurses in neonatal ICU and the control group of 11 mothers was provided with usual management only. The designed programs were given 4 times to the experimental group while their babies were hospitalized, and telephone consultation was provided 3 times after discharge. The stress, anxiety, identity, support from their husbands & family members, and postpartum depression were measured 3 times using Edinburgh Postnatal Depression Scale (the 4th day of premature's hospitalization, the day of discharge and the day of 4 weeks after discharge). Results: There was no significant difference in general characteristics and the influential factors of postpartum depression between the two groups, so they were homogeneous. There was no significant difference in depression (F=0.01, p=.917). However there was significant difference over time (F=6.74, p=.003) and the interaction between measurement time and treatment (F=3.59, p=.037). Conclusion: The supportive nursing management on postpartum depression of mothers with premature infants is considered effective and useful in reducing postpartum depression. Further research is warranted to investigate paternal depression and the program's long-term effects.

• Korea Journal of Hospital Management
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• v.22 no.2
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• pp.28-43
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• 2017

The purpose of this study was to investigate the influence of professional self-concept and interpersonal relations on nursing competence of clinical nurses. This study was conducted as a descriptive cross sectional survey with 182 nurses who work at a tertiary hospital which has over 1,000 beds, located in Gyeounggi - do. The data was collected from October 11th, 2016 to October 28th, 2016. The main findings of this study were as follows. The mean score for professional self-concept was $2.65{\pm}0.29$ points in the range of 1 point to 4 points. And interpersonal relations was an average of $3.55{\pm}0.35$ points in the range of 1 point to 5 points. Nursing competence was an average of $2.65{\pm}0.39$ points in the range of 1 point to 4 points. Professional self-concept and interpersonal relations were positively correlated with nursing competence. Nursing competence was differed from clinical career(F=10.518, p<.001), working unit(F=4.139, p=.018), educational background(F=6.542, p=.002), and satisfaction on nursing(F=6.326, p<.001). The regression model with clinical career, working unit, educational background, satisfaction on nursing, 3 sub domain of professional self-concept(professional practice, satisfaction, communication), and interpersonal relation was statistically significant (F=31.94, p<.001). And this model could explain 51.5% of nursing competency(Adj R2=.515). Especially, professional practice(${\beta}=.532$, p<.001) of professional self-concept, interpersonal relations(${\beta}=.223$, p<.001), clinical career(${\beta}=.169$, p<.001), working unit: ICU (${\beta}=.169$, p<.05) were identified the factors influencing on nursing competence. Therefore, improving clinical nurses' nursing competence can be achieved with broad approach that includes improvements in professional self-concept and interpersonal relations. And also, working unit, and clinical career should be considered to develop the actual program for nursing competence, too.