• Journal of Korean Biological Nursing Science
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• 제16권4호
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• pp.259-266
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• 2014

Purpose: The purpose of this study was to analyze risk factors in predicting medical patients transferred to Intensive Care Unit (ICU) on the general ward. Methods: We reviewed retrospectively clinical data of 120 medical patients on the general ward and a Modified Early Warning Score (MEWS) between ICU group and general ward group. Data were analyzed with multivariate logistic regression and the area under the receiver operating characteristic curves using SPSS/WIN 18.0 program. Results: Fifty-two ICU patients and 68 general ward patients were included. In multivariate logistic regression, the MEWSs (Odds Ratio [OR], 1.91; 95% confidence interval [CI], 1.32-2.76), sequential organ failure assessment score (OR, 1.28; 95% CI, 1.10-1.72), $PaO_2/FiO_2$ ratio (OR, 0.98; 95% CI, 0.98-0.99), and saturation (OR, 0.93; 95% CI, 0.88-0.99) were predictive of ICU transfer. The sensitivity and the specificity of the MEWSs used with a cut-off value of six were 80.8% and 70.6% respectively for ICU transfer. Conclusion: These findings suggest that early prediction and treatment of patients with high risk of ICU transfer may improve the prognosis of patients.

• 중환자간호학회지
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• 제4권1호
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• pp.51-63
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• 2011

Purpose: This study aimed to examine the effects of extended family visiting hours in the intensive care unit (ICU). Methods: The subjects were 168 ICU patients and their family members. Two 30-minute visits a day were allowed to the control group according to current policy, while four 30-minute visits a day were allowed to the experimental group. Patients' state anxiety was measured at the first day of ICU admission, and on the third day of ICU admission patients' anxiety and family satisfaction were measured. For the infection rate, comparison was made between the experimental and control data-collecting periods. Results: The patients' state anxiety significantly decreased in the experimental group. Family satisfaction of experimental group was significantly higher than that of control group. There was no significant difference in the infection rate. Nurses positively evaluated extension of visiting hours because it could stabilize patients, reduce the number of arrangements for additional visits, and help establish trust relationship with families. Conclusion: Extended family visiting hours in the ICU reduced patients' anxiety and improved family satisfaction but had no effect on the infection rate. Extended family visiting hours in the ICU is expected to improve the quality of critical care.

• 기본간호학회지
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• 제21권4호
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• pp.413-422
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• 2014

Purpose: The purpose of this study was to identify the nutrition-related factors influencing the prevalence of pressure ulcers among patients admitted to an intensive care unit. Methods: Research participants were 112 patients who were admitted to the ICU of a university hospital. Data were collected through questionnaires which included general characteristics, diet-related characteristics, nutritional status, and pressure ulcer status. Multivariate logistic regression was used to identify independent factors association with prevalence of pressure ulcer Results: The prevalence of pressure ulcers was 58 patients (51.8%) at 10th day after ICU admission. In multivariate analysis, prevalence of pressure ulcers at 10th day in ICU was significantly higher in the nutritional risk group (OR=6.43), malnutrition group (OR=88.02), and deceased serum albumin group (OR=28.83). Conclusion: The results of this research indicate that scores on MNA (Mini Nutritional Assessment) and serum albumin were significant predictors of pressure ulcer prevalence in ICU patients. Therefore, regular MNA-SF and albumin checkups are needed to identify risk for pressure ulcer for ICU patients. In the case of decreased MNA-SF scores and serum albumin levels, more intensive pressure ulcer care is needed for ICU patients.

• 대한간호학회지
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• 제52권2호
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• pp.134-143
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• 2022

Purpose: The study aimed to understand the delirium experience of intensive care unit (ICU) patients. Methods: We performed a qualitative study using Colaizzi's phenomenological method. Eleven patients, who experienced delirium according to the Confusion Assessment Method for ICU, participated after transferring to general wards from the ICU. Individual in-depth semi-structured interviews ranging from 30 minutes to 2 hours in length were conducted between November 2018 and August 2019. Results: Nine themes and four theme clusters emerged. The four theme clusters were: 1) "Overwhelmed by fear," which describes the experience of a patient close to death and the feeling of difficulty in understanding disorganized thinking; 2) "Anxious about not understanding the situation," which means that patients' sense of time and space were disordered in the ICU; 3) "Being deserted," which indicates the feeling of being separated from others and yourself; and 4) "Resistance to protect my dignity," which indicates that the dignity and autonomy of an individual in the patient's position at the ICU, are ignored. Conclusion: Nursing interventions are needed that would enable patients to maintain orientation and self-esteem in the ICU. In addition, healthcare providers need to provide information about the unfamiliar environment in the ICU in advance.

• Journal of Hospice and Palliative Care
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• 제26권1호
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• pp.22-25
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• 2023

Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

• Tuberculosis and Respiratory Diseases
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• 제87권2호
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• pp.115-122
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• 2024

Post-intensive care unit (ICU) syndrome may occur after ICU treatment and includes ICU-acquired weakness (ICU-AW), cognitive decline, and mental problems. ICU-AW is muscle weakness in patients treated in the ICU and is affected by the period of mechanical ventilation. Diaphragmatic weakness may also occur because of respiratory muscle unloading using mechanical ventilators. ICU-AW is an independent predictor of mortality and is associated with longer duration of mechanical ventilation and hospital stay. Diaphragm weakness is also associated with poor outcomes. Therefore, pulmonary rehabilitation with early mobilization and respiratory muscle training is necessary in the ICU after appropriate patient screening and evaluation and can improve ICU-related muscle weakness and functional deterioration.

• 임상간호연구
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• 제18권1호
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• pp.149-158
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• 2012

Purpose: The purpose of this study was to investigate incidence and factors related to diarrhea in an intensive care unit (ICU). Methods: Retrospective correlational design was used. Data were collected from reviewing medical records of 210 patients stayed at an ICU in one university hospital, Seoul. Patients were included in the study if they 1) had no gastrointestinal disorders or fecal incontinence before coming to the ICU, 2) stayed longer than 5 days at the ICU, 3) were not on stool softners, 4) were without abdominal surgery, and 5) were 20-year-old or older. Results: The incidence of diarrhea was 27.1%. Durations of ICU stay, antibiotics administration, and enteral feeding were found to be statistically significant factors correlated with diarrhea. The enteral feeding was the significant predictors of the diarrhea in ICU. Conclusion: Since characteristics of diarrhea in ICU patients is shown to be multifactorial, nursing strategies for evaluating and managing related factors are recommended.

• Asian Pacific Journal of Cancer Prevention
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• 제13권1호
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• pp.97-101
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• 2012

Objective: With the background of aging population in China and advances in clinical medicine, the amount of operations on old patients increases correspondingly, which imposes increasing challenges to critical care medicine and geriatrics. The study was designed to describe information on the length of ICU stay from a single institution experience of old critically ill gastric cancer patients after surgery and the framework of incorporating data-mining techniques into the prediction. Methods: A retrospective design was adopted to collect the consecutive data about patients aged 60 or over with a gastric cancer diagnosis after surgery in an adult intensive care unit in a medical university hospital in Shenyang, China, from January 2010 to March 2011. Characteristics of patients and the length their ICU stay were gathered for analysis by univariate and multivariate Cox regression to examine the relationship with potential candidate factors. A regression tree was constructed to predict the length of ICU stay and explore the important indicators. Results: Multivariate Cox analysis found that shock and nutrition support need were statistically significant risk factors for prolonged length of ICU stay. Altogether, eight variables entered the regression model, including age, APACHE II score, SOFA score, shock, respiratory system dysfunction, circulation system dysfunction, diabetes and nutrition support need. The regression tree indicated comorbidity of two or more kinds of shock as the most important factor for prolonged length of ICU stay in the studied sample. Conclusions: Comorbidity of two or more kinds of shock is the most important factor of length of ICU stay in the studied sample. Since there are differences of ICU patient characteristics between wards and hospitals, consideration of the data-mining technique should be given by the intensivists as a length of ICU stay prediction tool.

• 중환자간호학회지
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• 제13권3호
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• pp.62-74
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• 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.

• 대한간호학회지
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• 제38권6호
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• pp.874-880
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• 2008

Purpose: The purpose of this study was to identify muscle atrophy in critically ill patients on ventilators. A comparison was made between limb circumferences and muscle areas on the day of admission to an intensive care unit (ICU) and on the 8th day after admission. Methods: The data were collected from 30 critically ill patients using ventilators at S hospital ICU in Seoul during the period from October 2005 to April 2006. Limb circumferences and skinfold thickness were measured on the day of admission and on the 8th day after admission to the ICU. Limb circumferences and skinfold thickness were measured on the right mid-arm, right mid-thigh, and right mid-calf using a measuring tape and a skinfold calipers. Limb muscle areas were calculated by an equation after measuring limb circumferences and skinfold thickness. The data were analyzed by paired t-test and independent t-test. Results: 1) Mid-arm circumference, mid-thigh circumference and mid-calf circumference on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 2) Mid-arm muscle area, mid-thigh muscle area and mid-calf muscle area on the 8th day after admission to the ICU were significantly less than those on the day of admission to the ICU, 3) Steroid and vecuronium medication didn't affect changes in limb circumferences (mid-arm, mid-thigh, mid-calf) and muscle areas (mid-arm, mid-thigh, mid-calf on the 8th day after admission to the ICU compared to the day of admission. Conclusion: Limb muscle atrophy may occur on the 8th day after admission to the ICU in critically ill patients using ventilator.