• Tuberculosis and Respiratory Diseases
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• v.78 no.3
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• pp.175-179
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• 2015

The intensive care unit (ICU) is the most common place to die. Also, ethical conflicts among stakeholders occur frequently in the ICU. Thus, ICU clinicians should be competent in all aspects for ethical decision-making. Major sources of conflicts are behavioral issues, such as verbal abuse or poor communication between physicians and nurses, and end-of-life care issues including a lack of respect for the patient's autonomy. The ethical conflicts are significantly associated with the job strain and burn-out syndrome of healthcare workers, and consequently, may threaten the quality of care. To improve the quality of care, handling ethical conflicts properly is emerging as a vital and more comprehensive area. The ICU physicians themselves need to be more sensitive to behavioral conflicts and enable shared decision making in end-of-life care. At the same time, the institutions and administrators should develop their processes to find and resolve common ethical problems in their ICUs.

• Korean Journal of Clinical Pharmacy
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• v.24 no.1
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• pp.9-14
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• 2014

Background: It is known to reduce the mortality when glutamine is supplied to patients during the surgery or in intensive care unit through intravenous nutrition supply. The purpose of this study is to establish the appropriate basis for use of glutamine and guidelines of nutrition supply for critically ill patients in the hospital by examining the clinical effects of administration of glutamine with subjects of elderly critically ill patients receiving intravenous nutrition in one hospital in Korea. Method: Among elderly patients with age of 60 or more hospitalized in Yeuido St. Mary's Hospital from August 2012 to July 2013, those who stayed in the intensive care unit for more than a week and received TPN (Total Parenteral Nutrition) for more than 3 days during staying in the intensive care unit were classified to a test group using glutamine and a control group without glutamine. Duration of use of mechanical ventilator, duration of hospitalization, occurrence of infectious disease and death were compared between two groups. We would like to identify the clinical test figures affected by the use of glutamine by examining changes in SCr, Total Protein, Albumin, AST, ALT, TB, DB and GFR at the time of admission and discharge. Results: At the time of admission to intensive care unit, gender, physical measurement information and clinical test figures did not show any significant difference between 72 subjects in a test group and 24 subjects in a control group. Thus, two groups began in the same condition. There were no significant difference in duration of hospitalization, duration of intensive care unit, use of mechanical ventilator, occurrence of infectious disease and death. As the results of statistical analysis of the average changes of clinical test figures at the time of admission and discharge of intensive care unit, SCr and GFR were significantly changed in the test group. GFR was significantly changed in a control group. As the result of analysis of the clinical test figures at the time of discharge with reflection of average changes after clinical test figures were corrected at the time of admission of intensive care unit, TB and GFR were significantly increased in a test group compared with those in a control group. Other clinical test figures were not significantly changed. Conclusion: If glutamine is administered to critically ill patients over age 60 receiving TPN and careful monitoring for total bilirubin is made in the future, it is expected to give the positive effect on renal function andminimize the side effect of arise in total bilirubin.

• Journal of Korean Academy of Nursing
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• v.38 no.5
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• pp.656-666
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• 2008

Purpose: The purpose of this study was to develop visions of nursing service, nursing strategies and key performance indicators (KPIs) for an intensive care unit (ICU) based on a Balanced Scorecard (BSC). Methods: This study was undertaken by using methodological research. The development process consisted of four phases; the first phase was to develop the vision of nursing in ICUs. The second phase was to develop strategies according to 4 perspectives of a BSC. The third phase was to develop KPIs according to the 4 perspectives of BSC and the final phase was to combine the nursing visions, strategies and KPIs of ICUs. Results: Two main visions of nursing service for ICUs were established. These were 'realization of harmonized professional nursing with human respect' and 'recovery of health through specialized nursing' respectively. In order to reach the aim of developing nursing visions, thirteen practical strategies and nineteen KPIs were developed by four perspectives of the BSC. Conclusion: The results will be used as objective fundamental data to attain business outcomes for the achievement of nursing visions and strategies of ICUs.

• Journal of Korean Clinical Nursing Research
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• v.17 no.1
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• pp.90-100
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• 2011

Purpose: This paper was to develop an elbow restraint which can reduce the side effects of the wrist restraint which was frequently used in an intensive care unit and to evaluate its application. Methods: A nonequivalent control group non-synchronized design was used. Subjects were 38 patients (elbow restraint group: 18, wrist restraint group: 20) and 20 nurses who used both restraints in medical intensive care unit at G National University Hospital. Restraints were applied to subjects for 72 hours. Data were collected from December 1, 2009 through March 31, 2010. The data collected were analyzed using $x^2-test$, Fisher's exact test, t-test, and ANCOVA using SPSS 12.0 program. Results: Elbow restraint significantly decreased range of wrist motion reduction, swelling and significantly increased the convenience of wearing restraint compared to wrist restraint. Conclusion: The new elbow restraint are more efficient than the old wrist restraint, which have been used in an intensive care unit, in terms of convenience of restraint application, range of joint motion and prevention of swelling.

• Journal of Korean Clinical Nursing Research
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• v.25 no.1
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• pp.25-33
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• 2019

Purpose: This study was done to develop a program to promote maternal role confidence and maternal attachment for mothers of premature infants and to evaluate the effects in a neonatal intensive care unit (NICU). Methods: This program was developed through a literature review and validation of an expert group, and tested with 60 preterm infants (experimental group 30, control group 30) in a NICU in South Korea. Data were collected from December 2017 to March 2018 and analyzed using descriptive statistics, t-test, $x^2-test$ and Fisher's exact test with the SPSS/Win statistical program. Results: Maternal role confidence for the experimental group increased significantly compared to the control group (t=3.22, p=.002). Maternal attachment in the experimental group increased significantly compared to the control group (t=2.30, p=.025). Conclusion: The program developed in this study should be effective in promoting maternal role confidence and maternal attachment in mothers of premature infants.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.17 no.4
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• pp.478-486
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• 2010

Purpose: To explore nurses' compliance with standards for critical care nursing practice in intensive care units (ICUs) and to provide basic data for high quality of critical care nursing. Method: A total of 616 participants from 61 ICUs which are graded from 1 to 7 throughout the nation were surveyed. Data were collected from February 9 to February 27, 2009 using a questionnaire consisting of 58 questions including 50 nursing activities as indicators. Results: The rate of ICU nurses' compliance with standards for critical care nursing practice was high. As for individual standards, compliance with the standard of assessment was the highest, followed by implementation, diagnosis, and planning in that order. There were differences in compliance according to nurses' ICU experience, work place (unit), and ICU grade. A shortage of manpower was considered as a main cause for noncompliance. Conclusion: The present compliance rate with standards for critical care nursing practice by ICU nurses was identified. Therefore, compliance rate can be used to promote quality of critical care nursing and development of educational programs for ICU nurses.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.12
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• pp.7359-7366
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• 2013

Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.

• Journal of Korean Academy of Nursing
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• v.39 no.2
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• pp.288-297
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• 2009

Purpose: This study was done to evaluate the mean venous velocity (MVV) response with knee and thigh length compression stockings (CS) versus intermittent pneumatic compression (IPC) devices in immobile patients with brain injuries. Methods: We carried out a randomized controlled study. We analyzed both legs of a randomly chosen sample of 43 patients assigned to one of 4 groups (86 legs). The patients were sequentially hospitalized in the intensive care unit (ICU) in "S hospital" from November 2005 to December 2006. The base line and augmented venous velocity was measured at the level of the common femoral vein. We applied leg compression 42 times over 7 days (for 2 hours at a time at 2 hour intervals). Results: There was a statistical difference among the 4 groups. The difference for the "IPC" group was more significant than the "CS" group. Conclusion: These results indicate that the application of IPC can be considered as an effective method to prevent deep vein thrombosis for immobile patients with brain injury.

• Child Health Nursing Research
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• v.16 no.4
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• pp.352-359
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• 2010

Purpose: To explore premature infants' pain response to routine procedures in the neonatal intensive care unit (NICU). Methods: The participants were 56 preterm infants who showed 149 pain responses to 8 high frequency routine procedures which were evaluated using the Premature Infant Pain Scale (PIPS). Videotaped recording was used for data collection. Data were analyzed with descriptive analysis, paired t-test, and Pearson's correlation coefficient. Results: PIPS scores for each procedure were as follows; for removal of central catheter dressing, 6.17 (2.04), venous sampling, 6.12 (2.87), intramuscular injection, 6.05 (2.38), insertion of a peripheral line, 5.38 (2.16), insertion of feeding tube, 4.40 (1.34), heel stick, 4.33 (1.23), insertion of central line, 4.00 (2.12), and endotracheal suctioning, 2.90 (1.25). PIPS score was negatively correlated with gestational age (r=-.218, p=.007) and birth weight (r=-.249, p=.002) among general characteristics of the infants. Conclusion: The majority of 8 routine procedures were found to be painful for premature infants in the NICU. Therefore, adequate pain management related to procedures should be provided to premature infant in the NICU.

• Child Health Nursing Research
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• v.25 no.3
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• pp.255-261
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• 2019

Purpose: This study compared the pain-relieving effects of human milk, sucrose, and distilled water during examinations for retinopathy of prematurity. Methods: Forty-five preterm infants were randomly assigned to receive a pacifier dipped in one of three solutions: human milk (n=14), 24% sucrose (n=15), or distilled water (n=16), 2 minutes before an eye examination. Their pain score, pulse rate, and oxygen saturation were measured at three time points: 5 minutes before the examination, 30 seconds after speculum introduction, and 2 minutes after the examination. Results: The infants' mean gestational age and weight at birth were $33.1{\pm}2.1$ weeks and $1,842{\pm}470g$, respectively. There were no between-group differences in pain relief during the eye examination. The pain score significantly increased both during (p<.001) and after the examinations (p=.003). Oxygen saturation decreased during the examinations (p<.001); however, the infants in the 24% sucrose group showed higher oxygen saturation (p=.047) during the examinations than the infants in the other groups. Conclusion: Sucking on a pacifier dipped in human milk or 24% sucrose did not reduce the pain associated with eye examinations in preterm infants. Pacifiers dipped in sucrose can be used to maintain better oxygen saturation during these examinations.