• Title/Summary/Keyword: Intensive Care Unit (ICU)

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Investigation of Delirium Occurrence and Intervention Status in Intensive Care Unit at a Hospital and Perception of Delirium by Medical Staff (일 종합병원 중환자실의 섬망 발생 및 중재 현황과 의료진의 섬망 인식 조사)

  • Kang, Yi-Seul;Kim, Soon-Hee;Lee, Min-Jeoung;Lee, Hyo-Jin;Lim, Oak-Bun;Hong, Sang-Bum;Choi, Hye-Ran
    • Journal of Korean Critical Care Nursing
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    • v.16 no.1
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    • pp.71-86
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    • 2023
  • Purpose : This study aims to investigate the status of delirium intervention in adult intensive care unit (ICU) patients and the perception of this delirium by medical staff. Methods : This retrospective study involves 185 patients, whereas, a descriptive survey is conducted with 197 medical staff members. Results : The delirium group includes 100 patients (54.1%). The incidence of delirium is 64.9% in the medical ICU, 65.9% in the surgical ICU, 42.4% in the neuro ICU, and 46.5% in the cardiac ICU. The percentages of delirium prevention intervention differs between the two groups: 65.0% in the delirium group and 95.3% in the non-delirium group. The medical staff recognize that delirium is a common problem in the ICU (100.0%) and requires active medical intervention (98.5%). Conclusion : The length of stay at the ICU is longer in the delirium group than in the non-delirium group. It is necessary to standardize delirium prevention and treatment protocols to be equally applicable to all ICU patients.

Glucose Control in Intensive Care Unit Patients: Recent Updates (중환자의 혈당 조절: 최신 업데이트)

  • Rhee, Sang Youl
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.81-85
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    • 2018
  • Proper glucose management in hospitalized patients can improve clinical outcomes. In particular, intensive care unit (ICU) patients are known to have significantly higher rates of mortality from changes in blood glucose due to severe comorbidities. Improving glucose control in ICU patients, therefore, can improve mortality and prognosis. Several studies related to the management of blood glucose in the ICU patients have been conducted. Intensive glucose management of surgical ICU patients has been successful. However, studies on medical ICU patients did not demonstrate positive effects of strict glycemic control. There is no independent glucose management goal for neurological ICU patients. However, maintenance of the usual glucose control target of 140-180 mg/dL is recommended for ICU patients. Intravenous insulin infusion is essential for glucose control in ICU patients not consuming a regular diet, and caution should be exercised to prevent hypoglycemia.

Risk Factors for Cognitive Impairment in Intensive Care Unit Survivors (중환자실 퇴원환자의 인지장애 위험요인)

  • Kang, Ji Yeon;Yi, Bo Kyung
    • 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.

Analysis of capacity management of the intensive care unit in a hospital

  • Kim, Seung-Chul;Horowitz, Ira;Young, Karl K.;Buckley, Thomas A.
    • Proceedings of the Korean Operations and Management Science Society Conference
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    • 1997.10a
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    • pp.79-82
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    • 1997
  • A hospital's intensive care unit (ICU) is a limited and critical resource whose efficient utilization of capacity impacts on both the welfare of patients and the hospital's cost effectiveness. Decisions made in the ICU affect the operations of other departments. Yet, decision making in an ICU tends to be mainly subjective and lacking in clear criteria upon which to base any given decision. The study reviews the capacity utilization of one particular ICU, that of a public hospital in Hong Kong, and develops a computer simulation model to improve both the unit's capacity utilization and the quality of care provided to its patients.

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A Study on the Space Planning of Intensive Care Unit in General Hospital, China (중국 종합병원의 중환자부 영역별 소요공간 연구)

  • Lyu, Cheng;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.27 no.1
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    • pp.53-63
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    • 2021
  • Purpose: Intensive Care Unit (ICU) is an important field of inpatient treatment, in which critically ill patients have been treated intensively with advanced medical technology. The level of treatment in the intensive care unit and the modernization of related facilities are important indicators of the quality of medical care. At present, when regional public hospitals are expanding frequently, reasonable planning of ICU has become an important part of medical institutions that treat ICU. The purpose of this study is to provide basic data on the net area of each unit, which can be used in ICU building planning. Methods: The investigation and analysis of the ICU were conducted in 12 medical institutions, based on theoretical analysis based on relevant guidelines and literature, and analysis of actual space composition and net area through architectural drawings. Results: This research provides basic data, such as the location relationship with other important departments, regional division, spatial composition, the relationship between main activities and regions, the composition of facilities in the region, and the area and proportions of each region. Implications: It is expected that the results of this article will provide effective reference materials for the reasonable spatial organization and effective operation of the intensive care units of ordinary public hospitals of different sizes in the future.

The Perception of Delirium, Barriers, and Importance of Performing Delirium Assessment of ICU Nurses Utilizing the CAM-ICU (섬망사정도구를 사용하는 중환자실 간호사의 섬망인식, 섬망사정의 장애요인 및 섬망사정 수행의 중요도)

  • Gong, Kyung-Hee;Ha, Yi-Kyung;Gang, In-Soon
    • Journal of Korean Critical Care Nursing
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    • v.8 no.2
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    • pp.33-42
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    • 2015
  • Purpose: This study was conducted to identify the perception, barriers, and importance of delirium assessment of intensive care unit nurses utilizing a tool for delirium assessment. Methods: The subjects were 150 intensive care unit nurses who routinely use the CAM-ICU to screen delirium. Data were collected using self-report questionnaires and analyzed using descriptive statistics and ranking. Results: Most intensive care unit nurses had experience of education about delirium and delirium assessment, and had assessed over once in a shift. However, a small number of nurses recognized utilizing their assessment result and the effect on higher mortality and underdiagnosed and preventable problem. The first rank of barriers was being too busy to assess patients and the second was difficulty of interpreting intubated patients. The importance of delirium assessment was considered lower than assessing catheter placement and level of pain. Conclusion: The study identified intensive care unit nurses' use of a delirium assessment tool, and the perception, barriers, and importance of delirium assessment. Furthermore, it is necessary to develop education programs to improve the early recognition of delirium by intensive care unit nurses.

A Study on the Types of Layout in the Intensive Care Unit of Regional Public Hospitals based on the Relationship between the Beds and Nurse Station (병상과 간호스테이션의 관계를 기반으로 한 지방의료원 중환자부 배치유형에 관한 연구)

  • Lyu, Cheng;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.25 no.3
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    • pp.37-46
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    • 2019
  • Purpose: The Intensive Care Unit (ICU) is an important inpatient care area where critical patients are treated intensively with advanced medical technology. The level of care of ICU and the modernization of related facilities is an important indicator of health care quality. At the present time, when the Regional public hospitals are frequently expanding, the rational planning of the ICU has become an important part of the medical institutions treating the ICU. The purpose of this study is to present basic data with net area which can be used in the architectural planning of the ICU. Methods: The investigation and analysis of the ICUs were conducted on 24 medical facilities, based on theoretical analysis through relevant guidelines, articles, and documents, and on the basis of the actual space composition and net area analysis through the architectural drawings. Results: This study provides basic data such as bed placement type of ICU, relationship with other departments, distance between NS and bed, distance between beds, and net area of disease by type. Implications: The results of this paper are expected to be effective reference materials for future research for rational spatial organization and efficient operation of the Intensive Care Unit in regional public hospitals.

Intensive Care Unit Nurse's Knowledge and Nursing Performance on Intensive Care Unit Syndrome (중환자실 간호사의 중환자실 증후군에 대한 지식과 간호수행도)

  • Yang, Ya-Ki
    • Journal of Korean Academy of Nursing Administration
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    • v.16 no.3
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    • pp.240-249
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    • 2010
  • Purpose: This study was to investigate intensive care unit (ICU) nurse's knowledge and nursing performance on the intensive care unit syndrome. Method: A survey questionnaire was administered to a convenience sample of 123 nurses in a university hospital. Data were collected from August 1st to August 25th, 2009. Data were analyzed using SPSS/WIN 12.0. Results: The mean score for knowledge and nursing performance were66.96 and 74.97 respectively. According to the general characteristics, there were significant differences in knowledge depending on marital status, education level and career length and in nursing performance depending on their age, education level and career length. The correlation between knowledge and nursing performance was a significant positive one. Conclusion: Comprehensive educational programs are needed to decrease accident rates related to ICU syndrome and to improve the health of ICU patients.

The Effects of Sleep Improvement Intervention on the Sleep Quality and Incidence of Delirium in the Intensive Care Unit Patients (중환자실 환자의 수면증진 중재가 수면의 질 및 섬망발생에 미치는 효과)

  • Lee, Eun-Nam;Cho, Jeong-Lim;Kim, Mae-Ri;Lee, Eun-Ju;Lee, Yeong-Hui;Choi, Eun-Ju;Lee, Hye-Ran
    • Journal of Korean Critical Care Nursing
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    • v.5 no.1
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    • pp.23-33
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    • 2012
  • Purpose: The purpose of this study is to investigate the effect of eye-shields and sleep-inducing music application on sleep quality and incidence of delirium for intensive care unit (ICU) patients. Methods: This study was a untreated control group design with pretest and posttest. The data was collected in the ICU of D University Hospital in Busan, from June to September 2011. Thirteen subjects were assigned to eye-shields and sleep-inducing music intervention and 15 subjects were in the control group. Results: Eye-shields and sleep-inducing music application was effective for improving the quality of sleep in ICU patients. There was no statistically significant difference in the incidence of delirium between the two groups. Conclusion: The sleep improvement intervention with eye-shields and sleep-inducing music would be a meaningful part of nursing intervention programs to enhance the quality of sleep in ICU patients.

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Delirium Experience of the Intensive Care Unit Patients (중환자실 환자의 섬망 경험)

  • Jung, Jaeyeon;Jang, Sujin;Jo, Seonmi;Lee, Sunhee
    • Journal of Korean Academy of Nursing
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    • v.52 no.2
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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.