• Journal of Korean Clinical Nursing Research
• /
• v.16 no.3
• /
• pp.85-98
• /
• 2010

Purpose: This study was aimed to investigate the awareness and attitudes towards withdrawal of the life-sustaining treatment among nurses, physicians, and the families of intensive care unit (ICU) patients in general hospitals. Methods: The data were collected using a questionnaire from 80 ICU nurses, 80 physicians, and 80 families of ICU patients in general hospitals. Data were collected from February 22nd to May 31st, 2010. Rusults: ICU nurses, physicians, and families of ICU patients felt that objective and ethical guidelines were needed in making a decision to withdraw the life-sustaining treatment. The main reason for withdrawal of the life-sustaining treatment was found that the patients could not recovered despite many efforts. The role of nurses in decision making process on withdrawal of the life-sustaining treatment was considered very positive from the view of physicians and family members. The most important role of nurses for those patients in ICU was found to try their best to care for the patients. Conclusion: ICU nurses should play a major coordinating role in communication among patients, their families, and medical teams. Also, an appropriate roles of nurses in the process of the withdrawal of the life-sustaining treatment should be established.

• Journal of Trauma and Injury
• /
• v.36 no.3
• /
• pp.210-216
• /
• 2023

Purpose: This preliminary retrospective cohort study analyzed the relationship between the parameters provided by sonorheometry device Quantra and the coagulation values obtained from standard venous blood samples in patients admitted in intensive care unit (ICU). Methods: We reviewed medical charts of 13 ICU adult patients in whom at least one coagulation study with Quantra was performed. The relationship between Quantra and laboratory data was analyzed with the Spearman rank correlation coefficient (rho). The 95% confidence interval (CI) was computed. A P-value <0.05 was considered statistically significant. Results: We collected 28 data pairs. Statistically significant moderate correlations were found for the following parameters: clot time (CT) and activated partial thromboplastin time (rho=0.516; 95% CI, 0.123-0.904; P=0.009; clot stiffness (CS) and the international normalized ratio (INR; rho=0.418; 95% CI, 0.042-0.787; P=0.039); INR and platelet contribution to CS (rho=0.459; 95% CI, 0.077-0.836; P=0.022); platelet count and platelet contribution to CS (PCS; rho=0.498; 95% CI, 0.166-0.825; P=0.008); and fibrinogen and fibrinogen contribution to CS (FCS; rho=0.620; 95% CI, 0.081-0.881; P=0.001). Conclusions: Quantra can provide useful information regarding coagulation status, showing modest correlations with the parameters obtained from laboratory tests. During diffuse bleeding, CT and FCS values can guide the proper administration of clotting factors and fibrinogens. However, the correlation of INR with CS and PCS can cause misinterpretation. Further studies are needed to clarify the relationship between Quantra parameters and laboratory tests in the critical care setting and the role of sonorheometry in guiding targeted therapies and improving outcomes.

• Korean Journal of Adult Nursing
• /
• v.29 no.1
• /
• pp.76-86
• /
• 2017

Purpose: The purpose of the study was to provide deep understanding of the reported experiences of families with their loved one in the intensive care unit (ICU), focusing on interactions with healthcare providers. Methods: The data were collected by individual interviews of eleven participants. The transcribed data were analyzed using qualitative content analysis to identify major themes and sub-themes that represented the experiences of families. Results: Five themes and 13 sub-themes emerged. "Captive of patients' delayed death: Fear and anxiety" describes psychological problems arising when the family member became critically ill enough to warrant being admitted to the ICU. "Families as the weak: Suppression and resistance" describes interpersonal difficulties arising due to lack of information and trust with healthcare providers. "Deprivation of authority and duty as families: Helplessness" illustrate situational barriers in attempting to protect and support family member. "Re-establishment of trust relationship with healthcare providers: Gratitude and appreciation" describes how they satisfied with themselves by regaining trust relationship. Lastly, "Acceptance of reality through direct care participation: Relief and peace" illustrates peace of mind by gaining sense of reality through active direct care participation. Conclusion: This study demonstrates the positive and negative experiences of families with ICU patients. The results will be useful in developing family-centered nursing interventions.

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

• Biomedical Science Letters
• /
• v.7 no.3
• /
• pp.117-125
• /
• 2001

This study was performed in order to evaluate the risk factors for nosocomial urinary tract infection and the frequencies of organisms isolated, and to provide the epidemiologic and basic data of hospital acquired urinary tract infection in intensive care unit. A prospective analysis was performed with 1,235 urine samples following urinary bladder catheterization in 569 patients, who had no evidence of UTI at the time of catheter insertion, admitted to intensive care unit in Pusan P hospital between June 1997 and May 1998. To identify risk factors for UTI, clinical characteristics of infected patients were analyzed. We analyzed these data by percentage, chi-square and odd ratio. Obtained results were as follows: A total of 569 patients (male 341 and female 228) were an average age of 50.8 years and catheterization of 8.04 days. Incidence of UTI was 16.1% (199/1,235) and The risk factors of UTI were duration of catheterization over 7 days, no use of systemic antibiotics, summer and female, and During the first 7 days these risk factors were no use of systemic antibiotics, summer, place of first catheter insertion (ICU) and type of intensive care unit (NSICU). A total of 220 the isolated strains were Gram negative rod 83 (37.7%), yeast like fungi 74 (33.6%) and Gram positive cocci 63 (28.6%). The common organisms isolated were Enterococcus faecalis 23 (10.5%), Serratia marcescens 19 (8.6%), Pseudomonu spp.17 (7.7%), E. ooh 16 (7.3%), Staphylococcus epidemidis 11 (5.0%) mdklebsiellapneumoniae 8 (3.6%). Therefore, in these results 199 of 569 (35%) patients in ICU with indwelling urinary catheter developed UTI. The risk factors for UTI are prolonged duration of catheterization, no use of systemic antibiotics, summer, and female.

• Acute and Critical Care
• /
• v.33 no.4
• /
• pp.216-221
• /
• 2018

Background: In this study, we analyze the performance of the Acute Physiology and Chronic Health Evaluation (APACHE) II, APACHE IV, Simplified Acute Physiology Score (SAPS) 3, and Mortality Probability Model $(MPM)_0$ III in order to determine which system best implements data related to the severity of medical intensive care unit (ICU) patients. Methods: The present study was a retrospective investigation analyzing the discrimination and calibration of APACHE II, APACHE IV, SAPS 3, and $MPM_0$ III when used to evaluate medical ICU patients. Data were collected for 788 patients admitted to the ICU from January 1, 2015 to December 31, 2015. All patients were aged 18 years or older with ICU stays of at least 24 hours. The discrimination abilities of the three systems were evaluated using c-statistics, while calibration was evaluated by the Hosmer-Lemeshow test. A severity correction model was created using logistics regression analysis. Results: For the APACHE IV, SAPS 3, $MPM_0$ III, and APACHE II systems, the area under the receiver operating characteristic curves was 0.745 for APACHE IV, resulting in the highest discrimination among all four scoring systems. The value was 0.729 for APACHE II, 0.700 for SAP 3, and 0.670 for $MPM_0$ III. All severity scoring systems showed good calibrations: APACHE II (chi-square, 12.540; P=0.129), APACHE IV (chi-square, 6.959; P=0.541), SAPS 3 (chi-square, 9.290; P=0.318), and $MPM_0$ III (chi-square, 11.128; P=0.133). Conclusions: APACHE IV provided the best discrimination and calibration abilities and was useful for quality assessment and predicting mortality in medical ICU patients.

• Physical Therapy Rehabilitation Science
• /
• v.8 no.3
• /
• pp.134-140
• /
• 2019

Objective: The purpose of this study was to investigate the effect of exercise therapy and bedside ergometer exercise on muscle strength, function level, and quality of life of persons in intensive care. Design: Randomized Controlled Trial Methods: Sixteen patients in the ICU were randomly assigned to either the exercise group (n=8) or the bedside cycle ergometer group (n=8). Activities in the ICU exercise group (rolling, sitting at the edge of the bed, transfer from sitting to standing, standing balance training, ambulation) and bedside cycle ergometer group were performed 5 times a week for 30 minutes during the ICU admission period. Medical Research Council (MRC) and Functional Status Scale-Intensive Care Unit (FSS-ICU) parameters were assessed at the time of admission to the ICU, and reevaluation was assessed on the day of ICU discharge. The Short Form-36 (SF-36) was assessed at the time of discharge from the ICU. Results: MRC and FSS-ICU were significantly increased before and after intervention in both the experimental and control groups (p<0.05). There was a significant difference between MRC and FSS-ICU in the comparison of the changes before and after the intervention (p<0.05). SF-36 was compared between groups after intervention and there was a significant difference between the experimental and the control group (p<0.05). Conclusions: Muscle strength and functional levels improved after intervention in both the experimental and control groups. The ICU exercise group was more effective than the bedside cycle ergometer group to improve muscle strength, functional level, and quality of life performance of persons in the ICU.

• Korean Journal of Adult Nursing
• /
• v.26 no.3
• /
• pp.352-361
• /
• 2014

Purpose: The purpose of this study was to explore the communication experience of intensive care unit (ICU) nurses in the workplace. Methods: The present study utilized a qualitative approach using focus group interview method. A total of three focus groups of 15 ICU nurses from two university hospitals were formed. The conversations during the focus group interviews were recorded and analyzed through Colaizzi's phenomenological method. Results: As a result of analyzing participants' conversation, Five theme clusters were elicited, namely, "one-way communication", "differences in the position of senior and junior nurses", "communication crisis", "beginning of understanding", and "movement toward change" out of 15 themes and 138 significant sentences. Conclusion: ICU nurses report having experienced communication crisis because of the one-way communication of the ICU nursing environment and the hierarchical differences in junior and senior nurses' position. Systematic education and continuous training on communication skills need to be provided to improve interpersonal relationship among nurses and work environment in the ICUs.

• The Journal of Korean Academic Society of Nursing Education
• /
• v.21 no.1
• /
• pp.28-35
• /
• 2015

Purpose: The purpose of this study was to examine the effects of prior information about ICU environment on the anxiety and environmental stress of cardiac surgery ICU patients. Methods: A non-equivalent control group non-synchronized quasi-experimental research design was used. Participants were 60 (control 30, experimental 30) patients who had been admitted to ICU. Prior information about the ICU environment was provided to the experimental group. The anxiety level of subjects was measured by State-Trait Anxiety Inventory (STAI) and the stress level of subjects was measured by the Intensive Care Unit Environmental Stressor Scale (ICUESS). Data were analyzed using a Chi-square test or a Fisher's exact test, independent samples t-test, and paired samples t-test. Results: There was no difference in Anxiety (t=-0.58, p=.563), but there was a significant difference in environmental stress (t=10.46, p<.001). Conclusion: Providing prior information would be an effective nursing intervention to reduce environmental stress.

• Journal of Korean Academy of Fundamentals of Nursing
• /
• v.12 no.3
• /
• pp.395-403
• /
• 2005

Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUS). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. Method: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. Result: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. Conclusion: Our findings give support to recent studies that suggest that frequent physical contact maγ increase the nosocomial acquisition of MRSA in a neurosurgical ICU.