• 중환자간호학회지
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• 제10권1호
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• pp.1-12
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• 2017

Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

• 중환자간호학회지
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• 제11권1호
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• pp.67-78
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• 2018

Purpose : A meta-analysis was conducted to identify the effectiveness of strategies designed to prevent the incidence and prevalence of pressure ulcers in intensive care units (ICUs). Method : The search strategy was designed to retrieve studies both published and unpublished between 2007 and 2017 including studies in English across PubMed and CINAHL, as well as in Korean across RISS, DBPia, NDSL, KISS, and NAL. All adult ICU participants were 18 years or over. Inclusion criteria were randomized controlled trials, quasi-experimental and comparative studies. Two independent reviewers conducted quality assessments of the included studies by Scottish Intercollegiate Guidelines Network. A Review Manager 5 was used to analyze effect sizes and to identify possible sources of heterogeneity among the studies. Results : The odds ratio (OR) effect sizes were all statistically significant. The OR of total effect size was 0.30(95% CI: 0.19, 0.47), care bundle was 0.37(95% CI: 0.24, 0.57), position change was 0.45(95% CI: 0.10, 2.08), and a silicone border foam dressing was 0.14 (95% CI: 0.07, 0.29). Conclusion : The preventive interventions for patients in the ICUs have positive impacts on reducing the incidence of pressure ulcers.

• 기본간호학회지
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• 제16권1호
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• pp.92-102
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• 2009

Purpose: Relocation stress is a common phenomenon in patients discharged from an intensive care unit(ICU) to a ward. Therefore, nurses need to be aware of the problems that can arise during the transfer process. The aim of this study was to identify nurses' experiences in transferring critically ill patients from the ICU to a ward. Method: Focus group interviews were done with 13 nurses from wards and ICU, which participated in receiving and sending of ICU patients. The debriefing notes and field notes were analyzed using the consistent comparative data analysis method. Result: Seven major categories were identified in the analysis of the data. These were 'mixed feeling about transfer', 'lack of transfer readiness', 'increase in family burden', 'uncertainty with unfamiliar environment', 'difficulty in decision making', 'difference of perception of the relationships between patients and health care providers', 'need for continuity of nursing care'. Conclusion: Transferring out of the critical care area should be presented to the patient and family as a positive step in the recovery process. However, a more universal method of passing information from nurse to nurse is needed to assist in a smooth transition.

• 중환자간호학회지
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• 제14권2호
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• pp.70-81
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• 2021

Purpose : The purpose of this study was to identify the moderating effects of emotional intelligence on the relationship between traumatic events and turnover intention among nurses working in intensive care units (ICUs). Method : In this predictive correlation study, the convenience sample included 133 ICU nurses. Data were collected using an online, structured self-report survey. The collected data were analyzed by descriptive statistics, an independent t-test, an analysis of variance, Pearson's correlation coefficient, and a hierarchical multiple regression analysis using SPSS/WIN 25.0. Results : The most frequently experienced traumatic events in ICUs were "nursing patients with abnormal behavior, including shouting and delirium," "end-of-life care," and "nursing patients with a risk of disease transmission, including AIDS and tuberculosis." The moderating effect of emotional intelligence was found to be statistically significant on the relationship between traumatic events and turnover intentions (𝛽=-0.15, p =.029). Conclusion : Intervention to improve the emotional intelligence of ICU nurses can be a salient strategy to reduce turnover intention resulting from traumatic events.

• 대한간호학회지
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• 제50권6호
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• pp.787-798
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• 2020

Purpose: This study aimed to assign weights for subscales and items of the Post-Intensive Care Syndrome questionnaire and suggest optimal cut-off values for screening unplanned hospital readmissions of critical care survivors. Methods: Seventeen experts participated in an analytic hierarchy process for weight assignment. Participants for cut-off analysis were 240 survivors who had been admitted to intensive care units for more than 48 hours in three cities in Korea. We assessed participants using the 18-item Post-Intensive Care Syndrome questionnaire, generated receiver operating characteristic curves, and analysed cut-off values for unplanned readmission based on sensitivity, specificity, and positive likelihood ratios. Results: Cognitive, physical, and mental subscale weights were 1.13, 0.95, and 0.92, respectively. Incidence of unplanned readmission was 25.4%. Optimal cut-off values were 23.00 for raw scores and 23.73 for weighted scores (total score 54.00), with an area of under the curve (AUC) of .933 and .929, respectively. There was no significant difference in accuracy for original and weighted scores. Conclusion: The optimal cut-off value accuracy is excellent for screening of unplanned readmissions. We recommend that nurses use the Post-Intensive Care Syndrome Questionnaire to screen for readmission risk or evaluating relevant interventions for critical care survivors.

• 성인간호학회지
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• 제27권3호
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• pp.325-336
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• 2015

Purpose: This study was conducted to identify factors influencing compliance of multidrug-resistant organism infection control in intensive care units (ICU) nurses. Methods: Data were collected from 254 ICU nurses who were working at 6 general and advanced general hospitals in D city and G Province. Results: 77.2% and 84.4% of the subjects correctly answered to questions about Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE), respectively. The scores of MRSA infection control compliance and VRE infection control compliance were 3.41 and 3.43, respectively. The factors influencing MRSA infection control compliance were empowerment, environmental safety recognition, and education satisfaction, which explained 30% of MRSA infection control compliance. The factors significantly related to VRE infection control compliance were empowerment, hospital types, environmental safety recognition, number of education sessions, and neonatal ICU, which explained 37% of VRE infection control compliance. Conclusion: It is necessary to develop efficient educational programs for infection control including educational contents to improve empowerment and environmental safety recognition of nurses. Furthermore, administrative support for those infection control programs is also necessary.

• 임상간호연구
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• 제26권3호
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• pp.352-364
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• 2020

Purpose: The purpose of this study was to understand and describe the meaning of the experience of male nurses working in Intensive Care Units (ICU). Methods: Data were collected through in-depth interviews with 8 male nurses. Data were collected from november 2019 to february 2020 and were analyzed using Colaizzi's method, a phenomenological approach. Results: 8 theme clusters, and 28 themes were identified. The 8 clusters were as follows; the feeling of burden in a busy and sensitive situation, the daily life facing life and death, female colleagues and patients who are still difficult to treat, a reliable and grateful male colleague, being proud of this role that a man can do, various experiences that improve me, constant effort to be recognized as a team member, and wavering and weighing in the career. Conclusion: These results could help to expand understanding the role of male nurses working in the ICU and in other areas. In addition, the results provide basic data needed to improve mutual respect and relationships between male and female nurses. It is necessary to offer mentoring programs for male nurses to adapt to nursing field.

• 기본간호학회지
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• 제26권4호
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• pp.221-230
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• 2019

Purpose: This study was done to examine incidence of diarrhea and explore factors influencing occurrence of diarrhea in patients admitted to intensive care units (ICU). Methods: For this retrospective research, data based on inclusion criteria were collected from the electronic medical records for 142 patients admitted to a university hospital ICU from September 2014 to August 2015. Statistical analysis was conducted using SPSS/WIN 22.0 program. Results: Incidence of diarrhea was 53.5% during the 12-month study period. Diarrhea occurred at 4.54 days and continued for 1.79 days on average. Average total frequency of diarrhea was 5.56 times. Increased ICU stay, enteral nutrition, and infection state were significant predictors of the occurrence of diarrhea. Infection increased risk of diarrhea 3.4 times and enteral nutrition increased risk of diarrhea to 2.2 times greater than patients not receivng enteral nutrition. Conclusion: Diarrhea in ICU patients is associated with multiple factors that should be considered to implement preventive strategies. Infection control should be emphasized, and close monitoring of diarrhea should be provided for those with enteral nutrition. Further studies are warranted to determine standardized clinical definition of diarrhea and diarrhea risk factors in ICU patients with different levels of severity and comorbidity.

• 중환자간호학회지
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• 제15권3호
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• pp.37-50
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• 2022

Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory. Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability. Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents. Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the "recall of experience" subscale, and reduction of the scale response level.

• Clinical and Experimental Pediatrics
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• 제50권1호
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• pp.1-6
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• 2007

In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.