• 제목/요약/키워드: Intensive Care Units

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중환자실 환자의 집중치료 경험 및 관련 요인: 이차분석 연구 (Intensive Care Experience of Critical Care Patients and Its Related Factors : A Secondary Analysis Study)

  • 강지연;우효정
    • 중환자간호학회지
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    • 제16권3호
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    • pp.11-23
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    • 2023
  • Purpose : This study investigates the experiences of patients in intensive care units (ICUs), and the factors influencing these experiences. Method : We used a cross-sectional survey design to analyze previously collected cohort data from 891 patients who spent over 24 hours in 19 ICUs across four university hospitals in Busan, South Korea between June 2019 and July 2020. Within a week of ICU discharge, participants completed the Korean version of the Intensive Care Experience Questionnaire, covering four areas: "awareness of surroundings," "frightening experiences," "satisfaction with care," and "recall of experiences." We used multiple linear regression to identify factors associated with the ICU experience. Results : Low income (𝛽 = -.08, p = .016), unplanned hospitalization (𝛽 = -.09, p = .006), sedation (𝛽 = -.16, p < .001), and delirium (𝛽 = -.15, p < .001) reduce patients' awareness of their surroundings. Frightening experiences are associated with being female (𝛽 = -.07, p = .027), experiencing delirium(𝛽= -.15, p<.001), and longer stays in the ICU (𝛽= -.14, p <.001). Using sedatives decreases satisfaction with care (𝛽 = -.08, p = .048). Living alone (𝛽 = -.08, p = .013) and using painkillers (𝛽 = -.08, p = .020) reduces recall of experiences. Conclusion : Negative ICU experiences are significantly associated with being female, living alone, lower income, unplanned admission, using sedatives and painkillers, delirium, and longer stays in the ICU. Thus, improving ICU experiences requires interventions that address modifiable factors, such as delirium, medication, and length of ICU stays.

상급종합병원 중환자실 간호사의 전문직 삶의 질이 전문직 자아개념에 미치는 영향 (Effect of Professional Quality of Life on the Professional Self-Concept of Intensive Care Unit Nurses in Tertiary Hospital)

  • 홍진영;손수경
    • 중환자간호학회지
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    • 제12권2호
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    • pp.13-25
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    • 2019
  • Purpose : The purpose of this study was to identify factors influencing the professional self-concept of nurses working in intensive care units (ICUs). Methods : Data were collected from July 1 to August 15, 2014. The subjects were 206 ICU nurses working in four university hospitals in B and U cities, Korea. Their professional self-concept was measured using Arthur's Scale revised by Yoon (2012), and professional quality of life (QOL) was measured using Pro QOL Korean Ver. 5 developed by Stamm (2010). Data were analyzed with SPSS Ver. 18, using a t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis. Results : Professional self-concept was significantly correlated with compassion satisfaction (r=.61, p<.001), and burn out (r=-.57, p<.001). The factors influencing professional self-concept were compassion satisfaction (${\beta}=.46$, p<.001), burn out (${\beta}=-.27$, p<.001), and education level (${\beta}=.14$, p =.014). The explanatory power of this model was 46.5%. Conclusion : The results suggest that the influencing factors found in this study should be considered when planning nursing intervention programs for improving the professional self-concept of ICU nurses.

Ethics in the Intensive Care Unit

  • Moon, Jae Young;Kim, Ju-Ock
    • Tuberculosis and Respiratory Diseases
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    • 제78권3호
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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.

외과계 중환자실 수술 후 환자의 섬망 예방 중재가 섬망 발생에 미치는 효과 (The Effects of Delirium Prevention Intervention on the Delirium Incidence among Postoperative Patients in a Surgical Intensive Care Unit)

  • 심미영;송숙희;이미미;박민아;양은진;김민수;김유진;김두나
    • 임상간호연구
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    • 제21권1호
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    • pp.43-52
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    • 2015
  • Purpose: This study was aimed to develop the multicomponent intervention for preventing delirium among postoperative patients in a surgical intensive care unit (SICU). Methods: Using a quasi-experimental pre & post-test design with a non-equivalent control group, a total of 88 hospitalized patients in a SICU participated in this study. The 44 patients were allocated in each experimental and control group. The experimental group received the multicomponent intervention for delirium prevention including a delirium assessment and nursing intervention using a checklist, whereas the control group was provided with a standard care. The primary outcome of this study was the delirium incidence during the course of hospitalization. Results: There were no significant differences in the demographic and clinical characteristics between the two groups. The delirium occurred in 19.2% in the experimental group, whereas 38.6% in the control group ($x^2=4.526$, p<.05). Conclusion: The findings of the study demonstrated an effect of the multicomponent delirium prevention intervention in decreasing the delirium incidence rate over the standard care among the patients in SICU.

중환자실 간호사의 임상등급 (clinical ladder)별 간호역량 측정도구 개발 (Development of a Nursing Competency Scale according to a Clinical Ladder System for Intensive Care Nurses)

  • 박지은;김소선
    • 간호행정학회지
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    • 제19권4호
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    • pp.501-512
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    • 2013
  • Purpose: This study was done to develop a nursing competency scale according to a clinical ladder system for intensive care nurses. Methods: Index of content validation was done by 20 clinical experts and 80 nurses in Intensive Care Units (ICU). Results: The process and results of study are as follows. First, 12 nursing competencies were used in the establishment of the clinical ladder system (Jang, 2000). Second, the first draft of the competency lists was developed. It was based on the clinical nurses' behavioral indicators of nursing competency by Jang (2000), and was modified and supplemented through various literature reviews including competency standards for specialist intensive care nurses in Australia and consultation with 2 clinical nurses with over 10 years experience in the ICU. Third, the draft was examined by 20 clinical experts for content validity. Finally, the final draft was analysed using clinical validity where 20 nurses in each ladder participated. The final number of items was fixed at 309. Conclusion: The tool represents expected nursing competency of nurses working in ICU. Intensive care nurses can recognize their strengths and weaknesses, and identify directions for their professional growth by analysing results of their competency evaluation using this tool.

산모 집중치료실에 입원한 고위험 임부의 건강관리 요구: 혼합적 연구방법 적용 (Health-care Needs of High-risk Pregnant Women Hospitalized in Maternal-Fetal Intensive Care Units: A Mixed-methods Design)

  • 김현진;박호란
    • 여성건강간호학회지
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    • 제24권2호
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    • pp.196-208
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    • 2018
  • Purpose: To identify the characteristics and health-care needs of high-risk pregnant women in maternal-fetal intensive care units (MFICU). Methods: A mixed-methods design was adopted. Data were collected from 78 high-risk pregnant women admitted to the MFICU. Qualitative data included ten participants' experiences with hospitalization and childbirth, which were analyzed using mixed content analysis. Quantitative data were analyzed using at-test and one-way ANOVA testing. Results: The average score for pregnancy and childbirth health-care needs was 3.54 points. Average score by area was before-admission health care (3.70), health care of baby (3.67), health of childbirth (3.61), postpartum health (3.51), and pregnancy health care during hospitalization (3.48). Qualitative results showed diverse feelings and experiences of high-risk pregnant women and their need for health care, which was expressed in three themes and 11 sub-themes. Conclusion: Nurses should recognize high-risk mothers' feelings and needs for pregnancy and childbirth-focused health care to help patients accept their vulnerability and cope positively.

중환자실 간호사의 폭력경험 (Experience of Workplace Violence among Intensive Care Unit Nurses)

  • 황윤영;박영례;박성희
    • 성인간호학회지
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    • 제27권5호
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    • pp.548-558
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    • 2015
  • Purpose: The purpose of this study was to explore the experience of workplace violence among intensive care unit nurses. Methods: The participants of this research were twelve registered nurses who work in the intensive care units (ICU) at the hospitals in Seoul and Gyunggido. Data were collected by individual in-depth interviews and analyzed using the phenomenological methodology by Colaizzi. Results: From significant statements, five theme clusters emerged as follow; 1) vulnerable young women to violence, 2) my own reflection was bruised and exhausted, 3) a hopeless everyday, 4) seeking a solution in relation, 5) establishing one's status as a professional nurse. Conclusion: This study provides a profound understanding on the experiences of workplace violence among ICU nurses. The hospitals are suggested to provide a safe environment by developing programs and policies to prevent and cope with hospital workplace violence for ICU nurses.

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

  • 강이슬;김순희;이민정;이효진;임옥분;홍상범;최혜란
    • 중환자간호학회지
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    • 제16권1호
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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.

APACHE III 시스템을 이용한 병원간 중환자실 치료결과 비교분석 (Interhospital Comparison of Outcome from Intensive Care Unit with APACH III Scoring System)

  • 이덕희;노미영;김병성
    • Journal of Preventive Medicine and Public Health
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    • 제27권3호
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    • pp.437-445
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    • 1994
  • The objective of this study was to evaluate outcome for the patients of the intensive care unit, using APACHE III prognostic system. We prospectively collected the information of 429 patients in intensive care units at 2 tertiary care hospitals and 4 secondary care hospitals in PUSAN who had been admitted from December 1, 1993 to February 28, 1994. The results were as follows. 1. APACHE III scores were various from 0 to 173. But the distribution of the scores were similar between tertiary care hospitals and secondary care hospitals. 2. The mortality rate significantly increased as APACHE III score rised (p<0.001). Within the interval of same score, generally, the mortality of operative patients was higher in secondary care hospitals but in the case of nonoperative patients higher in tertiary care hospitals. 3. When the tertiary care hospitals compared with secondary for ratio of the predicted mortality rate to the actual mortality rate, there was little difference. 4. When we compared the 6 hospitals, one hospital had significantly better results and another hospital was significantly inferior (p<0.05).

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중환자실 환자의 간호지속성 유지를 위한 중환자실-병동간 연계형 전환간호 프로그램 개발 및 효과 (Development and Effects of the Collaborative Transitional Care Program for Continuity of Care in Patients Transferred to General Wards from ICUs)

  • 손연정
    • 임상간호연구
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    • 제15권3호
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    • pp.143-155
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    • 2009
  • Purpose: This study was conducted to develop and evaluate the collaborate transitional care program for improving continuity of care in patients transferred to general wards from ICUs. Methods: 18 years and older who were hospitalized in adult intensive care units at A university affiliated medical center was recruited for the study. The experimental group for patients transferred from an ICU consisted of 33 patients and family caregivers; 34 patients and family caregivers for the control group. This study was utilized a quasi-experimental research design. The collaborative transitional care program was administered in transfer process. Data were collected two times by interviews, medical records, and telephone using questionnaires. Results: There were statistically significant differences between the two groups on relocation stress (p<.001), perceived health status (p<.001), satisfaction of caring (p=.011), physical domain (p=.022) and mental domain (p<.001) of the QOL. There were significant differences between the families of the two groups on burden (p<.001) and satisfaction of caring (p<.001). Conclusion: The collaborative transitional care programs administered in transfer process to general wards from an ICU have positive effects on patients and families' intrinsic and extrinsic factors. This program will be able to be utilized in clinical fields to improve continuity of care for patients and families between ICUs and general wards.