• 제목/요약/키워드: Intensive care

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

  • Jiyeon Kang;Hyojeong Woo
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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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.

SMC Full PACS로의 전환 및 System 구축

  • Kim, Sam-Soo;Ro, Duk-Woo;Cheung, Hwan
    • Korean Journal of Digital Imaging in Medicine
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    • v.3 no.1
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    • pp.20-23
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    • 1997
  • The purpose of this paper is to describe the transition of a 1,100 beds teritary hospital from 50% softcopy operation to full PACS operation. For the past 2 years, radiologists and clinicians have been using PACS to provide softcopy services to the outpatient clinics and inpatient wards of orthopedics surgery, neurosurgery and neurology as well as emergency room, surgical intensive care unit, medical intensive unit, pediatrics intensive care unit and neonatal intensive care unit. The examinations requested by these departments account for about 50% of hospital's radiological exams. In September 1996, we began the second phase of PACS implementation and installed additional workstations (102) in the remaining wards and clinics, interfaced to PACS additional imaging modalites, and increased the capacity of both the image server (256 Gbytes) and optical juke boxes (3 Tbytes). As of January 1997, we are in the final phase of moving away from conventional film system to full PACS operation.

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Noise Level and Frequency Experienced by Premature Infants Receiving Incubator Care in the Neonatal Intensive Care Unit (신생아집중치료실 내 인큐베이터 간호를 받는 미숙아가 경험하는 소음 수준 및 빈도)

  • Joo, So Hyun;Kim, Tae Im
    • Child Health Nursing Research
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    • v.26 no.2
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    • pp.296-308
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    • 2020
  • Purpose: The purpose of this study was to identify the noise level and frequency experienced by premature infants receiving incubator care in the neonatal intensive care unit (NICU). Methods: The participants were 20 premature infants receiving incubator care in the NICU of a university hospital in Daejeon Metropolitan city. The noise level was measured using a professional sound-level meter (ET-958, FLUS, Shenzhen, China) based on a noise classification table developed by the author. The data were analyzed with descriptive statistics, the t-test, analysis of variance, and Pearson correlation coefficients using SPSS for Windows version 22.0. Results: The average noise level experienced by premature infants receiving incubator care in the NICU was 51.25 dB (range: 45.0~81.7 dB). The frequency of noises was highest for factors related to nursing activities (40.3%), followed by human factors (29.1%), machine alarm sounds (20.1%), incubator operation (6.6%), and internal environmental factors (3.9%). Conclusion: According to the above results, the noise level experienced by premature infants receiving incubator care in the NICU exceeded the recommendations of the American Academy of Pediatrics. Therefore, it is necessary to develop an interventional program to reduce noise in the NICU, and to conduct follow-up studies to verify its effectiveness.

National Survey of Kangaroo Care Practice, Barriers, Knowledge, and Belief (신생아중환자실 캥거루 케어 전국 실태조사- 간호행위, 장애요인, 간호사의 지식과 신념)

  • Kim, Hee Young;Jang, Eun Kyung;Lee, Jin-Hee;Lee, Eun Jung;Oh, Seyeon;Jo, Keum Sig
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.2
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    • pp.211-221
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    • 2017
  • Purpose: A National survey was conducted to assess neonatal intensive care nurses' practice, barriers, knowledge, and belief regarding Kangaroo Care (KC). Methods: A descriptive survey was conducted. Kangaroo care questionares were sent to nurses in all hospitals in Korea whose were identified as providing neonatal intensive care services(N=263). Descriptive statistics were used to summarized the data. Results: Among 67 neonatal care units, 61.1% adapted KC in their practice. About 60% of nurses in the KC providing hospital actually practiced KC. Major barrier of practicing KC were infant safety concerns, as well as work load of nurses. Respondants who had practiced KC were more knowledgable and were more positive in their belief regarding KC. Conclusion: The findings suggest that in order to overcome barriers of practicing KC, educational programs are recommended designed for nurses. In addition, development of KC practice guideline is necessary to facilicate successful and safe KC.

Discharge education reinforcement activities for mother of premature infants (미숙아 어머니의 퇴원교육 프로그램 강화활동)

  • Lee, Hui-Jeong;Soul, Hyun A;Lee, Kyeong-Nam;Seo, Gyeong-Ok;Moon, Su-Mi;Kim, Ki-Hwi
    • Quality Improvement in Health Care
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    • v.20 no.1
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    • pp.76-88
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    • 2014
  • Objectives: Parents of a premature baby feel a pressure on their baby's growth and they are highly in need for proper education. However, the lack of proper education can cause the difficulty of follow-up care and rehospitalization. Currently, methods of education among each nurse are based on verbal explanation and can be often different. Therfore, it is true that the psychological burden is great during education. Hence, by enforcing discharge education activities, we intend to provide information; induce participation of parents; promote the level of performance; standardize education program; and increase the job satisfaction of nurses. Methods: NICU conducted a questionnaire survey of the demand and satisfaction for discharge education among mothers that left hospital. And before and after the improvement activity, the satisfaction level of mothers and nurses were studied, and rehospitalization rate were analyzed. Results 1)The survey results of the satisfaction level of mothers towards education program as followes: The level of understanding of content, general babysitting, special situation, education method, and educator attitude showed statistically significant increase. 2)The survey results of the satisfaction level of nurses towards education program as followes: While, the need for education program decreased, the adequacy of education content and method, consistency of education, understanding of learner, and learner's performance increased. All the factors except for the need for education program and the adequacy of education content showed statistically significant difference. 3)Rehospitalization rate of premature babies decreased. According to analysis of the cause of rehospitalization, breast-feeding related apnea turned out to be the highest. Conclusion: Through QI, satisfaction of mothers and nurses improved more than 10%. And rehospitalization rate of premature babies decreased by the same amount as well. Therefore, with the help of the standardized discharge education program, mothers who is not easy to take care of after leaving hospital can be seen to significantly affect their healthy growth and development.

Perception of Nurses and Physicians in Neonatal Intensive Care Units on Kangaroo Care (신생아집중치료실 캥거루케어에 대한 간호사와 의사의 인식)

  • Bang, Kyung-Sook
    • Child Health Nursing Research
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    • v.17 no.4
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    • pp.230-237
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    • 2011
  • Purpose: To identify the perception and practices of kangaroo care in nurses and doctors working in neonatal intensive care units (NICU) in Korea. Methods: One hundred forty-nine nurses and nineteen doctors working in the NICU from six university hospitals completed a survey questionnaire. Results: Most agreed that Kangaroo care promoted attachment and parental confidence as well as physical health of the infant. However, nurses and doctors showed a negative perception in providing kangaroo care for premature infants under 1,000 grams or within several hours after birth. Major barriers for kangaroo care were worrying about extubation and safety problems of premature infants. Married or senior nurses showed a more positive perception than others. Also nurses who worked in hospitals where kangaroo care was provided had a lower barrier perception than other nurses. Conclusion: Nurses and doctors working in NICU worried about adverse effects of kangaroo care even though they perceived positive effects. Standard education programs and manuals should be developed before dissemination of kangaroo care in Korea.

Psychological and Physical Health in Family Caregivers of Intensive Care Unit Survivors: Current Knowledge and Future Research Strategies

  • Choi, JiYeon;Donahoe, Michael P.;Hoffman, Leslie A.
    • Journal of Korean Academy of Nursing
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    • v.46 no.2
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    • pp.159-167
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    • 2016
  • Purpose: This article provides an overview of current knowledge on the impact of caregiving on the psychological and physical health of family caregivers of intensive care unit (ICU) survivors and suggestions for future research. Methods: Review of selected papers published in English between January 2000 and October 2015 reporting psychological and physical health outcomes in family caregivers of ICU survivors. Results: In family caregivers of ICU survivors followed up to five years after patients' discharge from an ICU, psychological symptoms, manifested as depression, anxiety and post-traumatic stress disorder, were highly prevalent. Poor self-care, sleep disturbances and fatigue were identified as common physical health problems in family caregivers. Studies to date are mainly descriptive; few interventions have targeted family caregivers. Further, studies that elicit unique needs of families from diverse cultures are lacking. Conclusion: Studies to date have described the impact of caregiving on the psychological and physical health in family caregivers of ICU survivors. Few studies have tested interventions to support unique needs in this population. Therefore, evidence for best strategies is lacking. Future research is needed to identify ICU caregivers at greatest risk for distress, time points to target interventions with maximal efficacy, needs of those from diverse cultures and test interventions to mitigate family caregivers' burden.

Impact of Socioeconomic Status on 30-Day and 1-Year Mortalities after Intensive Care Unit Admission in South Korea: A Retrospective Cohort Study

  • Oh, Tak Kyu;Jo, Jihoon;Jeon, Young-Tae;Song, In-Ae
    • Acute and Critical Care
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    • v.33 no.4
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    • pp.230-237
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    • 2018
  • Background: Socioeconomic status (SES) is closely associated with health outcomes, including mortality in critically ill patients admitted to intensive care unit (ICU). However, research regarding this issue is lacking, especially in countries where the National Health Insurance System is mainly responsible for health care. This study aimed to investigate how the SES of ICU patients in South Korea is associated with mortality. Methods: This was a retrospective observational study of adult patients aged ${\geq}20$ years admitted to ICU. Associations between SES-related factors recorded at the time of ICU admission and 30-day and 1-year mortalities were analyzed using univariable and multivariable Cox regression analyses. Results: A total of 6,008 patients were included. Of these, 394 (6.6%) died within 30 days of ICU admission, and 1,125 (18.7%) died within 1 year. Multivariable Cox regression analysis found no significant associations between 30-day mortality after ICU admission and SES factors (P>0.05). However, occupation was significantly associated with 1-year mortality after ICU admission. Conclusions: Our study shows that 30-day mortality after ICU admission is not associated with SES in the National Health Insurance coverage setting. However, occupation was associated with 1-year mortality after ICU admission.

The Effect of Perceived Patient- and Family-Centered Care on Nurses' Caring Behavior in Intensive Care Units (중환자실 간호사의 환자-가족 중심 간호에 대한 인식이 돌봄 행위 수행에 미치는 영향)

  • Kim, Na-Yeon;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.23 no.3
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    • pp.208-216
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    • 2021
  • Purpose: The purpose of this study was to identify the factors influencing nurses' caring behavior. Methods: The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson's correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. Results: Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses' caring behaviors (r=.36, p<.001). Multiple regression analysis showed that perception of support (β=.36, p<.001), total career length (β=.33, p<.001), and familiarity with PFCC (β=.15, p=.018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. Conclusion: Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.

An analysis of nursing focuses for standardization of ICU nursing records (중환자실 간호기록 표준화를 위한 간호초점 분석)

  • Kang, Young-Mi;Yu, Ji-Ho;Cho, Yong-Ae;Ryoo, Sung-Suk;Cho, Jeong-Koo;Sung, Young-Hee
    • Journal of Korean Critical Care Nursing
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    • v.1 no.1
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    • pp.73-83
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    • 2008
  • Purpose: Purpose of this study was to analyze the nursing focuses for standardization of ICU nursing records. Methods: The data were collected from 1,000days'nursing records of 197 ICU patients at a tertiary hospital in Seoul. Nursing focuses were unified at the consulting group meeting and they were cross-mapped with the NANDA nursing diagnoses. Results: The 62 nursing focuses in 7 NANDA categories were extracted from nursing record. Among total nursing focuses 41 correspond to the NANDA nursing diagnoses and 21 were added to ICU nursing focuses. The 10 most frequently used nursing focuses are 'Ineffective airway clearance', 'Impaired gas exchange', 'Ineffective tissue perfusion: cardiopulmonary', 'Ineffective breathing pattern', 'Ineffective tissue perfusion: renal', 'Ineffective infant feeding pattern', 'Risk for impaired skin integrity', 'Hyperthermia', 'Impaired skin integrity', 'Decreased cardiac output', Conclusion: Nursing focuses list of ICU was extracted from the result of this study. These nursing focuses might form a framework for development of research-based assessment guideline and care plans for ICU patients through standardization of nursing records.

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