• Title/Summary/Keyword: Intensive care

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Nitrous oxide splurge in a tertiary health care center and its environmental impact: No more laughing stock

  • Amit Sharma;GD Puri;Rajeev Chauhan;Ankur Luthra;Gauri Khurana;Amarjyoti Hazarika;Shyam Charan Meena
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.24 no.1
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    • pp.67-73
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    • 2024
  • Background: Nitrous oxide has been an integral part of surgical anesthesia for many years in the developed world and is still used in developing countries such as India. The other main concerns in low-resource countries are the lack of an advanced anesthesia gas-scavenging system and modular surgical theatres. As a greenhouse gas that has been present in the atmosphere for more than 100 years and damages the ozone layer, nitrous oxide is three times worse than sevoflurane. Here, we conducted an observational study to quantify the annual nitrous oxide consumption and its environmental impact in terms of carbon dioxide equivalence in one of busiest tertiary health care and research centers in Northern India. Methods: Data related to nitrous oxide expenditure' from the operation theatre and manifold complex of our tertiary care hospital and research center from 2018 to 2021 were collected monthly and analyzed. The outcomes were extracted from our observational study, which was approved by our institutional ethics board (INT/IEC/2017/1372 Dated 25.11.2017) and registered prospectively under the Central Registry (CTRI/2018/07/014745 Dated 05.07.2018). Results: The annual nitrous oxide consumption in our tertiary care hospital was 22,081.00, 22,904.00, 17,456.00, and 18,392.00 m3 (cubic meters) in 2018, 2019, 2020, and 2021, respectively. This indicates that the environmental impact of nitrous oxide (in terms of CO2 equivalents) from our hospital in 2018, 2019, 2020, and 2021 was 13,016.64, 13,287.82, 10,289.94, and 10,841.24 tons, respectively. Conclusion: This huge amount of nitrous oxide splurge is no longer a matter of laughter, and serious efforts should be made at every central and peripheral health center level to reduce it.

Person-Centered Relational Care Experienced by Critical Care Nurses: An Interpretative Phenomenological Analysis Study (중환자실 간호사가 경험한 사람-중심의 관계 돌봄에 대한 해석 현상학적 분석 연구)

  • Jang, Myoung Sun;Kim, Sungjae
    • Journal of Korean Academy of Nursing
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    • v.49 no.4
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    • pp.423-436
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    • 2019
  • Purpose: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. Methods: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through indepth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. Results: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. Conclusion: The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

Concept Analysis of Relocation Stress - Focusing on Patients Transferred from Intensive Care Unit to General Ward - (전실 스트레스[relocation stress]의 개념분석 - 중환자실에서 일반 병실로 전실하는 환자를 중심으로 -)

  • Son, Youn-Jung;Hong, Sung-Kyung;Jun, Eun-Young
    • Journal of Korean Academy of Nursing
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    • v.38 no.3
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    • pp.353-362
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    • 2008
  • Purpose: This study was conducted to analyze and clarify the meaning of the concept for relocation stress -focusing on patients transferred from an intensive care unit to a general ward. Methods: This study used Walker and Avant's process of concept analysis. Results: Relocation stress can be defined by these attributes as follows: 1) involuntary decision about relocation, 2) moving from a familiar and safe environment to an unfamiliar one, 3) broken relationship of safety and familiarity, 4) physiological and psychosocial change after relocation. The antecedents of relocation stress consisted of these facts: 1) preparation degrees of transfer from the intensive care unit to a general ward, 2) pertinence of the information related to the transfer process, 3) change of major caregivers, 4) change in numbers of monitoring devices, 5) change in the level of self-care. There are consequences occurring as a result of relocation stress: 1) decrease in patients' quality of life, 2) decrease in coping capacity, 3) loss of control. Conclusion: Relocation stress is a core concept in intensive nursing care. Using this concept will contribute to continuity of intensive nursing care.

The Relationship of Stress, Coping and Partnership between Nurses and Parents of Children Hospitalized in the Pediatric Intensive Care Unit (병원 소아중환자실 환아 부모의 스트레스, 대처 및 부모·간호사와의 파트너십 상관관계)

  • Cho, In Young;Lee, Hye Jung
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.2
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    • pp.195-207
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    • 2013
  • Purpose: This study was conducted to describe the relationship of parents' stress, coping, and partnership between nurse and parents whose children were hospitalized in the Pediatric Intensive Care Unit. Methods: A descriptive correlation study design was used. The participants were 81 parents whose children were hospitalized at S-hospital located in Seoul from October 18 to November 27, 2012. This study used the 'Parental Stress Scale: Pediatric Intensive Care Unit,' the coping scale, and 'Pediatric Nurse Parents Partnership Scale, PNPPS'. The data were analyzed using t-test, ANOVA and pearson correlation. Results: The parents of children hospitalized in pediatric intensive care unit were experiencing high level of stress ($3.22{\pm}0.82$). There was a significant positive correlation between parents' coping and nurse parents partnership (p<.001), however there was no relationship between parents' stress and coping, and parents' stress and nurse parents partnership. Conclusion: Nurse-parents partnership had significant relationship with parents' coping In the care of children hospitalized in pediatric intensive care unit. The results of this study provided a foundation to recognize importance of nurse parents partnership and to develop intervention program for nurses and parents to improve their partnership.

Analysis of the educational needs of nurses in the neonatal intensive care unit for developmental supportive care (발달지지간호에 대한 신생아집중치료실 간호사의 교육요구도 분석)

  • Shin, Da-Ae;Bang, Kyung-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.27 no.3
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    • pp.261-273
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    • 2021
  • Purpose: This study used a descriptive investigative design to identify educational needs for developmental supportive care for the purpose of establishing a developmental supportive care education program for nurses in neonatal intensive care units. Methods: A survey was conducted on 93 nurses working in neonatal intensive care units located in a metropolitan area, and the collected data were analyzed using descriptive statistics and a paired t-test with the SPSS 25.0 program. For the purpose of analyzing educational needs, we further analyzed data through an importance-performance analysis (IPA) and the Borich needs assessment and the locus for focus models. Results: The average importance of the developmental supportive care of nurses in neonatal intensive care units was 3.74±0.78 out of 5, and the average performance was 3.46±0.81 out of 5. A t-test on the difference between the IPA and Borich needs assessment showed the highest educational need in the categories of 'individualized care', and 'I serve on the Developmental Care Committee at my institution'. In addition, according to the results of deriving the priorities of educational needs using the Borich needs assessment and the locus for focus model, the highest priority was 'I provide appropriate pain management when noxious procedures are necessary'. Conclusion: These findings can be used as basic data to design a developmental supportive care program suitable for nurses in neonatal intensive care units to meet the educational needs for developmental supportive care.

Experience of Life-sustaining Treatment in Patient Care among Intensive Care Unit Nurses: Phenomenological Approach (중환자실 간호사의 연명치료환자 간호 경험: 현상학적 접근)

  • Lee, Su Jeong;Kim, Hye Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.2
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    • pp.172-183
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    • 2016
  • Purpose: The purpose of this study was to explore the subjective experience of life-sustaining treatment care among nurses in intensive care units. Method: A phenomenology was used for the study. Data were collected from October to December, 2015 using open-ended questions during in-depth interviews. Participants were nurses working in intensive care units and were contacted through purposive techniques. Eight nurses participated in this study. Results: Four categories emerged from the analysis using Colaizzi's method: (a) difficulties due to life-sustaining treatment care, (b) dilemma of extension or cessation of life-sustaining treatment, (c) repressed feelings and emotional exhaustion, and (d) forming values for life-sustaining treatment from nursing experience. Conclusion: Provision of clearer guidelines on life-sustaining treatment which reflect a family-oriented culture is important for nurses in ICU and will promote nurses involvement in the decision-making process of life-sustaining treatment of patients.

ICU Nurses' Work Experience for Attempted Suicide Patient by Drug Ingestion: A Focus Group Study (일 대학병원 중환자실 간호사의 음독자살시도 환자 간호 경험: 포커스 그룹 연구)

  • Kim, Mi Ok;Cho, Heung Don;Bong, Eun Kyung;Son, Youn-Jung;Park, Young-Su
    • Journal of Korean Critical Care Nursing
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    • v.6 no.1
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    • pp.11-20
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    • 2013
  • Purpose: This study to describe experiences of nurses who work in intensive care units (ICUs) where they frequently encounter patients with attempted suicide by drug ingestion. Methods: Data were collected by 2 focus group interviews with 9 ICU nurses. The interview were recorded and transcribed, and data were analyzed using qualitative content analysis. Results: The results of data analysis, five themes were drawn: 'Confusion about for the attempted suicidal patient care', 'Helplessness for dying with attempted suicidal patients', 'Guilty for insufficient care', 'Ambivalence for the attempted suicidal patients', 'Recognition of need for professional approach'. Conclusion: The results of this study help us to understand patients who attempted suicide through the ICU nurses' experience. It would be useful to develop effective education programs for ICU nurses to preventive strategies for patients who are high risk of recurrence of suicidal crisis situation.

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Experiences of Nurses Working in a Single-Room-Structured Intensive Care Unit (전 병상 1인실 구조인 중환자실에 근무하는 간호사의 경험)

  • Youn, Jung Hee;Shin, Young Mi;Shin, Su Jin;Hong, Eun Min
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.1-13
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    • 2021
  • Purpose : This study aims to provide basic data for effective nursing interventions and improvement of nurses' work by exploring their work experiences in single-room-structured intensive care units (ICU) through focus group interviews. Methods : Data were collected through two focus group discussions conducted from March to November 2020 with 13 ICU nurses. Interviews were audio-recorded and analyzed thematically by investigators. Results : Through content analysis, 15 sub-categories and 6 categories were formed. Two themes, "positive experiences patients care in an independent space" and "difficulties in nursing work according to space separation of patients" emerged. There are positive aspects of single-room-structured ICUs, but it was found that practicing nurses had difficulties and required specialized nursing competencies. Therefore, efforts to reduce the burden of nurses in single-room-structured ICUs are necessary. Conclusion : The limitation of this study is that it was conducted in a single hospital because single-room-structured intensive care units are uncommon in Korea. However, this study is of great significance as a basis for establishing guidelines on the efforts required from nurses, hospitals, and governments single-room-structured ICUs in the future.

Nurses' experiences of caring for severe COVID-19 patients (COVID-19 중환자를 돌보는 간호사들의 경험)

  • Kang, Myoung Mi;Park, Ye Na;Park, Seong Young;Kim, Ju Hyun
    • Journal of Korean Critical Care Nursing
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    • v.15 no.2
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    • pp.14-26
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    • 2022
  • Purpose : This study aimed to understand and describe the nurses' experiences caring for severe COVID-19 patients at isolation room with negative pressure in South Korea. Methods : Data were collected through individual in-depth interviews from February 16 to March 31, 2021 with 11 nurses who had been caring for severe COVID-19 patients at isolation room. Verbatim transcripts were analyzed according to Colaizzi's phenomenological analysis. Results : As a result, 5 theme clusters were extracted about nurses' experiences. The 5 theme clusters, "Adapting to unexpected adversity", "Accepting unresonable and heavy work", "Dulness and disconnection from the outside world", "Changing in perception of new infectious diseases", and "Pathetic isolated patients" emerged. Conclusion : The results of this study provided a deeper understanding of nurses struggling to care for COVID-19 severe patients. This study is expected to be useful in providing basic evidence for improving intensive care practices and for preparing policies in other infection disease situations.