• 제목/요약/키워드: Intensive care

검색결과 1,932건 처리시간 0.029초

혈당 조절 프로토콜 적용에 따른 흉부외과 중환자의 혈당 조절 상태와 혈당 변동 (The Effects of the Application of a Glucose Control Protocol on Glycemia and Glucose Variability in Critically Ill Cardiothoracic Surgery Patients)

  • 유혜진;이남주;이순행
    • 중환자간호학회지
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    • 제8권2호
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    • pp.1-12
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    • 2015
  • Purpose: The study sought to determine the state of blood glucose control, and the consequent clinical effects and variation in blood glucose level, of adult patients admitted to intensive care units following cardiothoracic surgery by comparing the blood glucose levels before and after the application of a blood glucose control protocol. Methods: The protocol was developed by modifying and supplementing the Yale protocol, and was first used in 2012. The resulting blood glucose data of an experimental group (n = 314), to which the blood glucose control protocol had been applied, and a control group (n = 347), whose blood glucose levels had been controlled according to physicians'prescriptions without the protocol, were collected through the medical records. Results: The target blood glucose ratio increased significantly in the experimental group, and the low blood glucose ratio decreased significantly in the experimental group. The two groups exhibited a significant difference (p < .001) in the degree of variation in the blood glucose levels. The duration of the use of a ventilator was significantly reduced in the experimental group (p < .001). Conclusion: It is expected that the protocol can be used for the safe and effective control of critically ill cardiothoracic surgery patients' blood glucose levels.

지방의료원 중환자부 건축계획을 위한 영역별 공간구성에 관한 연구 (A Study on the Spatial Composition by Zone for the Architectural Planning of the Intensive Care Unit in Regional Public Hospitals)

  • 여정;채철균
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제26권1호
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    • pp.51-62
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    • 2020
  • Purpose: The Intensive Care Unit (ICU) is an important inpatient care area where critical patients are treated intensively with advanced medical technology. The level of care of ICU and the modernization of related facilities is an important indicator of health care quality. At the present time, when the Regional public hospitals are frequently expanding, the rational planning of the ICU has become an important part of the medical institutions treating the ICU. The purpose of this study is to present basic data with net area which can be used in the architectural planning of the ICU. Methods: The investigation and analysis of the ICUs were conducted on 26 medical facilities, based on theoretical analysis through relevant guidelines, articles, and documents, and on the basis of the actual space composition and net area analysis through the architectural drawings. Results: This study provides basic data such as zone division, spatial composition, relationship between main activities and zones, composition of facilities in the zone and area ratio within each zone. Implications: The results of this paper are expected to be effective reference materials for future research for rational spatial organization and efficient operation of the Intensive Care Unit in regional public hospitals.

병상과 간호스테이션의 관계를 기반으로 한 지방의료원 중환자부 배치유형에 관한 연구 (A Study on the Types of Layout in the Intensive Care Unit of Regional Public Hospitals based on the Relationship between the Beds and Nurse Station)

  • 여정;채철균
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제25권3호
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    • pp.37-46
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    • 2019
  • Purpose: The Intensive Care Unit (ICU) is an important inpatient care area where critical patients are treated intensively with advanced medical technology. The level of care of ICU and the modernization of related facilities is an important indicator of health care quality. At the present time, when the Regional public hospitals are frequently expanding, the rational planning of the ICU has become an important part of the medical institutions treating the ICU. The purpose of this study is to present basic data with net area which can be used in the architectural planning of the ICU. Methods: The investigation and analysis of the ICUs were conducted on 24 medical facilities, based on theoretical analysis through relevant guidelines, articles, and documents, and on the basis of the actual space composition and net area analysis through the architectural drawings. Results: This study provides basic data such as bed placement type of ICU, relationship with other departments, distance between NS and bed, distance between beds, and net area of disease by type. Implications: The results of this paper are expected to be effective reference materials for future research for rational spatial organization and efficient operation of the Intensive Care Unit in regional public hospitals.

Hospice and Palliative Care for Patients in the Intensive Care Unit: Current Status in Countries Other than Korea

  • Minkyu Jung
    • Journal of Hospice and Palliative Care
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    • 제26권1호
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    • pp.22-25
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    • 2023
  • Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

한국형 신생아중환자간호 분류도구를 이용한 간호요구도 평가 (Evaluating Nursing Needs in the Neonatal Intensive Care Unit with the Korean Patient Classification System for Neonatal Intensive Care Nurses)

  • 안효남;안숙희
    • 중환자간호학회지
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    • 제13권2호
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    • pp.24-35
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    • 2020
  • Purpose : This study aimed to determine whether the Korean Patient Classification System for Neonatal Care Nurses (KPCSN) properly measures neonatal intensive care needs and to compare the scale's results with those of the Workload Management System for Critical Care Nurses (WMSCN). Methods : Data were collected from the medical records of 157 patients who were admitted to the NICU of a university hospital, in D city. Two types of patient classification systems were applied to investigate the total points and distributions to investigate the total points and distributions by categories and compare relationships and classification groups between two scales. Finally, the score distribution among the classification groups was analyzed when the KPCSN was applied. Results : Scores on the KPCSN for the feeding, monitoring, and measure categories were 19.16±15.40, 16.88±3.52, and 9.13±4.78, respectively. Classification group distribution of the KPCSN was as follows : 1.9% for the first group, 24.2% for the second group, 58% for the third group, and 15.9% for the fourth group. The classification group distribution of the WMSCN was as follows: 35.7% for the third group, 61.1% for the fourth group, and 3.2% for the fifth group. Finally, the scores by categories were analyzed according to KPCSN classification group, and the characteristics of the patients' nursing needs were identified for each classification group. Conclusion : Results of this study indicate that the KPCSN effectively measures feeding needs, which account for many nursing activities in neonatal intensive care. Comparisons between the KPCSN and WMSCN classification group scores and distribution ratios verified the correlation and significance of nursing requirements.

Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

  • Lee, Hongyeul;Leem, Cho Sun;Lee, Jae Ho;Lee, Choon-Taek;Cho, Young-Jae
    • Tuberculosis and Respiratory Diseases
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    • 제77권4호
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    • pp.193-196
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    • 2014
  • Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

정상 신생아 어머니와 고위험 신생아 어머니의 신생아에 대한 지각 및 교육요구도 비교 (The Educational Needs and Perception of the Mothers of High Risk Infant and Normal Neonate)

  • 이미자;서현선;홍유희;김소연;유은주;박송자
    • Child Health Nursing Research
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    • 제9권1호
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    • pp.18-27
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    • 2003
  • The purpose of this study is to compare the educational needs and perception of mothers of normal neonates and high risk infants. This research was designed as a descriptive study. Data were collected for two months from April 2002 to March 2002. Subjects were 41 mothers of high risk infants and 60 mothers of normal neonates in one general hospital in Seoul participated in the study. Measurement tools used in this study were the educational needs scale developed by Cho Kyoul Ja et al and the neonatal perceptive inventories scale developed by Broussard. They ask mothers to rate each item on a four point Likert type scale. The collected data were analyzed using SPSS 8.0 program. The variables were listed as frequency, mean, standard deviation, X2 test, t-test, ANOVA. The results were as follows: The educational needs of the mothers of primi pregnancy was higher than the mothers of multi pregnancy. The educational needs on management of diseases such as prevention of infection, symptoms of disease, mental development, attachment promotion, congenital metabolism test, management of convulsion, care of vomiting and fever were higher than general care of infants such as immunization, measurement of temperature, hiccough care, follow up care. The informations must be included in nursing intervention program to reduce the mothers' stress level. In conclusion, in order to promote positive mother infant relationship, nurse need to give information and educate the mothers of high risk infant and normal neonate.

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신생아중환자실에서의 가족중심돌봄 기반 가족중재연구에 대한 통합적 문헌고찰 (An Integrative Review of Family Interventions based on a Philosophy of Family-Centered Care in Neonatal Intensive Care Units)

  • 정나리;김예슬;박은영;여리사;황지원
    • Perspectives in Nursing Science
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    • 제16권1호
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    • pp.35-44
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    • 2019
  • Purpose: The aim of this study is to analyze the characteristics of family interventions based on a philosophy of family-centered care conducted in neonatal intensive care units through an integrative literature review. Methods: We searched the PubMed, CINAHL, RISS, KISS, and DBpia databases; a total of 20 studies, published between January 2013 and May 2018, was selected according to our criteria. Results: Mothers accounted for a greater proportion of participants in family interventions than did fathers. Family interventions described in the studies were categorized into four educational and sixteen non-educational interventions. Among non-educational interventions, skin-to-skin-contact interventions, such as kangaroo care, accounted for the highest proportion. Only one paper employed a theoretical framework. Conclusion: More family interventions based on theoretical frameworks should be conducted as these frameworks serve as guidelines for nursing research. As the stress patterns experienced by parents in neonatal intensive care units showed gender differences, more programs tailored for fathers are needed. Moreover, further research should be conducted to evaluate feasibility as an outcome variable, and studies of family interventions based on a philosophy of family-centered care should be performed more actively in the neonatal intensive care units in Korea.

A novel association between cerebral sinovenous thrombosis and nonketotic hyperglycinemia in a neonate

  • Yurttutan, Sadik;Oncel, Mehmet Yekta;Yurttutan, Nursel;Degirmencioglu, Halil;Uras, Nurdan;Dilmen, Ugur
    • Clinical and Experimental Pediatrics
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    • 제58권6호
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    • pp.230-233
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    • 2015
  • Lethargy in newborns usually indicates central nervous system dysfunction, and many conditions such as cerebrovascular events, infections, and metabolic diseases should be considered in the differential diagnosis. Nonketotic hyperglycinemia is an autosomal recessive error of glycine metabolism, characterized by myoclonic jerks, hypotonia, hiccups, apnea, and progressive lethargy that may progress to encephalopathy or even death. Cerebral sinovenous thrombosis is a rare condition with various clinical presentations such as seizures, cerebral edema, lethargy, and encephalopathy. Here, we report the case of a newborn infant who presented with progressive lethargy. An initial diagnosis of cerebral venous sinus thrombosis was followed by confirmation of the presence of nonketotic hyperglycinemia.

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.