• 기본간호학회지
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• 제12권1호
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• pp.121-130
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• 2005

Purpose: This study was done to determine the rate for handwashing by intensive care unit nurses according to the content of nursing tasks, to investigate the relationship between hand washing practice evaluated by nurses themselves and their actual practice observed, and finality to provide basic materials for strategy for hand washing education. Method: Data were collected by observing 27 nurses working in intensive care units of a hospital in Uijeongbu, Gyeonggi-do and by using observation and a structured self-assessment tool. Collected data were analyzed with SPSS and SAS. Results: The handwashing rate for the nurses was 4.3%. The handwashing rate was high in proportion to the risk of cross infection. In addition, the handwashing rate was highest in nurses working in the neurosurgery intensive care unit. The average score for self-assessment of handwashing was $49.42{\pm}3.78$ points and it was higher than their actual practice of handwashing. Conclusion: In order to improve handwashing by nurses, it is necessary to educate them on the importance of handwashing. In addition, there should be strategies for standardizing knowledge and attitudes to handwashing and inducing nurse:3 to practice hand washing in compliance with the policies and working conditions of the institution.

• 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.

• 임상간호연구
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• 제22권2호
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• pp.205-216
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• 2016

Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Neonatal care nurses (KPCSN). Methods: The study was conducted in tertiary and general hospitals with 1~2 grade according to nursing fee differentiation policy for NICU (neonatal intensive care unit) nurse staffing. The reliability was evaluated for the classification of 218 patients by 10 nurse managers and 56 staff nurses working in NICUs from 10 hospitals. To verify construct validity, 208 patients were classified and compared for the type of stay, gestational age, birth weight, and current body weight. Nursing time was measured by nurses, nurse managers, and nurse aids. For the calculation of conversion index (total nursing time divided by the KPCSN score), 426 patients were classified using the KPCSN. Data were collected from September 5 to October 28, 2015, and analyzed using t-test, ANOVA, intraclass correlation coefficient, and non-hierarchial cluster analysis. Results: The final KPCSN consisted of 11 nursing categories, 71 nursing activities and 111 criteria. The reliability of the KPCSN was r=.83 (p<.001). The construct validity was established. The KPCSN score was classified into four groups; group $1:{\leq}57points$, group 2: 58~80 points, group 3: 81~108 points, and group $4:{\geq}109points$ in the KPSCN score. The conversion index was calculated as 7.45 minutes/classification score. Conclusion: The KPCSN can be utilized to measure specific and complex nursing demands for infants receiving care in the NICUs.

• 중환자간호학회지
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• 제13권3호
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• pp.75-85
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• 2020

Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU). Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation. Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65~30.33, p<.001), education < high school graduation (OR=2.53, 95% CI=1.07~6.01, p=.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p=.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p=.038). Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions.

• 중환자간호학회지
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• 제15권3호
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• pp.12-22
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• 2022

Purpose : This study aimed to examine the relationships of burnout and compassion competency with job satisfaction among nurses working in the intensive care units and emergency rooms. Methods : A correlational survey was conducted from August 1 to August 14, 2018 and involved in 102 nurses working at four university hospitals for more than 1 year. A structured questionnaire was used to measure burnout, compassion competency, and job satisfaction, and data were analyzed using hierarchical multiple regression and mediation effect analysis. Results : The mean scores of burnout, compassion competency, and job satisfaction were 2.58, 4.35, and 2.95, respectively. Burnout and compassion competency along with working night shifts and a wish to transfer explained 35.3% of variance in job satisfaction. Compassion competency showed a small but significant mediating effect in the relationship between burnout and job satisfaction (indirect effect -.0446, 95% CI -.1133, -.0075). Conclusion : Burnout and compassion competency were the significant influencing factors of job satisfaction among nurses working in intensive care units and emergency rooms. Since compassion competency showed a significant mediating effect, further studies should focus on intervention strategies for compassion competency to improve job satisfaction in this population.

• 중환자간호학회지
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• 제17권1호
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• pp.17-29
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• 2024

Purpose : This study sought to investigate novice nurses' communication education needs in the intensive care unit (ICU) using Importance-Performance Analysis (IPA) and Borich's need assessment model. This study identified communication challenges in clinical settings to develop a simulation program that enhances communication competencies based on educational requirements. Methods : A descriptive research design and a self-report questionnaire were used. The latter was developed and administered to 121 novice nurses with less than one year of experience in the ICU at various university hospitals in Korea. Data were collected via the online open chatroom from June 24th to July 28th, 2023. The communication education needs were identified using descriptive statistics, t-tests, IPA, and Borich's needs assessment model. Text analysis was used to categorize the participants' communication experience. Results : The results revealed that "communication with physicians," "communication with patients," and "communication with nurse on another shift" domains contained the most substantial educational needs for novice nurses working in the intensive care units. Conclusion : The results provide fundamental data for developing and enhancing customized communication education programs for novice ICU nurses. This valuable information could help ICU nurses and educators improve new nurses' communication skills, which would ultimately contribute to the advancement of nursing education and clinical practice.

• Clinical and Experimental Pediatrics
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• 제51권3호
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• pp.243-247
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• 2008

대한신생아학회에서 실시한 세 차례의 조사를 통하여 얻은 자료를 분석하여 우리나라 신생아 중환자실의 현황을 알아보았다. 신생아 중환자실의 면적은 다소 향상되었으나 아직 집중치료를 위한 수준의 면적의 60% 정도에 머물러 있으며, 가스송출구 등의 설비도 아직 부족한 실정이다. 신생아 집중치료에 중요한 인공환기기 등의 장비의 보유 숫자는 증가하였으나, 환자를 담당할 인력의 부족 현상은 전혀 개선되지 않고 오히려 악화되고 있다. 신생아 중환자실 담당 전문의는 1.2명, 전공의는 1.7명으로 1999년 보다 감소하였으며, 간호인력의 부족도 오히려 악화되었다. 간호사 1인당 담당 환자수는 평균 7,7명으로 많은 부담이 되어 집중치료의 어려움을 나타내고 있다. 이러한 현상은 신생아 집중치료에 대한 비현실적으로 부족한 건강보험수가 때문에 의료기관들이 시설이나 장비 부족에 대해서는 다소 개선을 하였으나 인력 투입에 매우 어려움을 가지고 있다는 것을 보여 준다. 전국적으로 신생아 중환자실의 병상 규모는 필요병상수의 71.1% 정도를 갖추고 있는 것으로 집계되므로 이를 개선하기 위해서는 정부의 정책적 지원이 절실히 필요하다.

• 임상간호연구
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• 제28권1호
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• pp.1-12
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• 2022

Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data. Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on the bed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x² test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission. Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00). Conclusion: To reduce the patient mortality, it is necessary to ensure a sufficient number of nurses by improving the nursing fee system according to the nurse staffing level.

• 임상간호연구
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• 제29권3호
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• pp.312-326
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• 2023

Purpose: This study attempted to analyze the staffing level and critical care nursing fees of intensive care units at tertiary and general hospitals and to provide a professional judgment-based recommendation on staffing level and critical care nursing fee schedules. Methods: Staffing grades and critical care nursing fee schedules for the first quarter of 2017~2020 and the fourth quarter of 2020~2022 were analyzed. A survey was conducted on nursing managers and nurses about the current and appropriate staffing levels. A total of 77 nurse managers and 708 nurses working in Intensive Care Unit(ICU)s at tertiary and general hospitals participated in the study. Results: Grade 1 staffing increased from 25.6% in 2017 to 92.1% in 2022 at tertiary hospitals and from 0.8% in 2017 to 28.4% in 2022 at general hospitals. The current staffing ratios of tertiary and general hospitals were 1:2.21 and 1:2.77, respectively. The appropriate staffing ratio according to nurse managers and nurses was 1:1.00 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in tertiary hospitals, and it was 1:1.25 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in general hospitals, respectively. Conclusion: The appropriate staffing level was suggested from 1:1.0 to 1:2.0. The new nursing fee schedules were suggested from 1:1.0 (Grade 1) to 1:3.0 (Grade 5) and recommended to be paid based on the staffing grade, minimum number of nurses, and standard annual working days. It is expected to increase staffing levels and provide a better nursing work environment.

• 한국융합학회논문지
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• 제11권3호
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• pp.321-331
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• 2020

본 연구의 목적은 권역 외상 중환자실 간호사의 교육 현황, 교육 요구 및 간호사 역량을 파악 하는데 있다. 자료 수집은 5개 권역 외상 중환자 치료센터에 근무하는 123명 간호사로부터 설문지를 수집하였다. 조사 설문지는 외상 중환자실 간호사의 교육 현황, 교육 요구 및 간호사의 역량으로 구성되었다. 연구 분석은 SPSS 21.0 프로그램을 이용하여 서술통계, t-test, One-way ANOVA, Pearson Correlation으로 분석하였다. 연구결과 국내 외상 중환자 간호 교육 참여는 78.9%이었다. 외상 중환자 간호 교육 중요도 결과 '태도'는 3.64, '지식'은 3.52, '기술'은 3.47로 나타났다. 교육 요구도 결과 '지식'은 3.18, '태도'는 3.05, '기술'은 2.97로 나타났다. 간호사의 역량 조사 결과 '윤리적 역량'은 3.62, '심미적 역량'은 3.53, '인격적 역량'은 3.39, '과학적 역량'은 3.37로 나타났다. 결론적으로 현시점에 맞고 적용 가능한 외상 간호교육의 표준화된 교육과정 및 실습위주의 교육개발에 초점을 두는 것이 필요하다. 또한 외상 중환자실 간호사의 전문성과 간호역량증진을 위한 전략모색이 필요하다.