Lee, Hyun Ah;Hur, Yujin;Lee, Young Gew;Song, Garam;Lee, Eunji;Shin, Sujin
Journal of Korean Critical Care Nursing
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v.10
no.3
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pp.19-30
/
2017
Purpose : This study investigated factors affecting the knowledge and attitude of organ procurement from brain dead patients in nurse clinicians. Methods : A survey was conducted with 160 clinical nurses from a university hospital in Seoul. Descriptive statistics, t-tests, an ANOVA, $Scheff{\acute{e}}^{\prime}s$ test, Pearson's correlation coefficient, and a multiple regression analysis were used. Results : The mean score for knowledge of organ procurement from brain dead patients was $12.41{\pm}2.16$ (mean correct answers = 62.1). Factors influencing the knowledge of organ procurement among nurse clinicians were working department (${\beta}=.454$, p < .001), a recent family death (${\beta}=.187$, p = .014), experience recognizing potential brain dead patients (${\beta}=.182$, p = .033), and experience referring to potential brain dead patients (${\beta}=-.192$, p = .048). Conclusion : To ensure effective organ procurement from brain dead patients, it is necessary to continually educate nurse clinicians to improve their attitude and knowledge concerning organ donation.
Purpose: The study was conducted to survey intensive care unit nurse's knowledge, nursing performance, and stress involving delirium. Methods: The subjects of this study were 278 nurses from three hospitals in Seoul, who had worked at the intensive care unit more than six months. Data were collected using questionnaire from December, 2005 to January, 2006. Results: The mean score of knowledge about delirium was 31.60 out of 50 and it was significantly lower among those with clinical experience of 12-35 months and 60-119 months and those who didn't experience conflicts with patients' families. The mean score of nursing performance for delirium was 16.10 out of 23, and it was significantly higher among those who took care of 2 patients. The mean score of stress related to delirium was 63.92 out of 100, and it was significantly higher among those aged over 40, nurses who were university graduates, nurses who experienced conflicts with patients' families, and nurses who took care of 5 patients. Conclusion: We need to develop systematic education programs in charge of patients with delirium.
Purpose: This study aimed to identify factors related to the workload of intensive care unit nurses through a systematic literature review and meta-analysis to provide basic data to explore the direction of development of nursing staffing standards. Methods: This study involved quantitative studies about nurses working in intensive care units related to nursing workload published in English or Korean since 2000. Search terms included 'intensive care unit', 'nursing workload', and their variations. Databases such as RISS, DBpia, MEDLINE(PubMed), CINAHL, PsycINFO, and Web of Science were utilized. Quality assessment was conducted using the Joanna Briggs Institute's Critical Appraisal Checklist for Analytical Cross-Sectional Studies. JAMOVI software facilitated the analysis of effect sizes, employing a meta-analysis approach for 7 studies with correlational or regression data. Results: From 16 studies on the workload of intensive care unit nurses, a total of 20 patient and nurse-related factors were identified. Patient-related factors included severity of illness, length of stay, and age. Meta-analysis was conducted for three patient-related factors: age, severity of illness measured by SAPS 3, and length of stay. Only severity of illness measured by SAPS 3 was significantly associated with nurse workload (Zr=0.16, p<.001, 95% CI=0.09-0.24). Conclusion: In previous studies, the characteristics of intensive care units and patients varied across studies, and a variety of scales for measuring workload and severity of illness were also used. Sustained research reflecting domestic intensive care unit work environments and assessing the workload of intensive care unit nurses should be imperative.
Cho Sung-Hyun;Hwang Jeong-Hae;Kim Yun-Mi;Kim Jae-Sun
Journal of Korean Academy of Nursing
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v.36
no.5
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pp.691-700
/
2006
Purpose: This study was done to analyze variations in unit staffing and recommend policies to improve nursing staffing levels in intensive care units (ICUS). Method: A cross-sectional study design was used, employing survey data from the Health Insurance Review Agency conducted from June-July, 2003. Unitstaffing was measured using two indicators; bed-to-nurse (B/N) ratio (number of beds per nurse), and patient-to-nurse (P/N) ratio (number of average daily patients per nurse). Staffing levels were compared according to hospital and ICU characteristics. Result: A total of 414 institutions were operating 569 adult and 86 neonatal ICUs. Tertiary hospitals (n=42) had the lowest mean B/N (0.82) and P/N (0.76) ratios in adult ICUs, followed by general hospitals (B/N: 1.34, P/N: 0.97). Those ratios indicated that a nurse took care of 3 to 5 patients per shift. Neonatal ICUs had worse staffing and had greater variations in stafnng ratios than adult ICUs. About 17% of adult and 26% of neonatal ICUs were staffed only by adjunct nurses who had responsibility for a general ward as well as the ICU Conclusion: Stratification of nurse staffing levels and differentiation of ICU utilization fees based on staffing grades are recommended as a policy tool to improve nurse staffing in ICUs.
Purpose: The purpose of this study was to explore and identify the role adaptation processes of family caregivers with patients transferred from intensive care unit to general ward. Methods: Using a grounded theory methodology, in-depth individual interviews were conducted. Data were collected from 11 participants. The participants were asked about their experiences of role adaptation considering situational contexts and interactional strategies. Transcribed data and field notes were analyzed using constant comparative analysis. Results: The core category was 'becoming almost a nurse with hope and fear'. The identified phenomena by the participants were the joy of being alive, having hope for a full recovery, anxiety and fear of uncertain future, feeling burdensome on a given role. The results included both role adaptation and mal-adaptation of caregivers. Conclusion: The role adaptation processes of family caregiver with patients transferred from intensive care unit to general ward can be explained as becoming almost a nurse with hope and fear. The findings of the study provided fundamental information for developing programs to support the given family caregivers for successful role adaptation.
Purpose: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. Methods: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. Results: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). Conclusion: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.
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.
Purpose: Maximizing human comfort in design of medical environments depends immensely on specialized architects particularly critical care design; the study proposes Evidence-Based Design as an apparent analog to Evidence-Based Medicine. Healthcare facility designs are substantially based on the findings of study in an effort to design environments that augment care by improving patient safety and being therapeutic. On SPSS (Statistical Package for Social Science) t-test is applied to simulate two independent variables of PDR (Pre Design-Research) and POE (Post- Occupancy Evaluation). PDR is conducted on relatively new hospital Hallym University Dongtan Sacred Heart Hospital to analyse visibility from researchers' point of view, here the ICU is arranged in I-Shape. POE is applied on Dongguk University Ilsan Hospital to simulate walking on LogWare where two NS are designed based on L- Shape and Seoul St. Mary's Hospital, The Catholic University of Korea where five NS are functional for ICU Intensive Care Unit, Surgical Intensive Care Unit (SICU), Medical Intensive Care Unit (MICU), Critical Care Unit (CCU), Korean Oriental Medical Care Unit which are mostly arranged in U-Shape, and walking pattern is recognized to be in a zigzag path. Method: T-Test is applied on two dependent communication variables: walkability and visibility, with confidence interval of 95%. This study systematically analyses the Nurse Station (NS) typo-morphology, and simulates nurse horizontal circulation, by computing round route visits to patient's bed, then estimating minimum round route on LogWare stop sequence software. The visual connectivity is measured on depth map graphs. Hence the aim is to reduce staff stress and fatigue for better patients care by minimizing staff horizontal travel time and to facilitate nurse walk path and support space distribution by increasing effectiveness in delivering care. Result: Applying visibility graph and isovist field on space syntax on I- Shape, L- Shape and U- Shape ICU (SICU, MICU and CCU) configuration, I-shape facilitated 20% more patients in linear view as they stir to rise from their beds from nurse station compared to U-shape. In conclusion, it was proved that U-Shape supply minimum walking and maximum visibility; and L shape provides just visibility as the nurse is at pivot. I shape provides panoramic view from the Nurse Station but very rigorous walking.
Journal of the Korean Institute of Oriental Medical Informatics
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v.22
no.1
/
pp.27-36
/
2016
Purpose: The purpose of this study was to compare the level of job stress, burn-out and job satisfaction between intensive care unit nurses and general unit nurses. Methods: The subjects of this study were 100 intensive care unit nurses and 100 general unit nurses in university's hospitals. The data were collected using self-report questionnaires. The data were analyzed by descriptive statistics, -test, ANCOVA, t-test, ANOVA, and Pearson correlation coefficient by using the SPSS WIN 20.0 program. Results: There were significantly negative correlation in the score of job stress and job satisfaction in both groups of nurses. Job stress of intensive care unit nurses was significantly differences according to department satisfaction. Burn-out of intensive care unit nurses was significantly differences according to position, department satisfaction. Job satisfaction of intensive care nurses unit was significantly differences according to department satisfaction. Job stress of general unit nurses unit was significantly differences according to department satisfaction. Burn-out of general unit nurses was significantly differences according to clinical experience, position, department satisfaction. Job satisfaction of general unit nurses was significantly differences according to clinical experience, department satisfaction. Conclusions: The appropriate rewards for intensive care nurses and general unit nurses to decrease their job stress will be needed in hospital settings. In addition, a plan for systemic nurse training program is needed to provide high quality nursing education for each unit nurses effectively.
Journal of Korean Academy of Fundamentals of Nursing
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v.16
no.1
/
pp.92-102
/
2009
Purpose: Relocation stress is a common phenomenon in patients discharged from an intensive care unit(ICU) to a ward. Therefore, nurses need to be aware of the problems that can arise during the transfer process. The aim of this study was to identify nurses' experiences in transferring critically ill patients from the ICU to a ward. Method: Focus group interviews were done with 13 nurses from wards and ICU, which participated in receiving and sending of ICU patients. The debriefing notes and field notes were analyzed using the consistent comparative data analysis method. Result: Seven major categories were identified in the analysis of the data. These were 'mixed feeling about transfer', 'lack of transfer readiness', 'increase in family burden', 'uncertainty with unfamiliar environment', 'difficulty in decision making', 'difference of perception of the relationships between patients and health care providers', 'need for continuity of nursing care'. Conclusion: Transferring out of the critical care area should be presented to the patient and family as a positive step in the recovery process. However, a more universal method of passing information from nurse to nurse is needed to assist in a smooth transition.
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