• 제목/요약/키워드: Intensive care nursing

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Urinary Tract Infection Related to The Indwelling Cathete with Closed Drainage (도뇨환자의 유치기간별 요로감염상태에 관한 연구)

  • 이경심;박형숙
    • Journal of Korean Academy of Nursing
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    • 제24권3호
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    • pp.345-363
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    • 1994
  • This study attempted to identify important problems of the factors related to the indwelling catheter with closed drainage and to enhance recognization of Urinary Tract Infection management to protect patients with indwelling catheter from UTI. We selected the 58 patients with indwelling catheter with closed drainage from md-surg. intensive care units, and general neurological and neurosurgical ward, in one hospital in Pusan, Korea from May 30 to October 15, 1993. Patients were examined by urinary analysis before inserting catheter and then by urine cultures three times. The obtained data was analized using an SPSS /PC$^{+}$ The statistical analyses employed here was the frequency, percentage and x$^2$-tests. 1. Analyses for Indwelling Catheter induced UTI and infection rates were found to be presented in patients related to the factors of being on antibiotic drugs (x$^2$=14.105, p=.000) and the duration of the indwelling catheter(x$^2$=58.0, p=.000), both of which were found to affect the UTI. 2. UTI rates according to the duration of the in-dwelling catheter were high 8.6% for the 2nd day, 27.6 for the 4th day, and 36.2% for the 7th day, and as the duration for the indwelling catheter was longer, UTI rates were higher. 3. The UTI rates according to the duration of the indwelling catheter related re factors, on the 7th day, were high-52.0% for women, 37.0% for more than 50 years in ages, 30.0% for patients under sur-gery, 33.3% for altered mental states outsides the alert, 76.7% for patients not given antibiotic drugs, 36.4% for less than 3500cc of fluids intakes, it was found that these affected to increase the UTI. 4. Causative organisms of UTI were found ; E.Coli appears the most than all other isolated organisms in women and Klebsiella and Pseudomonas in men. For antibiotic susceptibility of causative organisms, all causative organisms were found to be susceptible to Sul -cefoperazone, Trim-prim, and unasyn and Pseudomonas mostly net susceptible.e.

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Health in Optimal Fitness and its Related Factors in Young Korean Children Born Prematurely

  • Lee, Sangmi;Sohn, Min;Kim, Shinjeong;Choi, Sunha;Jun, Yonghoon;Ahn, Youngmee
    • Child Health Nursing Research
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    • 제22권4호
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    • pp.336-345
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    • 2016
  • Purpose: This study was conducted to describe health in optimal fitness (HOF) in young children born prematurely and to analyze factors affecting HOF in health status, investment resources, and anthropological values, based on HOF theory. Methods: A case-control study of 76 children with preterm births (PTB) was conducted at 24 to 42 months of corrected age. Their HOF status was evaluated based on height, weight, head circumference, and the Korean-Bayley Scale of Infant Development-II and classified as either HOF-achieved or HOF-uncertain in the domain of growth, development, and all together. Results: For growth, development, and all, 26.3%, 27.6%, and 47.4% of children, respectively, belonged to the HOF-uncertain group. Logistic regression analysis showed that longer length of hospital stay (${\geq}21days$; OR=7.8; 95% CI [1.5, 40.5]), worse scores on the Home Observation for Measurement of the Environment (HOME) (${\geq}38$; OR=0.1; 95% CI [0.0, 0.4]), having a working mother, (OR=5.7; 95% CI [1.2, 27.6]), and an older mother (${\geq}35years$; OR=8.8; 95% CI [2.1, 37.3]) were statistically significant contributors of HOF-uncertain in the domain of all. Conclusion: Findings show that young children born prematurely with prolonged stays in a neonatal intensive care unit and insufficient socioeconomic resources at home are more likely to exhibit delayed growth and development.

Lifestyle factors related to glucose control for diabetes management strategies: Nested case control design using KNHANES data (당뇨병 관리전략을 위한 혈당조절 관련 생활습관 요인: 국민건강영양조사 활용 코호트내 환자-대조군 연구)

  • Kim, Yunjung;Cho, Eunhee
    • Journal of the Korea Convergence Society
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    • 제10권11호
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    • pp.501-510
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    • 2019
  • This study aimed to find health related lifestyle factors that influence glycemic control for diabetes mellitus (DM) management strategies. This study used nested case-control design with matching variables that were not controlled by individuals such as age, sex, insulin or oral hypoglycemic agent (OHA) use, disease duration, education level and household income. This study analyzed 983 subjects with type 2 DM who enrolled in the $7^{th}$ (2016-2017) Korean National Health and Nutrition Examination Survey (KNHANES). The target HbA1c level of controlled glucose was defined as less than 6.5%, and 289 (30%) were achieved. Conditional multivariable logistic regression analysis was performed to find self-control factors associated with HbA1c levels. The results statistically significant for variables such as duration of diabetes, insulin or OHA use in overall cohort and body mass index (BMI), smoking and fundus Examination in matched cohort. These results are expected to provide as evidence for the intensive care criteria(disease duration, drug use) and lifestyle management strategy(BMI, smoking, fundus examination).

Survival-related Factors in Patients with Traumatic Acute Subdural Hematoma (외상성 급성 경막하 혈종 환자의 생존 관련 요인)

  • Ha, Hey-Jin;Woo, Sang-Jun;Lee, Seung-Woo
    • Journal of the Korea Convergence Society
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    • 제12권4호
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    • pp.285-291
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    • 2021
  • This study is a retrospective study attempted to determine the factors that influence the survival of patients with traumatic acute subdural hematoma. The study subjects were 207 patients with traumatic subdural hematoma who visited the emergency room from January 2017 to February 2019 at C University Hospital in G Metropolitan City. Data analysis was using the SPSS 23.0 program, and χ2-test, t-test, and logistic regression analysis. As a result of the study, the factors affecting the survival of the subjects were under disease, complications, and initial GCS. Therefore, it is necessary to establish a medical system to check the subject's history and to train medical staff to prevent complications. In addition, it is necessary to improve the transfer system so that the GCS of the subject can be measured from the stage before transfer to a medical institution and transferred to a hospital that can be treated quickly.

A Study on the Degree of Need of Human Structure and Function Knowledge in Clinical Nurses (기초간호자연과학의 인체구조와 기능 내용별 필요도에 대한 연구)

  • Choe, Myoung-Ae;Byun, Young-Soon;Seo, Young-Sook;Hwang, Ae-Ran;Kim, Hee-Seung;Hong, Hae-Sook;Park, Mi-Jung;Choi, Smi;Lee, Kyung-Sook;Seo, Wha-Sook;Shin, Gi-Soo
    • Journal of Korean Biological Nursing Science
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    • 제1권1호
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    • pp.1-24
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    • 1999
  • The purpose of this study was to define the content of requisite human structure and function knowledge needed for clinical knowledge of nursing practice. Subjects of human structure and function were divided into 10 units, and each unit was further divided into 21 subunits, resulting in a total of 90 items. Contents of knowledge of human structure and function were constructed from syllabus of basic nursing subjects in 4 college of nursing, and textbooks published by nurse scholars prepared with basic nursing sciences. The degree of need of 90 items was measured with a 4 point scale. The subjects of this study were college graduated 136 nurses from seven university hospitals in Seoul and three university hospitals located in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, hospice ward, and their working period was mostly under 5 years. The results were as follows: 1. The highest scored items of human structure and function knowledge necessary for nursing practice were electrolyte balance, blood clotting mechanism and anticoagulation mechanism, hematopoietic function, body fluid balance, function of plasma, and anatomical terminology in the order of importance. The lowest scored items of human structure and function knowledge necessary for nursing practice was sexual factors of genetic mutation. 2. The highest order of need according to unit was membrane transport in the living unit, anatomical terminology in movement and exercise unit, mechanism of hormone function in regulation and integration unit, component and function of blood in oxygenation function unit, structure and function of digestive system in digestive and energy metabolism unit, temperature regulation in temperature regulation unit electrolyte balance in body fluid and electrolyte unit, concept of immunity in body resistance unit, and genetics terminology in genetics unit. The highest order of importance according to subunit was membrane transportation in cell subunit, classification of tissues in tissue unit, function of skin and skin in skin subunit, anatomical derivatives of the skeleton subunit, classification of joints in joint subunit, an effect of exercise on muscles in muscle subunit, function of brain in nervous system subunit, special sense in sensory subunit mechanism of hormone function in endocrine subunit, structure and function of female reproductive system in reproductive system unit, structure and function of blood in blood unit, structure of heart, electrical and mechanical function in cardiovascular system unit, structure of respiratory system in respiratory system subunit, structure and function of digestive system in digestive system subunit, hormonal regulation of metabolism in nutrition and metabolism subunit, function of kidney in urologic system subunit, electolyte balance in body fluid, electolyte and acid-base balance subunit. 3. The common content of human structure and function knowledge need for all clinical areas in nursing was structure and function of blood, hematopoietic function, function of plasm, coagulation mechanism and anticoagulation mechanism, body fluid, electrolyte balance, and acid-base balance. However, the degree of need of each human structure and function knowledge was different depending on clinical areas. 4. Significant differences in human structure and function knowledge necessary for nursing practice such as skin and derivatives of the skin, growth and development of bone, classification of joint, classification of muscle, structure of muscle, function of muscle, function of spinal cord, peripheral nerve, structure and function of pancrease, component and function of blood, function of plasma, structure and function of blood, hemodynamics, respiratory dynamics, gas transport, regulation of respiration, chemical digestion of foods, absorption of foods, characteristics of nutrients, metabolism and hormonal regulation, body energy balance were demonstrated according to the duration of work. 5. Significant differences in human structure and function knowledge necessary for nursing practice such as classification of tissue, classification of muscles, function of muscles, muscle metabolism, classification of skeletal muscles, classification of nervous system, neurotransmitters, mechanism of hormone function, pituitary and pituitary hormone, structure and function of male reproductive organ, structure and function of female reproductive organ, component and function of blood, function of plasma, coagulation mechanism and anticoagulation mechanism, gas exchange, gas transport, regulation of respiration, characteristics of nutrients, energy balance, function of kidney, concept of immunity, classification and function of immunity were shown according to the work area. Based on these findings, all the 90 items constructed by Korean Academic Society of Basic Nursing Science should be included as contents of human structure and function knowledge.

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A study on the degree of need of the knowledge of pathophysiology, clinical microbiology and mechanisms and effects of drugs in clinical nurses (기초간호자연과학의 병태생리학, 병원미생물, 약물의 기전과 효과 내용별 필요도에 대한 연구)

  • Choe, Myoung-Ae;Byun, Young-Soon;Seo, Young-Sook;Hwang, Ae-Ran;Kim, Hee-Seung;Hong, Hae-Sook;Park, Mi-Jung;Choi, S-Mi;Lee, Kyung-Sook;Seo, Wha-Sook;Shin, Gi-Soo
    • Journal of Korean Biological Nursing Science
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    • 제2권1호
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    • pp.1-19
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    • 2000
  • The purpose of this study was to define the content of the requisite knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for clinical knowledge for nursing practice. Contents of knowlege on pathological physiology, clinical microbiology, and mechanisms and effects of drugs were constructed from syllabus of basic nursing subjects in 4 colleges of nursing, and textbooks. The degree of need of 72 items was measured with a 4 point scale. The subjects of this study were college-graduated 136 nurses from seven university hospital in Seoul and three in Chonnam Province, Kyungbook Province, and Inchon. They have been working at internal medicine ward, surgical ward, intensive care unit, obstetrics and gynecology ward, pediatrics ward, opthalmology ward, ear, nose, and throat ward, emergency room, rehabilitation ward, cancer ward, and hospice ward. The results were as follows : 1. The highest scored items of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice were side effects of drugs, anticoagulants, mechanisms of drugs, antihypertensive drugs, tolerance and addiction of drugs, interactions among drugs, hospital infection in the order of importance. The lowest scored item was structure of microorganisms. 2. The highest order of need according to unit was repair in tissue injury unit, definition etiology classification of inflammation in inflammation unit, transplantation and immunologic response in alterations in immunity unit, thrombus and thrombosis in disorders of cardiovascular function unit, gene disorders in genetic disorders unit, hospital infection in infection unit, virus in microorganisms unit, side reactions of drugs in introduction unit, anticonvulsants in drugs for central nervous system unit, local anesthesia in anesthesia unit, anticoagulants in drugs for cardiovascular system unit, anti-inflammatory drugs in antibiotics unit, anti-ulcer drugs in drugs for digestive system unit, and bronchodilators in drugs for respiratory system unit. 3. The common content of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs needed for all clinical areas in nursing were side effects of drugs, anticoagulants, interactions among drugs, and hospital infection. However, the degree of need of each pathological physiology, clinical microbiology, clinical microbiology, and mechanisms and effects of drugs was different depending on clinical areas. 4. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as tissue changes due to injurious stimuli, degenerative changes of tissue, alterations in metabolism of carbohydrates, ischemia, hyperemia and congestion, hospital infection, structure of microorganism, classification of microorganism, bacteria, virus, antidepressants, antipsychotic drugs, antiemetic drugs, antiparkinsonism drugs, antianxiety drugs, antibiotics, tuberculostatics, antiviral drugs, antifungal drugs, parasiticides, antiulcer drugs, antidiarrheais, and anti constipation drugs were shown according to the work area. 5. Significant differences in the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs necessary for nursing practice such as transplantation and immunologic response, alterations in the metabolism of uric acid, structure of microorganism, classification of microorganism, immunosuppressants, drugs for congestive heart failure were demonstrated according to the duration of work. Based on these findings, all the 72 items constructed by Korean Academic Society of Basic Nursing science should be included as contents of the knowledge of pathophysiology, clinical microbiology, and mechanisms and effects of drugs.

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The Effects of Bed Baths with 2% Chlorhexidine on the Incidence of Methicillin-resistant Staphylococcus aureus and Blood Stream Infection in Intensive Care Units (2% 클로르헥시딘 침상목욕 간호가 중환자실 입원환자의 메티실린 내성 황색포도상구균과 혈류감염 발생에 미치는 효과)

  • Yoon, Hyeng-Sook;Choi, Eun-Hee;Kim, Jin-Hee
    • The Journal of the Korea Contents Association
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    • 제14권11호
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    • pp.838-848
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    • 2014
  • The purpose of this study was to identify the effects of bed baths with 2% chlorhexidine on the incidence of Methicillin-resistant Staphylococcus aureus (MRSA) and blood stream infection (BSI) and to suggest guidelines on the therapeutic bed baths using skin cleaner. This study was designed to compare the incidence of MRSA and BSI of the experimental group(n=188) who received the bed baths with 2% chlorhexidine with the incidence of MRSA and BSI of the control group(n=199) who received the existing bed baths with soap and skin cleaner. A research design used in the study was a randomized control group posttest-only design. The experimental group had 6.7% decrease in MRSA acquisition than the control group (7.4% vs 14.1%, p=.036). The experimental group was decreased in the incidence density of MRSA than the control group (9.32 cases per 1,000 patient-days at risk of experimental group vs 15.44 cases per 1,000 patient-days at risk of control group; p=.099). The experimental group had 4.5% decrease in the rate of BSI than the control group (0.5% vs 5.0%, p=.011). The experimental group was decreased in the incidence density of BSI than the control group (0.67 cases per 1,000 patient-days at risk of experimental group vs 5.52 cases per 1,000 patient-days at risk of control group; p=.052). These finding indicated that bed baths with 2% chlorhexidine is an effective nursing intervention to decrease the incidence of MRSA and BSI.

Burden and Needs of the Family Members of the Intensive Care Unit Patients (중환자실 입원환자 가족의 부담감과 요구도)

  • Lee, Ji-Won;Lim, Sun-Young
    • The Journal of the Korea Contents Association
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    • 제14권2호
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    • pp.421-429
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    • 2014
  • This study set out to investigate the burden and needs of family members of ICU(Intensive Care Unit) patients facing a crisis situation of a family member being hospitalized in ICU and check their connections. Data were collected from May to October 2013. The subjects include 93 main family caregivers of patients hospitalized in ICU at four general hospitals in the B area for three days or longer. Collected data were put to t-test, ANOVA, Scheff$\acute{e}$ test, and Pearson's correlation coefficient analysis with the SPSS WIN 20.0 program. As a result, the family members of ICU patients scored mean 3.56 points(out of five) on burden and mean 3.58 points(out of four) on needs, recording a moderate or higher level in both the areas. There was significant difference(F=3.463, p=.036) in burden according to the general characteristics with the number of days in the hospital. There was significant positive correlation(r=.332, p<.001) between their burden and needs. Those findings indicate that an active nursing intervention to reduce the burden of the families of ICU patients in a crisis situation and check their needs will be able to mitigate the family crisis and further have positive influences on the recovery of ICU patients.

Knowledge and Compliance Level of the Multi-drug resistant Organisms of ICU nurses (중환자실 간호사의 다제내성균 감염관리 지식과 이행도)

  • Shon, Joung-A;Park, Jin Hee
    • Journal of the Korea Academia-Industrial cooperation Society
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    • 제17권7호
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    • pp.280-292
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    • 2016
  • This descriptive survey assessed knowledge of intensive care unit (ICU) nurses regarding compliance with infection control for six kinds of multi-drug resistant organisms to assist in development of effective intervention strategies. Participants included 210 nurses working in the ICUs of general hospitals who completed a structured questionnaire. The results showed that the nurses' knowledge level and infection control compliance was 10.54 and 3.39 for MRSA; 11.25 and 3.69 for VRE; and 9.60 and 3.49 for CRGNB, respectively[ED highlight - consider providing additional information to describe what these values indicate.]. Knowledge regarding MRSA infection control differed significantly based on age, clinical experience, and experience as a trainee, while compliance with MRSA infection control differed based on age. Knowledge regarding VRE infection control was significantly different based on academic qualification level, experience as a trainee, and whether guidelines existed, while compliance with VRE infection control differed based on academic qualification level and the presence of an isolation environment. Knowledge regarding CRGNB infection control differed significantly based on academic qualification level and experience as a trainee, while compliance with CRGNB infection control differed based on the presence of an isolation environment. Thus, intervention strategies should include education programs for enhancing ICU nurse' knowledge regarding strategies for creating isolation environments.

ICU Nurses' Perceptions of Communication Difficulties, Importance, Satisfaction and Communication Barrier with Patient Families (중환자실 간호사의 의사소통 난이도, 중요도 및 만족도에 관한 인식과 환자 가족과의 의사소통 장애에 대한 조사연구)

  • Ahn, Jung Won;Kim, Keum Soon
    • Perspectives in Nursing Science
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    • 제10권1호
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    • pp.12-23
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    • 2013
  • Purpose: This study was conducted to investigate ICU nurses' perceptions of communication difficulties, the importance of and satisfaction with communication with doctors, other nurses, patients, and family, as well as to explore communication barrier with patient families. Methods: Investigators developed a 15-item communication perception questionnaire and 58-item communication barrier questionnaire. Communication barrier included 4 domains: nurses, family, environment, and patient condition. A total of 151 ICU nurses with a minimum of one year of ICU experience participated. Results: ICU patients ($3.38{\pm}0.73$) were the most difficult group to communicate with, followed by family ($3.32{\pm}0.72$), senior nurses ($3.25{\pm}0.74$), doctors ($3.21{\pm}0.68$), and nurse colleagues ($2.64{\pm}0.73$). Doctors ($4.61{\pm}0.53$) were the most important group to communicate with, followed by nurse colleagues ($4.52{\pm}0.54$), patients ($4.49{\pm}0.58$), senior nurses ($4.44{\pm}0.55$), and family ($4.43{\pm}0.61$). Satisfaction with communication was the highest with colleague nurses ($3.60{\pm}0.68$), then senior nurses ($3.37{\pm}0.74$), family ($3.18{\pm}0.71$), patients ($3.09{\pm}0.75$), and doctors ($3.06{\pm}0.83$).The total score of the communication barrier was $2.83{\pm}0.52$, where each domain was scored as follows: patient condition $3.13{\pm}0.74$, nurses $2.83{\pm}0.60$, environment $2.81{\pm}0.66$, and family $2.76{\pm}0.57$. The ICU nurses reported that communication was difficult due to 'sudden deterioration in the patient's condition', 'being too busy', 'a noisy environment', and 'information not being shared between family members.' Significant differences were noted by age, clinical experience, and marital status of nurse respondents. Conclusion: The findings indicated that development of a protocol on communication between nurses and doctors as well as development of an educational program on communication skills are necessary.

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