• 중환자간호학회지
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• 제15권3호
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• pp.1-11
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• 2022

Purpose : The purpose of this study was to not only examine the importance and performance status of patient safety nursing activities in the intensive care unit but also to understand nurses' educational needs in this respect. Methods : In this descriptive study, 196 nurses working in the intensive care units of university hospitals located at B City and G Province were enrolled. They completed the Importance-Performance Analysis (IPA) questionnaire, and the data were statistically analyzed. Results : Mean±standard deviation item scores of importance and performance of patient safety nursing activities were 4.75±0.33 and 4.48±0.38, respectively. In the IPA results, a total of 10 items were included in the second quadrant, including 1 item related to 'transfer,' 1 to 'infection,' and 1 to 'firefighting surveillance.' As the second quadrant contains the high-importance, low-performance items, these 10 items resemble the nurses' educational needs that should be prioritized. Conclusion : The results of this study can be used as a basis for the development of nursing educational programs for patient safety in the intensive care unit.

• Journal of Hospice and Palliative Care
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• 제26권2호
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• pp.69-79
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• 2023

Purpose: This study aimed to investigate the involvement of patients who died from hematologic neoplasms in the decision-making process surrounding the withdrawal of life-sustaining treatment (LST). Methods: A total of 255 patients diagnosed with hematologic neoplasms who ultimately died following decisions related to LST during their end-of-life period at a university hospital were included in the study. Data were retrospectively obtained from electronic medical records and analyzed utilizing the chi-square test, independent t-test, and logistic regression. Results: In total, 42.0% of patients participated in the decision-making process regarding LST for their hematologic neoplasms, while 58.0% of decisions were made with family involvement. Among these patients, 65.1% died in general wards and 34.9% in intensive care units (ICUs) as a result of decisions such as the suspension of LST. The period from the LST decision to death was longer when the decision was made by the patient (average, 27.15 days) than when it was made by the family (average, 7.48 days). Most decisions were made by doctors and family members in the ICU, where only 20.6% of patients exercised their right to make decisions regarding LST, a rate considerably lower than 79.4% observed in general wards. Decisions to withhold or withdraw LST were more commonly made by patients themselves than by their families. Conclusion: The key to discussing the decision to suspend hospice care and LST is respecting the patient's self-determination. If a patient is lucid prior to admission to the ICU, considerations about suspending LST should involve the patient input.

• 중환자간호학회지
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• 제15권1호
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• pp.13-23
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• 2022

Purpose : Life-threatening illnesses represent a crisis for individual patients and their families. Little has been made to understand the priorities or perspectives in developing a care plan. This results in poor outcomes, and patients and families return home without being satisfied with the care provided. This study aimed to address nurses' and families' care priorities on patient and family-centered care principles and compare those priorities. Methods : A quantitative comparative descriptive research was conducted. The data were part of a study that was carried out to elicit and compare nurses' and families' perceptions of complying with patient and family-centered care (PFCC) principles in intensive care units (ICU) in Ghana. The respondents were ICU nurses (n=123) and family members of hospitalized patients in the ICU (n=111). The tool for the study was a "modernized version of a hospital self-assessment inventory on PFCC," and data analyses were performed using SPSS version 20.0. Results : Nurses and families differed significantly in their priorities of care based on the principles of PFCC. The means and p-values were significantly different for the definition, pattern of care and access to information/education, and the overall total scores of the patient and family-centered care principles (PFCCP) Conclusion : To render care that aligns with the care priority of families and patients in the ICU, nurses must plan care in consultation with their families.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제21권3호
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• pp.37-45
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• 2015

Purpose: The main objective of this paper is, to evaluate the unit design for patient-centered care and to draw lessons-learned for further improvement. Methods: This study conducted a case study of the intensive care unit, designed to fulfill patient-centered care in the US. It evaluated the effectiveness of the unit by incorporating several study methods such as plan analyses, direct observations through nursing tracking and behavior mapping, and focus group interviews. Results: The major design decision made in this patient-centered unit was the use of patient rooms with designated family areas and distributed nursing stations. Both design features appeared to be a success on a variety of research metrics and outcomes. The study identified that the patient rooms ultimately help family members to spent more time with their loved ones, which leads to increased satisfaction of family members and nurses also report that they generally enjoy the distributed nurses' stations, which provide a comfortable environment to complete their regular lines of work such as charting, monitoring patients, and collaborating with their colleagues. Implications: Certain design features in intensive care units such as patient rooms with designated family areas and distributed nursing stations could appropriately support hospitals to fulfill patient-centered care.

• 중환자간호학회지
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• 제9권2호
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• pp.1-12
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• 2016

Purpose: This study aimed to develop a nursing handoff protocol for intensive care units and test its relevance. Methods: This is a methodological research to develop a protocol. A preliminary protocol was developed by composing items and testing content validity through literature review and experts' review. We revised and complemented the preliminary protocol following practical relevance assessment of 38 intensive care unit nurses at a university hospital to test content validity and to assess practical relevance of the final protocol. Results: On the basis of the content validity test for the final protocol, 40 items were adopted. The scores for the practical relevance of the final protocol increased significantly for items such as accuracy of handoff, reduction of handoff-related errors, convenience in using the protocol, reduction in handoff time, and simplification of handoff. Conclusions: The nursing handoff protocol for intensive care units in this study is expected to improve nursing performance with a standardized handoff in intensive care units, promote patient safety, and improve communication among the medical staff.

• 중환자간호학회지
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• 제11권1호
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• pp.89-100
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• 2018

Purpose : The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO). Method : Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized. Results : The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %. Conclusion : The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.

• 임상간호연구
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• 제29권3호
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• pp.296-311
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• 2023

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.

• 중환자간호학회지
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• 제10권2호
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• pp.56-70
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• 2017

Purpose: This study was conducted to identify ICU nurses' knowledge of the five moments of hand hygiene and the ambiguity of these moments when demonstrating hand hygiene. Methods: The subjects were 200 intensive care unit nurses at a university hospital. Data was collected using self-report questionnaires, translated according to the instructions of training films developed by WHO, and analyzed using descriptive statistics and ranking tests. Results: The highest number of correct answers was regarding the moment before contact with a patient and the lowest was regarding the moment after contact with a patient. The rate of providing wrong answers regarding required moments of hand hygiene was high. Conclusion: The study identified ICU nurses' knowledge of specific moments of hand hygiene; they had difficulty differentiating between the moments that happened simultaneously, i.e. after touching a patient, and that patient's surroundings, and there was ambiguity concerning patient areas and medical treatment areas. It was concluded that it is necessary to educate nurses regarding both required and unrequired moments of hand hygiene and to ensure that they can distinguish between these moments.

• 대한간호학회지
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• 제49권4호
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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.

• 중환자간호학회지
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• 제11권2호
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• pp.51-62
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• 2018

Purpose : This study aimed to provide primary data for developing a program to enhance communication competence by identifying the patient-centered communication competency level of Intensive Care Unit (ICU) nurses and the related factors. Method : Data were collected from August 28th to October 8th, 2015, from 199 ICU nurses working in 30 tertiary hospitals. The study questionnaire included items assessing the patient-centered communication competency of ICU nurses, nursing organizational culture, types of communication, the Teamwork Measurement Tool, the Perceived Nursing Work Environment tool, and the Wong & Law Emotional Intelligence Scale. The collected data were analyzed using descriptive statistics, a correlation test, and a multiple regression. Results : The ICU nurses' mean score on patient-centered communication competency was 3.97 points. The factors influencing the patient-centered communication competency level of ICU nurses were professionalism (p =.002), innovation-oriented organizational culture (p =.015), and emotional intelligence (p<.001). These variables explained 42.2% of the total variance in the patient-centered communication competency of ICU nurses. Conclusion : These findings suggest the need for developing a patient-centered communication competency improvement program that focuses on improving ICU nurses' professionalism and emotional intelligence, and facilitates the creation of an innovation-oriented organizational culture.