• The Journal of Korean Academic Society of Nursing Education
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• v.20 no.1
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• pp.60-70
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• 2014

Purpose: Bedside electrocardiograph (ECG) monitoring is continuously used for assessing patients' cardiac status in intensive care units. However, it has not been explored whether it is used with proper knowledge and nursing practices; if not, its usage will be limited and the risk for compromised patient safety might be significant. This study, therefore, explored knowledge and nursing practices regarding bedside ECG monitoring in nurses working at intensive care units. Methods: Participants in this survey research were a convenience sample of 156 nurses from 25 intensive care units distributed in five hospitals with more than 1,000 beds each in Seoul, South Korea. Results: Participants showed limited and incorrect knowledge and nursing practices. Only 4 (2.6%) participants correctly answered to all electrode placement sites of RA, LA, LL, and V1. Lead II was the most frequently monitored unit regardless of the main purpose of ECG monitoring, and nursing practices to manage noisy signals did not include skin care at the top priorities. Conclusion: Educators and clinicians alike need to make an effort to ensure that a safe level of knowledge and practices for the monitoring is maintained in order to make sure that patient outcomes are not compromised.

• Journal of Korean Critical Care Nursing
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• v.14 no.2
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• pp.12-23
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• 2021

Purpose : The purposes of this study were to examine the levels of job stress, perceptions of the patient safety culture, and patient safety nursing activities, and to identify factors influencing patient safety nursing activities among intensive care unit (ICU) nurses. Methods : For this cross-sectional study, data were collected from 161 ICU nurses working in two university-affiliated hospitals in Gyeonggi-do between June 30 and July 30, 2020. The data were analyzed with descriptive statistics, an independent t-test, a one-way ANOVA, the Pearson correlation method, and multiple regression using the SPSS program. Results : The average levels of job stress, perception of patient safety culture, and patient safety nursing activities were 3.48, 3.44, and 4.45 out of 5, respectively. Multiple regression showed that perception of patient safety culture and career in current workplace were found to be statistically significant correlates of patient safety nursing activities. Conclusion : In order to promote patient safety nursing activities, patient safety culture needs to be incorporated into the education of ICU nurses. Perception of patient safety should be enhanced to improve patients safety nursing activity.

• Journal of Korean Biological Nursing Science
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• v.23 no.3
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• pp.208-216
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• 2021

Purpose: The purpose of this study was to identify the factors influencing nurses' caring behavior. Methods: The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson's correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. Results: Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses' caring behaviors (r=.36, p<.001). Multiple regression analysis showed that perception of support (β=.36, p<.001), total career length (β=.33, p<.001), and familiarity with PFCC (β=.15, p=.018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. Conclusion: Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.

• Acute and Critical Care
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• v.33 no.4
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• pp.238-245
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• 2018

Background: Infection by multidrug-resistant (MDR) pathogens leads to poor patient outcomes in intensive care units (ICUs). Contact precautions are necessary to reduce the transmission of MDR pathogens. However, the importance of the surrounding environment is not well known. We studied the effects of ICU relocation on MDR respiratory pathogen detection rates and patient outcomes. Methods: Patients admitted to the ICU before and after the relocation were retrospectively analyzed. Baseline patient characteristics, types of respiratory pathogens detected, antibiotics used, and patient outcomes were measured. Results: A total of 463 adult patients admitted to the ICU, 4 months before and after the relocation, were included. Of them, 234 were admitted to the ICU before the relocation and 229 afterward. Baseline characteristics, including age, sex, and underlying comorbidities, did not differ between the two groups. After the relocation, the incidence rate of MDR respiratory pathogen detection decreased from 90.0 to 68.8 cases per 1,000 patient-days, but that difference was statistically insignificant. The use of colistin was significantly reduced from 53.5 days (95% confidence interval [CI], 20.3 to 86.7 days) to 18.7 days (95% CI, 5.6 to 31.7 days). Furthermore, the duration of hospital stay was significantly reduced from a median of 29 days (interquartile range [IQR], 14 to 50 days) to 21 days (IQR, 11 to 39 days). Conclusions: Incidence rates of MDR respiratory pathogen detection were not significantly different before and after ICU relocation. However, ICU relocation could be helpful in reducing the use of antibiotics against MDR pathogens and improving patient outcomes.

• Journal of Korean Critical Care Nursing
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• v.9 no.1
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• pp.1-14
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• 2016

Purpose: To investigate the post-intensive care syndrome (PICS) and to analyze the factors affecting the quality of life (QoL) of survivors of critical illness. Methods: Subjects were 114 outpatients who had been discharged from intensive care units of a university hospital in B city, Korea. From July 30 through September 30, 2015, PICS was assessed using the Korean Montreal Cognitive Assessment, Hospital Anxiety-Depression Scale, Korean Instrumental/Activities of Daily Living (K-I/ADL) index, and handwriting transformation, while physical and mental health-related QoL was measured using the SF-12. Results: Of the subjects, 39.5% were screened for mild cognitive disorder and 23.7% experienced handwriting transformation after discharge. Multiple regression analysis revealed that restraint application, current job, time of ${\geq}36$ months after discharge, depression, anxiety, and handwriting transformation accounted for 40.9% of the physical health-related QoL, and depression, anxiety and experience of delirium accounted for 62.4% of the mental health-related QoL. Conclusions: It is necessary to make efforts to reduce restraint application in intensive care units and prevent the occurrence of delirium, with the objective of reducing PICS and improving the QoL of critical illness survivors.

• Child Health Nursing Research
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• v.28 no.4
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• pp.259-268
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• 2022

Purpose: Nursing students are susceptible to medication safety incidents in the neonatal intensive care unit (NICU) related to a lack of communication experience. The purpose of the present study was to investigate the impact of a NICU medication safety simulation (NMSS) focusing on communication clarity, patient hand-off confidence, and patient safety competency in senior-year nursing students. Methods: The study utilized a nonequivalent control group pretest-posttest design. In total, 60 nursing students were assigned to two groups. The experimental group participated in the NMSS, which included three medication error scenarios. Pairs of students completed the scenarios together in 10 to 20 minutes. Data were analyzed using the chi-squared test, independent t test, and ANCOVA. Results: The experimental group showed significant improvements in communication clarity (p=.015), and patient safety competency (p<.001) compared to the control group. Using the pretest values as covariates, patient hand-off confidence scores significantly increased (p=.027). Conclusion: Implementing the NMSS focusing on communication in the pediatric nursing curriculum helped students to communicate clearly and concisely about medication errors, and its use is recommended to promote patient safety competency in the NICU.

• Journal of Korean Critical Care Nursing
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• v.14 no.2
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• pp.1-11
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• 2021

Purpose : The aim of this study was to propose appropriate nurse staffing of adult intensive care units considering patients' nursing care needs according to the Workload Management System for Critical Care Nurses (WMSCN). Methods : In a cross-sectional survey conducted in September 2017, 1,786 patients' WMSCN scores, surveys from 2,145 nurses, and administrative data from 118 units in 41 hospitals were analyzed. The means (standard deviations) of the aforementioned scores and nursing hours per patient day were presented. Nurse-to-patient ratios and nurse-to bed ratios for staffing to meet patients' nursing care needs were calculated. Results : The mean WMSCN scores were 109.50±17.17 in tertiary hospitals and 96.38±19.26 in general hospitals. Nursing hours per patient day were 12.47±2.80 in tertiary hospitals and 11.01±2.45 in general hospitals. Nursing hours per patient day correlated with WMSCN scores. Nurse-to-bed ratios required for the provision of ICU nursing care ranged from 1: 0.36 to 1: 0.48. Conclusion : Our findings provide evidence that current ICU nurse staffing is insufficient for meeting patients' nursing care needs. We suggest adjusting the legal standards for adequate nurse staffing considering these needs.

• Journal of Korean Critical Care Nursing
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• v.17 no.2
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• pp.55-70
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• 2024

Purpose : The demand for skilled critical care nurses and the significant impact of the practice-readiness gap underscore the need for educational programs bridging nursing education and clinical practice. This would ensure safe, high-quality patient care and a stable workforce. This study aimed to explore the educational needs of critical care nurses to develop an essential nursing education program for nursing students, addressing the practice-readiness gap they may encounter as new nurses. Methods : The study espoused a qualitative approach by utilizing focus group interviews conducted in South Korea in April and May 2022. A total of 11 nurses participated in the study. Data were collected from three focus groups, each consisting of three to four nurses from intensive care units. Focus group interviews were conducted using a semi-structured questionnaire. Content analysis was performed on the interview data using thematic analysis. Ethical approval for the study was obtained from the institutional review board. Results : Nursing education programs in intensive care units should prioritize fundamental nursing competencies such as basic nursing and physical examinations. Participants' critical care nursing education needs were categorized into four main themes: holistic nursing competency, advancement of practical education, skilled communication, and systematic critical care nursing education. Conclusion : The study's findings provide valuable insights and guidelines for developing critical and intensive care nursing education programs tailored for nursing students.

• Journal of Korean Academy of Nursing
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• v.50 no.6
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• pp.787-798
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• 2020

Purpose: This study aimed to assign weights for subscales and items of the Post-Intensive Care Syndrome questionnaire and suggest optimal cut-off values for screening unplanned hospital readmissions of critical care survivors. Methods: Seventeen experts participated in an analytic hierarchy process for weight assignment. Participants for cut-off analysis were 240 survivors who had been admitted to intensive care units for more than 48 hours in three cities in Korea. We assessed participants using the 18-item Post-Intensive Care Syndrome questionnaire, generated receiver operating characteristic curves, and analysed cut-off values for unplanned readmission based on sensitivity, specificity, and positive likelihood ratios. Results: Cognitive, physical, and mental subscale weights were 1.13, 0.95, and 0.92, respectively. Incidence of unplanned readmission was 25.4%. Optimal cut-off values were 23.00 for raw scores and 23.73 for weighted scores (total score 54.00), with an area of under the curve (AUC) of .933 and .929, respectively. There was no significant difference in accuracy for original and weighted scores. Conclusion: The optimal cut-off value accuracy is excellent for screening of unplanned readmissions. We recommend that nurses use the Post-Intensive Care Syndrome Questionnaire to screen for readmission risk or evaluating relevant interventions for critical care survivors.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.23 no.2
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• pp.172-183
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• 2016

Purpose: The purpose of this study was to explore the subjective experience of life-sustaining treatment care among nurses in intensive care units. Method: A phenomenology was used for the study. Data were collected from October to December, 2015 using open-ended questions during in-depth interviews. Participants were nurses working in intensive care units and were contacted through purposive techniques. Eight nurses participated in this study. Results: Four categories emerged from the analysis using Colaizzi's method: (a) difficulties due to life-sustaining treatment care, (b) dilemma of extension or cessation of life-sustaining treatment, (c) repressed feelings and emotional exhaustion, and (d) forming values for life-sustaining treatment from nursing experience. Conclusion: Provision of clearer guidelines on life-sustaining treatment which reflect a family-oriented culture is important for nurses in ICU and will promote nurses involvement in the decision-making process of life-sustaining treatment of patients.