• Title/Summary/Keyword: Intensive care units(ICUs)

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Current Status of Respiratory Care in Korean Intensive Care Units (국내 중환자실내 호흡치료의 현황)

  • Park, So-Yeon;Kim, Tae-Hyung;Kim, Eun-Kyung;Shim, Tae-Sun;Lim, Chae-Man;Lee, Sang-Do;Kim, Woo-Sung;Kim, Dong-Soon;Kim, Won-Dong;Koh, Youn-Suck
    • Tuberculosis and Respiratory Diseases
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    • v.49 no.3
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    • pp.343-352
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    • 2000
  • Backgrounds : Respiratory care for patients in intensive care units (ICUs) has been performed mainly by nurses in Korea. However, the current status of respiratory care in the Korea ICUs is not well known. Respiratory care and the methods of delivery in ICUs were surveyed. Method : A confidential questionnaire was distributed to the head nurses working the ICUs at 117 hospitals in Korea. One hundred hospitals returned the questionnaires, for a response rate of 85%. The hospitals were divided into three groups : Main university hospitals (MUH), university associated hospitals (UAH), and general hospitals (GH) Result : Eighteen units of 66 units in MUH and 35 units of 58 units in GH were organized as a general ICUs. The percentage of ICUs with full-time doctors was 47.1%. The nurses usually delivered respiratory care spending from 1 to 4 h during their 8 h of working time. Although the respondents felt that respiratory care should be delivered by trained respiratory therapists, these therapists were not found at the hospitals. Most of the units performed percussion, tracheal suctioning, and positional changes. However, vibration and IPPB were less frequently performed in GH. Among oxygen supply apparatus, venturi mask and T-piece were not frequently used in GH. GH applied a noninvasive ventilator mode less frequently than MUH and UAH. The percentage of Swan-Ganz catheter monitoring was only 21.4% in GH. Conclusion : Respiratory care for patients in the Korean ICUs was provided by nurses on the whole. In addition, there were many differences in the level of respiratory care according to the type of hospital. To overcome the current problems revealed, an effective in-hospital training program for the development of full-time respiratory care therapists should be established urgently in Korea.

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Effectiveness of the Intervention Programs for Pressure Ulcer Prevention in Intensive Care Units : A Meta-analysis (중환자실의 욕창 예방 중재 프로그램의 효과 : 메타 분석)

  • Kang, Hyunwook;Ko, Ji Woon
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.67-78
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    • 2018
  • Purpose : A meta-analysis was conducted to identify the effectiveness of strategies designed to prevent the incidence and prevalence of pressure ulcers in intensive care units (ICUs). Method : The search strategy was designed to retrieve studies both published and unpublished between 2007 and 2017 including studies in English across PubMed and CINAHL, as well as in Korean across RISS, DBPia, NDSL, KISS, and NAL. All adult ICU participants were 18 years or over. Inclusion criteria were randomized controlled trials, quasi-experimental and comparative studies. Two independent reviewers conducted quality assessments of the included studies by Scottish Intercollegiate Guidelines Network. A Review Manager 5 was used to analyze effect sizes and to identify possible sources of heterogeneity among the studies. Results : The odds ratio (OR) effect sizes were all statistically significant. The OR of total effect size was 0.30(95% CI: 0.19, 0.47), care bundle was 0.37(95% CI: 0.24, 0.57), position change was 0.45(95% CI: 0.10, 2.08), and a silicone border foam dressing was 0.14 (95% CI: 0.07, 0.29). Conclusion : The preventive interventions for patients in the ICUs have positive impacts on reducing the incidence of pressure ulcers.

The Influence of Traumatic Events on Turnover Intention among Nurses Working in Intensive Care Units: The Moderating Effect of Emotional Intelligence (중환자실 간호사의 외상성 사건 경험이 이직의도에 미치는 영향 : 감성지능의 조절효과)

  • Kim, Hyunmi;Park, Jiyoung
    • Journal of Korean Critical Care Nursing
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    • v.14 no.2
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    • pp.70-81
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    • 2021
  • Purpose : The purpose of this study was to identify the moderating effects of emotional intelligence on the relationship between traumatic events and turnover intention among nurses working in intensive care units (ICUs). Method : In this predictive correlation study, the convenience sample included 133 ICU nurses. Data were collected using an online, structured self-report survey. The collected data were analyzed by descriptive statistics, an independent t-test, an analysis of variance, Pearson's correlation coefficient, and a hierarchical multiple regression analysis using SPSS/WIN 25.0. Results : The most frequently experienced traumatic events in ICUs were "nursing patients with abnormal behavior, including shouting and delirium," "end-of-life care," and "nursing patients with a risk of disease transmission, including AIDS and tuberculosis." The moderating effect of emotional intelligence was found to be statistically significant on the relationship between traumatic events and turnover intentions (𝛽=-0.15, p =.029). Conclusion : Intervention to improve the emotional intelligence of ICU nurses can be a salient strategy to reduce turnover intention resulting from traumatic events.

A Study on the Space Design for Nosocomial Infection Control in Intensive Care Unit (병원 감염관리를 위한 중환자부 공간계획에 관한 연구)

  • Lee, Hyunjin;Kim, Khilchae;Oh, Young-Hun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.22 no.4
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    • pp.87-95
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    • 2016
  • Purpose: Recently an experience in the MERS crisis focused on the importance of infection control in hospitals. According to Korean National healthcare-associated Infection Surveillance System (KONIS) of the KSICP, a great number of 498 people, 841 people, and 1021 people were infected by pneumonia, urinary tract infection, and bacteremia respectively from 94 hospital ICUs during the year of 2014. Therefore, the purpose of this study is to investigate the configuration and design guidelines for the ICU rooms to minimize the nosocominal infections. Methods: Based on the several infection control guidelines and revised Medical Law, consequent analyses which classified the planning and operational behavior in the ICUs of seven hospitals, were performed to reduce the cross-infection. Results: The results of this study are offering a space, configuration and design guidelines for effective infection control in the intensive care units through the unit-bed area, the bed-to-bed distance, the isolation room, etc. Implications: It is expected that this study propose the direction of architectural planning and guideline for the ICU room in order to realize the intension of revised Medical Law.

Estimation of Nurse Staffing Based on Nursing Workload with Reference to a Patient Classification System for a Intensive Care Unit (중환자의 중증도에 따른 적정 간호인력 수요 산정)

  • Park, Young Sun;Song, Rhayun
    • Journal of Korean Critical Care Nursing
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    • v.10 no.1
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    • pp.1-12
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    • 2017
  • Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

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Patients' Anxiety in Intensive Care Units and Its Related Factors (중환자실 환자의 불안 정도와 불안에 영향하는 요인 분석)

  • Koh, Chin-Kang
    • Journal of Korean Academy of Nursing
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    • v.37 no.4
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    • pp.586-593
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    • 2007
  • Purpose: The purpose of this study was to describe patients' anxiety in the ICU and to investigate related factors on the anxiety level. Methods: An exploratory cross-sectional survey design was used. Forty-eight patients participated in the study. Questionnaires were asked to patients who had been cared in the ICUs. Results: Related to the anxiety level, the mean of the total anxiety score was 5.47, and 60% of the patients had moderate or severe level of anxiety. Patients from the coronary care unit had a significantly higher level of anxiety than those from surgical intensive care unit or pulmonary surgery care unit. Moreover, significantly different levels of anxiety were found among patients who had been stayed for 2, 3, or 4 days. Conclusion: Patients who were from the coronary care unit or had been stayed longer (up to 4 days) in the ICU were significantly associated with higher anxiety level.

ICU Nurses' Compliance with Standards for Critical Care Nursing Practice (중환자실 간호사의 중환자간호 실무표준 이행에 대한 조사)

  • Yi, Young-Hee;Jung, Yoen-Yi;Kim, Mi-Soon;Kim, Soon-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.4
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    • pp.478-486
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    • 2010
  • Purpose: To explore nurses' compliance with standards for critical care nursing practice in intensive care units (ICUs) and to provide basic data for high quality of critical care nursing. Method: A total of 616 participants from 61 ICUs which are graded from 1 to 7 throughout the nation were surveyed. Data were collected from February 9 to February 27, 2009 using a questionnaire consisting of 58 questions including 50 nursing activities as indicators. Results: The rate of ICU nurses' compliance with standards for critical care nursing practice was high. As for individual standards, compliance with the standard of assessment was the highest, followed by implementation, diagnosis, and planning in that order. There were differences in compliance according to nurses' ICU experience, work place (unit), and ICU grade. A shortage of manpower was considered as a main cause for noncompliance. Conclusion: The present compliance rate with standards for critical care nursing practice by ICU nurses was identified. Therefore, compliance rate can be used to promote quality of critical care nursing and development of educational programs for ICU nurses.

Intensive Care Experience of Critical Care Patients and Its Related Factors : A Secondary Analysis Study (중환자실 환자의 집중치료 경험 및 관련 요인: 이차분석 연구)

  • Jiyeon Kang;Hyojeong Woo
    • Journal of Korean Critical Care Nursing
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    • v.16 no.3
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    • pp.11-23
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    • 2023
  • Purpose : This study investigates the experiences of patients in intensive care units (ICUs), and the factors influencing these experiences. Method : We used a cross-sectional survey design to analyze previously collected cohort data from 891 patients who spent over 24 hours in 19 ICUs across four university hospitals in Busan, South Korea between June 2019 and July 2020. Within a week of ICU discharge, participants completed the Korean version of the Intensive Care Experience Questionnaire, covering four areas: "awareness of surroundings," "frightening experiences," "satisfaction with care," and "recall of experiences." We used multiple linear regression to identify factors associated with the ICU experience. Results : Low income (𝛽 = -.08, p = .016), unplanned hospitalization (𝛽 = -.09, p = .006), sedation (𝛽 = -.16, p < .001), and delirium (𝛽 = -.15, p < .001) reduce patients' awareness of their surroundings. Frightening experiences are associated with being female (𝛽 = -.07, p = .027), experiencing delirium(𝛽= -.15, p<.001), and longer stays in the ICU (𝛽= -.14, p <.001). Using sedatives decreases satisfaction with care (𝛽 = -.08, p = .048). Living alone (𝛽 = -.08, p = .013) and using painkillers (𝛽 = -.08, p = .020) reduces recall of experiences. Conclusion : Negative ICU experiences are significantly associated with being female, living alone, lower income, unplanned admission, using sedatives and painkillers, delirium, and longer stays in the ICU. Thus, improving ICU experiences requires interventions that address modifiable factors, such as delirium, medication, and length of ICU stays.

Effect of Sleep Disturbance on Fatigue, Sleepiness, and Near-Miss among Nurses in Intensive Care Units (중환자실 간호사의 수면장애가 피로, 졸음과 근접오류에 미치는 영향)

  • Mun, Gyoung Mi;Choi, Su Jung
    • Journal of Korean Critical Care Nursing
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    • v.13 no.3
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    • pp.1-10
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    • 2020
  • Purpose : This study aims to investigate the differences in fatigue, sleepiness, and near-miss according to sleep disturbance among shift nurses in intensive care units (ICUs). Methods : A cross-sectional study in a tertiary hospital was performed. A total of 122 shift nurses working in the six ICUs were recruited. They completed self-reported questionnaires about sleep disturbance, fatigue, sleepiness, and near-miss in the past two weeks. Results : The prevalence of reported sleep disturbance was 30.3% (37 out of 122 subjects). Compared to the non-sleep disturbance group, the sleep disturbance group reported significantly more sleepiness (11.46 vs. 8.86) and higher fatigue (82.62 vs. 69.39). The sleep disturbance group showed higher rates of near-miss (78.4 vs. 57.6%) and a higher frequency of them (4.49 vs. 2.11/2weeks) compared to the non-sleep disturbance group. Medication error was the most common type of near-miss. Conclusions : This study suggests that sleep disturbances could increase fatigue, sleepiness, and near-miss among ICU shift nurses. Personal and organizational programs should be developed to support the sleep of ICU nurses.

Influence of Posttraumatic Stress Symptoms and Conflict Management Styles on Nursing Performance of Intensive Care Unit (중환자실 간호사의 외상후 스트레스와 갈등관리 유형이 간호업무수행에 미치는 영향)

  • Hwang, Ji Na;Park, Wan Ju
    • Journal of Korean Critical Care Nursing
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    • v.11 no.3
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    • pp.58-70
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    • 2018
  • Purpose : This study examined the factors influencing posttraumatic and conflict management styles for nursing performance in intensive care units (ICUs). Methods : In this study, 250 nurses from eight general hospitals in three cities participated. Structured self-report questionnaires were used to collect data on posttraumatic, conflict management styles, and nursing performance. Finally, the data were analyzed by SAS 9.3 program. Results : The mean of total sum scores was 31.29, and the high risk of posttraumatic symptoms was 61.2%. It was noted that nursing performance is significantly correlated with collaboration, compromise, accommodation styles, and intrusion. Collaboration styles (${\beta}=0.39$, p<.001) and hyperarousal (${\beta}=-0.22$, p=.050), ICU experience below 1 year (${\beta}=-0.21$, p=.027) and that of 5-10 years (${\beta}=-0.19$, p=.049), and compromise style (${\beta}=0.16$, p=.049) were found to be the factors influencing nursing performance with 35.9% explanatory power value of regression model. Conclusions : The results of the study reveal that conflict management styles, hyperarousal, and ICU experience are factors predicting the successful performance of ICUs. These findings emphasize the need of developing interventions to reduce stress symptoms and conflicts in ICUs.