• Child Health Nursing Research
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• 제22권4호
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• pp.257-264
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• 2016

Purpose: The purpose of this study was to investigate the relationship among knowledge and attitude toward palliative care and perception of death for Neonatal Intensive Care Unit (NICU) nurses. Methods: A cross-sectional descriptive study was conducted with 110 nurses who work in NICUs in South Korea. The participants filled out a questionnaire regarding their knowledge, attitude towards palliative care and perception of death. The attitude scale was divided into 3 subscales: comfort level, nurses' role and nurses' involvement with family. Results: Comfort level regarding attitude towards palliative care was positively correlated with knowledge (r=.220, p=.016) and the perception of death (r=.194, p=.042). Nurses' role showed a positive correlation with perception of death (r=.395, p=.001). Conclusion: NICU nurses' knowledge of palliative care was below standard across the board, implying that there is a definite need for palliative care education for nurses. The education program for palliative care should include a section that focuses on fostering a positive perception of death as well as defining and delineating the role of nurses.

• Clinical and Experimental Pediatrics
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• 제55권8호
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• pp.272-279
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• 2012

Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

• 성인간호학회지
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• 제27권3호
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• pp.325-336
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• 2015

Purpose: This study was conducted to identify factors influencing compliance of multidrug-resistant organism infection control in intensive care units (ICU) nurses. Methods: Data were collected from 254 ICU nurses who were working at 6 general and advanced general hospitals in D city and G Province. Results: 77.2% and 84.4% of the subjects correctly answered to questions about Methicillin-Resistant Staphylococcus Aureus (MRSA) and Vancomycin-Resistant Enterococcus (VRE), respectively. The scores of MRSA infection control compliance and VRE infection control compliance were 3.41 and 3.43, respectively. The factors influencing MRSA infection control compliance were empowerment, environmental safety recognition, and education satisfaction, which explained 30% of MRSA infection control compliance. The factors significantly related to VRE infection control compliance were empowerment, hospital types, environmental safety recognition, number of education sessions, and neonatal ICU, which explained 37% of VRE infection control compliance. Conclusion: It is necessary to develop efficient educational programs for infection control including educational contents to improve empowerment and environmental safety recognition of nurses. Furthermore, administrative support for those infection control programs is also necessary.

• Clinical and Experimental Pediatrics
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• 제63권9호
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• pp.361-367
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• 2020

Background: Length of stay is a significant indicator of care effectiveness and hospital performance. Owing to the limited number of healthcare centers and facilities, it is important to optimize length of stay and associated factors. Purpose: The present study aimed to investigate factors associated with neonatal length of stay in the neonatal intensive care unit (NICU) using parametric and semiparametric models and compare model fitness according to Akaike information criterion (AIC) between 2016 and 2018. Methods: This retrospective cohort study reviewed 600 medical records of infants admitted to the NICU of Bandar Abbas Hospital. Samples were identified using census sampling. Factors associated with NICU length of stay were investigated based on semiparametric Cox model and 4 parametric models including Weibull, exponential, log-logistic, and log-normal to determine the best fitted model. The data analysis was conducted using R software. The significance level was set at 0.05. Results: The study findings suggest that breastfeeding, phototherapy, acute renal failure, presence of mechanical ventilation, and availability of central venous catheter were commonly identified as factors associated with NICU length of stay in all 5 models (P<0.05). Parametric models showed better fitness than the Cox model in this study. Conclusion: Breastfeeding and availability of central venous catheter had protective effects against length of stay, whereas phototherapy, acute renal failure, and mechanical ventilation increased length of stay in NICU. Therefore, the identification of factors associated with NICU length of stay can help establish effective interventions aimed at decreasing the length of stay among infants.

• Child Health Nursing Research
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• 제17권3호
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• pp.190-197
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• 2011

Purpose: The purpose of this study was to identify factors influencing neonatal pain management by nurses in order to provide evidence-based data for the development of more efficient neonatal pain care programs. Methods: This study used a descriptive research design to survey 204 registered nurses working in neonatal intensive care units and nurseries in Busan. Data collection was done from July to September 2010. General knowledge of pain and pain scale, pain intervention, neonatal pain management, and barriers to pain management were measured. Data were analyzed using stepwise multiple regression with SPSS 17.0. Results: it was found that among the factors affecting neonatal pain management by nurses, the unit where the nurse worked was the most important influential factor, followed by knowledge of pain management, education level, and barriers from medical personnel in that order. The explanatory power of these four variables accounted for 42.0% of neonatal pain management. Conclusion: Study results indicate that it is necessary to develop education programs to increase knowledge of neonatal pain management for nurses caring for neonates. Also, plans for reduction of obstacle factors in medical personnel should be prepared.

• Child Health Nursing Research
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• 제21권3호
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• pp.261-271
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• 2015

Purpose: This study was done to identify the meaning and substantial nature of NICU practice among nursing students by applying a research method based on hermeneutic phenomenology in an attempt to lay a foundation for enhancing theoretical and practical child nursing education. Methods: The participants were eight nursing student who had experience in clinical practicing in NICU. In-depth interviews were performed from April to December, 2014 until data were fully saturated. Collected data were analyzed using Colaizzi's method. Results: Seven theme clusters were extracted from fourteen themes. The seven theme clusters of the nursing students' clinical practice experience in NICU were: 1) Excitement about the clinical practice setting 2) Afraid of practice environment 3) Babies have priority over clinical practice 4) Comparing with adult nursing clinical practice 5) Feeling pity for babies and their parents 6) New awareness about the role of nurses 7) Demands of enhancing clinical practice. Conclusion: The results of the study provide useful information in understanding nursing students' practice experience in NICU and establishing effective strategies to support these nursing students.

• 대한간호학회지
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• 제35권7호
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• pp.1401-1409
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• 2005

Purpose: Infants at neonatal intensive care units (NICU) are invariably exposed to various procedural and environmental stimuli. The study was performed to compare the pain responses in three NICU stimulants and to examine the clinical feasibility for NICU infants using CRIES, FLACC and PIPP. Method: In a correlational study, a total of 94 NICU stimulants including angio-catheter insertions, trunk-rubbings and loud noises, was observed for pain responses among 64 infants using CRIES, FLACC and PIPP. Results: A significant difference was identified among the mean scores in CRIES($F_{(2, 91)}$=47.847, p=.000), FLACC($F_{(2, 91)}$=41.249, p=.000) and PIPP($F_{(2. 91)}$=16.272, p=.000) to three stimulants. In a Post-hoc Scheff test, an angio-catheter insertion showed the highest scores in CRIES, FLACC and PIPP compared to the other two stimulations. A strong correlation was identified between CRIES and FLACC in all three stimulations(.817 < r < .945) while inconsistent findings were identified between PIPP and CRIES or FLACC. Conclusions: The results of the study support that CRIES and FLACC are reliable and clinically suitable pain measurements for NICU infants. Further studies are needed in data collection time-point as well as clinical feasibility on PIPP administration to assess pain response in infants, including premature infants.

• Clinical and Experimental Pediatrics
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• 제49권5호
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• pp.494-499
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• 2006

목 적: Acinetobacter baumannii는 숙주 저항력이 저하된 고위험군에서 주요 원내 감염균으로 잘 알려져 있으나 A. baumannii 이외의 Acinetobacter species의 경우 드물게 감염과 연관된 것으로 받아들여지는 등 임상적 중요성과 원내 감염원으로써의 역학에 대해 알려진 바가 적다. 저자들은 신생아 집중치료실에서 A. baumannii가 아닌 것으로 확인된 Acinetobacter species에 의해 집단 발생한 패혈증 11례를 경험하였기에 이에 대한 임상적, 역학적 특징을 알고자 본 연구를 실시하였다. 방 법: 2004년 2월 4일부터 24일까지 일신기독병원 신생아 집중치료실에서 감염되었던 환아의 혈액에서 Acinetobacter species가 배양된 11례를 대상으로 임상적 특징을 조사하였고, 집단 발생의 역학을 조사하기 위해 두 차례에 걸쳐 의료진 및 환경 검체에 대한 배양을 실시하였으며, 항생제 감수성 검사를 통해 환아에서 배양된 균주가 동일 균주인지를 알고자 하였다. 결 과: 임상 양상은 발열, 수유 부진, 복부 팽만, 설사, 혈변, 구토, 빈호흡, 무호흡 등 다양하였으나 다른 원인에 의한 감염증과 비슷하였다. 집중 치료를 요하는 중증 경과를 보인 경우가 없었고 항생제 치료에 즉각적인 반응을 보이며 회복되어 A. baumannii 감염증에서 흔히 보이는 중증의 임상 증상과 높은 사망률(11-57%)과 비교하여 경한 경과를 보였다. 도관 관련 균혈증 2례, 도관 관련 균혈증 의증 9례로 말초 정맥 도관이 중요 유발 인자로 고려되었다. 감염의 역학을 알고자 두 차례에 걸쳐 의료진의 손과 환경 검체에 대한 배양 검사를 실시하였으나 동일 균주를 분리하는데는 실패하였다. 결 론: 우리의 연구를 통해 A. baumannii 이외의 Acinetobacter species의 경우 상대적으로 비병원성으로 여겨졌으나 임상 증상이 동반되면서 환자에서 배양되면 감염의 원인균임을 알 수 있었다.

• Clinical and Experimental Pediatrics
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• 제62권10호
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• pp.386-394
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• 2019

Background: Preterm infants have difficulty maintaining body temperature after birth. However, clinical guidelines advocate that neonatal body temperature should be maintained at 36.5℃-37.5℃. Purpose: We aimed to investigate the incidence of admission hypothermia in very low birth weight (VLBW) infants and to determine the association of admission temperature with in-hospital mortality and morbidities. Methods: A cohort study using prospectively collected data involving 70 neonatal intensive care units (NICUs) that participate in the Korean Neonatal Network. From registered infants born between January 2013 and December 2015, 5,343 VLBW infants born at less than 33 weeks of gestation were reviewed. Results: The mean admission temperature was 36.1℃±0.6℃, with a range of 31.9℃ to 38.4℃. Approximately 74.1% of infants had an admission hypothermia of <36.5℃. Lower birth weight, intubation in the delivery room and Apgar score <7 at 5 minutes were significantly related to admission hypothermia. The mortality was the lowest at 36.5℃-37.5℃ and adjusted odd ratios for all deaths increased to 1.38 (95% confidence interval [CI], 1.04-1.83), 1.44 (95% CI, 1.05-1.97) and 1.86 (95% CI, 1.22-2.82) for infants with admission temperatures of 36.0℃-36.4℃, 35.0℃-35.9℃, and <35.0℃, respectively. Admission hypothermia was also associated with high likelihoods of bronchopulmonary dysplasia, pulmonary hypertension, proven sepsis, pulmonary hemorrhage, air-leak, seizure, grade 3 or higher intraventricular hemorrhage and advanced retinopathy of prematurity requiring laser therapy. Conclusion: A large portion of preterm infants in Korea had hypothermia at NICU admission, which was associated with high mortality and several important morbidities. More aggressive interventions aimed at reducing hypothermia are required in this high-risk population.

• 중환자간호학회지
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• 제15권3호
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• pp.37-50
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• 2022

Purpose : This study aimed to examine the item characteristics of the Korean version of the intensive care experience questionnaire (K-ICEQ) using the Rasch analysis model of the item response theory. Methods : In this methodological study, the validity of the scale was examined, and a secondary analysis was conducted using cohort data of patients who were discharged from the intensive care units (ICU). Data from 891 patients who responded to the K-ICEQ upon ICU discharge were analyzed. The WINSTEP program was used to analyze item characteristics, including item difficulty, fit indices, appropriateness scale, and separation reliability. Results : The difficulty level of all 26 items of the K-ICEQ was appropriate, and the fit indices of the 25 items, except for item 18, were good. The 5-point scale of the K-ICEQ was not appropriate in the three subscales. The item separation reliability was good in all subscales, but did not meet the criteria in terms of respondents. Conclusion : The results of examining the item characteristics of the K-ICEQ revealed a good degree of difficulty, fitness, and item separation reliability. To increase the validity of the K-ICEQ, we suggest the rearrangement of the overall item order, modification of the item description of the "recall of experience" subscale, and reduction of the scale response level.