• Title/Summary/Keyword: Intensive-care unit

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Analysis of capacity management of the intensive care unit in a hospital

  • Kim, Seung-Chul;Horowitz, Ira;Young, Karl K.;Buckley, Thomas A.
    • Proceedings of the Korean Operations and Management Science Society Conference
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    • 1997.10a
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    • pp.79-82
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    • 1997
  • A hospital's intensive care unit (ICU) is a limited and critical resource whose efficient utilization of capacity impacts on both the welfare of patients and the hospital's cost effectiveness. Decisions made in the ICU affect the operations of other departments. Yet, decision making in an ICU tends to be mainly subjective and lacking in clear criteria upon which to base any given decision. The study reviews the capacity utilization of one particular ICU, that of a public hospital in Hong Kong, and develops a computer simulation model to improve both the unit's capacity utilization and the quality of care provided to its patients.

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Concept Analysis of Relocation Stress - Focusing on Patients Transferred from Intensive Care Unit to General Ward - (전실 스트레스[relocation stress]의 개념분석 - 중환자실에서 일반 병실로 전실하는 환자를 중심으로 -)

  • Son, Youn-Jung;Hong, Sung-Kyung;Jun, Eun-Young
    • Journal of Korean Academy of Nursing
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    • v.38 no.3
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    • pp.353-362
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    • 2008
  • Purpose: This study was conducted to analyze and clarify the meaning of the concept for relocation stress -focusing on patients transferred from an intensive care unit to a general ward. Methods: This study used Walker and Avant's process of concept analysis. Results: Relocation stress can be defined by these attributes as follows: 1) involuntary decision about relocation, 2) moving from a familiar and safe environment to an unfamiliar one, 3) broken relationship of safety and familiarity, 4) physiological and psychosocial change after relocation. The antecedents of relocation stress consisted of these facts: 1) preparation degrees of transfer from the intensive care unit to a general ward, 2) pertinence of the information related to the transfer process, 3) change of major caregivers, 4) change in numbers of monitoring devices, 5) change in the level of self-care. There are consequences occurring as a result of relocation stress: 1) decrease in patients' quality of life, 2) decrease in coping capacity, 3) loss of control. Conclusion: Relocation stress is a core concept in intensive nursing care. Using this concept will contribute to continuity of intensive nursing care.

Knowledge, Confidence, and Learning Needs Regarding Advance Directives among Hospital Nurses (상급종합병원 간호사의 사전연명의료의향서에 대한 지식, 자신감 및 교육요구도)

  • Jang, Nan-Soon;Park, Hae-Sook;Kim, Mi-Ra;Lee, Joo-Yeon;Cho, Yeo-Won;Kim, Kyoung-Mi;Son, Youn-Jung
    • Journal of Korean Critical Care Nursing
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    • v.11 no.1
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    • pp.35-45
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    • 2018
  • Purpose : Nurses' knowledge regarding advance directives may affect their administration of and confidence towards end of life care. This study aimed to describe the relationships of knowledge, confidence, and learning needs with advance directives among hospital nurses. Method : This cross-sectional study was performed at a tertiary university hospital in Seoul between September 25 and October 14, 2017. Convenience sampling was used to recruit nurses who provided bedside care and had at least 1 year of clinical experience. We used a validated self-report questionnaire. Results : The mean score of knowledge, confidence and learning needs were $5.00{\pm}1.73$, $29.81{\pm}7.52$, and $64.54{\pm}8.48$ respectively. Hospital nurses' knowledge, confidence and learning needs were significantly different according to age, job position, educational level and perceived advance directives. Knowledge regarding advance directives was significantly associated with confidence (r = .27, p < .001) and learning needs (r = .16, p = .005). Conclusion : Knowledge regarding advance directives was relatively low compared to the findings of previous studies. Therefore, nurses should be knowledgeable and encouraged to initiate advance directives. It is necessary to develop a standardized educational program regarding advance directives based on Korean cultures.

Participation and Influencing Factors in the Decision-Making of Life-Sustaining Treatment: A Focus on Deceased Patients with Hematologic Neoplasms

  • Jae Eun Jang;Jeong Moon Ryu;Min Hee Heo;Do Eun Kwon;Ji Yeon Seo;Dong Yeon Kim
    • Journal of Hospice and Palliative Care
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    • v.26 no.2
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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.

Intensive Care Unit Nurse's Knowledge, Nursing Performance, and Stress about Delirium (중환자실 간호사의 섬망 관련 지식, 간호수행도 및 스트레스)

  • Suh, Hee Jung;Yoo, Yang Sook
    • Korean Journal of Adult Nursing
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    • v.19 no.1
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    • pp.55-65
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    • 2007
  • Purpose: The study was conducted to survey intensive care unit nurse's knowledge, nursing performance, and stress involving delirium. Methods: The subjects of this study were 278 nurses from three hospitals in Seoul, who had worked at the intensive care unit more than six months. Data were collected using questionnaire from December, 2005 to January, 2006. Results: The mean score of knowledge about delirium was 31.60 out of 50 and it was significantly lower among those with clinical experience of 12-35 months and 60-119 months and those who didn't experience conflicts with patients' families. The mean score of nursing performance for delirium was 16.10 out of 23, and it was significantly higher among those who took care of 2 patients. The mean score of stress related to delirium was 63.92 out of 100, and it was significantly higher among those aged over 40, nurses who were university graduates, nurses who experienced conflicts with patients' families, and nurses who took care of 5 patients. Conclusion: We need to develop systematic education programs in charge of patients with delirium.

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Effects of Radiation Safety Management Education with the Use of a Booklet for Intensive Care Unit Nurses (중환자실 간호사를 대상으로 소책자를 활용한 방사선 안전관리 교육의 효과)

  • Lee, Jeong Eun;Kim, Sang Hee
    • Journal of Korean Critical Care Nursing
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    • v.10 no.2
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    • pp.1-13
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    • 2017
  • Purpose: This study investigated the effects that the use of a booklet for intensive care unit nurses had on radiation safety management education (knowledge about and behaviors in radiation safety management, and awareness of anxiety caused by radiation hazards). Methods: A randomized control group pretest-posttest design was used. A booklet about radiation safety management developed by the authors was used as educational material. Participants (N=42) were intensive care unit nurses of P hospital in B city. Training was provided to the experimental group (N=21). Knowledge about and behaviors in radiation safety management and awareness of anxiety caused by radiation hazards were measured by questionnaires before and after the intervention. Data was analyzed by an $X^2$-test, non-paired t-test, and paired t-test. Results: There was a significant difference between groups in knowledge of (t=-14.932, p<.001) and behaviors in (t=-8.297, p<.001) radiation safety management and awareness of anxiety caused by radiation hazards (t=9.378, p<.001). Conclusion: The levels of knowledge about and behaviors in radiation safety management and awareness of anxiety generated by radiation hazards of intensive care unit nurses increased after receiving one session of radiation safety management education using the booklet. Therefore, providing radiation safety management training is suggested as an effective strategy for improving radiation safety management.

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Impact of Role Conflict, Nursing Organizational Culture, and Nurse-Physician Collaboration on Job Embeddedness of Intensive Care Unit Nurses (중환자실 간호사의 역할갈등, 간호조직문화, 간호사-의사협력관계가 직무착근도에 미치는 영향)

  • Jin, Young Eun;Lee, Yun Mi;Park, Hyo Jin
    • Journal of Korean Critical Care Nursing
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    • v.16 no.1
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    • pp.15-27
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    • 2023
  • Purpose : The purpose of this study is to identify the factors affecting the degree of job embeddedness by examining role conflict among intensive care unit nurses, the nursing organizational culture, nurse-physician collaboration, degree of job embeddedness, to understand the relationship between these variables. Method : Participants are 148 nurses from two hospitals in the intensive care unit. Collected data are analyzed using independent t-tests, ANOVA, Scheffé test, Pearson correlations, and multiple regressions using the SPSS 25.0 program. Results : The factors that significantly influenced the participants' job embeddedness are role conflict (𝛽=-.19, p =.015), innovation-oriented culture (𝛽=.26, p =.003), and nurse-physician collaboration (𝛽=.24, p =.002). The total explanatory power of these factors for job embeddedness is 44.5% (F=15.06, p =.001). Conclusion : This study identifies role conflict among intensive care unit nurses, innovation-oriented culture, and nurse-physician collaboration as important factors affecting job embeddedness.

Pain Reducing Effects of Dextrose-coated Pacifier on Venipuncture in Premature Infants (포도당 코팅 노리개 젖꼭지 제공이 미숙아의 정맥주사 시 통증 반응에 미치는 효과)

  • Seo, Jung-Suk;Kwon, In-Soo;Kim, Hee;Jung, Young-Ran;Jo, Sung-Jin;Hwang, Ju-Young;Kang, Hyun-Sun
    • Korean Parent-Child Health Journal
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    • v.13 no.2
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    • pp.78-85
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    • 2010
  • Purpose: The purpose of this study was to examine the pain reducing effects of the dextrose-coated pacifier on venipuncture in premature infants. Methods: The design of this study is a nonequivalent control group pretest-posttest design and a crossover trial. The analysed cases were 40 premature infants (20 in experimental group and 20 in control group) in neonatal intensive care unit of a University Hospital, Gyeongnam Province, Korea. The data were collected from April to October, 2009. The experimental treatment was carried out nursing 20% dextrose-coated pacifier on venipuncture for IV injection. The instruments were $O_2$ saturation and heart rate on pulse oxymeter monitor to measure physiologic pain responses, and NIPS to measure behavioral pain responses. Collected data were analyzed with $x_2$ test, t-test using SPSS program. Results: The effects of the 20% dextrose-coated pacifier were found in the physiologic (only heart rate) and behavioral pain response on venipuncture. Conclusion: These finding is suggested that the dextrose-coated pacifier could be an effective nursing intervention for reducing pain on venipuncture in premature infants.

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Nurses' experiences of caring for severe COVID-19 patients (COVID-19 중환자를 돌보는 간호사들의 경험)

  • Kang, Myoung Mi;Park, Ye Na;Park, Seong Young;Kim, Ju Hyun
    • Journal of Korean Critical Care Nursing
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    • v.15 no.2
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    • pp.14-26
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    • 2022
  • Purpose : This study aimed to understand and describe the nurses' experiences caring for severe COVID-19 patients at isolation room with negative pressure in South Korea. Methods : Data were collected through individual in-depth interviews from February 16 to March 31, 2021 with 11 nurses who had been caring for severe COVID-19 patients at isolation room. Verbatim transcripts were analyzed according to Colaizzi's phenomenological analysis. Results : As a result, 5 theme clusters were extracted about nurses' experiences. The 5 theme clusters, "Adapting to unexpected adversity", "Accepting unresonable and heavy work", "Dulness and disconnection from the outside world", "Changing in perception of new infectious diseases", and "Pathetic isolated patients" emerged. Conclusion : The results of this study provided a deeper understanding of nurses struggling to care for COVID-19 severe patients. This study is expected to be useful in providing basic evidence for improving intensive care practices and for preparing policies in other infection disease situations.

A Study on the Space Planning of Intensive Care Unit in General Hospital, China (중국 종합병원의 중환자부 영역별 소요공간 연구)

  • Lyu, Cheng;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.27 no.1
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    • pp.53-63
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    • 2021
  • Purpose: Intensive Care Unit (ICU) is an important field of inpatient treatment, in which critically ill patients have been treated intensively with advanced medical technology. The level of treatment in the intensive care unit and the modernization of related facilities are important indicators of the quality of medical care. At present, when regional public hospitals are expanding frequently, reasonable planning of ICU has become an important part of medical institutions that treat ICU. The purpose of this study is to provide basic data on the net area of each unit, which can be used in ICU building planning. Methods: The investigation and analysis of the ICU were conducted in 12 medical institutions, based on theoretical analysis based on relevant guidelines and literature, and analysis of actual space composition and net area through architectural drawings. Results: This research provides basic data, such as the location relationship with other important departments, regional division, spatial composition, the relationship between main activities and regions, the composition of facilities in the region, and the area and proportions of each region. Implications: It is expected that the results of this article will provide effective reference materials for the reasonable spatial organization and effective operation of the intensive care units of ordinary public hospitals of different sizes in the future.