• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.3
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• pp.355-365
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• 2000

The purpose of this research was to find out the effect of chest physiotherapy on the amount of tracheal secretion and $PaO_2$. After changing position of the neurosurgical patients who had tracheostomy cannula, experimental treatments were applied as bellows, manual chest percussion on groupI, chest percussion and manual chest vibration on groupII, chest percussion and mechanical chest vibration on groupIII were done. After these trials, we have analyzed the efficacy of each procedures comparing the group differences in the quantity of tracheal secretion and $PaO_2$. Target samples were sixty patients aged between 20 to 60 who have tracheostomy state and decreased consciousness status that were admitted in NICU of a university hospital from June 1 to August 31, 1999. They assigned randomly into three experimental groups. To compare the effect of each interventions, tracheal secretion quantify was measured and $PaO_2$ was analyzed via arterial blood gas analyzer. The data were analyzed by ANCOVA of 5% significance level using SPSS P/C program. The results were as bellows. 1) The first hypothesis 'There is a difference In the quantify of the secretion among GroupI, GroupII and GroupIII' was accepted.(F=29.27, p=0.00) 2) The second hypothesis 'There is a difference in $PaO_2$ among GroupI, GroupII and GroupIII' was rejected.(F=1.71, p=0.19) From this study results, positional change and manual chest vibration including chest percussion were the most effective treatment to get maximum amount of tracheal secretion and it was confirmed that mechanical chest vibration also made much better effect than sole chest percussion method. Therefore, we concluded that the mechanical or manual chest vibration with chest percussion is more effective respiratory care method than the sole chest percussion.

• Clinical and Experimental Pediatrics
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• v.62 no.10
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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.

• Journal of Korean Critical Care Nursing
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• v.13 no.2
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• pp.24-35
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• 2020

Purpose : This study aimed to determine whether the Korean Patient Classification System for Neonatal Care Nurses (KPCSN) properly measures neonatal intensive care needs and to compare the scale's results with those of the Workload Management System for Critical Care Nurses (WMSCN). Methods : Data were collected from the medical records of 157 patients who were admitted to the NICU of a university hospital, in D city. Two types of patient classification systems were applied to investigate the total points and distributions to investigate the total points and distributions by categories and compare relationships and classification groups between two scales. Finally, the score distribution among the classification groups was analyzed when the KPCSN was applied. Results : Scores on the KPCSN for the feeding, monitoring, and measure categories were 19.16±15.40, 16.88±3.52, and 9.13±4.78, respectively. Classification group distribution of the KPCSN was as follows : 1.9% for the first group, 24.2% for the second group, 58% for the third group, and 15.9% for the fourth group. The classification group distribution of the WMSCN was as follows: 35.7% for the third group, 61.1% for the fourth group, and 3.2% for the fifth group. Finally, the scores by categories were analyzed according to KPCSN classification group, and the characteristics of the patients' nursing needs were identified for each classification group. Conclusion : Results of this study indicate that the KPCSN effectively measures feeding needs, which account for many nursing activities in neonatal intensive care. Comparisons between the KPCSN and WMSCN classification group scores and distribution ratios verified the correlation and significance of nursing requirements.

• The Journal of Korean Physical Therapy
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• v.29 no.4
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• pp.211-217
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• 2017

Purpose: The purpose of this study was to trace the development of premature babies who had undergone neurodevelopmental treatment in the neonatal intensive care unit and to identify the effects of early neurodevelopmental treatment on the development of premature babies. Methods: Fifty-one premature babies, who had been hospitalized in the neonatal intensive care unit and received an infant motor performance test and Bayley scales-III evaluation of their developments during the six months of corrected age were included. They were divided into three groups: the intervention group (n=16), control group (n=23), and comparison group (n=12), depending on the risk of developmental delays and the existence of an intervention. The results of this study were analyzed using SPSS 22.0 for windows. The statistical significance level was set at ${\alpha}=0.05$. Results: Regarding the infant motor performance test scores for each group before the intervention, at two weeks after the start of intervention, and at post-conception of 40 weeks, the intervention group showed a significantly higher improvement than the control or comparison group (p<0.01). With respect to the Bayley scales-III at the corrected age of six months, the intervention group exhibited statistically significant differences from the control group in the domains of language and fine movements (p<0.01). Conclusion: The findings of this study could confirm that the early neurodevelopmental treatment of premature babies in the neonatal intensive care unit has continuous effects on the development of premature babies even after being discharged from the hospital.

• Journal of Korean Clinical Nursing Research
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• v.22 no.2
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• pp.205-216
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• 2016

Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Neonatal care nurses (KPCSN). Methods: The study was conducted in tertiary and general hospitals with 1~2 grade according to nursing fee differentiation policy for NICU (neonatal intensive care unit) nurse staffing. The reliability was evaluated for the classification of 218 patients by 10 nurse managers and 56 staff nurses working in NICUs from 10 hospitals. To verify construct validity, 208 patients were classified and compared for the type of stay, gestational age, birth weight, and current body weight. Nursing time was measured by nurses, nurse managers, and nurse aids. For the calculation of conversion index (total nursing time divided by the KPCSN score), 426 patients were classified using the KPCSN. Data were collected from September 5 to October 28, 2015, and analyzed using t-test, ANOVA, intraclass correlation coefficient, and non-hierarchial cluster analysis. Results: The final KPCSN consisted of 11 nursing categories, 71 nursing activities and 111 criteria. The reliability of the KPCSN was r=.83 (p<.001). The construct validity was established. The KPCSN score was classified into four groups; group $1:{\leq}57points$, group 2: 58~80 points, group 3: 81~108 points, and group $4:{\geq}109points$ in the KPSCN score. The conversion index was calculated as 7.45 minutes/classification score. Conclusion: The KPCSN can be utilized to measure specific and complex nursing demands for infants receiving care in the NICUs.

• Journal of Korean Neurosurgical Society
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• v.58 no.4
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• pp.363-367
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• 2015

Objective : The purpose of this study was to evaluate the clinical utility and validity of using a pupillometer to assess patients with acute brain lesions. Methods : Pupillary examinations using an automated pupillometer ($NeurOptics^{(R)}NPi^{TM}$-100 Pupillometer) were performed every 4 hours and were simultaneously assessed using the Glasgow Coma Scale (GCS) and for intracranial pressure (ICP), from admission to discharge or expire in neuro-intensive care unit (NICU). Manual pupillary examinations were also recorded for comparison. By comparing these data, we evaluated the validity of using automated pupillometers to predict clinical outcomes. Results : The mean values of the Neurologic Pupillary index (NPi) were different in the groups examined manually. The GCS correlated well with NPi values, especially in severe brain injury patients (GCS below 9). However, the NPi values were weakly correlated with intracranial pressure (ICP) when the ICP was lower than 30 cm $H_2O$. The NPi value was not affected by age or intensity of illumination. In patients with a "poor" prognosis who had a Glasgow Outcome Scale (GOS) of 1 or 2, the mean initial NPi score was $0.88{\pm}1.68$, whereas the value was $3.89{\pm}0.97$ in patients with a "favorable" prognosis who had a GOS greater than 2 (p<0.001). For predicting clinical outcomes, the initial NPi value of 3.4 had the highest sensitivity and specificity. Conclusion : An automated pupillometer can serve as a simple and useful tool for the accurate measurement of pupillary reactivity in patients with acute brain lesions.

• Clinical and Experimental Pediatrics
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• v.53 no.5
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• pp.634-638
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• 2010

Purpose: In Kyung Hee East-West Neo Medical Center, Seoul, Korea, efforts to raise rooming-in care success rate have been undertaken since when the hospital was established in 2006. We intended to analyze our experience over the past 3 years of period and to discuss the advantages of rooming-in. Methods: We analyzed the rooming-in practice rate, failure rate, and the breast feeding rate. Subjects were 860 normal healthy neonates from June 2006 to June 2009. Results: Among these 860 cases, 83 babies were required separation out of rooming-in in the middle of the course. Among these 83 cases, 70 cases had to stop the course due to poor condition of babies and 13 cases due to maternal condition. 70 cases of infant's causes consist of 68 cases of NICU admission and 2 cases of poor feeding support. The other 13 cases of separation include refusal by maternal condition. Therefore the success rate of rooming-in for the last 3 years was 90.3%, that is 777 cases among the total 860 cases. The percentage of exclusive breast feeding was 64%, that of mixed feeding with breast and formula feeding was 25%, and formula feeding only was 11%. Conclusion: We experienced successful rooming-in care for the last 3 years. Nursery facilities should educate and encourage the advantages of rooming-in, including the good formation of attachment between mother and infant, emotional stability, protection from infection, and increased breast feeding rate so that rooming-in care can be fully established.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.243-247
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• 2008

Neonatal intensive care in Korea has improved remarkably since the 1990s, but there is still a shortage of facilities and equipment in NICUs. Only 71.1% of the beds needed for neonatal intensive care are available. Mechanical ventilators are not appropriately distributed to the NICUs that are equipped to handle neonatal intensive care. The number of doctors is far too small, making the number of patients per doctor very high. Nurses, too, need to take care of 7.7 patients per nurse, making it very difficult to provide adequate intensive care. All this is caused by insufficient investment by the hospitals, which, in turn, is caused by inadequate reimbursement from health insurance. Therefore, a government-sponsored effort is necessary to bring the level of neonatal intensive care up to par.

• Clinical and Experimental Pediatrics
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• v.54 no.2
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• pp.69-78
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• 2011

Purpose: The aim of this study was conducted to investigate the mean nRBC count in very low births weight infants (VLBWIs) and to determine the usefulness of the nRBC as an independent prognostic factors of perinatal complications in VLBWIs. Methods: This study was conducted on 112 VLBWIs who were hospitalized in the neonatal intensive care unit (NICU) of the author's hospital within the period from March 2003 to and May 2008. Based on the infants' nucleated red blood cells (nRBC) counts at birth, on the third day after birth, on the seventh day after birth, in the second week after birth, and in the fourth week after birth in the medical records, the correlation between nRBC or absolute nRBC counts with birth weight, gestational age, and other perinatal outcomes were retrospectively investigated. Results: In VLBWIs, their mean nRBC and absolute nRBC counts were showing a gradual decrease after birth, and they were consisteantly kept at low values since one week after and inversely proportional to the birth weights. The mean nRBC counts based on the stage after birth showed a significant correlation with perinatal death, necrotizing enterocolitis, and severe intraventricular hemorrhage. Conclusion: The increase in the nRBC count showed a significant correlation with having a severe intraventricular hemorrhage, necrotizing enterocolitis, and perinatal death in VLBWIs. If an increase or no decrease in the nRBC count after birth is observed, newborninfant care precautions should be required.

• Child Health Nursing Research
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• v.20 no.4
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• pp.350-358
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• 2014

Purpose: The purpose of this study was to define and clarify the concept of developmental care for preterm infants. Methods: The hybrid model method was used to identify the main attributes and indicators. In the field work stage, data were collected in Seoul and Cheonan, Korea. The participants were 5 nurses working in the NICU. Results: The concept of developmental care was found to have six attributes and ten indicators in 2 dimensions. For the nursing practice dimension, four attributes were derived. They were being like intrauterine state, individualization, interaction, and integrative care with awareness of development. For the family centeredness dimension, supporting parental attachment and professional alliance were attributes of developmental care. Conclusion: Developmental focused care can facilitate the identification of behavioral responses of newborns and provide individualized interventions for fostering growth and development. This concept analysis could provide guidelines for "developmental care" nursing practice and be useful for research in the neonatal field.