• Child Health Nursing Research
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• v.28 no.1
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• pp.9-22
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• 2022

Purpose: The purpose of this study was to identify the gaps in research related to developmentally supportive care in the neonatal intensive care unit (NICU). The ultimate goal was to explore directions of further research on developmentally supportive care for premature patients. Methods: The Arksey and O'Malley scoping review method was used. Articles on developmentally supportive care for preterm infants in the NICU, written in English or Korean, were identified through electronic search engines. A total of 279 papers were identified in the initial search, of which 22 full-text papers were included in this review. Results: Several nursing studies have been published in the past 5 years. The important elements of developmentally supportive care were family-centered care and management of the NICU environment. The primary developmentally supportive care interventions were training programs to promote the care competency of NICU nurses. Conclusion: It is necessary to actively develop comprehensive developmental support interventions that consider the various elements of developmentally supportive care for preterm infants. Additional studies should be done to develop programs that provide direct intervention for premature infant and their families.

• Child Health Nursing Research
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• v.9 no.3
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• pp.272-284
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• 2003

Purpose: The purpose of this research is to provide basic informations for the encouragements of premature infants' breast feeding. Method: From August 10 to October 9, 2002, we have carried out a statical research which surveyed 148 mothers of premature infants registered in NICU. The sample had generated cluster-randomly from 25 General Hospitals, all over the Korea peninsula and being surveyed with 74 questionnaires. Result: Mean hospitalized day of premature infants was 27.9 days. The mean total feeding period was 19.1 days and continuous breast feeding period 12.4days. They were interested in breast feeding education-they answered that they would join the breast feeding education if they were given the chance 87.8％. There was significant relation between babies fed only breast milk and the body weight of birth(p<.05). The reasons why mother gave the baby her breast milk include 'for her baby's health' and 'people said breast milk is good for babies' with a portion of 99％. The main reason why mothers could not execute breast feeding was 'the deficit of breast milk volume' 50.0％ and other reason were 'because of start to support more nutritions '18.2％, 'difficulty to carry out the breast milk to hospital'13.6％. The reasen why mothers could not try breast feeding at first were 'deficit of breast milk volume'37.0％, 'not to be prepared for breast feeding because of unexpected delivery'32.6％. Conclusion: We need a program to inform importance and excellent of the breast feeding and a plan to increase the premature infants' breast feeding through the importation of fortifier.

• Clinical and Experimental Pediatrics
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• v.48 no.9
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• pp.939-945
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• 2005

Purpose : The purpose of this study was to report outcome of fetal infants with birth weight below 500 g known as lower limit of viability and to evaluate treatment characteristics and short-term morbidity of their survivors. Methods : We retrospectively analyzed the medical records of all fetal infants with birth weight below 500 g who were delivered at Samsung Medical Center(SMC), or transferred to neonatal intensive care unit(NICU) of SMC within 24 hrs after birth between 1994 and 2004. Data for all interventions and morbidity outcome were analyzed for infants who were admitted to the NICU and were compared between NICU survivors and deaths. Results : Among 53 infants with birth weights of 400 to 499 g who were born in SMC during the study period, 8(15.1%) infants were admitted to the NICU and one was transferred to NICU from other hospital. Overall, 4(44%) of 9 survived and were discharged from the NICU. The smallest infant who survived weighed 439 grams. The least gestational age was $23^{+3}$ among the survivors. Compared with NICU deaths, NICU survivors had larger gestational age($24^{+2}{\pm}1^{+3}$ vs. $25^{+4}{\pm}2^{+3}$) and birth weight($424{\pm}17$ vs. $453{\pm}19$)(P<0.05). Median survival duration of NICU deaths was 15 days. None of NICU survivors had severe IVH, but 3(75%) had laser therapy for retinopathy of prematurity and bronchopulmonary dysplasia, respectively. Conclusion : Fetal infants with birth weight below 500 g known as lower limit of viability survived successfully. Study for their long-term follow-up will be needed to define our limit of viability and indication for their active resuscitation.

• Neonatal Medicine
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• v.17 no.1
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• pp.13-20
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• 2010

Purpose : Because infants who have been hospitalized in the neonatal intensive care unit (NICU) are usually ill or premature, they are hospitalized repeatedly after their discharge. We intended to survey the frequencies and the medical costs of those rehospitalizations. Methods : The NICUs of 7 major hospitals were included. The subjects were 3,451 infants that were admitted to the NICU from July 2005 to June 2006, and discharged to home. The frequency, causes, mean cost and distribution and proportion of National Health Insurance coverage and non covered costs were analyzed. Results : The rate of rehospitalization after discharge from the NICU over 1 year was 14.8%. If multiple cases are considered as individual cases, it is 21.7%. The major causes of admission were pneumonia (15.8%), bronchiolitis (14.5%), gastroenteritis (10.4%), urinary tract infection (6.3%) and sepsis (6.3%). The mean cost for each admission was 1,652 thousand won. The mean cost of National Health Insurance coverage was 1,170 thousand won and non covered coat were 472 thousand won 70.9% and 28.6% respectively. Conclusion : The ratio of rehospitalization of infants after their discharge from the NICU over 1 year was approximately 20% and it means that follow-up management of these infants is very important and meticulous concerns after discharge should be given. However the rehospitalization and the non-coverage proportion of National Health Insurance cost is considerably high. It strongly implies that National Health Insurance should cover much more proportion, and personal cost exemption should be proceeded in case of rehospitalization of infants after discharge from the NICU.

• Child Health Nursing Research
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• v.24 no.4
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• pp.407-419
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• 2018

Purpose: The purpose of this study was to explore and describe the meaning and essence of a mother's experience of hospitalization of her newborn in the neonatal intensive care unit (NICU). Methods: This study employed a qualitative research design. An interview was conducted with a mother whose newborn was hospitalized in the NICU, and the data were analyzed using Giorgi's phenomenological method. Results: Five main themes and 19 formulated meanings were indentified. The 5 themes were 'drowning in pain', 'just look outside the glass door', 'being a pillar', 'a deepening attachment', and 'prepare for nurturing with hope'. Conclusion: The results of this study provided an in-depth understanding of the experience of a mother with a newborn in the NICU. These results can be used in the development of a nursing intervention program that provides psychological and emotional support to the mother and family.

• Neonatal Medicine
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• v.25 no.2
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• pp.53-57
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• 2018

Even with the increasing number of high risk infants, neonatal care in Korea has undergone development with improved survival rate. This rapid improvement in the outcomes brought care quality in neonatal intensive care unit (NICU) to the surface. Quality improvement (QI) involves safe, timely, effective, efficient, equitable, and patient-centered care. In this review, methods of QI are described with examples of NICU QI topics. Each NICU can voluntarily develop a QI project, but systematic supports are essential. As human and systemic resources in NICUs in Korea are insufficient, institutional and national supports are necessary to attain QI. Furthermore, collaborative neonatal network can provide a QI standard and evidence based-medicine, as well as QI research.

• Pediatric Infection and Vaccine
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• v.18 no.1
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• pp.15-22
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• 2011

Invasive Candida infections (ICI) have become the third most common cause of late-onset infection among premature infants in the neonatal intensive care unit (NICU). Risk factors include birth weight less than 1,000 g, exposure to more than two antimicrobials, third generation cephalosporin exposure, parenteral nutrition including lipid emulsion, central venous catheter, and abdominal surgery. Candida colonization of the skin and gastrointestinal tract is an important first step in the pathogenesis of invasive disease. Strict infection control measures against the infection should be done in the NICU. The following practices are likely to contribute to reducing the rate of ICI: (1) restriction of broad-spectrum antibiotics, antacids and steroid; (2) introduction of early feeding and promoting breast milk. Fluconazole prophylaxis may be an effective control measure to prevent Candida colonization and infections in individual units with high incidence of fungal infection. In addition, there is a need of further data including the development of resistant strains and the effect on long-term neurodevelopmental outcomes of infants exposed to drugs before the initiation of routine application of antifungal prophylaxis in the NICU.

• Child Health Nursing Research
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• v.17 no.4
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• pp.230-237
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• 2011

Purpose: To identify the perception and practices of kangaroo care in nurses and doctors working in neonatal intensive care units (NICU) in Korea. Methods: One hundred forty-nine nurses and nineteen doctors working in the NICU from six university hospitals completed a survey questionnaire. Results: Most agreed that Kangaroo care promoted attachment and parental confidence as well as physical health of the infant. However, nurses and doctors showed a negative perception in providing kangaroo care for premature infants under 1,000 grams or within several hours after birth. Major barriers for kangaroo care were worrying about extubation and safety problems of premature infants. Married or senior nurses showed a more positive perception than others. Also nurses who worked in hospitals where kangaroo care was provided had a lower barrier perception than other nurses. Conclusion: Nurses and doctors working in NICU worried about adverse effects of kangaroo care even though they perceived positive effects. Standard education programs and manuals should be developed before dissemination of kangaroo care in Korea.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.17 no.1
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• pp.12-20
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• 2010

Purpose: The study examined differences in stress between the parents of sick newborns. Methods: Participants were the mothers (n=57) and fathers (n=57) of newborns in NICU of six university hospitals. An established stress measurement tool (Miles and Carter, 1993) was used. Results: Fathers and mothers displayed the highest stress scores (4.44 and 4.67, respectively) when the baby looked in pain. Maternal overall stress scores were significantly higher than paternal scores. Conclusions: Mothers and fathers experience differing levels of stress concerning their newborn. Further studies are needed to develop customized stress management intervention programs for parents of newborns in the NICU.

• Child Health Nursing Research
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• v.23 no.2
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• pp.179-189
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• 2017

Purpose: The purpose of this study was to investigate NICU nurses' nursing interventions for pain and factors affecting nursing interventions for pain. Methods: Participants were 120 NICU nurses from 5 university hospitals located in Daejeon Metropolitan City and Chungcheong Province. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA and Duncan test, Pearson correlation coefficients and multiple regression analysis with SPSS Windows 23.0 IBM program. Results: The factors affecting nursing interventions for pain included knowledge about non-pharmacological nursing interventions for pain and self-efficacy about nursing interventions for pain. These variables explained 28.3% of nursing interventions for pain. Conclusion: The results of this study suggest that it is necessary to develop education programs in which effective nursing interventions for neonatal pain are considered. The programs should be made available to NICU nurses.