• Neonatal Medicine
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• v.28 no.3
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• pp.116-123
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• 2021

Purpose: The aim of this study was to estimate the effect of targeting risk factors for the control of central line-associated bloodstream infection (CLABSI) among high-risk infants in a tertiary neonatal intensive care unit (NICU). Methods: Infants admitted to the NICU and diagnosed with CLABSI from January to December 2013 were eligible for inclusion to the study. The CLABSI group (n=47) was matched in a 1:2 ratio to the control group (n=94) based on gestational age, birth weight, and Score for Neonatal Acute Physiology-II. Risk factors for CLABSI were identified using the Cox proportional hazard model, and analysis of the effect of these risk factors targeting infection control was performed. Results: The risk factors associated with CLABSI were prolonged central line dwell days (adjusted hazard ratio [HR], 1.028; 95% confidence interval [CI], 1.011 to 1.045; P=0.001), use of a silicone catheter (adjusted HR, 5.895; 95% CI, 1.893 to 18.355; P=0.002), surgical treatment (adjusted HR, 3.793; 95% CI, 1.467 to 9.805; P=0.006), and less probiotic supplementation (adjusted HR, 0.254; 95% CI, 0.068 to 0.949; P=0.042). By targeting these risk factors with a quality improvement initiative, the mean CLABSI incidence rate per 1,000 catheter-days decreased from 6.6 to 3.1 (P=0.004). Conclusion: Targeting risk factors for infection control significantly reduced the rate of CLABSI among high-risk infants in the NICU.

• Child Health Nursing Research
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• v.26 no.4
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• pp.434-444
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• 2020

Purpose: The aim of this retrospective study was to analyze the characteristics of peripheral arterial ischemia and tissue necrosis in premature babies, as well as the effects of nitroglycerin. Methods: In total, 513 newborns were enrolled who were admitted to the neonatal intensive care unit with a gestational age of 34 weeks or younger. Data were collected on general personal and clinical information, peripheral arterial ischemia, and nitroglycerin patch application in the premature infants. The collected data were analyzed using the χ² test, t-test, Mann-Whitney U test, logistic regression. Results: Thirty-six (7.0%) infants had peripheral arterial ischemia, while 477 (93.0%) infants did not. Lower gestational age (χ²=35.97, p<.001), lower birth weight (χ²=29.40, p<.001), lower blood pressure (χ²=23.10, p<.001), and insertion of an umbilical artery catheter (p<.001) were significantly associated with the occurrence of peripheral arterial ischemia. Among the preterm infants in whom nitroglycerin patches were applied, 30 (83.3%) premature infants without necrosis improved without complications, 4 (11.1%) showed hypotension, and 2 (5.6%) showed skin damage. Conclusion: Based on a review of our experiences with nitroglycerin patches, we recommend closely observing skin color and using nitroglycerin patches on the skin to help improve flow in premature infants with peripheral arterial ischemia.

• Child Health Nursing Research
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• v.26 no.2
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• pp.267-276
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• 2020

Purpose: Caring for a vulnerable premature baby is a challenging task, but some mothers experience growth through that process. The purpose of this study was to investigate the factors influencing post-traumatic growth in mothers with premature infants admitted to the neonatal intensive care unit. Methods: A correlational research design was used and 105 mothers of premature infants were recruited from an online community. Data were collected from January 15 to January 25, 2019. Post-traumatic growth was measured using the Korean version of the Posttraumatic Growth Inventory. Data were analyzed using descriptive statistics, the t-test, analysis of variance, the Scheffé test, Pearson correlation coefficients, and hierarchical multiple regression. Results: The final model developed in this study explained 45.5% of post-traumatic growth (F=13.66, p<.001). Resilience (β=.54, p<.001) was the strongest predictor of post-traumatic growth, followed by the age of the mother when giving birth (β=.17, p=.028) and current employment status (β=.17, p=.049). Conclusion: For mother with premature infants to grow psychologically after their experience, it may be needed to support them to develop and strengthen their resilience through either education or their own support network.

• The Journal of Korean Academic Society of Nursing Education
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• v.17 no.2
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• pp.267-276
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• 2011

Purpose: This study was done to develop a performance appraisal tool (PAT) for neonatal intensive care unit (NICU) registered nurses (RNs). Methods: The PAT was developed in three steps: 1) a standard of NICU nursing was established; 2) a draft was made; and 3) the PAT was ratified and its reliability and validity were tested. Results: The standard of practice of NICU nursing was predominantly based on role description and responsibilities for nurses. We identified 4 domains of nursing: professional practice, education, research, and leadership. The validity score for each item ranged from 3.93 to 3.27. The PAT consisted of 76 indicators, 49 reflecting components of professional practice, 5 related to responsibility for education, 3 representing research, and 19 relating to leadership. Cronbach's ${\alpha}$ averaged 0.99 for the 76 items. Conclusions: The PAT for NICU RNs that we created was found to be reliable and valid. This PAT would be very useful in evaluating nursing performance and facilitate the professional growth of nurses.

• Child Health Nursing Research
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• v.28 no.1
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• pp.70-81
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• 2022

Purpose: This study aimed to develop and evaluate the effectiveness of an educational program on developmental positioning (EPDP) for nurses in neonatal intensive care units (NICUs). Methods: The study utilized a non-equivalent control group pretest-posttest design. Sixty NICU nurses were recruited from two university hospitals in Daejeon, South Korea. The EPDP consisted of a 7-week program: 3 weeks of education and practice, followed by 4 weeks of encouragement messages using social networking services. Developmental positioning (DP) posters and DP aids were also provided during the intervention period. The intervention group (n=30) received the EPDP, but not the control group. The data were analyzed using the 𝜒² test, the Fisher exact test, the independent t-test, and repeated-measures analysis of variance. Results: Participants' knowledge (t=7.49, p<.001), attitudes (t=1.99, p=.001), self-efficacy (t=2.99, p=.004), performance of DP (t=2.98, p=.004) and Infant Positioning Assessment Tool (IPAT) scores (F=29.50, p<.001) were significantly higher in the intervention group than in the control group. Conclusion: The EPDP can be an effective and useful program for improving the performance of DP among NICU nurses by increasing their knowledge, attitudes, and self-efficacy of DP. However, further research involving various NICU settings is needed to gather more empirical evidence.

• Child Health Nursing Research
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• v.28 no.4
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• pp.259-268
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• 2022

Purpose: Nursing students are susceptible to medication safety incidents in the neonatal intensive care unit (NICU) related to a lack of communication experience. The purpose of the present study was to investigate the impact of a NICU medication safety simulation (NMSS) focusing on communication clarity, patient hand-off confidence, and patient safety competency in senior-year nursing students. Methods: The study utilized a nonequivalent control group pretest-posttest design. In total, 60 nursing students were assigned to two groups. The experimental group participated in the NMSS, which included three medication error scenarios. Pairs of students completed the scenarios together in 10 to 20 minutes. Data were analyzed using the chi-squared test, independent t test, and ANCOVA. Results: The experimental group showed significant improvements in communication clarity (p=.015), and patient safety competency (p<.001) compared to the control group. Using the pretest values as covariates, patient hand-off confidence scores significantly increased (p=.027). Conclusion: Implementing the NMSS focusing on communication in the pediatric nursing curriculum helped students to communicate clearly and concisely about medication errors, and its use is recommended to promote patient safety competency in the NICU.

• Journal of Korean Clinical Nursing Research
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• v.16 no.2
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• pp.69-84
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• 2010

Purpose: The purpose of this study was to identify the state of infection control in neonatal intensive care units (NICUs) including disinfection methods, disinfection cycles, and exchange cycles for medical devices and to suggest a basic framework which would help develop standardized infection control guidelines. Methods: From a list of NICU equipment developed from the NICUs in 4 tertiary hospitals, a structured questionnaire on 74 types of medical equipment was developed and sent to 31 hospitals by mail. The results were reviewed by panel of experts (56 persons), and analyzed for internal validity by a focus group (4 persons) using guidelines from the Centers for Disease Control and the Korean Hospital Nurses Association. Results: The results showed various methods, cycles, disinfectant levels for the disinfectants and exchange cycles in the medical equipment infection control of the 31 hospitals. The focus group developed a 66-item basic framework based on validity testing. Conclusion: From the results of this study, a framework of infection control standards for 66 types of medical equipment in the NICU was developed. It is suggested that further study be done to more precisely establish standard infection control guidelines for NICU medical equipment.

• Korean Journal of Digital Imaging in Medicine
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• v.3 no.1
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• pp.20-23
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• 1997

The purpose of this paper is to describe the transition of a 1,100 beds teritary hospital from 50% softcopy operation to full PACS operation. For the past 2 years, radiologists and clinicians have been using PACS to provide softcopy services to the outpatient clinics and inpatient wards of orthopedics surgery, neurosurgery and neurology as well as emergency room, surgical intensive care unit, medical intensive unit, pediatrics intensive care unit and neonatal intensive care unit. The examinations requested by these departments account for about 50% of hospital's radiological exams. In September 1996, we began the second phase of PACS implementation and installed additional workstations (102) in the remaining wards and clinics, interfaced to PACS additional imaging modalites, and increased the capacity of both the image server (256 Gbytes) and optical juke boxes (3 Tbytes). As of January 1997, we are in the final phase of moving away from conventional film system to full PACS operation.

• Child Health Nursing Research
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• v.24 no.4
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• pp.475-483
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• 2018

Purpose: This study aimed to identify stress levels due to end-of-life care, coping strategies, and psychological well-being among nurses in neonatal intensive care unit, and to investigate the effect of stress levels and coping strategies on their well-being. Methods: A total of 128 nurses in the neonatal intensive care units of general hospitals in B city participated. The data were collected using a self-report questionnaire. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Pearson correlation coefficient, and hierarchical regression with SPSS version 22.0. Results: The coping strategy that nurses most often used was seeking social support. The factors affecting the well-being of the participants were wishful thinking, problem-focused coping and seeking social support, in order. Those 3 variables explained 21 % of the total variance in psychological well-being. Problem-focused coping and seeking social support were positively associated with psychological well-being, while wishful thinking showed a negative association. Conclusion: In order to improve the psychological well-being of nurses in neonatal intensive care units, it is necessary to provide nurses with a program to build a social support system and to improve their problem-based coping skills.

• Clinical and Experimental Pediatrics
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• v.62 no.10
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• pp.382-383
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• 2019