• 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.

• 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.54 no.9
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• pp.363-367
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• 2011

Central venous catheters (CVCs) are regularly used in intensive care units, and catheter-related bloodstream infection (CRBSI) remains a leading cause of healthcare-associated infections, particularly in preterm infants. Increased survival rate of extremely-low-birth-weight infants can be partly attributed to routine practice of CVC placement. The most common types of CVCs used in neonatal intensive care units (NICUs) include umbilical venous catheters, peripherally inserted central catheters, and tunneled catheters. CRBSI is defined as a laboratory-confirmed bloodstream infection (BSI) with either a positive catheter tip culture or a positive blood culture drawn from the CVC. BSIs most frequently result from pathogens such as gram-positive cocci, coagulase-negative staphylococci, and sometimes gram-negative organisms. CRBSIs are usually associated with several risk factors, including prolonged catheter placement, femoral access, low birth weight, and young gestational age. Most NICUs have a strategy for catheter insertion and maintenance designed to decrease CRBSIs. Specific interventions slightly differ between NICUs, particularly with regard to the types of disinfectants used for hand hygiene and appropriate skin care for the infant. In conclusion, infection rates can be reduced by the application of strict protocols for the placement and maintenance of CVCs and the education of NICU physicians and nurses.

• Child Health Nursing Research
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• v.27 no.1
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• pp.3-12
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• 2021

Purpose: While clinical practice is crucial for nursing students to acquire the skills needed to provide professional, high-quality nursing care, further studies on improving undergraduate nursing programs are needed to provide a supportive clinical learning environment for student nurses. This study aimed to understand nursing students' clinical experiences in newborn nurseries and neonatal intensive care units and to provide basic data for the establishment of strategies to promote effective clinical education. Methods: Interviews were held with 15 nursing students at J University who had clinical practice experience in the newborn nursery and neonatal intensive care unit. The collected data were analyzed using the phenomenological analysis method developed by Colaizzi (1978). Results: The nursing students' experiences were grouped into four categories: "expectations for and anxiety about clinical practice", "acquisition of a wide range of knowledge regarding neonatal nursing", "challenges faced in clinical practice", and "experiencing interpersonal changes". Conclusion: The current neonatal practice nursing education system provides students with positive learning experiences. However, the lack of practice opportunities, insufficient instruction, and the theory-practice gap were identified as major issues hindering students' learning needs. These study results are expected to provide basic data for curriculum development to improve undergraduate nursing education.

• 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.

• 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 Clinical Nursing Research
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• v.23 no.1
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• pp.64-72
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• 2017

Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

• Journal of Korean Clinical Nursing Research
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• v.23 no.2
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• pp.211-221
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• 2017

Purpose: A National survey was conducted to assess neonatal intensive care nurses' practice, barriers, knowledge, and belief regarding Kangaroo Care (KC). Methods: A descriptive survey was conducted. Kangaroo care questionares were sent to nurses in all hospitals in Korea whose were identified as providing neonatal intensive care services(N=263). Descriptive statistics were used to summarized the data. Results: Among 67 neonatal care units, 61.1% adapted KC in their practice. About 60% of nurses in the KC providing hospital actually practiced KC. Major barrier of practicing KC were infant safety concerns, as well as work load of nurses. Respondants who had practiced KC were more knowledgable and were more positive in their belief regarding KC. Conclusion: The findings suggest that in order to overcome barriers of practicing KC, educational programs are recommended designed for nurses. In addition, development of KC practice guideline is necessary to facilicate successful and safe KC.

• Child Health Nursing Research
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• v.18 no.4
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• pp.170-176
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• 2012

Purpose: The purpose of this study was to identify the current status and needs in neonatal emergency training for nursing students in Korea and to obtain preliminary information to develop a simulation based educational program on neonatal emergency care for nursing students. Methods: Structured questionnaires were distributed to five hospitals and ten nursing schools during April and May, 2012. Data were collected from 59 nurses who worked in the nursery or Neonatal Intensive Care Units and 13 nursing educators who had specialized in pediatric nursing. Results: Most nurses (86.4%) reported that they had experienced an emergency situation with newborns. Most nursing educators (84.6%) claimed that more intensive training with newborns is needed for nursing students. In particular, training in neonatal resuscitation (72.2%), respiratory distress (59.7%), and neonatal seizures (18.1%) were highly recommended as simulation based training for nursing students. Conclusion: A significant need for neonatal emergency educational programs was found. More efforts should be made to provide nursing students with knowledge and skills for working with neonates. The findings of this survey will ultimately provide a basis for developing a simulation based educational program on neonatal emergency care for nursing students.

• Child Health Nursing Research
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• v.28 no.2
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• pp.142-153
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• 2022

Purpose: Preventing missed care is important in neonatal intensive care units (NICUs) due to neonates' vulnerabilities. This study examined missed care and its influencing factors among NICU nurses. Methods: Missed care among 120 Korean NICU nurses was measured using a cross-culturally adapted online questionnaire. The frequency of missed care for 32 nursing activities and the significance of 23 reasons for missed care were collected. Results: All participants had missed at least 1 activity, missing on average 19.35 activities during a typical work-day. The most common missed item was "provide developmental care for the baby". The most common reason for missed care was "emergency within the unit or deterioration of one of the assigned patients". The final regression model explained 9.6% of variance in missed care. The average daily number of assigned patients receiving inotropes or sedation over the last month influenced the total number of missed care items. Conclusion: Missed care was affected by nurses' workload related to the number of patients taking medication. Frequently missed activities, especially those related to developmental care, require patience and time, conflicting with safety prioritization and inadequate working conditions. NICU nurses' working conditions should be improved to ensure adequate time for nursing activities.