• Child Health Nursing Research
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• v.21 no.3
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• pp.261-271
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• 2015

Purpose: This study was done to identify the meaning and substantial nature of NICU practice among nursing students by applying a research method based on hermeneutic phenomenology in an attempt to lay a foundation for enhancing theoretical and practical child nursing education. Methods: The participants were eight nursing student who had experience in clinical practicing in NICU. In-depth interviews were performed from April to December, 2014 until data were fully saturated. Collected data were analyzed using Colaizzi's method. Results: Seven theme clusters were extracted from fourteen themes. The seven theme clusters of the nursing students' clinical practice experience in NICU were: 1) Excitement about the clinical practice setting 2) Afraid of practice environment 3) Babies have priority over clinical practice 4) Comparing with adult nursing clinical practice 5) Feeling pity for babies and their parents 6) New awareness about the role of nurses 7) Demands of enhancing clinical practice. Conclusion: The results of the study provide useful information in understanding nursing students' practice experience in NICU and establishing effective strategies to support these nursing students.

• Child Health Nursing Research
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• v.27 no.3
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• pp.297-307
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• 2021

Purpose: This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU). Methods: In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4. Results: The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had significantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/ restless behavior (t=2.70, p=.008). Conclusion: Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles.

• Clinical and Experimental Pediatrics
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• v.55 no.8
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• pp.272-279
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• 2012

Purpose: The aim of this study was to develop an appropriate nursing information guideline according to corrected age, after investigating parents' concerns about the growth, development, and diseases of their premature infants after discharge from the neonatal intensive care unit (NICU). Methods: The parents of premature infants (birth weight, <2,500 g; gestational age, <37 weeks) who went to a neonatal follow-up clinic after NICU discharge at Seoul St. Mary's Hospital from January 2005 to December 2009, were asked with regard to their concerns about their infants through a questionnaire survey. The results of physical examinations, including body measurements and neurodevelopmental status at 4, 8, 12, and 18 months of corrected age, were retrospectively reviewed in 390 infants. Results: The most common parental concerns were developmental delay, poor growth, and feeding and nutritional problems. Parental concerns about developmental delay, growth failure in improvement in body weight and length, and overweightness were high in specificity but very low in sensitivity. After NICU discharge, 30% of premature infants experienced infectious diseases before 18 months of corrected age, the most common of which was respiratory tract infection. Conclusion: For guiding of premature infants in outpatient day clinics after NICU discharge, it is necessary to identify the parents' highest concerns, to educate them about the possibilities of growth and neurodevelopmental disabilities in their infants and to provide them with handouts containing guidelines on the management of infectious diseases, especially respiratory infections.

• 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.

• Journal of Korean Academy of Nursing
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• v.51 no.1
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• pp.119-132
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• 2021

Purpose: This study aimed to identify the effects of a direct breastfeeding program for premature infants in neonatal intensive care units (NICUs). Methods: This quasi-experimental study was conducted during August 2016 to April 2017. Sixty mothers of premature infants were assigned to the experimental (n = 31) or control groups (n = 29). The program was comprised of breastfeeding education and direct breastfeeding support. The experimental and control groups were provided with education and counseling on breastfeeding at the time of admission and discharge. In the experimental group, the mothers initiated oral feeding with direct breastfeeding and engaged in breastfeeding at least seven times during the NICU stay. The collected data were analyzed by the χ2-test and repeated measures ANOVA using an SPSS program. Results: The experimental group showed a higher direct breastfeeding practice rate (χ2 = 19.29, p < .001), breastfeeding continuation rate (χ2 = 3.76, p < .001), and self-efficacy (F = 25.37, p < .001) than the control group except for maternal attachment. Conclusion: The direct breastfeeding program in the NICU has significant effects on the practice and continuation rate of breastfeeding and breastfeeding self-efficacy. Therefore, this program can be applied in the NICU settings where direct breastfeeding is limited.

• Pediatric Infection and Vaccine
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• v.23 no.2
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• pp.87-93
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• 2016

Purpose: An outbreak of influenza virus is uncommon in neonatal intensive care unit (NICU). The clinical presentation of influenza virus infection in neonates is diverse. This study was aimed to report an outbreak of influenza A in a NICU and to investigate the clinical characteristics of influenza virus infection in neonates especially preterm infants during the 2011-2012 influenza season in Korea. Methods: We reviewed the medical records of 29 patients who were evaluated by respiratory virus multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) at NICU of Kosin University Gospel Hospital during the 2011-2012 seasonal influenza outbreak in Korea. Results: Eleven patients (37.9%) were influenza A virus RT-PCR positive during the survey periods. They were all preterm infants and three of them had no symptoms. Eight patients had symptoms and it was fever (18%, 2/11), respiratory difficulty (72.7%, 8/11) without symptoms of upper respiratory infection, and gastrointestinal symptoms (27.3%, 3/11). The median duration of symptom was 5 days. There were differences of duration of admission at the test of respiratory RT-PCR, Clinical Risk Index for Babies (CRIB) score, use of mechanical ventilation, and use of dexamethasone before infection between influenza A virus RT-PCR positive and negative group. All 11 patients with influenza A were discharged without any complications. Conclusions: The symptoms of influenza A virus infection in the preterm infants is nonspecific. Influenza A virus should be considered as a possible cause of infection in NICU during the influenza season in the community.

• Neonatal Medicine
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• v.18 no.2
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• pp.272-279
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• 2011

Purpose: The incidence of nosocomial infection caused by Gram-negative bacilli (GNB) has increased in neonatal intensive care units (NICU). This study identified the progression of sepsis caused by GNB colonization and analyzed the risk factors associated with using periodic stool culture surveillance. Methods: We included 86 newborns admitted to the NICU, Kosin University Gospel Hospital from October 2007 to May 2008. Three stool specimens were collected right after birth and two more were collected at 2 week intervals. The risk factors related to GNB colonization were established from each medical record and related references. Results: The incidence of colonization by GNB was 22 (25.6%) per 86 neonates but none had culture-proven sepsis. The three most commonly isolated GNB were Pseudomonas aeruginosa, Enterobacter cloacae, and Citrobacter freundii. Approximately 89% (32/36) of isolated GNB were susceptible to amikacin. The probability of GNB colonization increased in infants who were fed a small volume during enteral feeding. In contrast, delayed enteral feeding resulted in a decreased probability for GNB colonization. Conclusion: Colonized GNB in the intestine was confirmed by enteric surveillance culture of newborns admitted to the NICU. However, we found no evidence of culture-proven GNB sepsis. As lower feeding volume on the colonization day is a risk factor for GNB colonization, the chance for GNB colonization should be considered when feeding intolerance is present.

• Child Health Nursing Research
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• v.22 no.4
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• pp.257-264
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• 2016

Purpose: The purpose of this study was to investigate the relationship among knowledge and attitude toward palliative care and perception of death for Neonatal Intensive Care Unit (NICU) nurses. Methods: A cross-sectional descriptive study was conducted with 110 nurses who work in NICUs in South Korea. The participants filled out a questionnaire regarding their knowledge, attitude towards palliative care and perception of death. The attitude scale was divided into 3 subscales: comfort level, nurses' role and nurses' involvement with family. Results: Comfort level regarding attitude towards palliative care was positively correlated with knowledge (r=.220, p=.016) and the perception of death (r=.194, p=.042). Nurses' role showed a positive correlation with perception of death (r=.395, p=.001). Conclusion: NICU nurses' knowledge of palliative care was below standard across the board, implying that there is a definite need for palliative care education for nurses. The education program for palliative care should include a section that focuses on fostering a positive perception of death as well as defining and delineating the role of nurses.

• 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.

• The Journal of Korean Physical Therapy
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• v.32 no.3
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• pp.168-175
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• 2020

Purpose: This study aimed to investigate and report the current status of physical therapy (PT) performed in Korean neonatal intensive care units (NICU) to present foundational data that promotes the advances in neonatal PT in Korea. Methods: Based on the Health Insurance Review and Assessment (HIRA) data, we administered a questionnaire survey to 74 hospitals (39 tertiary and 35 general hospitals) in Korea equipped with a NICU and pediatric PT unit. We developed a 32-item questionnaire with reference to previous Korean studies. The questionnaires were distributed and retrieved via regular mail and an online system. Results: Of the 74 hospitals, 58 (78%) practiced neonatal PT and the duration of each session significantly differed according to the hospital rating. PT was given, depending on clinical symptoms, to infants who were preterm and low birth-weight (96.5%), had brain and spinal cord diseases (84.5%), had pathological tonus (94.8%), with respiratory problems (65.5%), for range of motion exercises (82.8%), for neurodevelopment approaches (72.4%), and for positioning (70.7%). Interdisciplinary meetings were held to share clinical decisionmaking in 17.2% of the hospitals surveyed and parent-participating education to ensure a family-centered approach was offered in 63.8% of the hospitals. The barriers of neonatal PT included low insurance fees, insufficient awareness of colleagues, and the severity of the patient. Conclusion: This study is the first report of the current status of neonatal PT in Korea. The findings of this study will serve as foundational data to review the current neonatal PT practice and promote further advances.