• Title/Summary/Keyword: Nursing care units

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Development of a Delirium Occurrence Screening Model for Patients in Medical Intensive Care Units (내과계 중환자 섬망발생 선별모형 개발)

  • Lee, Hyun Sim;Kim, So Sun
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.3
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    • pp.357-368
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    • 2013
  • Purpose: The purpose of this study was to investigate risk factors related to delirium and to develop screening model on delirium occurrence in MICU (Medical Intensive Care Unit) patients. Methods: For developing a preliminary tool for delirium, the data of 166 patients were collected and analyzed. In order to estimate the accuracy and discriminating power for the developed screening model, 98 patients were enrolled. The data used in this study were collected by EMR (Electronic Medical Record) review from January to September in 2012. The collected data were analyzed using SPSS/PC Win 18.0 program. Results: Screening model on delirium in MICU patients was developed using the results of logistic regression. The total score of screening model was 24 point and measuring point was 10 point. When the measuring point is over 10 point, it means that the risk of delirium occurrence is high. The discriminating power and the validity of screening model showed AUC .908 (p <.001) and .935 (p <.001) respectively. This result showed that the screening model on delirium which developed in this study was an appropriate model for screening the delirium risk group in MICU. The sensitivity of the screening model was 83%, specificity 89% and accuracy 84%. Conclusion: The developed screening model on delirium occurrence in MICU should be combined with EMR for screening and preventing delirium in a high risk group.

Untact Visit Service Development Based on an Application Reflecting the Circumstances during COVID-19: Focusing on Utilization in the Pediatric Intensive Care Units (COVID-19 상황을 반영한 어플리케이션 기반의 언택트 면회 서비스 개발: 소아중환자실에서의 활용을 중심으로)

  • Woo, Dahae;Yu, Hanui;Kim, Hyo Jin;Choi, Minyoung;Kim, Dong Hee
    • Journal of Korean Academy of Nursing
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    • v.51 no.5
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    • pp.573-584
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    • 2021
  • Purpose: This study aimed to develop an untact visit service based on an application that can be utilized in the pediatric intensive care unit (PICU) during COVID-19. Methods: This study adopted the double diamond process of service design comprising the discovery, defining, and development stages. Results: We developed an untact visit service based on an application that considered the child's status, schedule, photo, and video messages, and so on. Moreover, we derived a service flow regarding the required roles and the type of flow shown between each stakeholder. Conclusion: Considering the ongoing pandemic, the untact visit service is designed to increase rapport and participation of parents, share the child's information in real-time, and provide one-stop service without increasing healthcare providers' work. It will be a useful visit service that can be applied and evaluated in various hospital settings and the PICU.

Evaluation of Clinical Alarms and Alarm Management in Intensive Care Units (중환자실에서 사용되는 의료장비의 경보음 발생과 관리 현황)

  • Jeong, Yu Jin;Kim, Hyunjung
    • Journal of Korean Biological Nursing Science
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    • v.20 no.4
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    • pp.228-235
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    • 2018
  • Purpose: This study aimed to investigate the clinical alarm occurrence and management of nurses toward clinical alarms in the intensive care unit (ICU). Methods: This observational study was conducted with 40 patients and nurses cases in two ICUs of a university hospital. This study divided 24 hours into the unit of an hour and conducted two times of direct observation per unit hour for 48 hours targeting the medical devices applied to 40 patients. Data were analyzed using IBM SPSS Statistics 23. Results: On average, 3.8 units of medical devices were applied for each patient and the ranges of alarm settings were wide. During 48 hours, 184 cases of clinical alarm were occurred by four types of medical devices including physiological monitors, mechanical ventilators, infusion pumps, and continuous renal replacement therapy. Among them, false alarm was 110 cases (59.8%). As for the alarm management by ICU nurses, two-minute alarm mute took up most at 38.0% (70 cases), and no response was second most at 32.6% (60 cases). When valid alarm sounded, nurses showed no response at 43.2%. Conclusion: The findings suggest that a standard protocol for alarm management should be developed for Korean ICU settings. Based on the protocol, continuous training and education should be provided to nurses for appropriate alarm management.

The moderating effect of resilience in the relationship between traumatic event experience and turnover intention of nurses in intensive care units (중환자실 간호사의 외상성 사건 경험과 이직 의도의 관계에서 회복탄력성의 조절 효과)

  • Jeong, Da Woon;Kim, Soukyoung
    • The Journal of Korean Academic Society of Nursing Education
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    • v.27 no.4
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    • pp.447-455
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    • 2021
  • Purpose: The present study utilizes a descriptive research design to investigate the moderating effect of resilience on the relationship between the experience of traumatic events and turnover intention among intensive care unit (ICU) nurses. Methods: The participants were 161 hospital nurses who voluntarily agreed to participate in this study. Traumatic event experience, turnover intention, and resilience were assessed. The data were analyzed with hierarchical multiple regression using the SPSS 26.0 software program. Results: The experience of traumatic events had a statistically significant positive correlation with turnover intention (r=.17, p=.037), whereas it had a statistically significant negative correlation with turnover intention and resilience (r=-.37, p<.001). Resilience had a moderating effect on the relationship between the experience of traumatic events and turnover intention (𝛽=-.20, p=.007). Conclusion: The results of this study found that the experience of traumatic events among ICU nurses was a significant factor in turnover intention and that resilience moderated the strength of the relationship between such experiences and turnover intention. Therefore, to prevent ICU nurses' experience of a traumatic event from leading to their leaving nursing, it is necessary to formulate preventive measures and interventions for traumatic events, while enhancing resilience among ICU nurses.

ICU nurses' experiences of feeling hurt by medical personnel (중환자실 간호사의 의료인과의 관계에서 마음의 상처 경험)

  • Lee, Jung-Hoon;Song, Yeoungsuk
    • The Journal of Korean Academic Society of Nursing Education
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    • v.27 no.4
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    • pp.347-358
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    • 2021
  • Purpose: The purpose of this study is to explore the experiences of nurses who have suffered from hurt feelings in their relationships with medical personnel in intensive care units (ICUs). Methods: Data were collected from May 2019 to August 2020 through individual in-depth interviews with 8 ICU nurses. Verbatim transcripts were analyzed using the MAXQDA program, employing a phenomenological method designed by Colaizzi. Results: Four theme clusters and nine themes were identified. The themes cluster that emerged were as follows: high-handedness from a lack of understanding and consideration, not being respected as a professional, having to endure sadness alone, and strategies for accepting pain. Conclusion: In ICUs, nurses are being emotionally wounded, resulting in a variety of hurt feelings, not only by doctors, but also by other nurses. Nurses were heavy-hearted because they wanted the participants to do their part and care for critically ill patients proficiently. However, they did not treat ICU nurses as specialized professionals. The participating nurses said they felt pressure, fear, and intimidated. In addition, they felt lonely because their head nurses, seniors, or colleagues did not protect or support them. This study helped develop a program to decrease the nurses' emotional distress and create a safe work environment where they respected and cared for each other without undergoing anguish.

The Effect of Patient-Engaged Bedside Handoffs Protocol in Comprehensive Care Units (간호·간병통합서비스 병동에서의 환자참여 침상인계 프로토콜 적용 효과)

  • Lee, Bo Young;Park, Kyung Jin;Im, Jae Hyun;Song, A Reum;Yeon, Mi Hyang;Song, Hyun Ju;Jeon, Do Jin;Baek, Kyu Won;Jang, Joo Young;Choi, Su Jung
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.3
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    • pp.223-232
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    • 2022
  • Purpose: The purpose of this study was to apply patient-engaged bedside handoffs in comprehensive care units, and to evaluate the effects of bedsides to nurses and patients. Methods: This study employed a cluster randomized cross-over design.Electrical Medical Record (EMR)-based handoffs and patient-engaged bedside handoffs were alternatively applied to 104 patients, who were assigned to a total of 30 clusters (nursing handoff teams) in 4 comprehensive care units at the S medical center in Seoul, and the patients evaluated each type of handoffs. A total of 139 nurses were also participated in the same units and evaluated each type of handoffs. Data were analyzed using t-test, Wilcoxon rank sum test, ANOVA, and Kruskal-Walls test. Results: The patient's satisfaction of the patient-engaged bedside handoffs was higher than that of the EMR-based handoffs (Z=-5.16, p<.001). On the other hand, the nurse's satisfaction of the patient-engaged bedside handoffs was significantly lower than that of the EMR-based handoffs (t=13.21, p<.001). There were no differences in length of the reporting time between two types of handoffs (t=-0.48, p=.634). Conclusion: Patient satisfaction with the patient-engaged bedside handoffs was higher than that of EMR-based handoffs, and nurses' satisfaction with the patient-engaged bedside handoffs was significantly lower than that of EMR-based handoffs. Future studies are needed regarding the impacts of patient-engaged bedside handoffs on the quality of healthcare by identifying the benefits of the handoffs.

Effects of the Schematized Alarm-managing Manual for Continuous Renal Replacement Therapy on the Alarm Resolution Rate and Nursing Competence of Nurses in Intensive Care Units (지속적 신대체요법 시 도식화된 알람 관리 매뉴얼 사용이 중환자실 간호사의 알람 해결률과 간호수행능력에 미치는 효과)

  • Choi, Aeng Ja;Yi, Young Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.5
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    • pp.535-544
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    • 2014
  • Purpose: This study was done to develop a schematized alarm-managing manual for continuous renal replacement therapy (CRRT) and to investigate its effects in maintaining continuity in the patients' treatment and promptly resolving alarms when CRRT is being carried out. Methods: Sixtynurses from two medical intensive care units (ICUs) (one experimental and one control) at one hospital were asked to answer a questionnaire including their CRRT nursing competency and satisfaction with the manual. Data on alarm resolution rate were collected by analyzing existing data, such as the details of each alarm and the number of resolutions around the clock in the CRRT device. Results: The alarm resolution rate and some of CRRT nursing competency scores in the experimental group were higher than those in the control group. The experimental group was also satisfied with the manual. Conclusion: The study confirmed that the schematized alarm-managing manual can be useful for ICU nurses to resolve alarms and can be used as a guideline. Application of this manual to clinical practices and its use can therefore, be encouraged through continuous education and promotion.

The Experiences of Patients in Intensive Care Units(ICU) (중환자실 환자의 경험)

  • Kim, Young-Hae;Koo, Mi-Jee;Kim, So-Hee;Kim, Young-Mi;Lee, Nae-Young;Chang, Koung-Oh
    • Journal of Korean Academy of Nursing
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    • v.37 no.6
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    • pp.924-931
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    • 2007
  • Purpose: The purpose of this study was to describe the essence of the experiences of patients in an ICU, and to understand them from the patients' point of view. Methods: Participants in this study were six patients in P hospital. Data collection consisted of in-depth interviews and an observation method done from January to April in 2005. The method was analysis using the phenomenological method proposed by Colaizzi(1978). Results: The themes were classified into eight theme clusters. The eight theme clusters were finally grouped into four categories, 'shock', 'pain', 'gratefulness' and 'pleasure of revival'. Conclusion: The ICU patients had negative experiences in physical mental critical situations, but also positive experiences in consolation and nurses and families' encouragement. Therefore, ICU nurses must support patients and their families to minimize the negative experiences and maximize the positive experiences.

A Study on the Budget and Management of the Nursing Service Equipment (병원 간호업무를 위한 예산과 간호용품의 관리에 관한 조사연구)

  • 황복녀;윤은자;조규숙
    • Journal of Korean Academy of Nursing
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    • v.14 no.1
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    • pp.34-49
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    • 1984
  • This study was carried out to collect basic information of the budget and management of the nursing service equipment A survey was conducted with charge nurses (72), head nurses (400), supervisors (93), nursing directors (43) in 134 Hospitals The questionnaire was consisted of 34 questions related to management of budget, facility, supplies, and equipment We investigated from l0th to 22nd, Oct 1983. The results obtained were summarized as follows: 1) A budget for the department of nursing was 65.4% (51/78) 2) A budget commitee was 43.6% (34/78) 3) 51.3% took corrective action for the deviation from the budget, if indicated (40/78) 4) An established lost conciousness program in the hospital was 87.2% (64/68) 5) A formalized system for the maintenance of supplies for the patient care units was 87.2% 6) 87.9% had stocks level which was established for patient care units. 7) 64.6% had safeguards for the storage of special equipment which was investigated regularly in 54.7%. 8) The director of nursing or her representative, participates in the selection was 72.4%, 9) 58.2% was provided instruction in the use of equipment by manufacturers of technical equipment.

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Adaptation and Evaluation of the Incontinence Care Protocol (실금간호 프로토콜 수용개작 및 효과 검증)

  • Park, Kyung Hee;Choi, Heejung
    • Journal of Korean Academy of Nursing
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    • v.45 no.3
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    • pp.357-366
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    • 2015
  • Purpose: This study was done to develop an evidence-based incontinence care protocol through an adaptation process and to evaluate the effects of the protocol. Methods: The protocol was developed according to the guideline of adaptation. A non-randomized controlled trial was used for testing the effects of the new Incontinence Care Protocol. A total of 120 patients having bowel incontinence with Bristol stool type 5, 6, and 7 and admitted to intensive care units were recruited to this study. The newly developed incontinence care protocol was used with patients in the experimental group and conventional skin care was given to patients in the control group. Outcome variables were incontinence-associated dermatitis (IAD) severity, pressure ulcer occurrence and severity. Results: The experimental group had significantly less severe IAD (t=6.69, p <.001), lower occurrence of pressure ulcers (${\chi}^2=7.35$, p =.007), and less severity of pressure ulcers (Mann-Whitney=86.00, p =.009) than the control group. Conclusion: Use of this incontinence care protocol has the effects of preventing pressure ulcers and inhibiting worsening of IAD and pressure ulcers. Therefore, this incontinence care protocol is expected to contribute to managing IAD and pressure ulcers.