• Title/Summary/Keyword: Nursing care units

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Critical Care Nurses' Perception, Knowledge, and Practices of Enteral Nutrition (중환자간호사의 경관영양 공급에 대한 인식과 지식 및 수행)

  • Kim, Hyunjung;Soun, Eunjin
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.23 no.4
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    • pp.383-392
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    • 2016
  • Purpose: The purpose of this study was to assess critical care nurses' perception, knowledge, and nursing practices regarding enteral nutrition. Methods: A descriptive study was conducted with 187 nurse participants who worked in one of the eight medical and surgical intensive care units (ICUs) from four hospitals in Korea. Data were collected using a self-administered questionnaire. Results: Although critical care nurses' perception toward enteral nutrition was high, knowledge was relatively low. The overall perception and knowledge of the nurses did not differ significantly between medical ICU and surgical ICU nurses. Perception of their own knowledge, in particular, 'nutritional goal' was lower for medical ICU nurses compared to surgical ICU nurses. Nurses also had limited knowledge about the significance of enteral nutrition, confirmation of feeding tube location, and nutritional requirements for ICU patients. They inadequately performed the following: changing the feeding tube every 24 hours, inspecting nostrils daily, and adjusting feeding schedule if feeding was stopped. Conclusion: Our results indicate that ICU nurses need up-to-date information about enteral nutrition. Based on the improved perception and knowledge, nursing practice activities with regard to enteral nutrition should be emphasized to enable nurses to provide optimal nutrition for ICU patients.

Surgical Intensive Care Unit Patients' Risk Factors for Postoperative Pulmonary Complications after Abdominal Surgery (외과중환자실에 입실한 복부수술 환자의 수술 후 폐합병증 발생 위험요인에 대한 연구)

  • Joo, Soon Yeo;Kim, Hee-Seung
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.26 no.1
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    • pp.32-41
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    • 2019
  • Purpose: The purpose of this study was to identify the risk factors for postoperative pulmonary complications (PPCs) after upper or lower abdominal digestive tract surgery. Methods: Participants in this retrospective observational study had undergone upper or lower digestive tract surgery and entered the surgical intensive care unit between March 1, 2016 and February 28, 2017. Data were collected from the medical records, operative records, results of laboratory test, and the nursing records of the hospitals. Results: Of the patients, 544 patients were enrolled in the study and PPCs -developed in 335 (61.6%) patients. On multivariate logistic regression analysis, significant risk factors of PPCs were identified: BMI (Body Mass Index; $kg/m^2$), preoperative serum BUN (Blood Urea Nitrogen; mg/dL), abdominal open surgery, or blood transfusion during operation. Conclusion: These risk factors could be used to help identify patients at risk for PPCs and then appropriate nursing interventions could be provided for patients at risk of PPCs.

Effects of an emotional regulation program on maladaptive cognitive emotion regulation, stress, anxiety, and postpartum depression among South Korean mothers of premature infants in the neonatal intensive care unit

  • Choi, Hyo Sin;Lee, Kyung Eun;Shin, Yeonghee
    • Child Health Nursing Research
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    • v.27 no.1
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    • pp.24-33
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    • 2021
  • Purpose: This study aimed to evaluate the effects of a rational emotive behavior therapy (REBT)-based emotional regulation program for mothers of premature infants in the neonatal intensive care unit (NICU). Methods: The study utilized a nonequivalent control group pretest-posttest design. Seventeen mothers were recruited for the experimental group and 21 mothers for the control group. Data were collected from July 9, 2018, to Oct 12, 2018 from mothers of premature infants in the NICU regarding parental stress, state anxiety, depression, and maladaptive cognitive emotion regulation. The experimental group received eight sessions of the REBT-based emotional regulation program for 3~4 weeks, and the control group only received standard nursing care. Results: Significant differences were found between the two groups in maladaptive cognitive emotion regulation (Z=-3.88, p<.001), stress (Z=-2.76, p=.006), state anxiety (Z=-3.72, p<.001), and postpartum depression(Z=-2.62, p=.009) after the intervention in the experimental group. Conclusion: The REBT-based emotional regulation program for mothers of premature infants was effective for reducing maladaptive cognitive emotion regulation, stress, anxiety, and postpartum depression. Therefore, it may be necessary to provide an REBT-based emotional regulation program for mothers of premature infants in the NICU in clinical practice.

Adherence to Clinical Guideline for Endotracheal Suction in ICU Nurses (중환자실 간호사의 기관내 흡인 임상지침 수행 현황)

  • Yang, Eunjung;Shin, Hyunsook
    • Journal of East-West Nursing Research
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    • v.23 no.1
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    • pp.53-62
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    • 2017
  • Purpose: This study aimed to evaluate the adherence to the clinical guideline for endotracheal suction in nurses working at intensive care units (ICU) and to identify the characteristics of nurses with good adherence. Methods: This study was a descriptive study to evaluate the pattern of adherence and its related factors to endotracheal suction. One hundred fifty five nurses working at ICU participated in this study. We used a questionnaire developed based on American Association for Respiratory Care (AARC) guidelines and other associated factors from previous studies. Results: Around half of the participants reported that their adherence to the clinical guideline was poor. Items deviated from the recommended guideline were reasons for initiating a suctioning, applied suction pressure ranged from 20 to 200mmHg, and applied catheter size from 6 to 17 french. Other factors deviated were the depth of inserted catheter, and inappropriate use of normal saline instillation. The most significant factor was related to hospital; the misused or misled clinical protocol. Conclusions: The adherence to the clinical guidelines of the endotracheal suction in ICU nurses was not appropriate, which might contribute to the patient health outcomes. More enhanced continuing education as well as hospital regulation is warranted.

Development and evaluation of a neonatal intensive care unit medication safety simulation for nursing students in South Korea: a quasi-experimental study

  • Son, Mi Seon;Yim, Minyoung;Ji, Eun Sun
    • 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.

A Study on the Quality Improvement Activities of Clinical Nurses: Nursing Care Unit level (임상간호사의 의료 질 향상 활동에 관한 연구: 병원 간호병동 수준으로)

  • Yoo, Ji-Yeon;Kim, Kwang-Jum
    • Korea Journal of Hospital Management
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    • v.22 no.1
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    • pp.10-20
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    • 2017
  • Purposes: This study analyzed activities for improvement of quality of care in nursing units to identify group-level success factors of quality improving efforts. Methodology/Approach: Research subjects were 31 general wards of C university hospital, which has 1,200 beds. Data were collected through survey and focus group interview. The mean value of nurses in a ward was converted to unit-level variable value of the ward. The SPSS 24.0 version was used to analyse the data. The units were classified into two groups, high performing and low performing, by the subjective level of quality improvement performance. Findings: The main findings are as follows: 1. The high performing groups participated more in education related to quality improvement and showed more quality improvement cases in progress than that of their counterpart. 2. The high performing group's nurses show more positive perception and attitude on quality improvement activities, and they have positive assessment on the necessity, effect, satisfaction about the quality improvement activities. 3. Middle managers' ability, attitude, motivation, and effective communication across members of the ward played pivotal roles in boosting the quality improvement activities of wards.

Development and Validation of a Korean Nursing Work Environment Scale for Critical Care Nurses (한국형 중환자실 간호근무환경 측정도구 개발 및 평가)

  • Lee, Hyo Jin;Moon, Ji Hyun;Kim, Se Ra;Shim, Mi Young;Kim, Jung Yeon;Lee, Mi Aie
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.3
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    • pp.279-293
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    • 2021
  • Purpose: The purpose of this study was to develop a Korean nursing work environment scale for critical care nurses (KNWES-CCN) and verify its validity and reliability. Methods: A total of 46 preliminary items were selected using content validity analysis of experts on 64 candidate items derived through literature reviews and in-depth interviews with critical care nurses. 535 critical care nurses from 21 hospitals responded to the preliminary questionnaire from February to March 2021. The collected data were analysed using construct, convergent and discriminant validities, and internal consistency and test-retest reliability. Results: The 23 items in 4 factors accounted for 55.6% of the total variance were identified through item analysis and exploratory factor analysis (EFA). EFA was performed with maximum likelihood method including direct oblimin method. In the confirmatory factor analysis, KNWES-CCN consisted of 21 items in 4 factors by deleting the items that were not meet the condition that the factor loading over .50 or the squared multiple correlation over .30. This model was considered to be suitable because it satisfied the fit index and acceptable criteria of the model [𝒳2=440.47 (p<.001), CMIN/DF=2.41, GFI=.86, SRMR=.06, RMSEA=.07, TLI=.90, CFI=.91]. The item total correlation values ranged form .32 to .73 and its internal consistency was Cronbach's α=.92. The reliability of the test-retest correlation coefficient was .72 and the intra-class correlation coefficient was .83. Conclusion: The KNWES-CCN showed good validity and reliability. Therefore, it is expected that the use of this scale would measure and improve nursing work environment for critical care nurses in Korea.

Measurement of the Nursing Workload by Patient Classification System in a Secondary Hospital;As a Preliminary Step for Computerization of Nursing Staffing and Scheduling (환자분류에 의한 일개 2차 의료기관의 간호업무량 조사;전산화를 위한 기초작업으로서)

  • Park, Jung-Ho;Joe, Hyon;Park, Hyeoun-Ae;Han, Hye-Rah
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.1
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    • pp.132-146
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    • 1995
  • Even though Korean medical law stipulates that number of patients attended by a nurse is 2.5 for hospitalization and 30 for ambulatory care, the number of patients cared by a nurse per day is much greater than the standard prescribed by the medical law. Current productivity of nurses is not desirable unless the quality of care is considered. And nursing manpower staffing based on neither current nurses' productivity nor standard of medical law cannot respond properly to dynamic situation of the medical services. Under this background, the necessity of more efficient management of nursing manpower occupying 1/3 of total hospital workers has been recognized by many nursing administrators. Many nursing researchers have studied to foretell the nursing manpower objectively on the basis of measured nursing workload according to patient classification as well. Most of These researches, however, have been conducted in the tertiary hospitals, so it is imperative to conduct other researches to predict necessary nursing manpower in the secondary and the primary hospitals. The study was performed to measure nursing workload and predict pertinent nursing manpower to a secondary hospital with 400beds. Nursing workload was surveyed using measuring tool for direct and indirect care hours in a surgical unit and a medical unit. Survey was conducted from Sep.10 to Sep.16 and from Oct.5 to Oct.11, 1994 respectively by two skilled nurses, Subjects were patients, patients' family members and nursing personnels. Results are follows : 1. Patient classification distributed as 22% of class I (mildly ill patient), 57% of class II (moderately ill patient), and 21% of class III (acutely ill patient) in the medical nursing unit, while 23% of class I, 29% of class II, 12% of class III, and 36% of classIV (critically ill patient) in the surgical nursing unit. There was no difference of inpatient number between weekday and weekend. Bed circulation rate was 89% in both units and average patients number per day was 37.4 (total 42beds) in the medical nursing unit, 32.9 (total 37beds) in the medical nursing unit. 2. Direct care hours per day measured as 2.8hrs for class I, 3.3hrs for class II, and 3.5hrs for class III in the medical nursing unit, while 3.1hrs for class I, 3hrs for class II, 2.7hrs for class III, and 2.2hrs for classIV in the surgical nursing unit. Meanwhile, hours for nursing assistant activities per patient by patients' family members were 11mins and 200mins respectively. Direct care hour rate by shift was day 36%, evening 25%, and night 39% in the medical nursing unit, while 40%, 29%, and and 31% respectively in the surgical nursing unit. 3. Measurement and observation activity held 44.2% of direct care activities of nurses and medication 36.7%, communication 11.7%, exercise 1.8%, treatment 1.3%, hygiene 1.3%, elimination and irrigation 1.1%, suction 1%, nutrition 0.5%, thermotherapy 0.3%, oxygen therapy 0.1% in order. 4. Indirect care hours per day were 294.2mins in the medical nursing unit, and 273.9mins in the surgical nursing unit. By shift, evening was the highest in both units. Indirect care hours for each patient were 44.5mins in the medical nursing unit and 46mins in the surgical nursing unit. 5. checking activities including doctor's order, medication, and delivering patients to the next shift occupied 39.7% of indirect care activities, and preparation 26%, recording 23.8%, communication and conference 6.7%, managing equipments 2.1%, messenger activity 1.7% in order. 6. On the ground of these results, nursing manpower needed in a secondary hospital was estimated ; 27 nursing personnels for the medical nursing unit of 37beds, and 20 nursing personnels for the surgical nursing unit of 33beds.

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Comparison of Nursing Activities Reflected in Nursing Notes rind In-depth Interviews of Nurses in an Acute Hospital (간호일지와 간호사의 면담자료에 나타난 간호활동 내용의 비교분석)

  • 송미순;김매자;박영숙;이은옥;하양숙;한경자;류세앙;강혜영;김경남
    • Journal of Korean Academy of Nursing
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    • v.33 no.6
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    • pp.802-811
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    • 2003
  • Purpose: The purpose of this study was to compare the nursing activities delineated by interview of nurses with those on nursing notes. Method: The participants of interview were 18 nurses working in medical and surgical units of a large hospital in Seoul. Each nurse was asked to choose one patient who demand most nursing care among her patients. The nurse was then interviewed to describe what her nursing activities for the patient was that day. The audio-taped interview was transcribed and the content was analyzed by researchers. Nursing notes of each nurses' patients were copied and the content analyzed by researchers. Finally, themes from the interview data and those from nursing notes were compared. Result: Activities related to emotional or psychological nursing, education for patient and families, and problem solving related to treatment or nursing procedure were most often omitted in nursing notes. Most of the documentation in nursing notes were related to physical condition of patients or physician's orders. Nurses described that they will do better recording if they were given less patient care responsibility, had better nursing knowledge, had better recording system, and received more training on nursing record. Conclusion: Nursing notes did not reflect nursing activities properly. Few independent nursing roles were documented in the nursing notes. Development of nursing education program and nursing record system is needed for improvement of nursing record.

The Study of Curriculums on the Nursing in Oriental Medicine (한방간호관련(韓方看護關聯) 교과과정(敎科課程) 現況(현황)에 대한 연구)

  • Moon, Heui-Ja;Shin, Hye-Sook;Yang, Kil-Mo
    • Journal of East-West Nursing Research
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    • v.5 no.1
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    • pp.114-119
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    • 2000
  • This paper reviews the curriculums on the nursing in oriental medicine currently provided by Korean nursing education institutes. As of October 2000, 14 of 48 four-year-system and 40 of 65 three-years system nursing schools provide the various academic courses and programs titled with the nursing care in oriental medicine. Depending on schools, the credit assigned to these courses and programs vary widely ranged from 1 to 8 units. Even in some schools the courses are offered not as a regular credit course but as a part of other courses on time sharing base. It is absolutely insufficient efforts in promoting education on the nursing in oriental medicine. The oriental medicine is basically based on the principles that the most critical factor in promoting health and preventing disease is the process for improving the condition of both physical and mental part of patients. In this context it seems to be an valuable attempt to apply the principles of oriental medicine to the field of nursing care, and to develop the new methods. It is because promoting health, preventing disease, recovering health, alleviating pains are the basic responsibilities of nursing care. The national health policies have been increasingly emphasizing low-cost and high-efficiency just as in economic policies. In terms of cost-effectiveness nursing education in oriental medicine seems to be evaluated as good enough to satisfy these efficiency requirements. As a initial step for promoting and specializing the nursing education in oriental medicine it is absolutely needed to introduce and expand the curriculum on this new field. Increasing concerns about the oriental medicine as the third medical care is the world wide phenomenon now. Considering this trend, current insufficient curriculum on nursing in oriental medicine in education institutes, especially in four-year system nursing school, might be an undesirable phenomenon for future development of nursing education in Korea. In-depth studies about this issue are seriously needed.

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