• 가정간호학회지
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• 제23권1호
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• pp.25-33
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• 2016

Purpose: This study aimed to survey caregivers of patients with Neuromuscular Rare and Incurable Disease (NRID) using invasive home mechanical ventilator (HMV), in order to compare the incident rate of pneumonia by tracheal suction procedures used. Method: Participants were 99 family caregivers of NRID patients using HMV. Participants were given a questionnaire consisting of 12 demographic items, 10 items about disease and HMV related characteristics, 11 items about tracheal suction procedures, and 2 items about the incidence of pneumonia. Data were analyzed using chi-square tests and t-tests. Results: The items that predicted the incidence of pneumonia were "change of irrigation saline every suction" (p=.047), "use of aseptic catheter every suction" (p=.004), and "instillation of normal saline before suction" (p=.027). In addition, these items were 47.4%, 51.4%, and 38.8% respectively. Conclusion: Family members caring for NRID patients with invasive HMV should be educated about tracheal suction, especially the necessity of changing irrigation saline after every suction, using the aseptic catheter for every suction, and instillation of normal saline before suction. Medical personnel such as home care nurses should periodically check tracheal suction procedures, and re-educate family caregivers when necessary.

• Journal of Korean Biological Nursing Science
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• 제21권2호
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• pp.133-140
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• 2019

Purpose: The purpose of this study was to check the degree of residual microbial contamination after disinfection of reusable suction containers, used in an intensive care unit (ICU) and present basic data for efficient use through cost analysis in comparison to disposable suction containers. Methods: This study was conducted on 32 reusable suction containers used in an ICU on a selected specific day. After disinfection and washing, specimens were collected from the used containers and cultured to check for microbial contamination. Additionally, a comparative narrative study analyzes the cost of using reusable suction containers and disposable suction containers. Data were analyzed with the SPSS WIN 20.0 program using real numbers and percentage ${\chi}^2$-test. Results: As a result of the study, microorganisms were found in all samples where in 30 were gram-positive (62.5%) while 13 were gram-negative (27.1%). Based on level of contamination, microorganisms were less than 10CFU/ml in 18 samples (56.3%); 11-99CFU/ml in six samples (18.8%); and more than 100CFU/ml in eight samples (25%). Cost per day for a reusable suction container was $10,655+{\alpha}$ while cost per day for a disposable suction container was 10,666 won. Conclusion: This study found that reusable suction containers, even after disinfection, accounted for factors of potential infection as well as microbial contamination. So, disposable suction containers are superior in cost-effectiveness and highly efficient for use with infected patients.

• 동서간호학연구지
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• 제23권1호
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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.

• 가정간호학회지
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• 제22권1호
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• pp.88-97
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• 2015

Purpose: This study was conducted to identify the effects of a suction care self video-based debriefing-assisted learning in the fundamentals of nursing practice for nursing students on clinical performance, self-efficacy and problem-solving process. Methods: A nonequivalent control group non-synchronized design study was used and included 97 junior nursing students at P University as participants, 48 of whom were assigned to the experimental group, and 49 of whom were assigned to the control group. The outcome measurements were clinical performance for suction care, self-efficacy, and the problem-solving process. Results: The scores of clinical performance were 23.75 in the experimental group who used the materials and 21.55 in the control group, and the difference was statistically significant (p<.000). Self-efficacy was 4.30 in the experimental group and 4.18 in the control group, which was a statistically significant difference (p=.000), and the pre-to-post differences of self-efficacy was statistically significant as well (p<.001). However, there were no significant differences in the pre-to-post differences of the problem-solving process (p<.802). Conclusions: Self video-based debriefing-assisted learning may be more effective in enhancing clinical performance and self-efficacy than that of conventional practice. Whether self-efficacy will contribute to enhanced learning motivation for nursing students needs further examination.

• 한국산학기술학회논문지
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• 제14권3호
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• pp.1197-1206
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• 2013

본 연구는 흡인간호 교육프로그램을 개발하고, 개발된 프로그램을 적용하여 간호학생의 흡인간호 임상수행능력, 흡인에 대한 자기효능감과 문제해결과정에 미치는 효과를 규명하기 위함이다. P대 4년제 대학교 간호학과 2학년에 재학중인 96명을 대상으로 2011년 10월 6일부터 10월 10일까지 자료를 수집하였다. SPSS/WIN 18.0을 사용하여 기술통계, ${\chi}^2$-test, t-test, ANCOVA로 분석하였다. 흡인간호 교육프로그램을 적용한 임상수행능력 점수는 실험군 23.72점, 대조군 22.16점으로 두 군간의 유의한 차이가 있었다(p<.001). 자기효능감은 실험군 7.58점, 대조군 7.08점으로 두 군간의 유의한 차이가 있었고(p=.03), 사전-사후검사 차이점수도 두 군간의 유의한 차이가 있었다(p<.001). 문제해결과정은 두 군간에 유의한 차이가 없었고(p=.06), 사전-사후검사 차이점수도 유의한 차이가 없었다(p=.11). 이에 간호학생에게 적용한 흡인간호 교육프로그램은 임상수행능력, 흡인에 대한 자기효능감에 효과가 있음을 확인하였다.

• Tuberculosis and Respiratory Diseases
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• 제65권3호
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• pp.198-206
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• 2008

연구배경: 폐쇄관을 이용한 기관내 흡인은 임상적으로 중한 환자에게 생리적인 이점이 있지만, 병원성 균주에 의한 기관지 내의 집락화가 증가될 수 있다는 보고가 있다. 비용증가는 폐쇄흡인의 또 다른 제한점이다. 본 연구는 폐쇄흡 인 및 개방흡인에 따른 병원균주의 집락화와 인공환기관련폐렴의 빈도와 가격효율성을 비교해보고자 시행되었다. 방 법: 각각 한 달의 간격을 사이에 두고 내과계 중환자실에 입원한 환자들을 대상으로 다중사용 개방흡인, 단일사용 개방흡인, 다중사용 폐쇄흡인을 순차적으로 시행하였다. 비용, MRSA의 기관지내 집락화, 인공환기폐렴의 발생 률을 분석하였다. 결 과: 106명의 환자가 연구 대상으로 포함이 되었고, 이 중 20명의 환자가 다중사용 개방흡인을, 42명이 단일사용 개방흡인을, 44명이 다중사용 폐쇄흡인술을 시행받았다. MRSA의 집락화와 인공환기관련폐렴의 빈도는 세 군간에 의미있는 차이를 보이지 않았다. 입원 일당 소모되는 비용은 다중사용 개방흡인이 $10.58, 단일사용 개방흡인이 $28.27, 다중사용 폐쇄흡인의 경우 $23.76인 것으로 나타났다. 결 론: 다중사용 폐쇄흡인을 매 48시간마다 교환하는 경우 MRSA 집락화와 인공환기폐렴 발생 빈도는 비슷하였고, 기관내 흡인술에 있어서 비용면에서도 효율적인 방법임을 알 수 있었다.

• 대한간호학회지
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• 제23권2호
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• pp.245-254
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• 1993

The purpose of this study was to identify effective methods to minimize increases in intracranial pressure(IICP ) during endotracheal suction by means of comparing two methods of hyperventilation and oxygen supply before and after endotracheal suction. In order to evaluate the effects of these two methods, the ICP during suctioning and the sustained time of IICP were measured. For hyperventilation, ambu-bagging was done 10 times for 30 seconds with a tidal volume of 800-900m1. For oxygen supply, 100 percent oxygen was supplied for 2 minutes before and after suction. The subjects for this study were 12 neurosurgical patients who had had a subarachnoid bolt inserted for ICP monitoring and they were all on mechanical ventilatory support in a surgical intensive care unit of Seoul National University Hospital from July 1, 1991 to March 31, 1992. In each patient hyperventilation was performed five times and oxygen supply was given five times and intracranial pressures were measured immediately before and every 30 seconds for 15 minutes after suction. For case assignments counterbalancing and repeated measure designs were combined. And so the total number of experiments were sixty for each group. The effects of hyperventilation and oxygen supply on the IICP and the sustained time of IICP after suction were analyzed by t-test. The results of study were as follows 1. There was a significant difference between the two groups in the increased ICP during suction (t=2.49, p=.014). 2. The sustained time of IICP after suctioning in the oxygen supply group was shorter than that in the hyperventilation group(t=2.35, p=.020) In summary, the Increase in the ICP during suction was lower and the time for the ICP to return to the presuction level was shorter in the oxygen supply group as compared to the hyperventilation group. Therefore, oxygen supply can be re commended before and after endotracheal suction.

• 기본간호학회지
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• 제12권3호
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• pp.395-403
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• 2005

Purpose: Methicillin-resistant Staphylococcus aureus (MRSA) is a major nosocomial pathogen in the intensive care units (ICUS). The purpose of this case-control study is to identify risk factors for acquisition of MRSA during ICU stays in patients with and without MRSA. Method: The study was conducted in a 16 beds-neurosurgical intensive care unit of a 2200-bed tertiary care university hospital in Seoul, Korea. Medical record and Critical Classification Scoring System were reviewed retrospectively in patients who were admitted more than 3 days from August 1, 2003 to May 30, 2004. Cases and controls were matched for age and gender. The obtained specimens were nasal swab and sputum. Result: There were 950 patients' admissions during the period. Among them, MRSA was isolated from twenty-three patients who were considered as hospital acquired. Artificial airway (p=.045), frequency of suction (p=.002), nasogastric tube (p=.004), wound drain (p=.045), and vancomycin (p=.019) were risk factors for MRSA acquisition in univariate analysis. Frequency of suction (p=.012, OR 3.5) was revealed as the only risk factor in multivariate conditional logistic regression. Conclusion: Our findings give support to recent studies that suggest that frequent physical contact maγ increase the nosocomial acquisition of MRSA in a neurosurgical ICU.

• 대한간호학회지
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• 제34권7호
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• pp.1315-1325
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• 2004

Purpose: The purpose of this study was to examine the effects of a closed endotracheal suction system(CES) on oxygen saturation, ventilator associated pneumonia(VAP), and nursing efficacy in mechanically ventilated patients. Method: This study was conducted in the intensive care unit of a University Hospital in Gwangju City. Data was collected from July to October, 2003. Seventy mechanically ventilated patients were randomly divided into two groups; 32 for CES and 38 for open endotracheal suction system(OES) protocol. Twenty one nurses were also involved to examine the nurses' attitude of usefulness about CES. Result: $SaO_2$ was significantly different between CES and OES. The incidence of VAP in CES was lower than that of OES. Nursing efficacy was related to time, cost, and usefulness of the suction system. Time of suctioning in CES was shorter than that of OES. CES also contributed significantly to lower the cost of treatment than OES. The usefulness score of CES increased after 6 months of use. Conclusion: CES prevented VAP, was cost effective, and a safe suctioning system. CES can be used with patients with sensitivity to hypoxygenation and with a high risk of VAP.

• Archives of Plastic Surgery
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• 제33권1호
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• pp.131-134
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• 2006

The closed suction drain is commonly inserted after various surgical procedures. It has an important role to prevent possible hematoma or seroma that can cause postoperative wound problems. But there is still no consensus on managing the insertion site of suction drain after operation. Suture-tie fixation of drain to skin and classical Y shape gauze dressing is a usually accepted method, but it has many limitations. We introduce a new approach to the care for the insertion site of suction drain by using occlusive transparent film dressing, $IV3000^{(R)}$(Smith & Nephew, London, UK). By using transparent film, insertion site of drain can be easily checked without removal of dressing. Because it can reduce the tension of suture-tie fixation, it helps to prevent skin injury. Furthermore, occlusive film dressing can block air leakage from insertion site of drain, and the water-proof character of film allows patients to take a shower without dressing change. This new method is more convenient, more efficient, and less harmful to skin than classic one.