• 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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• 제5권1호
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• pp.45-53
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• 2003

The purpose of this study was to identify the proper changing time of tracheal suction catheter by examining the microorganisms inside after used The samples were the adult and the elderly patients who were in the intensive cane unit of one university hospital in Korea from the early December, 2002 to the end of May 2003. Since the patients needed tracheal suction, sterile catheter including other equipments were used whenever tracheal suction provided, to the experimental group. The sterile catheter with others was provided when the catheter repeatedly used for four hours, to the comparative group. Research was permitted by the head of hospital administration, hospital nursing department; microbiology and intensive care unit. The main results of the study are as follows. 1) The demographic characteristics between the two groups present statistically no difference. 2) Every the experimental group showed various kinds of microorganisms, the numbers of the kinds and carries of the microorganisms were less than those of the comparative group. 3) The mean numbers of the microorganisms between the two groups were significantly different, p < 0.05. This study results strongly emphasize the needs of using sterile catheter whenever a nurse suctions to keep patient's airway open.

• 한국간호교육학회지
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• 제23권3호
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• pp.330-340
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• 2017

Purpose: This study was conducted to explore the relationship between simulation-based clinical judgment and performance ability for tracheal suction in nursing students. Methods: With a convenience sampling, 207 nursing students participated in this descriptive study. Lasater clinical judgment rubric was used for self-reported clinical judgment in addition to observe the skill of tracheal suction using a checklist. Data were analyzed by descriptive statistics, t-test and Pearson's correlation coefficients using the SPSS/WIN 22. Results: A scenario with pneumonia patient was developed to observe the skill of tracheal suction during simulation-based practices. Then self-reported clinical judgment was scored. The mean score of total sum of clinical judgment, total mean of clinical judgment, and performance skill were $36.44{\pm}4.82$, $13.44{\pm}1.71$, and $42.32{\pm}5.05$, respectively. Statistically, students having good skills in suction showed significant differences in clinical judgment of interpreting (p=.031) compared to students having fair skills. Conclusion: The results of this study show that a structured debriefing method utilizing Lasater clinical judgment rubric is helpful. Also, simulation-based practice related to adult nursing in the respiratory system was useful for increasing the core basic skills among nursing students.

• 기본간호학회지
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• 제10권1호
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• pp.96-107
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• 2003

Objective: The purpose of this study was to identify the effects of tracheal suction and the effects of different methods of bronchodilator inhalation (Ultrasonic nebulizer: MDI puff, MDI puff with spacer) in VSD surgery patients. Material & Method: From June 2001 to March 2002, sixty consecutive patients were randomly assigned to a control group (n= 15), ultrasonic nebulizer group (n=15), metered dose inhalation (MDI) puff group (n=15) and MDI with spacer group (n=15). Vital signs (HR, BP, CVP), ABGA and pulmonary functions were measured before suction (baseline for suction), after suction, 15 minutes after suction (base of bronchodilator inhalation), 30 minutes after bronchodilator inhalation, and 2 hours after bronchodilator inhalation. Stastistical analysis was performed using SPSS software. Repeated measure ANOVA was used to examine the effects of tracheal suction. One way ANOVA with Bonferroni's correction and multiple range test (the least significant difference test) were used to examine the effects of albuterol inhalation. Result: 1. Heart .ate increased significantly immediately after suction (p<.01) and recovered 15 minutes after suction. 2. $PaO_2$ and PH decreased significantly immediately after suction (p<.05) and $PaO_2$ recovered 15 minutes after suction. $PaCO_2$ increased immediately after suction and significantly 15 minutes after suction (p<.01). But changes in vital signs and ABGA were within the normal range. 3. Tidal volume decreased significantly 15 minutes after suction (p<.05). 4. Changes of HR and tidal volume were greater in the nebuizer group compared to the other groups (p<.05) 30 minutes after bronchodilator inhalation and recovered 2 hours after bronchodilator inhalation. 5. Changes of airway deadspace was greater in the nebulizer group compared to the control group and MDI puff group 30 minutes after albuterol inhalation (p<.05) and at 2 hours (p<.01). Conclusion: Tracheal suction did not have significant effect on vital signs and pulmonary functions after OHS. Although the methods of bronchodilator inhalation did not showed any significant difference on pulmonary function, the nebulizer method increased $PaO_2$ (20%) and tidal volume transiently. If the patient needs bronchodilator inhalation with bronchospasm after OHS, the nebulizer method is the best choice. More study on the effects of bronchodilator inhalation in bronchospasm group is needed.

• 성인간호학회지
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• 제18권5호
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• pp.718-726
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• 2006

Purpose: The purpose of this study was to investigate differences between a pulmonary aspiration group and a non-pulmonary aspiration group in glucose concentration of tracheal secretions by measuring time and feeding methods. Method: The subjects were 36 ICU patients who were receiving formula via nasogastric tubes and had endotracheal tubes or tracheostomy tubes. Tracheal secretions were collected by connecting suction traps to a suction catheter in three different times(within 1 hour after feeding, between 1 to 2 hours after feeding, and between 2 to 3 hours after feeding) for 2 days, overall six times. Glucose concentration of tracheal secretions was measured with the glucometer(Accucheck II). Results: Glucose concentration of tracheal secretions increased in progression after feeding. The mean of specimens collected last(between two to three hours after feeding) was shown to be the highest value(M=61.61mg/dl) in the pulmonary aspiration group. Significantly(p=.000) more subjects(94.44%) in the pulmonary aspiration group received formula via a 50cc syringe than those in the non-pulmonary aspiration group(22.22%). Conclusion: Critically ill patients may need more time for head-elevation after tube feeding to prevent pulmonary aspiration. In practice, enteral formula should not be given the patients via a $50_cc$ syringe anymore, instead a feeding bag or infusion pump should be used to prevent pulmonary aspiration.

• Journal of Korean Biological Nursing Science
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• 제15권4호
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• pp.247-256
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• 2013

Purpose: This study aimed to determine the effects of listening to music on pain and vital signs of critically ill patients with ventilatory support in intensive care units during nursing treatment (changes of posture and tracheal suction). Methods: The experimental treatment was to use an mp3 player and a speaker to let them listen to classical music by Mozart during nursing treatment. To determine the effects of music intervention, pain (Critical-Care Pain Observation Tool-K) was used. The data analysis was carried out by using PASW Statistics 20.0. Results: Hypothesis "The scores for pain would differ between the experimental group provided with music intervention during nursing treatment, and the control group" was supported. Conclusion: Application of music intervention during nursing treatment for critically ill patients with ventilatory support in intensive care units was found to be effective in reducing pain. Therefore, music intervention during nursing treatment for critically ill patients with ventilatory support can be used as non-pharmaceutical nursing intervention to reduce pain for the patients.

• 한국간호교육학회지
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• 제21권3호
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• pp.393-405
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• 2015

Purpose: This study was conducted to plan and apply simulation-based practice for raising the achievement of program outcomes (POs) in nursing students. Methods: Using convenience sampling, 95 nursing students participated in this descriptive study. A self-reported questionnaire was used to measure the achievement of POs (self-directed learning, problem-solving ability, critical thinking) and usefulness of curriculum in addition to observing tracheal suction skills using a checklist. Results: A scenario with a pneumonia patient was developed to observe tracheal suction skills during simulation-based practices. Self-directed learning, problem-solving ability, and critical thinking were then scored. The mean scores of performance skill, self-directed learning, problem-solving ability, critical thinking were $37.82{\pm}6.03$. $3.61{\pm}0.38$, $3.61{\pm}0.33$, and $3.73{\pm}0.32$, respectively. All students passed the simulation-based practice in terms of performance ability and met the required achievement level for the POs at this university. Students with good suction skills showed significant differences in problem identification (p=.044) and alternative development (p=.019), which are components of problem-solving ability, compared to students with only fair skills. Conclusion: These findings indicate that simulation-based practice related to an adult nursing respiratory course was useful for evaluating the achievement of POs in nursing students. Further study is needed to develop a universal method of outcome measurement.

• Journal of Chest Surgery
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• 제37권10호
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• pp.884-887
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• 2004

폐 절제술 후 남아 있는 폐엽의 무기폐는 술 후 흔히 볼 수 있는 합병증이다. 이는 효율적인 객담 제거가 되지 않으면 재원일수의 연장 및 전신 상태가 좋지 않은 환자들에겐 치명적일 수도 있다. 따라서 저자들은 고식적인 방법으로 객담 배출이 원활히 되지 앓는 환자에게 선택적 기관지내 흡입도관 유치술을 시행하였다. 기관지 내시경하에 시행하였으며 4번째 기관지륜 상방에 국소 마취를 하여 중심 정맥 도관을 기관지 내로 삽입하였으며 무기폐가 생긴 엽에 도관 끝을 유치하여 반복적 강제 객담배출을 시행하였다. 아주 효과적인 결과를 경험하였기에 보고하는 바이다.

• 대한후두음성언어의학회지
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• 제31권2호
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• pp.87-91
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• 2020

The tracheostomy directs external air into the airway tract. This process causes mucosal dryness, irritation and inflammation in the tracheo-bronchial tree. In order to prevent such problems, several methods are applied; ointment application, humidification and careful suction etc. The heat-moisture exchanger (HME) is commercially sold device that assists heating and humidification of the inhaled air. The authors experienced successful treatment outcome of intractable tracheitis caused by repetitive and vigorous intra-tracheal suction by applying HME in a total laryngectomized patient. We report an interesting and didactic case with a brief literature review.

• 성인간호학회지
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• 제28권6호
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• pp.628-636
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• 2016

Purpose: This study examined the effects of a program designed to prevent ventilator-associated pneumonia (VAP) on VAP rate and endotracheal colonization. The program focused on aspiration prevention and oral care. Methods: A nonequivalent control group post-test only design was utilized. One hundred patients admitted to a medical intensive care unit (MICU) or coronary care unit (CCU) were assigned to either a experimental group (n=50) or a control group (n=50). The participants were selected 48 hours following an endotracheal intubation. VAP prevention program given to the experimental group includes keeping the head of the bed to $30^{\circ}{\sim}45^{\circ}$ high, maintaining continuous endotracheal cuff pressure at 25 cm $H_2O$, performing endotracheal suction before change position, and providing oral care with 0.1% chlorhexidine every four hours. The control group received usual care. Data were analyzed using t-test, $x^2$ test, Mantel-Haenszel $x^2$ and Cox proportional harzard regression model. Results: The experimental group showed a lower VAP rate than the control group although the difference was not statistically significant ($x^2=0.79$, p=.375). The experimental group showed lower colonization in tracheal secretion than the control group ($x^2=14.59$, p<.001). Conclusion: Results showed that a VAP prevention program is effective in reducing colonization of tracheal secretion. Therefore, VAP prevention programs are recommended as an ICU nursing intervention.