• Title/Summary/Keyword: intensive care

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Transmission Aspect of Methicillin-resistant Staphylococcus aureus in the Neurosurgical Intensive Care Unit by Analysing Genotype (유전자형 분석에 의한 신경외과 중환자실의 메티실린 내성 황색포도알균의 전파양상)

  • Kim, Yun-Kyung;Hong, Hae-Sook
    • Journal of Korean Academy of Nursing
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    • v.37 no.6
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    • pp.976-985
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    • 2007
  • Purpose: The aim of this study was to identify the present situation of hospital infection and route of infection by clarifying the transmission aspect of methicillin-resistant Staphylococcus aureus(MRSA) in a Neurosurgical Intensive Care Unit by analysing genotype. Methods: MRSA was cultured from twenty five patients with a tracheostomy, twenty five health care workers, and environments in the Neurosurgical Intensive Care Unit of one hospital in D city. Data was collected from December 21, 2004 to November 5, 2005. MRSA isolates representing each genotype were analyzed by spaA typing and a multiplex PCR method capable of identifying the structural type of the staphylococcal cassette chromosome mec(SCCmec) carried by the bacteria. Results: As the same genotype and gene sequence were found among health care workers, patients, and environments, it was assumed that there was cross transmission among them. Conclusion: This study suggests that first, as the hospital infection by MRSA between health care workers and patients in the Neurosurgical Intensive Care Unit was due to result of cross transmission and the relevance of transmission between them was verified, it is necessary to take preventive measures and conduct education. Secondly, development of nursing interventions and study of infection are needed. Thirdly, consistent investment in prevention against hospital infections and environmental renovation is needed.

The Effects of the Application of a Glucose Control Protocol on Glycemia and Glucose Variability in Critically Ill Cardiothoracic Surgery Patients (혈당 조절 프로토콜 적용에 따른 흉부외과 중환자의 혈당 조절 상태와 혈당 변동)

  • Yoo, Hye Jin;Lee, Nam Ju;Lee, Soon Haeng
    • Journal of Korean Critical Care Nursing
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    • v.8 no.2
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    • pp.1-12
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    • 2015
  • Purpose: The study sought to determine the state of blood glucose control, and the consequent clinical effects and variation in blood glucose level, of adult patients admitted to intensive care units following cardiothoracic surgery by comparing the blood glucose levels before and after the application of a blood glucose control protocol. Methods: The protocol was developed by modifying and supplementing the Yale protocol, and was first used in 2012. The resulting blood glucose data of an experimental group (n = 314), to which the blood glucose control protocol had been applied, and a control group (n = 347), whose blood glucose levels had been controlled according to physicians'prescriptions without the protocol, were collected through the medical records. Results: The target blood glucose ratio increased significantly in the experimental group, and the low blood glucose ratio decreased significantly in the experimental group. The two groups exhibited a significant difference (p < .001) in the degree of variation in the blood glucose levels. The duration of the use of a ventilator was significantly reduced in the experimental group (p < .001). Conclusion: It is expected that the protocol can be used for the safe and effective control of critically ill cardiothoracic surgery patients' blood glucose levels.

A Study on the Spatial Composition by Zone for the Architectural Planning of the Intensive Care Unit in Regional Public Hospitals (지방의료원 중환자부 건축계획을 위한 영역별 공간구성에 관한 연구)

  • Lyu, Cheng;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.26 no.1
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    • pp.51-62
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    • 2020
  • Purpose: The Intensive Care Unit (ICU) is an important inpatient care area where critical patients are treated intensively with advanced medical technology. The level of care of ICU and the modernization of related facilities is an important indicator of health care quality. At the present time, when the Regional public hospitals are frequently expanding, the rational planning of the ICU has become an important part of the medical institutions treating the ICU. The purpose of this study is to present basic data with net area which can be used in the architectural planning of the ICU. Methods: The investigation and analysis of the ICUs were conducted on 26 medical facilities, based on theoretical analysis through relevant guidelines, articles, and documents, and on the basis of the actual space composition and net area analysis through the architectural drawings. Results: This study provides basic data such as zone division, spatial composition, relationship between main activities and zones, composition of facilities in the zone and area ratio within each zone. Implications: The results of this paper are expected to be effective reference materials for future research for rational spatial organization and efficient operation of the Intensive Care Unit in regional public hospitals.

A Study on the Types of Layout in the Intensive Care Unit of Regional Public Hospitals based on the Relationship between the Beds and Nurse Station (병상과 간호스테이션의 관계를 기반으로 한 지방의료원 중환자부 배치유형에 관한 연구)

  • Lyu, Cheng;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.25 no.3
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    • pp.37-46
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    • 2019
  • Purpose: The Intensive Care Unit (ICU) is an important inpatient care area where critical patients are treated intensively with advanced medical technology. The level of care of ICU and the modernization of related facilities is an important indicator of health care quality. At the present time, when the Regional public hospitals are frequently expanding, the rational planning of the ICU has become an important part of the medical institutions treating the ICU. The purpose of this study is to present basic data with net area which can be used in the architectural planning of the ICU. Methods: The investigation and analysis of the ICUs were conducted on 24 medical facilities, based on theoretical analysis through relevant guidelines, articles, and documents, and on the basis of the actual space composition and net area analysis through the architectural drawings. Results: This study provides basic data such as bed placement type of ICU, relationship with other departments, distance between NS and bed, distance between beds, and net area of disease by type. Implications: The results of this paper are expected to be effective reference materials for future research for rational spatial organization and efficient operation of the Intensive Care Unit in regional public hospitals.

Factors Influencing Nursing Performance of Intensive Care Unit Nurses: Role of Clinical Reasoning Competence, Positive Psychological Capital, and Nursing Work Environment (중환자실 간호사의 임상추론역량, 긍정심리자본, 간호근무환경이 간호업무성과에 미치는 영향)

  • Heo, MiRim;Jang, Haena
    • Journal of Korean Critical Care Nursing
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    • v.17 no.2
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    • pp.83-95
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    • 2024
  • Purpose : This study aimed to investigate the impact of clinical reasoning competence, positive psychological capital, and nursing work environment on nursing performance of intensive care unit (ICU) nurses in tertiary general hospitals. Methods : Data were collected from 169 ICU nurses in tertiary general hospitals in Busan, South Korea, from July 27 to August 15, 2023, using a self-report questionnaire. After excluding 12 questionnaires with insufficient responses, 157 responses were analyzed. Descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and stepwise multiple regression analysis were employed. Results : Factors influencing nursing performance included clinical reasoning competence (β=.51, p <.001), hope as a subfactor of positive psychological capital (β=.31, p <.001), and the nursing foundations for quality of care in the nursing work environment (β=.21, p <.001). The explanatory power of the regression model was 62% (F=87.41, p <.001). Conclusion : The study underscores the importance of improving clinical reasoning competence among ICU nurses to enhance nursing performance and foster a hopeful attitude through reflective practices and personal growth. Organizational interventions, such as educational and psychological support programs, along with creating a supportive nursing environment, are crucial for improving nursing performance among intensive care unit nurses.

Hospice and Palliative Care for Patients in the Intensive Care Unit: Current Status in Countries Other than Korea

  • Minkyu Jung
    • Journal of Hospice and Palliative Care
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    • v.26 no.1
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    • pp.22-25
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    • 2023
  • Although most patients prefer dying at home, patients whose condition rapidly becomes critical need care in the intensive care unit (ICU), and it is rare for them to die at home with their families. Therefore, interest in hospice and palliative care for patients in the ICU is increasing. Hospice and palliative care (PC) is necessary for all patients with life-threatening diseases. The following patients need palliative care in the ICU: patients with chronic critical illnesses who need tracheostomy, percutaneous gastrostomy tube, and extracorporeal life support; patients aged 80 years or older; stage 4 cancer patients; patients with specific acute diseases with a poor prognosis (e.g., anoxic brain injury and intracerebral hemorrhage requiring mechanical ventilation); and patients for whom the attending physician expects a poor prognosis. There are two PC models-a consultative model and an integrative model-in the ICU setting. Since these two models have advantages and disadvantages, it is necessary to apply the model that best fits each hospital's circumstances. Furthermore, interdisciplinary decision-making between the ICU care team and PC specialists should be strengthened to increase the provision of hospice and palliative care services for patients expected to have poor outcomes and their families.

Evaluating Nursing Needs in the Neonatal Intensive Care Unit with the Korean Patient Classification System for Neonatal Intensive Care Nurses (한국형 신생아중환자간호 분류도구를 이용한 간호요구도 평가)

  • An, Hyo nam;Ahn, Sukhee
    • Journal of Korean Critical Care Nursing
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    • v.13 no.2
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    • pp.24-35
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    • 2020
  • Purpose : This study aimed to determine whether the Korean Patient Classification System for Neonatal Care Nurses (KPCSN) properly measures neonatal intensive care needs and to compare the scale's results with those of the Workload Management System for Critical Care Nurses (WMSCN). Methods : Data were collected from the medical records of 157 patients who were admitted to the NICU of a university hospital, in D city. Two types of patient classification systems were applied to investigate the total points and distributions to investigate the total points and distributions by categories and compare relationships and classification groups between two scales. Finally, the score distribution among the classification groups was analyzed when the KPCSN was applied. Results : Scores on the KPCSN for the feeding, monitoring, and measure categories were 19.16±15.40, 16.88±3.52, and 9.13±4.78, respectively. Classification group distribution of the KPCSN was as follows : 1.9% for the first group, 24.2% for the second group, 58% for the third group, and 15.9% for the fourth group. The classification group distribution of the WMSCN was as follows: 35.7% for the third group, 61.1% for the fourth group, and 3.2% for the fifth group. Finally, the scores by categories were analyzed according to KPCSN classification group, and the characteristics of the patients' nursing needs were identified for each classification group. Conclusion : Results of this study indicate that the KPCSN effectively measures feeding needs, which account for many nursing activities in neonatal intensive care. Comparisons between the KPCSN and WMSCN classification group scores and distribution ratios verified the correlation and significance of nursing requirements.

Successful Removal of Endobronchial Blood Clots Using Bronchoscopic Cryotherapy at Bedside in the Intensive Care Unit

  • Lee, Hongyeul;Leem, Cho Sun;Lee, Jae Ho;Lee, Choon-Taek;Cho, Young-Jae
    • Tuberculosis and Respiratory Diseases
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    • v.77 no.4
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    • pp.193-196
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    • 2014
  • Acute airway obstruction after hemoptysis occurs due to the presence of blood clots. These conditions may result in lifethreatening ventilation impairment. We report a case of obstruction of the large airway by endobronchial blood clots which were removed using bronchoscopic cryotherapy at the bedside of intensive care unit. A 66-year-old female with endometrial cancer who had undergone chemotherapy, was admitted to the intensive care unit due to neutropenic fever. During mechanical ventilation, the minute ventilation dropped to inadequately low levels and chest radiography showed complete opacification of the left hemithorax. Flexible bronchoscopy revealed large blood clots obstructing the proximal left main bronchus. After unsuccessful attempts to remove the clots with bronchial lavage and forceps extraction, blood clots were removed using bronchoscopic cryotherapy. This report shows that cryotherapy via flexible bronchoscopy at the bedside in the intensive of intensive care unit is a simple and effective alternative for the removal of endobronchial blood clots.

The Educational Needs and Perception of the Mothers of High Risk Infant and Normal Neonate (정상 신생아 어머니와 고위험 신생아 어머니의 신생아에 대한 지각 및 교육요구도 비교)

  • Lee Mee-Ja;Suh Hyun-Sun;Hong Yoo-Hee;Kim So-Yeon;Yoo Eun-Joo;Park Song-Ja
    • Child Health Nursing Research
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    • v.9 no.1
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    • pp.18-27
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    • 2003
  • The purpose of this study is to compare the educational needs and perception of mothers of normal neonates and high risk infants. This research was designed as a descriptive study. Data were collected for two months from April 2002 to March 2002. Subjects were 41 mothers of high risk infants and 60 mothers of normal neonates in one general hospital in Seoul participated in the study. Measurement tools used in this study were the educational needs scale developed by Cho Kyoul Ja et al and the neonatal perceptive inventories scale developed by Broussard. They ask mothers to rate each item on a four point Likert type scale. The collected data were analyzed using SPSS 8.0 program. The variables were listed as frequency, mean, standard deviation, X2 test, t-test, ANOVA. The results were as follows: The educational needs of the mothers of primi pregnancy was higher than the mothers of multi pregnancy. The educational needs on management of diseases such as prevention of infection, symptoms of disease, mental development, attachment promotion, congenital metabolism test, management of convulsion, care of vomiting and fever were higher than general care of infants such as immunization, measurement of temperature, hiccough care, follow up care. The informations must be included in nursing intervention program to reduce the mothers' stress level. In conclusion, in order to promote positive mother infant relationship, nurse need to give information and educate the mothers of high risk infant and normal neonate.

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An Integrative Review of Family Interventions based on a Philosophy of Family-Centered Care in Neonatal Intensive Care Units (신생아중환자실에서의 가족중심돌봄 기반 가족중재연구에 대한 통합적 문헌고찰)

  • Chung, Nary;Kim, Yeseul;Park, Eunyoung;Yeo, Lisa;Hwang, Jiwon
    • Perspectives in Nursing Science
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    • v.16 no.1
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    • pp.35-44
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    • 2019
  • Purpose: The aim of this study is to analyze the characteristics of family interventions based on a philosophy of family-centered care conducted in neonatal intensive care units through an integrative literature review. Methods: We searched the PubMed, CINAHL, RISS, KISS, and DBpia databases; a total of 20 studies, published between January 2013 and May 2018, was selected according to our criteria. Results: Mothers accounted for a greater proportion of participants in family interventions than did fathers. Family interventions described in the studies were categorized into four educational and sixteen non-educational interventions. Among non-educational interventions, skin-to-skin-contact interventions, such as kangaroo care, accounted for the highest proportion. Only one paper employed a theoretical framework. Conclusion: More family interventions based on theoretical frameworks should be conducted as these frameworks serve as guidelines for nursing research. As the stress patterns experienced by parents in neonatal intensive care units showed gender differences, more programs tailored for fathers are needed. Moreover, further research should be conducted to evaluate feasibility as an outcome variable, and studies of family interventions based on a philosophy of family-centered care should be performed more actively in the neonatal intensive care units in Korea.