• Journal of Korean Academy of Fundamentals of Nursing
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• v.23 no.2
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• pp.172-183
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• 2016

Purpose: The purpose of this study was to explore the subjective experience of life-sustaining treatment care among nurses in intensive care units. Method: A phenomenology was used for the study. Data were collected from October to December, 2015 using open-ended questions during in-depth interviews. Participants were nurses working in intensive care units and were contacted through purposive techniques. Eight nurses participated in this study. Results: Four categories emerged from the analysis using Colaizzi's method: (a) difficulties due to life-sustaining treatment care, (b) dilemma of extension or cessation of life-sustaining treatment, (c) repressed feelings and emotional exhaustion, and (d) forming values for life-sustaining treatment from nursing experience. Conclusion: Provision of clearer guidelines on life-sustaining treatment which reflect a family-oriented culture is important for nurses in ICU and will promote nurses involvement in the decision-making process of life-sustaining treatment of patients.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.17 no.4
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• pp.478-486
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• 2010

Purpose: To explore nurses' compliance with standards for critical care nursing practice in intensive care units (ICUs) and to provide basic data for high quality of critical care nursing. Method: A total of 616 participants from 61 ICUs which are graded from 1 to 7 throughout the nation were surveyed. Data were collected from February 9 to February 27, 2009 using a questionnaire consisting of 58 questions including 50 nursing activities as indicators. Results: The rate of ICU nurses' compliance with standards for critical care nursing practice was high. As for individual standards, compliance with the standard of assessment was the highest, followed by implementation, diagnosis, and planning in that order. There were differences in compliance according to nurses' ICU experience, work place (unit), and ICU grade. A shortage of manpower was considered as a main cause for noncompliance. Conclusion: The present compliance rate with standards for critical care nursing practice by ICU nurses was identified. Therefore, compliance rate can be used to promote quality of critical care nursing and development of educational programs for ICU nurses.

• Journal of Korean Critical Care Nursing
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• v.11 no.1
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• pp.89-100
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• 2018

Purpose : The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO). Method : Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized. Results : The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %. Conclusion : The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.

• Journal of Korean Critical Care Nursing
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• v.10 no.2
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• pp.56-70
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• 2017

Purpose: This study was conducted to identify ICU nurses' knowledge of the five moments of hand hygiene and the ambiguity of these moments when demonstrating hand hygiene. Methods: The subjects were 200 intensive care unit nurses at a university hospital. Data was collected using self-report questionnaires, translated according to the instructions of training films developed by WHO, and analyzed using descriptive statistics and ranking tests. Results: The highest number of correct answers was regarding the moment before contact with a patient and the lowest was regarding the moment after contact with a patient. The rate of providing wrong answers regarding required moments of hand hygiene was high. Conclusion: The study identified ICU nurses' knowledge of specific moments of hand hygiene; they had difficulty differentiating between the moments that happened simultaneously, i.e. after touching a patient, and that patient's surroundings, and there was ambiguity concerning patient areas and medical treatment areas. It was concluded that it is necessary to educate nurses regarding both required and unrequired moments of hand hygiene and to ensure that they can distinguish between these moments.

• Child Health Nursing Research
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• v.28 no.2
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• pp.142-153
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• 2022

Purpose: Preventing missed care is important in neonatal intensive care units (NICUs) due to neonates' vulnerabilities. This study examined missed care and its influencing factors among NICU nurses. Methods: Missed care among 120 Korean NICU nurses was measured using a cross-culturally adapted online questionnaire. The frequency of missed care for 32 nursing activities and the significance of 23 reasons for missed care were collected. Results: All participants had missed at least 1 activity, missing on average 19.35 activities during a typical work-day. The most common missed item was "provide developmental care for the baby". The most common reason for missed care was "emergency within the unit or deterioration of one of the assigned patients". The final regression model explained 9.6% of variance in missed care. The average daily number of assigned patients receiving inotropes or sedation over the last month influenced the total number of missed care items. Conclusion: Missed care was affected by nurses' workload related to the number of patients taking medication. Frequently missed activities, especially those related to developmental care, require patience and time, conflicting with safety prioritization and inadequate working conditions. NICU nurses' working conditions should be improved to ensure adequate time for nursing activities.

• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.14-28
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• 2020

Purpose: The purpose of this study was to calculate the total daily nursing workload and the optimum number of nurses per intensive care unit (ICU) based on the nursing intensity and the direct nursing time per inpatient using the patient classification. Methods: Two ICUs at one general hospital were investigated. To calculate the nursing intensity, patient classification according to the nursing needs was conducted for 10 days in each unit during September 2018. We performed patient classifications for a total of 167 patient-days in the Medical Intensive Care Unit (MICU) and 86 patient-days in the Surgical Intensive Care Unit (SICU). The total number of person-days for nurses who responded to the Nursing Time survey was 151 for MICU and 85 for SICU. In each unit, direct and non-direct nursing hours, nursing intensity score, and direct nursing hours were analyzed using descriptive statistics such as frequency, percentage, and average calculated using Microsoft Excel. The amount of nursing workload and the optimum number of nurses were calculated according to the formula developed by the authors. Findings: For the MICU, the average direct nursing time per patient was 5.59 hours for Group 1, 6.98 hours for Group 2, and 9.28 hours for Group 3. For the SICU, the average direct nursing time per patient was 5.43 hours for Group 1, 7.21 hours for Group 2, 9.75 hours for Group 3, and 12.82 hours for Group 4. Practical Implications: This study confirmed that the appropriate number of nurses was not secured in the nursing unit of this study, and that leisure time such as meal time during nursing work hours was not properly guaranteed. The findings suggest that to create working environments where nurses can serve for extended periods of time without compromising their professional standards, hospitals should secure an appropriate number of nurses.

• Journal of Korean Critical Care Nursing
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• v.8 no.2
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• pp.13-22
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• 2015

Purpose: This study identified the current status and perception of intensive care unit nurses' handover. Methods: A cross sectional descriptive survey was employed. The population included nurse managers and staff nurses who worked in intensive care units in hospitals with more than 500 beds and excluded nursing homes, psychiatric hospitals, and military hospitals. Results: Of the nurses, 61.7% were satisfied with the current handover method, 68.36% had no handover-related guidelines, and 83.2% of them perceived that the handover was important for patients' safety. The most frequent cause for errors related to handover was that the "nursing workload is heavy." The nurses perceived that their handover was informative ($5.62{\pm}0.79$) and efficient ($5.04{\pm}0.98$). The variables associated with their perception of the handover were the level of satisfaction with the current handover method, existence of handover guidelines, and importance of handover for patient safety. Conclusion: The development of standardized handover guidelines, especially for intensive care units, is necessary to reduce handover time and errors and to improve handover quality for patients'safety and high standards of nursing care.

• Journal of Korean Critical Care Nursing
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• v.17 no.1
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• pp.17-29
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• 2024

Purpose : This study sought to investigate novice nurses' communication education needs in the intensive care unit (ICU) using Importance-Performance Analysis (IPA) and Borich's need assessment model. This study identified communication challenges in clinical settings to develop a simulation program that enhances communication competencies based on educational requirements. Methods : A descriptive research design and a self-report questionnaire were used. The latter was developed and administered to 121 novice nurses with less than one year of experience in the ICU at various university hospitals in Korea. Data were collected via the online open chatroom from June 24th to July 28th, 2023. The communication education needs were identified using descriptive statistics, t-tests, IPA, and Borich's needs assessment model. Text analysis was used to categorize the participants' communication experience. Results : The results revealed that "communication with physicians," "communication with patients," and "communication with nurse on another shift" domains contained the most substantial educational needs for novice nurses working in the intensive care units. Conclusion : The results provide fundamental data for developing and enhancing customized communication education programs for novice ICU nurses. This valuable information could help ICU nurses and educators improve new nurses' communication skills, which would ultimately contribute to the advancement of nursing education and clinical practice.

• Child Health Nursing Research
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• v.27 no.3
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• pp.297-307
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• 2021

Purpose: This descriptive study compared the perceived parental stress levels between parents with very low birth weight infants (VLBWIs) and nurses in the neonatal intensive care unit (NICU). Methods: In total, 83 parents of VLBWIs and 78 NICU nurses were enrolled. Data were collected with the Parental Stress Scale (PSS) and analyzed using the t-test and analysis of variance in SAS version 9.4. Results: The average PSS score was 3.31 among parents and 3.45 among nurses. The stress score was significantly higher among nurses with children (t=2.46, p=.016) and senior nurses (t=2.12, p=.037). There was a significant difference in the stress score according to parents' education (t=3.29, p=.002) and occupation (F=3.14, p=.049) in the sights and sounds subscale. Mothers had significantly higher stress scores than fathers in the parental role alterations subscale (t=2.32, p=.023). Parental stress scores were higher than those perceived by nurses in the infant's appearance and behaviors subscale for breathing patterns (t=2.95, p=.004), followed by jerky/ restless behavior (t=2.70, p=.008). Conclusion: Nurses should provide explanations to parents of VLBWIs in order to reduce parental stress about the appearances and behavior of VLBWIs. This is more important than aspect of the NICU environment and education about parental roles.

• Journal of Korean Critical Care Nursing
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• v.17 no.1
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• pp.1-16
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• 2024

Purpose : This study aimed to explore and describe intensive care unit (ICU) nurses' experience of clinical adaptation. Methods : The participants were 14 ICU nurses with more than two years of working experience in the ICU. Data were collected through in-depth individual interviews conducted between July and October 2021. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using the Strauss and Corbin method. Results : A total of 79 concepts, 37 subcategories, and 16 categories were identified through open coding. Axial coding based on the paradigm model revealed that the central phenomenon was "The harsh adversity faced in the nursing field where life and death are determined" and the core category was "Enduring the adversity of caring for critically ill patients and achieving self-realization." ICU nurses' clinical adaptation process was explained in five phases: "confrontation period," "turbulent period," "seeking period," "struggling period," and "stabilized period." The five phases that affect interventional conditions were "Support from reliable people," "Recognition of administrative and financial support." Conclusion : This study provided novel insights for a comprehensive understanding of ICU nurses' clinical adaptation processes. Furthermore, the findings are expected to be used as basic data to develop multifaceted strategies to help ICU nurses' adaptation to critical care.