• Child Health Nursing Research
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• v.25 no.1
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• pp.38-47
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• 2019

Purpose: The purpose of this study was to investigate the influence of perceptions of death, end-of-life (EOL) care stress, and emotional intelligence on attitudes toward EOL care among nurses in the neonatal intensive care unit (NICU). Methods: The participants were 111 nurses working in a NICU who had experienced EOL care at least once. Data were analyzed using the t-test, Pearson correlation coefficient, and stepwise multiple regression analysis in SPSS for Windows. Results: The mean score for perceptions of death was 3.16 out of 5, the mean score for EOL care stress was 3.61 out of 5, the mean emotional intelligence score was 4.66 out of 7, and the average score for EOL care attitudes was 2.77 out of 4. The factors affecting attitudes towards EOL care were academic degree, anxiety regarding death, negativity towards death, experiences of patient death, and emotional intelligence. The explanatory power of these variables for attitudes towards EOL care was 24.7%. Conclusion: The results of this study are expected to serve as a basic reference for the development of nursing education programs and EOL care protocols to improve attitudes toward EOL care among NICU nurses.

• Pediatric Infection and Vaccine
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• v.9 no.2
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• pp.163-174
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• 2002

Background : To delineate the changes in the causative agents of neonatal sepsis and their antimicrobial susceptibilities in the neonatal intensive care unit and nursery of Hanyang University Hospital during the past 10 years. Methods : Hospital records of 15,144 patients hospitalized at the NICU and nursery of Hanyang University Hospital from 1989 to 1998 were reviewed and neonates diagnosed of neonatal sepsis were sorted and included in the study. The study period was divided into Period A(the first 5 years) and Period B(the second 5 years) to analyse causative agents and their antimicrobial susceptibilities. Results : Neonatal sepsis was diagnosed in 170 patients(1.1%{Period A 1.2%, Period B 1.0%}) among the total of 15,144 inpatients. Two hundred isolates(Period A 109 isolates, Period B 91 isolates) were identified in 186 blood cultures(Period A 99 cultures, Period B 87 cultures) from 170 patients(Period A 91 patients, Period B 79 patients). The average age at the onset of the disease, when the initial blood culture was drawn, was 12.3 days old(Period A 8.8 days, Period B 16.3 days), and the proportion of the early onset disease was 34.7% in Period A and 23.0% in Period B, indicating that neonatal sepsis developed earlier during Period A. Among the isolated organisms including Gram positive bacteria[132(66.0%)], Gram negative bacteria [60(30.0%)], and fungi[8(4.0%)], coagulase negative Staphylococcus(CNS) was the most common organism(69/34.5%), followed by Staphylococcus aureus(36/18.0%), Klebsiella pneumoniae(17/8.5%), Enterococcus(12/6.0%), Enterobacter cloacae(8/4.0%), Escherichia coli(6/3.0%), and Pseudomonas aeruginosae(5/2.5%). The isolated fungi were Candida parapsilosis, Candida albicans, and Trichosporon pullulans. CNS, S. aureus and Acinetobacter baumannii were isolated more frequently in Period A compared to Period B. Antimicrobial susceptibilities of CNS and S. aureus to methicillin and the first generation cephalo sporins were decreased in Period B compare to Period A, those to aminoglycosides were increased in Period B, and vancomycin resistant strains were not identified. K. pneumoniae, Enterococcus, E. coli, and P. aeruginosa were isolated less frequently in Period B, compared to Period A. For K. pneumoniae, antimicrobial susceptibilities to the first generation cephalosporins were low in both Periods A and B, those to tobramycin and gentamicin were increased in Period B, and those to amikacin, ceftriaxone, and trimethoprim-sulfamethoxazole were high in both Periods A and B. Antimicrobial susceptibilities of Enterococcous to ampicillin, penicillin, and the first generation cephalosporins were decreased in Period B, but vancomycin resistant strains were not identified. Conclusion : The occurrence rate of neonatal sepsis during the past 10 years in the NICU and nursery of the Hanyang University hospital was 1.1%, and the most common causitive agents were CNS and S. aureus, to which the antimicrobial susceptibilities to the first line drugs decreased in the later half of the study period with no vancomycin resistant isolates identified. Group B Streptococcus known to be the most common agent causing neonatal sepsis was not identified, and K. pneumoniae was isolated more commonly during the later half of the study period without decreased antimicrobial susceptibilities.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.1
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• pp.115-126
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• 2011

Purpose: This study was done to identify differences in work environment, work stress, turnover intention and burnout and investigate the relationship among these variables in nurses in Korean Neonatal Intensive Care Units. Method: Participants were 242 nurses working in 13 general hospitals. Burnout was measured by the Maslach Burnout Inventory (MBI), work stress with the instrument by Gu & Kim (1994), and turnover intention with the scale by Kim & Lee (2001). Size of the NICU, nurse to patient ratio, and communication satisfaction were included in work environment. Data were analyzed using Pearson correlation coefficients and multiple regression analysis with SPSS WIN program. Results: The mean score for work stress in NICU nurses was 3.43 points, for burnout, 2.72 points, and for turnover intention, 4.64 points. Burnout and turnover intention level of participants were moderate-high. Work stress, communication dissatisfaction with physician, and clinical career accounted for 33% of variance in burnout. Significant differences were found between size of NICU and staffing related to environmental characteristics in turnover intention and burnout. Conclusions: Results indicate that effective communication with coworkers and institutional support for appropriate staffing according to number of beds will help to prevent work stress, burnout, and ultimately, nurses' resignations.

• Korean Journal of Digital Imaging in Medicine
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• v.3 no.1
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• pp.20-23
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• 1997

The purpose of this paper is to describe the transition of a 1,100 beds teritary hospital from 50% softcopy operation to full PACS operation. For the past 2 years, radiologists and clinicians have been using PACS to provide softcopy services to the outpatient clinics and inpatient wards of orthopedics surgery, neurosurgery and neurology as well as emergency room, surgical intensive care unit, medical intensive unit, pediatrics intensive care unit and neonatal intensive care unit. The examinations requested by these departments account for about 50% of hospital's radiological exams. In September 1996, we began the second phase of PACS implementation and installed additional workstations (102) in the remaining wards and clinics, interfaced to PACS additional imaging modalites, and increased the capacity of both the image server (256 Gbytes) and optical juke boxes (3 Tbytes). As of January 1997, we are in the final phase of moving away from conventional film system to full PACS operation.

• Neonatal Medicine
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• v.18 no.2
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• pp.337-344
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• 2011

Purpose: To report our experience of gastrointestinal operations performed in neonates including low birth weight infants and to evaluate their clinical characteristics. Methods: We retrospectively reviewed the medical records of patients who underwent neonatal gastrointestinal surgery or had necrotizing enterocolitis (NEC) or inguinal hernia from January 2008 to December 2010 at Pusan National University School of Medicine. Results: The main disease was anorectal malformation and male patients were dominant. Twenty four patients (19.2%) had one or more associated anomalies including hydronephrosis and congenital heart disease. Eighteen patients (43.9%) of anorectal malformation had other anomalies. Seventy six percent of NEC cases were very low birth weight infants. Concerning mean days of full enteral feeding after operation, NEC patients needed 30.8 days, which was the longest period. Overall mortality of operation (except NEC and inguinal hernia operation) was 1.6%. The mortality of NEC with surgical treatment was 18.8%. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC patients. Conclusion: The morbidity and mortality after neonatal gastrointestinal surgery were excellent. The direct bilirubin in the operation group was significant higher than in the non-operation group in NEC.

• Pediatric Infection and Vaccine
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• v.30 no.1
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• pp.12-19
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• 2023

Purpose: Sepsis is the most common cause of neonatal death accounting for 30-50% of mortality annually in developing countries. This study was to determine the prognostic factors of neonatal sepsis mortality. Methods: A retrospective cohort was conducted in Dr. R. Sosodoro Djatikoesoemo Governor Hospital from April 2021 to September 2021 on 121 neonates in the neonatal intensive care unit (NICU) diagnosed with sepsis. The inclusion criteria were neonates aged 0-28 days, admitted to the NICU, and diagnosed with sepsis. The exclusion criteria were incomplete data and the presence of congenital abnormalities. A χ² test was performed on the sex, gestational age, mode of delivery, birth weight, APGAR score, birthplace, and blood culture. A normality test was performed on leukocytes, lymphocytes, neutrophils, platelets, C-reactive protein (CRP), and length of stay. Then performed a Mann-Whitney test. Results: Birth weight (P=0.038), gestational age (P=0.009), and blood culture (P=0.014) showed a significant relationship with the neonatal sepsis outcome while Mann-Whitney test showed significant differences in the platelets (P=0.018), CRP (P=0.002), and length of stay (P<0.001). Multivariate analysis showed that 3 prognostic factors associated with neonatal sepsis mortality were prematurity (odds ratio [OR], 3.906; 95% confidence interval [CI], 1.344-11.356; P=0.012), low birth weight (LBW, OR, 2.833; 95% CI, 1.030-7.790; P=0.044), and gram-negative bacteria (OR, 4.821; 95% CI, 1.018-22.842; P=0.047). Conclusions: Prematurity, LBW, and gram-negative bacteria were associated with the prognostic factors of neonatal sepsis.

• Journal of Korean Critical Care Nursing
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• v.4 no.1
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• pp.25-35
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• 2011

Purpose: The purpose of this study was to evaluate the actual outcomes of early discharge program for extremely low birth weight (ELBW) infants. Methods: Medical records of 122 ELBW infants admitted in the neonatal intensive care unit from January 2000 to June 2006 and those of their 112 mothers were analyzed retrospectively. Results: After being applied early discharge program to ELBW infants' mothers, their infants' lengths of stay, gestational age and body weight at discharge, duration of completion of oral feeding, number of emergency room visits after discharge were decreased and number of breast milk feeding was increased. Conclusion: Early discharge program for ELBW infants can be an effective intervention for parents and their ELBW infants contributing to neonatal nursing practices.

• Child Health Nursing Research
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• v.23 no.2
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• pp.179-189
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• 2017

Purpose: The purpose of this study was to investigate NICU nurses' nursing interventions for pain and factors affecting nursing interventions for pain. Methods: Participants were 120 NICU nurses from 5 university hospitals located in Daejeon Metropolitan City and Chungcheong Province. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA and Duncan test, Pearson correlation coefficients and multiple regression analysis with SPSS Windows 23.0 IBM program. Results: The factors affecting nursing interventions for pain included knowledge about non-pharmacological nursing interventions for pain and self-efficacy about nursing interventions for pain. These variables explained 28.3% of nursing interventions for pain. Conclusion: The results of this study suggest that it is necessary to develop education programs in which effective nursing interventions for neonatal pain are considered. The programs should be made available to NICU nurses.

• Journal of Korean Clinical Nursing Research
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• v.22 no.2
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• pp.205-216
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• 2016

Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Neonatal care nurses (KPCSN). Methods: The study was conducted in tertiary and general hospitals with 1~2 grade according to nursing fee differentiation policy for NICU (neonatal intensive care unit) nurse staffing. The reliability was evaluated for the classification of 218 patients by 10 nurse managers and 56 staff nurses working in NICUs from 10 hospitals. To verify construct validity, 208 patients were classified and compared for the type of stay, gestational age, birth weight, and current body weight. Nursing time was measured by nurses, nurse managers, and nurse aids. For the calculation of conversion index (total nursing time divided by the KPCSN score), 426 patients were classified using the KPCSN. Data were collected from September 5 to October 28, 2015, and analyzed using t-test, ANOVA, intraclass correlation coefficient, and non-hierarchial cluster analysis. Results: The final KPCSN consisted of 11 nursing categories, 71 nursing activities and 111 criteria. The reliability of the KPCSN was r=.83 (p<.001). The construct validity was established. The KPCSN score was classified into four groups; group $1:{\leq}57points$, group 2: 58~80 points, group 3: 81~108 points, and group $4:{\geq}109points$ in the KPSCN score. The conversion index was calculated as 7.45 minutes/classification score. Conclusion: The KPCSN can be utilized to measure specific and complex nursing demands for infants receiving care in the NICUs.

• The Korean Journal of Food & Health Convergence
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• v.6 no.3
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• pp.23-29
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• 2020

Blood transfusion in the neonatal period remains a therapeutic act, that no one dares to consider it as perfectly innocuous and that it is advisable to make rare, considering its risks as well immunological as infectious. The present work is a retrospective study, conducted in neonatal intensive care unit, in the University Hospital MOHAMED VI, Marrakech, during the period from January 1^st to December 31^st, 2019. All newborns were included in this work, who received one or multiple transfusions of red blood cells (RBC). Our study covered 60 neonates with a total of birth: 794 neonates, with a prevalence of 7.55%, hospitalized for various indications (60% of newborns were at term, 31.7% premature and 8, 33% were post-mature. The majority of transfusion procedures were performed during the first week of life. This is explained by the frequency of haemolytic anemias by fœto-maternal incompatibility. The main indications for transfusion were haemolysis, anemic syndrome and haemorrhagic syndrome. The average number of transfusion episodes was 1.95 +/- 1.47 per patient. Newborns were polytransfused in 18.33% of cases. A single transfusion accident was found in our study. However, we did not observe a correlation between the maternal diseases, the state of the newborn, and the transfusional indication.