• 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.

• Journal of Korean Academy of Nursing
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• v.49 no.1
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• pp.36-45
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• 2019

Purpose: The purpose of this study was to identify the characteristics of and risk factors for medical-device-related pressure ulcer (MDRPU) development in intensive care units. Methods: A prospective cohort study design was used, and the participants were 253 adult patients who had stayed in medical and surgical intensive care units. Data were collected regarding the application of medical devices and MDRPU-related characteristics over a period of six months from June to November, 2017. Data were analyzed using independent t-test, ${\chi}^2-test$, Fisher's exact test, and binary logistic regression analysis with the SPSS 21.0 program. Results: Among the 253 participants, MDRPUs occurred in 51 (19.8%) participants. The results of the logistic regression analysis showed that the risk factors for MDRPUs were the use of endotracheal tubes (OR=5.79, 95% CI: 1.66~20.20), having had surgery (OR=2.95, 95% CI: 1.11~7.77), being in a semi-coma/coma (OR=5.79, 95% CI: 1.04~32.05), and sedation (OR=5.54, 95% CI: 1.39~22.19). Conclusion: On the basis of the study results, it is effectively facilitated by nurses when they care for patients with MDRPUs in intensive care units and the results are expected to be of help in preventive education for MDRPU development as well as preparing the base data for intervention studies.

• Journal of Korean Academy of Nursing
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• v.37 no.4
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• pp.586-593
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• 2007

Purpose: The purpose of this study was to describe patients' anxiety in the ICU and to investigate related factors on the anxiety level. Methods: An exploratory cross-sectional survey design was used. Forty-eight patients participated in the study. Questionnaires were asked to patients who had been cared in the ICUs. Results: Related to the anxiety level, the mean of the total anxiety score was 5.47, and 60% of the patients had moderate or severe level of anxiety. Patients from the coronary care unit had a significantly higher level of anxiety than those from surgical intensive care unit or pulmonary surgery care unit. Moreover, significantly different levels of anxiety were found among patients who had been stayed for 2, 3, or 4 days. Conclusion: Patients who were from the coronary care unit or had been stayed longer (up to 4 days) in the ICU were significantly associated with higher anxiety level.

• 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.

• Journal of Chest Surgery
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• v.26 no.5
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• pp.365-372
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• 1993

We analyzed the patients who were admitted to Surgical Intensive Care Unit[SICU] of Kyungpook National University Hospital from January 1987 through December 1991. The results were as followings: The total number of patients for 5 years was 2446 and 1553[63.5%] were male,893[36.5%] were female. The average age was 34.1 years old and the greatest age group was the 1-9 age group.The number of the patients in the Department of Thoracic and Cardiovascular Surgery, which was the highest among all departments,was 1608 [65.7%].Congenital Heart disease was the most common among all diseases.The patients who had undergone any kinds of operations were 89.9% of all patients.The averge stay in SICU was 5.2 days.The overall mortality rate was 12.1% ,which included hopelessly discharged patients and the highest mortality rate occurred in the patients over 80 years old.The highest cause of death was cardiac problem[30.4%]. The next was sepsis.The proportion of patients who had received a mechanical ventilatory support was 35.7% and 52% of those patients belonged to the department of thoracic and cardiovascular surgery.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.13-22
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• 2010

Purpose: This study was intended to examine the effects of educating the Ventilator-Associated Pneumonia (VAP) control for the nurses working in the intensive care unit (ICU). Methods: The study was conducted using one group pre-post test research design. The education on infection control was provided to 31 nurses working at the medical and surgical ICUs. A comparison was then made in terms of the degree of performing infection control a month before, two weeks after, and three months after the education respectively. The incidences of VAP at the medical and surgical ICUs were compared for 3 months before and after the education. Results: The average performance scores between before and after the education showed statistically significant differences. Compared to three months before, the incidence of VAP after the education was decreased slightly from 5.48 to 1.88 per 1,000 ventilator days. Conclusion: It is necessary to continue the VAP education, specifically on infection prevention and control methods and the consistent evaluation of its effects as well as the development of standardized educational program should be approached extensively in further studies.

• Journal of Neurocritical Care
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• v.11 no.2
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• pp.81-85
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• 2018

Proper glucose management in hospitalized patients can improve clinical outcomes. In particular, intensive care unit (ICU) patients are known to have significantly higher rates of mortality from changes in blood glucose due to severe comorbidities. Improving glucose control in ICU patients, therefore, can improve mortality and prognosis. Several studies related to the management of blood glucose in the ICU patients have been conducted. Intensive glucose management of surgical ICU patients has been successful. However, studies on medical ICU patients did not demonstrate positive effects of strict glycemic control. There is no independent glucose management goal for neurological ICU patients. However, maintenance of the usual glucose control target of 140-180 mg/dL is recommended for ICU patients. Intravenous insulin infusion is essential for glucose control in ICU patients not consuming a regular diet, and caution should be exercised to prevent hypoglycemia.

• Acute and Critical Care
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• v.33 no.4
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• pp.252-259
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• 2018

Background: The aim of this study was to investigate the effects of using a systematic approach to tracheostomy care by a clinical nurse specialist and surgical intensivists for patients with a tracheostomy who were transferred from the surgical intensive care unit (SICU) to the general ward. Methods: In this retrospective study, subjects were limited to SICU patients with a tracheostomy who were transferred to the general ward. The study period was divided into a preintervention period (January 1, 2007 to December 31, 2010) and a postintervention period (January 1, 2011 to December 31, 2014), and electronic medical records were used to analyze and compare patient characteristics, clinical outcomes, and readmission to the SICU. Results: The analysis included 44 patients in the preintervention group and 96 patients in the postintervention group. Decannulation time ($26.7{\pm}25.1$ vs. $12.1{\pm}16.0days$, P=0.003), length of stay in the general ward ($70.6{\pm}89.1$ vs. $40.5{\pm}42.2days$, P=0.008), length of total hospital stay ($107.5{\pm}95.6$ vs. $74.7{\pm}51.2days$, P=0.009), and readmission rate of SICU decreased due to T-cannula occlusion (58.8% vs. 5.9%, P=0.010). Conclusions: Using a systematic approach to tracheostomy care in the general ward led to reduction in decannulation time through professional management, which resulted in a shorter hospital stay. It also lowered SICU readmission by solving problems related to direct T-cannula.

• Journal of Korean Academy of Nursing Administration
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• v.10 no.4
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• pp.449-457
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• 2004

Purpose: This study seeks to identify situations where nurses are required to consider alternatives, for the delivery of nursing care, appropriate to the needs of a medical care unit, surgical care unit, and intensive care unit in a university hospital. Method: Data was collected from 100 nurses using an open questionnaire, during a one week period in May, 2003. These nurses all had at least two years of experience within a medical care unit, surgical care unit, or intensive care unit at a university hospital. Results: The situations that nurses typically faced were categorized into 21 problems for nurses including : respiratory problems(26.8%), pain(23.6%), problems in relation to bowel habit(23.2%). In cases where nurses were faced with making decisions in relation to solving respiratory problems, the alternatives included ; applying oxygen(29.3%), physical assessment and monitoring(14.7%), refining and modifying order and suggestion order(9.3%). Ventilator care(9.3%), was chosen to solve pain problems ; doing pm orders(30.3%), placebo medication(27.3%), and to refine and modify orders and suggestions(18.2%). To solve problems in relation to bowel habits ; enemas accounted for 32.3%, and laxative medication 30.8%. Conclusion: To improve the quality of nursing, the outcome of nursing care associated with 21 problems for nurses including : respiratory problems, pain, and problems in relation to bowel habit, should be identified and the best alternative nursing care should be developed.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.37-48
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• 2010

Purpose: The purpose of this study was to examine the frequency and the course of delirium, and identify risk factors for the development of delirium in surgical intensive care unit (SICU). Methods: Subjects older than 19 years admitted to the SICU were recruited. After informed written consent, enrolled subjects had baseline cognitive and functional assessments. Subjects were assessed daily for delirium using the Confusion Assessment Method-ICU (CAM-ICU). Results: During the study period, 110 patients were enrolled. The overall incidence of delirium was 20% (22/110). The average time to onset of delirium was 3.04(${\pm}1.25$) days. Several variables were associated with an increased risk of delirium including older age (p<.05), higher admission APACHE II score (p<.001), use of opioid and analgesics (p<.01), using physical restraints (p<.001), and intraoperative hypotension (p<.05). In a multivariate logistic regression model, using physical restraints (p<.001), intraoperative hypotension (p<.05), and older age (p<.05) remained significant predictors of the delirium development. Conclusion: Using physical restraints, intraoperative hypotension and older age was strongly associated with development of delirium in the SICU. Prevention measures need to focus on identifying patients at higher risk for delirium development.