• Title, Summary, Keyword: 중환자실

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Development of the Kangaroo Care Protocol and its Effect on Premature Infants (미숙아를 위한 캥거루케어 프로토콜 개발 및 적용 효과)

  • Lee, Eun Jung;Kim, Eun Sook;Lee, You Na;Park, So Hyun;Lee, Gum Moon;Yi, Young Hee
    • Journal of Korean Clinical Nursing Research
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    • v.20 no.3
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    • pp.313-325
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    • 2014
  • Purpose: This study aimed to develop the protocol of kangaroo care for premature infants and to evaluate its effects including physiologic responses of premature infants, their parents'anxiety, and neonatal nurses'perception regarding the kangaroo care. Methods: Kangaroo care protocol was developed through a literature review and validation of an expert group. The developed kangaroo care protocol was tested with 27 preterm infants, 24 parents, and 60 nurses in one neonatal intensive care unit in S hospital. Data were collected from December 2012 to February 2013 and analyzed by descriptive statistics and t-test using the SPSS/Win statistical program. Results: Physiologic responses including heart rate, respiration rate, oxygen saturation, body temperature among premature infants received the kangaroo care were maintained within normal limit. The anxiety levels of the parents who provided kangaroo care for their infants were significantly decreased as it was compared before and after care (t=3.43, p=.002). There were no significant differences in nurses'perceptions about kangaroo care before and after the application of the protocol. Conclusion: The developed kangaroo care protocol is proved to be effective and can be used safely in nursing practice.

The Effects of an Advanced Cardiac Life Support Simulation Training Based on the Mastery Learning Model (완전학습 모델을 기반으로 한 시뮬레이션 훈련이 전문심장소생술 습득에 미치는 효과)

  • Kwon, Eun Ok;Shim, Mi Young;Choi, Eun Ha;Lim, Sang Hee;Han, Kyoung Min;Lee, Eun Joon;Chang, Sun Ju;Lee, Mi Mi
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.1
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    • pp.126-135
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    • 2012
  • Purpose: This study was aimed to develop a simulation training program of an advanced cardiac life support (ACLS) based on the mastery learning model (Simulation-MLM), and evaluate the effects of the program on critical care nurses. Methods: As an experimental pre-post test with a non-equivalent control group, the study employed convenience sampling of 38 critical care nurses. The experimental group received the Simulation-MLM including a theoretical lecture, formative evaluation, and simulation training, whereas only a theoretical lecture for the control group. The knowledge, self-efficacy, and performance degrees of respondents were measured to verify the effects of the Simulation-MLM. The statistical processing of the collected data utilized the SPSS WIN 17.0 program. Results: After receiving Simulation-MLM, the participants in the experimental group reported higher marks in the knowledge, self-efficacy and performance of ACLS compared with those in the control group. However, both experimental and control groups demonstrated no significant differences in knowledge, self-efficacy and performance. Conclusion: Despite of the limitation of a small sample size, this study was considered meaningful in a sense that it showed a venue for improving ACLS training efficiency. Future research with more distinct treatment differentiation and better adequate outcome variables was warranted in order to prove the effects of a theory-based simulation education.

Effects of a Home-based Discharge Program for Mothers of Premature Infants on Oxygen Therapy at Home (산소요법 적용 미숙아 어머니에 대한 재가 돌봄 퇴원프로그램 효과)

  • Lee, Ji-Min;Oh, Soon-Ja;Kim, Kyung-A;Lee, Eun-Jung;Lee, Ji-Yoon;Hwang, Moon-Sook;Kim, Jung-Sook
    • Child Health Nursing Research
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    • v.16 no.2
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    • pp.144-155
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    • 2010
  • Purpose: This study was done to develop and test a home-based discharge program. Methods: The study design was a pretest-posttest nonequivalent nonsynchronized quasi-experimental design. Participants were mothers of premature infants on oxygen therapy at home. The participants, 49 mothers, were assigned to either the experimental group (24) or control group (25). Data collection was conducted from September, 2008 through February, 2009. Maternal confidence and anxiety were measured using a questionnaire. Chi-square test, t-test and Repeated Measures ANOVA were used to analysis the data. Results: Two hypotheses, "Maternal confidence in the experimental group will be higher than that of the control group" and "Perceived anxiety level in the experimental group will be lower than that of the control group", were set up and both hypotheses were supported as there was a statistically significant difference between the two groups. Conclusion: It suggests that the discharge program developed in this study is an efficient intervention method to boost maternal confidence of the mothers with premature infants and to decrease their anxiety; therefore, this program is expected to be of use in nursing interventions.

Risk Factors of Delirium Among the Patients at a Surgical Intensive Care Unit (일 종합병원 외과계 중환자실 환자의 섬망 발생 요인)

  • Chun, You Kyoung;Park, Jeong Yun
    • Journal of Korean Critical Care Nursing
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    • v.10 no.3
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    • pp.31-40
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    • 2017
  • Purpose : This study examined the prevalence of delirium-related factors in a surgical intensive care unit (SICU). Methods : This retrospective study enrolled 73 patients who were admitted to an SICU from October 1, 2016 to March 20, 2017 and who had been hospitalized for more than 72 hours. Data was collected by reviewing electronic medical records. Results : Delirium occurred in 46 (63.0%) patients. Its related factors were age, education, mechanical ventilator, sleep, narcotics, physical restraint, and central line catheters. Conclusion : The results indicate that sleep and physical restraint are significant factors related to delirium occurrence. The results of this study can help in developing guidelines for the prevention of delirium.

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Path Analysis of Performance of Multidrug-Resistant Organisms Management Guidelines among Intensive Care Unit Nurses : With Focus on the Theory of Planned Behavior and Patient Safety Culture (중환자실간호사의 다제내성균 감염관리지침 수행에 영향을 미치는 요인에 관한 경로 분석 ; 계획된 행위이론과 환자안전문화를 중심으로)

  • Gu, Ji Eun;Ha, Yi Kyung;Hwang, Su Ho;Gong, Kyung Hee
    • 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.

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.

Post-intensive Care Syndrome and Quality of Life in Survivors of Critical Illness (중환자실 퇴원환자의 집중치료 후 증후군과 삶의 질)

  • Kim, Soo Gyeong;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.9 no.1
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    • pp.1-14
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    • 2016
  • Purpose: To investigate the post-intensive care syndrome (PICS) and to analyze the factors affecting the quality of life (QoL) of survivors of critical illness. Methods: Subjects were 114 outpatients who had been discharged from intensive care units of a university hospital in B city, Korea. From July 30 through September 30, 2015, PICS was assessed using the Korean Montreal Cognitive Assessment, Hospital Anxiety-Depression Scale, Korean Instrumental/Activities of Daily Living (K-I/ADL) index, and handwriting transformation, while physical and mental health-related QoL was measured using the SF-12. Results: Of the subjects, 39.5% were screened for mild cognitive disorder and 23.7% experienced handwriting transformation after discharge. Multiple regression analysis revealed that restraint application, current job, time of ${\geq}36$ months after discharge, depression, anxiety, and handwriting transformation accounted for 40.9% of the physical health-related QoL, and depression, anxiety and experience of delirium accounted for 62.4% of the mental health-related QoL. Conclusions: It is necessary to make efforts to reduce restraint application in intensive care units and prevent the occurrence of delirium, with the objective of reducing PICS and improving the QoL of critical illness survivors.

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Impact of Environmental Stressors on the Risk for Posttraumatic Stress Disorder and Quality of Life in Intensive Care Unit Survivors (중환자실 환자의 환경적 스트레스 요인이 외상후 스트레스장애 위험도와 삶의 질에 미치는 영향)

  • Cha, Hyo-Jung;Ahn, Sukhee
    • Journal of Korean Critical Care Nursing
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    • v.12 no.1
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    • pp.22-35
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    • 2019
  • Purpose : This study was to determine the levels of environmental stressor, posttraumatic stress disorder, and quality of life in intensive care units (ICU) survivors after intensive care, and to explore the factors affecting posttraumatic stress disorder and quality of life. Methods: With a longitudinal survey design, data were collected from 116 patients who were discharged from the ICU of a university hospital. The environmental stressor, posttraumatic stress disorder, and quality of life were measured immediately following and 1 month after the ICU discharge. Results: Of all the subjects, 16.4% experienced posttraumatic stress disorder after discharge. Multiple regression analysis revealed that ICU environmental stressors, experience of ICU readmission, using psychotropic drugs and narcotic analgesics, and ICU admission after surgery or cardiac intervention accounted for 22.2% of posttraumatic stress disorder. Posttraumatic stress disorder and sedation status when entering ICU accounted for 28.3% of the quality of life 1 month after ICU discharge. Conclusion: Nursing interventions focused on ICU environmental stressors would not only reduce environmental stress but also contribute to the reduction of posttraumatic stress disorder and later improvement of quality of life.

Changes in Limb Circumferences among Intensive Care Unit Patients and Related Factors (중환자실 환자의 입원기간에 따른 사지 둘레 변화 및 관련요인)

  • Shin, Hye Eun;Kang, Jiyeon
    • Journal of Korean Critical Care Nursing
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    • v.9 no.2
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    • pp.13-25
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    • 2016
  • Purpose: This study was conducted to identify changes in limb circumferences among patients admitted to the intensive care unit (ICU) and related factors. Methods: We conducted a prospective observational study with 27 patients from 3 ICUs at a university hospital located in B city of Korea, from September 1 to October 30, 2015. The circumferences of the left and right upper arms, thighs, and lower legs were measured on the first, third, fifth, and seventh days of ICU admission. Information on the related factors was collected from the medical records. The data were analyzed using a linear mixed model method. Results: The limbs circumferences significantly reduced from day 3, and the changes continued till day 7. These changes were related to the gender of the subjects, restraints application, use of steroids, and continuous renal replacement therapy. Conclusions: Based on the above results, it can be concluded that ICU-acquired weakness begins before the third day of admission. Thus, early mobilization protocols for ICU patients need to be developed and implemented in order to improve long-term outcomes.

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Clinical Study of Tracheostomy in Intensive Care Units (중환자실 환자의 기관절개술에 대한 임상적 고찰)

  • 양대석;김성학;김재호;김상윤;추광철
    • Proceedings of the KOR-BRONCHOESO Conference
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    • pp.82-82
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    • 1993
  • Tracheostomy was done to form temporary opening in the trachea, to remove secretion, to maintain ventilation and to protect against aspiration. In recent times, with the development of care methods such as low pressure cuff, endotracheal intubation is being combined with tracheostomy in the treatment of patients who are treated long period in the intensive care units and the duration from endotracheal intabation to tracheostomy is like to prolong. To determine the proper time of tracheostomy in the patient in the intensive care units, authors reviewed retrospectively the 96 patients who received the tracheostomy procedure among the 8776 patients who were admitted in the intensive care units of Asan medical center form March 1990 to March 1993, and analyzed the complications of tracheostomy, decannulation and the cause of decannulation failure according to disease, age indication of endotracheal intubation and duration of endotracheal intubation.

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