• Title/Summary/Keyword: Intensive care units

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Palliative Care Models in Intensive Care Units and Nurses' Roles in the Models (중환자실 완화의료 모델과 간호사의 역할)

  • Koh, Chin-Kang
    • Journal of Korean Critical Care Nursing
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    • v.7 no.1
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    • pp.40-46
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    • 2014
  • Purpose: In Korea, about 30,000 people die in intensive care units annually. However, their quality of life at the end-of-life seems very low. The purpose of this study was to describe palliative care models that could be applied in intensive care units and examine nurses' roles in the models. Methods: A conventional literature review was performed focusing on palliative care in intensive care units and nursing roles in the approaches identified. Results: There are two different models regarding the implementation of palliative care approaches in the intensive care unit. Those are the consultative model and the integrative model. Each model has advantages and disadvantages. Therefore, an appropriate model must be chosen according to the setting. Nurses' roles could vary depending on the setting. Conclusion: Palliative care in the intensive care unit is important to improve patients' quality of life. Moreover, nursing roles are important in providing comprehensive palliative care in intensive care units.

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Person-Centered Relational Care Experienced by Critical Care Nurses: An Interpretative Phenomenological Analysis Study (중환자실 간호사가 경험한 사람-중심의 관계 돌봄에 대한 해석 현상학적 분석 연구)

  • Jang, Myoung Sun;Kim, Sungjae
    • Journal of Korean Academy of Nursing
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    • v.49 no.4
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    • pp.423-436
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    • 2019
  • Purpose: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. Methods: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through indepth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. Results: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. Conclusion: The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

A Study on the Spatial Composition and Area Planning of the Intensive Care Units in the Public District Hospitals (지역거점공공의료원 중환자부 공간구성 및 면적계획에 관한 연구)

  • Yun, Woo Yong;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.2
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    • pp.47-61
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    • 2017
  • Purpose: This study aims to suggest the spatial composition and area of the intensive care units through analysis of current situation for the standards establishment of the intensive care units in public district hospitals in the future. Methods: Three Methods have been used in this paper. 1) Literature reviews about composition, location, foreign standards on intensive care units. 2) Comparative analysis on the architectural drawing for the space program and the area. 3) Field survey in order to confirm differences between architectural drawing and current situation. Results: 1) The intensive care units is required to be linked by the operating department, the emergency department and the sterile supply department upon considerations of accessibility of emergency patients and the infection control. 2) The intensive care unit consists of five areas such as the patient area, the medical staff area, the material and equipment area, the patient family area, and the public area. 3) The location of spaces in the intensive care unit is classified by three methods such as connection by view, circulation and connection to corridor. The [table 20] summarizes the type of space and the average size of the space in intensive care unit. Implications: This study is a basic research for guideline of intensive care units, and need to be followed by further study using various perspectives and methods in the future.

Rates for Handwashing Adherence Before and After Nursing Contact in Intensive Care Units (중환자실 간호사의 간호행위 전.후 손씻기 수행율 비교)

  • Kim, Young-Jung;Kim, Hee-Seung;Chang, Yun-Young
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.2
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    • pp.195-200
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    • 2011
  • Purpose: The purpose of this study was to assess rates for handwashing adherence before and after nursing contact in intensive care units (ICU). Methods: The participants included 90 nurses working in intensive care units of an 800-bed university-affiliated hospital in Gyeonggi Province and 2000-bed university-affiliated hospital in Seoul. Time for handwashing was calculated using the average number of handwashings during an 8-hour day shift. Nursing contact was based on indications as defined by the Centers for Disease Control and Prevention (CDC, 2002). Data were analyzed using frequency, percent, t-test and ${\chi}^2$-test. Results: During an 8-hour day shift, the average number of times that hands were washed was 25.0. The rates were significantly lower before the nursing contact than after the nursing contact when it involved sectioning, observation or contact with a wound, cleaning enteric feeding bag, physical exam, use of gloves, or contact with contaminants. Conclusions: The results indicate that as handwashing rates were significantly lower before nursing contacts than after nursing contacts, there is need to develop strategies to address this deficiency in handwashing.

Comparison of Experiences of Ethical Dilemma between Intensive Care Unit and General Unit Nurses regarding Treatment Decisions and Confidentiality (의료처치 및 환자 비밀유지에 대한 중환자실 간호사와 일반병동 간호사의 윤리적 갈등 경험 비교연구)

  • Ko, Chungmee;Koh, Chin-Kang
    • Journal of Korean Critical Care Nursing
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    • v.11 no.3
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    • pp.1-11
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    • 2018
  • Purpose : This study compares experiences of ethical dilemma between nurses working in intensive care units and those in general units under specific situations of treatment decisions and confidentiality. Method : This cross-sectional descriptive study utilizes the self-report survey method. The survey questionnaires were completed by 50 and 52 nurses working in intensive care units and general units, respectively. The instrument, which consisted of 16 items of ethical dilemma situations about treatment decision and confidentiality, was used. The mean scores for each item were compared between the two groups. Results : The study found no differences in terms of age, gender, education level, clinical experience in years, and being educated on healthcare ethics. For 9 out of 16 items, the mean scores of nurses in intensive care units were significantly higher than those of nurses in general units. Conclusions : Nurses in intensive care units experienced ethical dilemmas regarding treatment decisions and confidentiality more often than those in general units. This study emphasizes the need to establish strategies for improving the ethical competence of critical care nurses.

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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A Study on the Architectural Design Guideline for Intensive Care Unit - Focused on Cases of The US, The UK and Australia (중환자부 시설기준 수립을 위한 가이드라인 조사·분석연구 - 미국, 영국, 호주 사례를 중심으로)

  • Yun, Woo Young;Chai, Choul Gyun
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.21 no.4
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    • pp.17-25
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    • 2015
  • Purpose: At the moment, There is a facility standard for intensive care units on the Korea medical services Act. However, the contents of regulation are so limited and difficult to apply. Therefore, it is necessary to draw up the guideline to complement the regulation for efficient operation of intensive care units. This study aims to suggest basic data for guideline of intensive care units. Methods: 2 Methods have been used in this paper. 1) Comparative analysis between the national regulation of Korea with the design standard of the United States America, the United Kingdom and Australia. 2) A literature survey about operation method for intensive care unit, focused on materials published in intensive care medicine society of each country. Results: In comparison with guideline of abroad cases, additional supplement are required, with regard to item such as operation environment, size, nursing manpower ratio, bed space area, space program of intensive care units for healing environment. Implications: This study is a basic research for guideline of intensive care unit, and need to be followed by further study using various perspectives and methods.

Resource-Based Relative Value for Estimation of Nursing Behavior in Neonatal Intensive Care Units (신생아집중치료실 간호수가 산정을 위한 간호행위별 상대가치 산정)

  • Moon, Sun-Young
    • Child Health Nursing Research
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    • v.12 no.1
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    • pp.15-24
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    • 2006
  • Purpose: This study was done to define nursing behavior in neonatal intensive care units so as to estimate resource-based relative value-. Method: Participating in this study were 292 nurses in neonatal intensive care units. The study surveyed physical and mental labor, stress and time involved in nursing work. Tool used in this study was a nursing labor per relative value tool. For analyzes, the relative value of each nursing behavior was calculated, where the mean value of the three components, labor intensity and component-by-component explanatory power were in percentage terms. Results: 1. Nursing behaviors in neonatal intensive care unit were classified and defined at three levels: 5 main domains, 17 mid-domains, and 42 small domains. 2. The per component explanatory power of intensity involved in nursing labor showed physical effort to be 32.45%, mental 32.86%, and stress 34.69%. 3. The reliability of nursing labor factors was very strong, Cronbach's alpha value of 0.96. Conclusion: In this research, which is a first in defining nursing behavior in neonatal intensive care units, individual nursing behavior were broken down using resource-based relative value for nursing cost, and each nursing behavior was successfully translated to a numerical value.

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Intensive Care Unit Nurses' Knowledge and Nursing Practices regarding Bedside Electrocardiograph Monitoring (중환자실 간호사들의 침상모니터 심전도 관찰 관련 지식 및 간호행위)

  • Kang, Jeong Hee;Suh, In Sun;Kim, Ji Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.20 no.1
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    • pp.60-70
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    • 2014
  • Purpose: Bedside electrocardiograph (ECG) monitoring is continuously used for assessing patients' cardiac status in intensive care units. However, it has not been explored whether it is used with proper knowledge and nursing practices; if not, its usage will be limited and the risk for compromised patient safety might be significant. This study, therefore, explored knowledge and nursing practices regarding bedside ECG monitoring in nurses working at intensive care units. Methods: Participants in this survey research were a convenience sample of 156 nurses from 25 intensive care units distributed in five hospitals with more than 1,000 beds each in Seoul, South Korea. Results: Participants showed limited and incorrect knowledge and nursing practices. Only 4 (2.6%) participants correctly answered to all electrode placement sites of RA, LA, LL, and V1. Lead II was the most frequently monitored unit regardless of the main purpose of ECG monitoring, and nursing practices to manage noisy signals did not include skin care at the top priorities. Conclusion: Educators and clinicians alike need to make an effort to ensure that a safe level of knowledge and practices for the monitoring is maintained in order to make sure that patient outcomes are not compromised.

Catheter-related bloodstream infections in neonatal intensive care units

  • Lee, Jung-Hyun
    • Clinical and Experimental Pediatrics
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    • v.54 no.9
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    • pp.363-367
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    • 2011
  • Central venous catheters (CVCs) are regularly used in intensive care units, and catheter-related bloodstream infection (CRBSI) remains a leading cause of healthcare-associated infections, particularly in preterm infants. Increased survival rate of extremely-low-birth-weight infants can be partly attributed to routine practice of CVC placement. The most common types of CVCs used in neonatal intensive care units (NICUs) include umbilical venous catheters, peripherally inserted central catheters, and tunneled catheters. CRBSI is defined as a laboratory-confirmed bloodstream infection (BSI) with either a positive catheter tip culture or a positive blood culture drawn from the CVC. BSIs most frequently result from pathogens such as gram-positive cocci, coagulase-negative staphylococci, and sometimes gram-negative organisms. CRBSIs are usually associated with several risk factors, including prolonged catheter placement, femoral access, low birth weight, and young gestational age. Most NICUs have a strategy for catheter insertion and maintenance designed to decrease CRBSIs. Specific interventions slightly differ between NICUs, particularly with regard to the types of disinfectants used for hand hygiene and appropriate skin care for the infant. In conclusion, infection rates can be reduced by the application of strict protocols for the placement and maintenance of CVCs and the education of NICU physicians and nurses.