Purpose : The aim of this study was to compare shift satisfaction, sleep, fatigue, quality of life (QOL), and patient safety incidents between a newly implemented two-shift system and a traditional three-shift system. Methods : A total of 127 intensive care unit nurses (48 two-shift nurses and 79 three-shift nurses) working in a tertiary hospital in Seoul were recruited from January 1, 2017, to March 31, 2017. They completed a self-reported questionnaire about their work hours, shift satisfaction, sleep patterns, sleep quality, fatigue, QOL, and patient safety incidents in the past 2 weeks. Data were analyzed using SPSS version 23.0. Results : The two-shift group showed higher shift satisfaction scores compared with the three-shift group (6.93 vs. 4.37, p<.001). Sleep latency was shorter and sleep quality was better in the two-shift group compared with the three-shift group. There were no significant differences in other sleep parameters, fatigue, QOL, and patient safety incidents between the two groups. Conclusion : Although a two-shift system did not improve nurses' fatigue or QOL in this study, it may effectively serve as an alternative shift-work system that can increase sleep quality and shift satisfaction without increasing patient safety incidents.

Purpose : This study aimed to evaluate the clinical outcomes of direct interhospital transfers (IHTs) of patients with acute aortic syndrome (AAS) led by advanced practice nurses (APNs). Methods : From September 2014 to June 2017, the study retrospectively investigated 183 patients with AAS who were transferred to a high-volume tertiary hospital. Results : One hundred forty-eight (81%) patients were admitted through direct IHTs, and 35 (19%) patients were admitted through non-direct IHTs. The direct IHT group had a significantly shorter time from symptom onset to hospital arrival than the non-direct IHT group (11.4 vs. 32.1 h, p=.043). There were no significant differences in other clinical outcomes, such as peri-transfer status, mortality, hospital length of stay, and readmission, between the two groups. In the direct IHT group, 55% of transfers were led by APNs. There was no significant difference in outcomes between APN- and physician-led transfers. Conclusions : Implementation of direct IHTs markedly shortened the time from symptom onset to hospital arrival in patients with AAS. Finally, direct IHTs can potentially improve the outcomes of patients with AAS, a condition with time-dependent mortality and morbidity. In addition, APNs can effectively lead the direct IHT of patients with AAS.

Purpose : This study aimed to determine whether the Korean Patient Classification System for Neonatal Care Nurses (KPCSN) properly measures neonatal intensive care needs and to compare the scale's results with those of the Workload Management System for Critical Care Nurses (WMSCN). Methods : Data were collected from the medical records of 157 patients who were admitted to the NICU of a university hospital, in D city. Two types of patient classification systems were applied to investigate the total points and distributions to investigate the total points and distributions by categories and compare relationships and classification groups between two scales. Finally, the score distribution among the classification groups was analyzed when the KPCSN was applied. Results : Scores on the KPCSN for the feeding, monitoring, and measure categories were 19.16±15.40, 16.88±3.52, and 9.13±4.78, respectively. Classification group distribution of the KPCSN was as follows : 1.9% for the first group, 24.2% for the second group, 58% for the third group, and 15.9% for the fourth group. The classification group distribution of the WMSCN was as follows: 35.7% for the third group, 61.1% for the fourth group, and 3.2% for the fifth group. Finally, the scores by categories were analyzed according to KPCSN classification group, and the characteristics of the patients' nursing needs were identified for each classification group. Conclusion : Results of this study indicate that the KPCSN effectively measures feeding needs, which account for many nursing activities in neonatal intensive care. Comparisons between the KPCSN and WMSCN classification group scores and distribution ratios verified the correlation and significance of nursing requirements.

Purpose : The person-centered care is essential for better patient outcome. This study was conducted to identify the factors affecting to the person-centered care among intensive care unit (ICU) nurses. Method : This study was cross sectional survey, and the participants included 107 ICU nurses who provided a written consent to participate in the study. Using a structured survey, nurse's compassion fatigue, compassion satisfaction, and person-centered care among ICU nurses were assessed. The collected data were analyzed using t-test, ANOVA, and Pearson correlation test with SPSS 23.0 program. The factors affecting patient-centered care were analyzed using multiple regression. Results : According to the multiple regression analysis, education level, perceived caregivers need priority and compassion satisfaction were positive affecting factors to the person-centeredness of ICU nurses. Conclusion : In conclusion, the compassion satisfaction was an affecting factor to the person-centered care, however compassion fatigue didn't affect to the person-centered care among ICU nurses. Therefore, the strategy enhancing compassion satisfaction among ICU nurses will be needed to increase person centeredness.

Purpose : The purpose of this study was to identify relation of the communication skills, humanistic knowledge and professional quality of life and to investigate the enhancing ways of professional quality of life in intensive-care unit nurses. Methods : The study design was a descriptive survey from 152 intensive-care unit nurses, from December 1 to 30, 2019. The data analysis was with ANOVA, Scheffé test, Pearson's correlation coefficient and Multiple regression using the SPSS/WIN 23.0 program. Results : The factors affecting compassion satisfaction were communication skills (β=0.42, p=.001), satisfaction for working (β=0.61, p=.001), marriage (β=0.23, p=.005), humanistic knowledge (β=0.47, p=.008) and these factors explained 35.6%. The factors affecting secondary traumatic stress were job stress (β=0.19, p=.011), number of patients per nurse (β=-0.36, p=.004) and these factors explained 9.4%. The factors affecting burnout were job stress (β=-0.25, p=.001), communication skills (β=-0.29, p=.001), working period(β=-0.18, p=.010), satisfaction for working (β=-0.31, p=.001), self care (β=-0.11, p=.033) and these factors explained 36%. Conclusion : Therefore, it is necessary to develop solution to improve professional quality of life in intensive-care unit nurses. It needs to develop programs to improve communication skills and humanistic knowledge in order to enhance compassion satisfaction and to improve communication skills to prevent burnout.

Purpose : The aims of this study was to provide basic data to enhance the professional self-concept of nurses in intensive care unit and identify the relationship between job stress, working bullying, self-efficacy and professional self-concept and identify the factors influencing professional self-concept in intensive care unit nurses. Methods : This study was conducted from June to August, 2018 at five general hospitals over 500 beds. Structured questionnaire were completed by 120 nurses who had agreed to understand and participate in the study. The collected data were analyzed using the SPSS win 24.0 program. Results : Factors affecting the professional self-concept of the subjects were self-efficacy, working bullying, unsatisfaction and satisfaction of nursing job satisfaction, age. The explanatory power of these variables on professional self-concept was 55.1%. Conclusion : The self-efficacy, working bullying, nursing job satisfaction, and age of the intensive care unit nurses were identified as the major factors influencing the professional self-concept. Therefore, it is necessary to develop and apply an educational program to improve self-efficacy and nursing job satisfaction and reduce working bullying, which are influencing factors of professional self-concept of intensive care unit nurse.