Purpose: This study was designed to evaluate ICU nurses' clinical competence according to clinical ladder by job analysis tool for the evaluation tool development of clinical ladder development program, Methods: Data was collected using the ICU nurses job analysis tool from 148 ICU nurses who work for 6 ICUs of A hospital in S city, Results: The mean clinical competence score of the subjects was 3.03 on a 4 point scale, Competence score was increasing as ICU clinical ladder was higher (F=35.18, p<.001). Step_1 was the lowest and step_4 was higher than step_3 from Scheffe post hoc test, Result of multiple regression showed that ICU clinical ladder and ICU clinical nursing education explained 52.1% (F=38.83, p<.001) of ICU nurse's clinical competence. Conclusion: ICU nurses' clinical competence can be evaluated using ICU nurse's job analysis tool. Further researches is needed on job description according to clinical ladder for performance and evaluation.

Purpose: This study was conducted to explore and compare the level and type of nursing ethical values according to career and nursing units of clinical nurses, Methods: The subjects were 944 nurses working in General Hospital in Seoul and the data were collected from March 8 to August, 2007 using the nursing ethical values questionnaire, The collected data were analyzed using SPSS WIN 10.0 program. Results: The results were as follows; The level of clinical nurses' ethical values were significantly different according to career and nursing units (p<.01) and it was found that most clinical nurses had deontological ethics in the areas of professional nursing domain ($2.77{\pm}.31$), cooperative relations domain ($2.90{\pm}.26$) and customer relation domain ($3.03{\pm}.32$). but that they had utilitarian ethics in human life domain ($2.53{\pm}.32$). Conclusion: Different approaches are needed to develop to establish clinical nurses' ethical values based on career, characteristics of nursing unit and various clinical situations.

Purpose: This study was to investigate Job Stress and the Health status of ICU Nurses. Methods: Data was accumulated from 230 ICU nurses serving at least more than one year in 500 bed order hospitals during the period of three months from June 1 to August 31, 2009. Results: The average job stress was $3.14{\pm}.59$ points, which was relatively high, The average health status was $1.52{\pm}.19$ points, There was significant difference according to religion and subjective health status in Job Stress, There was significant difference according to age, religion and subjective health status in Health Status, There was significant difference according to satisfaction of work, satisfaction of personal relations, impulse to give up duty and in service education in Job Stress, There was significant difference according to satisfaction of work. satisfaction of personal relations, and expectant nursing job in Health Status, There was significantly negative relationship between job stress and health status. Conclusion: Job stress has the most important impact on health status of ICU nurses, Based on the finding, we could conclude that job stress management of ICU nurses should be required to improve health status.

Purpose: The purpose of this study was to identify the effects of family visits upon the stress response of patients and their families, Methods: This study was the interrupted time series design, The subjects consisted of 197 patients and 197 family members in the cardiac intensive care unit of S Hospital in Bucheon. Physiological stress responses such as blood pressure, heart rates, respiration rates, and oxygen saturation were measured using HP monitors. VAS was used to measure the emotional stress. Collected data was analyzed using repeated measure ANOVA, t-test by SPSS 17.0 statistical program. Results: The family visits did not change patients' blood pressure, pulse rate, respiration rate and oxygen saturation, However the anxiety level of patients and their family members were decreased significantly during family visits. Furthermore, 30-minute family visit reduced more effectively patient's anxiety than 15-minute family visit. Conclusion: Family visits need to be used as a means of nursing intervention to ease the emotional stress of patients and their families. In addition, increasing of visiting time should be considered.

Purpose: The purpose of this study was to identify the intensity and types of discomfort caused by an endotracheal tube in patients during ventilator therapy after cardiac surgery, and to analyze the differences in the intensity and types of discomfort by sociodemographic and clinical characteristics and characteristics related to endotracheal tubes. Methods: The intensity of discomfort was measured using an 11-point numeric rating scale and the types of discomfort were measured using a 4-point numeric rating scale. Sociodemographic and clinical characteristics and characteristics related to endotracheal tube were collected by observation and the electronic medical chart using a structured questionnaire. Results: The mean intensity of discomfort in patients due to endotracheal tubes was 6,91 points, 84% of patients reported discomfort over 5 points, The most severe discomfort was pain during endotracheal suctioning, and dry mouth and breathing difficulties were also found to induce discomfort. Patients who had more severe surgical site pain, longer duration of intubation and higher cuff pressure demonstrated more severe discomfort due to the endotracheal tube. Conclusion: These results can be used as basic data for developing nursing intervention to relieve the discomfort caused by endotracheal tubes in patients during ventilator therapy.

Purpose: This study was done to investigate knowledge of and compliance with the multidrug-resistant organism (MDRO) infection control guidelines among student nurses on clinical practicum, Methods: survey questionnaire on MORO infection control was administered to a convenience sample of 259 nursing students from 3 different nursing schools Results: The mean knowledge score was 28.01/39 (71.82%). The percentages of correct answers for basic concepts, route of transmission, hand washing/ protective devices and environment management, were 55.40, 81.14, 84.94 and 69.17 respectively. The mean compliance score was 3.83/5. The compliance scores for education, communication, contact precaution, environment management, and hand washing were 3.06, 3.33, 3.86, 4.50, 3.92 and 4.29 respectively. 96.9% of subjects knew that they should wash hands after touching MORO patient while only 22.8% of subjects knew how to collect samples for VRE surveillance culture, The highest compliant item was hand washing after touching MORO patient. The Lo-west compliant item was referring to infection control manual. Conclusion: Comprehensive MDRO infection control education programs for nursing students should be developed to decrease MORO infection.

Optimal nutrition serves to maintain normal organ function and to preserve body energy stores to guarantee survival during times of shortage of food. Adequate nutrition of intensive care unit (ICU) patients improves outcome, while malnutrition is strongly associated with increased morbidity and mortality rates among critically ill patients. Previously published researches showed that trials of nutritional support in critical illness rarely fulfill basic quality requirements. Nutrition support plays a vital role in the prevention and treatment of nutritional deficiencies in at-risk, critically ill patients. This paper reviewed the challenges in determining critically ill patients' nutrition requirements including nutrition assessment, determination of caloric requirements then providing them with adequate nutrition support while in the ICU with the guidelines published by Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Nutrition support can be effectively enhanced by using the guidelines.