• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.157-170
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• 2009

Purpose: This quasi-experimental study was conducted to investigate the effects of supportive nursing management on postpartum depression in the mothers with premature infants. Methods: The subjects were 21 mothers who delivered premature babies in a university hospital. The experimental group of 10 mothers was provided with supportive nursing management program by nurses in neonatal ICU and the control group of 11 mothers was provided with usual management only. The designed programs were given 4 times to the experimental group while their babies were hospitalized, and telephone consultation was provided 3 times after discharge. The stress, anxiety, identity, support from their husbands & family members, and postpartum depression were measured 3 times using Edinburgh Postnatal Depression Scale (the 4th day of premature's hospitalization, the day of discharge and the day of 4 weeks after discharge). Results: There was no significant difference in general characteristics and the influential factors of postpartum depression between the two groups, so they were homogeneous. There was no significant difference in depression (F=0.01, p=.917). However there was significant difference over time (F=6.74, p=.003) and the interaction between measurement time and treatment (F=3.59, p=.037). Conclusion: The supportive nursing management on postpartum depression of mothers with premature infants is considered effective and useful in reducing postpartum depression. Further research is warranted to investigate paternal depression and the program's long-term effects.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.243-247
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• 2008

Neonatal intensive care in Korea has improved remarkably since the 1990s, but there is still a shortage of facilities and equipment in NICUs. Only 71.1% of the beds needed for neonatal intensive care are available. Mechanical ventilators are not appropriately distributed to the NICUs that are equipped to handle neonatal intensive care. The number of doctors is far too small, making the number of patients per doctor very high. Nurses, too, need to take care of 7.7 patients per nurse, making it very difficult to provide adequate intensive care. All this is caused by insufficient investment by the hospitals, which, in turn, is caused by inadequate reimbursement from health insurance. Therefore, a government-sponsored effort is necessary to bring the level of neonatal intensive care up to par.

• Child Health Nursing Research
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• v.19 no.4
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• pp.252-261
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• 2013

Purpose: The purpose of this phenomenological study was to explore neonatal intensive care unit (NICU) nurses' experience in caring for infants who are approaching death and to identity the meaning and structure of their experiences. Methods: The participants were eight nurses who had experience in caring for these infants. In-depth interviews were performed from December, 2012 to February, 2013 until data were fully saturated. Collected data were analyzed using Colaizzi's method. Results: Four theme clusters were extracted from fifteen themes. The four theme clusters of the NICU nurses' experience in caring for infants who are dying were: 1) Crossroads between life and comfort of infants approaching death, 2) emotional suffering at the death of the infant, 3) adapting and coping with the death of the infant, 4) new expectations for caring for infants who are dying. Conclusion: The results of the study provide useful information in understanding NICU nurses' experience in caring for infants who are dying and establishing effective strategies to support these nurses.

• Neonatal Medicine
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• v.16 no.1
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• pp.55-63
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• 2009

Purpose: This study was conducted to investigate the incidence and clinical manifestations of rotaviral infections in the neonatal intensive care unit (NICU). We also investigated whether neonates referred from other hospitals cause outbreaks of rotaviral infections in the NICU. Methods: Neonates diagnosed wit rotaviral infections in the NICU at Korea University Ansan Hospital between January 2002 and December 2006 were evaluated retrospectively. Results: Of 1,501 neonates admitted to the NICU, the number of rotaviral infections was 94 (6.3%) and the prevalence was 4.9 cases per 1,000-hospital days. Of 223 neonates referred from other hospitals to our NICU, 24 (10.8%) were confirmed to have rotaviral infections at the time of referral. Common symptoms of rotaviral infections were jaundice diarrhea or loose stools, vomiting, fever, apnea, irritability, seizures, and moaning sounds. Necrotizing enterocolitis of stage II or more was diagnosed in 3 premature neonates, accounting for 3.2% of total infected neonates and 6.8% of premature infected patients. There were no statistically significant differences in the prevalence of symptoms between term and preterm neonates, except for jaundice that is more frequent in premature infants. In time series analysis, the admission of neonates who were born at other hospitals and diagnosed with rotaviral infections were associated 1 month later by increased cases of neonates with rotaviral infections who were born at our hospital, whereas new cases of rotaviral infections among inborn neonates were decreased 2 and 4 months later (P<0.05). Conclusion: Rotaviral infections in NICU were not rare and showed vague symptoms. Three cases (3.2%) were diagnosed with stage II or more necrotizing enterocolitis. The referred neonates with rotaviral infections may induce outbreaks in the NICU, therefore awareness and strict surveillance for rotaviral infections should be performed at the time of referral.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.17 no.1
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• pp.12-20
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• 2010

Purpose: The study examined differences in stress between the parents of sick newborns. Methods: Participants were the mothers (n=57) and fathers (n=57) of newborns in NICU of six university hospitals. An established stress measurement tool (Miles and Carter, 1993) was used. Results: Fathers and mothers displayed the highest stress scores (4.44 and 4.67, respectively) when the baby looked in pain. Maternal overall stress scores were significantly higher than paternal scores. Conclusions: Mothers and fathers experience differing levels of stress concerning their newborn. Further studies are needed to develop customized stress management intervention programs for parents of newborns in the NICU.

• Child Health Nursing Research
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• v.19 no.3
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• pp.198-206
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• 2013

Purpose: This study was done to identify the effectiveness of the 'intervention - mother's recorded song' on low-birth weight infants in an neonatal intensive care unit (NICU). Methods: This study was conducted with a nonequivalent control group pre-posttest quasi-experimental design and the participant group was low-birth weight infants who were admitted to the NICU. Forty-eight infants, 24 in each from two groups, the experimental and control group, participated in the study. Results: For physical response according to vital signs, there were no significant statistical differences in heart rate, respiration rate and pulse oximetry saturation between the experimental group and the control group. For behavioral state, there was a significant statistical difference between the experimental and control group. Conclusion: The study results indicate that the intervention using mother's song had some significance as a nursing intervention with positive impacts. Such an intervention can help pediatric nurses improve infants' stabilization of their vital signs and behavioral states. By showing the effectiveness of such an intervention, the results of this study provide further evidence-based information in developing the practice of pediatric nursing.

• Neonatal Medicine
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• v.16 no.2
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• pp.213-220
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• 2009

Purpose: Hearing loss is one of the common birth defects in humans, with a reported prevalence of 1-3 per 1000 newborns. We investigated the incidence of hearing loss and evaluated the use of neonatal hearing screening test in neonatal intensive care unit (NICU) graduates who are at greater risk for hearing loss than normal newborns. Methods: The neonates admitted to the NICU of Asan Medical Center from 1 March, 2003 to 30 March, 2008 who were available for follow-up were included. Those who failed the first auditory brainstem response prior to discharge were retested with the stapedial reflex test, auditory brainstem response and tympanometry in the Otolaryngology department. Results: Of 2,137 neonates, 2,000 (93.5%) neonates were tested prior to discharge. Sixty-seven neonates (3.4%) failed the first newborn hearing screening test. Of 67 infants, 52 infants were retested for a second hearing test. Excluding 10 infants (19.2%) who were lost during follow-up, 16 infants were confirmed to have hearing impairment of which 12 and 4 infants had unilateral and bilateral hearing loss, respectively. Of 16 infants, 5 did not meet the criteria set by the Korean National Health Insurance Corporation. Conclusion: The prevalence of hearing impairment in NICU graduates is about 0.8%, excluding those who were lost for follow up, necessitating a systemic and effective hearing assessment program among these high risk infants and more generous national insurance coverage.

• Neonatal Medicine
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• v.18 no.2
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• pp.345-352
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• 2011

Purpose: Nursing quality influences patient' outcomes in the neonatal intensive care unit (NICU). We compared differences in adverse events (AEs) by differences in the level of nursing experience at the NICU, developed guidelines to prevent AE, and then investigated the change in AE. Methods: AEs related to nursing were investigated from January 1, 2009 to December 31 2009 at the NICU of the newly established A hospital and B hospital that has been operating for 14 years. We also assessed the level of nursing experience. Guidelines to prevent nursing-related AEs were prepared at A hospital, and the change in the incidence of AE was investigated after 1 year. Results: Twenty nurses (80%) had <2 years experience at A hospital, whereas 13 nurses (65%) had 2 years or longer but less than 4 years experience at B hospital (P<0.001). The number of incidences of AE that occurred in 2009 in A hospital was higher (46) than that at B hospital (10). Intravenous (IV) injection-related incidents had the highest share in both hospitals: 24 incidents (52.2%) at hospital A and eight incidents (80%) at hospital B. After the guidelines were instituted in 2009, the number of nursing AEs decreased to 17, of which the number of IV incidents was the highest (6, 35%), athough its share decreased. Conclusion: Supervision and prevention guidelines should be in place to reduce nursing AEs, which would improve the quality of NICU service.

• Journal of Korean Academy of Nursing Administration
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• v.17 no.1
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• pp.115-126
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• 2011

Purpose: This study was done to identify differences in work environment, work stress, turnover intention and burnout and investigate the relationship among these variables in nurses in Korean Neonatal Intensive Care Units. Method: Participants were 242 nurses working in 13 general hospitals. Burnout was measured by the Maslach Burnout Inventory (MBI), work stress with the instrument by Gu & Kim (1994), and turnover intention with the scale by Kim & Lee (2001). Size of the NICU, nurse to patient ratio, and communication satisfaction were included in work environment. Data were analyzed using Pearson correlation coefficients and multiple regression analysis with SPSS WIN program. Results: The mean score for work stress in NICU nurses was 3.43 points, for burnout, 2.72 points, and for turnover intention, 4.64 points. Burnout and turnover intention level of participants were moderate-high. Work stress, communication dissatisfaction with physician, and clinical career accounted for 33% of variance in burnout. Significant differences were found between size of NICU and staffing related to environmental characteristics in turnover intention and burnout. Conclusions: Results indicate that effective communication with coworkers and institutional support for appropriate staffing according to number of beds will help to prevent work stress, burnout, and ultimately, nurses' resignations.

• The Journal of Korean Academic Society of Nursing Education
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• v.17 no.2
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• pp.267-276
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• 2011

Purpose: This study was done to develop a performance appraisal tool (PAT) for neonatal intensive care unit (NICU) registered nurses (RNs). Methods: The PAT was developed in three steps: 1) a standard of NICU nursing was established; 2) a draft was made; and 3) the PAT was ratified and its reliability and validity were tested. Results: The standard of practice of NICU nursing was predominantly based on role description and responsibilities for nurses. We identified 4 domains of nursing: professional practice, education, research, and leadership. The validity score for each item ranged from 3.93 to 3.27. The PAT consisted of 76 indicators, 49 reflecting components of professional practice, 5 related to responsibility for education, 3 representing research, and 19 relating to leadership. Cronbach's ${\alpha}$ averaged 0.99 for the 76 items. Conclusions: The PAT for NICU RNs that we created was found to be reliable and valid. This PAT would be very useful in evaluating nursing performance and facilitate the professional growth of nurses.