• Journal of Korean Critical Care Nursing
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• v.13 no.1
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• pp.15-26
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• 2020

Purpose : This study aimed to examine factors affecting radiation protective behaviors among emergency room nurses by assessing knowledge, attitude, and environment for radiation protection. Methods : The study employed a cross-sectional design. Subjects were a convenience sample of 129 nurses working in emergency rooms of three general hospitals. Data were collected using self-report questionnaires and analyzed using t-test, ANOVA, Pearson correlation coefficients, and multiple regression. Results : The more the nurses received radiation safety education (t=2.26, p=.026), used protective gear (t=4.40, p<.001), and took health screenings (t=2.65, p=.009), the higher their levels of radiation protection behavior. There were significant relations between radiation protective behaviors and attitude (r=.27, p=.002), and radiation protective behaviors and environment for radiation protection (r=.55, p<.001). The factors affecting radiation protective behaviors were protective environment (β=.53, p<.001), protective attitude (β=.32, p<.001), and the use of protective gear (β=.24, p=.002). Conclusions : The government, hospital administrators, and radiation protection-related organization should adopt the following measures to protect emergency room nurses from radiation: research and development of shield instrument, medical examination for emergency room nurses, protocol development of radiation protection behaviors, extension of education chances of radiation protection, and encouraging the use of protective equipment.

• Journal of Korean Critical Care Nursing
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• v.8 no.1
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• pp.25-40
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• 2015

Purpose: The purpose of the study was to identify the frequency and importance of task performance and the perceived competence to perform of the emergency nurse practitioners (ENPs) certified in Korea. Method: This cross-sectional study was conducted with 41 ENPs certified by March 2012. The questionnaire to identify frequency, importance, autonomy, and perceived competence to perform 131 typical ENP task elements was developed on the basis of the standardized role of an ENP defined by the Korean Accreditation Board of Nursing Education. The data were analyzed using descriptive statistics. Results: The professional nursing practice showed the highest scores for performance frequency, task importance, autonomy, and perceived competence to perform as compared to other job categories. Clinical decision making was the most frequently performed duty. Data collection was the duty with highest levels of importance, autonomy, and perceived competence for the ENPs. However, the ENPs reported that research was the duty with the lowest levels of frequency, importance, autonomy, and perceived competence Conclusion: ENPs in Korea perform various tasks. In order to improve their position in the field, it is necessary to clarify their job description and enhance their competence to perform evidencebased professional nursing practices.

• Journal of Korean Critical Care Nursing
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• v.3 no.2
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• pp.25-35
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• 2010

Purpose: The purpose of this pilot study was to investigate the effect of oral care using 0.1% chlorhexidine and tantum solution on oral status and incidence of oral pathogens among intubated ICU patients. Methods: The study subjects were 26 intubated patients of MICU in a university hospital. Oral care was provided with 0.1% chlorhexidine solution to the experimental group (n=12) and with tantum solution to the control group (n=14), 3 times a day for 6 days. After the intervention, the oral status of each subject was checked using structured method, and oral swab culture was done to count colonized bacterial pathogens. Results: The mean oral status score of experimental group was significantly higher than that of control group (U=42.50, p=.031). The mean incidence of oral pathogens in experimental group was smaller than that of control group, but the difference was not statistically significant. Conclusion: The oral care with 0.1% chlorhexidine solution is more effective than with tantum solution for improving oral status of intubated ICU patients. However, additional studies with larger sample size will be needed to figure out it's effects on the incidence of oral pathogens.

• Journal of Korean Critical Care Nursing
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• v.7 no.2
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• pp.45-57
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• 2014

Purpose: The purpose of this study was to examine the effect of a blood glucose control protocol for medical intensive care unit (ICU) patients. Methods: The subjects were recruited from medical ICU adult patients whose blood glucose levels exceeded 200 mg/dL in two consecutive tests. The experimental group (n=62) received the modified Yale (MY) insulin protocol, whereas the control group (n=64) was treated with the conventional insulin therapy methods. Results: In the experimental group, the mean blood glucose levels (p<.001) and the time to reach the target range of glucose (p<.001) decreased significantly while the incidence rates of a target range of glucose of 100-140 mg/dL (p<.001) increased significantly as compared to the control group. However, no statistically significant differences were found in the incidence of hypoglycemia(p=.644), or the number of glucose tests (p=.236) between the groups. The length of stays in the ICU (p=.001), ventilator care days (p=.038), and the Sequential Organ Failure Assessment (SOFA) score (p=.029) in the experimental group were significantly lower than those of the control group. Conclusion: Application of the protocol was effective in improving the state of blood glucose control in medical ICU patients. Therefore, this protocol is expected to be used as a part of nursing intervention in critical care nursing.

• 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.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.141-156
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• 2021

Purpose : This study aimed to systematically review the preventive interventions for delirium in Korean intensive care unit (ICU) patients and evaluate their efficacy. Methods : For this systematic review and meta-analysis, we searched the literature and selected studies from data sources that included the RISS, KISS, National Central Library, National Assembly Library, DBpia, Science on, MEDLINE, and Cochrane Library. We used Cochrane's revised tool for risk of bias in randomized trials and non-randomized studies of intervention tools to assess the quality of the selected studies. The effect size of the intervention was calculated as odds ratio (OR) and standardized mean difference (SMD). Results : Preventive interventions reported in 23 studies with a total of 4,799 ICU patients were effective in reducing the occurrence of delirium (OR=0.64, 95% CI : 0.49~0.91, p=.011), but not the duration (SMD=-0.22, 95% CI : -0.51~0.08, p=.148). As a result of a subgroup analysis, non-pharmacological interventions were effective in reducing the occurrence of delirium (OR=0.66, 95% CI : 0.47~0.94, p=.020), while pharmacological interventions had no effect (OR=0.68, 95% CI : 0.33~1.40, p=.295). Among the non-pharmacological interventions, multi-component intervention had the largest effect size (OR=0.38, 95% CI : 0.26~0.55, p<.001). Conclusion : Non-pharmacological interventions were effective in reducing the occurrence of delirium. We recommend the development and application of multi-component interventions to prevent delirium in the Korean ICU patients.

• Journal of Korean Critical Care Nursing
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• v.12 no.2
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• pp.85-96
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• 2019

Purpose : The purpose of this study was to examine the mediating effect of perceptions regarding the importance of patient safety management in the relationship between incident reporting attitudes and patient safety care activities for nurses in small-and medium-sized general hospitals. The objective was to provide a basis for planning tailored training programs aimed at improving patient safety care activities. Methods : This study was conducted with 187 participants in small- and medium-sized general hospitals in K city in South Korea from March 15 to March 31, 2019. The data collected from participants were analyzed using descriptive statistics, a t-test, ANOVA, Pearson's correlation coefficients, and a multiple regression using IBM SPSS/WIN 21.0 software. Results : Patient safety care activities were found to be correlated with incident reporting attitudes (r=.27, p < .001) and perceptions of the importance of patient safety management (r=.59, p < .001). Further, perceptions of the importance of patient safety management had a complete mediating effect (${\beta}=.409$, p < .001) on the relationship between incident reporting attitudes and patient safety care activities. Conclusion : Based on the findings of this study, tailored training programs regarding patient safety care activities focused on boosting perceptions of the importance of patient safety management are highly recommended to improve nurses' patient safety care activities in small- and medium-sized general hospitals.

• Journal of Korean Critical Care Nursing
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• v.12 no.1
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• pp.82-93
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• 2019

Purpose : The purpose of this study was to investigate the degree of post-traumatic stress disorder (PTSD) symptoms and the effect of PTSD on quality of life (QoL) among coronary artery disease (CAD) patients. Methods: The participants were 135 CAD patients who visited outpatient clinics in a university hospital in B city of Korea. Their PTSD symptoms and QoL were measured by structured questionnaires and analyzed with multiple hierarchical regression analysis. Results: Among the 135 participants, 20.7% were classified as moderate risk, and 3.7% as high risk for PTSD. PTSD symptoms were significantly higher in participants who were diagnosed with CAD within 6 months (t=26.02, p<.001). The physical component of health-related QoL was influenced by gender (${\beta}=-.25$, p =.003), recurrence of CAD (${\beta}=.21$, p =.008), and PTSD symptoms (${\beta}=-.33$, p <.001). The mental component of health-related QoL was influenced by religion (${\beta}=-.17$, p =.044), body mass index (${\beta}=.17$, p =.033), and PTSD symptoms (${\beta}=-.37$, p <.001). Conclusion: Patients who had had a CAD diagnosis for less than 6 months were found to be vulnerable to PTSD, and PTSD was found to have a negative impact on the physical and mental components of their QoL. It is necessary to develop an intervention program for the effective prevention and management of PTSD symptoms in patients with CAD.

• Journal of Korean Critical Care Nursing
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• v.12 no.3
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• pp.74-83
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• 2019

Purpose : The routine evaluation of gastric residuals (RGR) is considered standard care for premature infants. This study evaluated the usefulness of RGR in premature infants. Methods : The study retrospectively investigated 208 premature infants (gestational aged under 34 weeks) who underwent gavage feeding in a neonatal intensive care unit at a tertiary hospital. The patients were divided into two groups: RGR (n=104) and no-RGR (n=104). Those in the no-RGR group had their gastric residuals checked only if signs of feeding intolerance were present. Clinical outcomes, including the time to reach full enteral feeding (FEF) and the incidences of gastrointestinal disorders such as feeding intolerance (FI) and necrotizing enterocolitis (NEC), were compared. Data were analyzed with SPSS ver. 21, using a Mann-Whitney U test, chi-squared test, and Fisher's exact test. Results : There was no statistically significant difference for the time to FEF (z=-0.61, p=.541), incidence of FI ($X^2=0.38$, p=.540), and NEC ($X^2=1.42$, p=.234) between the two groups. Conclusion : No-RGR did not increase the risk for FI or NEC. These results suggest that RGR evaluation may not improve nutritional outcomes in premature infants. Recommendations for further research and practice guidelines will be provided.

• Journal of Korean Critical Care Nursing
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• v.14 no.1
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• pp.28-39
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• 2021

Purpose : This study investigated the occurrence of postoperative ileus and its related factors in patients after spinal surgery. Methods : After a retrospective review of data from patients who underwent spinal surgery at a single hospital located in Busan from 2012 through 2016, a total of 253 patients were included. The subjects were divided into non-ileus and ileus groups. We compared patient-, surgery-, and postoperative hematological-related factors. Results : A total of 41 (16.2%) out of 253 patients experienced postoperative ileus. Data analysis revealed significant differences between the two groups in mean age (68.44 vs 60.50 years), occupation (9.8 vs 28.8%), cardiovascular comorbidity (63.4 vs 37.7%), approach of surgery (supine/prone: 29.3/70.7 vs 12.7/87.3%), duration of anesthesia (5.86 vs 4.43 hours), narcotic use (75.6 vs 56.6%), postoperative serum hemoglobin level (3 days: 10.81 vs 11.41 g/dL), postoperative serum protein (immediately/3 days: 5.30/5.43 vs 5.62/5.68 g/dL), postoperative albumin level (3 days: 3.17 vs 3.40 g/dL), postoperative C-reactive protein level (3 days: 11.44 vs 8.36 mg/dL), postoperative bed stabilization period (3.32 vs 2.50 days), and onset of bowel movement (2.59 vs 1.94 days). In multivariate logistic regression, age and time of anesthesia were independent risk factors of postoperative ileus. Conclusion : To detect ileus after spinal surgery early, nurse education is needed with intensive screening on advanced age, surgery-related factors, and postoperative hematological indices.