• Journal of Korean Critical Care Nursing
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• v.7 no.1
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• pp.1-10
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• 2014

Purpose: The purpose of this study was developing a nasogastric tube feeding algorithm to prevent aspiration pneumonia. Methods: The algorithm was developed through a methodological design. First, a pilot study was performed to determine the incidence of pneumonia. The second step was development of a preliminary algorithm through a literature review and collection of nurse opinions. The third step was to establish content validity using a panel of 12 experts. The fourth step was revision of the algorithm. Next, 20 intensive care unit nurses applied the revised algorithm for six months to their actual treatment, and the practical feasibility was verified after that. Results: In the patients for whom this algorithm was applied, no cases of pneumonia occurred. The algorithm that was developed by the present author was suitable for clinical application. Conclusion: The effect and practical feasibility of the algorithm was tested with a few patients in this study. The effect of this algorithm should be examined by applying it to more patients on an ongoing basis.

• Journal of Korean Critical Care Nursing
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• v.7 no.1
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• pp.33-39
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• 2014

Purpose: The propose of this study was to introduce the clamping protocols for a biliary external drainage tube and trace the results of using clamping protocols to prevent some possible biliary complications or enable their early detection in living-donor liver transplantation. Method: This study was a retrospective study to analyze the cases of 97 subjects who had undergone liver transplantation in a hospital in Seoul, Korea. Clamping protocol 1 was applied to 47 patients, and clamping protocol 2 was applied to 50 patients. Results: In the case of protocol 1, the success rate of the clamping protocol was 74.5%, while that of protocol 2 was 84.0%. However, there was no significant difference in the compiled statistics from authentic sources (p = .246). Conclusions: The difference in the success rate between the two protocols was not significant for the clamping protocols of the biliary external drainage tube. However protocol 2 is suggested for the clamping method due to the simplicity of application. Further study with a large sample size is suggested.

• Journal of Korean Critical Care Nursing
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• v.3 no.1
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• pp.29-40
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• 2010

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.

• Journal of Korean Critical Care Nursing
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• v.3 no.1
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• pp.53-65
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• 2010

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.

• Journal of Korean Critical Care Nursing
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• v.2 no.2
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• pp.28-41
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• 2009

Purpose: The purpose of this study was to identify the knowledge, perception and compliance to prevent from blood borne infection for the nurses working at operating room. Methods: The data was collected from the questionnaire surveying 330 operating room nurses from 7 different hospitals located in Seoul and Gyeonggi-do from February 11 to March 7 2008. The instrument for perception and compliance to prevent from blood borne infection was 24-item questionnaire, which had been developed by Choi(2005). In addition, to find out the knowledge level of hepatitis B, hepatitis C, AIDS and handling of syringes, 19-item questionnaire was used, which was developed by researcher based on Kim(2003) and Choi(2005). Results: The average score of the knowledge was 14.42. The average perception was 4.51 out of 5.00. The average compliance was 3.91 out of 5.00. The correlation among the knowledge, perception and compliance to prevent from blood borne infection showed that there was positive correlation between the knowledge and perception(r= .234, p= .000) and also it was positive between perception and compliance(r= .415, p= .000). Conclusion: To improve compliance to prevent from blood borne infection for operating room nurses, it should be studied to enhance the perception to prevent from blood borne infection. Moreover, the operating room should be equipped with protective devices and written safety guidelines.

• Journal of Korean Critical Care Nursing
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• v.2 no.2
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• pp.42-55
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• 2009

Purpose: Despite numerous evidence based preventive strategies of ventilator associated pneumonia (VAP) have been introduced, the incidence rate of VAP continues in an unacceptable range. The purposes of this review were to identify risk factors and diagnosis of VAP and to introduce current evidence based preventive strategies of VAP. Methods: A comprehensive literature search using keywords, including ventilator associated pneumonia were entered into a search engine. A number of highly pertinent papers relevant to the purpose of the review were identified. The papers that discussed specific preventive strategies of VAP were selected for analysis and inclusion in this review. Results: A number of evidence based preventive strategies that nurses can implement in their clinical practice to prevent VAP were identified. Such strategies include hand washing, use of protective gloves and gowns, oral care, stress ulcer prophylaxis, avoidance of unnecessary intubation, weaning protocol, sedation vacation, use of non-invasive ventilation, semi-recumbent position, continuous aspiration of subglottic secretions, and maintenance of proper endotracheal tube cuff pressure. Staff education is essential in preventing VAP. Conclusion: Preventive strategies of VAP should be applied to daily nursing care and each critical nurse should play a functional role in preventing VAP.

• Journal of Korean Critical Care Nursing
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• v.3 no.1
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• pp.41-51
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• 2010

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.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.75-85
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• 2020

Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU). Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation. Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65~30.33, p<.001), education < high school graduation (OR=2.53, 95% CI=1.07~6.01, p=.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p=.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p=.038). Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.1-10
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• 2020

Purpose : This study aims to investigate the differences in fatigue, sleepiness, and near-miss according to sleep disturbance among shift nurses in intensive care units (ICUs). Methods : A cross-sectional study in a tertiary hospital was performed. A total of 122 shift nurses working in the six ICUs were recruited. They completed self-reported questionnaires about sleep disturbance, fatigue, sleepiness, and near-miss in the past two weeks. Results : The prevalence of reported sleep disturbance was 30.3% (37 out of 122 subjects). Compared to the non-sleep disturbance group, the sleep disturbance group reported significantly more sleepiness (11.46 vs. 8.86) and higher fatigue (82.62 vs. 69.39). The sleep disturbance group showed higher rates of near-miss (78.4 vs. 57.6%) and a higher frequency of them (4.49 vs. 2.11/2weeks) compared to the non-sleep disturbance group. Medication error was the most common type of near-miss. Conclusions : This study suggests that sleep disturbances could increase fatigue, sleepiness, and near-miss among ICU shift nurses. Personal and organizational programs should be developed to support the sleep of ICU nurses.

• Journal of Korean Critical Care Nursing
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• v.13 no.3
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• pp.11-23
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• 2020

Purpose : This study examined factors influencing the attitudes towards nurse-led defibrillation in the emergency department (ED) and intensive care unit (ICU). Methods : This was a cross-sectional study. A total of 212 nurses in the ED and ICU from three general hospitals responded to the survey. Data were collected between September and October 2015 using structured questionnaires. Independent t-test, Mann-Whitney U test, one-way analysis of variance (ANOVA), Pearson's correlation coefficient, and hierarchical multiple regression were used to analyze factors affecting nurses' attitudes towards nurse-led defibrillation. Results : The mean score of nurses' attitudes towards nurse-led defibrillation was 61.37 of a possible 91. Hierarchical multiple regression showed that nurses' attitudes towards nurse-led defibrillation were significantly affected by their experiences regarding cardiopulmonary resuscitation (p=.003), knowledge regarding electrocardiogram interpretation and defibrillation (p=.007), and tenure in ED or ICU (p=.043). Conclusion : Results indicate that employers should set policies to support nurses in maintaining their careers in the ED or ICU and conduct systematic educational programs for them. This will increase nurses' confidence in performing defibrillation, which will lead to early defibrillation during in-hospital cardiac arrest. Consequently, it can be a strategy to increase the survival rate of cardiac arrest patients.