• Title/Summary/Keyword: 중환자병동

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A Study on the Effect of Unit Design for Patient-Centered Care on Family Members and Caregivers - A Case Study of the Intensive Care Unit (ICU) for Patient-Centered Care in the United States (환자중심의료를 위한 병동디자인이 환자가족 및 의료진에 미치는 효과에 대한 연구 - 미국의 환자중심의료를 위한 중환자병동 사례를 중심으로)

  • Choi, Young-Seon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.21 no.3
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    • pp.37-45
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    • 2015
  • Purpose: The main objective of this paper is, to evaluate the unit design for patient-centered care and to draw lessons-learned for further improvement. Methods: This study conducted a case study of the intensive care unit, designed to fulfill patient-centered care in the US. It evaluated the effectiveness of the unit by incorporating several study methods such as plan analyses, direct observations through nursing tracking and behavior mapping, and focus group interviews. Results: The major design decision made in this patient-centered unit was the use of patient rooms with designated family areas and distributed nursing stations. Both design features appeared to be a success on a variety of research metrics and outcomes. The study identified that the patient rooms ultimately help family members to spent more time with their loved ones, which leads to increased satisfaction of family members and nurses also report that they generally enjoy the distributed nurses' stations, which provide a comfortable environment to complete their regular lines of work such as charting, monitoring patients, and collaborating with their colleagues. Implications: Certain design features in intensive care units such as patient rooms with designated family areas and distributed nursing stations could appropriately support hospitals to fulfill patient-centered care.

Knowledge and Performance of Guidelines for Evaluation of New Fever in Critically Ill Adult Patients (중환자 첫 발열 평가 근거기반 가이드라인에 대한 지식과 수행 정도)

  • Yang, Jin-Ju;Jang, Keum-Seong;Choi, Ja-Yun;Ryu, Seang;Kim, Yun-Hee
    • The Journal of the Korea Contents Association
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    • v.16 no.12
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    • pp.468-479
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    • 2016
  • The purpose of this study was to investigate nurses' knowledge and performance of guidelines for evaluation of new fever in critically ill adult patients according to the level of evidence. The total participants were 145 nurses working for medical surgical unit and intensive care unit in two hospitals. The knowledge and performance mean scores of guidelines were $0.70{\pm}0.09$ and $3.08{\pm}0.31$ respectively. The evidence level 1 of guidelines had the higher performance score in high score group than low score group of knowledge groups(F=3.86, p=.023) and performance groups(F=163.14, p<.001), while the evidence level 3 of guidelines had the higher performance score in low score group than high score group of knowledge groups(F=5.99, p=.003). Knowledge and performance scores were significantly correlated (r=.25, p=.003). In Conclusion, these findings emphasize that clinical professions need to enhance both of knowledge and practice with evidence based guideline of new fever in critically ill patient.

Characteristics of Patients Undergoing Telemetry in the Cardiology Ward (심장내과 병동의 텔레메트리 적용 환자 특성)

  • Kim, Yoon-Seon;Choi, Hye Ran
    • Journal of Korean Critical Care Nursing
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    • v.7 no.2
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    • pp.14-23
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    • 2014
  • Purpose: The purpose of this study was to provide basic information to develop appropriate nursing guidelines for cardiac telemetry. Methods: This retrospective research was conducted to identify the current usage of cardiac telemetry and considered 1,000 patients hospitalized for telemetry. The collected data were analyzed using IBM (SPSS Statistics for Windows 21.0). Results: Four-hundred and ninety-two patients (49.2%) were diagnosed with arrhythmia and 209 (20.9%) with heart failure. Electrocardiogram (ECG) rhythm changes were detected via telemetry in 464 cases. Major arrhythmias were ventricular tachycardia (183, 39.4%) and bradycardia (99, 21.3%). Interventions after detecting arrhythmia were cardioversion (16, 3.4%), defibrillation (1, 0.2%), and cardiopulmonary cerebral resuscitation (5, 1.1%); other patients were treated conservatively with close observation (381, 82.1%). Conclusion: There was appropriate intervention in 46.4% of the considered cases with the detection of ECG changes before patient notification, which implied that cardiac telemetry could be considered for application to patients with hemodynamic instability. Clear standards and guidelines are required to determine who requires telemetry and when to end the telemetry monitoring.

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Outcome Analysis of Endotracheal Intubation for General Ward Patients with and without Predicted Difficulty (일반병동 입원환자의 어려운 기도 예측 여부에 따른 기관 내 삽관의 결과 분석)

  • An, Ji-Young;Choi, Hye Ran
    • Journal of Korean Critical Care Nursing
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    • v.7 no.2
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    • pp.34-44
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    • 2014
  • Purpose: The purpose of this study was to determine the factors related to airway failure during endotracheal intubation among patients with and without predicted airway difficulty. Methods: Medical records were examined retrospectively. 329 patients who were admitted to the general ward and underwent endotracheal intubation were included. The incidence of airway failure in the two groups was investigated. Results: The group predicted to have airway difficulty consisted of 79 patients (24.0%) and the group without airway difficulty, 250 (76.0%). The number of cases of airway failure was 50 (15.2%). The factors that were associated with airway failure in the group with predicted airway difficulty were the jaw relaxation score, Cormack-Lehane score, and the device of the first endotracheal intubation attempt. The factors that were associated with the airway failure in the group predicted not to have airway difficulty were the induction agent, jaw relaxation score, Cormack-Lehane score, level of training of the personnel with the first endotracheal intubation success, and the device of the first endotracheal intubation attempt. Conclusion: The prediction of airway difficulty during endotracheal intubation was not effective; however, it was meaningful from the perspective of patient safety.

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Comparison of Experiences of Ethical Dilemma between Intensive Care Unit and General Unit Nurses regarding Treatment Decisions and Confidentiality (의료처치 및 환자 비밀유지에 대한 중환자실 간호사와 일반병동 간호사의 윤리적 갈등 경험 비교연구)

  • Ko, Chungmee;Koh, Chin-Kang
    • Journal of Korean Critical Care Nursing
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    • v.11 no.3
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    • pp.1-11
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    • 2018
  • Purpose : This study compares experiences of ethical dilemma between nurses working in intensive care units and those in general units under specific situations of treatment decisions and confidentiality. Method : This cross-sectional descriptive study utilizes the self-report survey method. The survey questionnaires were completed by 50 and 52 nurses working in intensive care units and general units, respectively. The instrument, which consisted of 16 items of ethical dilemma situations about treatment decision and confidentiality, was used. The mean scores for each item were compared between the two groups. Results : The study found no differences in terms of age, gender, education level, clinical experience in years, and being educated on healthcare ethics. For 9 out of 16 items, the mean scores of nurses in intensive care units were significantly higher than those of nurses in general units. Conclusions : Nurses in intensive care units experienced ethical dilemmas regarding treatment decisions and confidentiality more often than those in general units. This study emphasizes the need to establish strategies for improving the ethical competence of critical care nurses.

Development and Feasibility of a Video Recording-Based Standardized Handoff Program for Ward Nurses: A pilot study (비디오 녹화 기반 병동 간호 인수인계 프로그램 개발 및 적용가능성 : 예비연구)

  • Seo, Eun Koung;Kim, Sun-Hee;Son, Youn-Jung
    • Journal of Korean Critical Care Nursing
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    • v.11 no.3
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    • pp.71-84
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    • 2018
  • Purpose : This study develop a Video Recording-Based Standardized Handoff (VRSH) program at shift change for ward nurses. Methods : The study was conducted in five medical, three surgical, and one comprehensive nursing care service wards affiliated with a secondary general hospital. In this methodological study, the VRSH program was developed between April and December, 2017. It is noted that 65 nurses who were involved in the VRSH program participated in this study. Results : In line with the modified Situation, Background, Assessment, Recommendation tool, the VRSH program consisted of three phases. In the VRSH program, the average time for handoff duration was 3-5 minutes per patient. More than 90% of the ward nurses were satisfied with the VRSH program since it benefited them by reducing overtime work and improving the performance, as well as effective communication, of nurses. The content analysis of nurses' VRSH program experience, revealed three categories and eight sub-categories. Conclusions : This study provides evidence that the VRSH program improves effective nursing performance and, the handoff communication and relationships between nurses. Future studies on large sample sizes and multiple settings are required to substantially evaluate the impact of the VRSH program on clinical outcomes.

Effect of Role Conflict on Job Satisfaction by Comprehensive Nursing Care Service Ward Nurse: Moderating and Mediating Effect of Resilience (간호·간병통합서비스 병동간호사의 역할갈등이 직무만족에 미치는 영향: 회복탄력성의 조절 및 매개효과)

  • Lee, So Hee;Seol, Roma;Kim, Min Hye
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.50-61
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    • 2021
  • Purpose : This study aimed to identify the moderating and mediating effects of resilience on the relationship between role conflict and job satisfaction among nurses working in a comprehensive nursing care service ward. Methods : Participants were 130 comprehensive nursing care service ward nurses from four hospitals. Data were collected using structured questionnaires and analyzed by t-test, ANOVA, Scheffe test, Pearson correlation coefficients, and hierarchical multiple regression analysis, using SPSS 25.0. The mediating effect of resilience on the relationship between role conflict and job satisfaction was analyzed using multiple regression analysis according to Baron and Kenny's procedure. Results : Statistically significant negative correlations were found between role conflict and resilience (r=-.25, p<.007) and between role conflict and job satisfaction (r=-.38, p<.001). A significant positive correlation was found between resilience and job satisfaction (r=.54, p<.001). A partial mediating effect of resilience was found between role conflict and job satisfaction (Z=-2.53, p=.012) but no moderating effect was found. Conclusion : To improve the job satisfaction of comprehensive nursing care service ward nurses, interventions for alleviating role conflict and improving resilience as well as evaluations of the two variables are necessary.

Effects of Awareness of Patient Safety Culture, Emotional Labor and Job Stress on Patient Safety Nursing Activities by Comprehensive Nursing Care Medical Service Ward Nurses (간호·간병통합서비스 병동 간호사의 환자안전문화인식, 감정노동, 직무스트레스가 환자안전간호활동에 미치는 영향)

  • Choi, Hyo Jeong;Lee, Yun Mi;Park, Hyo Jin
    • Journal of Korean Critical Care Nursing
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    • v.14 no.3
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    • pp.87-98
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    • 2021
  • Purpose : This study aimed to examine the effects of the awareness of patient safety culture, emotional labor, and job stress on patient safety nursing activities by comprehensive nursing care medical service ward nurses. Methods : The participants were 112 nurses from the comprehensive nursing care service wards from six hospitals. Data were collected using structured questionnaires and analyzed using a t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression analysis using SPSS version 20.0. Results : The factors that significantly influenced patient safety nursing activities in the comprehensive nursing care medical service ward nurses included job stress (𝛽=-0.18, p<.032) and awareness of patient safety culture (𝛽=0.54, p<.001). The explanatory power of these factors was 31.0% (F=13.43, p<.001). Conclusion : This study showed that the factors that influenced patient safety management activities of comprehensive nursing care medical service ward nurses included job stress and awareness of patient safety culture.

Factors Influencing Professional Quality of Life in Intensive Care Unit Nurses of University Hospitals (간호·간병통합서비스병동 간호사의 직무스트레스가 소진에 미치는 영향: 감성지능의 조절 및 매개효과 )

  • Lee Yu Lim;Lee Yun Mi;Jang So Eun
    • Journal of Korean Critical Care Nursing
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    • v.16 no.1
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    • pp.44-55
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    • 2023
  • Purpose : This study aims to identify job stress, emotional intelligence, and exhaustion of the nurses in comprehensive nursing service units and then verify the moderating and mediating effects of emotional intelligence on the relationship between job stress and exhaustion. Methods : Participants are 118 nurses working in two general hospitals. The collected data are analyzed using the SPSS WIN 27.0 and AMOS 18.0 programs by assessing frequency and percentage, mean and standard deviation, independent t-test and one-way ANOVA, Scheffé test, Pearson correlation coefficient, and hierarchical multiple regression analysis and bootstrapping. Results : Exhaustion has a statistically significant positive correlation with job stress (r=.40, p <.001) and a statistically significant negative correlation with emotional intelligence (r=-.26, p =.004). A partial mediating effect of emotional intelligence is found between job stress and exhaustion, however, there is no moderating effect. Conclusion : It is expected that to reduce the exhaustion of nurses in comprehensive nursing service units, it is necessary to assess job stress and emotional intelligence, and strengthen emotional intelligence along with job stress intervention.

The Usefulness of B-type Natriuretic Peptide test in Critically Ill, Noncardiac Patients (심질환 병력이 없었던 중환자에서 B-type Natriuretic Peptide 검사의 유용성)

  • Kim, Kang Ho;Park, Hong-Hoon;Kim, Esther;Cheon, Seok-Cheol;Lee, Ji Hyun;Lee, Stephen YongGu;Lee, Ji-Hyun;Kim, In Jai;Cha, Dong-Hoon;Kim, Sehyun;Choi, Jeongeun;Hong, Sang-Bum
    • Tuberculosis and Respiratory Diseases
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    • v.54 no.3
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    • pp.311-319
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    • 2003
  • Background : Previous studies have suggested that a B-type natriuretic peptide(BNP) test can provide important information on diagnosis, as well as predicting the severity and prognosis of heart failure. Myocardial dysfunction is often observed in critically ill noncardiac patients admitted to the Intensive Care Unit, and the prognosis of the myocardial dysfunction needs to be determined. This study evaluated the predictability of BNP on the prognosis of critically ill noncardiac patients. Methods : 32 ICU patients, who were hospitalized from June to October 2002 and in whom the BNP test was evaluated, were enrolled in this study. The exclusion criteria included the conditions that could increase the BNP levels irrespective of the severity, such as congestive heart failure, atrial fibrillation, ischemic heart disease, and renal insufficiencies. A triage B-Type Natriuretic Peptide test with a RIA-kit was used for the fluorescence immunoassay of BNP test. In addition, the acute physiology and the chronic health evaluation (APACHE) II score and mortality were recorded. Results : There were 16 males and 16 females enrolled in this study. The mean age was 59 years old. The mean BNP levels between the ICU patients and control were significantly different ($186.7{\pm}274.1$ pg/mL vs. $19.9{\pm}21.3$ pg/mL, p=0.033). Among the ICU patients, there were 14(44----) patients with BNP levels above 100 pg/mL. The APACHE II score was $16.5{\pm}7.6$. In addition, there were 11 mortalities reported. The correlation between the BNP and APACHE II score, between the BNP and mortality were significant (r=0.443, p=0.011 & r=0.530, p=0.002). The mean BNP levels between the dead and alive groups were significantly different ($384.1{\pm}401.7$ pg/mL vs. $83.2{\pm}55.8$ pg/mL p=0.033). However, the $PaO_2/FiO_2$ did not significantly correlate with the BNP level. Conclusion : This study evaluated the BNP level was elevated in critically ill, noncardiac patients. The BNP level could be a useful, noninvasive tool for predicting the prognosis of the critically ill, noncardiac patients.