• Title/Summary/Keyword: 중환자실

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Comparative Effects and Ranks of Pressure Ulcer Preventive Programs in Intensive Care Units: A Network Meta-analysis (중환자실 욕창예방 프로그램 효과의 비교순위: 네트워크 메타분석)

  • Ko, Ji Woon
    • Journal of the Korea Convergence Society
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    • v.12 no.12
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    • pp.563-572
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    • 2021
  • This study conducted a network meta-analysis to compare the effectiveness and ranking of pressure ulcer preventive programs in intensive care units. A frequency network meta-analysis was performed to identify evidence from relevant randomized control trials. A total of 10 randomized control trials involving 5 intervention subgroups were included in this study. Based on the ranking probabilities(P-Score), preventive materials was ranked as the most effective among all programs (P-Score 85.3.%: OR=0.12, 95% CI: 0.03, 0.49). Next was silicone foam dressing(P-Score 84.5%: OR=0.14, 95% CI: 0.05, 0.38), care bundle(P-Score 60.0%: OR=0.29, 95% CI: 0.07, 1.25), reposition (P-Score 32.3%: OR=0.66, 95% CI: 0.21, 2.09) and synthetic fabrics (P-Score 23.8%: OR=0.85, 95% CI: 0.20, 3.65). It is necessary to develop practical and efficient interventions that can prevent pressure ulcers in intensive care unit patients, improve patient safety, and reduce nurses' workload.

Risk Factors of Medical Device-Related Pressure Ulcer in Intensive Care Units (중환자실 의료기기 관련 욕창의 위험요인)

  • Koo, MiJee;Sim, YoungA;Kang, InSoon
    • Journal of Korean Academy of Nursing
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    • v.49 no.1
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    • pp.36-45
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    • 2019
  • Purpose: The purpose of this study was to identify the characteristics of and risk factors for medical-device-related pressure ulcer (MDRPU) development in intensive care units. Methods: A prospective cohort study design was used, and the participants were 253 adult patients who had stayed in medical and surgical intensive care units. Data were collected regarding the application of medical devices and MDRPU-related characteristics over a period of six months from June to November, 2017. Data were analyzed using independent t-test, ${\chi}^2-test$, Fisher's exact test, and binary logistic regression analysis with the SPSS 21.0 program. Results: Among the 253 participants, MDRPUs occurred in 51 (19.8%) participants. The results of the logistic regression analysis showed that the risk factors for MDRPUs were the use of endotracheal tubes (OR=5.79, 95% CI: 1.66~20.20), having had surgery (OR=2.95, 95% CI: 1.11~7.77), being in a semi-coma/coma (OR=5.79, 95% CI: 1.04~32.05), and sedation (OR=5.54, 95% CI: 1.39~22.19). Conclusion: On the basis of the study results, it is effectively facilitated by nurses when they care for patients with MDRPUs in intensive care units and the results are expected to be of help in preventive education for MDRPU development as well as preparing the base data for intervention studies.

Outcome and risk factors of pediatric hemato-oncology patients admitted in pediatric intensive care unit (소아 중환자실에 입실한 소아 종양/혈액 질환 환자의 예후 및 위험인자)

  • Kim, Bo Eun;Ha, Eun Ju;Bae, Keun Wook;Kim, Seon Guk;Im, Ho Joon;Seo, Jong Jin;Park, Seong Jong
    • Clinical and Experimental Pediatrics
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    • v.52 no.10
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    • pp.1153-1160
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    • 2009
  • Purpose:To evaluate the risk factors for mortality and prognostic factors in pediatric hemato-oncology patients admitted to the pediatric intensive care unit (PICU). Methods:We retrospectively reviewed the medical records of pediatric hemato-oncology patients admitted at the PICU of the Asan Medical Center between September 2005 and July 2008. Patients admitted at the PICU for perioperative or terminal care were excluded. Results:Total 88 patients were analyzed. Overall ICU mortality rate was 34.1%. Mean age at PICU admission was $7.0{\pm}5.7$ years and mean duration of PICU stay was $18.1{\pm}22.2$ days. Hematologic diseases contributed to 77.3% of all the primary diagnoses, and the primary cause of admission was respiratory failure (39.8%). The factors related to increased mortality were C-reactive protein level (P<0.01), ventilation or dialysis requirement (P<0.01), and hematopoietic stem cell transplantation (P<0.05). In all, 3 scoring systems were investigated [Number of Organ System Failures (OSF number), the Pediatric Risk of Mortality III (PRISM III) score, and the Sequential Organ Failure Assessment (SOFA) score]; higher score correlated with worse outcome (P<0.01). The Oncological Pediatric Risk of Mortality (O-PRISM) scores of the 21 patients who had received hematopoietic stem cell transplantation were higher among the non-survivors, but not statistically significant (P=0.203). Conclusion:The PRISM III and SOFA scores obtained within 24 hours of PICU admission were found to be useful as early mortality predictors. The highest OSF number during the PICU stay was closely related to poor outcome.

Distribution of Hospital Airborne Microorganisms in Seoul, Korea (서울시내 종합 병원 공기중의 미생물 분포)

  • Hong, Jun-Bai;Chung, Yun-Hee;Yun hee Chang
    • Journal of Environmental Health Sciences
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    • v.29 no.1
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    • pp.1-7
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    • 2003
  • This study was carried out to investigate the airborne microbial pollution in hospital environment. Using a mechanical air sampler, microbiological samples were taken from intensive care unit, general ward room, patients wailing room and outdoor of 20 hospitals in Seoul, Korea. The concentration of airborne bacteria and fungi ranged 97-410 cfu/㎥ and 37-77 cfu/㎥, respectively and patients waiting room had highest bacterial count. 10 genera of molds were identified and the most frequently recovered molds were Aspergillus, followed by Penicillium, Alternaria and Cladosporium. Among Staphylococcus species, S. haemolyticus and S. epidermidis were predominant and 47% of Staphylococcus species were isolated from intensive rare unit.

Changes in Nurse Staffing Grades in General Wards and Adult and Neonatal Intensive Care Units (의료기관의 일반병동, 성인 중환자실, 신생아 중환자실의 간호등급 변화)

  • Hong, Kyung Jin;Cho, Sung-Hyun
    • Journal of Korean Clinical Nursing Research
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    • v.23 no.1
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    • pp.64-72
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    • 2017
  • Purpose: This study aimed to explore the distributions of nurse staffing grades and to report changes in staffing grades in general wards and adult and neonatal intensive care units(ICUs) by hospital type and location. Methods: Data collected from the Health Insurance Review and Assessment Service were analyzed. Nurse staffing was categorized from grades 1 to 6 or 7 for general wards, 1 to 9 for adult ICUs, and 1 to 4 for neonatal ICUs based on the nurse-to-bed ratio. Results: The staffing grade for the general wards improved during 2008-2016 in 69.8% of the tertiary hospitals, 58.5% of the general hospitals, and 31.7% of the non-general hospitals. The adult ICUs at tertiary hospitals exhibited a greater improvement in staffing grades (48.8%) than did those of general hospitals (44.2%) during 2008-2015. Tertiary hospitals in non-capital regions showed a greater improvement than those in the capital region. The majority of neonatal ICUs (67.1%) had no change in the staffing grade during 2008-2015. Conclusion: Improvements in nurse staffing differed by hospital type and location. Government policies to improve nurse staffing in non-tertiary hospitals and those in non-capital regions are required to reduce variations in nurse staffing.

Educational Needs Based on Analysis of Importance, Frequency and Difficulty of ICU Nursing Practice for ICU Nurses (중환자실 간호실무의 중요도, 수행 빈도 및 난이도 분석을 통한 중환자실 간호사의 교육요구도)

  • Kim, Keum-Soon;Kim, Jin-A;Park, Young-Rye
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.3
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    • pp.373-382
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    • 2011
  • Purpose: The purpose of this study was to assess the educational needs of ICU nurses based on an analysis of importance, frequency, and difficulty for ICU nursing practice. Method: A cross-sectional survey was conducted using a questionnaire with 80 questions in 14 ICU nursing categories. Data were collected from August to October 2009. A total of 295 ICU nurses from five hospitals who had minimum of one year clinical experience participated. Data were analyzed with using descriptive statistics. Results: For importance, emergency care had the highest score, followed by physical assessment, communication, cardiovascular care, and ICU basic nursing. Regarding the frequency, physical assessment had the highest score, followed by communication, medication, ICU basic nursing, and respiratory care. Cardiovascular care was the most difficult task, followed by neurological care, emergency care, other ICU related nursing care, diagnostic test, and communication. Conclusion: The findings indicate a high educational need in the areas of communication, medication, physical assessment, diagnostic test, emergency care, and cardiovascular care. Thus the development of educational programs on communication, medication, physical assessment, diagnostic test, emergency care, and cardiovascular care are needed for ICU nurses.

Reasons, Incidences, and Influencing Factors of Work Interruptions in Intensive Care Unit Nurses (중환자실 간호사에게 발생하는 업무 흐름 중단 이유와 발생빈도 및 영향요인)

  • You, Jung Eun;Lee, Eun Nam
    • Journal of muscle and joint health
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    • v.27 no.3
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    • pp.247-254
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    • 2020
  • Purpose: This was a descriptive observational study examining the reasons for, frequency of, and factors affecting work interruption among intensive care unit (ICU) nurses. Methods: Convenience sampling was used to recruit 46 regular nurses who had been working in an ICU at D tertiary hospital in B metropolitan city for at least six months. To measure the degree of work interruption, this study revised a tool used by Brixey et al. (2007) for analyzing the type of work interruption. Results: A total of 1,787 work interruptions occurred during 368 hours of observation, i.e., at an average of 4.85 times per hour. Communication-related factors caused work interruption most frequently, followed by environmental, work-related, and personal factors. As for the work-related characteristics of nurses, participants experienced work interruption more frequently while working on weekdays, when the medical staff were stationed, than on weekends. Conclusion: ICU nurses experienced work interruption frequently. With the health care system expected to become more complicated in the future, efforts should be made to reduce unnecessary work interruptions to improve the operation efficiency of ICUs.

Development and Effects of the Collaborative Transitional Care Program for Continuity of Care in Patients Transferred to General Wards from ICUs (중환자실 환자의 간호지속성 유지를 위한 중환자실-병동간 연계형 전환간호 프로그램 개발 및 효과)

  • Son, Youn Jung
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.3
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    • pp.143-155
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    • 2009
  • Purpose: This study was conducted to develop and evaluate the collaborate transitional care program for improving continuity of care in patients transferred to general wards from ICUs. Methods: 18 years and older who were hospitalized in adult intensive care units at A university affiliated medical center was recruited for the study. The experimental group for patients transferred from an ICU consisted of 33 patients and family caregivers; 34 patients and family caregivers for the control group. This study was utilized a quasi-experimental research design. The collaborative transitional care program was administered in transfer process. Data were collected two times by interviews, medical records, and telephone using questionnaires. Results: There were statistically significant differences between the two groups on relocation stress (p<.001), perceived health status (p<.001), satisfaction of caring (p=.011), physical domain (p=.022) and mental domain (p<.001) of the QOL. There were significant differences between the families of the two groups on burden (p<.001) and satisfaction of caring (p<.001). Conclusion: The collaborative transitional care programs administered in transfer process to general wards from an ICU have positive effects on patients and families' intrinsic and extrinsic factors. This program will be able to be utilized in clinical fields to improve continuity of care for patients and families between ICUs and general wards.

Nurses' Perceptions toward Parent Participation in Pediatric Intensive Care Unit: A Content Analysis (소아중환자실 부모의 돌봄참여에 대한 간호사의 인식: 내용 분석 연구)

  • Kim, Cho Hee;Chae, Sun Mi
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.12
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    • pp.493-501
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    • 2019
  • This paper describes nurses' perceptions toward parental participation in pediatric intensive care units (PICU). Qualitative data were collected from five nurses working at two PICUs in Seoul through individual in-depth interviews. The interviews were conducted from January to February 2016 and analyzed using traditional content analysis. Five categories were found for the parent participation in PICU: needs, attributes, benefits, barriers, and facilitating strategies for parent participation in PICU. Nurses acknowledged the necessities and benefits of parent participation, particularly in PICU, considering the parents' emotional burdens due to the critical health condition of their child as well as the limited visiting policy. The major barriers were a lack of knowledge and the skills of nurses to facilitate parent participation, nurses' heavy workloads, and lack of policies and guidelines supporting parent participation within the PICUs and hospitals. The participants indicated that organizational facilitating-strategies, such as education for nurses about meaning and skills of parent participation in PICU, raising awareness for nurses as well as parents, and ensuring professional staff dedicated to promoting parent participation, to be significant factors. Further study will be needed to develop nursing interventions to integrate parent participation in PICU care.