• Journal of Korean Academy of Nursing Administration
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• v.20 no.1
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• pp.117-127
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• 2014

Purpose: In order to provide a systematic and standardized treatment course for MVD patients, a critical pathway (CP) program was developed and the results of its long term application were analyzed. Methods: This was a methodological study. The CP was established and applied to 75 (step I) and 1,216 (step II). Another group of 56 with similar features was used as a control group. Results: The application of CP turned out to be useful in many regards: the rate of hearing loss was reduced from 1.8% to 0% (step I) and 0.5% (step II), and low cranial nerve palsy was reduced from 1.8% to 1.3% and 0.7%, respectively. The length of hospitalization decreased by 2.56 days (25.2%) for step I and 3.05 days (30.0%) for step II. Days of ICU stay were reduced by 7.9% and 1.8%. The total cost per patient was reduced by 14.8% (step I). The cost per day was increased by 13.7% and 52.4%. An increase in the patient satisfaction index was noted, as shown in the ICU information guide (p=.002). Conclusion: The development and application of CP was found to improve the quality of medical treatment and the efficacy of hospital management in MVD patients. Well organized and efficient system and multidisciplinary teamwork are the key component of the successful application of CP.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.3
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• pp.351-358
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• 2006

Purpose: The purpose of this study was to compare the effects of oral hygiene with 0.1% chlorhexidine or with normal saline on the incidence of pathogens in the oral cavity of patients in Intensive Care Units (ICU). Method: A quasi experimental design with non-equivalent control group and non-synchronized design was used. For the study 46 patients were recruited from a university hospital (24 for the experimental group, 22 for the control group). patients in the experimental group received mouth care with 0.1% chlorhexidine gluconate and those in the control group received mouth care with normal saline twice a day for 7 days in a row. Oral samples were taken for bacterial cultures on admission day, the 4th day and the 7th day for both groups. Results: The incidence of oral pathogens decreased in the experimental group, and increased in the control group. There was no significant difference in the incidence of oral pathogens between the two groups. However oral hygiene using 0.1% chlorhexidine gluconate decreased the incidence of oral pathogens significantly for patients who already had pathogenic bacteria in their mouths on the admission day. Conclusion: The results suggest that mouth care with 0.1% chlorhexidine is effective for decreasing the incidence of oral infection for ICU patients who have oral infections.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.13 no.2
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• pp.190-199
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• 2006

Purpose: To provide basic data and to identify the risk of pressure ulcers among neurological patients in ICU. Method: The participants in the study were on 78 neurological patients in the ICU of 3 hospitals. Data were collected every other day from 24 hours after admission, for up to 40 days or until discharge. The total period of data collection was 3 months. The risk assessment scales used for pressure ulcer were the Cubbin & Jackson(1991) scale and the National Pressure Ulcer Advisory Panel(1989) skin assessment tool. Results: There was a significant relationship between having a pressure ulcers and weight, skin condition, mental status, respiration, hygiene and hemodynamic status compared to not having a pressure ulcer. The incidence rate of the pressure ulcer was 28.2%(n=22). Of these patients the mean number of hospitalization days until pressure ulcer development was 5.2 days. The most common pressure ulcer site was the coccyx(39.3%). Based on a cut-off point of 24, 9 patients with risk scores <24 on admission also showed risk score for development of pressure ulcers, 10 patients with pressure ulcer scores ${\geq}24$ were older, hospitalized for a longer time, had low serum albumin, low hemoglobin, diabetes mellitus and surgery. Conclusion: In order to make the Cubbin & Jackson risk assessment scales more useful, there is a need to determine the reliability of the upper cut-off point 24. The result also showed a need to assess other risk factors and for early identification of at-risk patients in order to provide preventive care from admission to discharge.

• Journal of Korean Biological Nursing Science
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• v.21 no.2
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• pp.133-140
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• 2019

Purpose: The purpose of this study was to check the degree of residual microbial contamination after disinfection of reusable suction containers, used in an intensive care unit (ICU) and present basic data for efficient use through cost analysis in comparison to disposable suction containers. Methods: This study was conducted on 32 reusable suction containers used in an ICU on a selected specific day. After disinfection and washing, specimens were collected from the used containers and cultured to check for microbial contamination. Additionally, a comparative narrative study analyzes the cost of using reusable suction containers and disposable suction containers. Data were analyzed with the SPSS WIN 20.0 program using real numbers and percentage ${\chi}^2$-test. Results: As a result of the study, microorganisms were found in all samples where in 30 were gram-positive (62.5%) while 13 were gram-negative (27.1%). Based on level of contamination, microorganisms were less than 10CFU/ml in 18 samples (56.3%); 11-99CFU/ml in six samples (18.8%); and more than 100CFU/ml in eight samples (25%). Cost per day for a reusable suction container was $10,655+{\alpha}$ while cost per day for a disposable suction container was 10,666 won. Conclusion: This study found that reusable suction containers, even after disinfection, accounted for factors of potential infection as well as microbial contamination. So, disposable suction containers are superior in cost-effectiveness and highly efficient for use with infected patients.

• Journal of Korean Critical Care Nursing
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• v.15 no.3
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• pp.51-61
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• 2022

Purpose : This study aimed to verify the effectiveness of the clinical ladder system (CLS) by identifying the perception of the CLS, professional self-concept, self-efficacy, and organizational commitment among intensive care unit (ICU) nurses. Methods : Data were collected through a questionnaire survey of 173 nurses working in 11 ICUs at a tertiary hospital in Seoul. Results : The perception of the CLS, self-efficacy, and organizational commitment showed significant difference according to the CLS level. As a result of the partial Spearman correlation analysis after adjusting for demographic difference according to CLS (age, marital status, education, and clinical career), CLS positively correlated with the perception of the CLS (r=.16, p=.045), professional self-concept (r=.24, p=.001), and self-efficacy (r=.21, p=.007). On the contrary, organizational commitment negatively correlated with the perception of the CLS (r=-.43, p<.001) and self-efficacy (r=-.32, p<.001). Conclusion : The CLS is effective for professional self-concept and self-efficacy. However, specialists 2 nurses, who had high professional self-concept and self-efficacy, showed low level of organizational commitment. Thus, it is necessary to examine the factors of work burden and career plateau that are imposed after promotion and improve experience and planning according to the growth needs. Moreover, regular evaluation of the CLS will require hospital support to ensure that ICU nurses appreciate and actively participate in the support.

• Journal of Korean Academy of Nursing Administration
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• v.3 no.1
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• pp.37-50
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• 1997

The purpose of this study was to identify the gap between need-level and demonstration-level in nursing managerial competencies. In addition, the study proposes solutions to narrow this gap. The results of this study are as follows : 1) The mean score for need-level of each item was 4.0, and for demonstration-level, 3.5. This indicates that military hospital head nurses demonstrate a higher level of managerial competencies than the moderate level on all items. But items which were related to resource/ cost/ information managament, staff development management and professionalism management got relatively low ratings in the need-level. 2) The mean score for need-level of each category was 4.14, and for demonstration-level, 3.53. Categories on the individual dimension got a higher rating than categories on the group or organization dimension in both need-level and demonstration level. 3) The gap between need-level and demonstration-level appeared in all items(p<.05) and categories(p<.001). Although the gap was relatively low, it indicates that it is essential to plan a developmemt program for all nursing management competencies for military hospital head nurses. 4) There were significant differences in the gap between need-level and demonstration-level according to specific characteristics of the subjects. The gap did not appear in many categories on the individual dimension where the number of nursing staff was more than 10, a major grade, ICU head nurse or for head nurses having a long career. 5) Need-level and demonstration-level showed a difference according to specific characteristics of the subjects, because need-level and demonstration-level were higher where the number of nursing staff was more than 10, a major grade, and for ICU or Medical ward head nurses. The categories which showed need-level difference and demonstration-level differences according to specific characteristics of the subjects existed almostly completely in the group and organization dimension. Gap-level differences according to the number of hospital bed existed in only two categories. 6) The general causes of the gap were indicated to be 'Knowledge/ skill/ experience deficit', 'Limitation of rules and systems/ Inappropriate organizational environment' for most items, categories, and dimensions. The results of this study indicate that extensive competency developing strategies must be developed, because a gap was found in all items and categories. Specially, there is a need to concentrate attention on competencies in the group and organizational dimension which had a wider gap level. And it is important to take an individual approach according to the cause for each gap. In order to produce effective competency developing strategies, top managers must have sinsights into the importance of nursing staff development and nursing officer's efforts to develop themselves must be achieved. Further multi-dimensional(education, personnel-policy, nursing/ organizational environment) solutions to the gap must be developed and utilized.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.2
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• pp.195-200
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• 2011

Purpose: The purpose of this study was to assess rates for handwashing adherence before and after nursing contact in intensive care units (ICU). Methods: The participants included 90 nurses working in intensive care units of an 800-bed university-affiliated hospital in Gyeonggi Province and 2000-bed university-affiliated hospital in Seoul. Time for handwashing was calculated using the average number of handwashings during an 8-hour day shift. Nursing contact was based on indications as defined by the Centers for Disease Control and Prevention (CDC, 2002). Data were analyzed using frequency, percent, t-test and ${\chi}^2$-test. Results: During an 8-hour day shift, the average number of times that hands were washed was 25.0. The rates were significantly lower before the nursing contact than after the nursing contact when it involved sectioning, observation or contact with a wound, cleaning enteric feeding bag, physical exam, use of gloves, or contact with contaminants. Conclusions: The results indicate that as handwashing rates were significantly lower before nursing contacts than after nursing contacts, there is need to develop strategies to address this deficiency in handwashing.

• Journal of Korean Academy of Nursing
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• v.28 no.2
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• pp.457-467
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• 1998

The purpose of this research was to identify nursing interventions performed by MICU and SICU nurses. For data collection this study used the taxonomy of the Nursing Interventions Classification (NIC : 433 nursing interventions) which was modified by McCloskey and Bulecheck(1996). Each of the 433 interventions were identified as used by MICU and SICU nurses. More than 50% of the ICU nurses performed 280 nursing interventions at least monthly. Rarely used interventions included 26 nursing interventions in the childbearing care class. Overall, both MICU and SICU nurses used interventions in the Physiological : Complex domain most often on a daily basis and the interventions in the Family domain least often. The most frequently reported interventions as being used daily in the MICU were chest physiotherapy, airway suctioning and coughing enhancement and, in the SICU, documentation and airway suctioning. There were significant differences between MICU and SICU nurses in 17 nursing interventions childbearing care, cognitive therapy, communication enhancement, coping assistance, elimination management, lifespan care, health system mediation, immobility management, medication management, neurologic management, patient education, psychological comfort promotion, physical comfort promotion, respiratory management, risk management and information management. The SICU nurses performed there interventions more frequently than the MICU nurses. These findings will help in building of a standardized language for the MICU and SICU and enhance the quality of nursing care.

• Journal of Korean Clinical Nursing Research
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• v.26 no.2
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• pp.207-216
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• 2020

Purpose: The purpose of this study was to investigate the motor subtypes of delirium in patients in a Surgical Intensive Care Unit (SICU), and identify the factors related to the characteristics of patients according to the motor subtypes of delirium. Methods: Data were collected in the SICU of a tertiary hospital in ^⁎ city from October 2018 to June 2019. Delirium was detected using the Confusion Assessment Method for the ICU (CAM-ICU) and motor subtypes of delirium were measured with the Delirium Motor Subtype Scale (DMSS)-4. Patients' characteristics were obtained by using the electronic medical records. Descriptive statistics were used to analyze the data. Results: Among 1,112 patients, 172 patients showed delirium (15.5%). After excluding dementia patients and patients refusing to participate in the study, 126 patients included in the final analysis. Delirium patients were classified as hyperactive delirium (32.5%), hypoactive delirium (42.9%), mixed delirium (11.9%), and non-motor subtype delirium (12.7%). Conclusion: The study results suggest that hypoactive delirium is the most prevalent motor subtype of delirium in SICU. More application of ventilators, more administration of sedatives, more use of catheters, and higher nursing severity were reported for hypoactive delirium cases than hyperactive ones. Therefore, it is necessary to assess early the motor subtypes of delirium using structured tools and develop appropriate nursing interventions suitable for each subtype of delirium.

• Journal of Home Health Care Nursing
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• v.21 no.2
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• pp.120-126
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• 2014

Purpose: This study was carried out to investigate the effect of a decrease in indwelling catheter size and preoperative education on bladder discomfort and nursing needs. The study was conducted on patients in the recovery room after their surgery. Methods: This study is a randomized control trial. Data were collected from September 2011 to February 2012 at a university hospital in Bundang, Korea. The sample consisted of 75 patients, excluding one patient from the experimental group 2. From among the patients that were sent to the ICU, 24 were in experimental group 1, 24 were in experimental group 2, and 27 were in the control group. Data were collected and analyzed using a chi-square test, t-test, and one-way ANOVA. Results: There were significant differences between the bladder discomfort experienced by patients in experimental group 1 and the control group, and experimental group 2 and the control group. Then nursing needs of the control group were higher than those of the experimental groups 1 and 2. Conclusion: The decrease in indwelling catheter size and preoperative nursing education is an effective nursing intervention in perioperative care.