• Title/Summary/Keyword: Intensive Care Units

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Clinical Usefulness of Gastric Residual Volume as An Indicator to Provide Approximately Enteral Nutrition for Patients in Intensive Care Units: A Systematic Literature Review (중환자의 경관영양 공급 지표로서 위 잔여량의 임상적 효용성: 체계적 문헌고찰)

  • Kim, Hyunjung;Chang, Sun Ju
    • Journal of Korean Biological Nursing Science
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    • v.16 no.4
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    • pp.267-275
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    • 2014
  • Purpose: The practice of enteral nutrition with gastric residual volumes (GRVs) as a clinical indicator is poorly standardized in intensive care units. This study aims to summarize the results from studies that evaluated the clinical outcomes related to the GRVs. Methods: This systematic review study analyzed 11 studies consisting of four randomized controlled trials, one non-randomized controlled trial, and six observational studies. Results: No consistent relationship between GRV thresholds and clinical outcomes was observed. Higher GRVs were not consistently correlated with clinical outcomes such as higher gastrointestinal complications, aspiration pneumonia, or mortality. Higher GRVs significantly generate complications more often. Findings show that a single GRV more than 200 mL or two consecutive GRVs more than 150 mL should raise concern about negative consequences. Conclusion: Critical care nurses need to monitor GRVs closely during their practice of enteral nutrition. For critically ill patients receiving enteral nutrition, a GRV threshold of 200 ml would be a desirable limit to provide safe and adequate nutrition with a conservative approach.

Effect of a New Developed Physical Restraint to Reduce Skin Injury in Intensive Care Units (중환자실에서 피부손상을 감소시키기 위한 억제대 개발 및 적용효과)

  • Mun, Jung-Sook;Lee, Gyeong-Nam;Lee, Dong-Suk
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.18 no.1
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    • pp.28-36
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    • 2011
  • Purpose: The purpose of this study were to develop a new restraint for the intensive care units (ICU) and to investigate the application effect in comparison with a control group using existing restraints. Method: A non-equivalent control group non-synchronized quasi-experimental research design was used. The participants were 40 (control 20, experimental 20) patients who were recruited by convenience sampling the ICU of a university hospital. To avoid contamination of the experiment, data for the control group were collected prior to the experimental group. Measurement variables were edema and skin damage (redness and abrasion) at the application site, and nurses' perceived convenience in applying restraints. Results: Three days after applying the restraint, amount of edema at the application site was small and incidence of skin damage decreased in the experimental group in comparison with the control group. Also, score for application convenience measured by the nurses was higher in for the newly developed restraint than for existing restraints. Conclusion: Results indicate that the newly developed restraint has lower effects such as edema and skin damage and is more convenient compared with existing restraints, and is therefore recommended for patients in the ICU.

Influence of Communication Competence and Burnout on Nursing Performance of Intensive Care Units Nurses (중환자실 간호사의 의사소통 능력, 소진이 간호업무성과에 미치는 영향)

  • Son, Youn-Jung;Lee, Youn A;Sim, Kyoung Nan;Kong, Seong Sook;Park, Young-Su
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.20 no.3
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    • pp.278-288
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    • 2013
  • Purpose: The purpose of this study was to investigate the influence of communication competence and burnout on nursing performance in intensive care units (ICU). Method: The participants were 209 nurses from four university hospitals. Measurements included a socio-demographic and job related survey, communication competence inventory, the Maslach burnout inventory and a nursing performance scale. Data were collected from February 6 to 24, 2012, with a self-report questionnaire. The statistical analyses were performed with SPSS 18.0 software. Results: The mean scores for communication competence, burnout and nursing performance were 50.49, 84.72, and 62.18, respectively. Communication competence (r=.44, p<.001) and burn out (r=-.32, p<.001) were significantly correlated with nursing performance. In the multiple linear regression, factors influencing nursing performance were communication competence, age and burnout. These variables explained about 46% of the total variance of nursing performance. Communication competence (${\beta}$=.34, p<.001) was the most influential factor. Conclusion: Nurses' poor communication skills and burnout can influence the occurrences of medical errors in ICU nursing performance. The results suggest that good communication and burnout resolution skills programs should be implemented to improve nursing performance efficiency.

Stress due to End-of-Life Care, Coping Strategies, and Psychological Well-being among Nurses in Neonatal Intensive Care Units (신생아집중치료실 간호사의 임종간호 스트레스, 대처방식 및 심리적 안녕감)

  • Kwon, Eun Hee;Ju, Hyeon Ok;Jeung, Eun Ok;Han, Chun Hee;Im, Jin Ju;Lee, You Ri;Jung, Min Seung;Park, So Yeon
    • Child Health Nursing Research
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    • v.24 no.4
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    • pp.475-483
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    • 2018
  • Purpose: This study aimed to identify stress levels due to end-of-life care, coping strategies, and psychological well-being among nurses in neonatal intensive care unit, and to investigate the effect of stress levels and coping strategies on their well-being. Methods: A total of 128 nurses in the neonatal intensive care units of general hospitals in B city participated. The data were collected using a self-report questionnaire. The collected data were analyzed using descriptive statistics, the t-test, ANOVA, the Pearson correlation coefficient, and hierarchical regression with SPSS version 22.0. Results: The coping strategy that nurses most often used was seeking social support. The factors affecting the well-being of the participants were wishful thinking, problem-focused coping and seeking social support, in order. Those 3 variables explained 21 % of the total variance in psychological well-being. Problem-focused coping and seeking social support were positively associated with psychological well-being, while wishful thinking showed a negative association. Conclusion: In order to improve the psychological well-being of nurses in neonatal intensive care units, it is necessary to provide nurses with a program to build a social support system and to improve their problem-based coping skills.

Experience of Patients and Families about Flexible Visiting (중환자실 환자와 가족의 자율면회 경험)

  • Dan, So-Young;Park, Sook-Hyun;Lee, Seul;Park, Hye-Yeon;Yi, Young-Hee
    • Journal of Korean Critical Care Nursing
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    • v.10 no.1
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    • pp.51-62
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    • 2017
  • Purpose: This study aimed to understand the essence of experiences of patients and family members during flexible visiting in an intensive care unit (ICU). Methods: This is a qualitative study using interviews with open ended questions. We used Colaizzi's method of phenomenological interpretation. Results: Flexible visiting in the ICU impacted the patients and their families in various ways. The following categories were extracted from the patients' experiences with flexible visiting: 1) the opportunity to feel the presence of the family and 2) the burden of unrestricted visiting. The following categories were extracted from the families' experiences with flexible visiting: 1) psychological comfort by convenience 2) being aware of health care professionals and critical care nursing in the intensive care unit, and 3) double trouble. Conclusions: These results showed that flexible visiting in the ICU affected the patients and their families positively and negatively. Therefore, nursing staff need to design psychological and social interventions that address the needs of patients and their families.

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The Effect of Perceived Patient- and Family-Centered Care on Nurses' Caring Behavior in Intensive Care Units (중환자실 간호사의 환자-가족 중심 간호에 대한 인식이 돌봄 행위 수행에 미치는 영향)

  • Kim, Na-Yeon;Choi, Hye-Ran
    • Journal of Korean Biological Nursing Science
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    • v.23 no.3
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    • pp.208-216
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    • 2021
  • Purpose: The purpose of this study was to identify the factors influencing nurses' caring behavior. Methods: The descriptive study included 178 intensive care unit (ICU) nurses who completed a self-report structured questionnaire. The data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, and Pearson's correlation and multiple regression analysis using the IBM SPSS/WIN 23.0 program. Results: Significant correlation existed between perception of Patient- and Family-Centered Care (PFCC) and nurses' caring behaviors (r=.36, p<.001). Multiple regression analysis showed that perception of support (β=.36, p<.001), total career length (β=.33, p<.001), and familiarity with PFCC (β=.15, p=.018) affected the caring behavior of ICU nurses. These variables explained 30.0% of the variance in caring behavior. Conclusion: Effective strategies are needed to improve perceptions of support as well as to promote PFCC for increasig the frequency of caring behavior among ICU nurses.

Analysis of the Nursing Interventions Performed by Hospital Nurses Using NIC (간호중재분류(NIC)에 근거한 간호중재수행분석 I -병원 간호사를 중심으로-)

  • 염영희
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.346-360
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    • 1999
  • The purpose of this research was to identify nursing interventions performed by hospital nurses in Korea. The sample consisted of 311 nurses working in three hospitals. The Nursing Interventions Use Questionnaire developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean using the method of back-translation. Eighteen interventions were performed at least daily. Interventions in the Physiological : Basic domain were most frequently used at least daily. No interventions in the Family and Behavioral domains were used by nurses at least once a day. The most frequently used interventions was Documentation, followed by the interventions Medication : Parenteral, Intravenous(IV) Insertion, Temperature Control, and Shift Report. The intervention performed least often was Reproductive Technology Management. Nurses working in intensive care units on the whole performed interventions most often, while nurses working in obstetric, gynecological, and pediatric units performed them least often. The nurses working in intensive care unit, medical and surgical care units performed the interventions in the Physiological : Basic domain more often than the nurses working in obstetric, gynecological, and pediatric units. The nurses working in obstetric, gynecological, and pediatric units used the interventions in the Family domain more often than the nurses working in the other three units. This study contributes to the documentation of nursrs' work in Korea. Further study will be needed to validate nursing activities of each NIC intervention.

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Risk Factors for Deliberate Self-extubation (기관 내 삽관환자의 의도적 자가발관 위험요인)

  • Cho, Young Shin;Yeo, Jung Hee
    • Journal of Korean Academy of Nursing
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    • v.44 no.5
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    • pp.573-580
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    • 2014
  • Purpose: This study was conducted to analyze intubation survival rates according to characteristics and to identify the risk factors affecting deliberate self-extubation. Methods: Data were collected from patients' electronic medical reports from one hospital in B city. Participants were 450 patients with endotracheal intubation being treated in intensive care units. The collected data were analyzed using Kaplan-Meier estimation, Log rank test, and Cox's proportional hazards model. Results: Over 15 months thirty-two (7.1%) of the 450 intubation patients intentionally extubated themselves. The patients who had experienced high level of consciousness, agitation. use of sedative, application of restraints, and day and night shift had significantly lower intubation survival rates. Risk factors for deliberate self-extubation were age (60 years and over), unit (neurological intensive care), level of consciousness (higher), agitation, application of restraints, shift (night), and nurse-to-patient ratio (one nurse caring for two or more patients). Conclusion: Appropriate use of sedative drugs, effective treatment to reduce agitation, sufficient nurse-to-patient ratio, and no restraints for patients should be the focus to diminish the number of deliberate self-extubations.

Risk Factors for Nosocomial Urinary Tract Infection in the Intensive Care Unit with a Positive Urine Culture and Foley Catheterization (소변 미생물 균주 양성인 중환자실 유치도뇨관 환자의 병원성 요로감염 발생과 관련요인)

  • Yu, Seong-Mi;Park, Kyung-Yeon
    • Journal of Korean Academy of Nursing
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    • v.37 no.7
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    • pp.1149-1158
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    • 2007
  • Purpose: The purpose of this study was to identify the risk factors for a nosocomial urinary tract infection in intensive care units with a foley catheterization which showed a positive urine culture. Method: Three-hundred eighty-seven patients were included in the study. A retrospective review of the electrical medical record system's databases and medical record sheets in hospitalized patients from January 2003 to December 2003 was used. The collected data was analyzed by descriptive statistics, t-test, chi-square test and logistic regression analysis. Result: The frequency of the participants' nosocomial urinary tract infection was 72.9%. Significant risk factors for a nosocomial urinary tract infection were 'age', 'place of catheter insertion', 'frequency of catheter change', and 'duration of catheterization'. These variables explained 18.4% of variance in the experience of nosocomial urinary tract infection in intensive care units with foley catheterization. Conclusion: Medical personnel can decrease the incidence of a nosocomial urinary tract infection by recognizing and paying attention to the duration of catheterization, frequency of catheter change, and place of catheter insertion. As a result, specific and scrupulous strategies should be developed to reflect these factors for decreasing nosocomial urinary tract infections.

Glucose Control in Intensive Care Unit Patients: Recent Updates (중환자의 혈당 조절: 최신 업데이트)

  • Rhee, Sang Youl
    • Journal of Neurocritical Care
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    • v.11 no.2
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    • pp.81-85
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    • 2018
  • Proper glucose management in hospitalized patients can improve clinical outcomes. In particular, intensive care unit (ICU) patients are known to have significantly higher rates of mortality from changes in blood glucose due to severe comorbidities. Improving glucose control in ICU patients, therefore, can improve mortality and prognosis. Several studies related to the management of blood glucose in the ICU patients have been conducted. Intensive glucose management of surgical ICU patients has been successful. However, studies on medical ICU patients did not demonstrate positive effects of strict glycemic control. There is no independent glucose management goal for neurological ICU patients. However, maintenance of the usual glucose control target of 140-180 mg/dL is recommended for ICU patients. Intravenous insulin infusion is essential for glucose control in ICU patients not consuming a regular diet, and caution should be exercised to prevent hypoglycemia.