• The Korean Journal of Rehabilitation Nursing
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• v.14 no.1
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• pp.62-69
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• 2011

Purpose: The study assessed whether nurse staffing was associated with 3 nursing sensitive outcomes used in intensive care unit (ICU) nursing care plans. Methods: This study was a retrospective and descriptive study using clinical data extracted from the data warehouse of a large acute care hospital in the Midwest. One-way analysis of variance was used to analyze the records of 578 ICU patients admitted from March 25 to May 31, 2010. Results: 79 Nursing Outcomes Classification (NOC) outcomes were used in the nursing care plans. The 3 most commonly used NOC outcomes (Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes) were analyzed to determine their relationship to nurse staffing. As a nurse staffing ratio, the skill mix of nursing caregivers ranged from 0.74 to 1 with an average of 0.90. This skill mix of nursing caregivers significantly differed among the changes in Infection Severity scores. However, the mean difference was only 0.02. Conclusion: The results did not support that greater nurse staffing was associated with better outcomes. More research is still needed to determine the usefulness of Pain Level, Infection Severity, and Tissue Integrity: Skin and Mucous Membranes in evaluating the impact of nurse staffing.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.12 no.1
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• pp.121-130
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• 2005

Purpose: This study was done to determine the rate for handwashing by intensive care unit nurses according to the content of nursing tasks, to investigate the relationship between hand washing practice evaluated by nurses themselves and their actual practice observed, and finality to provide basic materials for strategy for hand washing education. Method: Data were collected by observing 27 nurses working in intensive care units of a hospital in Uijeongbu, Gyeonggi-do and by using observation and a structured self-assessment tool. Collected data were analyzed with SPSS and SAS. Results: The handwashing rate for the nurses was 4.3%. The handwashing rate was high in proportion to the risk of cross infection. In addition, the handwashing rate was highest in nurses working in the neurosurgery intensive care unit. The average score for self-assessment of handwashing was $49.42{\pm}3.78$ points and it was higher than their actual practice of handwashing. Conclusion: In order to improve handwashing by nurses, it is necessary to educate them on the importance of handwashing. In addition, there should be strategies for standardizing knowledge and attitudes to handwashing and inducing nurse:3 to practice hand washing in compliance with the policies and working conditions of the institution.

• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.3
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• pp.37-46
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• 2019

Purpose: The Intensive Care Unit (ICU) is an important inpatient care area where critical patients are treated intensively with advanced medical technology. The level of care of ICU and the modernization of related facilities is an important indicator of health care quality. At the present time, when the Regional public hospitals are frequently expanding, the rational planning of the ICU has become an important part of the medical institutions treating the ICU. The purpose of this study is to present basic data with net area which can be used in the architectural planning of the ICU. Methods: The investigation and analysis of the ICUs were conducted on 24 medical facilities, based on theoretical analysis through relevant guidelines, articles, and documents, and on the basis of the actual space composition and net area analysis through the architectural drawings. Results: This study provides basic data such as bed placement type of ICU, relationship with other departments, distance between NS and bed, distance between beds, and net area of disease by type. Implications: The results of this paper are expected to be effective reference materials for future research for rational spatial organization and efficient operation of the Intensive Care Unit in regional public hospitals.

• Journal of Korean Clinical Nursing Research
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• v.22 no.2
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• pp.205-216
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• 2016

Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Neonatal care nurses (KPCSN). Methods: The study was conducted in tertiary and general hospitals with 1~2 grade according to nursing fee differentiation policy for NICU (neonatal intensive care unit) nurse staffing. The reliability was evaluated for the classification of 218 patients by 10 nurse managers and 56 staff nurses working in NICUs from 10 hospitals. To verify construct validity, 208 patients were classified and compared for the type of stay, gestational age, birth weight, and current body weight. Nursing time was measured by nurses, nurse managers, and nurse aids. For the calculation of conversion index (total nursing time divided by the KPCSN score), 426 patients were classified using the KPCSN. Data were collected from September 5 to October 28, 2015, and analyzed using t-test, ANOVA, intraclass correlation coefficient, and non-hierarchial cluster analysis. Results: The final KPCSN consisted of 11 nursing categories, 71 nursing activities and 111 criteria. The reliability of the KPCSN was r=.83 (p<.001). The construct validity was established. The KPCSN score was classified into four groups; group $1:{\leq}57points$, group 2: 58~80 points, group 3: 81~108 points, and group $4:{\geq}109points$ in the KPSCN score. The conversion index was calculated as 7.45 minutes/classification score. Conclusion: The KPCSN can be utilized to measure specific and complex nursing demands for infants receiving care in the NICUs.

• 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.15 no.3
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• pp.12-22
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• 2022

Purpose : This study aimed to examine the relationships of burnout and compassion competency with job satisfaction among nurses working in the intensive care units and emergency rooms. Methods : A correlational survey was conducted from August 1 to August 14, 2018 and involved in 102 nurses working at four university hospitals for more than 1 year. A structured questionnaire was used to measure burnout, compassion competency, and job satisfaction, and data were analyzed using hierarchical multiple regression and mediation effect analysis. Results : The mean scores of burnout, compassion competency, and job satisfaction were 2.58, 4.35, and 2.95, respectively. Burnout and compassion competency along with working night shifts and a wish to transfer explained 35.3% of variance in job satisfaction. Compassion competency showed a small but significant mediating effect in the relationship between burnout and job satisfaction (indirect effect -.0446, 95% CI -.1133, -.0075). Conclusion : Burnout and compassion competency were the significant influencing factors of job satisfaction among nurses working in intensive care units and emergency rooms. Since compassion competency showed a significant mediating effect, further studies should focus on intervention strategies for compassion competency to improve job satisfaction in this population.

• Journal of Korean Critical Care Nursing
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• v.17 no.1
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• pp.17-29
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• 2024

Purpose : This study sought to investigate novice nurses' communication education needs in the intensive care unit (ICU) using Importance-Performance Analysis (IPA) and Borich's need assessment model. This study identified communication challenges in clinical settings to develop a simulation program that enhances communication competencies based on educational requirements. Methods : A descriptive research design and a self-report questionnaire were used. The latter was developed and administered to 121 novice nurses with less than one year of experience in the ICU at various university hospitals in Korea. Data were collected via the online open chatroom from June 24th to July 28th, 2023. The communication education needs were identified using descriptive statistics, t-tests, IPA, and Borich's needs assessment model. Text analysis was used to categorize the participants' communication experience. Results : The results revealed that "communication with physicians," "communication with patients," and "communication with nurse on another shift" domains contained the most substantial educational needs for novice nurses working in the intensive care units. Conclusion : The results provide fundamental data for developing and enhancing customized communication education programs for novice ICU nurses. This valuable information could help ICU nurses and educators improve new nurses' communication skills, which would ultimately contribute to the advancement of nursing education and clinical practice.

• Journal of Korean Clinical Nursing Research
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• v.28 no.1
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• pp.1-12
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• 2022

Purpose: The purpose of this study is to investigate the association between the nurse staffing level and the patient mortality using Korean National Health Insurance data. Methods: The data of 1,068,059 patients from 913 hospitals between 2015 and 2016 were analyzed. The nurse staffing level was categorized based on the bed-to-nurse ratio in general wards, intensive care units (ICUs), and hospitals overall. The x² test and generalized estimating equations (GEE) multilevel multivariate logistic regression analyses were used to explore in-hospital mortality and 30-day mortality after admission. Results: The in-hospital mortality rate was 2.9% and 30-day mortality after admission rate was 3.0%. Odd Ratios (ORs) for in-hospital mortality were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.72, 95% CI=0.63~0.84) and in ICUs with a bed-to-nurse ratio of less than 0.88 compared to that with 1.25 or more (OR=0.78, 95% CI=0.66~0.92). ORs for 30-day mortality after admission were statistically lower in general wards with a bed-to-nurse ratio of less than 3.5 compared to that with 6.0 or more (OR=0.83, 95% CI=0.73~0.94) and in ICUs with a bed-to-nurse ratio of less than 0.63 compared to that with 1.25 or more (OR=0.85, 95% CI=0.72~1.00). Conclusion: To reduce the patient mortality, it is necessary to ensure a sufficient number of nurses by improving the nursing fee system according to the nurse staffing level.

• Clinical and Experimental Pediatrics
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• v.51 no.3
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• pp.243-247
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• 2008

Neonatal intensive care in Korea has improved remarkably since the 1990s, but there is still a shortage of facilities and equipment in NICUs. Only 71.1% of the beds needed for neonatal intensive care are available. Mechanical ventilators are not appropriately distributed to the NICUs that are equipped to handle neonatal intensive care. The number of doctors is far too small, making the number of patients per doctor very high. Nurses, too, need to take care of 7.7 patients per nurse, making it very difficult to provide adequate intensive care. All this is caused by insufficient investment by the hospitals, which, in turn, is caused by inadequate reimbursement from health insurance. Therefore, a government-sponsored effort is necessary to bring the level of neonatal intensive care up to par.

• Journal of Korean Clinical Nursing Research
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• v.29 no.3
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• pp.312-326
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• 2023

Purpose: This study attempted to analyze the staffing level and critical care nursing fees of intensive care units at tertiary and general hospitals and to provide a professional judgment-based recommendation on staffing level and critical care nursing fee schedules. Methods: Staffing grades and critical care nursing fee schedules for the first quarter of 2017~2020 and the fourth quarter of 2020~2022 were analyzed. A survey was conducted on nursing managers and nurses about the current and appropriate staffing levels. A total of 77 nurse managers and 708 nurses working in Intensive Care Unit(ICU)s at tertiary and general hospitals participated in the study. Results: Grade 1 staffing increased from 25.6% in 2017 to 92.1% in 2022 at tertiary hospitals and from 0.8% in 2017 to 28.4% in 2022 at general hospitals. The current staffing ratios of tertiary and general hospitals were 1:2.21 and 1:2.77, respectively. The appropriate staffing ratio according to nurse managers and nurses was 1:1.00 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in tertiary hospitals, and it was 1:1.25 in patients with more than a ventilator application and 1:2.00 in patients without any ventilator application in general hospitals, respectively. Conclusion: The appropriate staffing level was suggested from 1:1.0 to 1:2.0. The new nursing fee schedules were suggested from 1:1.0 (Grade 1) to 1:3.0 (Grade 5) and recommended to be paid based on the staffing grade, minimum number of nurses, and standard annual working days. It is expected to increase staffing levels and provide a better nursing work environment.