Purpose: For this study an examination was done of relationships between intensive care unit (ICU) nurses' knowledge related to sedation and their clinical competencies in sedation practice. Methods: Ninety one ICU nurses were recruited from two tertiary hospitals in South Korea. A self-report questionnaire was used to examine the levels of knowledge related to sedation and nursing practice competence based on Ajzen's theory of planned behavior. Descriptive statistics, independent t-tests, one-way ANOVA, and Pearson correlations were performed using the IBM SPSS 21.0 Results: ICU nurses are more knowledgeable about general information on sedation rather than up-to-date information. Continuing education on sedation was related to difference in knowledge levels. However, the levels of knowledge were not related to competence in sedation practice. Instead, a positive attitude toward sedation practice was significantly related to the subjective norms; orders and goals, perceived behavioral control, practice of sedation, and intention to use. Conclusion: The results of this study provide fundamental information on levels of knowledge related to sedation practices of Korean ICU nurses. Continuing education should emphasize up-to-date information on sedation practice and need for positive attitudes which influence all other competencies towards sedation practices to achieve optical care of sedation in the ICU.
Purpose: The purpose of this study was to assess critical care nurses' perception, knowledge, and nursing practices regarding enteral nutrition. Methods: A descriptive study was conducted with 187 nurse participants who worked in one of the eight medical and surgical intensive care units (ICUs) from four hospitals in Korea. Data were collected using a self-administered questionnaire. Results: Although critical care nurses' perception toward enteral nutrition was high, knowledge was relatively low. The overall perception and knowledge of the nurses did not differ significantly between medical ICU and surgical ICU nurses. Perception of their own knowledge, in particular, 'nutritional goal' was lower for medical ICU nurses compared to surgical ICU nurses. Nurses also had limited knowledge about the significance of enteral nutrition, confirmation of feeding tube location, and nutritional requirements for ICU patients. They inadequately performed the following: changing the feeding tube every 24 hours, inspecting nostrils daily, and adjusting feeding schedule if feeding was stopped. Conclusion: Our results indicate that ICU nurses need up-to-date information about enteral nutrition. Based on the improved perception and knowledge, nursing practice activities with regard to enteral nutrition should be emphasized to enable nurses to provide optimal nutrition for ICU patients.
Purpose: The purpose of current study was to explore the positive outcomes of advanced practice nurse who have experienced the roles in their clinical settings. Methods: This study adopted a qualitative research design based on conventional content analysis. Participants were 16 nurse practitioners have been worked at hospitals or community centers. Data were collected via focus group interviews and analyzed using thematic analysis method. Results: Patients' aspect outcomes were "client-centered care in providing continuity", "providing trust based on expertise", "promoting skilled intervention in patient recovering", "blocking the negative consequences", "quality improvement: nursing becoming tighter", "providing total care for cases that require intensive care", "improving patients outcomes by total management", "increasing confidence in evidence-based professional nursing", "rising the satisfaction by cost-effective services", "providing skilled professional practice", and "providing comprehensive care related to covering various aspects". Other themes elicited also included "promoting efficacy by inter-related health professions supervising", "the expansion of specialized practice areas increase business efficiency", "formation of outside customers due to increasing the satisfaction with skilled nursing care", "filling in the emptying spaces of doctors by practicing reliable role to bridge", "attracting external customers through successful management of subjects", "increasing staff's satisfaction on the role to make a bridge between inside and outside doctors", "24 hours medical expertise of professional staff ready secured", and "low cost, same results, that is, cost-effective" in reference to health care resources aspect. Conclusion: These findings suggested that advanced practice nurses perceived various positive outcomes and provided basic data for outcome indicators of advanced practice nurses' role.
Our medical care system is trying to diversify in order to meet the client's needs, and to adjust to a medical environment which is changing very rapidly. Because current nursing theory and practice focus on holistic care, health care management, education, and research, contrary to the traditional emphasis on only assisting a physician, more autonomy and specialization for the implementation of nursing are required. Considering these trends and actual needs, the category of clinical nurse specialist should be established as soon as possible. In order to develop strategies for implementing this new professional specialty, the authors conducted a field survey and literature review of the current system in Korea. As a result, various obstacles and constraints were discovered as follows : 1) There are few accredited educational programs for the training of CNS's. 2) Several hospitals already have staff designated as clinical nurse specialist (CNS) even though the term CNS is not yet standardized or adopted in nationwide. 3) The role of the CNS is not clearly understood by the medical societies, or even nursing societies. A nurse who works in specific nursing areas such as central supply, kidney dialysis, intensive care, coronary care, etc. for a long time, considers herself /himself a CNS. Based upon the above findings, the following alternatives are recommended. 1) The role of the CNS should be defined according to specified functions and authority : professional autonomy ; counselling and educating patients and their familes, nurses, and even other medical personnel ; research on improvement of nursing ; and management of the nursing environment including medical resources, information, and cases. 2) the qualification of CNS should be attained only by a nurse who has an RN license and clinical experience of more than 3 years in a specific nursing field: passes a qualifying examination; and contributes to the professional development of peers, colleagues, and others. A master's degree should only be optional, because of the insufficient of graduate programs which are well designed for the CNS. 3) The CNS should initially be a head nurse rather than line staff in order to deal with as wide an experience base as possible. 4) The nursing specialty could be divided into two areas such as a clinical field and a community field. The clinical field could then be categorized by the Styles' classification such as diseases and pathogenics, systems, ages, acuity, skills/techniques, and function/role ; the community field could be classified according to work site.
Purpose : This study aimed to identify intensive care units (ICU) nurses' experience of traumatic events, deliberate rumination, self-disclosure, social support, and post-traumatic growth (PTG), and to explore relationships among the variables. Methods : Participants were 157 nurses who have provided direct patient care for six months or more in ICUs at a university hospital. Collected data were analyzed using descriptive statistics, independent t-tests, one-way ANOVAs, Pearson correlations, and multiple linear regressions using the SPSS/WIN version 23.0. Results : The PTG was found to be significantly associated with deliberate rumination (r=0.36, p<.001), self-disclosure (r=0.39, p<.001), and social support (r=0.54, p<.001). Factors that affect PTG significantly were found in the order of social support (𝛽=0.40, p<.001), self-disclosure (𝛽=0.25, p<.001), and deliberate rumination (𝛽=0.24, p<.001). The final regression model explained 40.1% of the variance of PTG (F=26.33, p<.001). Conclusion : The influencing factors identified in this study on PTG, including social support, self-disclosure, and deliberate rumination should be included in programs to promote PTG for ICU nurses who may experience traumatic events repeatedly.
Objective: The objective of this research was to develop a guideline for more effective use of physical restraint on patients in the intensive care unit and training the nurses on it and applying it on clinical practice to assess its effectiveness. Method: This research analyzed the before and after effect of the development of a guideline for physical restraint by dividing the category into nurse and patient. In the case of nurse, a comparison of knowledge and nursing service regarding the use of physical restraint from before the training on physical restraint guideline(Jan. 2011) and after the training on physical restraint guideline(Dec. 2011) was made. In the case of patient, a comparison of physical restraint usage rate and average usage time, the number of unplanned extubation cases were compared from before the use of physical restraint (Jan.~Apr. 2011) and after the use of physical restraint (Sep.~Dec. 2011) were made. Result: After the training on the physical restraint guideline, the knowledge of the nurse and the nursing practice showed notable improvement by (p<0.000) and (p<0.048) respectively and in patient, physical restraint usage rate and average time of usage decreased by (p<0.001) and (p<0.001) respectively. And despite the decrease in the number of cases in which the physical restraint was used, the number of unplanned extubation cases remained the same. Conclusion: Physical restraint guideline training and guideline usage can be stated to have brought out positive effect in both the nurse and patient. In order to maintain such positive effects, continuous training is necessary and continuous revaluation is necessary, regarding knowledge and nursing practices.
Purpose: The purpose of this study was to reclassify the advanced nursing practices of critical care nurse practitioners(CCNPs) in intensive care unit and measure the time and frequency of CCNP's activities. Method: Practices of ICU nurses are divided into RN's and CCNP's practices by a panel of ICU nursing experts. Each practice of CCNP is defined and CCNP's working time and service frequencies are monitored in general hospitals. Result: Practices of CCNP were classified into 4 domains and 32 practices. Fourteen practices by CCNPs were completed in 10 minutes and the other 12 practices consumed 10-30 minutes. A priority of practice in respiratory therapy was given to artificial airway management, management of tracheostomy patient, lower respiratory care, and the priority of CRRT was management of anticoagulation. Conclusions: Advanced nursing practices of CCNPs were recognized from those of RNs. A further research of CCNPs practices should be extended to other advanced practices and it is required to evaluate economic value of advanced nursing practice in the national health insurance system.
Purpose : The study aimed to identify relationship among intensive care unit (ICU) nurses' critical thinking disposition, medication error risk level of high-alert medication, and medication safety competency, as well as the factors affecting medication safety competency. Methods : The participants were 266 ICU nurses of one higher-tier general hospital and one general hospital in Province. The data were collected using structured self-administered questionnaire from August 10 to August 31, 2021. Measurements included the critical thinking disposition questionnaire, nurses's knowledge of high-alert medication questionnaire, the medication safety competency scale. Data were analyzed using hierarchical multiple regressions using SPSS/WIN 28.0. Results : In the multiple regression analysis, the medication safety competence has a statistically significant correlation with the working department, the critical thinking disposition, and medication error risk level of high-alert medication. Conclusion : Based on the results of this study, it is suggested to develop and apply an educational strategy that can strengthen the knowledge and skills of critical thinking disposition and medication error risk level of high-alert medication to improve the ICU nurse's medication safety competency.
This study was performed from september 26th to October 7th 1981 to investigate the contamination problems of Nurse's hands characterized by var-ious nursing functions. A total of 50 nurse's hands were sampled from 5 different wards of H. University Hospital. The samples were cultured for isolation of microorganisms. The results were as follows: 1. Of 50 Nurses 23 were found to be contaminated by 9 species of bacilli such as Non-fermentative gram negative Bacilli, Gram negative bacilli, Oxidase positive, Enterobacter, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter, Staphylococcus epidermidis, Gaffkya tetragens, Bacillus subtilis. 2. The contaminate rates by wards where they have been serving are; 7 (87.5%) of 8 nurses from Intensive care unit, 7(70%) of 10 nurses from general surgery ward, 3(50%) of 6 nurses from neurosurgery ward, 2(20%) of 10 nurses from orthopedic surgery ward, 4(25%) of 10 nurses from medical ward. 3. The contamination rates by the types of clinical service offered are 6(85.7%) of 7 nurses after wound dressing assist 6 (55.3%) of 13 nurses after vital sign check. 4. No statistical significance could he observed as to the between the rates of contamination of nurse's hands with various nursing functions (0.1
Purpose: This study aimed to identify the needs for the managerial competencies of nurse managers in general hospitals. Methods: A cross-sectional design was used. The participants were 203 nurse managers, 141 head nurses or unit managers, and 62 directors or team managers from 17 general hospitals. Data were collected by a self-administered questionnaire with 42 nursing management competencies and 181 behavioral indicators. Participants rated the importance and performance of each indicator. Data were analyzed using a paired t-test, independent t-test, importance-performance analysis, Borich's needs assessment model, and locus for focus model. Results: In all 42 competencies, importance was rated significantly higher than performance. The head nurses or unit managers had high demands for "human resource development," "performance management," and "information management," while the directors or team managers had high demands for "change management." Competencies in high demand in both groups were "development of nursing standards" and "self-management." Conclusion: Based on the results, it is necessary to select priorities and prepare educational content when developing educational programs to strengthen the nursing management competencies of general hospitals' nurse managers.
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