• Journal of Korean Academy of Nursing Administration
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• v.7 no.2
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• pp.285-300
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• 2001

To meet standards for high quality of care and satisfied customers, an evaluation tool about nursing care is necessary. And, We need to evaluate our practice continuously for the improvement in quality and outcomes. This study was intended to develop an evaluation tool about nursing care in NSICU, and was progressed of 3 steps; development, content validity verification and reliability verification. Data were obtained and analysed from Feb. To April, 2000. Development process of the study was as follows A preliminary list was made item by item on the basis of clinical Experience, literature review and patients' record review. Then the standards, criteria and indicators of preliminary evaluation tool were set by 5 clinical nursing panel, and their content validity was reviewed by 27 ICU nurses. Finally, an evaluation tool was developed and verified the reliability at c-university hospital located in Kwang-Ju. The results of this was as follows 1) The evaluation tool of this study developed 8 standards, 39 criterias and 106 indicators. The standards were divided into two dimensions. One was process dimension which contained 4 standards(26 criteria), The other was outcome dimension which contained 4 standards(13 criteria). 2) the Average content validity of the tool was 3.39 at standards, 3.55 at criteria and 3.51 at indicators. 3) Interrater reliability of the tool is r=.7993(p<.001) & internal consistency reliability ${\alpha}$ is .6031 4) Scores of NSICU Patients who participated in this study were 57 at total mean score, 58 at process mean score and 56 at outcome mean score The evaluation tool developed in this study seems to be useful in evaluation nursing practice appropriately for the improvement of nursing care in NSICU. I hope that this evaluation tool can be used effectively in NSICU as an intervention for the improvement of quality control.

• Journal of Korean Clinical Nursing Research
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• v.26 no.2
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• pp.232-239
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• 2020

Purpose: This study was an quasi-experimental study to compare the effect of applying polyethylene wrap and aircap in maintaining body temperature of preterm infants. Methods: The participants were 51 preterm infants. Aircap was applied to the experimental group (n=23) and polyethylene wrap was applied to the control group (n=28) when the preterm infants admitted to neonatal intensive care unit. The data was collected at W hospital in J-province from June 2016 to May 2017. A total of 9 body temperature measurements were taken at 3 hours interval from 5 min to 24 hours after admission. Repeated measure ANOVA, independent t-test and χ² test were conducted used with SPSS/WIN 24.0 Results: There were no significant difference in the homogeneity tests for general characteristics and dependent variables prior to the experiments (t=0.57, p=.566). There was a significant difference on body temperature of preterm infants over time (F=3.24, p=.020). There was no significant difference on body temperature between polyethylene wrap and aircap application groups (F=1.29, p=.261). The interaction between the group and the time was insignificant (F=1.51, p=.214). Conclusion: The findings demonstrated that both methods of applying polyethylene wrap and aircap on the body in preterm infants had effect in maintaining body temperature.

• Journal of Korean Biological Nursing Science
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• v.20 no.4
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• pp.205-213
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• 2018

Purpose: The purpose of this study was to confirm the compliance of the application of a ventilator-associated pneumonia bundle and understand its effects on the decrease in the incidence of ventilator-associated pneumonia. Methods: This was a retrospective observational study with history control group design. Subjects were selected from January to June 2014, prior to the intervention using the ventilator-associated pneumonia bundle. Subjects were also selected from October 2014 to March 2015, 3 months after the intervention. The number of subjects was 112 before the intervention, and 107 after the intervention. Results: The number of nurses who followed the bundles increased from 8 out of 29 (27.6%) before the intervention to 19 out of 29 (65.5%) after the intervention (odd ratio= 4.99, confidence interval= 1.63-15.25, p= .004). There were 3 cases of ventilator-associated pneumonia before the intervention and 1 case after the intervention. The ventilator days were 2,143 days before the intervention and 2,232 days after the intervention. The ventilator-associated pneumonia rate of the 1,000 ventilator days was 1.40 before the intervention and decreased to 0.45 after the intervention. Conclusion: This study is meaningful, as there has been little research conducted regarding the application of the ventilator-associated pneumonia bundle in South Korea.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.42-57
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• 2014

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.

• Korean Journal of Adult Nursing
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• v.18 no.4
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• pp.543-552
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• 2006

Purpose: The purpose of this descriptive study was to investigate the pattern of physical restraints used in ICUs and to identify influencing factors of application and removal of restraints. Method: The subjects of this study were 90 restrained patients out of 215 patients over 6 years old who were admitted to 6 ICUs in SMC during a 2 weeks period. The data was collected through a questionnaire of characteristics, guidelines and nursing care of restraint uses. The data were analyzed by non-parametric statistic with the use of the SAS program. Results: The restraints were applied to 31.4% of subjects. Mean time of physical restraint was $36.76{\pm}55.7$ hours. There were significant difference with mean time and frequency according to duty shift. GCS, restless behavior and discomfort factors, medical devices, and life sustaining devices had significant relation with application of restraints. In addition, the mean time of restraints used were related significantly with GCS, restless behavior, and discomfort factors. Conclusion: The used of restraints were dependent on mainly the nurses' decision. Thus ICU nurses have to develop the guidelines to applying restraints and removal of restraints in regard to patients rights and ethics. Continuous monitoring and evaluation of application of the restraints is essential in professional nursing.

• The Journal of the Korea Contents Association
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• v.16 no.12
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• pp.468-479
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• 2016

The purpose of this study was to investigate nurses' knowledge and performance of guidelines for evaluation of new fever in critically ill adult patients according to the level of evidence. The total participants were 145 nurses working for medical surgical unit and intensive care unit in two hospitals. The knowledge and performance mean scores of guidelines were $0.70{\pm}0.09$ and $3.08{\pm}0.31$ respectively. The evidence level 1 of guidelines had the higher performance score in high score group than low score group of knowledge groups(F=3.86, p=.023) and performance groups(F=163.14, p<.001), while the evidence level 3 of guidelines had the higher performance score in low score group than high score group of knowledge groups(F=5.99, p=.003). Knowledge and performance scores were significantly correlated (r=.25, p=.003). In Conclusion, these findings emphasize that clinical professions need to enhance both of knowledge and practice with evidence based guideline of new fever in critically ill patient.

• Journal of Korean Academy of Nursing Administration
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• v.15 no.4
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• pp.527-538
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• 2009

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.

• Korean Journal of Adult Nursing
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• v.20 no.5
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• pp.778-790
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• 2008

Purpose: This study was conducted to develop Web-based multimedia contents for supporting student nurses' clinical practice on critical care, and to evaluate learners' responses. Methods: Based on the steps of Assessment, Design, Development, Implementation, & Evaluation(ADDIE) model, a total of 13 self-directed learning modules including live lectures and real video clips were developed through faculty collaboration of nine nursing colleges in Gwangju and Chonnam province. The finally developed multimedia contents were published on the Web of the learning management system at a local e-learning center. Results: The Web contents were evaluated after self-learning by 81 junior college nursing students who were encouraged to study it at their own pace during their two-week clinical practice at a medical or surgical intensive care unit of a university hospital and two hospitals. The knowledge (t = -27.66, p < .001) and self-evaluated clinical performance level(t = 7.54, p < .001) were significantly increased after learning of the Web contents and clinical practice, and satisfaction level that measured post-test only was 4.0 out of 5 point. Conclusion: The use of Web contents for critical care need to be extended as a complimentary material in a class room lecture or clinical practice of students to increase their self-learning ability and understandings of clinical knowledge and situation.

• Asia-pacific Journal of Multimedia Services Convergent with Art, Humanities, and Sociology
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• v.6 no.12
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• pp.55-67
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• 2016

Purpose: The aims of this were to analyse the quantitative research trends and describe the factors influencing health related to quality of life (HRQoL) and instruments used to HRQoL after Intensive care units (ICU) discharge. Methods: This study were included 84 published papers regarding HRQoL after ICU discharge from initial data to December 2015. Results: The majority of papers were performed abroad. Only 4 papers with regard to HRQoL of ICU survivors were performed by nurses. 36 studies (42.8%) were used to measure HRQoL ICU survivors using the SF-36. 29 studies (34.5%) were used to measure HRQoL at 3~6 months after ICU discharge. Older age, longer length of stay at ICU, severity of illness, anxiety and depression were main risk factors to lower HRQoL in ICU patients. Conclusions: This study provides a better understanding of quality of life follwing critical illness. Therefore, further stduy is needed to develop patient centered intervention considered patients'health status and recovery phase. Additionally, large prospective multicenter cohort studies should be required.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.44-55
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• 2001

Background : This study aimed at identifying the effect of the standardized protocol on lowering the incidence of the ventilator associated pneumonia(VAP). Methods : The standard protocol focusing on decreasing VAP was made and applied at 5 ICUs (Medical ICU, surgical ICU, Respiratory ICU, Neonatal ICU, Pediatric ICU) in a university affiliated tertiary hospital, from April 1, 2000 to Oct 31, 2000. The protocol involved 3 parts : hand washing, the suctioning method and ventilator circuit management. All the nursing personnel received intensive education which was consisted of lecture, video film and demonstration. 176 nurses reported the performance of handwashing pre and post intervention. And randomly selected 15 nurses were observed by charge nurse and the handwashing practice was analyzed pre and post intervention. The incidence of VAP was compared with the former year incidence. Results : The self reported frequency of hand washing increased. In the direct observation of handwashing, the frequency, time, thoroughness of hand washing during 8 hours day duty was found to be improved. The frequency was increased from 1.1 time to 4.1 times; the time was improved from 1.7 seconds to 5.7 seconds and the thoroughness of the washing practice was from 0.2 times to 3.0 times respectively (p<0.001). The incidence of VAP decreased from at a rate of 15.63 number of case per 1,000 ventilator-day (April 1~August 31, 1999) to 7.23 number of case per 1,000 ventilator-days(April 1~Oct 31, 2000)(P<0.001). Conclusion : We developed the protocols which included hand washing, the suctioning method, and ventilator circuit management. Through the implementation of the protocol, the performance of hand washing improved and the VAP incidence rate in ICU was decreased.