• 모자간호학회지
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• v.2 no.1
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• pp.45-54
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• 1992

The purpose of this study was to explore the stressors in pediatric intensive care unit and impaired psychological responses of children after open heart surgery. Sixteen children aged 6 to 11, who were admitted to the hospital for open heart surgery during the period from July, 1991 to February, 1992 were the subjects of the study. Observations, drawings, and interviews were used to collect data for study. Behavioral responses about intensive care unit phenomena were analyzed according to the 4 categories identified to assess children's perceived stressors in ICU. Impaired psychological responses were examined using observational and interview data. Drawings were analyzed by content and color by this researcher and validated by the psychologist. The findings were as follows : 1. The most frequently perceived stressors by children in ICU were the physical stressors causing pain and discomfort(68.5%). It was followed by social stressors which denote disruption of relationship with family and friends(13.0% ), environmental stressors which denote unfamiliar surroundings, noise, staff, and other patients (11.2%), and psychological stressors which denote factors affecting self-esteem such as inability to communicate and inadquate knowledge of the situation (7.3%). 2. 81.3% of the children showed of least one of the impaired psychological responses. Three children (18.8%) experienced time disorientation. An equal number of subject experienced perceptual illusion. Two children(12.5%) experienced hallucination. Vivid dream about ICU phenomena was reported by 2 children. Seven children(43.8%) were identified as having exaggerated fear. They feared about oxygen mask and ICU environment in general. Seven children(43.8%) experienced impairment of memory about treatments, procedures, and environment of ICU. 3. The analysis of children's drawing revealed that 56.3% of children experienced fear in the ICU. 75% of children included nurses in the drawings and 62.5% of children drew other children. 81.3% of children drew and identified himself in the drawing. The colors used most by children were green, purple, and brown. From this result, it is recommended to prepare children before open heart surgery to reduce their stressors and impaired psychological responses in ICU.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.2
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• pp.229-243
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• 1997

Especially in NICU(Neonatal Intensive Care Unit), handwashing is an important factor in decresing nosocomial infections due to reduced immunity, prematurity and various invasive procedures. The purpose of this study was to investigate the basic characteristics related to handwashing by NICU nurses. It was composed of three parts ; questionnaire survey I (genoral characteristics of handwashing), questionnaire survey II(the awareness degree of handwashing importance) and actual performance. This study was performed from Oct. 8 to 14 in 1994. The results of this study were as follows ; 1. Frequency of handwashing were different by shift of working about 47.1% of the respondents. They were washing most frequently during day-shift about 75% of above. According to self evaluation to handwashing frequency, 64.7% of the respondents said their frequency of handwashing was inadequate, because of being too busy.(45.1%), bothering caused by detergent or disinfectant(17.6%), and too far from handwashing facilities(17.6%). 2. The most common handwashing agent was soap(88.2%), 52.9% of the subjects experienced adverse effects after handwashing ; rough hand(44.5%), dryness(33.3%) All subjects washed their hands with running water, and 70.6% of the subjects washed upto wrist. In duration of handwashing, 52.9% of subjects washed hands 5 to 10 seconds, 29.5% of them did 11 to 15 seconds. 3. 29.4% among subjects had participated to take in the handwashing educational program. About 60% responded they would like to take the course of handwashing if possible. 4. The important nursing activities that need handwashing were chaning of caring ostomy, suctioning, chaning IV dressing site. On the other hand, they responded handwashing was not essential before dealing with omitus, before and after transfering machine, before chaning diaper(stool) 5. Handwashing performance was 61.7%. Among seven nursing activities, suctioning(73.4%) was the highest, the next was dealing with discharge or sampling(71.1%), the lowest was bathing(34.6%). The performance was better after(70.2%) nursing activities that before(52.5%), and day(63.6%) or evening(68.3%) shift than night(56.7%)

• Journal of Korean Academy of Nursing
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• v.36 no.4
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• pp.621-629
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• 2006

Purpose. The purpose of this study was to identify the clinical variables that predict functional and cognitive recovery at 1- and 6-month in both severe and moderate/mild traumatic brain injury patients. Methods. The subjects of this study were 82 traumatically brain-injured patients who were admitted to a Neurological Intensive Care Unit at a university hospital. Potential prognostic factors included were age, motor and pupillary response, systolic blood pressure, heart rate, and the presence of intracranial hematoma at admission. Results. The significant predictors of functional disability in severe traumatic brain injury subjects were, age, systolic blood pressure, the presence of intracranial hematoma, motor response, and heart rate at admission. In moderate/mild traumatic brain injury patients, motor response, abnormal pupil reflex, and heart rate at admission were identified as significant predictors of functional disability. On the other hand, the significant predictors of cognitive ability for severe traumatic brain injury patients were motor response and the presence of intracranial hematoma at admission, whereas those for moderate/mild patients were motor response, pupil reflex, systolic blood pressure at admission, and age. Conclusions. The results of the present study indicate that the significant predictors of TBI differ according to TBI severity on admission, outcome type, and outcome measurement time. This can be meaningful to critical care nurses for a better understanding on the prediction of brain injury patients. On the other hand, the model used in the present study appeared to produce relatively low explicabilities for functional and cognitive recovery although a direct comparison of our results with those of others is difficult due to differences in outcome definition and validation methods. This implies that other clinical variables should be added to the model used in the present study to increase its predicting power for determining functional and cognitive outcomes.

• Journal of Korean Academy of Nursing
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• v.40 no.2
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• pp.298-305
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• 2010

Purpose: The objectives of this study were to determine the prevalence, incidence, and risk factors for postoperative surgical site infections (SSIs) after craniotomy. Methods: This study was a retrospective case-control study of 103 patients who had craniotomies between March 2007 and December 2008. A retrospective review of prospectively collected databases of consecutive patients who underwent craniotomy was done. SSIs were defined by using the Centers for Disease Control criteria. Twenty-six cases (infection) and 77 controls (no infection) were matched for age, gender and time of surgery. Descriptive analysis, t-test, $\chi^2$-test and logistic regression analyses were used for data analysis. Results: The statistical difference between cases and controls was significant for hospital length of stay (>14 days), intensive care unit stay more than 15 days, Glasgrow Coma Scale (GCS) score (${\leq}7$ days), extra-ventricular drainage and coexistent infection. Risk factors were identified by logistic regression and included hospital length of stay of more than 14 days (odds ratio [OR]=23.39, 95% confidence interval [CI]=2.53-216.11) and GCS score (${\leq}7$ scores) (OR=4.71, 95% CI=1.64-13.50). Conclusion: The results of this study show that patients are at high risk for infection when they have a low level of consciousness or their length hospital stay is long term. Nurses have to take an active and continuous approach to infection control to help with patients having these risk factors.

• Journal of Korean Academy of Nursing
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• v.20 no.1
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• pp.38-49
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• 1990

The Purpose of this study is for clinical nurses to be aware of the significance of prevention against bacteriuria caused form foley catheterization, through probing variables related to the occurrence of bacteriuria which appears as the most frequent occurring infection, and try to lower bacteriuria by applying to nursing care at the clinical. For this study 46 patients with catheterization and the closed drainage system were sampled and investigated from among patients at Intensive Care Unit in Two hospitals affiliated to K University in Seoul. Those patients sampled had not shown bacteriuria before foley catheterization. The research design is to explore the effectiveness of prevention against bacteriuria in accordance with bladder irrigation and no bladder irrigation. Especially, the frequency of occurrence of bacteriuria examined so as to compare the effectiveness of bladder irrigation depending on the type of foley catheter between 2-lumen foley catheter and 3-lumen foley catheter. The results Were as follows. 1. The occurrence of bacteriuria in patient with bladder irrigation was 21.7%, while in patient without bladder irrigation 26.1%. 2. The occurrence of bacteriuria in patient without bladder irrigation according to duration of Indwelling catheter, was 4.3% after 48 h, 8.7％ after 72 h and 21.7% after 96 h. 3. In case of 2-lumen foley catheter the occurrence of bacteriuria in patient with bladder irrigation was 0% after 72 h, and 4.35% after 96 h. In case of 3-lumen foley catheter, the occurrence of bacteriuria in patient with bladder irrigation was 13% after 48 h, 8.7% after 72 h and 4.3% after 96 h. 4. The occurrence of bacteriuria according to duration of catheterization was 8.7% after 48 h, 8.7% after 72 h and 15.2% after 96 h. In sex, female was 35% and male 15.4%. 5. The occurrence of bacteriuria according to mental state was 15% in clear state, while 29.6% in mental disorder. 6. In regard to a kind of microorganism induced bacteriuria, Gram negative bacteria was 63.7%, Gram positve bacteria 36.3%.

• Journal of Korean Academy of Nursing
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• v.22 no.4
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• pp.620-635
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• 1992

This study identified correlations between perceived family support and hopelessness in patients admitted to Neuro - surgical Intensive Care Units. The purpose was to enhance theoretical understanding of the relationships of these two variables. The subjects of this study were 51 patients admitted to N-lCU, at three general hospitals in Seoul. Data were collected by researcher in structured interviews from Aug. 12 to Oct. 13, 1992. The research tools were parts of the Moos Family Environment Scale and the Beck Hopelessness Scale. The general characteristic data were analyzed for frequency and percentage ; the hypothesis was tested by the pearson product Moment Correlation Coefficient. After normality tests by using Kolmogorov - Sminorvtest, and T- test, ANOVA and Mann-Whitney U test, Kruskal -Wallis test were used on the Family Support and the Hopelessness about general charcteristics. The results of the above analysis were as follows 1) The average family support score for the group was 63.61 (tool average 51) and item average was 3.74 (tool item average 3) : the family support score of this sample was higher than average. The average family cohesion score of family support was 35.25 (tool average 27) and item average was 3.91 (tool item average 3). The average family expression score of family support was 28.35 (tool average 24) and item average was 3.57 (tool average 3). In this sample, perceived family expression was lower than family cohesion. 2) The average hopelessness score was 45.88 (tool average 60) and item average was 2.29 (tool item average 3) : the hopelessness score of this sample was low in comparison to the average. 3) The hypothesis in this study was supported. The main hypothesis that the higher the perceived family support level, the lower the level Of the hopelessness, was Supported (r＝-.3869 p＝.003). The sub-hypothesis that the higher the perceived family cohesion level, the lower the level of hopelessness, was supported(r＝-.3688 p＝.004). The sub-hypothesis that the higher the perceived family expression level, the lower the level of hopelessness, was supported (r＝-.3068 p＝.014). 4) General characteristics of the objects related to family support were ‘economic status’(p＝.025) and ‘helping person’(P＝.044) : the higher the economic status, the greater the family support. When the patient identified the helping person as a spouse, family support was rated more highly. The only general characteristic related to family cohesion was ‘helping person’(p＝.041). No general characteristics were related to family expression. 5) The one general characteristic related to hopelessness was ‘education’(p＝.002) : the higher their education, the lower their hopelessness. For these ICU patients, were related perceived family support and hopelessness, and family expression level was low in comparison to family cohesion level. The perceived family support of these seriously ill patients in situational crisis may have influenced the patient's emotional reaction of hopelessness. This study concluded that nurses in the ICU confirm the family support of the patient, and involve the family as the most intimate support systems in the care of the patient to help reduce the patient's hopelessness.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.156-171
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• 1996

Background: Nosocomial infection control is one of important means to assure the quality of medical care in the hospital, however, it has been neglected by most of the hospital personnels. Of nosocomial infections, urinary tract infection is the highest incidence, which is related to the indwelling catheter. It is, therefore, necessary to pay primary attention to the patients with the indwelling catheter in intensive care unit in order to control nosocomial Infection and to improve the quality of medical care in the hospital. Methods : The subjects of this study were patients with indwelling catheter who were admitted to the ICU of Pusan Paik Hospital from March 1994 to May 1995. The author calculated UTI rate among the subjects through the cultivation of the urine, identified the related factors of the UTI through brain storming of study team and head nurses working at ICU, and analized the effectiveness of the proposed approaches through comparing the infection rates of before and after activities. Results : The major activities carried out by the study team were to conduct in-service education programs for the staffs working at ICU about the importance of the nosocomial infection control in QA, and nursing intervention to reduce the UTI rate among the patients with indwelling catether. 1. The major nursing interventions that the study team had implemented were as follows ; 1) Drainage system was changed from partial open system to completely closed system. 2) Bladder irrigation which was routinely practised in all patients stopped among the noninfected patients. 3) Bladder irrigation set was changed to the disposable one. 4) Catheter was inserted under the anesthesia for patients to be operated. 5) Male patient receiving wrapped with gauze after perineal care was not wrapped. 6) Clamp which had not been before was newly attached to drainage tube. 7) Urine bag which had been packed into a lot of pieces was done into each piece. 8) The interval of change of indwelling catheter had regularly been four weeks, however it was used continously until it worked well. 9) Catheter was attached well at the defined site. 10) Paper towel was used instead of cotton towel. 11) Mats at the entrance were removed and cleansing of wards was enhanced. 2. The UTI rate by month was 34.4% in maximum and 9.8% in minimum during the period of this study, however it had gradually decreased. After 6 months from initiating infection control activities, the trend of rates was relatively stable. It was identified that UTI rate was different by season 12.5% in winter and 27.2% in summer. 3. Utilization rate of indwelling catheter was maintained at under 50%, but it was increased above 57% from April 1995. 4. The number of bladder irrigation sets used per day was 33.3 sets in maximum and 2.8 sets in minimum. The number used per day were also remarkably deceased. Conclusion : It was found that a program to control UTI could contribute to nosocomial infection control, and it was, in turn, a mean to assure the quality of medical care in the hospital. The nursing interventions which this study team had implemented were effective in the reduce of UTI rates.

• Journal of Korean Biological Nursing Science
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• v.7 no.1
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• pp.69-87
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• 2005

Purpose : The purpose of this study was to identify pediatric nurses's knowledge related to children's pain and pediatric nurses' career including educational experience and to examine whether there is a difference of their knowledge according to their career. Method : Subjects of this study was 115 pediatric nurses of one university hospital who understood purpose of this study and accepted to participate in this study. Subjects responded questionnaire by self report. The data were gathered for 7 days during the period from October 20 to October '2:7, 2003. The pediatric nurses' knowledge and attitude survey regarding pain developed by Manworren(2001) was used to identify the knowledge related to children's pain of pediatric nurses. Nurses' career consisted of level of education, presently working ward, duration of experience at clinic, pediatric clinic and presently working ward and educational experience related to children's pain during undergraduate courses, ward orientation and continuing education. Educational experience regarding children's pain was measured by whether they had education related to children's pain during undergraduate courses, ward orientation and continuing education or not and their perception on the contents of education was measured by 5 point Likert type scale. SPSS Windows was used to analyze the data. Scores of the knowledge regarding children's pain and career including educational experience of pediatric nurses were presented as mean and standard deviation. Mean percentage of correct answers responded by the subjects was presented under the category of introduction, assessment, pharmacological and nonpharmacological intervention for children's pain. The difference of scores of the knowledge regarding children's pain according to nurses' career was analyzed using t-test, ANOVA and Tukey as a post hoc. Statistical significance was accepted at the level of p<.05. Result : Pediatric nurses had deficient knowledge related to children's pain on the whole and did not trust pain complaint and underestimated the pain. They were short of concrete practical knowledge about pain assessment and pharmacological and nonpharmacological intervention for children's pain. They were excessively concerned with side effect and addiction of analgesic drugs and had a negative view point on nonpharmacological pain intervention. About 50% of the subjects received education regarding children's pain while their undergraduate courses. The number of nurses who received education regarding children's pain while their undergraduate courses was found to be greater among the recently graduated nurses. In ward orientation and continuing education, only less than 10% of the nurses received education regarding children's pain. Nurses perceived their experienced educational content deficient; experienced educational content consisted of pain introduction, assessment and pharmacological and nonpharmacological intervention for children's pain while their undergraduate course, ward orientation and continuing education. There were no significant differences of the knowledge regarding children's pain of pediatric nurses according to level of education, duration of experience at clinic, pediatric clinic and presently working ward. Scores of the knowledge regarding children's pain of nurses at neonatal ward were significantly greater than those of nurses at pediatric intensive care unit. Scores of the knowledge regarding children's pain of pediatric nurses who received education during their undergraduate course were significantly greater than those who did not receive it during their undergraduate courses. Also scores of the knowledge regarding children's pain of pediatric nurses who received one kind of educational experience were significantly greater than those who had no educational experience. Conclusion : Pediatric nurses had deficient knowledge of children's pain and underestimated the pain of children. Also they were short of concrete practical knowledge on pain assessment and intervention for children's pain.

• Women's Health Nursing
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• v.1 no.1
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• pp.97-118
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• 1995

The purpose of this study was to compare the nurses' perceptions with the women's about the women's needs in premature labor and to find out how to accomplish effective nursing intervention for the women to cope with their crises in premature labor. The objects of this study consisted of 33 hospitalized mothers in post partum because of premature labor, who were delivered of new born, in four university hospitals, a general hospital and a lower general hospital which has a neonatal intensive care unit in Seoul during 17 days(Oct. 4, 1994 to Oct. 20, 1994) and 32 nurses who have worked at delivery rooms in the hospitals above for 6 months or more, accomplishing nursing intervention. The results of this investigation were as follows : 1) General characteristics of women : Their mean age was 29.4 years(SD 4.37) and the mean of their gestational periods 3 days over 34 weeks(SD 2.48). Most of them were the married(93.9%) and held high school degree or more(93.9%). And some of them were the deligious(68.7%), multiparae(59.4%) and had their jobs(21.2%). The also had hospitalized experience due to premature labor(51.5%), experienced in premature delivery(33.3%), the prental care(78.6%), cesearean section(63.6%), and pregnancies less than twice(62.5%). The most mothers were included in 34 weeks and a day to 37 weeks(60.6%). It was also confirmed that most of the sustaining presences in labor were their husbands(81.2%). 2) General characteristics of nurses : Their mean age was 27.6 years(SD 4.50), and their carrier with the service on the average 6 months over 3 years long(SD 3.63). Numbers of them were staff nurses(84.4%), maiden ladies(71.9%), graduated from junior colleges of nursing(71.9%), and had no experiences in delivery(78.1%).Besides, none of them had experiences in premature labor. 3) The whole mean of needs perceived by pregnant women was identified as 3.086 points and the degree of their perception was given much weight in order of interdependence need(3.14), self concept need(3.11), physical physiologic need(3.09), and role function need(2.74). So it was proved that they regarded interdependence need as being the most important need in crises caused premature labor. 4) The whole mean of needs felt by the nurses was 3.092 points and the degree of their feelings was given much weigh in order of physical physiologic need(3.22), self concept need(3.15), interdependence need(3.06) and role function need(2.75). So it was ascertained that they felt physical physiologic need the most important, differing from the women in it. 5) There were few differences on the degrees of the perceptions that the nurses and the women showed on each of the four parts. 6) On each part of the questionnaires, it was examined that the women felt the need for the fetus to be the most important generally while the nurses perceived the need with the women to be more important than that. 7) The primiparae(40.6%) felt role function need be more important than multiparae(59.4%) (p<0.05), and the women from universities and above(39.4%) perceived self concept need to be more important than those holding the high school degrees and below(60.6%). (p<0.05) 8) The nurses having experience in delivery(21.9%) perceived interdependence need and role function need to be more important than important than those having no experiences(78.1%). (p<0.05) So far most of the nurses have concentrated their efforts on nursing for safety for the women in premature labor hospitalized in delivery rooms. But the women are not satisfied with just it because of having perceived the need for the fetus more important above all. In nursing for the future, therefore, every nurse caring for the women should offer them all the informations that they will want for their fetuses to adapt them to the crises effectively, understanding such their needs and making most of honest and simple terms for them, I insist. Through this study, I'm sure that inquiring into the need of women in premature labor minetely will show the way of more effective nursing interventions in clinic. And I suggest that the various kinds of studies about the more objects be done for the generalization of the results of this study in the future.

• The Journal of the Korea institute of electronic communication sciences
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• v.11 no.7
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• pp.707-716
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• 2016

The current research focused on the needs for discharge education and the educational performance of nurses perceived by mothers of premature infants. The subjects for the current research were 54 mothers of premature infants hospitalized in the neonatal intensive care unit at K general hospital in G metropolitan city. The data was collected between June 9, 2014 and September 30, 2014 through self-recording surveys. The needs for discharge education were $4.21{\pm}0.60$ and the perceived educational performance of nurses was $3.95{\pm}0.73$. There was a significant difference between the needs for discharge education and the perceived educational performance in abnormal symptom monitoring and management ($0.55{\pm}0.97$, p=0.001), excrement management ($0.45{\pm}1.11$, p=0.004) and growth development ($0.41{\pm}1.08$, p=0.007). The needs for discharge education was significantly different according to delivery type (vaginal delivery: $4.41{\pm}0.47$, caesarean section: $4.03{\pm}0.47$, p=0.040) and birth order (first: $4.37{\pm}0.53$, second: $4.25{\pm}0.51$, over third: $3.75{\pm}0.72$, p=0.031). Perceived educational performance of nurses was significantly different according to baby sitter (yes: $4.15{\pm}0.66$, no: $3.48{\pm}0.67$, p=0.002). ]