• Title/Summary/Keyword: Surgical intensive care unit

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A Study of Role-Conflict, Stress and Job Satisfaction of Nurses According to Their Current Work Posts (근무병동별 간호사의 역할갈등, 직무스트레스 및 업무만족에 관한 연구)

  • Park, Seon-Wha;Kim, Kwuy-Bun
    • Journal of East-West Nursing Research
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    • v.11 no.1
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    • pp.65-74
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    • 2005
  • This research has been conducted in order to compare and analyze the role-conflict, job stress and job satisfaction of nurses according to their current work posts. The subjects of this research were carefully selected 426 nurses from 2 university hospitals. The research tool were a role-conflict measurement index, job stress a tool, and job satisfaction Minnesota Satisfaction Questionnaire. The data have been collected using a structured questionnaire from March to May 2003. The collected data have been analyzed using the SPSS PC 10.0V program. The nurses at Intensive Care Unit (ICU) showed highest level of job stress while the nurses at surgical ward showed the lowest level of job stress (F=8.37, p=.000). There was no significant difference in role-conflict and job satisfaction according to the current work posts. According to the results of this research, there was a difference in stress according to the current work posts, and it turned out that the nurses at ICU had the highest level of stress compared to the nurses at other departments, and it causes a fall in job satisfaction.

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Concept Analysis of Cardiac Arrest: Identifying the Critical Attributes and Empirical Indicators (심정지(Cardiac Arrest)에 대한 개념분석: 개념적 속성 및 경험적 지표의 규명)

  • Lee, Kang Im;Oh, Hyun Soo
    • Korean Journal of Adult Nursing
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    • v.26 no.5
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    • pp.573-583
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    • 2014
  • Purpose: Cardiac arrest has multiple characteristics that need to be approached as an integrated method according to the various changes in the body system. This study was performed to develop a useful guideline for early detection of cardiac arrest by revealing the attributes of cardiac arrest through a concept analysis. Methods: This study was conducted according to the Walker and Avant's concept analysis method. Systematic literature review and in-depth interview with nurses who experienced cardiac arrest situation were conducted. Based on the literature reviews and in-depth interviews with nurses, the attributes and the empirical referents of the concept of cardiac arrest were elicited. Results: The definable attributes of cardiac arrest were 1) loss of consciousness, 2) abnormal respiratory condition, 3) abnormal cardiovascular signs. Cardiac arrest was found to occur by several antecedents such as cardiac problem, non-cardiac problem, or general problem, whereas ischemia and re-perfusion injury, which can lead to multiple organ failure and death, were derived as consequences. Conclusion: In this study, the concept analysis eliciting attributes and empirical referents is found to be useful as a guideline for understanding and managing cardiac arrest. Based on these findings, clinical providers are expected to make a precise and rapid decision on cardiac arrest and respond quickly, which may increase survival rate of the patients underwent the arrest event.

Factors Influencing on Pressure Ulcer Incidence among Older Patients with Hip Fracture in a Hospital (고관절 골절로 입원한 노인 환자의 욕창 발생 위험요인)

  • Lee, Sun Jin;Jeong, Jae Shim;Lim, Kyung-Choon;Park, Eun Young;Kim, Hye Youn
    • Journal of Korean Biological Nursing Science
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    • v.21 no.1
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    • pp.54-61
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    • 2019
  • Purpose: This study aimed to identify the incidence and risks for pressure ulcer among older patients with hip fracture. Methods: The subject were 215 older patients suffering from hip fracture who were admitted for surgical operation from January 1, 2012 to April 30, 2016 in a university-affiliated hospital. The incidence of pressure ulcer was collected retrospectively through medical record review and the risk factors were analyzed using Cox's proportional hazard model. Results: Out of the total, 32 patients (14.9%) developed pressure ulcer with the average occurrence period being 4.72 (${\pm}3.81$) days. Stage II pressure ulcer was the most common at 72.0%. Risk factors included ambulation status before injury (p= .039), spinal anesthesia (p= .029), and stay at intensive care unit after operation (p= .009). Conclusion: Despite pressure ulcer prevention efforts, the incidence remained relatively high. Considering the identified risk factors, more efforts is needed for early detection and prevention of pressure ulcers in such patients.

Right anterior mini-thoracotomy aortic valve replacement versus transcatheter aortic valve implantation in octogenarians: a single-center retrospective study

  • Ji Eun Im;Eun Yeung Jung;Seok Soo Lee;Ho-Ki Min
    • Journal of Yeungnam Medical Science
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    • v.41 no.2
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    • pp.96-102
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    • 2024
  • Background: The aim of this study was to compare the early outcomes of octogenarians undergoing minimally invasive right anterior mini-thoracotomy aortic valve replacement (RAT-AVR) with those undergoing transcatheter aortic valve implantation (TAVI) for aortic valve disease. Methods: In this single-center retrospective study, data were collected from octogenarians before and after RAT-AVR and TAVI between January 2021 and July 2022. Short-term outcomes, including the length of hospital stay, in-hospital mortality, all-cause mortality, and other major postoperative complications, were compared and analyzed. Results: There were no significant differences in in-hospital mortality, stroke, acute kidney dysfunction requiring renal replacement therapy, length of intensive care unit stay, or length of hospital stay. However, the TAVI group had a higher incidence of permanent pacemaker insertion (10% vs. 0%, p=0.54) and paravalvular leaks (75% vs. 0%, p<0.001). Conclusion: In the present study on octogenarians, both TAVI and RAT-AVR showed comparable short-term results. Although both procedures were considered safe and effective in the selected group, RAT-AVR had a lower incidence of complete atrioventricular block and paravalvular regurgitation.

A Study on the Perception of the Importance and Performance of Patient Education of the Clinical Nurses (종합병원 간호사가 인식하는 환자교육 중요도와 수행도의 관계연구)

  • Yoo, Eun-Kyung;Suh, Moon-Ja
    • The Journal of Korean Academic Society of Nursing Education
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    • v.6 no.2
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    • pp.287-302
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    • 2000
  • The purpose of the study are to examine the perception of the importance and performance of patient education of the clinical nurse and find out the interfering factors in practicing patient education. The data were collected from convenient sample of 256 clinical nurses working in the nursing units of adult patients except the psychiatric unit, obstetric unit, dental surgical unit and intensive care unit of one University Hospital in Seoul from September 29 to October 2, 1998. Three measurement tools of self-report- questionnaires developed by researcher used. For the content validity of the questionnaires, two sessions of panel discussion and a pilot test were done and finally factor analysis was done with Varimax method. Analysis of data was done with SAS program using frequency, percentage, means, standard deviation, Pearson's Correlation Coefficients, t-test and ANOVA. The obtained results were as follows : 1. The surveyed nurses perceived the importance of patient education at higher level with mean score of 4.08 among 5 point than their perception of practice( mean score : 3.42). 2. There was positive significant correlation(r=.29, p=0.0001)between nurses' perception of the importance of patient education and it's practice 3. Among the teaching contents for patients, 'information of diagnostic procedure and operation' and 'orientation of hospitalization' were perceived most important. And 'preparation for discharge' and 'understanding of disease and health promotion' were perceived least important 4. Among the teaching contents for patients, 'orientation of hospitalization' and 'information of diagnostic procedure and operation' were perceived highly performable. And 'understanding of disease and health promotion' and 'preparation for discharge' were perceived least performable. 5. Three types of interfering factors were identified as patient-factor, situational factor, nurse-factor. The mean degree of impediment with the interfering factors was at average level(3.09 among 5). The patient and situational factors of impediments were more interfering than nurse- factor for teaching patients. 6. In older age(p<.05), married state (p<.05), higher educational status (p<.01), higher clinical experience (p<.01) and higher position(p<.01), the score of perceived importance of patients education was more high. 7. In older age(p<.01), higher clinical experience(p<.001) and surgical unit (p<.01), the score of perceived performance of patients education was more high. In conclusion, in order to activate patient education practice in the clinical setting, the continuing education for patients education should be more emphasized and the effective teaching methods and materials should be developed to help patient teaching. And an organizational support such as budgeting for patient education and reimbursement system should be administrated.

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An 18-year experience of tracheoesophageal fistula and esophageal atresia

  • Seo, Ju-Hee;Kim, Do-Yeon;Kim, Ai-Rhan;Kim, Dae-Yeon;Kim, Seong-Chul;Kim, In-Koo;Kim, Ki-Soo;Yoon, Chong-Hyun;Pi, Soo-Young
    • Clinical and Experimental Pediatrics
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    • v.53 no.6
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    • pp.705-710
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    • 2010
  • Purpose: To determine the clinical manifestations and outcomes of patients with tracheoesophageal fistula (TEF) and esophageal atresia (EA) born at a single neonatal intensive care unit. Methods: A retrospective analysis was conducted for 97 patients with confirmed TEF and EA who were admitted to the neonatal intensive care unit between 1990 and 2007. Results: The rate of prenatal diagnosis was 12%. The average gestational age and birth weight were $37^{+2}$ weeks and $2.5{\pm}0.7kg$, respectively. Thirty-one infants were born prematurely (32%). Type C was the most common. The mean gap between the proximal and distal esophagus was 2 cm. Esophago-esophagostomy was performed in 72 patients at a mean age of 4 days after birth; gastrostomy or duodenostomy were performed in 8 patients. Forty patients exhibited vertebral, anorectal, cardiac, tracheoesophageal, renal, limb (VACTERL) association with at least 2 combined anomalies, and cardiac anomaly was the most common. The most common post-operative complications were esophageal stricture followed by gastroesophageal reflux. Balloon dilatation was performed for 1.3 times in 26 patients at a mean age of 3 months. The mortality and morbidity rates were 24% and 67%, respectively, and the most common cause of death was sepsis. The weight of approximately 40% patients was below the 10th percentile at 2 years of age. Conclusion: Mortality and morbidity rates of patients with TEF and EA are high as compared to those of infants with other neonatal surgical diseases. Further efforts must be taken to reduce mortality and morbidity and improve growth retardation.

Sleep Patterns of ICU Patients, Characteristics and Factors Related to Sleep Disturbance (중환자실 환자의 수면양상, 수면장애특성 및 수면장애요인)

  • Noh Won-Jae;Lee Young-Mee;Sohng Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.12 no.2
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    • pp.247-254
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    • 2005
  • Purpose: This study was done to examine the sleep pattern of ICU patients, as well as characteristics of, and factors related to sleep disturbances, and state anxiety. It was done to provide the basic data fur effective nursing interventions to improve quality of sleep for these patients. Methods: The participants were 104 patients who were admitted to the surgical ICU in a hospital in Seoul. To measure sleep patterns, the Verran and Snyder-Halpern Sleep Scale and the Sleeping Scale developed by Oh et al.(1998) were used. Characteristics of sleep disturbances were measured using the Sleep characteristics scale developed by Park(1999). To measure factors related to sleep disturbances, thirty items developed by Oh(1998) were used. Results: There was no statistically significant difference in the sleep patterns according to the general characteristics of the patients. The characteristics of sleep disturbances showed statistically significant differences in general and specific characteristics of sleep patterns but there was no statistically significant difference according to the general characteristics of the patients. There were significant negative correlations between factors related to sleep disturbances and general and specific characteristics of sleep patterns but there were no statistically significant difference according to the general characteristics of the patients. Conclusion: The results showed that the majority of patients staying in the surgical ICU experienced sleep disturbances and that the physical factor was the major factor of sleep disturbances.

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Predictors of Mortality after Surgery for Empyema Thoracis in Chronic Kidney Disease Patients

  • Pulle, Mohan Venkatesh;Puri, Harsh Vardhan;Asaf, Belal Bin;Bishnoi, Sukhram;Malik, Manish;Kumar, Arvind
    • Journal of Chest Surgery
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    • v.53 no.6
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    • pp.392-399
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    • 2020
  • Background: Surgical treatment of empyema thoracis in patients with chronic kidney disease is challenging, and few studies in the literature have evaluated this issue. In this study, we aim to report the surgical outcomes of empyema and to analyze factors predicting perioperative mortality in patients with chronic kidney disease. Methods: This retrospective study included data from 34 patients with chronic kidney disease (estimated glomerular filtration rate <60 mL/min/1.73 ㎡ for 3 or more months) who underwent surgery for empyema between 2012 and 2020. An analysis of demographic characteristics and perioperative variables, including complications, was carried out. Postoperative mortality was the primary outcome measure. Results: Patients' age ranged from 20 to 74 years with a 29-to-5 male-female ratio. The majority (n=19, 55.9%) of patients were in end-stage renal disease (ESRD) requiring maintenance hemodialysis. The mean operative time was 304 minutes and the mean intraoperative blood loss was 562 mL. Postoperative morbidity was observed in 70.5% of patients (n=24). In the subgroup analysis, higher values for operative time, blood loss, intensive care unit stay, and complications were found in ESRD patients. The mortality rate was 38.2% (n=13). In the univariate and multivariate analyses, poor performance status (Eastern Cooperative Oncology Group >2) (p=0.03), ESRD (p=0.02), and late referral (>8 weeks) (p<0.001) significantly affected mortality. Conclusion: ESRD, late referral, and poor functional status were poor prognostic factors predicting postoperative mortality. The decision of surgery should be cautiously assessed given the very high risk of perioperative morbidity and mortality in these patients.

Surgical Outcomes of Cardiac Myxoma: Right Minithoracotomy Approach versus Median Sternotomy Approach

  • Lee, Han Pil;Cho, Won Chul;Kim, Joon Bum;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
    • Journal of Chest Surgery
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    • v.49 no.5
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    • pp.356-360
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    • 2016
  • Background: The standard approach in treating cardiac myxoma is the median full sternotomy. With the evolution of surgical techniques, the right minithoracotomy approach has emerged as an alternative method. Since few studies have been published assessing the right minithoracotomy approach, we performed a retrospective study to compare the clinical outcomes of the right minithoracotomy approach with those of the sternotomy approach. Methods: From January 2005 to December 2014, 203 patients underwent resection of a cardiac myxoma. Patients with preexisting cardiac problems were excluded from this study. 146 patients were enrolled in this study; 83 patients were treated using a median sternotomy and 63 patients were treated using a right minithoracotomy. Results: No early mortalities were recorded in either group. Although the cardiopulmonary bypass time and aorta cross-clamp time were significantly shorter in the sternotomy group (p<0.001 and p=0.005), postoperative blood transfusions and arrhythmia events were significantly less common in the thoracotomy group (p=0.004 and p=0.025, respectively). No significant differences were found in the duration of the hospital stay, postoperative intubation time, the duration of the intensive care unit stay, and recurrence. Conclusion: The minimally invasive right minithoracotomy approach is a good alternative method for treating cardiac myxoma because it was found to be associated with a lower incidence of postoperative complications and a shorter postoperative recovery period.

Accurate transfer of bimaxillary orthognathic surgical plans using computer-aided intraoperative navigation

  • Chen, Chen;Sun, Ningning;Jiang, Chunmiao;Liu, Yanshan;Sun, Jian
    • The korean journal of orthodontics
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    • v.51 no.5
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    • pp.321-328
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    • 2021
  • Objective: To examine the accuracy of computer-aided intraoperative navigation (Ci-Navi) in bimaxillary orthognathic surgery by comparing preoperative planning and postoperative outcome. Methods: The study comprised 45 patients with congenital dentomaxillofacial deformities who were scheduled to undergo bimaxillary orthognathic surgery. Virtual bimaxillary orthognathic surgery was simulated using Mimics software. Intraoperatively, a Le Fort I osteotomy of the maxilla was performed using osteotomy guide plates. After the Le Fort I osteotomy and bilateral sagittal split ramus osteotomy of the mandible, the mobilized maxilla and the distal mandibular segment were fixed using an occlusal splint, forming the maxillomandibular complex (MMC). Real-time Ci-Navi was used to lead the MMC in the designated direction. Osteoplasty of the inferior border of the mandible was performed using Ci-Navi when facial symmetry and skeletal harmony were of concern. Linear and angular distinctions between preoperative planning and postoperative outcomes were calculated. Results: The mean linear difference was 0.79 mm (maxilla: 0.62 mm, mandible: 0.88 mm) and the overall mean angular difference was 1.20°. The observed difference in the upper incisor point to the Frankfort horizontal plane, midfacial sagittal plane, and coronal plane was < 1 mm in 40 cases. Conclusions: This study demonstrates the role of Ci-Navi in the accurate positioning of bone segments during bimaxillary orthognathic surgery. Ci-Navi was found to be a reliable method for the accurate transfer of the surgical plan during an operation.