• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.41-50
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• 2017

Purpose: The purpose of this study was to describe what critical care nurses perceived about life-sustaining treatment at end of life. Methods: A qualitative content analysis method was utilized. The unit of analysis was interview text obtained from fifty critical care nurses of a general hospital. Results: Seven categories in two content areas were abstracted. In the negative perception area, the following five categories were abstracted: patients' suffering, dying with damaged dignity, patients' isolation from family members, regret about choosing life-sustaining treatment, and family members' burden. In the positive perception area, the following two categories were abstracted: willingness to sustain life and duty as family members. Conclusions: Nurses have better competencies pertaining to understanding patients' responses and suffering than any other health care professions do. Nurses should play an important role in advocating for patients and their family in the process of end-of-life care decision making.

• Journal of Korean Clinical Nursing Research
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• v.22 no.1
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• pp.88-98
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• 2016

Purpose: The purpose of this study was to construct and test a structural equation model of burnout of the critical care nurses based on the job demand-resource model. Methods: A structured questionnaire was completed by 414 critical care nurses. The relationships between concepts of job stress, empathic ability, resilience, job satisfaction, compassion fatigue and burnout were analyzed. Using SPSS WIN 22.0 and AMOS 22.0 programs, the direct and indirect effects of factors affecting burnout among critical care nurses were calculated and modelled. Results: The modified model was yielded as follows: Chi-square= 216.59, GFI= .93, AGFI= .89, NFI= .90, CFI= .93, RMSEA= .07, SRMR= .06 and showed good fit indices. Job satisfaction and compassion fatigue had mediation effects between other three exogenous variables and burnout. Conclusion: The major findings of this study indicate that it is important to develop a support program for critical care nurse in order to improve their job satisfaction and ameliorate their compassion fatigue.

• Journal of Korean Critical Care Nursing
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• v.6 no.2
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• pp.78-88
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• 2013

Purpose: The purpose of this study was to identify the trends in studies published in Journal of Korean Critical Care Nursing (JKCCN) from 2008 to 2013. Methods: A total of 65 studies published between 2008 to 2013 were reviewed using criteria developed by researchers. Results: Approximately 36% of studies were conducted with patients. Intensive care unit (ICU) was the most popular site as the study setting. Among 59 research papers, 42.4% were approved by institutional review board (IRB). Quantitative studies were 78.6%, while qualitative studies were 4.6%. The research designs for the quantitative studies were survey (52.3%), quasi-experimental (16.9%), and so on. There was no randomized controlled trial. The most frequently used methods to provide nursing intervention was education. In addition, "nurse" and "ICU" were most commonly used keyword. Conclusion: Considering the low rate of IRB approval, more stringent application of research ethics is necessary to improve the quality of JKCCN. In addition, more randomized controlled trials should be encouraged to support evidence-based practice in critical care.

• Journal of Korean Critical Care Nursing
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• v.7 no.1
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• pp.40-46
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• 2014

Purpose: In Korea, about 30,000 people die in intensive care units annually. However, their quality of life at the end-of-life seems very low. The purpose of this study was to describe palliative care models that could be applied in intensive care units and examine nurses' roles in the models. Methods: A conventional literature review was performed focusing on palliative care in intensive care units and nursing roles in the approaches identified. Results: There are two different models regarding the implementation of palliative care approaches in the intensive care unit. Those are the consultative model and the integrative model. Each model has advantages and disadvantages. Therefore, an appropriate model must be chosen according to the setting. Nurses' roles could vary depending on the setting. Conclusion: Palliative care in the intensive care unit is important to improve patients' quality of life. Moreover, nursing roles are important in providing comprehensive palliative care in intensive care units.

• The Journal of the Korea Contents Association
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• v.11 no.12
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• pp.998-1006
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• 2011

Purpose: The purpose of this study was to identify the relationships among critical care competence, knowledge related to critical care, and satisfaction with clinical practice from third year college nursing students. Methods: The data were collected from questionnaires concerning critical care competence, knowledge related to critical care, and satisfaction with clinical practice given to 85 nursing students during June 2009. Results: The mean score of total critical care competence was 84.01 (${\pm}14.78$). Total knowledge related to critical care was 6.99 (${\pm}1.97$). Finally, satisfaction with clinical practice was 86.88 (${\pm}9.47$). Regarding critical care competence, common critical care competence was highest followed by neurologic care competence, cardiovascular care competence, and finally respiratory care competence. The mean score of knowledge related to cardiovascular care was highest followed by common critical care knowledge, respiratory care knowledge, and neurologic care knowledge for knowledge related to critical care competence. Critical care competence had a significant positive correlation with satisfaction with clinical practice but had no correlation with knowledge related to critical care. Conclusion: Results of this study suggest that developing educations of clinical practice in hospitals and laboratory practice in colleges for respiratory and cardiovascular critical care is necessary to promote critical care competence and satisfy clinical experiences of nursing students.

• Journal of Korean Critical Care Nursing
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• v.2 no.2
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• pp.68-78
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• 2009

Evidence based clinical practice guideline are designed to help healthcare practitioners evaluate and implement the increasing amount of evidence on best practice. Critical care area is one of the clinical sites where evidence based clinical practice guideline is needed most. This paper reviewed the definition of evidence based clinical practice guidelines, the development method of evidence based clinical practice guideline, and the current trends in guideline developing. Traditional method of guideline development is consensus based but it moves into evidence based development. Evidence based guideline is based on best available evidence and uses the strongest method to determine its effect on clinical outcomes. The current trends in guidelines is to develop the guideline at regional/national level and do subsequent modification to suit local circumstances. There is an urgent need of exploring the method of guideline development and adaptation which are appropriate for Korean clinical setting.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.13-30
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• 2017

Purpose: The purpose of this study was to integrate the results of qualitative studies to understand critical care survivors' experience of the post-intensive care syndrome (PICS). Methods: This was a meta-synthesis of primary studies that used qualitative methods. We reviewed 26 qualitative studies on PICS selected from 8 international and Korean databases and from a manual search. Thomas and Harden's 3 stages (free coding, development of descriptive themes, generation of analytical themes) for thematic synthesis were utilized to analyze the collected qualitative data. Results: Four descriptive themes emerged from the thematic synthesis: weak physical conditions, psycho-emotional changes, the painful-memory of intensive care units, and social vulnerability. The analytical theme for the current study was "unfamiliarity with the vulnerable self." Critical care survivors had to confront entirely different "selves" after discharge from intensive care units. They had become physically weak, psychologically unstable, and the critical memories continued to create distress. These changes increased their social vulnerability by making them dependent on others, causing family conflicts, and changing interpersonal relationships. Conclusions: Finding from this qualitative synthesis and other related literature highlight the severity of PICS and the importance of rehabilitative intervention for critical care survivors.

• Journal of Korean Critical Care Nursing
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• v.3 no.1
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• pp.79-88
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• 2010

Optimal nutrition serves to maintain normal organ function and to preserve body energy stores to guarantee survival during times of shortage of food. Adequate nutrition of intensive care unit (ICU) patients improves outcome, while malnutrition is strongly associated with increased morbidity and mortality rates among critically ill patients. Previously published researches showed that trials of nutritional support in critical illness rarely fulfill basic quality requirements. Nutrition support plays a vital role in the prevention and treatment of nutritional deficiencies in at-risk, critically ill patients. This paper reviewed the challenges in determining critically ill patients' nutrition requirements including nutrition assessment, determination of caloric requirements then providing them with adequate nutrition support while in the ICU with the guidelines published by Society of Critical Care Medicine and American Society for Parenteral and Enteral Nutrition. Nutrition support can be effectively enhanced by using the guidelines.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.1-12
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• 2017

Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

• Journal of Fisheries and Marine Sciences Education
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• v.28 no.2
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• pp.439-449
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• 2016

The purpose of this study was to identify the effects of simulation-based education regarding care in a cardio-pulmonary emergency care as related to knowledge, critical thinking, and problem solving ability in nursing students. The study was conducted with a nonequivalent control group pre-posttest design. Seventy four participants were assigned to either the experimental group(34) or control group(40). The simulation-based cardio-pulmonary emergency care education included lecture, team-based practice, and debriefing, and it was implemented with the experimental group for a week from September 1 to December 11, 2015. Data were analyzed using chi-square, t-test and ANCOVA by using SPSS 21.0 program. The experimental group who had the simulation-based education showed significantly higher knowledge(F=24.930, p<.001), and critical thinking(F=5.951, p<.05) for cardio-pulmonary emergency care compared with the control group who had traditional education. However, there were no significant differences in problem solving ability(F=3.327, p>.072). The results indicate that a simulation-based education is an effective teaching method to improve knowledge and critical thinking in nursing students learning cardio-pulmonary emergency care. Further study is needed to identify the effect of a simulation-based team positive education program of nursing students.