• Journal of Korean Academy of Nursing
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• v.49 no.4
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• pp.423-436
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• 2019

Purpose: The aim of the study was to explore nurses' experience of person-centered relational care in the context of critical care. Methods: Key interview questions were developed based on the human-to-human relationship model suggested by Travelbee. Data were collected through indepth interviews with a purposive sample of 11 nurses having more than 2 years of working experience in intensive care units. An interpretative phenomenological analysis was conducted to analyze the data. Results: Four super-ordinate and nine sub-ordinate themes were identified. Emerged super-ordinate themes were as follows: (1) encountering a live person via patient monitoring systems; (2) deep empathic connection; (3) humanistic and compassionate care, and (4) accompanying the journey to the end. Study findings revealed that nurses in intensive care units experienced 'balancing emotions' and 'authenticity' in caring when entering human-to-human relationships with dying patients. The phenomenon of person-centered relational care in intensive care units was found to subsume intrinsic attributes of empathy, compassion, and trust, similar to the central concepts of Travelbee's theory. Conclusion: The interpretative findings in this study provide deeper understanding of Travelbee's human-to-human relationship model. The technological environment in intensive care units did not hinder experienced nurses from forming human-to-human relationships. These themes need to be emphasized in critical care nursing education as well as in nursing management. The results of this study will contribute to understanding nurse-patient caring relationships in depth, and help improve the quality of nursing care in intensive care units.

• Journal of Korean Academy of Nursing
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• v.36 no.8
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• pp.1340-1351
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• 2006

Purpose. To determine and compare the perception among nurses and doctors of the roles and tasks of critical care advanced practice nurses (APNs) in order to establish standardized and formally agreed role criteria for such critical care APNs. Method. This study measured and analyzed the necessity of each of the roles and tasks of critical care APNs, as perceived by nurses and doctors, through a survey of 121 participants: 71 nurses in 7 intensive care units (ICUs) at a general hospital in Seoul, and 50 doctors who used ICUs. Data collection utilized a questionnaire of 128 questions in the following fields: direct practice (79), leadership and change agent (17), consultation and collaboration (15), education and counseling (11), and research (6). Results. Both the nurses' and the doctors' groups confirmed the necessity of critical care APNs, with doctors who frequently used ICUs indicating a particularly strong need. As for the priority of each role of critical care APNs, the nurses considered direct practice to be the most critical, followed by education and counseling, research, consultation and collaboration, and leadership and change agent. The doctors also considered direct practice to be the most critical, followed by education and counseling, consultation and collaboration, research, and leadership and change agent. There was a statistically significant difference between how the two groups regarded all the roles, except for the consultation and collaboration roles. As for the necessity of each role of critical care APNs, the nurses considered research to be the most necessary, followed by education and counseling, consultation and collaboration, leadership and change agent, and direct practice. The doctors, on the other hand, considered education and counseling to be the most necessary, followed by research, consultation and collaboration, leadership and change agent, and direct practice. The responses of the two groups to all the roles, except for education and counseling roles, were significantly different. Conclusion. Nurses and doctors have different perceptions of the roles and tasks of critical care APNs. Thus, it is necessary for the combined nursing and medical fields to reach an official agreement on a set of criteria to standardize for the roles and tasks of critical care APNs.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.14-25
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• 2021

Purpose : The purpose of this study is to examine the relationship between burnout, nursing work environment, patient-centered communication, and person-centered care nursing among intensive care unit (ICU) nurses and to identify factors related to person-centered care nursing. Methods : This is a descriptive study involving 156 ICU nurses. A structured questionnaire was used to assess burnout, nursing work environment, patient-centered communication, and person-centered critical care nursing performance. Data were collected from February to March 2020, and descriptive statistics, independent t-test, one-way ANOVA, Pearson's correlation coefficient, and multiple regression analysis were conducted using SPSS/WIN 25.0 program. Results : The mean scores for person-centered care nursing, burnout, nursing work environment, and patient-centered communication of ICU nurses were 3.52±0.42, 3.00±0.76, 2.62±0.34, 4.06±0.64, respectively. Person-centered nursing showed a statistically significant negative correlation with burnout (r=-.20, p=.013) and a statistically significant positive correlation with patient-centered communication (r=.49, p<.001). In addition, patient-centered communication (𝛽=.47, p<.001) was significantly correlated with person-centered nursing. Conclusion : The results of this study showed that the factors affecting the person-centered care nursing of ICU nurses were patient-centered communication. Therefore, it is necessary to develop and apply patient-centered communication programs for improving the person-centered nursing performance of ICU nurses.

• Journal of Korean Critical Care Nursing
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• v.15 no.2
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• pp.1-13
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• 2022

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.

• Journal of Korean Critical Care Nursing
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• v.15 no.3
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• pp.1-11
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• 2022

Purpose : The purpose of this study was to not only examine the importance and performance status of patient safety nursing activities in the intensive care unit but also to understand nurses' educational needs in this respect. Methods : In this descriptive study, 196 nurses working in the intensive care units of university hospitals located at B City and G Province were enrolled. They completed the Importance-Performance Analysis (IPA) questionnaire, and the data were statistically analyzed. Results : Mean±standard deviation item scores of importance and performance of patient safety nursing activities were 4.75±0.33 and 4.48±0.38, respectively. In the IPA results, a total of 10 items were included in the second quadrant, including 1 item related to 'transfer,' 1 to 'infection,' and 1 to 'firefighting surveillance.' As the second quadrant contains the high-importance, low-performance items, these 10 items resemble the nurses' educational needs that should be prioritized. Conclusion : The results of this study can be used as a basis for the development of nursing educational programs for patient safety in the intensive care unit.

• Journal of Korean Critical Care Nursing
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• v.9 no.2
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• pp.36-47
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• 2016

Purpose: The study examined core job characteristics and job preference to explain work performance among critical care nurses. The theoretical model was constructed based on the job characteristics model with core job characteristics as exogenous variables, and work performance and job preference as endogenous variables. Methods: A total of 228 hospital nurses participated in the study from May to September, 2015. Data were collected through structured questionnaires and analyzed using structural equation modeling. Results: The model showed a good fit to the data with $x^2/df=2.90$, goodness of fit index = .91, root mean square residual = .20, comparative fit index = .93, and incremental fit index = .93. The core job characteristics explained 64% of the variance in job preference. The core job characteristics and job preference explained 52% of the variance in work performance. Conclusions: The core job characteristics can explain the work performance among critical care nurses through job preference. Effective strategies to improve the work performance among critical care nurses should focus on the application of the core job characteristic into a productive work environment. Further studies are warranted to explore the role of job preference of critical care nurses in promoting their work performance.

• Journal of Korean Critical Care Nursing
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• v.14 no.3
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• pp.1-13
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• 2021

Purpose : This study aims to provide basic data for effective nursing interventions and improvement of nurses' work by exploring their work experiences in single-room-structured intensive care units (ICU) through focus group interviews. Methods : Data were collected through two focus group discussions conducted from March to November 2020 with 13 ICU nurses. Interviews were audio-recorded and analyzed thematically by investigators. Results : Through content analysis, 15 sub-categories and 6 categories were formed. Two themes, "positive experiences patients care in an independent space" and "difficulties in nursing work according to space separation of patients" emerged. There are positive aspects of single-room-structured ICUs, but it was found that practicing nurses had difficulties and required specialized nursing competencies. Therefore, efforts to reduce the burden of nurses in single-room-structured ICUs are necessary. Conclusion : The limitation of this study is that it was conducted in a single hospital because single-room-structured intensive care units are uncommon in Korea. However, this study is of great significance as a basis for establishing guidelines on the efforts required from nurses, hospitals, and governments single-room-structured ICUs in the future.

• Journal of Korean Critical Care Nursing
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• v.10 no.1
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• pp.51-62
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• 2017

Purpose: This study aimed to understand the essence of experiences of patients and family members during flexible visiting in an intensive care unit (ICU). Methods: This is a qualitative study using interviews with open ended questions. We used Colaizzi's method of phenomenological interpretation. Results: Flexible visiting in the ICU impacted the patients and their families in various ways. The following categories were extracted from the patients' experiences with flexible visiting: 1) the opportunity to feel the presence of the family and 2) the burden of unrestricted visiting. The following categories were extracted from the families' experiences with flexible visiting: 1) psychological comfort by convenience 2) being aware of health care professionals and critical care nursing in the intensive care unit, and 3) double trouble. Conclusions: These results showed that flexible visiting in the ICU affected the patients and their families positively and negatively. Therefore, nursing staff need to design psychological and social interventions that address the needs of patients and their families.

• Journal of Korean Critical Care Nursing
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• v.1 no.1
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• pp.73-83
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• 2008

Purpose: Purpose of this study was to analyze the nursing focuses for standardization of ICU nursing records. Methods: The data were collected from 1,000days'nursing records of 197 ICU patients at a tertiary hospital in Seoul. Nursing focuses were unified at the consulting group meeting and they were cross-mapped with the NANDA nursing diagnoses. Results: The 62 nursing focuses in 7 NANDA categories were extracted from nursing record. Among total nursing focuses 41 correspond to the NANDA nursing diagnoses and 21 were added to ICU nursing focuses. The 10 most frequently used nursing focuses are 'Ineffective airway clearance', 'Impaired gas exchange', 'Ineffective tissue perfusion: cardiopulmonary', 'Ineffective breathing pattern', 'Ineffective tissue perfusion: renal', 'Ineffective infant feeding pattern', 'Risk for impaired skin integrity', 'Hyperthermia', 'Impaired skin integrity', 'Decreased cardiac output', Conclusion: Nursing focuses list of ICU was extracted from the result of this study. These nursing focuses might form a framework for development of research-based assessment guideline and care plans for ICU patients through standardization of nursing records.

• Journal of Korean Critical Care Nursing
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• v.14 no.2
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• pp.1-11
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• 2021

Purpose : The aim of this study was to propose appropriate nurse staffing of adult intensive care units considering patients' nursing care needs according to the Workload Management System for Critical Care Nurses (WMSCN). Methods : In a cross-sectional survey conducted in September 2017, 1,786 patients' WMSCN scores, surveys from 2,145 nurses, and administrative data from 118 units in 41 hospitals were analyzed. The means (standard deviations) of the aforementioned scores and nursing hours per patient day were presented. Nurse-to-patient ratios and nurse-to bed ratios for staffing to meet patients' nursing care needs were calculated. Results : The mean WMSCN scores were 109.50±17.17 in tertiary hospitals and 96.38±19.26 in general hospitals. Nursing hours per patient day were 12.47±2.80 in tertiary hospitals and 11.01±2.45 in general hospitals. Nursing hours per patient day correlated with WMSCN scores. Nurse-to-bed ratios required for the provision of ICU nursing care ranged from 1: 0.36 to 1: 0.48. Conclusion : Our findings provide evidence that current ICU nurse staffing is insufficient for meeting patients' nursing care needs. We suggest adjusting the legal standards for adequate nurse staffing considering these needs.