• Journal of Korean Academy of Nursing
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• v.51 no.1
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• pp.119-132
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• 2021

Purpose: This study aimed to identify the effects of a direct breastfeeding program for premature infants in neonatal intensive care units (NICUs). Methods: This quasi-experimental study was conducted during August 2016 to April 2017. Sixty mothers of premature infants were assigned to the experimental (n = 31) or control groups (n = 29). The program was comprised of breastfeeding education and direct breastfeeding support. The experimental and control groups were provided with education and counseling on breastfeeding at the time of admission and discharge. In the experimental group, the mothers initiated oral feeding with direct breastfeeding and engaged in breastfeeding at least seven times during the NICU stay. The collected data were analyzed by the χ2-test and repeated measures ANOVA using an SPSS program. Results: The experimental group showed a higher direct breastfeeding practice rate (χ2 = 19.29, p < .001), breastfeeding continuation rate (χ2 = 3.76, p < .001), and self-efficacy (F = 25.37, p < .001) than the control group except for maternal attachment. Conclusion: The direct breastfeeding program in the NICU has significant effects on the practice and continuation rate of breastfeeding and breastfeeding self-efficacy. Therefore, this program can be applied in the NICU settings where direct breastfeeding is limited.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.18 no.2
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• pp.160-167
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• 2011

Purpose: The purpose of this study was to identify the effects of an oral stimulation program on premature infant's transition from tube feeding to bottle feeding, decrease in desaturation during feeding, and early discharge. Methods: This quasi-experimental study was performed in one neonatal intensive care unit (NICU) of an university hospital. The control group data (n=69) were obtained from June 2008 to May 2009, and the experimental group data (n=67), from June 2009 to May 2010. The oral stimulation program (OSP) was provided daily before feeding for the experimental group until transition to bottle feeding was completed. Results: The OSP group began bottle feeding earlier and were on complete bottle feeding earlier than control group. Discharge delay due to feeding desaturation was lower than for the control group. Conclusion: The results indicate that OSP for premature infants was helpful in transition from tube feeding to bottle feeding and early discharge and thus can contribute health and development in premature infants.

• Clinical and Experimental Pediatrics
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• v.56 no.8
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• pp.332-337
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• 2013

Purpose: To identify the frequency of bacterial isolates in early-onset neonatal sepsis (EONS) and their antimicrobial resistance pattern. Methods: A retrospective study of EONS was conducted at the Beni Suef University Hospital from September 2008 to September 2012. A case of EONS was defined as an infant who had clinical signs of infection or who was born to a mother with risk factors for infection, and in whom blood culture obtained within 72 hours of life grew a bacterial pathogen. Results: Of 673 neonates screened, there were 138 positive blood cultures (20.5%) (confirmed EONS). Of the recovered isolates, 86.2% were gram-negative pathogens. Klebsiella pneumoniae (42.8%), Enterobacter cloacae (22.5%), and Escherichia coli (13.8%) were the commonest isolated organisms. The most common gram-positive microorganism was Staphylococcus aureus accounting for only 12 isolates (8.7%). All Klebsiella isolates and 93% of Enterobacter isolates were resistant to ampicillin. Gram-negative pathogens had the maximum overall sensitivity to imipenem, cefepime, and ciprofloxacin; whereas, gram-positive isolates were most susceptible to vancomycin, imipenem, and piperacillin. Conclusion: K. pneumoniae was the predominant causative bacteria of EONS followed by E. cloacae and E. coli. There was a high resistance to ampicillin. Imipenem had the maximum overall activity against the causative bacteria. Continuous surveillance is needed to monitor the changing epidemiology of pathogens and antibiotic sensitivity.

• Child Health Nursing Research
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• v.22 no.4
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• pp.257-264
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• 2016

Purpose: The purpose of this study was to investigate the relationship among knowledge and attitude toward palliative care and perception of death for Neonatal Intensive Care Unit (NICU) nurses. Methods: A cross-sectional descriptive study was conducted with 110 nurses who work in NICUs in South Korea. The participants filled out a questionnaire regarding their knowledge, attitude towards palliative care and perception of death. The attitude scale was divided into 3 subscales: comfort level, nurses' role and nurses' involvement with family. Results: Comfort level regarding attitude towards palliative care was positively correlated with knowledge (r=.220, p=.016) and the perception of death (r=.194, p=.042). Nurses' role showed a positive correlation with perception of death (r=.395, p=.001). Conclusion: NICU nurses' knowledge of palliative care was below standard across the board, implying that there is a definite need for palliative care education for nurses. The education program for palliative care should include a section that focuses on fostering a positive perception of death as well as defining and delineating the role of nurses.

• Journal of Korean Academy of Nursing
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• v.40 no.4
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• pp.561-570
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• 2010

Purpose: This was a cross sectional descriptive study to introduce the Infants Coma Scale (ICS), describe mental status of high risk infants using ICS and explore the relationships between ICS and clinical variables in infants hospitalized in a neonatal intensive care unit of a university hospital in Korea. Methods: After ICS was developed and tested by the authors, a research nurse evaluated the mental status of the infants using the English version of ICS and obtained clinical information on the infants from their medical records. Results: Data from 88 infants were analyzed. About 60% were male, 90% were preterm births, and 40% had pathologic abnormalities. Their mean gestational age was 32.4 (${\pm}3.50$) weeks and the mean birth weight was 1,842 (${\pm}728.6$) grams. The Cronbach's alpha for the ICS was .78. There was a statistically significant positive correlation between ICS total score and five clinical variables including gestational age, birth weight, 1 and 5 min Apgar scores and respiration status. Conclusion: Mental status is an important parameter in nursing assessment. ICS is a valid and reliable instrument, which clinicians can easily use to evaluate the mental status of high risk infants.

• Child Health Nursing Research
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• v.22 no.3
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• pp.190-198
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• 2016

Purpose: The purpose of this study was to examine the paternal stress and nursing support as perceived by fathers of high risk infants admitted to Neonatal Intensive Care Units (NICU). Methods: The study participants included 88 fathers of high risk infants in NICUs. Their parental stress and nursing support were measured using a self-report questionnaire. Results: The parental stress level of the fathers was 3.57 of a possible 5. Among the parental stress items, 'Relationship with infant and parental role' had the highest scores. The perceived nursing support level was a relatively high, 3.90 on a 5-point scale. The lowest score was for the item 'showed concern about my well-being.' The parental stress was lower in fathers with low income, higher in fathers in nuclear families and when the infants' condition was serious. Conclusion: The findings indicate that fathers of high risk infants experience intense parental stress. Thus when designing care to provide support for these fathers and their infants, it is necessary to encourage the fathers' engagement, provide information on how to respond to the baby, and include supportive care to the fathers.

• Child Health Nursing Research
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• v.22 no.3
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• pp.172-181
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• 2016

Purpose: This study was conducted to examine the effect of education on infection control for multidrug resistant organism (MDRO). Methods: One group pre-post time series design was used. Infection control education for MDRO infection was provided to nurses working in the Neonatal Intensive Care Unit (NICU). Knowledge and recognition were evaluated before and after education. Hand hygiene compliance, MDRO isolation rate and central line-associated bloodstream infection (CLABSI) rate were used as outcome variables. Data from 45 nurses was used for analysis. Results: General knowledge about MDRO increased (p=.011). Responses to questions about image of MDRO and MDRO management tended to change in a positive direction (p=.046). Hand hygiene compliance was 100% at pre-test, 79.5% during education period and 98.4% at post-education period. MDRO isolation rate was 6.83 per 1,000 patient days at pre-test, 10.24 during education period and 6.68 at post-education period. CLABSI rate was 3.76 per 1,000 central line days at pre-test, 6.84 during education period and 4.71 at post-education period. Conclusion: Findings indicate that the education program is effective in improving knowledge about MDRO in NICU nurses. However, more reliable indicators should be used to determine long-term effects.

• Child Health Nursing Research
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• v.25 no.4
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• pp.417-424
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• 2019

Purpose: The purpose of this study was to investigate partnerships with nurses, social support and readiness for discharge among mothers of premature infants in the neonatal intensive care unit (NICU) and to examine the factors associated with readiness for discharge. Methods: A survey was conducted among 85 mothers of premature infants hospitalized in a NICU in Seoul, Korea. The collected data were analyzed with descriptive statistics, the t-test, one-way analysis of variance, Pearson' correlation coefficients, and multiple linear regression using SPSS version 25.0. Results: The results of the regression analysis showed that partnerships with nurses (${\beta}=.32$, p=.011) and parenting experience (${\beta}=.32$, p=.001) were significantly associated with readiness for discharge. Conclusion: To improve the readiness for discharge among mothers of premature infants, developing strategies to strengthen their partnership with nurses and to provide family-centered care will be needed.

• Neonatal Medicine
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• v.28 no.2
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• pp.77-82
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• 2021

We present the case of a healthy 28-day-old female full-term neonate who was admitted to the neonatal intensive care unit for severe metabolic acidosis, hypoglycemia, and an initial sinus rhythm. The first diagnostic hypothesis was hypovolemic shock, and fluid resuscitation was started immediately. During fluid therapy, cardiovascular collapse occurred with supraventricular tachycardia. The latter was successfully treated with adenosine and beta-blockers. After 8 days, electrocardiography showed ventricular pre-excitation, and Wolff-Parkinson-White syndrome was diagnosed. A novel variant of the MYL2 gene that is related to hypertrophic cardiomyopathy and conduction defect was found after discharge. Cardiogenic shock should be considered, despite being a rare cause of shock in neonates.

• Neonatal Medicine
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• v.28 no.1
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• pp.7-13
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• 2021

Purpose: To evaluate the risk factors and effects of fluctuations in oxygen saturation on the occurrence and severity of retinopathy of prematurity (ROP). Methods: From January 1, 2013 to January 31, 2020, 260 patients hospitalized in the neonatal intensive care unit of Ajou University Hospital were retrospectively analyzed. Results: Sixty-six patients (25%) were diagnosed with ROP; of them 39 required treatment. In the multivariate regression analysis of ROP severity, the odds ratio (OR) of gestational age was 0.32 (95% confidence interval [CI], 0.22 to 0.47; P<0.0001). The OR of saturation of peripheral oxygen (SpO₂) fluctuations at the 4th week after birth was 1.02 (95% CI, 1.02 to 1.12; P=0.041). Conclusion: SpO₂ fluctuations in premature infants younger than 30 weeks' gestational age affects ROP severity, especially at the 4th week of life.