중환자실 간호사의 임상추론역량, 긍정심리자본, 간호근무환경이 간호업무성과에 미치는 영향

허미림,장해나 한국중환자간호학회 2024 중환자간호학회지 Vol.17 No.2

Purpose : This study aimed to investigate the impact of clinical reasoning competence, positive psychological capital, and nursing work environment on nursing performance of intensive care unit (ICU) nurses in tertiary general hospitals.Methods : Data were collected from 169 ICU nurses in tertiary general hospitals in Busan, South Korea, from July 27 to August 15, 2023, using a self-report questionnaire. After excluding 12 questionnaires with insufficient responses, 157 responses were analyzed. Descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficient, and stepwise multiple regression analysis were employed.Results : Factors influencing nursing performance included clinical reasoning competence (<i>β</i>=.51, <i>p</i> <.001), hope as a subfactor of positive psychological capital (<i>β</i>=.31, <i>p</i> <.001), and the nursing foundations for quality of care in the nursing work environment (<i>β</i>=.21, <i>p</i> <.001). The explanatory power of the regression model was 62% (F=87.41, <i>p</i> < .001).Conclusion : The study underscores the importance of improving clinical reasoning competence among ICU nurses to enhance nursing performance and foster a hopeful attitude through reflective practices and personal growth. Organizational interventions, such as educational and psychological support programs, along with creating a supportive nursing environment, are crucial for improving nursing performance among intensive care unit nurses.

일 종합병원 외과계 중환자실 환자의 섬망 발생 요인

천유경,박정윤,Chun, You Kyoung,Park, Jeong Yun 한국중환자간호학회 2017 중환자간호학회지 Vol.10 No.3

Purpose : This study examined the prevalence of delirium-related factors in a surgical intensive care unit (SICU). Methods : This retrospective study enrolled 73 patients who were admitted to an SICU from October 1, 2016 to March 20, 2017 and who had been hospitalized for more than 72 hours. Data was collected by reviewing electronic medical records. Results : Delirium occurred in 46 (63.0%) patients. Its related factors were age, education, mechanical ventilator, sleep, narcotics, physical restraint, and central line catheters. Conclusion : The results indicate that sleep and physical restraint are significant factors related to delirium occurrence. The results of this study can help in developing guidelines for the prevention of delirium.

간호학 학사과정 내 중환자 간호학 교육의 운영 현황과 발전 방향

이영희,손연정,강지연,김복자,김정연,이윤미,최수정,최은희,하이경,Yi, Young Hee,Son, Youn-Jung,Kang, Jiyeon,Kim, Bog Ja,Kim, Jung Yeon,Lee, Yun Mi,Choi, Su Jung,Choi, Eun Hee,Ha, Yi Kyung 한국중환자간호학회 2017 중환자간호학회지 Vol.10 No.3

Purpose : This study examined the status of critical care nursing education in bachelor of science in nursing (BSN) to suggest future directions. Methods : The target of the survey was 185 BSN programs that were certified by the Korean Accreditation Board of Nursing Education as of October 31, 2016. We structurally reviewed the curriculums and the course syllabi. Results : Forty-eight courses of 42 BSN programs were analyzed. Only five programs offered both theoretical and practical courses in critical care nursing; 22 offered theoretical courses and 26 offered practical courses. Most courses were offered as electives with 1 or 2 credits, and were taught by faculty who were experts in adult health nursing. Conclusion : The results show that there is a quantitative shortage of critical care nursing education in the curriculum of BSN programs in Korea. The lack of knowledge and skills on critical care can lead to a burden of new intensive care unit nurses and is a threat to patients' health. It is necessary to develop a practical and integrative curriculum for critical care nursing education.

중환자실 환자의 환경적 스트레스 요인이 외상후 스트레스장애 위험도와 삶의 질에 미치는 영향

차효정,안숙희 한국중환자간호학회 2019 중환자간호학회지 Vol.12 No.1

Purpose : This study was to determine the levels of environmental stressor, posttraumatic stress disorder, and quality of life in intensive care units (ICU) survivors after intensive care, and to explore the factors affecting posttraumatic stress disorder and quality of life. Methods: With a longitudinal survey design, data were collected from 116 patients who were discharged from the ICU of a university hospital. The environmental stressor, posttraumatic stress disorder, and quality of life were measured immediately following and 1 month after the ICU discharge. Results: Of all the subjects, 16.4% experienced posttraumatic stress disorder after discharge. Multiple regression analysis revealed that ICU environmental stressors, experience of ICU readmission, using psychotropic drugs and narcotic analgesics, and ICU admission after surgery or cardiac intervention accounted for 22.2% of posttraumatic stress disorder. Posttraumatic stress disorder and sedation status when entering ICU accounted for 28.3% of the quality of life 1 month after ICU discharge. Conclusion: Nursing interventions focused on ICU environmental stressors would not only reduce environmental stress but also contribute to the reduction of posttraumatic stress disorder and later improvement of quality of life.

중환자실 퇴원환자의 인지장애 위험요인

강지연,이보경 한국중환자간호학회 2020 중환자간호학회지 Vol.13 No.3

Purpose : This study aimed to identify the prevalence and risk factors of cognitive impairment in survivors discharged from the intensive care unit (ICU). Methods : This secondary analysis study utilized data from a multicenter prospective cohort of post-ICU patients. We analyzed the data of 175 patients enrolled in the primary cohort who completed the cognitive function evaluation three months after ICU discharge. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) scale. The cut-off points for cognitive impairment were < 23 for face-to-face evaluation and < 18 for telephone evaluation. Results : The prevalence of cognitive impairment three months after ICU discharge was 32.6%. Significant risk factors for cognitive impairment were age ≥ 60 years (OR=10.52, 95% CI=3.65∼30.33, p <.001), education < high school graduation (OR=2.53, 95% CI=1.07∼6.01, p =.035), unplanned ICU admission (OR=4.01, 95% CI=1.45-11.14, p =.008), and delirium in the ICU (OR=4.33, 95% CI=1.08-17.23, p =.038). Conclusion : ICU nurses should use preemptive strategies to reduce post-ICU cognitive impairment of patients with risk factors. It is necessary to frequently assess and detect early delirium in critically ill patients, while attempting various non-pharmacological interventions.

중환자실 조기 재입실 관련 위험요인

장진녕,이윤미,박효진,이현주 한국중환자간호학회 2019 중환자간호학회지 Vol.12 No.1

Purpose : The purpose of this study was to identify status and characteristics of patients who have been readmitted to ICU, and to analyze risk factors associated with the readmission to ICU within 48hours. Method: Data were collected from patient’s electronic medical reports from one hospital in B city. Participants were 2,937 patients aged 18 years old or older admitted to the ICU. Data were analyzed using odd ratios (ORs) from multivariate logistic regressions. Results: 2.2% of the 2,937 patients were early readmitted to ICU. Risk factors for early readmission to ICU were existence of respiratory disease, use of mechanical ventilator, and duration of hospitalization (longer). Conclusion: The assessment on the respiratory system of the patient who will be discharged from the ICU was identified as an important nursing activity. Therefore, the respiratory system management and education should be actively conducted. In addition, early ICU readmission may be prevented and decreased if a link was built to share the information on patient condition between the ICU and general wards.

중환자실 간호사의 외상후 스트레스와 갈등관리 유형이 간호업무수행에 미치는 영향

황지나,박완주,Hwang, Ji Na,Park, Wan Ju 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.3

Purpose : This study examined the factors influencing posttraumatic and conflict management styles for nursing performance in intensive care units (ICUs). Methods : In this study, 250 nurses from eight general hospitals in three cities participated. Structured self-report questionnaires were used to collect data on posttraumatic, conflict management styles, and nursing performance. Finally, the data were analyzed by SAS 9.3 program. Results : The mean of total sum scores was 31.29, and the high risk of posttraumatic symptoms was 61.2%. It was noted that nursing performance is significantly correlated with collaboration, compromise, accommodation styles, and intrusion. Collaboration styles (${\beta}=0.39$, p<.001) and hyperarousal (${\beta}=-0.22$, p=.050), ICU experience below 1 year (${\beta}=-0.21$, p=.027) and that of 5-10 years (${\beta}=-0.19$, p=.049), and compromise style (${\beta}=0.16$, p=.049) were found to be the factors influencing nursing performance with 35.9% explanatory power value of regression model. Conclusions : The results of the study reveal that conflict management styles, hyperarousal, and ICU experience are factors predicting the successful performance of ICUs. These findings emphasize the need of developing interventions to reduce stress symptoms and conflicts in ICUs.

중환자 구강사정 도구개발

김진희,박경숙,Kim, Jin Hee,Park, Kyungsook 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.3

Purpose : This methodological study develops an oral health assessment tool for critically ill patients. Method : From February 15 to April 30, 2014, this study was conducted to test the validity and reliability of the tool at two general hospitals and three medical and surgical intensive care units (ICUs) in Seoul, Korea. Results : The result of the intraclass correlation coefficient to test the between-observer reliability by analyzing the oral health assessment scores before and after oral nursing care showed that .93 of before oral care and .90 of after oral care. The correlation coefficient values of .68 (p<.001) and .71 (p<.001) before and after providing oral nursing care, respectively, indicated the presence of a statistically significant correlation between the tool and the criterion. Using the paired t-test, the differentiated validity of the tool was tested in patients who had developed pneumonia after entering the ICU. A statistically significant difference in scores was found between the time of entering the ICU and that of developing pneumonia (t=-8.73, p<.001), which provided evidence for the differentiated validity of the tool. Conclusions : Since the validity and reliability of the tool developed in this study were verified, this tool can be used to assess the oral health conditions of critically ill patients.

의료처치 및 환자 비밀유지에 대한 중환자실 간호사와 일반병동 간호사의 윤리적 갈등 경험 비교연구

고정미,고진강,Ko, Chungmee,Koh, Chin-Kang 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.3

Purpose : This study compares experiences of ethical dilemma between nurses working in intensive care units and those in general units under specific situations of treatment decisions and confidentiality. Method : This cross-sectional descriptive study utilizes the self-report survey method. The survey questionnaires were completed by 50 and 52 nurses working in intensive care units and general units, respectively. The instrument, which consisted of 16 items of ethical dilemma situations about treatment decision and confidentiality, was used. The mean scores for each item were compared between the two groups. Results : The study found no differences in terms of age, gender, education level, clinical experience in years, and being educated on healthcare ethics. For 9 out of 16 items, the mean scores of nurses in intensive care units were significantly higher than those of nurses in general units. Conclusions : Nurses in intensive care units experienced ethical dilemmas regarding treatment decisions and confidentiality more often than those in general units. This study emphasizes the need to establish strategies for improving the ethical competence of critical care nurses.

영양집중지원에 따른 결과 비교 - 내과계 중환자실 대상으로 -

임완순,이윤미,Im, Waon Sun,Lee, Yun Mi 한국중환자간호학회 2018 중환자간호학회지 Vol.11 No.3

Purpose : This study evaluated the nutritional status and effect of nutritional support team (NST) management in critically ill patients. Methods : From January 2015 to August 2017, the study retrospectively investigated 128 patients aged above 19 years admitted to a medical intensive care unit (MICU). The patients were divided into two groups: NST (n=65) and non-NST (n=63) groups. Nutritional status, classification of bedsore risks, incidence rate of bedsore and clinical outcomes were compared. Results : The study found a higher rate of the use of enteral nutrition in the NST group (${\chi}^2=45.60$, p < .001). The prescription rate of parenteral nutrition (PN) was found to be lower in the NST group (4.6%) compared to the non-NST group (60.3%). There was a higher PN of total delivered/required caloric ratio in the NST, compared to the non-NST, group (${\chi}^2=3.33$, p=.025). There were significant differences for higher albumin levels (t=2.50, p=.014), higher total protein levels (t=2.94, p=.004), and higher proportion of discharge with survival rates (${\chi}^2=18.26$, p < .001) in the NST group. Conclusions : Providing NST management to critically ill patients showed an increase in the nutrition support. Further, to achieve effective clinical outcomes, measures such as nutrition education and continuous monitoring and management for the provision of nutritional support by the systemic administration of a nutritional support team should be considered.