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"Intensive care unit"

Original Articles
Purpose
To explore the relationship between nursing care needs and acuity based on the Korean Patient Classification System for Critical Care Nurses (KPCSC) and APACHE II, and to identify their prognostic value in predicting mortality.
Methods
A total of 617 patients admitted to a surgical intensive care unit in a tertiary hospital from January 1 to June 30, 2021 were included. The correlation between KPCSC and APACHE II scores, and their predictive power regarding mortality were examined.
Results
KPCSC and APACHE II scores showed a significant, positive correlation (r=.32, p<.001). The KPCSC score was significantly correlated with 10 out of 11 KPCSC categories and 2 out of 3 APACHE II domains, whereas the APACHE II score had a significant correlation with all APACHE II domains and only 4 out of 11 KPCSC categories. Both KPCSC and APACHE II demonstrated moderate discriminatory performance in predicting ICU and in-hospital death, and their AUC values were not significantly different.
Conclusion
KPCSC, reflecting the severity of illness, predicted mortality as well as APACHE II. However, KPCSC was found to consider factors other than severity, such as patient dependency, which substantiates its value as an assessment tool for nursing care needs.

Citations

Citations to this article as recorded by  
  • Comparisons of nursing hours and nurse-to-patient ratios required for patients with mechanical ventilation, CRRT, and ECMO in intensive care units: A cross-sectional study
    Sung-Hyun Cho, Shin-Ae Kim, Eunhye Kim
    Intensive and Critical Care Nursing.2025; 89: 103982.     CrossRef
  • Relationship between Nurse Staffing and Critical Nursing Activities in Intensive Care Units : Analysis of National Health Insurance Claims Data from 2009 to 2020
    U Ri Go, Sung-Hyun Cho
    Journal of Korean Critical Care Nursing.2024; 17(2): 25.     CrossRef
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ICU Nurses’ Experiences with Patient Care after Death
Ji Young Park, Ki Kyong Kim
J Korean Acad Nurs Adm 2022;28(1):43-56.   Published online January 31, 2022
DOI: https://doi.org/10.11111/jkana.2022.28.1.43
Purpose
This study aimed to identify ICU nurses‘experiences with patient care after death. Methods: The data were collected through two focus group interviews with eight nurses who had experienced the death of patients in the ICU. Giorgi’s method of descriptive phenomenology was used to interpret the data. Results: Five constituents and 14 subconstituents were extracted from the 68 units of meaning. The five constituents were as follows: respect the body as a person, consideration and support for the family, dichotomy between personal courtesy and performing tasks, overcoming the patient’s death and growing, and care after death: a unique role left to the nurse. Conclusion: These findings illuminate the meaning of care after death as a continuation of person-centered care and can be used as primary data for the development of organizational, educational, and emotional support for nurses to accomplish their roles in the ICU.

Citations

Citations to this article as recorded by  
  • Nurses’ perspectives about end-of-life care when family presence is restricted during a pandemic: A qualitative study
    Myung Hui Choi, Hyun Jung Kim, Hye Jin Yoo
    Australian Critical Care.2025; 38(1): 101091.     CrossRef
  • Effects of a Simulation-Based Care After-Death Mentoring Program for New Nurses: Augmented Reality End-of-Life Experience
    Ki Kyong Kim, Bokyoung Kim
    Journal of Palliative Medicine.2024; 27(12): 1631.     CrossRef
  • Experiences of Intensive Care Unit Nurses in Caring for Brain-Dead Donors
    Minseo Son, Nageong Kim
    Journal of Hospice & Palliative Nursing.2024; 26(1): E38.     CrossRef
  • Describing Medical Aid-in-Dying and Nursing “Leave-the-Room” Policies in California
    Karin Sobeck, Gianna R. Strand, David N. Hoffman
    Journal of Hospice & Palliative Nursing.2024; 26(6): 317.     CrossRef
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  • 4 Crossref
Compare Value Congruence of Nurse-Patient Assignment with Work Performance in Neonatal Intensive Care Unit
Hye Mim Kim, Dong Yeon Kim, Ji Young Kim, Ga Young Kim, Seol Hee Moon
J Korean Acad Nurs Adm 2021;27(5):355-365.   Published online December 31, 2021
DOI: https://doi.org/10.11111/jkana.2021.27.5.355
Purpose
This study aimed to compare the value congruence of nurse-patient assignment (NPA) with work performance in the neonatal intensive care unit (NICU). Methods: Data were collected with 30-items on factors that affect NPA and 17-items on work performance. Two questionnaire surveys each were conducted with 79 nurses from the NICU. The difference between expectations and actual experience on NPA were analyzed, and the effects of NPA on work performance and overtimes were investigated. The collected data were analyzed with a paired t-test, analysis of variance, and Pearson’s correlation coefficients using the SPSS software version 20.0. Results: The NPA criteria were surveyed with 30 items, with 13 patient-related, and 17 nurse-related. The validity of the tool was S-CVI .95 and the reliability (Cronbach’s ⍺) was .942. There were significant differences based on age (F=3.69, p=.029) and caring for patients on an artificial ventilator (t=2.55, p=.013). The higher the patient-related actual assignment score, the higher the nurse-related actual assignment score (r=.68, p<.001) and work performance (r=.48, p<.001). As the nurse-related actual assignment score increased, work performance also increased significantly (r=.36, p=.001). Conclusion: It was confirmed that the value congruence of NPA is positively correlated with work performance.

Citations

Citations to this article as recorded by  
  • Clinical decision support system for clinical nurses’ decision-making on nurse-to-patient assignment: a scoping review protocol
    Hyunjeong Kwon, Dayeon Lee
    BMJ Open.2024; 14(1): e080208.     CrossRef
  • A comparative analysis of nurses' reported number of patients and perceived appropriate number of patients in integrated nursing care services
    Hyunjeong Kwon, Jinhyun Kim
    Nursing & Health Sciences.2024;[Epub]     CrossRef
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Association between Nurse Staffing and Mortality in Patients with Ischemic and Hemorrhagic Stroke in the Intensive Care Units
Ju-Eun Kim, Sung-Heui Bae
J Korean Acad Nurs Adm 2021;27(5):311-322.   Published online December 31, 2021
DOI: https://doi.org/10.11111/jkana.2021.27.5.311
Purpose
This study examined the association between nurse staffing and in-hospital 30-day mortality among stroke patients considering the stroke type in the intensive care units in Korea using the Health Insurance Review and Assessment Service-National Inpatient Sample 2018 (HIRA-NIS 2018). Methods: The data included a total of 2,876 stroke patients admitted to intensive care units across 72 general hospitals and 39 tertiary hospitals between January and November 2018. Nurse staffing levels were measured using the nurse staffing grades of adult intensive care units in the 2nd quarter of 2018. The relationship between nurse staffing levels and mortality were analyzed using multi-level logistic regression analysis after controlling for patient and hospital characteristics. Results: In patients with ischemic stroke, the risk of death was lower in nurse staffing Grade 5 to 6 compared to Grade 1 (Odds ratio [OR] 0.43, 95% Confidence interval [CI] 0.24~0.75). In hemorrhagic stroke patients, the risk of death tended to be higher in nurse staffing grade 5 to 6 compared to Grade 1 (OR 2.11, 95% CI 1.00~4.45), which was marginally significant (p=.050). Conclusion: Health policies for adequate nurse staffing in intensive care units should be implemented to enhance the quality of care and lead to better outcomes in patients with stroke.
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Intensive Care Unit Nurse‘s Reaction Experience to Patient Monitoring Medical Device Alarms
Eunjin Kim, Miyoung Kim
J Korean Acad Nurs Adm 2021;27(3):215-226.   Published online June 30, 2021
DOI: https://doi.org/10.11111/jkana.2021.27.3.215
Purpose
This study was done to explore the meaning of the intensive care unit (ICU) nurse’s alarm reaction and identify essential structure of the reaction experience. Methods: Data were collected through in-depth interviews with 10 intensive care unit nurses working in higher general hospital. Data collection and analysis were conducted simultaneously by applying Giorgi's phenomenological method. Results: The ICU nurse’s alarm reaction was shown to be in a dynamic structure to recognize and respond to alarms. Medical device alarms were recognized through alarm sounds and the importance of alarms was determined through previous experience of alarms and whether alarms were true or false. The problem solving ability to manipulate the alarm devices increased with reaction to alarms, and the nurses showed flexibility to individualize alarm settings according to patients’ situations, or respond to alarms according to priority considering the degree of emergency of alarms. In addition, nurses resolved alarms while feeling a sense of mutual responsibility among colleagues in emergency situations. Conclusion: The essential structure of ICU nurses’ alarm reaction revealed through this study was the recognition of and reaction to alarms, and the major characteristics explaining this structure were sensitivity, judgment, problem solving ability, flexibility, and mutual responsibility.

Citations

Citations to this article as recorded by  
  • Degree of Alarm Fatigue and Mental Workload of Hospital Nurses in Intensive Care Units
    Yoonhee Seok, Yoomi Cho, Nayoung Kim, Eunyoung E. Suh
    Nursing Reports.2023; 13(3): 946.     CrossRef
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Relationship of ICU Nurses' Difficulties in End-of-Life Care to Moral Distress, Burnout and Job Satisfaction
Kkot Bi Jeon, Mihyun Park
J Korean Acad Nurs Adm 2019;25(1):42-51.   Published online January 31, 2019
DOI: https://doi.org/10.11111/jkana.2019.25.1.42
PURPOSE
The aim of this study was to identify the relationships between the difficulty of end-of-life care and moral distress, burnout and job satisfaction of nurses working in intensive care units (ICUs).
METHODS
This descriptive study was conducted using self-report questionnaires. Participants were nurses who had more than one year of ICU experience and were recruited from three university hospitals (N=168).
RESULTS
The mean scores for ICU nurses' difficulty in end-of-life care, moral distress, burnout and job satisfaction were 3.42, 113.88, 3.16 and 2.58 points, respectively. Difficulty in end-of-life care was positively correlated with moral distress (r=.48, p < .001) and burnout (r=.26, p=.001) and was negatively correlated with job satisfaction (r=−.17, p=.024). Difficulties in end-of-life was identified as a predictor of moral distress (β=.44, p < .001), burnout (β=.26, p=.001) and job satisfaction (β=−.18, p=.024).
CONCLUSION
The results of this study suggest the following: it is important to have a deep understanding of ICU nurses who experience various difficulties in end-of-life care and to provide realist support for these nurses. And practical efforts by nursing organizations are needed, including support systems and education programs to alleviate ICU nurses' difficulties in end-of-life care.

Citations

Citations to this article as recorded by  
  • A Conceptual Analysis of Psychological Burnout Among Nurses Providing Terminal Care
    Sunjung Kim, Sunghee H. Tak
    Journal of Advanced Nursing.2025;[Epub]     CrossRef
  • Relationship between moral resilience and secondary traumatic stress among ICU nurses: A cross‐sectional study
    Mengyi Hu, Hongli Zhang, Chao Wu, Lu Li, Xinhui Liang, Yu Zhang, Hongjuan Lang
    Nursing in Critical Care.2024; 29(6): 1363.     CrossRef
  • The Relationship Between Perceived Comfort Level with Moral Sensitivity and Moral Distress Among Oncology Nurses: A Descriptive Correlational Study
    Samira Beiranvand, Kourosh Zarea, Shahram Molavynejad, Simin Madhooshi, Parisa Sheini Jaberi
    Seminars in Oncology Nursing.2024; 40(6): 151742.     CrossRef
  • Factors related to burnout of nurses working at intensive care units: A descriptive survey study
    Yeon Ju Lee, Heeok Park, Ji Hun Joung
    Journal of Korean Gerontological Nursing.2024; 26(2): 221.     CrossRef
  • The Relationship Between Nurses’ Moral Distress, Their Spiritual Well-Being, and Moral Intelligence
    Masoume Moqaddam, Nasrin Hanifi, Parvin Shiri Ghaidari
    Journal of Archives in Military Medicine.2024;[Epub]     CrossRef
  • Talking about dying and death: Essentials of communicating about approaching death from the perspective of major stakeholders
    Sibylle J. Felber, Tommaso Guffi, Beate G. Brem, Felix M. Schmitz, Kai P. Schnabel, Sissel Guttormsen Schär, Steffen Eychmüller, Sofia C. Zambrano
    Palliative and Supportive Care.2024; 22(5): 1199.     CrossRef
  • National and International Trends in Research on Moral Distress in Nursing: Text-network Analysis and Topic Modeling
    Chan-Sook PARK
    Korean Journal of Medical Ethics.2023; 26(2): 133.     CrossRef
  • Perceived Stress, Moral Distress, and Spiritual Intelligence of Clinical Nurses in the Coronavirus Disease 2019 Pandemic
    Milad Bazghaleh, Mohammad Abbasi, Elahe Bahonar, Zohreh Ghomian, Mahdi Sadeghi, Reza Norouzadeh
    Annals of Military and Health Sciences Research.2023;[Epub]     CrossRef
  • The Relationship between Clinical Competence and Ethical Reasoning and Factors Affecting it in Nurses Working in Therapeutic Educational Centers of Ilam
    Masoumeh Otaghi, Mosayeb Mozafari, Yosof Veysani, Azam Taheri
    Romanian Journal of Military Medicine.2023; 126(1): 106.     CrossRef
  • The relationship between secondary traumatic stress and burnout in critical care nurses: The mediating effect of resilience
    Yun Jeong Jeong, Sujin Shin
    Intensive and Critical Care Nursing.2023; 74: 103327.     CrossRef
  • How Do Nursing Students Perceive Moral Distress? An Interpretative Phenomenological Study
    Chiara Gandossi, Elvira Luana De Brasi, Debora Rosa, Sara Maffioli, Sara Zappa, Giulia Villa, Duilio Fiorenzo Manara
    Nursing Reports.2023; 13(1): 539.     CrossRef
  • The severity of moral distress in nurses: a systematic review and meta-analysis
    Nader Salari, Shamarina Shohaimi, Behnam Khaledi-Paveh, Mohsen Kazeminia, Mohammad-Rafi Bazrafshan, Masoud Mohammadi
    Philosophy, Ethics, and Humanities in Medicine.2022;[Epub]     CrossRef
  • The Effect of Nursing Competence on Patient-Centered Care among Nurses Caring for Patients with Chronic Disease: The Mediating Effect of Burnout and the Moderating Effect of Nursing Work Environment
    Jin-Yeong Ahn, Young Eun
    Korean Journal of Adult Nursing.2021; 33(2): 134.     CrossRef
  • Levels of Moral Distress among Health Care Professionals Working in Hospital and Community Settings: A Cross Sectional Study
    Noemi Giannetta, Rebecca Sergi, Giulia Villa, Federico Pennestrì, Roberta Sala, Roberto Mordacci, Duilio Fiorenzo Manara
    Healthcare.2021; 9(12): 1673.     CrossRef
  • End-of-Life Care Mobile App for Intensive-Care Unit Nurses: A Quasi-Experimental Study
    Jin Hee Yang, Gisoo Shin
    International Journal of Environmental Research and Public Health.2021; 18(3): 1253.     CrossRef
  • Mixed Method Research Investigating Turnover Intension with ICU Nurses
    Jung-Hoon Lee, Yeoungsuk Song
    Journal of Korean Academy of Fundamentals of Nursing.2020; 27(2): 153.     CrossRef
  • Emergency nurses’ experience of coping with moral distress
    Na Kyoung Lee, Jee-In Hwang
    The Journal of Korean Academic Society of Nursing Education.2020; 26(2): 176.     CrossRef
  • Current Status of End-of-Life Care Education in Undergraduate Nursing Curriculum
    So-Hi Kwon, Yeon-Su Cho
    The Korean Journal of Hospice and Palliative Care.2019; 22(4): 174.     CrossRef
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Practical Communication Strategies to Improve the Surgical Outcomes in a Pediatric Cardiac Intensive Care Unit
Ju Yeon Uhm, Worlsook Lee
J Korean Acad Nurs Adm 2015;21(3):243-253.   Published online June 30, 2015
DOI: https://doi.org/10.11111/jkana.2015.21.3.243
PURPOSE
The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU).
METHODS
Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS.
RESULTS
The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (chi2=7.23, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (chi2=6.66, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (chi2=20.31, p<.001).
CONCLUSION
Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.
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Work Stress, Turnover Intention and Burnout among Nurses in Neonatal Intensive Care Units
Mi Yu
J Korean Acad Nurs Adm 2011;17(1):115-126.   Published online March 31, 2011
DOI: https://doi.org/10.11111/jkana.2011.17.1.115
PURPOSE
This study was done to identify differences in work environment, work stress, turnover intention and burnout and investigate the relationship among these variables in nurses in Korean Neonatal Intensive Care Units.
METHODS
Participants were 242 nurses working in 13 general hospitals. Burnout was measured by the Maslach Burnout Inventory (MBI), work stress with the instrument by Gu & Kim (1994), and turnover intention with the scale by Kim & Lee (2001). Size of the NICU, nurse to patient ratio, and communication satisfaction were included in work environment. Data were analyzed using Pearson correlation coefficients and multiple regression analysis with SPSS WIN program.
RESULTS
The mean score for work stress in NICU nurses was 3.43 points, for burnout, 2.72 points, and for turnover intention, 4.64 points. Burnout and turnover intention level of participants were moderate-high. Work stress, communication dissatisfaction with physician, and clinical career accounted for 33% of variance in burnout. Significant differences were found between size of NICU and staffing related to environmental characteristics in turnover intention and burnout.
CONCLUSIONS
Results indicate that effective communication with coworkers and institutional support for appropriate staffing according to number of beds will help to prevent work stress, burnout, and ultimately, nurses' resignations.

Citations

Citations to this article as recorded by  
  • Current Status and Issues of Infection Control in the Neonatal Intensive Care Units
    Do-Hyun Kim
    Korean Journal of Healthcare-Associated Infection Control and Prevention.2023; 28(1): 29.     CrossRef
  • Predictors of Nurse-Reported Quality of Care in Neonatal Intensive Care Units in Korea
    Mi Yu, Chang Gi Park, Sueyeon Lee
    Journal of Pediatric Nursing.2021; 60: e24.     CrossRef
  • Factors associated with patient safety in neonatal intensive care units: A multicenter study using ordinal logistic regression
    Mi Yu, Chang Gi Park
    Japan Journal of Nursing Science.2021;[Epub]     CrossRef
  • Differences in perceived parental stress between parents with very low birth weight infants and nurses in neonatal intensive care units, South Korea
    Seol-Hee Moon, Ho-Ran Park, Dong Yeon Kim
    Child Health Nursing Research.2021; 27(3): 297.     CrossRef
  • Influence of Perceptions of Death, End-of-Life Care Stress, and Emotional Intelligence on Attitudes towards End-of-Life Care among Nurses in the Neonatal Intensive Care Unit
    Ju-Young Park, Jina Oh
    Child Health Nursing Research.2019; 25(1): 38.     CrossRef
  • Stress due to End-of-Life Care, Coping Strategies, and Psychological Well-being among Nurses in Neonatal Intensive Care Units
    Eun Hee Kwon, Hyeon Ok Ju, Eun Ok Jeung, Chun Hee Han, Jin Ju Im, You Ri Lee, Min Seung Jung, So Yeon Park
    Child Health Nursing Research.2018; 24(4): 475.     CrossRef
  • Perception and Barriers to Kangaroo-Mother Care Among Neonatal Intensive Care Unit Nurses
    Sun Kyung Jeong, Tae-Im Kim
    Child Health Nursing Research.2016; 22(4): 299.     CrossRef
  • May 18 Democratic Uprising and Experiences of Nursing Activities in the Gwangju Area
    Ya Ki Yang
    Journal of Korean Academy of Nursing Administration.2014; 20(1): 82.     CrossRef
  • Structural Equation Modeling on Burnout in Clinical Nurses based on CS-CF Model
    Hyun-Jung Kim, Young-Hee Yom
    Journal of Korean Academy of Nursing.2014; 44(3): 259.     CrossRef
  • Factors to Affect Turnover Intention of Nurse: Focusing on Personal, Situational and Interpersonal Relation Variables
    Sook Bin Im, Mi-Kyoung Cho, Myoung Lyun Heo
    Korean Journal of Occupational Health Nursing.2013; 22(4): 314.     CrossRef
  • Relations of Burnout, Interpersonal Relations, Professional Self-concept and Depression in Clinical Nurses
    Eun Yi Yeom, Hae Ok Jeon
    Journal of the Korea Academia-Industrial cooperation Society.2013; 14(6): 2869.     CrossRef
  • Neonatal Intensive Care Unit Nurses' Experience in Caring for Infants Who Are Dying.
    Hyun Ju Kang, Kyung Sook Bang
    Child Health Nursing Research.2013; 19(4): 252.     CrossRef
  • The Mediating and Moderating Effect of Professional Self-concept in Relationship between Emotional Labor and Burnout of Organ Transplantation Coordinators
    Ya-Ki Yang, Hye-Sook You
    Journal of Korean Academy of Fundamentals of Nursing.2012; 19(2): 158.     CrossRef
  • Occupational Stress and Coping Styles as Factors Affecting the Burnout of Clinical Nurses
    Kyoung Ja Kwon, Seung-Hee Lee
    Journal of Korean Academy of Nursing Administration.2012; 18(4): 383.     CrossRef
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Intensive Care Unit Nurse's Knowledge and Nursing Performance on Intensive Care Unit Syndrome
Ya Ki Yang
J Korean Acad Nurs Adm 2010;16(3):240-249.   Published online September 30, 2010
DOI: https://doi.org/10.11111/jkana.2010.16.3.240
PURPOSE
This study was to investigate intensive care unit (ICU) nurse's knowledge and nursing performance on the intensive care unit syndrome. Method: A survey questionnaire was administered to a convenience sample of 123 nurses in a university hospital. Data were collected from August 1st to August 25th, 2009. Data were analyzed using SPSS/WIN 12.0.
RESULTS
The mean score for knowledge and nursing performance were66.96 and 74.97 respectively. According to the general characteristics, there were significant differences in knowledge depending on marital status, education level and career length and in nursing performance depending on their age, education level and career length. The correlation between knowledge and nursing performance was a significant positive one.
CONCLUSION
Comprehensive educational programs are needed to decrease accident rates related to ICU syndrome and to improve the health of ICU patients.

Citations

Citations to this article as recorded by  
  • Senior Nursing Students' Perceived Competence of Intensive and Critical Care Nursing
    Jin-il Kim, Doo Ree Kim, Hyo Nam Lim
    The Journal of Korean Academic Society of Nursing Education.2016; 22(2): 115.     CrossRef
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