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.
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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.
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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).
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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.
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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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