PURPOSE: The purpose of this study was to examine the effect of professional autonomy, organizational commitment, and perceived patient safety culture on patient safety management activities of nurses in medium and small-sized hospitals.METHODS: A cross-sectional design was employed. Self-reported questionnaires were completed by 121 nurses with at least 3 months of working experience in medium and small-sized hospitals located in B city. Data were analyzed using descriptive statistics, a t-test, a one-way ANOVA, Pearson correlation coefficients, and a multiple regression analysis.RESULTS: Professional autonomy (r=.22, p=.016), organizational commitment (r=.34, p < .001), and perceived patient safety culture (r=.55, p < .001) had a statistically significant positive correlation with patient safety management activities. The factors that might affect patient safety management activities were professional autonomy (β=.23, p=.003) and perceived patient safety culture (β=.55, p < .001). The explanatory power of these factors for patient safety management activities was 33.5% (F= 21.19, p < .001).CONCLUSIONS: The development of repetitive and continuous education programs is needed to improve a nurse's professional autonomy and perceived patient safety culture.
Education ; Humans ; Organizational Culture ; Patient Safety ; Professional Autonomy ; Safety Management

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.
Critical Care Nursing ; Delivery of Health Care ; Family Nursing ; Humans ; Intensive Care Units ; Methods ; Nursing Staff ; Visitors to Patients

PURPOSE: The purpose of this study was to describe what critical care nurses perceived about life-sustaining treatment at end of life.METHODS: A qualitative content analysis method was utilized. The unit of analysis was interview text obtained from fifty critical care nurses of a general hospital.RESULTS: Seven categories in two content areas were abstracted. In the negative perception area, the following five categories were abstracted: patients' suffering, dying with damaged dignity, patients' isolation from family members, regret about choosing life-sustaining treatment, and family members' burden. In the positive perception area, the following two categories were abstracted: willingness to sustain life and duty as family members.CONCLUSIONS: Nurses have better competencies pertaining to understanding patients' responses and suffering than any other health care professions do. Nurses should play an important role in advocating for patients and their family in the process of end-of-life care decision making.
Critical Care ; Decision Making ; Delivery of Health Care ; Hospitals, General ; Humans ; Methods

PURPOSE: The purpose of this study was to identify the factors influencing on burnout in operating room nurses.METHODS: Using a cross-sectional design, a total of 109 operating room nurses working at 7 general hospitals with 300 beds or more in B city were analyzed. The instruments used for this study assessed job stress, resilience, professional identity, and burnout. Data was analyzed using descriptive statistics, a t-test, an ANOVA, a Pearson's correlation coefficient and a multiple regression analysis.RESULTS: There was a statistically significant correlation between burnout and job stress (r=.53, p < .001), resilience (r=-.59, p < .001), and professional identity (r=-.47, p < .001). The factors influencing burnout include job stress (β=.27, p < .001), resilience(β=-.37, p < .001), dissatisfaction with the nursing job (β=.32, p < .001), and moderate satisfaction with the nursing job (β=.19, p=.014), and the explanatory power was 53.0%.CONCLUSIONS: The results suggest that intervention to reduce job stress and to improve resilience, which were the factors influencing burnout in operating room nurses, is necessary.
Hospitals, General ; Nursing ; Operating Rooms

PURPOSE: The purpose of this study was to integrate the results of qualitative studies to understand critical care survivors' experience of the post-intensive care syndrome (PICS).METHODS: This was a meta-synthesis of primary studies that used qualitative methods. We reviewed 26 qualitative studies on PICS selected from 8 international and Korean databases and from a manual search. Thomas and Harden's 3 stages (free coding, development of descriptive themes, generation of analytical themes) for thematic synthesis were utilized to analyze the collected qualitative data.RESULTS: Four descriptive themes emerged from the thematic synthesis: weak physical conditions, psycho-emotional changes, the painful-memory of intensive care units, and social vulnerability. The analytical theme for the current study was “unfamiliarity with the vulnerable self.” Critical care survivors had to confront entirely different “selves” after discharge from intensive care units. They had become physically weak, psychologically unstable, and the critical memories continued to create distress. These changes increased their social vulnerability by making them dependent on others, causing family conflicts, and changing interpersonal relationships.CONCLUSIONS: Finding from this qualitative synthesis and other related literature highlight the severity of PICS and the importance of rehabilitative intervention for critical care survivors.
Clinical Coding ; Critical Care ; Family Conflict ; Humans ; Intensive Care Units ; Qualitative Research ; Survivors

PURPOSE: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses.METHODS: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics.RESULTS: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift.CONCLUSIONS: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.
Checklist ; Classification ; Critical Care ; Humans ; Intensive Care Units ; Methods ; Nursing Care ; Nursing Staff ; Nursing

PURPOSE: This study was conducted to identify ICU nurses' knowledge of the five moments of hand hygiene and the ambiguity of these moments when demonstrating hand hygiene.METHODS: The subjects were 200 intensive care unit nurses at a university hospital . Data was collected using self-report questionnaires, translated according to the instructions of training films developed by WHO, and analyzed using descriptive statistics and ranking tests.RESULTS: The highest number of correct answers was regarding the moment before contact with a patient and the lowest was regarding the moment after contact with a patient. The rate of providing wrong answers regarding required moments of hand hygiene was high.CONCLUSION: The study identified ICU nurses' knowledge of specific moments of hand hygiene; they had difficulty differentiating between the moments that happened simultaneously, i.e. after touching a patient, and that patient's surroundings, and there was ambiguity concerning patient areas and medical treatment areas. It was concluded that it is necessary to educate nurses regarding both required and unrequired moments of hand hygiene and to ensure that they can distinguish between these moments.
Hand Hygiene ; Hand ; Humans ; Intensive Care Units

PURPOSE: This study was intended to standardize the Kangaroo care protocol for fathers, and to determine the effect of fathers' Kangaroo care experience on paternal attachment.METHODS: The data was collected from February to April, 2013. The study subjects were 34 fathers (17 experimental group subjects, 17 control group subjects) of premature babies, bornatatertiaryhospitalinSeoul, who agreed to participate. The standardized Kangaroo care protocol, which consisted of at least three 60-minutes sessions during the hospitalization period in a neonatal intensive care unit, was carried out with the experimental group. The data was analyzed by a χ2-test and Mann-Whitney U test.RESULTS: The results were as follows: 1) There were no between-group differences in the general characteristics of babies and their fathers. 2) The Kangaroo care fathers showed higher scores of paternal attachment than the control group (Z=-3.657, p=0.008).CONCLUSION: Fathers who attended the Kangaroo care sessions showed stronger paternal attachment than those who did not. Therefore, use of a Kangaroo care program for fathers of premature babies at neonatal intensive care units is recommended.
Fathers ; Hospitalization ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Intensive Care, Neonatal ; Kangaroo-Mother Care Method ; Macropodidae

PURPOSE: The purpose of this study was to identify post-operative discomfort, sense of loss, family support, and resilience in breast cancer surgery patients, and to investigate factors that affect resilience.METHOD: The sample of this study consisted of 108 patients who underwent surgery for breast cancer in two university hospitals located in B city. The collected data was analyzed with descriptive statistics, t-test, ANOVA, and Scheffé test, Pearson's correlation coefficients, and hierarchical multiple regression.RESULTS: The factors that significantly affected resilience were as follows: having a religion (β=-.20, p=.006), having an occupation (β=.14, p=.049), having a high school diploma (β=.31 p=.001), making less than 2–3 million won (β=-.19, p=.036) per month, experiencing a sense of loss (β=-.22, p=.003) and family support (β=.44, p < .001). The total explanatory power amounted to 53.8% (F=14.83, p < .001, AdjR²=.54).CONCLUSION: Educational intervention programs for breast cancer surgery patients that improve resilience by reducing the sense of loss and increasing family support must be developed.
Breast Neoplasms ; Breast ; Hospitals, University ; Humans ; Methods ; Occupations

PURPOSE: This study aimed to investigate the differences in exudate and bleeding incidence and the changes in back pain and discomfort based on the weight of a sand bag applied to the femoral puncture site after hepatic transcatheter arterial chemoembolization.METHODS: This quasi-experimental study comprised 82 patients randomly divided into three different groups. Experimental group 1 patients had a 600g sandbag, experimental group 2 patients an 800g sandbag, and control group patients a 1900g sandbag, on femoral access sites post procedure. The three groups of patients were assessed on level of exudate and bleeding and asked about back pain and discomfort at 30, 60, 120, 180 and 240 minutes after the procedure.RESULTS: There were no significant differences in exudate and bleeding between the three groups before and after application of the sandbag post procedure. Both back pain and discomfort were significantly lower in the experimental groups than in the control group.CONCLUSION: There was no significant effect on bleeding and exudation due to the weight of the sandbag. The lowest level of back pain and discomfort was found in the group with the lightest weight (600 g). Therefore, the use of lighter-weight sandbags to prevent post procedure vascular complications is proposed.
Back Pain ; Exudates and Transudates ; Hemorrhage ; Humans ; Incidence ; Non-Randomized Controlled Trials as Topic ; Punctures