BACKGROUND AND OBJECTIVE

Replicating critical care practice settings in high-fidelity simulation (HFS) provides more learning opportunities to develop competencies, improve self-confidence, and learner satisfaction in a safe environment. Simulation is increasingly adopted globally as an alternative teaching strategy. Yet, data on the HFS experience of Filipino undergraduate nursing students is limited. This study describes the satisfaction, self- confidence, and perception of undergraduate nursing students on the use of HFS-based learning on critically-ill adult and pediatric patients requiring advanced life support (ALS).

A quantitative, descriptive, correlational study was conducted using purposive sampling on all fourth-year BS Nursing students enrolled in Critical Care Nursing course in a state university. Data were collected through an online survey on demographic data, and the students’ perceptions towards high-fidelity simulation-based learning (SBL) using three tools, namely: Simulation Design Scale, Educational Practices Questionnaire, and Student Satisfaction and Self-confidence in Learning. T-test and ANOVA were used to compare the means of the variables. Bivariate analysis (Pearson’s product-moment correlation) was performed to find the relationship between variables.

A total of 86 students participated in the survey. Overall, the students were highly satisfied with the simulation experience (4.46 out of 5.0, SD=0.47), and had high ratings of self-confidence in SBL (4.44 out of 5.0, SD=0.42). Overall satisfaction level was positively related to student’s perception on simulation design (r=0.61, p<0.01) and educational practices (r=0.59, p<0.01). Similarly, the students’ overall self-confidence with SBL was also positively correlated with their perceptions of the simulation design (r=0.32, p<0.01), and educational practices (r=0.34, p<0.01).

Effective use of technology through HFS-based learning is useful in increasing satisfaction and self-confidence of Filipino undergraduate nursing students in caring for critically-ill patients needing ALS. Educators must highly consider all parameters of simulation design and educational practices in planning and implementing HFS- based learning to achieve meaningful learner experience.

PURPOSE: To explore the person-centered care (PCC) experienced by critical patients.METHOD: This qualitative study deductively examined the attributes of the PCC model proposed by Jakimowicz and Perry. The participants were 16 patients who were recently discharged from intensive care units at a university hospital. Data were collected through in-depth interviews and were analyzed using the deductive method of content analysis.RESULTS: A total of 4 categories, 16 subcategories, and 33 codes were generated from 171 meaningful statements. The final 4 categories were “compassionate presence,” “professional interaction,” “outstanding competency,” and “patient identity.” These were consistent with the main attributes of Jakimowicz and Perry's model. However, most of the codes belonged to the “compassionate presence” and “patient identity” categories. Among the attributes of the model, “continuity of nursing,” “therapeutic relationship,” “expert knowledge,” “clinical knowledge,” “evidence-based intervention,” and “patient's rights” were not derived as codes.CONCLUSION: These findings deepen the understanding of the PCC model from the patient's point of view. The main attributes of PCC identified in the current study can be applied to the development of practical guidelines for intensive care nursing. In addition, we recommend the development of a PCC measurement tool for critical care patients.
Critical Care Nursing ; Critical Care ; Humans ; Intensive Care Units ; Methods ; Nursing ; Qualitative Research

PURPOSE: This study was conducted to investigate the factors influencing the competence in intensive and critical care nursing of senior nursing students. METHODS: A descriptive survey was used to examine the factors that influence competence in intensive and critical care nursing. The data were collected using self-administered questionnaires; 237 senior nursing students were asked about general characteristics, critical thinking, communication competence, self-esteem, self-resilience, and self-leadership. RESULTS: Multiple regression analysis indicated that self-leadership, self-esteem, and confidence in intensive care unit practice predicted the competence in intensive and critical care nursing (37.8% of explanatory power). Critical thinking, communication competence, and self-resilience were not shown to be significant predictors of, but were positively correlated with, the competence in intensive and critical care nursing. CONCLUSION: Based on the results, it is suggested that self-leadership, self-esteem, and confidence in intensive care unit practice should be considered in nursing education in order to improve nursing students' level of competence in intensive and critical care nursing.
Clinical Competence ; Critical Care Nursing* ; Critical Care* ; Education, Nursing ; Humans ; Intensive Care Units ; Mental Competency* ; Nursing* ; Students, Nursing* ; Thinking

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 aims to develop a self-reflection program for nurses who have experienced the death of pediatric patients in the intensive care unit and to evaluate its effectiveness. METHODS: The self-reflection program was developed by means of the following four steps: establishment of the goal through investigation of an initial request, drawing up the program, preliminary research, and implementation and improvement of the program. The study employed a methodological triangulation to evaluate the effectiveness of the program. Participants were 38 nurses who had experienced the death of pediatric patients (experimental group=15, control group=23); they were recruited using convenience sampling. The self-reflection program was provided over 6 weeks (6 sessions). Data were collected from April to August, 2014 and analyzed using t-tests and content analysis. RESULTS: The quantitative results showed that changes in personal growth (t=-6.33, p<.001) and burnout scores (z=-2.76, p=.005) were better in the experimental group compared to the control group. The qualitative results exhibited two themes, namely “personal growth” and “professional growth”, and ten sub-themes. CONCLUSION: The self-reflection program developed by this study was effective in helping nurses who had experienced the death of pediatric patients to achieve personal growth through self-reflection, and it was confirmed that the program can be applied in a realistic clinical nursing setting. Furthermore, it can be recommended as an intervention program for clinical nurses.
Critical Care* ; Humans ; Intensive Care Units* ; Nursing ; Program Development

PURPOSE: This study was done to identify the level of stress, hardiness, and professional burnout of intensive care unit (ICU) nurses and to provide basic data for the qualitative improvement of nursing work achievement in the workplace. METHOD: The data were obtained from 129 ICU nurses through a questionnaire. RESULTS: Stress showed positive correlation with the level of professional burnout and there was negative correlation between hardiness and professional burnout. Nurses in the group with a high level of stress, and a high level of hardiness reported a low level of professional burnout compared to those in the group with a lower level of hardiness (t=-2.60, p= .012). Nurses in the group with a low level of hardiness and a low level of stress showed a lower level of professional burnout than those with a high level of stress (t=3.51, p= .001). CONCLUSION: The results show that the high level of stress when coupled with a low level of hardiness of ICU nurses results in a high level of professional burnout. For this reason, it is important for nursing administration to support nurses to reduce levels of stress and the resulting burnout in ICU nurses.
Burnout, Professional* ; Intensive Care Units* ; Critical Care* ; Nursing ; Questionnaires

PURPOSE: The purpose of this study was to investigate the effect of the perceived nursing work environment (NWE) on person-centered critical care nursing (PCCN) practices among nurses in intensive care units (ICUs).METHODS: A cross-sectional research design was adopted for this study; participants were 126 ICU nurses working in five hospitals in B city. From December 2018 to February 2019, a survey questionnaire on NWE and PCCN were conducted. The collected data were analyzed with a multiple hierarchical regression analysis.RESULTS: The mean score for NWE was 2.98±0.39. Among the factors, basic work system was the highest (3.39±0.41), followed by leadership of the head nurse (3.31±0.55), interpersonal relationships (2.77±0.62), and institutional support (2.58±0.52). The mean score for PCCN was 3.52±0.46. Among the factors, comfort was the highest (3.77±0.62), followed by respect (3.55±0.56), compassion (3.43±0.60), and individuality (3.38±0.56). The interpersonal relationship (β =.31, p=.001) and the number of patients per shift (β =−.23, p=.005) had a significant effect on PCCN, accounting for 25.9% of the total variance.CONCLUSION: These results suggest that it is necessary to enhance the relationship-oriented culture and reduce the workload of nurses in order to improve the quality of nursing care in ICUs.
Critical Care Nursing ; Critical Care ; Empathy ; Humans ; Individuality ; Intensive Care Units ; Leadership ; Nursing ; Nursing Care ; Nursing, Supervisory ; Patient-Centered Care ; Research Design

PURPOSE: The purpose of this study was to examine the degree of intensive and critical care nursing competence in senior nursing students. METHODS: The research method for this study comprised a descriptive survey study with a convenience sample of 113 senior nursing students from one university. The instrument entitled ICCN-CS-1, which measures intensive and critical care nursing competence, was translated by the authors following WHO guidelines for translation process. The data were collected using ICCN-CS-1. RESULTS: The mean score of intensive and critical care nursing was above the intermediate level. The competence indices of knowledge, skill and attitude/value were also above the intermediate level, which suggests that their competence is good. For two intensive and critical care nursing domains, the nursing students' mean score of clinical competence is higher than that of professional competence. The competence of intensive and critical care is also influenced by nursing students' satisfaction in their major and clinical practice as well as their confidence in clinical practice. CONCLUSION: The senior nursing students' competence of intensive and critical care nursing is above the intermediate level. A consideration of the influencing factors of satisfaction of nursing major/ICU practice and confidence of ICU practice is needed in intensive and critical care nursing education.
Clinical Competence ; Critical Care Nursing* ; Critical Care* ; Education ; Humans ; Mental Competency* ; Methods ; Nursing* ; Professional Competence ; Students, Nursing

PURPOSE: The purpose of this study was to examine the possible direction of critical care nursing research in the future by analyzing the trends of recent Korean studies.METHOD: Using a database search, we selected 263 articles on critical care nursing that were published in Korean journals between 2008 and 2017. Then, we conducted an integrative review of the contents of the selected articles and analyzed the English abstracts using the relevant packages and functions of the R program.RESULTS: The number of studies concerning critical care nursing has increased over the 10-year period, and the specific topic of each study has diversified according to the time at which it was conducted. In terms of quality, the majority of the research was published in high-level academic journals. The key words regularly studied over the past decade were: knowledge, delirium, education, restraint, stress, and infection. Studies related to vancomycin-resistant enterococci infection, compliance, and standards have decreased, while studies related to death, communication, and safety have increased.CONCLUSION: Randomized controlled trials and protocol research for evidence-based critical care need to be conducted, as does research on family involvement. The key word analysis of unstructured text used in this study is a relatively new method; it is suggested that this method be applied to various critical care nursing research and develop it methodologically.
Compliance ; Critical Care Nursing ; Critical Care ; Data Mining ; Delirium ; Education ; Humans ; Korea ; Methods ; Nursing Research ; Nursing ; Vancomycin-Resistant Enterococci

The purpose of this study was to develop Intensive Care Unit (ICU) admission and discharge criteria that would lead to the appropriate utilization of ICU resources and nursing services. For this study, a conceptual framework was developed through a review of the literature. Then in order to identify the overall health condition of patients in the ICU, and to draw up preliminary criteria, the medical records of 58 patients who were admitted to the ICU of Y Medical Center in Seoul between March, 1999 to February, 2000 of were analyzed. Two expert validity tests were done for the preliminary criteria for admission and discharge with 21 patients over 18 years of age who were admitted patients and for 12 patients who were discharged between May 30, 2000 and June 5, 2000 a clinical validity test was also done. After this process, the final admission and discharge criteria were developed. The results of this study are summarized as follows: 1. After a review of the literature, there were 9 categories for admission criteria cardiologic, gastrointestinal, neurologic, endocrine, post-op care of major surgery, vital signs, laboratory values, and a category of miscellaneous items. Discharge criteria had 3 categories which were vital signs, laboratory values, and a category of miscellaneous items. 2. From the medical records of the 58 patients who were admitted to the ICU, 45 items for preliminary criteria for admission and 17 for discharge were identified. 3. The two expert validity tests showed that of the 45 items 29 admission items received over 75 percent agreement. The 16 admission items which received less than 75 percent agreement were revised or deleted from the admission criteria. Of the 17 discharge items, 11 had over 75 percent agreement and 6 less then 75 percent agreement. These were revised or deleted from the discharge criteria. 4. In the clinical validity test, 14 admission items showed more than 75 percent agreement and 11 discharge items more than 83 percent agreement. 5. The final criteria consisted of 29 items for admission and 11 items for discharge. Since patients being considered for admission to the ICU have complex problems, there is a need to make the decision based on more than a single issue. This tool will insure that the ICU nursing care and treatment resources are appropriately used by allowing a multi-professional health team to make admission and discharge decisions.
Humans ; Intensive Care Units* ; Critical Care* ; Medical Records ; Nursing Care ; Nursing Services ; Seoul ; Vital Signs