1.The Influence of Traumatic Events on Turnover Intention among Nurses Working in Intensive Care Units: The Moderating Effect of Emotional Intelligence
Journal of Korean Critical Care Nursing 2021;14(2):70-81
Purpose:
: The purpose of this study was to identify the moderating effects of emotional intelligence on the relationship between traumatic events and turnover intention among nurses working in intensive care units (ICUs).Method : In this predictive correlation study, the convenience sample included 133 ICU nurses. Data were collected using an online, structured self-report survey. The collected data were analyzed by descriptive statistics, an independent t-test, an analysis of variance, Pearson’s correlation coefficient, and a hierarchical multiple regression analysis using SPSS/WIN 25.0.
Results:
: The most frequently experienced traumatic events in ICUs were “nursing patients with abnormal behavior, including shouting and delirium,” “end-of-life care,” and “nursing patients with a risk of disease transmission, including AIDS and tuberculosis.” The moderating effect of emotional intelligence was found to be statistically significant on the relationship between traumatic events and turnover intentions (β=-0.15, p =.029).
Conclusion
: Intervention to improve the emotional intelligence of ICU nurses can be a salient strategy to reduce turnover intention resulting from traumatic events.
2.Effects of Clinical Nurses’ Workplace Bullying, Empathic Ability, and Resilience on Job Satisfaction
Journal of Korean Critical Care Nursing 2021;14(2):57-69
Purpose:
: The purpose of this study was to understand the relationship between workplace bullying, empathic ability, resilience, and job satisfaction to provide basic data for the development of programs and education aimed at improving nurses’ job satisfaction.
Methods:
: Data were collected through a structured questionnaire disseminated to nurses working in general hospitals. A total of 226 questionnaires were used for the analysis. We analyzed the data using descriptive statistics, an independent t-test, a one-way ANOVA, Pearson’s correlation coefficient, and a stepwise multiple regression analysis.
Results:
: Nurses’ job satisfaction showed a significant positive correlation with empathic ability and resilience and a significant negative correlation with workplace bullying. Additionally, resilience, workplace bullying, empathic ability, religion, and the hope of moving to another department were significant factors affecting job satisfaction. The explanatory power of these variables for job satisfaction was 41.0%.
Conclusion
: To improve job satisfaction, a strategy to lower workplace bullying and increase empathic ability and resilience is necessary. The results of this study suggest the need for further research to develop educational programs for nurses to strengthen their empathic ability and resilience.
3.Experience of Healthcare Providers in the Advanced Practice Nurse System
Min Young KIM ; Mi-Kyeong JEON ; Su Jung CHOI ; Jeong Hye KIM ; Heeyoung KIM ; Cho Sun LEEM
Journal of Korean Critical Care Nursing 2021;14(2):42-56
Purpose:
: The purpose of this study was to understand and describe the experiences of the advanced nurse practitioner (APN) system used by healthcare providers including APNs, doctors who worked with APNs, and APN master’s course professors at a graduate school.
Methods:
: Qualitative data were collected via snowball sampling. The participants were nine APNs, six doctors, and three professors. They were divided into three focus groups, each of which consisted of all three types of healthcare providers. Data were collected via interviews with the three focus groups conducted from September to October 2019. All interviews were audiotaped and transcribed verbatim. The transcribed data then underwent qualitative content analysis.
Results:
: Based on the data, we extracted four themes and 14 categories. The themes were “Role and system of APNs started according to healthcare environment changes”, “Optimal healthcare provider to ensure quality of care”, “Confused role and system of APNs due to incomplete medical law”, and “Tasks for the stable operation of the APN system.”
Conclusion
: For quality treatment and safety of patients, a legal basis must be established for the APN system. For its stable operation, social consensus regarding legislation about APNs’ scope of practice is required. Finally, a discussion is necessary about the integration of APNs’ 13 fields.
4.Communication Experiences and Needs among the Critically Ill with an Artificial Airway: An Integrative Review
Soo Hyun KIM ; Juyoung KIM ; JiYeon CHOI
Journal of Korean Critical Care Nursing 2021;14(2):24-41
Purpose:
: The aim of this integrative review was to describe communication experiences and needs among the critically ill with an artificial airway and evaluate relevant intervention studies.
Methods:
: Using the method employed by Whittemore and Knafl (2005), we searched for papers on PubMed, CINAHL, and Web of Science published from January 1, 2015 to September 25, 2020. A total of 26 papers (11 descriptive studies, 15 experimental ones) were identified and evaluated.
Results:
: Communication experiences while having an artificial airway, identified either by patients’ recall or direct observation, were predominantly negative. However, positive experiences were reported in patients with improvements in physical conditions and functions. Patients’ communication needs were diverse, encompassing physical, psycho-emotional, social, spiritual, and medical issues. Interventions tested included alternative and augmentative communication strategies, communication intervention packages, and voice restorative devices. Physical, psychosocial, and communication-related patient outcomes were evaluated using various methods including self-report surveys, interviews, and observations.
Conclusions
: The findings from this review represent the state of science regarding communication of the critically ill whose vocal abilities are inhibited by the presence of an artificial airway. Future studies with rigorous experimental designs and measures are warranted to better understand and support the complex needs of this highly vulnerable patient population.
5.Factors Influencing Patient Safety Nursing Activities of Intensive Care Unit Nurses
Jae Eun KIM ; Ju Eun SONG ; Jeong Ah AHN ; Sunjoo BOO
Journal of Korean Critical Care Nursing 2021;14(2):12-23
Purpose:
: The purposes of this study were to examine the levels of job stress, perceptions of the patient safety culture, and patient safety nursing activities, and to identify factors influencing patient safety nursing activities among intensive care unit (ICU) nurses.
Methods:
: For this cross-sectional study, data were collected from 161ICU nurses working in two university-affiliated hospitals in Gyeonggi-do between June 30 and July 30, 2020.The data were analyzed with descriptive statistics, an independent t-test, a one-way ANOVA, the Pearsoncorrelation method, and multiple regression using the SPSS program.
Results:
: The average levels of job stress, perception of patient safety culture, and patient safety nursing activities were 3.48, 3.44, and 4.45 out of 5, respectively. Multiple regression showed that perception of patient safety culture and career in current workplace were found to be statistically significant correlates of patient safety nursing activities.
Conclusion
: In order to promote patient safety nursing activities, patient safety culture needs to be incorporated into the education of ICU nurses. Perception of patient safety should be enhanced to improve patients safety nursing activity.
6.The Nurse Staffing in Intensive Care Units based on Nursing Care Needs: A Multicenter Study
Miok PARK ; Eunjin YANG ; Mimi LEE ; Sung-Hyun CHO ; Miyoung SHIM ; Soon Haeng LEE
Journal of Korean Critical Care Nursing 2021;14(2):1-11
Purpose:
: The aim of this study was to propose appropriate nurse staffing of adult intensive care units considering patients’ nursing care needs according to the Workload Management System for Critical Care Nurses (WMSCN).
Methods:
: In a cross-sectional survey conducted in September 2017, 1,786 patients’ WMSCN scores, surveys from 2,145 nurses, and administrative data from 118 units in 41 hospitals were analyzed. The means (standard deviations) of the aforementioned scores and nursing hours per patient day were presented. Nurse-to-patient ratios and nurse-to bed ratios for staffing to meet patients’ nursing care needs were calculated.
Results:
: The mean WMSCN scores were 109.50±17.17 in tertiary hospitals and 96.38±19.26 in general hospitals. Nursing hours per patient day were 12.47±2.80 in tertiary hospitals and 11.01±2.45 in general hospitals. Nursing hours per patient day correlated with WMSCN scores. Nurse-to-bed ratios required for the provision of ICU nursing care ranged from 1: 0.36 to 1: 0.48.
Conclusion
: Our findings provide evidence that current ICU nurse staffing is insufficient for meeting patients’ nursing care needs. We suggest adjusting the legal standards for adequate nurse staffing considering these needs.
7.Factors influencing the clinical competence of nursing students
Journal of Korean Critical Care Nursing 2024;17(1):57-67
Purpose:
: The purpose of this study was to identify factors influencing the clinical competence of nursing students.
Methods:
: The participants of this study were 209 nursing students who were in 3rd and 4th grade. The collected data were analyzed using one-way ANOVA, Kruskal-Wallis test, Mann-Whitney test, Pearson’s correlation coefficients, and stepwise multiple regression.
Results:
: Clinical competence had positive relationships with self-leadership (r=.59, p <.001) and resilience (r=.64, p <.001). Clinical competence was influenced by resilience (β=.45), self-leadership (β=.20), and grade (β=.20), with an explanatory power of 44.9%.
Conclusions
: Based on these results, it is suggested that future nursing education should develop a curriculum that enhances students’ personal abilities such as self-leadership and resilience, rather than only teaching knowledge and skills.
8.Effects of Intensive Care Experience on Post-Intensive Care Syndrome among Critical Care Survivors : Partial Least Square-Structural Equation Modeling Approach
Journal of Korean Critical Care Nursing 2024;17(1):30-43
Purpose:
: Post-intensive care syndrome (PICS) is characterized by a constellation of mental health, physical, and cognitive impairments, and is recognized as a long-term sequela among survivors of intensive care units (ICUs). The objective of this study was to explore the impact of intensive care experience (ICE) on the development of PICS in individuals surviving critical care.
Methods:
: This secondary analysis utilized data derived from a prospective, multicenter cohort study of ICU survivors. The cohort comprised 143 survivors who were enrolled between July and August 2019. The original study's participants completed the Korean version of the ICE questionnaire (K-ICEQ) within one week following discharge from the ICU. Of these, 82 individuals completed the PICS questionnaire (PICSQ) three months subsequent to discharge from hospital. The influence of ICE on the manifestation of PICS was examined through Partial Least Squares-Structural Equation Modeling (PLS-SEM).
Results:
: The R2 values of the final model ranged from 0.35 to 0.51, while the Q2 values were all greater than 0, indicating adequacy for prediction of PICS. Notable pathways in the relationship between the four ICE dimensions and the three PICS domains included significant associations from ‘ICE-awareness of surroundings’ to ‘PICS-cognitive’, from ‘ICE-recall of experience’ to ‘PICS-cognitive’, and from ‘ICE-frightening experiences’ to ‘PICS-mental health’. Analysis found no significant moderating effects of age or disease severity on these relationships. Additionally, gender differences were identified in the significant pathways within the model.
Conclusion
: Adverse ICU experiences may detrimentally impact the cognitive and mental health domains of PICS following discharge. In order to improve long-term outcomes of individuals who survive critical care, it is imperative to develop nursing interventions aimed at enhancing the ICU experience for patients.
9.Experience of Clinical Adaptation among Nurses in Intensive Care Unit
Jin Young HONG ; Sue Kyung SOHN
Journal of Korean Critical Care Nursing 2024;17(1):1-16
Purpose:
: This study aimed to explore and describe intensive care unit (ICU) nurses’ experience of clinical adaptation.
Methods:
: The participants were 14 ICU nurses with more than two years of working experience in the ICU. Data were collected through in-depth individual interviews conducted between July and October 2021. Theoretical sampling was used to the point of theoretical saturation. Data were analyzed using the Strauss and Corbin method.
Results:
: A total of 79 concepts, 37 subcategories, and 16 categories were identified through open coding. Axial coding based on the paradigm model revealed that the central phenomenon was “The harsh adversity faced in the nursing field where life and death are determined” and the core category was “Enduring the adversity of caring for critically ill patients and achieving self-realization.” ICU nurses’ clinical adaptation process was explained in five phases: “confrontation period,” “turbulent period,” “seeking period,” “struggling period,” and “stabilized period.” The five phases that affect interventional conditions were “Support from reliable people,” “Recognition of administrative and financial support.”
Conclusion
: This study provided novel insights for a comprehensive understanding of ICU nurses’ clinical adaptation processes. Furthermore, the findings are expected to be used as basic data to develop multifaceted strategies to help ICU nurses’ adaptation to critical care.
10.Oral Hygiene Care of Endotracheal Intubated Patients in Korean Intensive Care Units : A Scoping Review
Jungeun LIM ; Dukyoo JUNG ; Leeho YOO
Journal of Korean Critical Care Nursing 2024;17(1):68-82
Purpose:
: This scoping review was designed to identify gaps in knowledge and guide future directions for clinical nursing practices and research on oral hygiene care for endotracheally intubated patients in Korean intensive care units.
Methods:
: We conducted a scoping review using the methodological framework proposed by Arksey and O’Malley. PubMed, CINAHL, RISS, Science On, and DBpia databases were searched. Two reviewers independently selected the studies and extracted data. A total of 445 studies were identified, of which 17 were included in the final analysis.
Results:
: No research has been conducted from 2021 to the present. A total of 12 instruments were utilized in 13 studies to assess the effectiveness of oral hygiene care. All studies investigating the effectiveness of oral hygiene care have consistently documented that chlorhexidine has the most significant effect. The frequency and time of oral hygiene care were each examined in one study.
Conclusion
: A research study is necessary to develop a measurement tool for assessing the effectiveness of oral hygiene care suitable for endotracheal intubated patients in intensive care units. Interventional studies should be conducted to determine the effects of chlorhexidine and the appropriate frequency and time of oral hygiene care. Thereafter, revision of domestic evidence-based clinical practice guidelines by integrating these results will be necessary.