Using the APCHE III tool, this study was about the factors related to the death of ICU-patients. From 1999. 12. 1 to 2000. 9. 30, the 284 patients admitted to ICU at P university who were over 15 years of age were selected for the subjets. The data was analyzed through SPSS WIN program for frequency, percentile, x2-test, t-test and logistic regression. The results are summarized as follows: 1) Of the 284 patients, 88died. The mortality is 31.0 percent. The average APACHE III point was 48.62 +/- 32.32. The average point of non-survivors was higher than that of survivors. 2) There are the significant difference between APACHE III marks and mortality. The mortality rate were over 50 percent 60 points of the mark. When the marks were over 100 points, the mortality were over 90 percent. Below 40 points, the mortality was below 10 percent. Among the variables in the APACHE III, the most significant variables in explaining death were neurologic abnormalities, pulse, PaO2/ AaDO2, creatinine, sodium, glucose, chronic health state and age. According to the variables, the models explained the 42.43 percent of the variance in patient's death. In conclusion, the APACHE III tool can be used to predict the progress of ICU patients, and can also be used for the selection of patients for ICU admission/discharge criteria.
APACHE* ; Creatinine ; Glucose ; Humans ; Logistic Models ; Mortality ; Sodium ; Survivors

PURPOSE: The purpose of this study was to analyze and clarify the ambiguous concept of DNR, and to distinguish between DNR and euthanasia. METHOD: This study used the process of Walker & Avant's concept analysis. RESULT: The definable attributes of DNR were care for comfort, no further treatment and no CPR. The antecedents of DNR were the autonomy of patients and families feelings about death, the uselessness of treatment and the right to die with dignity. The process of the DNR decision should be documented and the antecedents of DNR also can be a basis for objective standards of DNR decision-making. The result of DNR was the acceptance of death by patients and families. CONCLUSION: DNR is decided and documented by the antecedents of DNR, and the result is a natural acceptance of death, the last process of human life. Hospice care should be activated and nurses must be patient's advocates and families' supporters in the process.
*Attitude to Death ; Decision Making ; Family ; Hospice Care ; Humans ; *Resuscitation Orders

Purpose: The purpose of this study was to identify and analyze the characteristics of nurses’ medication errors during three years. Methods: Retrospective survey study design was used to analyze medication errors by nurses among patient safety accidents. Data were collected for three years from January, 2017 to December, 2019. Data were analyzed using frequency, percentage, x2 -test, and logistic regression with SPSS 26.0 program. Results: Of a total 677 medication errors, 40.6% were caused by nurses. Among the medication errors, near miss (n=154, 56.0%), intravenous bolus injection (n=170, 61.8%), wrong dose (n=102, 37.1%) and carelessness for repetitive work (n=98, 35.6%) were the most common. Medication errors differed by department, and nurses’ career, and patient safety accident type. The results of the logistic regression analysis showed that the risk factors of adverse events were medication of fluids (OR=3.93, 95% CI: 1.26~12.27), insulin subcutaneous injection (OR=39.06, 95% CI: 4.58~333.18), and occurrence of extravasation/infiltration (OR=7.26, 95% CI: 1.85~28.53). Conclusion The simplest and most effective way to prevent medication errors is to keep 5 right, and a differentiated education program according to department and nurse career is needed rather than general education programs. Hospital-level integrated interventions such as a medication barcode system or a team nursing method are also necessary.

Purpose: The purpose of this study was to identify and analyze the characteristics of nurses’ medication errors during three years. Methods: Retrospective survey study design was used to analyze medication errors by nurses among patient safety accidents. Data were collected for three years from January, 2017 to December, 2019. Data were analyzed using frequency, percentage, x2 -test, and logistic regression with SPSS 26.0 program. Results: Of a total 677 medication errors, 40.6% were caused by nurses. Among the medication errors, near miss (n=154, 56.0%), intravenous bolus injection (n=170, 61.8%), wrong dose (n=102, 37.1%) and carelessness for repetitive work (n=98, 35.6%) were the most common. Medication errors differed by department, and nurses’ career, and patient safety accident type. The results of the logistic regression analysis showed that the risk factors of adverse events were medication of fluids (OR=3.93, 95% CI: 1.26~12.27), insulin subcutaneous injection (OR=39.06, 95% CI: 4.58~333.18), and occurrence of extravasation/infiltration (OR=7.26, 95% CI: 1.85~28.53). Conclusion The simplest and most effective way to prevent medication errors is to keep 5 right, and a differentiated education program according to department and nurse career is needed rather than general education programs. Hospital-level integrated interventions such as a medication barcode system or a team nursing method are also necessary.

PURPOSE: This study was to develop a nursing education program for mothers with a young child undergoing cardiac surgery and determine effects of the program on her knowledge, anxiety and coping behavior. METHODS: The research design was a nonequivalent control group non-synchronized design. 18 mothers were assigned to the experimental group and 18 to the control group. The effects were evaluated by measuring knowledge, anxiety, and coping behavior. The collected data was analyzed through independent t-test, and repeated measures ANOVA respectively using SPSS/WIN 12.0 program. RESULTS: The point of knowledge in the experimental group was significantly increased tan that in the control group. The point of subjective, physiological, and behavior anxiety in the experimental group was significantly decreased than that in the control group by time change. The point of coping behavior in the experimental group was significantly higher than that in the control group. CONCLUSION: The nursing educational program for a young child with cardiac surgery is expected to be clinically applied as an intervention program for mothers with a young child undergoing cardiac surgery.
Adaptation, Psychological ; Anxiety ; Child ; Education, Nursing ; Humans ; Mothers ; Research Design ; Thoracic Surgery ; Triacetoneamine-N-Oxyl

PURPOSE: The purpose of this study was done to investigate the effects of oral care using 0.12% chlorhexidine and saline solution on oral status, incidence of oral pathogens and pneumonia among children who had cardiac surgery. METHODS: The study participants were 84 children who underwent cardiac surgery and were admitted to the SICU of a university hospital. Oral care was provided with 0.12% chlorhexidine to the experimental group (n=43) and with saline solution to the control group (n=41), 3 times a day for 3 days. Before and after the intervention, the oral status, oral swab culture, and CPIS were checked. RESULTS: There was no significant difference in oral status score between the two groups. The incidence of oral pathogens in the experimental group was significantly lower than that of the control group (t=-5.780, p<.001). The CPIS in experimental group was significantly lower than that of control group (t=-3.665, p<.001). CONCLUSION: The oral care with 0.12% Chlorhexidine is more effective than with only saline solution for reducing incidence of oral pathogens and pneumonia.
Child ; Chlorhexidine ; Humans ; Incidence ; Oral Hygiene ; Pneumonia ; Sodium Chloride ; Thoracic Surgery

PURPOSE: The purpose of this study was to understand the experiences of mental health hospital workers. METHODS: Participants in the study were a total of 8 mental health hospital workers who consisted of nurses, social welfare workers and health managers. To prevent them from being omitted, the interviews were all recorded under the participants prior agreement. The method was analysis using the phenomenological method proposed by Colaizzi(1978). RESULTS: The experiences of the participants of this study were classified into 15 significant areas, from which 10 subjects hard work, conflicts, heavy feeling, irritability, getting familiar, changes of recognition, aptitude determination, feeling of achievement and sense of pride were drawn out. These subjects were then grouped into 5 themes. These five themes were finally grouped into 5 categories, negative emotion, depressive emotion, changes of thinking, delight and value discovery. CONCLUSIONS: The study tried to analyze the experiences of key informants like nurses, social welfare workers and health managers all of whom were serving at mental health hospitals, contribute to social recognition about the special medical establishment, promote qualitative mental health nursing and further provide educational information necessary for understanding mental health hospital workers.
Health Personnel/*psychology ; Helping Behavior ; Hospitals, Psychiatric ; Humans ; Interviews as Topic ; *Mental Health ; Models, Nursing ; Nursing Staff, Hospital/*psychology ; Workplace/psychology

PURPOSE: The purpose of this study is to explore and understanding the nature of the shift workers' experience in industries requiring 24 hours-a-day service provision and support. For the purpose, the present researcher made a research question, "What are workers' experience in the shift work?" METHODS: In the study, 5 male shift workers, 3 female shift worker and a woman (key informant) whose husband is a shift worker participated. Then profound interviews with the participants were made after their agreement. RESULTS: The researcher classified the significant statements under 6 theme clusters, 1) sense of difference; 2) worries about health; 3) draining of emotion; 4) anxiety; 5) sadness; and 6) being comfortable. CONCLUSIONS: Shift work which is inevitable in modern society may have severe influences on shift workers' physical, mental and psychological aspects by causing their work cycle rhythm to be unbalanced. Finally, the researcher hopes that the results of the study would help understand workers' life and increase social concern and support to the workers.
Anxiety ; Female ; Hope ; Humans ; Male ; Spouses

PURPOSE: The purpose of this study was to describe the essence of the experiences of patients in an ICU, and to understand them from the patients' point of view. METHODS: Participants in this study were six patients in P hospital. Data collection consisted of in-depth interviews and an observation method done from January to April in 2005. The method was analysis using the phenomenological method proposed by Colaizzi(1978). RESULTS: The themes were classified into eight theme clusters. The eight theme clusters were finally grouped into four categories, 'shock', 'pain', 'gratefulness' and 'pleasure of revival'. CONCLUSION: The ICU patients had negative experiences in physical.mental critical situations, but also positive experiences in consolation and nurses and families' encouragement. Therefore, ICU nurses must support patients and their families to minimize the negative experiences and maximize the positive experiences.
Adult ; Aged ; Attitude to Health ; Critical Illness/psychology ; Female ; Humans ; Inpatients/*psychology ; *Intensive Care Units ; Interviews as Topic ; Male ; Middle Aged ; Nursing Methodology Research ; Patient Transfer ; Qualitative Research

Glucocorticoid receptor (GR) functions as a suppressor of inflammation by inhibiting the expression of many cytokine gene activated by NF-κB. The goal of this study is to investigate the mechanism by which GR repress NF-κB activation in lung epithelial cells. We used A549 and BEAS-2B lung epithelial cell lines. Using IgGκ-NF-κB luciferase reporter gene construct, we found that dexamethasone significantly suppressed TNF-α-induced NF-κB activation and the overexpression of GR showed dose-dependent reduction of TNF-α-induced NF-κB activity in both cell lines. However, DNA binding of NF-κB induced by TNF-α in electromobility shift assay was not inhibited by dexamethasone. Super shift assay with anti-p65 antibody demonstrated the existence of p65 in NF-κB complex induced by TNF-α Western blot showed that IκBα degradation induced by TNF-α was not affected by dexamethasone and IκBκ was not induced by dexamethasone, neither. To evaluate p65 specific transactivation, we adopted co-transfection study of Ga14-p65TA1 or TA2 fusion protein expression system together with 5xGa14-luciferase vector. Co-transfection of GR with Ga14-p65TA1 or TA2 repressed luciferase activity profoundly to the level of 10-20% of p65TA1- or TA2-induced transcriptional activity. And this transrepressional effect was abolished by co-transfection of CBP or SRC-1 expression vectors. These results suggest that Gr-mediated transrepression of NF-κB in lung epithelial cells is through competing for binding to limiting amount of transcriptional coactivators, CBP or SRC-1.
Blotting, Western ; Cell Line ; Dexamethasone* ; DNA ; Epithelial Cells* ; Genes, Reporter ; Inflammation ; Luciferases ; Lung ; NF-kappa B* ; Receptors, Glucocorticoid ; Transcriptional Activation*