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Factors influencing Healthcare-associated Infection Control of Caregivers

Journal of Korean Critical Care Nursing.2021;14(1):63-75. doi:10.34250/jkccn.2021.14.1.63

Purpose: : The purposes of this study were to examine the relationships between knowledge, awareness, safe environment, and performance of standard precautions and identify factors associated with performance of standard precautions.
Methods: : This study was a descriptive research. A structured questionnaire on knowledge, awareness, safe environment, and performance of standard precautions was used for the survey with a convenience sample of 150 caregivers. Data were collected from July to August 2019 and were analyzed using descriptive statistics, independent t-test, one way ANOVA, Pearson’s correlation coefficient, and multiple regression with SPSS/WIN 25.0 program.
Results: : The mean scores on knowledge, awareness, safe environment, and performance of standard precautions were 15.77±3.34, 7.35±1.91, 4.55±2.05, and 55.20±10.11 respectively. Performance of standard precautions showed a statistically significant positive correlation with knowledge (r=.54, p<.001), awareness (r=.54, p<.001), and safe environment (r=.50, p<.001). Awareness (β=.24, p=.025) and safe environment (β=.35, p<.001) were significantly associated with factors of performance of standard precautions. Also, education level (high school and above college), affiliated institution (private association), and importance of infection control education (moderate) were significantly associated with factors of performance of standard precautions.
Conclusion : The results of the study indicate that factors influencing the performance of standard precautions of caregivers were awareness and safe environment. Therefore, to improve implementation of the standard precautions among caregivers, a safe environment within the hospital must be supported, and appropriate infection management education needs to be provided to caregivers to improve their knowledge and awareness of the standard precautions.

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The Effects of an Integrated Management Program on Physical Function, Cognitive Function, and Depression in Patients with Subacute stroke

Gun Young YANG ; Hye Sook MIN

Journal of Korean Critical Care Nursing.2021;14(1):50-62. doi:10.34250/jkccn.2021.14.1.50

Purpose: : This study examined the effects of an integrated management program on physical function, cognitive function, and depression in patients with subacute stroke.
Methods: : A nonequivalent control group design was adopted. The participants were assigned to either the experimental group (n=20) or control group (n=23). The experimental group received an 8-week integrated management program and standard rehabilitation service (i.e., physical therapy and occupational therapy), while the control group received the standard rehabilitation service only. Physical function was measured as gait speed and balance ability using the Berg Balance Scale (BBS). Cognitive function was measured with neuro-behavioral cognitive status examination (NCSE), and depression was measured using the Beck Depression Inventory-II (BDI-II). Repeated measure ANOVA was used to determine changes in physical function, cognitive function, and depression over 8-weeks.
Results: : The interaction between group and time was significant, indicating that the experimental group showed improvement in gait speed, balance ability, cognitive function (linguistic ability, linguistic memory, reasoning), and a decrease in depression compared to the control group.
Conclusion : These results indicate that the integrated management program developed herein was beneficial in restoring physical function, cognitive function, and depression in subacute stroke patients.

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Influence of Cultural competency and Intercultural Communication on Clinical competence of Emergency Unit Nurses Caring for Foreign Patients

Yoon Ji RYU ; Yun Mi LEE

Journal of Korean Critical Care Nursing.2021;14(1):40-49. doi:10.34250/jkccn.2021.14.1.40

Purpose: : This study identified the factors affecting the clinical competence of emergency unit nurses caring for foreign patients.
Methods: : This study utilized a descriptive correlation design. Participants were 112 emergency unit nurses working in different hospitals designated as the government’s emergency medical centers and agencies in 2018. The collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation coefficients, and multiple linear regression analysis.
Results: : Subjects’ clinical competence showed positive relationships with cultural competency (r=.45, p<.001) and intercultural communication (r=.53, p<.001). Factors that affect the clinical competence of subjects showed intercultural communication (β=0.38, p=.001).
Conclusion : It is necessary to develop programs to improve intercultural communication, factors that influence clinical competence of emergency unit nurses, and apply them to practical fields.

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Ju Ri HWANG ; Hye Sook MIN

Journal of Korean Critical Care Nursing.2021;14(1):28-39. doi:10.34250/jkccn.2021.14.1.28

Purpose: : This study investigated the occurrence of postoperative ileus and its related factors in patients after spinal surgery.
Methods: : After a retrospective review of data from patients who underwent spinal surgery at a single hospital located in Busan from 2012 through 2016, a total of 253 patients were included. The subjects were divided into non-ileus and ileus groups. We compared patient-, surgery-, and postoperative hematologicalrelated factors.
Results: : A total of 41 (16.2%) out of 253 patients experienced postoperative ileus. Data analysis revealed significant differences between the two groups in mean age (68.44 vs 60.50 years), occupation (9.8 vs 28.8%), cardiovascular comorbidity (63.4 vs 37.7%), approach of surgery (supine/prone: 29.3/70.7 vs 12.7/87.3%), duration of anesthesia (5.86 vs 4.43 hours), narcotic use (75.6 vs 56.6%), postoperative serum hemoglobin level (3 days: 10.81 vs 11.41 g/dL), postoperative serum protein (immediately/3 days: 5.30/5.43 vs 5.62/5.68 g/dL), postoperative albumin level (3 days: 3.17 vs 3.40 g/dL), postoperative C-reactive protein level (3 days: 11.44 vs 8.36 mg/dL), postoperative bed stabilization period (3.32 vs 2.50 days), and onset of bowel movement (2.59 vs 1.94 days). In multivariate logistic regression, age and time of anesthesia were independent risk factors of postoperative ileus.
Conclusion : To detect ileus after spinal surgery early, nurse education is needed with intensive screening on advanced age, surgery-related factors, and postoperative hematological indices.

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Effects of Work Environment and Nursing Organizational Culture on Tertiary Hospital Nurses’ Turnover Intention

Haena JANG ; Hyoung Eun CHANG

Journal of Korean Critical Care Nursing.2021;14(1):14-27. doi:10.34250/jkccn.2021.14.1.14

Purpose: : This study examined the effects of work environment and organizational culture on tertiary hospital nurses’ turnover intention.
Methods: : A cross-sectional design was used, with a convenience sample of 371 hospital nurses from 16 units of three tertiary hospitals in South Korea. Data were collected through a self-report survey conducted during September and October 2016. Data were analyzed using the chi-square test, Fisher’s exact test, independent t-test, and binary logistic regression analysis.
Results: : A total of 43.7% of the participants were identified as having turnover intention within 1 year. Factors related to turnover intention among hospital nurses were age, marital status, and total clinical career. Furthermore, a relationship-oriented organizational culture showed a negative association with turnover intention.
Conclusion : These findings suggest it is important to provide appropriate motivational programs and incentives for nurses according to their clinical career to decrease turnover intention. Moreover, establishing a relationship-oriented organizational culture will also help to reduce the turnover intention of tertiary hospital nurses.

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A Structural Equation Model of Clinical Nurses’ End-of-life Care Performance

Hyo jin PARK ; Yun Mi LEE ; Min Hye KIM

Journal of Korean Critical Care Nursing.2021;14(1):1-13. doi:10.34250/jkccn.2021.14.1.1

Purpose: : Based on Quint’s theory and the relevant literature, this study constructed a structural equation model for explaining and predicting end-of-life care performance in clinical nurses.
Methods: : A self-administered questionnaire was used to collect data from 265 nurses between September 1 and September 30, 2016. The data were analyzed using SPSS ver. 21 and AMOS ver. 21.
Results: : The goodness of fit of the modified model was found to be relatively satisfactory (χ2=114.82, Nomed χ2(χ2/df)=2.44, SRMR=.06, GFI=.94, AGFI=.89, CFI=.95, TLI=.91, RMSEA=.07). End-of-life care performance was affected by the attitudes toward nursing care of the dying, working unit, and death anxiety. The attitudes toward such care had the highest effect on end-of-life care performance.
Conclusion : The results suggest that end-of-life care performance is directly and indirectly affected by attitudes toward nursing care of the dying, participation in end-of-life care education, working unit, death perception, and death anxiety. To improve clinical nurses’ end-of-life care performance, effective programs to promote death anxiety and attitudes toward nursing care of the dying need to be developed. In addition, hospital nursing organizations should attempt to produce concrete measures for death anxiety and terminal care attitudes in clinical nurses.

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The Influence of Traumatic Events on Turnover Intention among Nurses Working in Intensive Care Units: The Moderating Effect of Emotional Intelligence

Hyunmi KIM ; Jiyoung PARK

Journal of Korean Critical Care Nursing.2021;14(2):70-81. doi:10.34250/jkccn.2021.14.2.70

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.

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Effects of Clinical Nurses’ Workplace Bullying, Empathic Ability, and Resilience on Job Satisfaction

Mi Young LEE ; Youngrye PARK

Journal of Korean Critical Care Nursing.2021;14(2):57-69. doi:10.34250/jkccn.2021.14.2.57

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.

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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. doi:10.34250/jkccn.2021.14.2.42

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.

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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. doi:10.34250/jkccn.2021.14.2.24

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.

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