Journal of Korean Academy of Nursing

Research Paper

Development and Evaluation of Evidence-Based Nursing Protocol for Extracorporeal Membrane Oxygenation to Critically Ill Patients: Kim, Soomi , Kim, Chul-Gyu; J Korean Acad Nurs 2023;53(3):275-294. Published online June 30, 2023; DOI: https://doi.org/10.4040/jkan.22109

Abstract PDF: Purpose
This study aimed to develop an evidence-based extracorporeal membrane oxygenation (ECMO) nursing protocol for critically ill patients receiving ECMO treatment by using an adaptation process, and to verify the effects of the protocol.
Methods
The protocol was developed according to the adaptation guidelines. A non-randomized controlled trial was conducted to test the protocol’s effects. Data were collected between April 2019 and March 2021. The differences in physiological indicators and complication rates between the two groups were investigated using a chart review to evaluate patient outcomes. The nurses’ outcome variables were evaluated using a questionnaire.
Results
First, after reviewing 11 guidelines by appraisal of the guidelines for research and evaluation collaboration II, 5 guidelines with a standardization grade of over 50 points were selected. An ECMO nursing protocol was developed based on these guidelines. Second, there were no statistically significant differences in physiological indicators between the two groups of patients. However, the experimental group showed a statistically significant decrease in the infection rate (p = .026) and pressure injury rates (p = .041). The levels of satisfaction with ECMO nursing care, and empowerment and performance of the nurses who used the ECMO nursing protocol were higher than those of nurses who did not (p < .001).
Conclusion
This protocol may help prevent infections and pressure injuries in patients, and improve nurses’ satisfaction and empowerment. The nursing protocol developed for critically ill patients receiving ECMO treatment can be utilized in evidence-based nursing practice.

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Original Articles

A Review of the Effects of Respite Care for Patients with Dementia and Caregivers: Jin Sun Kim, Eun Hyun Lee; Journal of Korean Academy of Nursing 2001;31(6):1077-1087. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2001.31.6.1077

PURPOSE: The purpose of this study was to analyze the effects of respite care. The analysis was conducted by reviewing published intervention studies on the effects of formal respite care for caregivers of dementia patients, patients with dementia, and the prevented or delayed rate of institutionalization of the patients.
METHOD
Two computerized databases (MEDLINE, CINAHL) were searched to find respite care-related articles published from the year of 1981 to 2000. A total of 49 published articles were identified. Of them, nine studies, which met for the inclusion criteria of this study, were included.
RESULTS
Results revealed that there was little evidence of the effect of respite care on, not only caregivers' burden, stress, depression and well-being, but also the rate of institutionalization of the patients. It was noteworthy that dementia patients reported fewer problems in behavior, although cognitive functioning and activity of daily living abilities continued to decline. However, these findings should be carefully interpreted because of methodological problems, such as non-random sampling, non random group assignment, a small sample size, uncontrolled confounding variables, limited period of services, and no specific types of services.
CONCLUSION
It is recommended to conduct intervention studies of respite care being conducted in Korea with the corrections of methodological problems suggested from this study.

Citations

Citations to this article as recorded by

Factors Relevant to Life Satisfaction of Female Caregivers for the Elderly: Focused on Long-Term Care Insurance Settlement
Sang-Nam Jeon, Hak-Gene Shin
The Korean Journal of Health Service Management.2014; 8(4): 187. CrossRef
An Analysis of the Meaning of Respite for Family Caregivers of Elderly with Dementia
Mi Ryeong Song, Yong-Mi Lee, Suk-Hee Cheon
Journal of Korean Academy of Nursing.2010; 40(4): 482. CrossRef

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Recovery outcomes of Korean adolescents with substance Abuse problems: Myung Sun Hyun; Journal of Korean Academy of Nursing 2000;30(7):1658-1666. Published online March 29, 2017; DOI: https://doi.org/10.4040/jkan.2000.30.7.1658

Abstract PDF: Recovery in substance abuse has been simplistically measured; a more comprehensive understanding of recovery outcomes is needed. This study therefore explored recovery outcomes of Korean adolescents with substance abuse by qualitative research. The recovery was found to occur in several domains; they included reconciliation with the self, hope for the future, reconciliation with family, self-liberation, socialization, conventional norm pursuit, and a struggle for realistic independence. An understanding of the recovery process and recovery outcomes may provide guidance for clinical interventions with substance abuse adolescents.

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Validation of Nursing Care Sensitive Outcomes related to Knowledge: Eun Joo Lee; Journal of Korean Academy of Nursing 2003;33(5):625-632. Published online March 28, 2017; DOI: https://doi.org/10.4040/jkan.2003.33.5.625

Abstract PDF

Purpose

The purpose of this study was to assess the importance and sensitivity to nursing interventions of four nursing sensitive nursing outcomes selected from the Nursing Outcomes Classification (NOC). Outcomes for this study were “Knowledge: Diet”, “Knowledge: Disease Process”, “Knowledge: Energy Conservation”, and “Knowledge: Health Behaviors”.

Method

Data were collected from 183 nurses working in 2 university hospitals. Fehring method was used to estimate outcome and indicators' content and sensitivity validity. Multiple and stepwise regression were used to evaluate relationships between each outcome and its indicators.

Result

Results confirmed the importance and nursing sensitivity of outcomes and their indicators. Key indicators of each outcomes were found by multiple regression. “Knowledge: Diet” was suggested for adding new indicators because the variance explained by indicators was relatively low. Not all of the indicators selected for stepwise regression model were rated for highly in Fehring method. The R² statistics of the stepwise regression models were between 18 and 63% in importance by selected indicators and between 34 and 68% in contribution by selected indicators.

Conclusion

This study refined what outcomes and indicators will be useful in clinical practice. Further research will be required for the revision of outcome and indicators of NOC. However, this study refined what outcomes and indicators will be useful in clinical practice.

Citations

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Developing an Electronic Nursing Record System for Clinical Care and Nursing Effectiveness Research in a Korean Home Healthcare Setting
EUN JOO LEE, MIKYOUNG LEE, SUE MOORHEAD
CIN: Computers, Informatics, Nursing.2009; 27(4): 234. CrossRef

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Effects of Hospital Nurse Staffing on in-hospital Mortality, Pneumonia, Sepsis, and Urinary Tract Infection in Surgical Patients: Yunmi Kim, Sung-Hyun Cho, Kyung Ja June, Soon Ae Shin, Jiyun Kim; J Korean Acad Nurs 2012;42(5):719-729. Published online October 12, 2012; DOI: https://doi.org/10.4040/jkan.2012.42.5.719

Abstract PDF

Purpose

This study was done to examine relationships between nurse staffing level and postsurgical patient outcomes using inpatient database from the National Health Insurance.

Methods

Records of 111,491 patients who received one of 12 types of surgery between January and December, 2009 were identified and analyzed in this study. Nurse staffing level was measured using adjusted nurse staffing grades from 0 to 7. Patient outcomes were defined as in-hospital mortality, or pneumonia, sepsis, or urinary tract infection after surgery. Logistic regression analyses estimated by Generalized Estimation Model, were used to analyze the association between nurse staffing level and patient outcomes.

Results

An inverse relationship was found between nurse staffing and patient mortality. Compared with patients who were cared for in hospitals with the highest nurse staffing (Grades 0-1), increases in the odds of dying were found in those with Grades 6-7 [OR (odds ratio)= 2.99, 95% CI (confidence interval)= 1.94-4.60], those with Grades 4-5 (OR= 1.78, 95% CI= 1.24-2.57) and those with Grades 2-3 (OR= 1.57, 95% CI= 1.25-1.98). Lower nurse staffing level was also associated with higher number of cases in pneumonia and sepsis.

Conclusion

Policies for providing adequate nurse staffing is required to enhance quality of care and lead to better perioperative patient outcomes.

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Effects of Community-based Case Management Program for Clients with Hypertension: Ae-Young So, Yun-Mi Kim, Eun-Young Kim, Chang-Yup Kim, Cheol-Hwan Kim, Hee-Gerl Kim, Eun-Young Shin, Weon-Seob Yoo, Ggod-Me Yi, Kyung-Ja June; J Korean Acad Nurs 2008;38(6):822-830. Published online December 31, 2008; DOI: https://doi.org/10.4040/jkan.2008.38.6.822

Abstract PDF

Purpose

The purpose of this study was to analyze effects of a community-based case management program for clients with hypertension living in the community.

Methods

The research design was a one group pre and post-test design with 30 participants with hypertension who agreed to participate in the 8-12 week case management program provided by case managers from the National Health Insurance Corporation in 2002. Data were collected three times, before and after the case management services, and 6 months later. Outcomes included changes in blood pressure, knowledge of hypertension and daily life practices, including alcohol consumption, smoking, exercise, and medication adherence.

Results

Repeated-measures ANOVA and post-hoc tests of means revealed significant differences before and after service for systolic blood pressure, daily life practices (monitoring body weight and BP, low salt and cholesterol and high vegetable diet, and stress-relief practices), and exercise. The goal for medication adherence was attained after service. Significant improvements from baseline to 6 months after service were observed in measures of salt and vegetables in diet. There were no significant differences on hypertension knowledge, alcohol consumption or smoking behavior between before service and after, and at 6 months.

Conclusion

The findings provide preliminary evidence that case management intervention can have positive outcomes on BP control, daily life practices, exercise, and medication adherence for clients with hypertension. However, additional interventions are needed to sustain long-term effects.

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Development and Application of a Computerized Nursing Process Program for Orthopedic Surgery Inpatients: NANDA, NOC, and NIC Linkages: Hye Suk Kim; Journal of Korean Academy of Nursing 2005;35(6):979-990. Published online October 31, 2005; DOI: https://doi.org/10.4040/jkan.2005.35.6.979

Abstract PDF

Purpose

The purpose of this study was to develop and to apply the NANDA, NOC, and NIC (NNN) linkages into a computerized nursing process program using the classification systems of nursing diagnoses, nursing outcomes and nursing interventions.

Method

The program was developed with planning, analysis, design and performance stages. The program was applied to 117 patients who were admitted to orthopedic surgery nursing units from January to February, 2004.

Results

Thirty-five of fifty-three nursing diagnoses were identified. Five nursing diagnoses in order of frequency were: Acute pain (28.4%), Impaired physical mobility (15.6%), Impaired walking (8.7%), Chronic pain (5.5%) and Risk for disuse syndrome (5.0%). The nursing outcomes of the 'Acute pain' nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (95.2%), Comfort level (35.5%) and Pain level (17.7%). The nursing interventions of the ‘Acute pain’ nursing diagnosis tended to have higher frequencies (cumulative) in order of Pain management (71.0%), Splinting (24.2%) and Analgesic administration (17.7%). In comparison of outcome indicator scores between before and after the intervention according to the 61 nursing outcomes, the mean scores of 52 outcome indicators after the intervention were significantly higher than before the intervention.

Conclusion

It is expected that this program will help nurses perform their nursing processes more efficiently.

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