1가톨릭대학교 서울성모병원 신생아집중치료실 수간호사
2가톨릭대학교 서울성모병원 신생아집중치료실 간호사
3가톨릭대학교 간호대학 교수
1NICU · Unit Manager, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
2NICU · Nurse, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Korea
3Professor, College of Nursing, The Catholic University of Korea, Seoul, Korea
Copyright © 2018 Korean Academy of Child Health Nursing. All rights reserved.
This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
전신 저체온치료와 선택적 두부 저체온치료를 받는 신생아의 간호활동 빈도 차이를 확인한다.
전신 저체온치료와 선택적 두부 저체온치료를 받는 신생아의 간호시간 차이를 확인한다.
전신 저체온치료와 선택적 두부 저체온치료를 받는 신생아의 간호중재 중요도의 차이를 확인한다.
Variables | Categories |
STH (n=8) |
SHTH (n=7) |
t or Z | p |
---|---|---|---|---|---|
n (%) or M±SD | n (%) or M±SD | ||||
Neonates (n=15) | Gestational age (week) | 39.91±0.97 | 37.82±2.23 | 2.30 | .051* |
Birth weight (g) | 3,290±210 | 3,020±650 | 1.06 | .322* | |
Apgar score (min) | |||||
1 | 4.86±1.86 | 4.86±1.77 | 0.14 | .890† | |
5 | 7.00±1.55 | 6.43±2.51 | 0.00 | >.999† | |
Sex | |||||
Male | 7 (87.50) | 3 (57.14) | 1.76 | .282‡ | |
Female | 1 (12.50) | 4 (42.86) | |||
Sarnat stage§ | 2.38±0.52 | 2.29±0.49 | 0.28 | .777† | |
Nurses (n=108) | Age of nurse (year) | 25.86±1.63 | 25.96±1.83 | 0.37 | .708† |
Clinical work experience (month) | 37.33±20.10 | 38.29±20.79 | 0.42 | .672† | |
NICU work experience (month) | 32.83±18.35 | 34.18±20.13 | 0.64 | .521† |
Variables | Categories |
STH (n=8) |
SHTH (n=7) |
χ2 | p |
---|---|---|---|---|---|
Frequency*/n | Frequency*/n | ||||
Vital sign check | Rectal, axillary, tympanic membrane temperature measurement | 23.3 | 24.9 | 2.60 | .107 |
Measuring (V/S-BT, HR, RR) | 21.6 | 24.9 | 0.79 | .375 | |
Monitoring | Physical examination | 18.3 | 15.7 | 9.64 | .002 |
Observation of consciousness and pain assessment | 8.9 | 7.4 | 5.21 | .022 | |
Preparation and installation (NIBP, HR, SpO2, ETCO2, PCO2) | 2.5 | 2.0 | 1.74 | .187 | |
Monitoring (NIBP, HR, SpO2, ETCO2, PCO2) | 22.8 | 22.6 | 5.17 | .023 | |
A-line/ICP/CVP preparation and installation of surveillance equipment | 0.0 | 0.9 | 5.44 | .032† | |
A-line/ICP/CVP monitoring | 0.1 | 4.6 | 26.36 | <.001 | |
Intake/excretion measurement | 21.6 | 20.9 | 6.03 | .014 | |
Other monitoring (Holter monitoring, EEG, 24hr pH monitoring, pacemaker) | 14.4 | 8.3 | 25.58 | <.001 | |
Basic nursing care | Weight measurement | 1.3 | 0.1 | 8.31 | .004 |
In-bed scale | 1.0 | 3.3 | 5.90 | .015 | |
In-bed bathing | 1.4 | 2.0 | 0.13 | .722 | |
Exchange of linen | 2.8 | 3.1 | 0.11 | .744 | |
Elimination | 17.8 | 21.0 | 0.31 | .580 | |
Eye care/ear care | 3.3 | 3.3 | 0.60 | .438 | |
Position change | 14.0 | 18.6 | 0.16 | .688 | |
Fall prevention care | 14.9 | 16.6 | 0.94 | .333 | |
Incubator, ICS, bassinet management | 1.5 | 2.6 | 0.69 | .407 | |
Incubator care (humidity, temperature check, control) | 8.1 | 34.9 | 91.73 | <.001 | |
Isolation (gown and gloves) | 20.1 | 11.3 | 38.24 | <.001 | |
Isolation (environmental management) - MRSA, rotavirus, VRE, EKC | 0.1 | 1.0 | 3.95 | .073† | |
Infection control | 6.4 | 3.6 | 11.80 | .001 | |
Other acts (within 15 minutes) | 4.4 | 4.9 | 0.28 | .595 | |
Medication | Starting IV | 1.1 | 0.9 | 0.94 | .334 |
Medication (IV push) | 17.3 | 16.1 | 5.80 | .016 | |
Medication (IV continuous infusion) | 13.4 | 15.3 | 0.54 | .464 | |
Transfusion | 2.0 | 2.6 | 0.00 | .955 | |
Respiratory care | Oxygen therapy or oxyhood | 0.1 | 0.6 | 1.52 | .378† |
Ventilator setup (invasive/noninvasive): include NCPAP | 1.1 | 1.4 | 0.00 | .988 | |
Ventilator maintenance care | 16.6 | 16.6 | 3.58 | .058 | |
Intubation care | 0.8 | 2.3 | 3.64 | .056 | |
Airway care (invasive/noninvasive) | 1.6 | 2.1 | 0.01 | .906 | |
Suction (oral/nasal/intra-tracheal) | 22.3 | 24.9 | 1.37 | .242 | |
Percussion | 4.5 | 2.9 | 6.35 | .012 | |
NO gas setup | 1.8 | 2.9 | 0.56 | .456 | |
ES & CE | Family support (anxiety, denial, abuse, etc.) visiting time | 1.9 | 1.7 | 0.70 | .404 |
Treatment & procedure | Support for invasive procedures (examination, treatment) | 1.6 | 1.4 | 0.75 | .388 |
NG tube insertion | 0.6 | 0.9 | 0.02 | .889 | |
Foley catheter insertion | 1.0 | 1.7 | 0.46 | .499 | |
Urine collection | 0.1 | 0.3 | 0.24 | >.999† | |
Wound and skin care | 1.4 | 0.4 | 5.42 | .020 | |
Blood glucose measurement | 2.5 | 6.4 | 7.42 | .007 | |
USG, stool OB test, bilirubin test | 0.1 | 0.6 | 1.52 | .378† | |
ABGA (VBGA-capillary) | 0.5 | 0.3 | 0.88 | .433† | |
Drainage management (EVD, chest tube, biliary duct, gastric tube) | 14.9 | 19.0 | 0.01 | .916 | |
Therapeutic hypothermia | Preparing hypothermia therapy equipment | 1.0 | 1.6 | 0.23 | .634 |
Inducing hypothermia therapy | 3.5 | 3.1 | 1.44 | .229 | |
Maintaining hypothermic treatment | 13.6 | 65.6 | 201.95 | <.001 | |
Ending hypothermic treatment and re-warming | 5.3 | 6.4 | 0.02 | .891 |
STH=Systemic therapeutic hypothermia; SHTH=Selective head therapeutic hypothermia; V/S=Vital signs; BT=Body temperature; HR=Heart rate; RR=Respiratory rate; NIBP=Noninvasive blood pressure; SpO2=Saturation by pulse oximetry; ETCO2=End-tidal carbon dioxide concentration; PCO2=Pressure of carbon dioxide; A-line=Arterial line; ICP=Intra cranial pressure; CVP=Central venous pressure; EEG=Electroencephalography; ICS=Intensive care system; MRSA=Methicillin-resistant staphylococcus aureus; VRE=Vancomycin-resistant enterococcus; EKC=Epidemic keratoconjunctivitis; IV=Intravenous injection; NCPAP=Nasal continuous positive airway pressure; NO=Nitric oxide; NG=Nasogastric; ES & CE=Emotional support & communication/education; USG=Ultrasonography; OB=Occult blood; ABGA=Arterial blood gas analysis; VBGA=Venous blood gas analysis; EVD=External ventricular drainage.
Variables | Categories |
STH (n=8) |
SHTH (n=7) |
t or Z† | p |
---|---|---|---|---|---|
Sec*/n M±SD (sec) | Sec*/n M±SD (sec) | ||||
Vital sign check | Rectal, axillary, tympanic membrane temperature measurement | 484.25±236.37 | 371.71±328.86 | 1.62 | .105 |
Measuring (V/S-BT, HR, RR) | 1,657.13±571.36 | 2,613.86±1,211.58 | 2.00 | .067‡ | |
Monitoring | Physical examination | 935.88±320.83 | 1,549.29±746.63 | 2.02 | .079‡ |
Observation of consciousness and pain assessment | 275.00±90.92 | 175.43±152.50 | 1.48 | .164‡ | |
Preparation and installation (NIBP, HR, SpO2, ETCO2, PCO2) | 189.83±209.79 | 87.14±77.18 | 0.79 | .428 | |
Monitoring (NIBP, HR, SpO2, ETCO2, PCO2) | 934.13±621.96 | 734.29±349.97 | 0.29 | .772 | |
A-line/ICP/CVP preparation and installation of surveillance equipment | 1110.00 | ||||
A-line/ICP/CVP monitoring | 30.00 | 415.00 | |||
Intake/excretion measurement | 1,293.25±778.36 | 1,333.71±560.07 | 0.11 | .911‡ | |
Other monitoring (Holter monitoring, EEG, 24hr pH monitoring, pacemaker) | 1,320.63±1,161.65 | 1,299.80±1,155.89 | 0.22 | .826 | |
Basic nursing care | Weight measurement | 364.00±286.06 | 30.00 | 1.17 | .242 |
In-bed scale | 343.33±130.51 | 508.33±374.03 | 0.72 | .494‡ | |
In-bed bathing | 526.00±259.77 | 480.00±179.67 | 0.35 | .737‡ | |
Exchange of linen | 166.88±95.05 | 336.67±206.11 | 2.07 | .060‡ | |
Elimination | 746.13±422.30 | 1,027.14±590.87 | 1.07 | .304‡ | |
Eye care/ear care | 97.50±65.47 | 42.86±35.57 | 1.96 | .071‡ | |
Position change | 584.57±482.96 | 1,050.57±652.03 | 1.41 | .160 | |
Fall prevention care | 419.38±390.31 | 421.86±299.99 | 0.75 | .452 | |
Incubator, ICS, bassinet management | 310.00±230.54 | 368.00±329.21 | 0.00 | >.999 | |
Incubator care (humidity, temperature check, control) | 146.14±63.41 | 538.71±214.84 | 4.64 | .002‡ | |
Isolation (gown and gloves) | 1014.29±395.02 | 381.00±224.82 | 3.21 | .009‡ | |
Isolation (environmental management) - MRSA, rotavirus, VRE, EKC | 30.00 | 165.00±148.49 | 0.61 | .540 | |
Infection control | 425.71±419.19 | 363.60±279.62 | 0.29 | .780‡ | |
Other acts (within 15 minutes) | 651.57±387.63 | 445.29±322.70 | 1.08 | .301‡ | |
Medication | Starting IV | 438.00±602.84 | 330.00±235.12 | 0.30 | .766 |
Medication (IV push) | 3284.38±1073.43 | 2,899.00±1,078.83 | 0.69 | .501‡ | |
Medication (IV continuous infusion) | 2,700.00±1,046.26 | 3,063.43±1,780.50 | 0.49 | .632‡ | |
Transfusion | 503.33±225.45 | 1,095.83±1,275.35 | 0.64 | .521 | |
Respiratory care | Oxygen therapy or oxyhood | 60.00 | 870.00 | ||
Ventilator setup (invasive/noninvasive): include NCPAP | 585.00±463.89 | 654.00±370.11 | 0.19 | .851 | |
Ventilator maintenance care | 683.00±293.13 | 602.29±404.02 | 0.45 | .662‡ | |
Intubation care | 343.33±187.79 | 242.00±114.98 | 1.05 | .322‡ | |
Airway care (invasive/noninvasive) | 156.00±115.02 | 301.00±232.07 | 1.25 | .246‡ | |
Suction (oral/nasal/intra-tracheal) | 2,269.00±1,080.21 | 2,175.71±996.92 | 0.17 | .865‡ | |
Percussion | 557.75±717.05 | 280.00±35.36 | 0.52 | .633‡ | |
NO gas setup | 930.00 | 1485.00 | |||
ES & CE | Family support (anxiety, denial, abuse, etc) visiting time | 362.50±293.10 | 617.86±1,124.40 | 0.64 | .523 |
Treatment & procedure | Support for invasive procedure (examination, treatment) | 784.17±646.78 | 1,000.00±633.25 | 0.56 | .592‡ |
NG tube insertion | 70.00±37.42 | 63.33±25.17 | 0.26 | .802‡ | |
Foley catheter insertion | 402.86±207.02 | 368.33±116.35 | 0.36 | .725‡ | |
Urine collection | 120.00 | 720.00 | |||
Wound and skin care | 356.67±492.17 | 80.00 | 0.00 | >.999 | |
Blood glucose measurement | 137.14±138.17 | 225.71±286.16 | 0.26 | .798 | |
USG, Stool OB test, bilirubin bilirubin test | 30.00 | 85.00±105.36 | 0.00 | >.999 | |
ABGA (VBGA-capillary) | 25.00±10.00 | 20.00 | 0.40 | .693 | |
Drainage management (EVD, chest tube, biliary duct, gastric tube) | 563.25±327.66 | 570.43±427.67 | 0.04 | .971‡ | |
Therapeutic hypothermia | Preparing hypothermia therapy equipment | 465.00±298.71 | 1,118.14±674.87 | 2.18 | .029 |
Inducing hypothermia therapy | 269.38±297.38 | 1,241.00±1,179.37 | 2.32 | .021 | |
Maintaining hypothermic treatment | 434.38±398.99 | 1,811.29±745.27 | 2.95 | .003 | |
Ending hypothermic treatment and re-warming | 271.63±364.63 | 610.29±644.20 | 1.80 | .072 |
STH=Systemic therapeutic hypothermia; SHTH=Selective head therapeutic hypothermia; V/S=Vital signs; BT=Body temperature; HR=Heart rate; RR=Respiratory rate; NIBP=Noninvasive blood pressure; SpO2=Saturation by pulse oximetry; ETCO2=End-tidal carbon dioxide concentration; PCO2=Pressure of carbon dioxide; A-line=Arterial line; ICP=Intra cranial pressure; CVP=Central venous pressure; EEG=Electroencephalography; ICS=Intensive care system; MRSA=Methicillin-resistant staphylococcus aureus; VRE=Vancomycin-resistant enterococcus; EKC=Epidemic keratoconjunctivitis; IV=Intravenous injection; NCPAP=Nasal continuous positive airway pressure; NO=Nitric oxide; NG=Nasogastric; ES & CE=Emotional support & communication/education; USG=Ultrasonography; OB=Occult blood; ABGA=Arterial blood gas analysis; VBGA=Venous blood gas analysis; EVD=External ventricular drainage.
Variables |
STH (n=45) |
SHTH (n=45) |
Z | p* | ||
---|---|---|---|---|---|---|
M±SD | Rank | M±SD | Rank | |||
Risk for ineffective thermoregulation (body core temperature) | 3.20±0.69 | 9 | 3.82±0.39 | 1 | 154.5 | <.001 |
Risk for impaired skin integrity (scalp) | 2.87±0.66 | 18 | 3.29±0.55 | 9 | 95.5 | .001 |
Risk for impaired skin integrity (systemic) | 3.16±0.56 | 12 | 3.18±0.58 | 12 | 4.5 | >.999 |
Risk for caregiver role strain | 2.67±0.56 | 22 | 2.73±0.62 | 21 | 3.0 | .250 |
Risk for infection related to impaired immune function | 2.98±0.58 | 16 | 2.89±0.57 | 17 | 5.0 | .125 |
Ineffective breathing pattern related to pulmonary hemorrhage | 3.33±0.52 | 6 | 3.38±0.58 | 6 | 4.5 | .727 |
Risk for bleeding related to DIC | 3.20±0.55 | 9 | 3.24±0.53 | 11 | 4.5 | .727 |
Risk for ineffective cerebral tissue perfusion | 3.56±0.55 | 1 | 3.53±0.55 | 4 | 2.0 | >.999 |
Risk for unstable blood pressure related to pulmonary hypertension | 3.29±0.51 | 8 | 3.36±0.53 | 7 | 3.0 | .250 |
Risk for decreased cardiac output related to bradycardia | 3.56±0.55 | 1 | 3.56±0.55 | 2 | 0.0 | >.999 |
Risk for decreased cardiac output related to hypotension | 3.56±0.55 | 1 | 3.56±0.55 | 2 | 0.0 | >.999 |
Risk for decreased cardiac output related to arrhythmia | 3.02±0.62 | 15 | 2.96±0.64 | 16 | 7.5 | .508 |
Risk for decreased cardiac output related to anemia | 2.84±0.71 | 19 | 2.89±0.61 | 17 | 4.5 | .727 |
Ineffective breathing pattern related to atelectasis | 3.20±0.55 | 9 | 3.16±0.56 | 13 | 4.5 | .727 |
Risk for ineffective renal perfusion | 3.04±0.74 | 14 | 3.16±0.64 | 13 | 12.5 | .273 |
Risk for electrolyte imbalance | 3.33±0.52 | 6 | 3.29±0.59 | 9 | 3.5 | .688 |
Risk for unstable blood glucose level | 3.11±0.61 | 13 | 3.13±0.66 | 15 | 2.5 | >.999 |
Risk for impaired liver function | 2.73±0.72 | 21 | 2.71±0.76 | 22 | 1.5 | >.999 |
Impaired gas exchange | 3.42±0.62 | 5 | 3.36±0.65 | 7 | 7.5 | .508 |
Ineffective breathing pattern related to ventilation-perfusion imbalance | 3.49±0.59 | 4 | 3.42±0.62 | 5 | 4.5 | .375 |
Risk for dysfunctional gastrointestinal motility related to ileus | 2.89±0.65 | 17 | 2.80±0.59 | 19 | 5.0 | .125 |
Risk for dysfunctional gastrointestinal motility related to ulcer | 2.82±0.68 | 20 | 2.76±0.57 | 20 | 6.0 | .453 |
Variables | Categories | STH (n=8) |
SHTH (n=7) |
t or Z | p |
---|---|---|---|---|---|
n (%) or M±SD | n (%) or M±SD | ||||
Neonates (n=15) | Gestational age (week) | 39.91±0.97 | 37.82±2.23 | 2.30 | .051 |
Birth weight (g) | 3,290±210 | 3,020±650 | 1.06 | .322 |
|
Apgar score (min) | |||||
1 | 4.86±1.86 | 4.86±1.77 | 0.14 | .890 |
|
5 | 7.00±1.55 | 6.43±2.51 | 0.00 | >.999 |
|
Sex | |||||
Male | 7 (87.50) | 3 (57.14) | 1.76 | .282 |
|
Female | 1 (12.50) | 4 (42.86) | |||
Sarnat stage |
2.38±0.52 | 2.29±0.49 | 0.28 | .777 |
|
Nurses (n=108) | Age of nurse (year) | 25.86±1.63 | 25.96±1.83 | 0.37 | .708 |
Clinical work experience (month) | 37.33±20.10 | 38.29±20.79 | 0.42 | .672 |
|
NICU work experience (month) | 32.83±18.35 | 34.18±20.13 | 0.64 | .521 |
Variables | Categories | STH (n=8) |
SHTH (n=7) |
χ2 | p |
---|---|---|---|---|---|
Frequency |
Frequency |
||||
Vital sign check | Rectal, axillary, tympanic membrane temperature measurement | 23.3 | 24.9 | 2.60 | .107 |
Measuring (V/S-BT, HR, RR) | 21.6 | 24.9 | 0.79 | .375 | |
Monitoring | Physical examination | 18.3 | 15.7 | 9.64 | .002 |
Observation of consciousness and pain assessment | 8.9 | 7.4 | 5.21 | .022 | |
Preparation and installation (NIBP, HR, SpO2, ETCO2, PCO2) | 2.5 | 2.0 | 1.74 | .187 | |
Monitoring (NIBP, HR, SpO2, ETCO2, PCO2) | 22.8 | 22.6 | 5.17 | .023 | |
A-line/ICP/CVP preparation and installation of surveillance equipment | 0.0 | 0.9 | 5.44 | .032 |
|
A-line/ICP/CVP monitoring | 0.1 | 4.6 | 26.36 | <.001 | |
Intake/excretion measurement | 21.6 | 20.9 | 6.03 | .014 | |
Other monitoring (Holter monitoring, EEG, 24hr pH monitoring, pacemaker) | 14.4 | 8.3 | 25.58 | <.001 | |
Basic nursing care | Weight measurement | 1.3 | 0.1 | 8.31 | .004 |
In-bed scale | 1.0 | 3.3 | 5.90 | .015 | |
In-bed bathing | 1.4 | 2.0 | 0.13 | .722 | |
Exchange of linen | 2.8 | 3.1 | 0.11 | .744 | |
Elimination | 17.8 | 21.0 | 0.31 | .580 | |
Eye care/ear care | 3.3 | 3.3 | 0.60 | .438 | |
Position change | 14.0 | 18.6 | 0.16 | .688 | |
Fall prevention care | 14.9 | 16.6 | 0.94 | .333 | |
Incubator, ICS, bassinet management | 1.5 | 2.6 | 0.69 | .407 | |
Incubator care (humidity, temperature check, control) | 8.1 | 34.9 | 91.73 | <.001 | |
Isolation (gown and gloves) | 20.1 | 11.3 | 38.24 | <.001 | |
Isolation (environmental management) - MRSA, rotavirus, VRE, EKC | 0.1 | 1.0 | 3.95 | .073 |
|
Infection control | 6.4 | 3.6 | 11.80 | .001 | |
Other acts (within 15 minutes) | 4.4 | 4.9 | 0.28 | .595 | |
Medication | Starting IV | 1.1 | 0.9 | 0.94 | .334 |
Medication (IV push) | 17.3 | 16.1 | 5.80 | .016 | |
Medication (IV continuous infusion) | 13.4 | 15.3 | 0.54 | .464 | |
Transfusion | 2.0 | 2.6 | 0.00 | .955 | |
Respiratory care | Oxygen therapy or oxyhood | 0.1 | 0.6 | 1.52 | .378 |
Ventilator setup (invasive/noninvasive): include NCPAP | 1.1 | 1.4 | 0.00 | .988 | |
Ventilator maintenance care | 16.6 | 16.6 | 3.58 | .058 | |
Intubation care | 0.8 | 2.3 | 3.64 | .056 | |
Airway care (invasive/noninvasive) | 1.6 | 2.1 | 0.01 | .906 | |
Suction (oral/nasal/intra-tracheal) | 22.3 | 24.9 | 1.37 | .242 | |
Percussion | 4.5 | 2.9 | 6.35 | .012 | |
NO gas setup | 1.8 | 2.9 | 0.56 | .456 | |
ES & CE | Family support (anxiety, denial, abuse, etc.) visiting time | 1.9 | 1.7 | 0.70 | .404 |
Treatment & procedure | Support for invasive procedures (examination, treatment) | 1.6 | 1.4 | 0.75 | .388 |
NG tube insertion | 0.6 | 0.9 | 0.02 | .889 | |
Foley catheter insertion | 1.0 | 1.7 | 0.46 | .499 | |
Urine collection | 0.1 | 0.3 | 0.24 | >.999 |
|
Wound and skin care | 1.4 | 0.4 | 5.42 | .020 | |
Blood glucose measurement | 2.5 | 6.4 | 7.42 | .007 | |
USG, stool OB test, bilirubin test | 0.1 | 0.6 | 1.52 | .378 |
|
ABGA (VBGA-capillary) | 0.5 | 0.3 | 0.88 | .433 |
|
Drainage management (EVD, chest tube, biliary duct, gastric tube) | 14.9 | 19.0 | 0.01 | .916 | |
Therapeutic hypothermia | Preparing hypothermia therapy equipment | 1.0 | 1.6 | 0.23 | .634 |
Inducing hypothermia therapy | 3.5 | 3.1 | 1.44 | .229 | |
Maintaining hypothermic treatment | 13.6 | 65.6 | 201.95 | <.001 | |
Ending hypothermic treatment and re-warming | 5.3 | 6.4 | 0.02 | .891 |
Variables | Categories | STH (n=8) |
SHTH (n=7) |
t or Z |
p |
---|---|---|---|---|---|
Sec |
Sec |
||||
Vital sign check | Rectal, axillary, tympanic membrane temperature measurement | 484.25±236.37 | 371.71±328.86 | 1.62 | .105 |
Measuring (V/S-BT, HR, RR) | 1,657.13±571.36 | 2,613.86±1,211.58 | 2.00 | .067‡ | |
Monitoring | Physical examination | 935.88±320.83 | 1,549.29±746.63 | 2.02 | .079‡ |
Observation of consciousness and pain assessment | 275.00±90.92 | 175.43±152.50 | 1.48 | .164‡ | |
Preparation and installation (NIBP, HR, SpO2, ETCO2, PCO2) | 189.83±209.79 | 87.14±77.18 | 0.79 | .428 | |
Monitoring (NIBP, HR, SpO2, ETCO2, PCO2) | 934.13±621.96 | 734.29±349.97 | 0.29 | .772 | |
A-line/ICP/CVP preparation and installation of surveillance equipment | 1110.00 | ||||
A-line/ICP/CVP monitoring | 30.00 | 415.00 | |||
Intake/excretion measurement | 1,293.25±778.36 | 1,333.71±560.07 | 0.11 | .911‡ | |
Other monitoring (Holter monitoring, EEG, 24hr pH monitoring, pacemaker) | 1,320.63±1,161.65 | 1,299.80±1,155.89 | 0.22 | .826 | |
Basic nursing care | Weight measurement | 364.00±286.06 | 30.00 | 1.17 | .242 |
In-bed scale | 343.33±130.51 | 508.33±374.03 | 0.72 | .494‡ | |
In-bed bathing | 526.00±259.77 | 480.00±179.67 | 0.35 | .737‡ | |
Exchange of linen | 166.88±95.05 | 336.67±206.11 | 2.07 | .060‡ | |
Elimination | 746.13±422.30 | 1,027.14±590.87 | 1.07 | .304‡ | |
Eye care/ear care | 97.50±65.47 | 42.86±35.57 | 1.96 | .071‡ | |
Position change | 584.57±482.96 | 1,050.57±652.03 | 1.41 | .160 | |
Fall prevention care | 419.38±390.31 | 421.86±299.99 | 0.75 | .452 | |
Incubator, ICS, bassinet management | 310.00±230.54 | 368.00±329.21 | 0.00 | >.999 | |
Incubator care (humidity, temperature check, control) | 146.14±63.41 | 538.71±214.84 | 4.64 | .002‡ | |
Isolation (gown and gloves) | 1014.29±395.02 | 381.00±224.82 | 3.21 | .009‡ | |
Isolation (environmental management) - MRSA, rotavirus, VRE, EKC | 30.00 | 165.00±148.49 | 0.61 | .540 | |
Infection control | 425.71±419.19 | 363.60±279.62 | 0.29 | .780‡ | |
Other acts (within 15 minutes) | 651.57±387.63 | 445.29±322.70 | 1.08 | .301‡ | |
Medication | Starting IV | 438.00±602.84 | 330.00±235.12 | 0.30 | .766 |
Medication (IV push) | 3284.38±1073.43 | 2,899.00±1,078.83 | 0.69 | .501‡ | |
Medication (IV continuous infusion) | 2,700.00±1,046.26 | 3,063.43±1,780.50 | 0.49 | .632‡ | |
Transfusion | 503.33±225.45 | 1,095.83±1,275.35 | 0.64 | .521 | |
Respiratory care | Oxygen therapy or oxyhood | 60.00 | 870.00 | ||
Ventilator setup (invasive/noninvasive): include NCPAP | 585.00±463.89 | 654.00±370.11 | 0.19 | .851 | |
Ventilator maintenance care | 683.00±293.13 | 602.29±404.02 | 0.45 | .662‡ | |
Intubation care | 343.33±187.79 | 242.00±114.98 | 1.05 | .322‡ | |
Airway care (invasive/noninvasive) | 156.00±115.02 | 301.00±232.07 | 1.25 | .246‡ | |
Suction (oral/nasal/intra-tracheal) | 2,269.00±1,080.21 | 2,175.71±996.92 | 0.17 | .865‡ | |
Percussion | 557.75±717.05 | 280.00±35.36 | 0.52 | .633‡ | |
NO gas setup | 930.00 | 1485.00 | |||
ES & CE | Family support (anxiety, denial, abuse, etc) visiting time | 362.50±293.10 | 617.86±1,124.40 | 0.64 | .523 |
Treatment & procedure | Support for invasive procedure (examination, treatment) | 784.17±646.78 | 1,000.00±633.25 | 0.56 | .592‡ |
NG tube insertion | 70.00±37.42 | 63.33±25.17 | 0.26 | .802‡ | |
Foley catheter insertion | 402.86±207.02 | 368.33±116.35 | 0.36 | .725‡ | |
Urine collection | 120.00 | 720.00 | |||
Wound and skin care | 356.67±492.17 | 80.00 | 0.00 | >.999 | |
Blood glucose measurement | 137.14±138.17 | 225.71±286.16 | 0.26 | .798 | |
USG, Stool OB test, bilirubin bilirubin test | 30.00 | 85.00±105.36 | 0.00 | >.999 | |
ABGA (VBGA-capillary) | 25.00±10.00 | 20.00 | 0.40 | .693 | |
Drainage management (EVD, chest tube, biliary duct, gastric tube) | 563.25±327.66 | 570.43±427.67 | 0.04 | .971‡ | |
Therapeutic hypothermia | Preparing hypothermia therapy equipment | 465.00±298.71 | 1,118.14±674.87 | 2.18 | .029 |
Inducing hypothermia therapy | 269.38±297.38 | 1,241.00±1,179.37 | 2.32 | .021 | |
Maintaining hypothermic treatment | 434.38±398.99 | 1,811.29±745.27 | 2.95 | .003 | |
Ending hypothermic treatment and re-warming | 271.63±364.63 | 610.29±644.20 | 1.80 | .072 |
Variables | STH (n=45) |
SHTH (n=45) |
Z | p |
||
---|---|---|---|---|---|---|
M±SD | Rank | M±SD | Rank | |||
Risk for ineffective thermoregulation (body core temperature) | 3.20±0.69 | 9 | 3.82±0.39 | 1 | 154.5 | <.001 |
Risk for impaired skin integrity (scalp) | 2.87±0.66 | 18 | 3.29±0.55 | 9 | 95.5 | .001 |
Risk for impaired skin integrity (systemic) | 3.16±0.56 | 12 | 3.18±0.58 | 12 | 4.5 | >.999 |
Risk for caregiver role strain | 2.67±0.56 | 22 | 2.73±0.62 | 21 | 3.0 | .250 |
Risk for infection related to impaired immune function | 2.98±0.58 | 16 | 2.89±0.57 | 17 | 5.0 | .125 |
Ineffective breathing pattern related to pulmonary hemorrhage | 3.33±0.52 | 6 | 3.38±0.58 | 6 | 4.5 | .727 |
Risk for bleeding related to DIC | 3.20±0.55 | 9 | 3.24±0.53 | 11 | 4.5 | .727 |
Risk for ineffective cerebral tissue perfusion | 3.56±0.55 | 1 | 3.53±0.55 | 4 | 2.0 | >.999 |
Risk for unstable blood pressure related to pulmonary hypertension | 3.29±0.51 | 8 | 3.36±0.53 | 7 | 3.0 | .250 |
Risk for decreased cardiac output related to bradycardia | 3.56±0.55 | 1 | 3.56±0.55 | 2 | 0.0 | >.999 |
Risk for decreased cardiac output related to hypotension | 3.56±0.55 | 1 | 3.56±0.55 | 2 | 0.0 | >.999 |
Risk for decreased cardiac output related to arrhythmia | 3.02±0.62 | 15 | 2.96±0.64 | 16 | 7.5 | .508 |
Risk for decreased cardiac output related to anemia | 2.84±0.71 | 19 | 2.89±0.61 | 17 | 4.5 | .727 |
Ineffective breathing pattern related to atelectasis | 3.20±0.55 | 9 | 3.16±0.56 | 13 | 4.5 | .727 |
Risk for ineffective renal perfusion | 3.04±0.74 | 14 | 3.16±0.64 | 13 | 12.5 | .273 |
Risk for electrolyte imbalance | 3.33±0.52 | 6 | 3.29±0.59 | 9 | 3.5 | .688 |
Risk for unstable blood glucose level | 3.11±0.61 | 13 | 3.13±0.66 | 15 | 2.5 | >.999 |
Risk for impaired liver function | 2.73±0.72 | 21 | 2.71±0.76 | 22 | 1.5 | >.999 |
Impaired gas exchange | 3.42±0.62 | 5 | 3.36±0.65 | 7 | 7.5 | .508 |
Ineffective breathing pattern related to ventilation-perfusion imbalance | 3.49±0.59 | 4 | 3.42±0.62 | 5 | 4.5 | .375 |
Risk for dysfunctional gastrointestinal motility related to ileus | 2.89±0.65 | 17 | 2.80±0.59 | 19 | 5.0 | .125 |
Risk for dysfunctional gastrointestinal motility related to ulcer | 2.82±0.68 | 20 | 2.76±0.57 | 20 | 6.0 | .453 |
Independent t-test; Wilcoxon rank-sum test; Chi-square test (if the expected count was below 5, the Fisher exact test was used as an alternative to the chi-square test); Neurologic examination for neonatal therapeutic hypothermia criteria; STH=Systemic therapeutic hypothermia; SHTH=Selective head therapeutic hypothermia; NICU=Neonatal intensive care unit.
Full time during 3days; Fisher exact test; STH=Systemic therapeutic hypothermia; SHTH=Selective head therapeutic hypothermia; V/S=Vital signs; BT=Body temperature; HR=Heart rate; RR=Respiratory rate; NIBP=Noninvasive blood pressure; SpO2=Saturation by pulse oximetry; ETCO2=End-tidal carbon dioxide concentration; PCO2=Pressure of carbon dioxide; A-line=Arterial line; ICP=Intra cranial pressure; CVP=Central venous pressure; EEG=Electroencephalography; ICS=Intensive care system; MRSA=Methicillin-resistant staphylococcus aureus; VRE=Vancomycin-resistant enterococcus; EKC=Epidemic keratoconjunctivitis; IV=Intravenous injection; NCPAP=Nasal continuous positive airway pressure; NO=Nitric oxide; NG=Nasogastric; ES & CE=Emotional support & communication/education; USG=Ultrasonography; OB=Occult blood; ABGA=Arterial blood gas analysis; VBGA=Venous blood gas analysis; EVD=External ventricular drainage.
Full time during 3days; Fisher exact test; STH=Systemic therapeutic hypothermia; SHTH=Selective head therapeutic hypothermia; V/S=Vital signs;
BT=Body temperature; HR=Heart rate; RR=Respiratory rate; NIBP=Noninvasive blood pressure; SpO2=Saturation by pulse oximetry; ETCO2=End-tidal carbon dioxide concentration; PCO2=Pressure of carbon dioxide; A-line=Arterial line; ICP=Intra cranial pressure; CVP=Central venous pressure; EEG=Electroencephalography; ICS=Intensive care system; MRSA=Methicillin-resistant staphylococcus aureus; VRE=Vancomycin-resistant enterococcus; EKC=Epidemic keratoconjunctivitis; IV=Intravenous injection; NCPAP=Nasal continuous positive airway pressure; NO=Nitric oxide; NG=Nasogastric; ES & CE=Emotional support & communication/education; USG=Ultrasonography; OB=Occult blood; ABGA=Arterial blood gas analysis; VBGA=Venous blood gas analysis; EVD=External ventricular drainage.
Wilcoxon signed rank test; STH=Systemic therapeutic hypothermia; SHTH=Selective head therapeutic hypothermia; DIC=Disseminated intravascular coagulopathy.