Acute and Critical Care

Review Article

Nursing
Nurse-led glycemic control protocols in intensive care units: a scoping review: Eugene Han, Eunhye Park, Eui Geum Oh; Received August 16, 2025 Accepted October 8, 2025 Published online December 19, 2025; DOI: https://doi.org/10.4266/acc.003225 [Epub ahead of print]

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Abstract PDF Supplementary Material: Nurse-led glycemic management in critical care settings has been demonstrated to reduce the incidence of dysglycemia, including hyperglycemia and hypoglycemia, while stabilizing glycemic variability, contributing to enhanced patient outcomes. This scoping review aimed to identify nurse-led glycemic management protocols in intensive care units, analyze their components (e.g., target glucose range, monitoring frequency, and implementation methods), and evaluate their effectiveness. Seven databases, including PubMed and CINAHL, were searched for studies published between January 2015 and April 2025. Studies were selected using predefined inclusion criteria, and two independent reviewers evaluated methodological quality using the JBI critical appraisal tool. Ultimately, seven quasi-experimental studies were included. Most protocols employed continuous intravenous insulin infusions (n=5), whereas others focused on hypoglycemia management (n=2). The target glucose levels ranged from 100–180 mg/dl, and the monitoring intervals varied from 15 minutes to 4 hours depending on the protocol type. All protocols excluded patients on oral diets and those receiving intermittent enteral nutrition. Four studies used printed guidelines with manual adjustments, whereas three employed computerized decision-support systems. The studies indicated that nurse-led glycemic control management was associated with reductions in both glycemic variability and in the incidence of hyper- and hypoglycemia. These findings highlight the need for evidence-based updates to nurse-led glycemic control protocols in critical care for safe and effective management through a multidisciplinary approach.

Original Articles

Epidemiology
Impact of medical crisis on the critical care system in South Korea: Ye Rim Chang, Jae Hwa Cho, Joongbum Cho, Tae Sun Ha, Bo Gun Kho, Eunhye Kim, Im-kyung Kim, Dong Hyun Lee, Suk-Kyung Hong; Acute Crit Care. 2025;40(3):393-401. Published online August 21, 2025; DOI: https://doi.org/10.4266/acc.000575

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Background
The ongoing medical crisis in Korea has severely impacted the operational environment of intensive care units (ICU), posing significant challenges to quality care for critically ill patients. This study aimed to evaluate the effects of the ongoing crisis on ICUs.
Methods
A survey was conducted in July 2024 among intensivists in charge of ICUs at institutions accredited by the Korean Society of Critical Care Medicine for critical care. The survey compared data from January 2024 (pre-crisis) and June 2024 (post-crisis) on the number ICU beds, staffing composition, work hours, and the number and roles of nurse practitioners.
Results
Among the total of 71 participating ICUs, 22 experienced a reduction in the number of operational beds, with a median decrease of six beds per unit, totaling 127 beds across these ICUs. The numbers of residents and interns decreased from an average of 2.3 to 0.1 per ICU, and the average weekly working hours of intensivists increased from 62.3 to 78.8 hours. Nurse practitioners helped fill staffing gaps, with their numbers rising from 150 to 242 across ICUs, and their scope of practice expanded accordingly.
Conclusions
The medical crisis has led to major changes in the critical care system, including staffing shortages, increased workloads, and an expanded role for nurse practitioners. This is a critical moment to foster interest and engage in active discussions aimed at creating a sustainable and resilient ICU system.

Citations

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From trauma surgery to acute care surgery: a 4-year observational study at a single trauma center in Korea
Jung-Woo Woo, Jae Yool Jang, Yo Seok Cho, Hongkyung Shin, Chan Yong Park
Journal of Trauma and Injury.2025; 38(4): 382. CrossRef

Nursing
Engagement and perspectives regarding the family conference process when considering discontinuation of life-sustaining treatments among critical care specialist nurses: a nationwide cross-sectional survey in Japan: Akane Kato, Yuta Tanaka, Yoshiyuki Kizawa, Hiroaki Yamase, Asami Tado, Junko Tatsuno, Mitsunori Miyashita; Acute Crit Care. 2025;40(2):339-348. Published online May 20, 2025; DOI: https://doi.org/10.4266/acc.003096

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Abstract PDF: Background
Recognizing the importance of multidisciplinary collaboration during treatment family conferences is increasing in critical care settings. We aimed to elucidate how critical care specialist nurses engage in the family conference process in terms of the actual discussions held, the recommended topics, and their perspectives regarding transfer of critical care patients to general wards.
Methods
This self-administered nationwide survey was conducted between October and December 2020, targeting a random sample of 740 critical care specialist nurses. An anonymous questionnaire based on established guidelines and pilot tests was used to assess the level of engagement with the family conference process, content of discussions, considerations regarding withholding or withdrawing treatment, and perspectives concerning patient care location and discontinuation of life-sustaining treatments among the surveyed nurses.
Results
Of the 396 returned questionnaires (response rate, 51.9%), 384 were analyzed. Less than 35% of the nurses consistently participated in family conferences and ensured that decisions regarding withholding or withdrawing life-sustaining treatments were re-evaluated following the conferences. Discussions focused predominantly on the patients’ physical aspects, whereas the nurses believed that patients’ values and preferences should be discussed. More than 70% of the nurses supported transferring patients from critical care settings to general wards for end-of-life scenarios.
Conclusions
Critical care specialist nurses in Japan exhibit limited engagement in family conferences and often fail to address their patients’ values and preferences. Educational programs and enhanced interprofessional collaborations are warranted to improve nurse involvement in family conferences and ensure continuity of care between critical care and general ward settings.

Nursing
Nurses’ knowledge, attitude, and perceived barriers toward protective lung strategies of pediatrics mechanically ventilated patients in a tertiary care hospital in Pakistan: Tasnim Zainib, Salma Rattani, Nimira Asif, Hussain Maqbool Ahmed Maqbool; Acute Crit Care. 2025;40(1):128-135. Published online February 19, 2025; DOI: https://doi.org/10.4266/acc.004761

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Abstract PDF Supplementary Material: Background
Protective lung strategies (PLS) are guidelines about recent clinical advances that deliver an air volume compatible with the patient’s lung capacity and are used to treat acute respiratory distress syndrome. These mechanical ventilation guidelines are not implemented within intensive care units (ICUs) despite strong evidence-based recommendations and a dedicated professional staff. Nurses’ familiarity with clinical guidelines can bridge the gap between actual and recommended practice. However, several barriers undermine this process. The objectives of this study were to identify those barriers and explore the knowledge, attitudes, and behavior of ICU nurses regarding the implementation of PLS.
Methods
This was a descriptive, cross-sectional study. The participants were nurses working in the six ICUs of a pediatric tertiary care hospital in Lahore, Pakistan. Using purposive sampling with random selection, the total sample size was 137 nurses. A summative rating scale was used to identify barriers to the implementation of PLS.
Results
Overall, the nurses’ barrier score was high, with a mean of 66.77±5.36. Across all the barriers subscales, attitude was a much more significant barrier (35.74±3.57) to PLS than behavior (6.53±1.96), perceived knowledge (17.42±2.54), and organizational barriers (7.08±1.39). Knowledge-related barriers were also significantly high.
Conclusion
This study identified important barriers to PLS implementation by nurses, including attitudes and knowledge deficits. Understanding those barriers and planning interventions to address them could help to increase adherence to low tidal volume ventilation and improve patient outcomes. Nurses’ involvement in mechanical ventilation management could help to safely deliver air volumes compatible with recommendations.

Rapid response system
Resident and nurse attitudes toward a rapid response team in a tertiary hospital in South Korea: Sung Yoon Lim, Ho Geol Woo, Jong Sun Park, Young-Jae Cho, Jae Ho Lee, Yeon Joo Lee; Acute Crit Care. 2025;40(1):29-37. Published online February 12, 2025; DOI: https://doi.org/10.4266/acc.004272

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Abstract PDF Supplementary Material

Background
Residents and nurses who activate rapid response teams (RRTs) are well positioned to offer insights on its effectiveness. Here, we assess such evaluation of RRTs and identify barriers to activation in a 1,400-bed teaching hospital.
Methods
We conducted a 24-item Likert-scale survey from January to May 2017 among residents and ward nurses with RRT experience. Factor analysis was used to identify the barriers.
Results
This study comprised 305 nurses and 53 residents, most of whom were satisfied with their RRT experiences. Factor analysis showed that lack of awareness of activation criteria was a major barrier, with only 21.4% and 22.2% participants, respectively, confident about their knowledge of activation protocols. Of the survey respondents, 85.7% reported first contacting the doctor before activating the RRT. Despite the protocol, 66.7% first discussed the decision with other staff, and 71.5% called the RRT when the patient’s condition worsened despite management.
Conclusions
Nurses and residents value RRTs but face barriers in initiation, primarily due to a lack of confidence in applying the activation criteria. Many prefer to consult a doctor or manage the patient before calling the RRT.

Citations

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The effect of nurses' perceptions and satisfaction with hospital rapid response teams on burnout related to emergency situations in Korea: a cross-sectional study
Bumin Kim, Nahyun Kim
Journal of Korean Biological Nursing Science.2025; 27(2): 234. CrossRef

Nursing
Palliative care knowledge and attitudes toward end-of-life care among intensive care unit nurses in Jordan: Khaldoun Mohammad Hamdan, Ahmad M. Al-Bashaireh, Mohammad Al-Dalahmeh, Ahmad Rajeh Saifan, Maha Alkaid Albqoor, Abeer M. Shaheen; Acute Crit Care. 2023;38(4):469-478. Published online November 28, 2023; DOI: https://doi.org/10.4266/acc.2023.00430

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Abstract PDF

Background
There is a growing need for palliative care globally due to the rapid aging of the population and improvement in cancer survival rates. Adequate knowledge and a positive attitude are vital for palliative care nurses. The study’s purpose was to examine nurses’ knowledge and attitudes toward palliative care.
Methods
A cross-sectional design with convenience sampling was used. The study included 182 intensive care unit (ICU) nurses from Jordanian hospitals in all sectors. Self-administered questionnaires were used to assess nurses' knowledge and attitudes toward palliative care. Descriptive statistics, analysis of variance, and the Kruskal-Wallis H test were used to analyze the data.
Results
We measured nurses’ knowledge using the Palliative Care Quiz for Nursing, and we measured nurses' attitudes using the Frommelt Attitude Toward Care of the Dying scale. The mean total knowledge and attitude scores were 8.88 (standard deviation [SD], 2.52) and 103.14 (SD, 12.31), respectively. The lowest level of knowledge was in psychosocial and spiritual care (mean, 0.51±0.70). The percentage of nurses with unfavorable attitudes was 53.3%. Significant differences in knowledge and attitude levels were observed according to educational level, experience, and hospital type.
Conclusions
ICU nurses have insufficient knowledge and inappropriate attitudes toward palliative care. Knowledge of psychological and spiritual aspects of palliative care was particularly lacking as were appropriate attitudes towards communication with dying patients. Improving knowledge and attitudes toward palliative care in nursing schools and hospitals would help overcome this problem.

Citations

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The effect of moral distress experienced by intensive care nurses on end-of-life care attitudes and care behaviours: a single-centre cross-sectional and correlational study
Pakize Özyürek, İbrahim Kılıç, Ahmet Akarsu, Öznur Gürlek Kısacık
BMC Nursing.2026;[Epub] CrossRef
Core competency in palliative care among intensive care unit nurses: A latent profile analysis
Qin Guan, Xiaoling Zhu, Zhipeng Xue, Mengyun Peng
Nursing in Critical Care.2025;[Epub] CrossRef
Knowledge, attitudes, and self-efficacy regarding palliative care among Palestinian nurses in intensive care units
Bilal Awad, Ahmad Batran, Malakeh Z. Malak, Ahmad Ayed, Anas Shehadeh, Bahaa Alassoud, Moath Abu Ejheisheh
BMC Nursing.2025;[Epub] CrossRef
Soulful support: Exploring critical care nurses' spiritual caregiving towards end‐of‐life scenario
Ayman Mohamed El‐Ashry, Sameh Eltyebani, Shimmaa Mohamed Elsayed, Mahmoud Abdelwahab Khedr, Mona Metwally El‐Sayed, Mohamed Adel Ghoneam, Haitham Mokhtar Mohamed Abdallah
Nursing in Critical Care.2025;[Epub] CrossRef
Palliative Care Knowledge, Attitudes, and Self-Competence of Nurses Working in Hospital Settings
Mona Ibrahim Hebeshy, Darcy Copeland
Journal of Palliative Care.2025;[Epub] CrossRef
Towards enhancing palliative care competencies through comprehensive training for nurses and physicians in resource-limited settings: a cross-sectional study
Mohammad Alhaddar, Heba Falna, Haya Sultan, Hammoda Abu-Odah, Mohammad Khleif, Shahenaz Najjar
BMC Nursing.2025;[Epub] CrossRef
Empowering critical care nurses: bridging knowledge gaps in palliative care
Halima A. Almahrizi, Fawwaz Alaloul, Ohood K. Al Mamari, Esther K. Rani, Zayoon A. Al Mahrizi, Salma A. Al Harthy, Zakariya Al-Naamani
BMC Nursing.2025;[Epub] CrossRef
Spiritual and cultural influences on end-of-life care decision-making: a comparative analysis of the Arab Middle East and the United Kingdom
Hanan Hamdan Alshehri, Chris McParland, Hibah Abdulrahim Bahri, Bridget Johnston
Current Opinion in Supportive & Palliative Care.2025; 19(4): 242. CrossRef
The Correlation Between Nurses' Knowledge and Attitudes and the Provision of Patients' Spiritual Care in the High Care Unit
Hidayatul Rahmi, Rebbi Permata Sari Rebbi, Revi Neini Iqbal, Willady Rasyid
Journal of Health Sciences and Epidemiology.2025; 3(1): 51. CrossRef
Knowledge of undergraduate nursing students about palliative care
Aruna Jothishanmugam
Journal of Education and Health Promotion.2025;[Epub] CrossRef
Investigation of the Relationship between Personality Traits of Intensive Care Nurses and Their Attitudes and Behaviours towards End-of-life Care
Fırat Demir, Cansu Polat Dünya, İlknur Özkan
Sağlık Bilimleri Üniversitesi Hemşirelik Dergisi.2024; 6(3): 243. CrossRef
Knowledge and attitude towards palliative care and associated factors among nurse: a cross-sectional descriptive study
Saeedeh Rafiee, Ismail Azizi-Fini, Zahra-Sadat Banihashemi, Safoura Yadollahi
BMC Nursing.2024;[Epub] CrossRef
Knowledge, Attitudes, and Determinants of Palliative Care Among Nurses: A Descriptive Study
Kalkidan Girma, Gebremedhin Desta, Saba Tsegaye, Melkamu Tesfaye
Journal of Integrative Nursing and Palliative Care.2023; 4(1): 108. CrossRef

Review Article

Nursing
Theoretical definition of nurse–conscious mechanically ventilated patient communication: a scoping review with qualitative content analysis: Arezoo Mohamadkhani Ghiasvand, Meimanat Hosseini, Foroozan Atashzadeh-Shoorideh; Acute Crit Care. 2023;38(1):8-20. Published online February 27, 2023; DOI: https://doi.org/10.4266/acc.2022.01039

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Abstract PDF Supplementary Material

Providing critical nursing care for conscious mechanically ventilated patients is mediated via effective communication. This study aimed to identify and map the antecedents, attributes, consequences, and definition of nurse–conscious mechanically ventilated patient communication (N-CMVPC). This scoping review was conducted by searching the Cochrane Library and the CINAHL, EMBASE, PubMed, Web of Science, and Scopus databases, between 2001 and 2021. The keywords queried included "nurses," "mechanically ventilated patients," "mechanical ventilation," "intubated patients," "communication," "interaction," "relationships," "nurse–patient communication," "nurse–patient relations," "intensive care units," and "critical care." Studies related to communication with healthcare personnel or family members were excluded. The results indicated that N-CMVPC manifests as a set of attributes in communication experiences, emotions, methods, and behaviors of the nurse and the patient and is classified into three main themes, nurse communication, patient communication, and quantitative-qualitative aspects. N-CMVPC is a complex, multidimensional, and multi-factor concept. It is often nurse-controlled and can express itself as questions, sentences, or commands in the context of experiences, feelings, and positive or negative behaviors involving the nurse and the patient.

Citations

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Optimizing infection control: Evaluating nurses' knowledge and practices for preventing infections in mechanically ventilated patients
Safar awadh alotaibi, Maha AlOtaibi, Hadiya Nassar Alrashedi, Huda Ali S Alasmari, Abdelaziz Hendy, Rasha Kadri Ibrahim
Infection, Disease & Health.2025; 30(3): 194. CrossRef
Interaction Experiences of Family Members With Their Unconscious Relatives on Mechanical Ventilation in the Intensive Care Unit: A Phenomenological Qualitative Study
Hülya Koçyiğit Kavak, Suna Demirci
Nursing in Critical Care.2025;[Epub] CrossRef
Lived experiences of critical care nurses in communicating with non-verbal or unconscious patients in Western Amhara, Northwest Ethiopia: A descriptive phenomenological study
Abebe Dilie Afenigus, Mastewal Ayehu Sinshaw
International Journal of Africa Nursing Sciences.2025; 23: 100924. CrossRef
Communication Methods Used with Conscious Intubated Patients: Scoping Review
Mahuya Karmakar, Santhna Letchmi Panduragan, Faridah Mohd Said
The Open Nursing Journal.2024;[Epub] CrossRef
A Study on Nurses' Communication Experiences with Intubation Patients
Ye Rim Kim, Hye Ree Park, Mee Kyung Shin
The Korean Journal of Rehabilitation Nursing.2023; 26(1): 28. CrossRef
The Application of Augmentative and Alternative Communication in Intubated Patients in the Intensive Care Unit: A Scoping Review
Mee-Kyung Shin, Hyejin Jeon
The Korean Journal of Rehabilitation Nursing.2023; 26(2): 97. CrossRef

Original Articles

Nursing
How do physicians and nurses differ in their perceived barriers to effective enteral nutrition in the intensive care unit?: Masoumeh Mirhosiny, Mansour Arab, Parvin Mangolian Shahrbabaki; Acute Crit Care. 2021;36(4):342-350. Published online November 16, 2021; DOI: https://doi.org/10.4266/acc.2021.00185

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Abstract PDF

Background
Patients hospitalized in intensive care units are susceptible to chronic malnutrition from changes in protein and energy metabolism in response to trauma. Therefore, nutritional support, especially enteral nutrition, is one of the most important treatment measures for these patients. However, there are several barriers in the hospitals in treating patients with enteral nutrition. This study was performed to compare the perceptions of care providers (physicians and nurses) on the barriers to enteral nutrition in intensive care units.
Methods
This was a cross-sectional descriptive and analytic study. This study included 263 nurses and 104 physicians in the intensive care units of XXXX southeast hospitals. A questionnaire of enteral nutrition barriers in intensive care units was used. IBM SPSS ver. 19 was used to analyze data.
Results
There was a significant difference between the two groups in the three subscales of intensive care units (P=0.034), dietician support (p=0.001>) and critical care provider attitudes and behavior (P=0.031). There was also a significant difference between having completed educational courses and the score of enteral nutrition barriers in the two groups (P<0.05); the people who received an educational course had a better perception of enteral nutrition barriers.
Conclusions
Physicians and nurses agreed with the perception of enteral nutrition barriers, but there was a difference in their perception on some barriers. Strategies such as in-service training and increasing the knowledge and skills of physicians and nurses can reduce these differences.

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What influences the implementation of clinical guidelines related to enteral nutrition in the intensive care unit: A mixed‐methods systematic review
Jia Qi Li, Ting Sun, Jun Tao Zuo, Yao Xu, Li Na Cai, Heng Yu Zheng, Xiang Hong Ye
Journal of Advanced Nursing.2025; 81(3): 1172. CrossRef
Enteral Nutrition Practices and Complications in ICU Settings: A Cross-Sectional Study of Healthcare Professionals’ Perspectives in Saudi Arabia
Sara Zaher, Reham Alhindi, Layan Alturki, Elaf Alsobhi, Lora Alahmadi, Hadeel Aldhowayan
Journal of Multidisciplinary Healthcare.2025; Volume 18: 289. CrossRef
Knowledge, attitude, and practice of nurses regarding enteral feeding for patients admitted to intensive care units of National Referral Hospitals in Dar es Salaam, Tanzania: a cross-sectional study
Shamim Muhudi Abeid, Masunga Kidula Iseselo, Menti Lastone Ndile, Dickson A. Mkoka, Rashidi Heri Kiangi
International Journal of Africa Nursing Sciences.2025; 23: 100920. CrossRef
Nutrition practices in critically ill adults receiving noninvasive ventilation: A quantitative survey of Australian and New Zealand intensive care clinicians
Kaitlyn Page, Elizabeth Viner Smith, Mark P. Plummer, Emma J. Ridley, Kristy Burfield, Lee-anne S. Chapple
Australian Critical Care.2024; 37(1): 43. CrossRef
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Enfermería Intensiva.2024; 35(1): 1. CrossRef
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I. Zaragoza-García
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Mensure Turan, Zeliha Cengiz, Dilek Olmaz
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Adequacy of protein and calorie delivery according to the expected calculated targets: a day‐by‐day assessment in critically ill patients undergoing enteral feeding
Adam Fabiani, Lorella Dreas, Enzo Mazzaro, Elena Trampus, Michela Zanetti, Antonella Calabretti, Giuseppe Gatti, Gianfranco Sanson
Journal of Human Nutrition and Dietetics.2023; 36(3): 697. CrossRef
Barriers to Delivery of Enteral Nutrition in Intensive Care Settings in Saudi Arabia: A Comparative Study of the Perceptions of Health Care Providers Working in Adult and Paediatric ICUs
Sara Zaher
Risk Management and Healthcare Policy.2022; Volume 15: 2357. CrossRef

Nursing
Association between perception of caring behaviors and self-efficacy in patients with cardiovascular disease at coronary care units: a cross-sectional study: Leila Kargar, Zahra Khademian, Masoume Rambod; Acute Crit Care. 2021;36(2):118-125. Published online April 29, 2021; DOI: https://doi.org/10.4266/acc.2020.00752

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Abstract PDF

Background
Assessing and improving patient self-efficacy are among the major roles of nurses. Nurses are also responsible for providing direct patient care, and they play a major role in improving patient care quality. Therefore, it is essential to evaluate nurses’ care-giving behaviors. This study aimed to determine the association between caring behaviors and self-efficacy in patients with cardiovascular disease.
Methods
In this cross-sectional study, 400 patients with cardiovascular disease who were admitted to hospitals in Jahrom, southern Iran, were selected through a stratified sampling. The Caring Behaviors Inventory and the Strategies Used by People to Promote Health questionnaires were used to collect data. Data were analyzed using descriptive statistics, Kolmogorov-Smirnov test and Spearman correlation coefficient in SPSS ver. 22.
Results
Results showed significant relationships between perception of caring behaviors and self-efficacy (r=0.16, P=0.001) as well as subscales of respectful deference to others (r=0.12, P=0.01), assurance of human presence (r=0.12, P=0.02), and positive connectedness (r=0.18, P=0.001). Additionally, among the subscales of caring behaviors, “attentive to others’ experience,” with a mean of 5.17±1.10, was the highest priority and “positive connectedness,” with a mean of 4.81±1.31, was the lowest priority for patients. The mean self-efficacy score was 73.94±29.78, and 169 patients (43.2%) had low self-efficacy.
Conclusions
Given the positive relationship between perception of caring behaviors and self-efficacy in patients with cardiovascular disease, self-efficacy could be improved by paying more attention to patient care priorities and improving patient perception of caring behaviors.

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Review Article

The Association of Nurse Staffing Levels and Patient Outcome in Intensive Care Units: Hyunjung Lee, Hongbeom Bae; Korean J Crit Care Med. 2013;28(2):75-79.; DOI: https://doi.org/10.4266/kjccm.2013.28.2.75

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Abstract PDF

Nurses play a crucial role in providing high-quality care in intensive care units (ICU). Previous studies have shown an association between nurse staffing levels and outcome of critically ill patients. Increasing nurse staffing levels in ICU has been recommended to improve the outcome of critically ill patients. However, nursing staff shortages associated with decreased budgets may prevent adequate nurse-to-patient ratios although there lies increasing needs for critical care. Several studies have suggested that higher nurse staffing level is associated with favorable patient outcome, including mortality, length of stay, and infections, but some of studies did not find an association between nurse staffing and patient outcome. Although there are some controversies in the associations between nurse staffing levels and patient outcome, it is difficult to apply such effect as compared with other developed countries in North American and Europe as the nurse-to-patient ratio in Korea's ICU is relatively low. By studying the nurse staffing effects for patient outcome from the Korea ICU, it is found that higher nurse staffing level is associated with improved patient mortality. This finding may suggest that a shortage of nursing staff is currently a serious issue for caring of critically ill patients in Korea.

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Junghyeon Kim, Moonsik Kim, Yongjoo Kim, Dongho Rie
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Journal of Korean Critical Care Nursing.2019; 12(2): 73. CrossRef

Original Article

The Distribution of Medical Personnel and Medical Equipments in the Intensive Care Units in Korea: Shin Ok Koh, Pyung Hwan Park, Myoung Hoon Kong, Yong Lak Kim; Korean J Crit Care Med. 2001;16(2):138-143.

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Abstract PDF: BACKGROUND
Not much of the fund is invested in the intensive care unit (ICU) in Korean hospitals since the cost of ICU care is set too low compared to the other medical fields as well as to the other part of the world. This study is designed to support the base of an ICU standard guideline in Korea.
METHODS
The questionnaire were sent to 73 ICUs and 24 neonatal ICUs (NICU) of 30 hospitals. Twenty-two of them were teaching hospitals and 8 of them were general hospitals.
RESULTS
The ratios of ICU bed number to total bed number were 5.0% and 6.0% in teaching hospital and general hospital respectively. The ratios of NICU bed to total bed were 3.4% and 2.0% in teaching hospital and general hospital respectively. Intensivists were kept in 24.6% of ICU and 36.4% of NICU. Residents were kept in 43.1% of ICU and 45.5% of NICU. The utilization of ICU service was 90% for teaching hospital and 86% for general hospital. The utilization of NICU was 89% for teaching hospital and 3% of general hospital. Nurse to patient ratios varied widely. Most ICUs in teaching hospital showed the nurse to patients ratio of 1 : 4 which was about 32% of total ICU. Most NICUs in teaching hospital showed the nurse to patients ratio of 1 : 5 which was around 20% of total NICU. Most of the ICUs were equipped with central piping system for oxygen and compressed air supply, vacuum system and all the necessary medical gadgets such as mechanical ventilators, ECG monitors, defibrillators, pulse oximeters and infusion pumps.
CONCLUSIONS
The distribution of medical personnel as well as medical equipments were varied widely. The variation existed between teaching hospital and general hospital as well as within the teaching hospitals. We need to establish a standard, which grades the level of ICU according to the number of keeping physician, nurse-patients ratio, and the types of medical equipments they have.

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