PURPOSE
This review aimed to determine the effectiveness of oral care using Chlorhexidine Gluconate (CHX) in Ventilator-Associated Pneumonia (VAP) in the intensive care unit.
METHODS
An electronic databases search was conducted with Ovid-MEDLINE, EMBASE, CENTRAL, CINAHL and four domestic databases from July 10 to 16, 2018. Two reviewers independently selected the studies; three reviewers assessed their methodological quality and extracted relevant data. We conducted a meta-analysis of the effect of CHX oral care versus placebo using the Review Manager 5.3 software program and summarized the results of intervention from the included studies.
RESULTS
Of the 512 articles identified, 17 randomized controlled trials met the inclusion criteria for review. The incidence of VAP differed significantly between the CHX and placebo groups (Relative Risk [RR]=0.72, 95% Confidence Interval [CI]=0.63~0.84). The pooled effects of oral care using 0.12% CHX were RR=0.65 (95% CI=0.52~0.80) and RR=0.68 (95% CI=0.54~0.86) using CHX solution, which were statistically significant. When CHX oral care was performed three times a day, the size of the effect was statistically significant (RR=0.63, 95% CI=0.40~0.99). There was no significant difference in mortality between the CHX oral care and placebo groups (RR=1.08, 95% CI=0.94~1.28).
CONCLUSION
This review provides evidence that performing oral care using a 0.12% CHX solution three times a day could decrease the incidence of VAP. For improving the quality of nursing practice, the results of this review should be used as the basis for the oral care evidence-based practice guidelines for critical patients.

Citations

• Oral Hygiene Care of Endotracheal Intubated Patients in Korean Intensive Care Units : A Scoping Review
  Jungeun Lim, Dukyoo Jung, Leeho Yoo
  Journal of Korean Critical Care Nursing.2024; 17(1): 68.     CrossRef
• Effect of 2% Chlorhexidine Bathing on the Incidence of Hospital-Acquired Infection and Multidrug-Resistant Organisms in Adult Intensive Care Unit Patients: Systematic Review and Meta-Analysis
  Jisu Seo, Rhayun Song
  Journal of Korean Academy of Nursing.2021; 51(4): 414.     CrossRef

PURPOSE
The aims of this study were to describe the incidence rate of delirium and to identify factors influencing delirium in neurological intensive care unit patients.
METHODS
The participants were 193 critically ill patients with neurological disorder from Chonbuk national university hospital in Jeonju. Data were collected between April 1 and November 25, 2017 using four structured questionnaires: Confusion Assessment Method for the Intensive Care Unit, Glasgow Coma Scale, Acute Physiology and Chronic Health Evaluation II, and Karnofsky Performance Scale. Data were analyzed using descriptive statistics, independent t-test, χ2 test, Mann-Whitney U test, and logistic regression using the SPSS/WIN 24.0 program.
RESULTS
The incidence rate of delirium was 11.9%. Delirium was related with age, length of stay in intensive care unit, Glasgow Coma Scale score, Acute Physiology and Chronic Health Evaluation II score, Karnofsky Performance Scale score, use of physical restraint, antihypertensive drugs, and anticonvulsants. Logistic regression analysis showed that age, length of stay in intensive care unit, use of physical restraint, and anticonvulsants were factors influencing delirium in neurological intensive care unit patients.
CONCLUSION
Delirium was related to demographic, clinical, medication-related, and environmental factors in patients in neurological intensive care units. Therefore, nurses should consider the patient's age, length of stay intensive care unit, use of physical restraint, and anticonvulsants in assessing delirium in neurological intensive care unit patients. Delirium prevention programs considering these factors may be effective for such patients.

Citations

• Factors-related to the severity of delirium among older adults in neurologic intensive care units: A retrospective study using electronic medical record data
  Ae Young Cho, JiYeon Choi, Jung Yeon Kim, Kyung Hee Lee
  Journal of Korean Gerontological Nursing.2025; 27(2): 166.     CrossRef
• Risk Factors for Delirium in Trauma Intensive Care Unit Patients
  Jongran Kim, Jeong-Ah Ahn
  Korean Journal of Adult Nursing.2020; 32(6): 623.     CrossRef

PURPOSE
This study was conducted to evaluate quality of sleep and to assess the factors that influence quality of sleep in surgical ICU. METHODS: The subject of the study were consisted 109 adult patients who admitted to surgical ICU. The data were collected from May 20 to December 10, 2007 by structured questionnaires. The data were analyzed with descriptive analysis, paired t-test, Pearson correlation coefficient and stepwise multiple regression. RESULTS: The score of quality of sleep was 4.57 point. The main sleep disturbance factors related to quality of sleep in surgical ICU inpatient were sleep time, machinery alarm and noise(adjusted R2=33.2). CONCLUSION: Based on the finding of this study, it is needed to develop a nursing intervention program that including to promote quality of sleep and to decrease machinery alarm and noise in surgical ICU.

PURPOSE
The purpose of this study was to understand the meanings and nature of ICU admission experienced among patients with critical illness. The present study adopted a hermeneutic phenomenological method which was developed by van Manen.
METHODS
The participants for this study were 6 men and 3 women, who were over the age of 20 with ICU admission period more than 3 days. Data were collected by using in-depth interviews and observations from March, 2007 to September, 2007. The contents of the interviews were tape-recorded with the consent of the subject.
RESULTS
The essential themes that fit into the context of the 4 existential grounds of body, time, space and other people were as follows: a body that cannot react the way it wants, a wave of fear and insecurity everywhere, a struggle to survive, coming out from death's door, loss of time path, a long and continued waiting until escaping, more of machinery room than a patient's room, existence of life and death, an abyss of suffering seen thru another patient, taken care of by a doctor, trust and distrust, family, the ultimate safe zone.
CONCLUSION
Critically ill patients in ICU experienced feelings of discomfort, unsafety, and insecurity. The result of this study can give nurses some insight into these experiences and help promote empathetic care.