Purpose
The purpose of this study was to identify the incidence and risk factors associated with the unplanned removal of nasogastric (NG) tubes in neurocritical patients.
Methods
Data were collected retrospectively from the medical records of 479 patients admitted to the tertiary hospital's neuro-intensive care units (NCU). Subjects were divided into two groups depending on whether there was unplanned NG tube removal. Multivariate logistic regression analysis was used to identify risk factors.
Results
Unplanned removal of NG tubes occurred in 35.9% of patients. The incidence of unplanned NG tube removal was 47.2 per 1,000 patient days. Intubated time of the NG tube was 3.96 days in patients with unplanned removal. Risk factors associated with unplanned removal were men (Odds Ratio [OR]=2.19), epilepsy (OR=9.99), traumatic brain injury (OR=5.50), stroke (OR=4.42), improvement of Glasgow Coma Scale (GCS) (OR=1.08), delirium (OR=1.88), physical restraint (OR=2.44), and drainage or decompression purpose (OR=1.67).
Conclusion
Unplanned removal of NG tubes occurred very frequently in neurocritical patients. Care should be taken for patients with neurological diseases who show improvement in their level of consciousness but are still confused due to brain lesions or delirium to reduce it. The application of physical restraints cannot guarantee the prevention of unplanned NG tube removal. Therefore, nurses need to assess the condition of patients and NG tubes frequently.In particular, more attention should be paid to using NG tubes for decompression or drainage purposes. It is also proposed to actively review the NG tube removal plan through periodic evaluation.

Citations

• Impact of the restraint decision tree for physical restraint use in South Korean neurointensive care units
  Jaejin Kang, Sol Kim, Minji Lee, Hyunjoo Na
  Nursing in Critical Care.2024; 29(5): 1110.     CrossRef

Purpose
This study aimed to investigate the symptom clusters and quality of life among patients with type 2 diabetes mellitus and to identify the relationship between quality of life and symptoms by cluster.
Methods
Data were collected through questionnaires and medical records of 123 patients with type 2 diabetes between December 27, 2018 and May 8, 2019. Type 2 diabetes-related symptoms were investigated using the Diabetes Symptom Self-Care Inventory, and quality of life was evaluated using the EuroQoL 5-Dimension 5-Level (EQ-5D-5L). The collected data were analyzed using mean, standard deviation, factor analysis, Pearson correlation coefficient, and hierarchical multiple regression analysis.
Results
Tiredness was a most frequently reported symptom; however, symptom with weight loss was the most critical symptom reported. Five symptom clusters were identified, four of which correlated with quality of life. Hierarchical multiple regression analysis showed that thirst-fatigue clusters affected quality of life (β=-.26, p=.019).
Conclusion
Active treatment and continuous lifestyle management are needed to maintain proper blood sugar levels to address type 2 diabetes mellitus-related symptoms within a thirst-fatigue cluster. Identifying the cause of fatigue and applying physical and psychosocial interventions is also required. Symptoms experienced by patients with type 2 diabetes are connected to clusters. Effective disease management and improvement in the quality of life can be achieved by identifying these symptoms through merging and managing the relevant symptoms simultaneously.

Citations

• Development and Effectiveness of a Pattern Management Educational Program Using Continuous Glucose Monitoring for Type 2 Diabetic Patients in Korea: A Quasi-Experimental Study
  Seung-Yeon Kong, Mi-Kyoung Cho
  Healthcare.2024; 12(14): 1381.     CrossRef
• Associated Factors with Health-related Quality of Life among Older Adults with Diabetes in Korea
  Eun-Kyung Lee, Sun-Young Jung
  The Korean Journal of Rehabilitation Nursing.2022; 25(2): 61.     CrossRef

Purpose
This study aimed to develop an intervention to reduce noise in the Intensive Care Unit (ICU) and evaluate the effects of applying it. Methods: The research design was a non-equivalent control group quasi-experimental study. To develop noise reduction interventions in ICUs, preliminary intervention techniques to reduce noise were derived through a literature review, field survey, and focus group interviews. The intervention was developed by verifying the validity of the content and the clinical applicability, and the result was applied to practice. To assess the effect of the intervention, the following were evaluated: noise level in the ICU, perceived noise level, response to noise, satisfaction of patients and staff with noise management, sleep quality of patients, noise-related knowledge, and perception and performance of noise management of the staff. Results: With the intervention developed in this study, the noise level in the ICU, perceived noise level, and response to noise of patients and staff decreased, and satisfaction with noise management increased. The sleep quality of patients, noise-related knowledge, and perception and performance of noise management of the staff increased. Conclusion: This intervention is shown to be effective in reducing the noise level in the ICU. Therefore, if it is used actively in practice, it is expected to create a comfortable environment by reducing the noise level in the ICU.

Citations

• Factors Affecting Nurses’ Performance of Noise Management in Adult Intensive Care Units
  Seo Jeong Kim, Haeyoung Min, Majd T. Mrayyan
  Journal of Nursing Management.2023; 2023: 1.     CrossRef