Current status of respiratory care in Korean intensive care units

Park, So Yeon; Kim, Tae Hyung; Kim, Eun Kyung; Shim, Tae Sun; Lim, Chae Man; Lee, Sang Do; Kim, Woo Sung; Kim, Dong Soon; Kim, Won Dong; Koh, Youn Suck

Abstract

BACKGROUND
Respiratory care for patients in intensive care units(ICUs) has been performed mainly by nurses in Korea. However, the current status of respiratory care i the Korea ICUs is not well known. Respiratory care and the methods of delivery in ICUs were surveyed. METHOD: A confidential questionnaire was distributed to the head nurses working the ICUs at 117 hospitals in Korea. One hundred hospitals returned the questionnaires, for a response rate of 85%. The hospitals were divided into three groups : Main university hospitals(MUH), university associated hospitals(UAH), and general hospitals(GH) RESULT: Eighteen units of 66 units in MUH and 35 units of 58 units in GH were organized as a general ICUs. The percentage of ICUs with full-time doctors was 47.1%. The nurses usually delivered respiratory care spending from 1 to 4 h during their 8 h of working time. Although the respondents felt that respiratory care should be delivered by trained respiratory therapists, these therapists were not found at the hospitals. Most of the units performed percussion, tracheal suctioning, and positional changes. However, vibration and IPPB were less frequently performed in GH. Among oxygen supply apparatus, venturi mask and T-piece were not frequently used in GH. GH applied a noninvasive ventilator mode less frequently than MUH and UAH. The percentage of Swan-Ganz catheter monitoring was only 21.4% in GH.
CONCLUSION
Respiratory care for patients in the Korean ICUs was provided by nurses on the whole. In addition, there were many differences in the level of respiratory care according to the type of hospital. To overcome the current problems revealed, an effective in-hospital training program for the development of full-time respiratory care therapists should be established urgently in Korea.