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Purpose@#This study aimed to investigate student nurses’ satisfaction by type of clinical practicum and to determine predictors of clinical competence in pediatric nursing. @*Methods@#A total of 189 Junior and Senior student nurses across seven colleges in the Busan Metropolitan City were enrolled in the study. The participants completed a structured questionnaire containing items about their learning satisfaction with different types of pediatric nursing practicums and their clinical competence. Data were analyzed using the mean, standard deviation, independent t-test, ANOVA, and multiple regression analysis. @*Results@#Regarding satisfaction with each type of clinical practicum, the mean satisfaction score (out of 10) was 8.18±2.26 for on-site clinical rotations and 7.35±2.20 for alternative practicums. Among the different types of alternative practicum approaches, those with a satisfaction score of 7 or higher included fundamental nursing skills, watching videos, simulation etc., while those with a satisfaction score of less than 6 were virtual simulation and problem-based learning. The predictors of clinical competence in pediatric nursing were learning satisfaction with practice, school year, and alternative practicum, accounting for 35.0% of the variance in clinical competency. @*Conclusion@#It would be helpful to combine on-site clinical rotations with alternative practicum approaches and to develop various alternative practice programs using simulation practice, virtual reality, immersive interactive systems, and standardized patients to enhance students’ clinical competency.
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Background@#The purpose of this study was to identify the differences in the importance of oral pathology learning objectives forinstructors and clinical dental hygienists and provide basic data that can guide learning objectives for acquiring practically necessary basic knowledge in the clinical field. @*Methods@#Through the first-stage expert meeting, 27 items with less than four points out of 129 learning objectives in 15 detailed areas were deleted, 12 additional opinions were reflected, 114 learning objectives were set, and a survey was conducted with 253 people. @*Results@#There were statistically significant differences in 92 items after examining the difference between professors and clinical dental hygienists. Among the areas of inflammation and repair, “Can explain the five symptoms of inflammation” had the highest with a score at 4.76 in the case of the professors. Among the areas of tooth damage, “Can explain abrasion” had the highest with a score at 4.61 in the case of the clinical dental hygienists. @*Conclusion@#I would like to propose the existing 15 detail areas and 129 learning objectives as 14 detail areas and 98 learning objectives and strengthen the job competency of dental hygienists in the future. First, you need to develop competencies that are highly relevant to your work. Second, it is necessary to develop related textbooks and educational materials based on revised learning objectives and competencies. Third, based on revised learning objectives, the dental hygienist national examination should be improved. Through these changes in education, the education of oral and maxillofacial disease subjects should strengthen job competencies among dental hygienists with learning objectives that can be applied to actual clinical practice based on basic knowledge rather than knowledge orientation. In addition, it is possible to improve the quality of dental hygiene studies.
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Purpose@#This study aimed to identify the mediating effect of Psychological stress of COVID-19 stress on the relationship between nursing work environment and turnover intention of nurses in long-term care hospitals. @*Methods@#The participants were 176 nurses working at three long-term care hospitals in Changwon City. Data were collected from August 11 to 14, 2021, using self-report questionnaires. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson’s correlation coefficients, and hierarchical regression, using the SPSS 23.0 software. A mediation analysis was performed according to the Baron and Kenny’s test, and Sobel test. @*Results@#Turnover intention was positively correlated with Psychological stress of COVID-19 stress (r=.23, p=.002) and negatively correlated with nursing work environment (r=-.44, p<.001). Psychological stress of COVID-19 stress had a significantly negative relationship with nursing work environment (r=-.15, p=.045). Psychological stress of COVID-19 stress partially mediated the relationship between nursing work environment and turnover intention. @*Conclusion@#The findings of this study indicate that a positive nursing work environment can help nurses reduce their Psychological stress of COVID-19 stress and turnover intention. To reduce the turnover intention among nurses’ in long-term care, it is necessary to promote better work environments suitable for COVID-19 and to establish detailed strategies for reducing their physiological stress.
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Objectives@#This study aims to determine the influence of social exchange relationships, leader’s political skills, job stress, job satisfaction, and organizational commitment on turnover intention among dental hospital hygienists. @*Methods@#A self-administrated questionnaire survey was conducted from April 1-May 12, 2020, involving 209 dental hospital hygienists in Seoul, Busan, and Gyeongnam. The collected data were analyzed using SPSS and AMOS statistical analysis programs. @*Results@#In the hypotheses testing, 9 of 18 hypotheses were supported. In social exchange relationships, job stress, job satisfaction, and organizational commitment, the path to turnover intention had a significant effect, but it was not statistically significant in leader’s political skills. With regard to mediating effect, job stress, job satisfaction, and organizational commitment played a complete mediating role in the path from social exchange relationships to turnover intention. @*Conclusions@#To increase job satisfaction and organizational commitment, and lower job stress in order to have a positive impact on turnover intentions, it is imperative to develop and apply a program to enhance social exchange relationships.
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Purpose@#To report a case of preseptal cellulitis after strabismus surgery in a patient with no previous history of ocular surgery.Case summary: A 33-year-old male visited the ophthalmology clinic with a 4-day history of left eye pain and lid swelling after strabismus surgery. He was a healthy patient with a history of polio resulting in left hemiparalysis and difficulty walking. He was followed up with left medial rectus and lateral rectus muscle resection surgery for secondary sensory esotropia. His best corrected visual acuity was 0.6 in his left eye and physical examination revealed pain, eyelid edema, chemosis, and purulent discharge from the left conjunctival fornix. Computed tomography scanning with contrast enhancement revealed diffuse preseptal periorbital soft tissue swelling and enhanced fat stranding suggesting left preseptal cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. Left eye swelling was improved and purulent discharge had decreased after 3 days; he was discharged after a 5-day course of intravenous antibiotic treatment. Oral antibiotics were administrated for 1 week. The patient had no recurrent symptoms during the 3-month follow-up. @*Conclusions@#Although rare, preseptal cellulitis after strabismus surgery must be promptly recognized to prevent secondary complications related to infection.
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Objectives@#This study aims to determine the influence of social exchange relationships, leader’s political skills, job stress, job satisfaction, and organizational commitment on turnover intention among dental hospital hygienists. @*Methods@#A self-administrated questionnaire survey was conducted from April 1-May 12, 2020, involving 209 dental hospital hygienists in Seoul, Busan, and Gyeongnam. The collected data were analyzed using SPSS and AMOS statistical analysis programs. @*Results@#In the hypotheses testing, 9 of 18 hypotheses were supported. In social exchange relationships, job stress, job satisfaction, and organizational commitment, the path to turnover intention had a significant effect, but it was not statistically significant in leader’s political skills. With regard to mediating effect, job stress, job satisfaction, and organizational commitment played a complete mediating role in the path from social exchange relationships to turnover intention. @*Conclusions@#To increase job satisfaction and organizational commitment, and lower job stress in order to have a positive impact on turnover intentions, it is imperative to develop and apply a program to enhance social exchange relationships.
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Purpose@#To report a case of preseptal cellulitis after strabismus surgery in a patient with no previous history of ocular surgery.Case summary: A 33-year-old male visited the ophthalmology clinic with a 4-day history of left eye pain and lid swelling after strabismus surgery. He was a healthy patient with a history of polio resulting in left hemiparalysis and difficulty walking. He was followed up with left medial rectus and lateral rectus muscle resection surgery for secondary sensory esotropia. His best corrected visual acuity was 0.6 in his left eye and physical examination revealed pain, eyelid edema, chemosis, and purulent discharge from the left conjunctival fornix. Computed tomography scanning with contrast enhancement revealed diffuse preseptal periorbital soft tissue swelling and enhanced fat stranding suggesting left preseptal cellulitis. The patient was hospitalized with intravenous broad spectrum antibiotics. Left eye swelling was improved and purulent discharge had decreased after 3 days; he was discharged after a 5-day course of intravenous antibiotic treatment. Oral antibiotics were administrated for 1 week. The patient had no recurrent symptoms during the 3-month follow-up. @*Conclusions@#Although rare, preseptal cellulitis after strabismus surgery must be promptly recognized to prevent secondary complications related to infection.
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Baclofen, a gamma-aminobutyric acid B agonist, is frequently used in the treatment of various neurologic diseases including spasticity, dystonia and trigeminal neuralgia. This drug usually acts at the presynaptic motor neuron to induce an antispastic response. Oral baclofen toxicity is extremely rare, but is often reported to affect patients with renal disease. Here, we report a patient with chronic kidney disease who was treated with relatively low doses of baclofen (5 mg twice per day) and experienced nonconvulsive status epilepticus.
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Objectives@#The purpose of this study was to provide basic data for the improvement of healthrelated behaviors, oral health behaviors and develop an oral health promotion program for adolescents. Therefore, this study investigated health-related behaviors of adolescents and their oral disease symptoms. @*Methods@#Data of 62,276 adolescents were derived from the 13th Korea youth risk behavior webbased survey. Chi-square tests and logistic regression analyses were performed using complex sampling to determine the effects of health-related behaviors and oral health behaviors on the experience of oral disease symptoms among the adolescents. @*Results@#In total, 52.9% had developed oral symptoms in the previous year. The sample population consisted of 55.1% females, 53.4% third grade high school students, and 51.1% academic achievers. Among the adolescents, 57.6% of those categorized as having low economic status showed high oral disease experience (P<0.001). The increased intake of sweet drinks and snacks due to a higher subjective depression and perception of stress, increased the experience of oral symptoms (P<0.05). Fewer times of toothbrushing per day was correlated to an increase in oral disease symptoms (P<0.001). @*Conclusions@#As health-related behaviors and oral health behaviors formed during adolescence affect adulthood, a systematic oral health education program should be developed and implemented for proper health-related behaviors and oral health management in adolescents.
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Objectives@#The purpose of this study was to analyze the relations between general health status, oral health behavior, oral health status, and quality of life, as well as the mediating effects of oral health behavior and oral health status. @*Methods@#Subjects aged ≥19 years participated in a health questionnaire in the third year of the Japanese National Health and Nutrition Examination Survey (2015). @*Results@#Analysis of the overall path of periodontal disease showed that respiratory and circulatory diseases and oral health behaviors had statistically significant indirect effects on quality of life through the mediation of oral health behavior and oral health conditions, while analysis of the overall trend of the decayed, missing, and filled teeth (DMFT) index showed significant indirect effects on quality of life through mediation between oral and oral health conditions. As a result of these analyses, the association of general health status with quality of life, and its effect thereon, were confirmed through the intermediary of oral health behaviors and oral health conditions. @*Conclusions@#Therefore, further research is needed on the relation of general diseases to oral health management. Special oral health departments need to be established in both general and university hospitals, and dental hygienists in charge of oral care need to be deployed to improve oral health for general diseases. Manuals and systems for oral health management and oral health promotion need to be developed for certified dental hygienists in Japan, specifically for each systemic disease. For example, hygienists should have guidance on the oral health practices that help in the prevention of diabetes.
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Objectives@#The purpose of this study was to evaluate the association between metabolic syndrome and the number of present teeth in a Korean adult population. @*Methods@#We analyzed the effect of the components of metabolic syndrome in adults aged older than 45 years on the number of present teeth using raw data from the 6th National Health and Nutrition Survey (2013-2015). For the data analysis, complex samples multivariable logistic regression analysis was performed by correcting the disturbance variables as demographic and socioeconomic variables (gender, age, education level, household income, residential area, family type, and economic activity) and oral health-related behavioral variables (smoking, alcohol consumption, tooth brushing frequency, interdental tooth brushing, flossing, and dental checkups). @*Results@#On analyzing the association between the effects of metabolic syndrome components on less than 20 present teeth by adjusting for demographic and socioeconomic variables and correcting for both general characteristics and oral health-related behavioral variables, the risk of having less than 20 present teeth was 1.25 times (95% confidence interval 1.08-1.46) higher in the high fasting glucose group compared to that in the non-high fasting glucose group. Metabolic syndrome composed of three or more components was significantly associated with less than 20 present teeth. @*Conclusions@#It is necessary to continuously educate Korean adults about oral health behavior. Appropriate interventional programs to prevent oral disease should be provided when patients with metabolic syndrome visit dental clinics and public health centers.
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Purpose@#To investigate the influence of intraocular pressure (IOP)-lowering eye drops on myopic retinoschisis. @*Methods@#We investigated myopic retinoschisis patients with high myopia (defined as a myopic refractive error more than -8.0 dioptersor an axial length longer than 26.5 mm), who were suspected of having glaucomatous optic neuropathy, using IOP-loweringeye drops between April 2014 and December 2018. We retrospectively analyzed the changes in optical coherence tomographyfindings after 6 months using IOP-lowering eye drops. The progression of retinoschisis was assessed by analyzing retinalvolume changes. A decrease in the total retina volume and a decrease in volume more than 10% in one section out of five withoutmore than a 10% volume increase in any other section was defined as resolution of myopic retinoschisis. The opposite casewas defined as an aggravation. @*Results@#We analyzed 17 eyes of 15 patients with high myopia. Six of 17 eyes (35.3%) showed a resolution of myopic retinoschisisat 6 months after using IOP-lowering eye drops. Of the 17 eyes, two (11.8%) experienced progression of myopicretinoschisis. Seven out of 14 eyes (50.0%) who were followed-up over 1 year showed resolution of myopic retinoschisis, andtwo eyes (14.3%) experienced progression of myopic retinoschisis. There was no macular hole development or posterior vitreousdetachment during the follow-up period in the seven eyes, and there was no significant correlation between the absolute valueof the initial IOP, axial length, IOP change, and degree of improvement of myopic retinoschisis. @*Conclusions@#The use of IOP-lowering eye drops on highly myopic eyes with retinoschisis showed a significant improvement ofmyopic retinoschisis, when compared to previous studies. These findings suggest the possibility of IOP-lowering eye drops delayingor improving the natural course of myopic retinoschisis.
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Background@#Post-cardiac arrest syndrome (PCAS) is one of the critical conditions which can result in a more serious brain injury. Early and accurate prognostication is crucial for deciding the patient’s therapeutic plan and setting the treatment goal. This study aimed to establish the prognostication values of quantitative electroencephalography (QEEG) in PCAS patients. @*Methods@#We recruited 183 PCAS patients treated with therapeutic hypothermia. Electroencephalography (EEG) data within 72 hours after cardiac arrest (CA) and clinical data were collected. QEEG analysis including power spectral density (PSD) and connectivity analysis of default mode network (DMN) with imaginary coherence were performed. @*Results@#There were significantly different patterns of PSD between neurologic good and poor outcome groups; absolute and relative power of the alpha 2 and beta 1 frequency (10-15 Hz) bands were increased in all brain regions of good outcome group. However, the relative power of the delta band and higher frequency bands over fast alpha (beta 3 and gamma bands over 20 Hz) were poor outcome markers. We found out that connectivity of DMN were significantly decreased in the poor outcome group compared with the good outcome group. @*Conclusions@#These findings suggest that QEEG analysis could quantify and automate the interpretation of EEG. Furthermore, they can improve the prognostic values for neurologic outcomes relatively accurately and objectively in PCAS patients treated with hypothermia compared with traditional visual grading.
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Background@#Tacrolimus, a calcineurin inhibitor, is an immunosuppressant used in post-transplantation maintenance therapy. The drug has a narrow therapeutic range and requires periodic therapeutic drug monitoring. Although many studies have reported the effects of intrapatient variability of tacrolimus on survival, rejection, and complications in renal transplant recipients, very few studies have reported these effects in liver transplant recipients. The purpose of this study was to evaluate the effect of intrapatient variability of tacrolimus on clinical outcomes after liver transplantation. @*Methods@#Intrapatient variability was calculated using individual, averaged tacrolimus concentrations. Patients were divided into two groups according to their median variability value:high-variability and low-variability groups. The rate of deviation from the therapeutic range, incidence of acute rejection, posttransplant diabetes, incidence of infection, and estimated glomerular filtration rate (eGFR) after transplantation were compared between the groups. @*Results@#Of the total patients (n=82), the high-variability group (n=41) exhibited significantly greater deviation from the therapeutic range (65.92% vs. 56.84%; p<0.001). There was no significant difference in acute rejection or posttransplantation diabetes incidence or eGFR; however, the number of infection in the first 6 months was significantly lower in the low-variability group (0.4 vs. 0.9 times; p=0.039). Multiple linear regression analysis showed that the number of infection significantly increased as intrapatient variability increased (p=0.015). @*Conclusion@#High intrapatient variability in tacrolimus concentrations was strongly associated with an increased frequency of deviation from the suggested therapeutic range and an increased number of infection.
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Background@#Tacrolimus, a calcineurin inhibitor, is an immunosuppressant used in post-transplantation maintenance therapy. The drug has a narrow therapeutic range and requires periodic therapeutic drug monitoring. Although many studies have reported the effects of intrapatient variability of tacrolimus on survival, rejection, and complications in renal transplant recipients, very few studies have reported these effects in liver transplant recipients. The purpose of this study was to evaluate the effect of intrapatient variability of tacrolimus on clinical outcomes after liver transplantation. @*Methods@#Intrapatient variability was calculated using individual, averaged tacrolimus concentrations. Patients were divided into two groups according to their median variability value:high-variability and low-variability groups. The rate of deviation from the therapeutic range, incidence of acute rejection, posttransplant diabetes, incidence of infection, and estimated glomerular filtration rate (eGFR) after transplantation were compared between the groups. @*Results@#Of the total patients (n=82), the high-variability group (n=41) exhibited significantly greater deviation from the therapeutic range (65.92% vs. 56.84%; p<0.001). There was no significant difference in acute rejection or posttransplantation diabetes incidence or eGFR; however, the number of infection in the first 6 months was significantly lower in the low-variability group (0.4 vs. 0.9 times; p=0.039). Multiple linear regression analysis showed that the number of infection significantly increased as intrapatient variability increased (p=0.015). @*Conclusion@#High intrapatient variability in tacrolimus concentrations was strongly associated with an increased frequency of deviation from the suggested therapeutic range and an increased number of infection.
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PURPOSE@#To evaluate the clinical outcomes of aspheric hydrophilic acrylic EYELIKE® (Koryo Eyetech Co., Seoul, Korea) intraocular lenses (IOLs).@*METHODS@#We conducted a retrospective study of 176 consecutive eyes of 160 patients who underwent cataract surgery with implantation of aspheric EYELIKE® IOLs. The following preoperative measurements were collected: slit-lamp examination, uncorrected distance visual acuity (UCDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), automatic and manual keratometry, fundus examination, corneal topography, and specular microscopy. The UCDVA, CDVA, IOP, refraction, and slit-lamp examination were evaluated postoperatively at 1 week and at 1, 3, and 6 months. Specular microscopy was also postoperatively conducted at 1 month.@*RESULTS@#At the 6-month postoperative visit, the mean UCDVA was 0.15 ± 0.23, and the mean CDVA was 0.03 ± 0.07 logarithm of minimal angle of resolution (logMAR). No statistically significant differences were observed among the four groups (postoperative 1 week, postoperative 1 month, postoperative 3 months, and postoperative 6 months) in the manifest spherical equivalent. In total, 74% of IOL Master700 and 54% of A-scan measurements were within ± 0.5 diopters (D) difference from the target refraction, and 95% and 77%, respectively, were within ± 1.0 D from the target refraction. With regard to complications, one case of CME and posterior capsule opacification with decreased visual acuity was detected at month 3 postoperatively; in this case, the CDVA recovered to 0 logMAR with conventional treatment and yttrium aluminium garnetlaser posterior capsulotomy after postoperative 6 months.@*CONCLUSIONS@#Domestically produced EYELIKE® IOLs had high refraction predictability and stability.
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OBJECTIVES: There is currently little research on dental hygienists' interest and need related to oral care. To perform elderly oral care effectively, dental hygienists must understand the features of aging in the elderly. The purpose of this study is to investigate how dental hygienists' interest affects oral care for the elderly.METHODS: 232 dental hygienists completed a self-reported questionnaire from March to April 2019. The questionnaires consisted of general characteristics of the subjects (6 items), elderly patient experience (11 items), and questions regarding aging (7 items). This study analyzed collected data by frequency analysis, ANOVA, Pearson correlation analysis, and multiple regression analysis.RESULTS: Correlation analysis between concern, need, and participation in elderly oral care showed a significant amount of correlation among all variables. We found that gender (P=0.022), education level (P=0.029), workplace type (P=0.002), and the proportion of future elderly patients were statistically significant (P=0.001) factors affecting the level of concern.CONCLUSIONS: The results of this study suggest that experience in treating and caring for the elderly are essential factors for raising the interest and understanding of oral health care for elderly patients. Therefore, we should consider the development of various programs to raise interest in oral health for the elderly.
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Idoso , Humanos , Envelhecimento , Higienistas Dentários , Educação , Saúde BucalRESUMO
PURPOSE: Epilepsy is the most common neurological disorder in childhood. Hospital nurses, who are the first to recognize seizures in epilepsy patients in the ward environment, possess expertise related to epilepsy and play a central role in epilepsy management. The purpose of this study was to develop an algorithm-based education program and to improve nurses' knowledge and self-efficacy related to providing nursing care to children with epilepsy. METHODS: The education program consisted of lectures on the definition, cause, classification, diagnosis, treatment, and nursing of epilepsy based on a booklet, as well as practice using an algorithm for nursing interventions when a child experiences a seizure. Twenty-seven nurses working at pediatric neurological wards and a pediatric emergency room participated in the education program. The data were analyzed using descriptive statistics and the paired t-test. RESULTS: Nurses' knowledge and self-efficacy showed a statistically significant improvement after participation in the education program on nursing care for children with epilepsy. CONCLUSION: The application of this education program for hospital setting is expected to improve nurses' capability to care for children with epilepsy, thereby contributing to a higher quality of nursing.
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Criança , Humanos , Classificação , Diagnóstico , Educação , Educação em Enfermagem , Serviço Hospitalar de Emergência , Epilepsia , Aula , Doenças do Sistema Nervoso , Cuidados de Enfermagem , Enfermagem , Folhetos , ConvulsõesRESUMO
OBJECTIVE: This study examined the efficacy of the white matter (WM) to gray matter (GM) signal intensity ratio (SIR) in predicting the clinical prognosis of cardiac arrest patients. METHODS: Thirty-one patients who were resuscitated from cardiac arrest and underwent brain magnetic resonance imaging (MRI) were investigated retrospectively. Thirty one subjects with normal brain MRI findings served as the controls. The signal intensities (SI) were measured on T2-weighted image (T2WI). The circular regions of measurement (2–10 mm²) were placed over the regions of interest, and the average signals in GM and WM were recorded in the caudate nucleus (CN), putamen, anterior limb of the internal capsule, corpus callosum (CC), and in the cortex and WM of the frontal lobe. Cerebral performance category (CPC) 1–2 were classified as a good prognosis, and CPC 3–5 were classified as a poor prognosis. RESULTS: Most combinations of the SIR of WM to GM and most SIs of GM, except the frontal cortex, were significantly different between the two groups. On the other hand, the SI of WM was insignificant between both groups. In receiver operating characteristic (ROC) curve analysis, the SIR of the CC to CN had an area under the ROC curve (AUROC) of 1.00 for a cut-off value of 1.59 (sensitivity, 100%; specificity, 100%), the SIR of the CC to putamen had also an AUROC of 1.00 for a cut-off value of 1.43 (sensitivity, 100%; specificity, 100%). CONCLUSION: The SIR of WM to GM measured on a T2WI is related to the neurological outcome after a cardiac arrest.
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Humanos , Encéfalo , Núcleo Caudado , Coma , Corpo Caloso , Extremidades , Lobo Frontal , Substância Cinzenta , Mãos , Parada Cardíaca , Cápsula Interna , Imageamento por Ressonância Magnética , Prognóstico , Putamen , Estudos Retrospectivos , Curva ROC , Sensibilidade e Especificidade , Substância BrancaRESUMO
BACKGROUND AND PURPOSE: To investigate whether appointing a full-time neurointensivist to manage a closed-type neurological intensive care unit (NRICU) improves the quality of critical care and patient outcomes. METHODS: This study included patients admitted to the NRICU at a university hospital in Seoul, Korea. Two time periods were defined according to the presence of a neurointensivist in the preexisting open-type NRICU: the before and after periods. Hospital medical records were queried and compared between these two time periods, as were the biannual satisfaction survey results for the families of patients. RESULTS: Of the 15,210 patients in the neurology department, 2,199 were admitted to the NRICU (n=995 and 1,204 during the before and after periods, respectively; p<0.001). The length of stay was shorter during the after than during the before period in both the NRICU (3 vs. 4 days; p<0.001) and the hospital overall (12.5 vs. 14.0 days; p<0.001). Neurological consultations (2,070 vs. 3,097; p<0.001) and intrahospital transfers from general intensive care units to the NRICU (21 vs. 40; p=0.111) increased from the before to after the period. The mean satisfaction scores of the families of the patients also increased, from 78.3 to 89.7. In a Cox proportional hazards model, appointing a neurointensivist did not result in a statistically significant change in 6-month mortality (hazard ratio, 0.82; 95% confidence interval, 0.652–1.031; p=0.089). CONCLUSIONS: Appointing a full-time neurointensivist to manage a closed-type NRICU had beneficial effects on quality indicators and patient outcomes.