title: Nursing home nurses conceptualize how to care for residents with cardiac vulnerability.
abstract: With ageing, older people face cardiovascular problems as the major cause of disability and death. Although immediate medical attention is a major factor in determining outcomes of cardiac problems, lack of personnel (i.e. registered nurse, certified nursing assistant and home care aide) in nursing homes without residing doctor limits the awareness of such problems, thus making it difficult to initiate timely and appropriate intervention.
  
  
  
  The aim of this study was to conceptualize critical care for nursing home residents with cardiac vulnerability and develop practical knowledge in nursing practice.
  
  
  
  Conventional content analysis was performed on date from interviews with 30 nurses from 10 nursing homes in South Korea between July and November 2010.
  
  
  
  The analysis revealed three major cardiac problems resulting from residents' cardiac vulnerability: angina, myocardial infarction (MI) and cardiogenic shock. Through content analysis, we extracted 6 themes and 21 subthemes for nurses' conceptualization of critical care for nursing home residents with cardiac vulnerability. In nursing homes without a residing doctor, nurses assessed the physical, functional and cognitive conditions along with the responses and symptoms of residents when emergency situations related to the cardiac problems occurred. Moreover, with a lack of infrastructures of a hospital, nurses provided critical care to the elderly by using personal practice strategies based on their personal experience in facilities along with practical knowledge of nurses while following the management principles of emergencies.
  
  
  
  We found that nurses conceptualized critical nursing care for cardiac problems at nursing homes, which are different from those of general hospitals. The results of this study will provide basis for the development of care guidelines and educational materials that can be used by novice nurses or nursing students.
authors: College of Nursing, Korea University, Seoul, Republic of Korea.
authors: Mi So
authors: MS
authors: Kim
authors: College of Nursing, Korea University, Seoul, Republic of Korea.
authors: Hyun Ju
authors: HJ
authors: Kim
authors: Operation Room, Korea University Anam Hospital, Seoul, Republic of Korea.
authors: Jung Eun
authors: JE
authors: Choi
authors: Baekseok Culture University College of Nursing, Cheonan, Republic of Korea.
authors: Su Jin
authors: SJ
authors: Kim
authors: College of Nursing, Korea University, Seoul, Republic of Korea.
authors: Sung Ok
authors: SO
authors: Chang
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000175:diagnosis / Q000401:mortality / Q000451:nursing; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000401:mortality / Q000451:nursing*; D002423:Cause of Death; D003422:Critical Care / Q000379:methods*; D064648:Critical Care Nursing / Q000458:organization & administration*; D006707:Homes for the Aged / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000451:nursing; D009735:Nursing Homes / Q000458:organization & administration*; D036301:Qualitative Research; D056910:Republic of Korea; D018570:Risk Assessment; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000401:mortality / Q000451:nursing; D016019:Survival Analysis; D035862:Vulnerable Populations / Q000523:psychology*
keywords: Cardiovascular disease; Critical care nursing; Emergency care; Nursing homes; Older adults; Qualitative research