• Title, Summary, Keyword: Patient Classification System

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The Development of patient classification system for hemodialysis (혈액투석환자 중증도 분류체계 개발)

  • Kim, Moon-Sil;Yoon, Ji-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.4
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    • pp.633-643
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    • 2002
  • Purpose : This study was conducted to develop a patient classification system for hemodialysis and to test its validity and reliability. Method : The process of the system development was as below. The lists of hemodialysis nursing activities were collected from literature and hemodialysis practice guideline and they were classified into 10 factors and 16 elements. And then, 4 classification levels were identified for each element. The content validity and interrater reliability of developed patient classification system were tested. Result & Conclusion : 10 factors of patient classification system for hemodialysis were consisted of psychosocial support, mobility, access, teaching, assessment, stability, supportive therapy, test, general nursing during hemodialysis, hemodialysis room management. According to validity and reliability results and experts' opinions, 4 classification levels revised to 3 classification levels and 2 elements were deleted. Finally, patient classification system were consisted of 10 factors, 14 elements, 3 classification levels, 3 categories.

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Development of patient classification tool using the computerizing system (환자 분류도구 전산 개발;간호활동 중심으로)

  • Kang, Myung-Ja;Kim, Jeoung-Hwa;Kim, Young-Shil;Park, Hung-Suk;Lee, Hae-Jung
    • Journal of Korean Academy of Nursing Administration
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    • v.7 no.1
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    • pp.15-23
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    • 2001
  • This study was a methodological research to develop computerized patient classification system. The subjects of this investigation were 435 inpatients except redundant data and outliers in P University Hospital from January 18, 2000 to January 24, 2000. The data was analyzed by discrimination analysis and adopted discriminant variables were 1) sum of frequency for the nursing activities, 2) the number of nursing activities that do not need to consider intensity of the activities, and 3) total hours of nursing activities that need to consider their intensities. Discriminant function developed by this study classified the patients into 4 groups; class I, 251 ; class II, 125 ; class III, 39 ; class IV, 20. The Hit ratio was 89.23. Based on this study, following suggestions can be made for the future research 1. Inclusive patient classification system, which includes more expanded direct nursing care factors, need to be developed and examined. 2. This developed classification system can be utilized to evaluate patient distribution and to estimate adequate numbers of nursing staffs in each nursing unit.

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Development of KPCS(Korean Patient Classification System for Nurses) Based on Nursing Needs (간호요구 정도에 기초한 한국형 환자분류도구(KPCS)의 개발)

  • Song, Kyung Ja;Kim, Eun Hye;Yoo, Cheong Suk;Park, Hae Ok;Park, Kwang Ok
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.1
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    • pp.5-17
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    • 2009
  • Purpose: This study was to develop a factor-type patient classification system for general nursing unit based on nursing needs (KPCS; Korean patient classification system for nurses). Method: We reviewed workload management system for nurses(WMSN) of Walter Reed Medical Center, Korean patient classification system for ICU, and nursing activities in nursing records and developed the first version of KPCS. The final version KPCS was evaluated via validity and reliability verifications based on panel discussions and data from 800 patient classifications. Content validity was performed by Delphi method and concurrent validity was verified by the correlation of two tools (r=.71). Construct validity was also tested by medical department (p<.001), patient type (p<.001), and nurse intuition (p<.001). These verifications were performed from April to October, 2008. Results: The KPCS has 75 items in classifying 50 nursing activities, and categorized into 12 different nursing area (measuring vital sign, monitoring, respiratory treatment, hygiene, diet, excretion, movement, examination, medication, treatment, special treatment, and education/emotional support). Conclusion: The findings of the study showed sound reliability and validity of KPCS based on nursing needs. Further study is mandated to refine the system and to develop index score to estimate the necessary number of nurses for adequate care.

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A Study for Formulating Criteria of Patient Classification System Based OR the Analysis of Direct Nursing Activities (직접 간호활동 분석을 기초로 한 환자분류체계의 기준 설정을 위한 연구)

  • 김조자;박지원
    • Journal of Korean Academy of Nursing
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    • v.17 no.1
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    • pp.9-23
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    • 1987
  • Nursing service, as the largest user of labor resources, has become concerned about appropriate allocation of staffing resources. Therefore, this project was designed to measure quantitatively the direct nursing care provided to patients and to develop a new patient classification system based on the direct nursing care activities. The initial step in the development of the classification instrument was to identify the content of direct nursing activities. The frequency with which these activities were carried out, the total time spent in carrying them out and the average time for one performance of each of the nursing activities was calculated. The next step was to select the items for the classification instrument taking into account these direct nursing activities. A list of 40 items was prepared. These items were then classified into 8 major categories: personal hygiene, moving & exercise, nutrition & elimination, observation, medication, treatment, collecting specimens and other care activities for severity ill patients. Each item was assigned a value unit based on the average time required by the nursing staff to complete the specific item. The third step was to determine the practicality of the items and value units, so an attempt was made to establish content validity for these items and units by obtaing a consensus from 8 head nurses, representing eight different departments. The 4th step was to conducted a pilot study to establish the score range for the classification boundaries. For this purpose an instrument was designed using the list of items and value units and a prepared classification criteria as a guideline to validate the patient classification. A judgment group consisting of 52 supervisory nurses and head nurses were asked to select the proper patient to fit each classification criteria and to fill out the instrument for each patient. The total value unit and the frequency for each classification group was calculated. According to the frequency distribution, the score range for the classification group was determined as follows : 0~15 for groupI, 16~30 for group II, 31~50 for group III, and above 51 for group IV. Finally a patient classification form was developed.

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A Study on the Validity Test of Patient Classification System for Optimal Nursing Manpower of Hospital in China (중국 일 종합병원에서 적정 간호인력 추정을 위한 환자분류체계의 타당성 검증)

  • Song, Young-Sun;Lee, Dong-Mei
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.2
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    • pp.209-218
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    • 2005
  • Purpose: This study was to setup the basis on hospital and national nursing manpower estimation accurately according to apply patient classification system of Song's study to China hospital system. Method: This study was surveyed to 964 patients at surgical and medical ward on Yanbian University Hospital in China from 17th to 31th January, 2005. Results: There was study results to test hypotheses for estimating optimal nursing manpower as follows. First, a trimodel classification scheme was developed which suggested three categories of patients as minimal care(category 1), moderate care(category 2), intensive care(category 3). Second, there was not significant difference with nursing time by sex. Third, there was not significant difference with nursing time by medical wards. Fourth, there was not significant difference with average nursing care time for each category of patients. Category 1 was estimated to spend average 19.59minutes for patients, Category 2 was about 35.68 minutes, Category 3 was 72.07minutes respectively. Total nursing hours was 62,610 minutes. Conclusion: Patient classification system of Song's study is validity for optimal nursing manpower of hospital in China.

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Development of Patient Classification System based on Nursing Intensity in Stroke Unit (뇌졸중 전문치료실의 간호강도에 근거한 환자분류도구 개발)

  • Kim, Eunjung;Kim, Heejung;Kim, Miyoung
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.5
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    • pp.545-557
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    • 2014
  • Purpose: The purpose of this study was to develop a patient classification system based on nursing care intensity for patients with acute stroke-related symptoms and verify its validity and reliability. Methods: Data were collected between November, 2013 and February, 2014. The verification for content validity of the patient classification system was conducted by a group of seven professionals. Both interrater reliability and concurrent validity were verified at stroke units in tertiary hospitals. Results: The intensive nursing care for acute stroke patients consisted of 14 classified domains and 56 classified contents by adding 'neurological assessment and observation' and 'respiratory care': 'hygiene', 'nutrition', 'elimination', 'mobility and exercise', 'education or counselling', 'emotional support', 'communication', 'treatment and examination', 'medication', 'assessment and observation', 'neurological assessment and observation', 'respiratory care', 'coordination between departments', and 'discharge or transfer care'. Each domain was classified into four levels such as Class I, Class II, Class III, and Class IV. Conclusion: The results show that this patient classification system has satisfactory validity for content and concurrent and verified reliability and can be used to accurately estimate the demand for nursing care for patients in stroke units.

Evaluating Nursing Needs in the Neonatal Intensive Care Unit with the Korean Patient Classification System for Neonatal Intensive Care Nurses (한국형 신생아중환자간호 분류도구를 이용한 간호요구도 평가)

  • An, Hyo nam;Ahn, Sukhee
    • Journal of Korean Critical Care Nursing
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    • v.13 no.2
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    • pp.24-35
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    • 2020
  • Purpose : This study aimed to determine whether the Korean Patient Classification System for Neonatal Care Nurses (KPCSN) properly measures neonatal intensive care needs and to compare the scale's results with those of the Workload Management System for Critical Care Nurses (WMSCN). Methods : Data were collected from the medical records of 157 patients who were admitted to the NICU of a university hospital, in D city. Two types of patient classification systems were applied to investigate the total points and distributions to investigate the total points and distributions by categories and compare relationships and classification groups between two scales. Finally, the score distribution among the classification groups was analyzed when the KPCSN was applied. Results : Scores on the KPCSN for the feeding, monitoring, and measure categories were 19.16±15.40, 16.88±3.52, and 9.13±4.78, respectively. Classification group distribution of the KPCSN was as follows : 1.9% for the first group, 24.2% for the second group, 58% for the third group, and 15.9% for the fourth group. The classification group distribution of the WMSCN was as follows: 35.7% for the third group, 61.1% for the fourth group, and 3.2% for the fifth group. Finally, the scores by categories were analyzed according to KPCSN classification group, and the characteristics of the patients' nursing needs were identified for each classification group. Conclusion : Results of this study indicate that the KPCSN effectively measures feeding needs, which account for many nursing activities in neonatal intensive care. Comparisons between the KPCSN and WMSCN classification group scores and distribution ratios verified the correlation and significance of nursing requirements.

A Study on the Classification of ICU Patients by K-DRG and the Nursing Care Hours and Costs of Craniotomy Patients (중환자실에서의 K-DRG 분류와 개두술환자군의 간호시간과 간호원가연구)

  • Cho, Jung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.229-246
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    • 1998
  • This dissertation classifies sample patients by a measure of K-DRG to identify the most frequent group. and investigates the differences in the dependency of nursing by patient classification system in the SICU of Seoul National University Hospital in Korea. It also calculates the mean nursing care hours and costs per craniotomy patient, who is shown to be the most frequent patient group. The results of the research can be used as basic data for the development of relevant nursing cost system in the future. The results of the research are as follows: 1. Using data from 97 sample patients, as many as 26 groups are identified when the patients are classified by K-DRG. KDRG-001 (craniotomy) is found to be the most frequent group(43.30%). 2. The result from patient classification system grouping in craniotomy patients shows homogeneity in terms of dependency of nursing with 35 patients in the 4th group, 145 patients(74.36%) are in the 5th group. and 15 patients are in the 6th group among the total 195 sample patients. 3. The direct nursing care hours for the 4th, 5th, and 6th patient classification system groups are found to be 381 minuites. 483 minuites, and 519 minuites, respectively, which shows that the nursing care hours increases as the dependency of nursing is intensified. The indirect nursing care hours are found to be 454 minuites(7.57 hours). The total mean nursing care hours, which is the sum of the direct nursing care hours(467 min.: 7.78 hours) and the indirect nursing care hours (454 min.: 7.57 hours), is 921 minuites(15.35 hours) per patient a day. 4. The nursing care cost is calculated to be 123,297 won per patient a day. Considering the average duration in the ICU, we can find the total nursing care cost is 610,318 won.

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Estimation of nursing cost for selected special nursing services;operative nursing, emergency nursing, and ambulatory nursing (임상특수분야 간호원가 산정;응급실, 수술실, 외래를 중심으로)

  • Park, Jung-Ho;Sung, Young-Hee;Kim, Eul-Soon;Park, Kwang-Ok;Park, Jung-Sook;Sung, Il-Soon;Song, Mi-Sook;Cho, Moon-Soo
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.2
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    • pp.309-321
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    • 2002
  • Purpose: A cost analysis for nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing unit was performed using patient classification system by nursing intensity in order to determine an appropriate nursing fee schedule. Method: The data were collected from 4 secondary hospitals and 5 tertiary hospitals from November 14th 2000 to January 15th 2001. The study was conducted through four phases as follows: 1) Nursing hours of each nursing service in special nursing units were measured using three kinds of patient classification systems by nursing intensity. 2) The nursing cost of nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing units was estimated based on patient classification system by nursing intensity. Results: As a result, nursing hours by nursing intensity of each special nursing unit were measured, and every nursing cost by nursing intensity in operation room and emergency room was estimated, meanwhile, the cost of nursing services in ambulatory care units was estimated only per visit as shown in chapter 4. Conclusion: Future research on nursing cost should be extended to other special nursing units such as various intensive nursing care units, delivery room, and so on. In addition, the patient classification system should be refined for its appropriateness to apply all levels of medical institutions.

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