Journal of Korean Academy of Nursing Administration (간호행정학회지)

Korean Academy of Nursing Administration (한국간호행정학회)
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Impact of Nurse Staffing Level and Oral Care on Hospital Acquired Pneumonia in Long-term Care Hospitals

요양병원의 간호인력 확보수준과 구강간호 실시여부가 노인 환자의 폐렴발생에 미치는 영향

  • Chae, Jung Mi (Health Insurance Review & Assessment Research Department) ;
  • Song, Hyunjong (Department of Health Policy and Management, Sangji University) ;
  • Kang, Gunseog (Department of Statistics and Actuarial Science, Soongsil University) ;
  • Lee, Ji Yun (Department of Nursing, Kangwon National University)
  • 채정미 (건강보험심사평가원) ;
  • 송현종 (상지대학교 의료경영학과) ;
  • 강근석 (숭실대학교 정보통계.보험수리학과) ;
  • 이지윤 (강원대학교 간호학과)
  • Received : 2014.10.20
  • Accepted : 2015.01.29
  • Published : 2015.03.31
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Abstract

Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.

Keywords

References

  1. Statistics Korea. Annual report on the causes of death statistics 2012. Daejeon: Statistics Korea; 2013.
  2. Attridge RT. Healthcare-associated pneumonia: Refining the HCAP criteria [Internet]. Texas: The University of Texas at Austin College of Pharmacy. 2009 [cited 2014. May 21]. Available from: http://www.utexas.edu/pharmacy/divisions/pharmaco/rounds/11-20-09.pdf
  3. Chae JM, Song HJ, Park CM, Kim YJ. Management of pneumonia and sepsis development of inpatients in long term care hospital. Health Insurance Review & Assessment Service, 2012, February. Report No:F8E-2012-19.
  4. Jung KS. Pneumonia in the elderly patients. The Korean Journal of Medicine. 2008;75(2):129-140.
  5. Fry AM, Shay DK, Holman RC, Cums AT, Anderson LJ. Trends in hospitalizations for pneumonia among persons aged 65 years or older in the United States, 1988-2002. JAMA. 2005;294 (21):2712-2719. http://dx.doi.org/10.1001/jama.294.21.2712
  6. Shanley C, O'Loughlin G. Dysphagia among nursing home residents: An assessment and management protocol. Journal of Gerontological Nursing. 2000;26(8):35-48. https://doi.org/10.3928/0098-9134-20000801-09
  7. El-Solh AA. Nursing home acquired pneumonia: Approach to management. Current Opinion in Infection Diseases. 2011;24 (1):148-151. http://dx.doi.org/10.1097/QCO.0b013e328343b6cc
  8. Abe S, Ishihara K, Adachib M, Okudaa K. Oral hygiene evaluation for effective oral care in preventing pneumonia in dentate elderly. Archives of Gerontology and Geriatrics. 2006;43 (1):53-64. http://dx.doi.org/10.1016/j.archger.2005.09.002
  9. Yoneyama T, Yoshida M, Matsui T, Sasaki H. Oral care and pneumonia. The Lancet. 1999;354(9177):515. http://dx.doi.org/10.1016/S0140-6736(05)75550-1
  10. Sjogren P, Nilsson E, Forsell M, Johansson O, Hoogstraate J. A systematic review of the preventive effect of oral hygiene on pneumonia and respiratory tract infection in elderly people in hospitals and nursing homes: Effect estimates and methodological quality of randomized controlled trials. Journal of American Geriatric Society. 2008;56:2124-2130. http://dx.doi.org/10.1111/j.1532-5415.2008.01926.x
  11. Unruh L. Licensed nurse staffing and adverse events in hospitals. Medical Care. 2003;41(1):142-152. http://dx.doi.org/10.1097/01.mlr.0000039835.19305.1d
  12. Needleman J, Buerhaus S, Mattke M, Stewart M, Zelevinsky K. Nurse-staffing levels and the quality of care of hospitals. The New England Journal of Medicine.2002;346(22):1715-1722. http://dx.doi.org/10.1056/NEJMsa012247
  13. Kovner C, Jones C, Zhan C, Gergen PJ, Basu J. Nurse staffing and postsurgical adverse events: An analysis of administrative data from a sample of U.S. hospitals, 1990-1996. Health Services Research;37(3):611-629. http://dx.doi.org/10.1111/1475-6773.00040
  14. Zimmerman S, Gruber-Baldini AL, Hebel JR, Sloane PD, Magaziner J. Nursing home facility risk factors for infection and hospitalization: Importance of registered nurse turnover, administration and social factors. Journal of American Geriatric Society. 2002;50:1987-1995. http://dx.doi.org/10.1046/j.1532-5415.2002.50610.x
  15. Kim YM, Cho SH, June KJ, Shin SA, Kim JY. Effect of hospital nurse staffing on in-hospital mortality, pneumonia, sepsis, and urinary tract infection in surgical patients. Journal of Korean Academy of Nursing. 2012;42(5):719-729. http://dx.doi.org/10.4040/jkan.2012.42.5.719
  16. Donabedian A. The quality of care: How can it be assessed? The Journal of the American Medical Association. 1988;260 (12):1743-1748. http://dx.doi.org/10.1001/jama.1988.03410120089033
  17. Spilsbury K, Hewitt C, Stirk L, Bowman C. The relationship between nurse staffing and quality of care in nursing homes: A systematic review. International Journal of Nursing Studies. 2011;48:732-750. http://dx.doi.org/10.1016/j.ijnurstu.2011.02.014
  18. Bostick JE, Rantz MJ, Flesner MK, Riggs CJ. Systematic review of studies of staffing and quality in nursing homes. Journal of American Medical Directors Association. 2006;7:366-376. http://dx.doi.org/10.1016/j-jamda.2006.01.024
  19. Castle NG, Anderson RA. Caregiver staffing in nursing homes and their influence on quality of care using dynamic panel estimation methods. Medical Care. 2011;49(6):545-552. http://dx.doi.org/10.1097/MLR.0b013e31820fbca9
  20. Arling G, Kane RL, Mueller C, Bershadsky J, Degenholtz HB. Nursing effort and quality of care for nursing home residents. The Gerontologist. 2007;47(5):672-682. http://dx.doi.org/10.1093/geront/47.5.672
  21. Zhang X, Grabowski DC. Nursing home staffing and quality under the nursing home reform act. The Gerontologist. 2004; 44(1):13-23. http://dx.doi.org/10.1093/geront/44.1.13
  22. Lee JY, Kim EY, Cho E. Factors impacting the physical function of older adults in Korean long-tern care hospitals. Journal of Korean Academy of Nursing. 2011;41(6):780-787. http://dx.doi.org/10.4040/jkan.2011.41.6.780
  23. Yoon JY, Lee JY, Bowers BJ, Zimmerman DR. The impact of organizational factors on the urinary incontinence care quality in long-term care hospitals: A longitudinal correlational study. International Journal of Nursing Studies. 2012;49:1544-1551. http://dx.doi.org/10.1016/j.ijnurstu.2012.07.011
  24. Kim YA, Lee JY, Kim HS, Hwang JH. A comparison of nursing problems identified through RAI-FC and by nurses caring for nursing home residents. Journal of Korean Gerontological Nursing. 2011;13(1):58-68.
  25. Bates-Jensen BM, Schnelle JF, Alessi CA, Al-Samarrai NR, Levy-Storms L. The effect of staffing on in-bed times and nursing home residents. Journal of the American Geriatrics Society. 2004;52:931-938. http://dx.doi.org/10.1111/j.1532-5415.2004.52260.x

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