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A Time Study of Nursing Activities by Home Care Nurses for Non-Cancer Terminal Patients

가정전문간호사의 비암성 말기환자 간호행위 시간 분석

  • Lee, Hanul (Department of Nursing, College of Nursing, The Catholic University of Korea) ;
  • Lee, Jong-Eun (Department of Nursing, College of Nursing, The Catholic University of Korea)
  • Received : 2019.06.17
  • Accepted : 2019.07.19
  • Published : 2019.08.30

Abstract

Purpose: To investigate the duration of each nursing activity performed by home care nurses for non-cancer patients and the relationship between patients' palliative prognostic index (PPI) and duration of each nursing activity. Methods: Nursing activities performed for six non-cancer terminal patients were timed using a stopwatch, and 18 parameters were measured by visiting each patient thrice. The mean and standard deviations of duration for each category of nursing activities were computed. The relationship between category-specific duration of nursing activities and PPI was analyzed with Spearman's correlation and multiple regression analysis. Results: Among nursing activities, the highest greatest duration of time was spent on traffic time (11.91 min), followed by urinary catheter management (10.65 min) and insertion and management of nasogastric tube (9.03 min). In terms of nursing categories, after excluding movement time, the greatest duration of time was spent on excretion care (5.48 min), nutrition care (5.40 min), and medication (3.82 min). PPI correlated with hygiene care, excretion care, and patient and information management. Multiple regression analysis revealed that PPI increased with increasing duration of hygiene care. Conclusion: These study findings provide grounds for the increased nursing time of hygiene care for people reaching the end of life.

Acknowledgement

Supported by : 한국보건산업진흥원

References

  1. Statistics Korea. Causes of Death Statistics in 2017 [Internet]. Seoul: Statistics Korea; 2017 [cited 2019 June 6]. Available from: http://kostat.go.kr/
  2. Ranmuthugala G, Nepal B, Brown L, Percival R. Impact of home based long term care on informal carers. Australian Family Physician. 2009;38(8):618-620.
  3. National Health Insurance. Long-Term Care Insurance Korea [Internet]. Wonju; National Health Insurance; [cited 2019 June 6]. Available from: http://www.longtermcare.or.kr/npbs/e/e/100/index.web
  4. Song CR, Lee MK, Hwang MS, Yoon YM. The current state of hospital-based home care services in Korea: Analysis of data on insurance claims for home care from 2007 to 2012. Journal of Korean Academic Society of Home Health Care Nursing. 2014;21(2):127-138.
  5. Ikezaki S, Ikegami N. Predictors of dying at home for patients receiving nursing services in Japan: A retrospective study comparing cancer and non-cancer deaths. BMC Palliative Care. 2011;10:3. https://doi.org/10.1186/1472-684x-10-3 https://doi.org/10.1186/1472-684X-10-3
  6. Lau KS, Tse DM, Tsan Chen TW, Lam PT, Lam WM, Chan KS. Comparing noncancer and cancer deaths in Hong Kong: a retrospective review. Journal of Pain and Symptom Management. 2010;40(5):704-714. https://doi.org/10.1016/j.jpainsymman.2010.02.023 https://doi.org/10.1016/j.jpainsymman.2010.02.023
  7. Jung KA, Han SJ. Home health care nursing service satisfaction and needs in cancer patients. Journal of Korean Academic Society of Home Health Care Nursing. 2012;19(2):139-149.
  8. Lee JE, Kim SL. Physical and psychospiritual care need by end-of-life stages among non-cancer patient at home: Based on the importance and difficulty of care need. Journal of Korean Academy of Community Health Nursing. 2012;23(2):127-133. https://doi.org/10.12799/jkachn.2012.23.2.127
  9. Burt J, Shipman C, Richardson A, Ream E, Addington-Hall J. The experiences of older adults in the community dying from cancer and non-cancer causes: a national survey of bereaved relatives. Age and Ageing. 2010;39(1):86-91. https://doi.org/10.1093/ageing/afp212 https://doi.org/10.1093/ageing/afp212
  10. Dy S, Lynn, J. Getting services right for those sick enough to die. BMJ. 2007;334:511-513. https://doi.org/10.1136/bmj.39127.653704.80 https://doi.org/10.1136/bmj.39127.653704.80
  11. Taylor FW. The principles of scientific management. New York and London: Harper & Brothers Publishers; 1914.
  12. Lopetegui M, Yen PY, Lai A, Jeffries J, Embi P, Payne P. Time motion studies in healthcare: what are we talking about? Journal of Biomedical Informatics. 2014;49:292-299. https://doi.org/10.1016/j.jbi.2014.02.017 https://doi.org/10.1016/j.jbi.2014.02.017
  13. Cho SH, Song KJ, Park IS, Kim YH, Kim MS, Gong DH, et al. Development of staffing levels for nursing personnel to provide inpatients with integrated nursing care. The Journal of Korean Nursing Administration Academic Society. 2017;23(2):211-222. https://doi.org/10.11111/jkana.2017.23.2.211
  14. Hwang MS, Lee SJ, Lim NY, Lee MK. Job descriptions of hospital based home care nurse practitioners in Korea by DACUM technique. Journal of Korean Academic Society of Home Health Care Nursing. 2011;18(1):48-57.
  15. Yong J. Analysis of clinical nursing activities using home hospice nursing intervention standards. Journal of Korean Academy of Adult Nursing. 2008;20(6):960-972.
  16. Lee TW, Sung YH, Choe WS, Hwang NM, Park HO, Hwang MS, et al. A study on estimating the nursing cost of home hospice care. The Journal of Korean Nursing Administration Academic Society. 2008;14(2):182-195.
  17. Kim EK, Kim YM, Kim MA. Estimation of nursing costs based on nurse visit time for long-term care servies. Journal of Korean Academy of Nursing. 2010;40(3):349-358. https://doi.org/10.4040/jkan.2010.40.3.349 https://doi.org/10.4040/jkan.2010.40.3.349
  18. Lee SM, Kim SJ, Choi YS, Heo DS, Baik S, Choi BM, et al. Consensus guidelines for the definition of the end stage of disease and last days of life and criteria for medical judgment. Journal of Korean Medical Association. 2018;61(8):509-521. https://doi.org/10.5124/jkma.2018.61.8.509 https://doi.org/10.5124/jkma.2018.61.8.509
  19. Jang JS. A study on home care nurse's activities for cancer patients: comparison to home care and home hospice care [master's thesis]. Seoul: The Catholic University of Korea; 2014.
  20. Doherty-King B, Yoon JY, Pecanac K, Brown R, Mahoney J, Frequency and duration of nursing care related to older patient mobility. Journal of Nursing Scholarship. 2014;46(1):20-27. https://doi.org/10.1111/jnu.12047 https://doi.org/10.1111/jnu.12047
  21. Cicchetti DV. Guidelines, criteria, and rules of thumb for evaluating normed and standardized assessment instruments in psychology. Psychological Assessment. 1994;6(4):284-290. https://doi.org/10.1037/1040-3590.6.4.284 https://doi.org/10.1037/1040-3590.6.4.284
  22. Liu Y, Su L, Wang Y, Liu S, Dong B. The application of the palliative prognostic index in predicting the life expectancy of patients in palliative care: a systematic review and meta-analysis. Aging Clinical and Experimental Research. 2018;30(12):1417-1428. https://doi.org/10.1007/s40520-018-0928-7 https://doi.org/10.1007/s40520-018-0928-7
  23. Morita T, Tsunoda J, Inoue S, Chihara S. The Palliative Prognostic Index: a scoring system for survival prediction of terminally ill cancer patients. Supportive Care in Cancer. 1999;7(3):128-133. https://doi.org/10.1007/s005200050242
  24. Hair JF, Black WC, Babin BJ, Anderson RE, Tatham RL. Multivariate data analysis. 5th ed. Upper Saddle River, New Jersey: Prentice Hall; 1998.
  25. Chatterjee S, Hadi AS. Regression analysis by example. 4th ed. New Jersey: John Wiley & Sons; 2006.
  26. Stiel S, Heckel M, Seifert A, Frauendorf T, Hanke RM, Ostgathe C. Comparison of terminally ill cancer- vs. non-cancer patients in specialized palliative home care in Germany - a single service analysis. BMC Palliative Care. 2015;14:34. https://doi.org/10.1186/s12904-015-0033-z https://doi.org/10.1186/s12904-015-0033-z
  27. Lee J, Park Y, Lim K, Lee A, Lee H, Lee JE. Care needs of patients at the end of life with a noncancer diagnosis who live at home. Journal of Nursing Research. 2019;27(2):e10. https://doi.org/10.1097/jnr.0000000000000277 https://doi.org/10.1097/jnr.0000000000000277
  28. Koh SJ, Lee KS, Hong YS, Yoo YS, Park HJ. Clinical change of terminally ill cancer patients at the end-of-life time. The Korean Journal of Hospice and Palliative Care. 2008;11(2):99-105.
  29. Mitchell SL, Kiely DK, Hamel MB. Dying with advanced dementia in the nursing home. Archives of Internal Medicine. 2004;164(3):321-326. https://doi.org/10.1001/archinte.164.3.321 https://doi.org/10.1001/archinte.164.3.321
  30. Martinsson L, Heedman PA, Lundstrom S, Axelsson B, Improved data validity in the Swedish Register of Palliative Care. PLoS One. 2017;12(10):e0186804. https://doi.org/10.1371/journal.pone.0186804 https://doi.org/10.1371/journal.pone.0186804