• 제목/요약/키워드: Admission Care

검색결과 722건 처리시간 0.032초

입원 시 상병의 수집 및 활용에 관한 보건의료정보관리사의 관점: 질적 연구 (Perceptions of Hospital Health Information Managers Regarding Present on Admission Indicators in Korea: A Qualitative Study)

  • 표지희;최은영;오혜미;이원;김주영;옥민수;김소윤;이상일
    • 한국의료질향상학회지
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    • 제26권1호
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    • pp.23-34
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    • 2020
  • Purpose: This qualitative study was conducted to examine the current status and problems concerning the collection of present on admission (POA) indicators and determine how to use these indicators for evaluating the quality of care and degree of patient safety. Methods: A total of 11 health information managers were divided into two groups according to the size of their hospitals. Two focus group discussions (FGDs) were conducted, one for each group, which followed a pre-developed semi-structured guideline. The verbatim transcriptions of the FGDs were analyzed. Results: The majority of participants were concerned about entering POA flags honestly because they did not know how future POA indicators would be used. In particular, for some participants, POA N was a burden that could imply a signal of mismanagement within the medical institution. In addition, the lack of awareness and indifference of physicians regarding POA indicators were some of the difficulties for POA flag entry. Although medical institutions are making efforts to improve the accuracy of POA flagging, many participants mentioned the need to develop real case-oriented POA entry guidelines to improve the accuracy of POA flagging. Conclusion: To increase the validity of POA indicators, it is necessary to increase the level of awareness of POA indicators in physicians and other medical professionals. Furthermore, efforts related to POA indicators by individual medical institutions need to be reflected in the process evaluation.

제주도 주민의 소득계층에 따른 암 입원 의료이용의 차이 (A Difference in Utilization of Cancer Inpatient Services by Income Class of Residents in Jeju Island)

  • 김철웅;이상이;홍성철
    • 보건행정학회지
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    • 제13권3호
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    • pp.104-128
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    • 2003
  • Equity in health care has taken priority in the Korean government's policy agenda after the government-led national health insurance achieved universal coverage in 1989 along with the final inclusion of the self-employed as beneficiary. The purpose of this study is to examine the extent to which there exists difference or inequality in the utilization of health care, especially cancer inpatient services among income classes. We analysed the utilization of cancer inpatient services of residents in Jeju Island for a year of 2000, using the national health insurance data for qualification of beneficiaries and utilization of health care. The independent variable are 10 income classes based on the national health insurance fee imposed on each household for a year of 2000. The dependent variables of this study are an amount of cancer inpatient health care utilization measured by cancer admission days and cancer treatment costs. Also, cancer inpatient health care utilization is analysed by three categories divided into utilization in medical care institutions (1) within Jeju Island, (2) outside Jeju Island, and (3) all within and outside Jeju Island. We measured concentration index of cancer inpatient health care utilization. This analysis showed negative concentration index within Jeju Island and positive outside Jeju Island, and positive in all within and outside Jeju Island. This results suggest inequality against the relatively poor income groups in utilization of cancer inpatient health care services. Especially, inequity of cancer inpatient health care would be more serious in Jeju Island of Korea, considering that lower income groups reportedly have higher incidence rates in most of cancer and thus use more health services.

Perioperative Comprehensive Supportive Care Interventions for Chinese Patients with Esophageal Carcinoma: a Prospective Study

  • Zhang, Xiao-Dan;Zhao, Qing-Yu;Fang, Yi;Chen, Guan-Xuan;Zhang, Hui-Fang;Zhang, Wen-Xiao;Yang, Xiao-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권12호
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    • pp.7359-7366
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    • 2013
  • Objective: To assess the effects of perioperative comprehensive supportive care interventions on outcome of Chinese esophageal cancer patients in a prospective study. Methods: 60 patients with primary esophageal carcinoma were randomized into an intervention group (IG, n=31) and a control group (CG, n=29). The Chinese version of symptom checklist-90 (SCL-90) was adopted to assess their psychological status. The interventions, including health education, psychological support, stress management, coping strategies and behavior training, were carried out in 3 phases (preoperative, postoperative I and postoperative II), and psychological effects were thereafter evaluated accordingly before surgery, and 1 week, 4 weeks and 24 weeks post-surgery. Medical costs were estimated at discharge. Survival of patients was estimated each year post-surgery. General health status and satisfaction-with-hospital were surveyed by a follow-up questionnaire 4 years post-surgery. Results: All the subjects demonstrated higher scores in the preoperative phase than the normal range of Chinese population concerning 7 psychological domains including somatization, obsessive-compulsive, depression, anxiety, hostility, phobic anxiety and paranoid ideation. Although no significant difference was observed between the two groups at admission, the scores of IG, which tended to decrease at a faster rate, were generally lower than those of CG at weeks 1, 4 and 24 post-surgery. The length of hospital stay and medical costs of IG were significantly less than those of CG and satisfaction-with-hospital was better. However, there was no significant difference in 4-year survival or health status between two groups. Conclusions: Appropriate perioperative comprehensive supportive care interventions help to improve the psychological state of Chinese patients with esophageal carcinoma, to reduce health care costs and to promote satisfaction of patients and their families with hospital.

21세기 신생아 전문 간호사의 역할과 전망 (The role of the Neonatal Nurse Specialist in 21st Century)

  • 이자형
    • 부모자녀건강학회지
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    • 제3권2호
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    • pp.81-93
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    • 2000
  • The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.

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간호·간병 통합서비스 병동 간호사의 역할 모호성 개념분석 (Role Ambiguity of Comprehensive Nursing Care Unit Nurses: A Concept Analysis)

  • 이지선;김윤아;문세미;정은영;박하영
    • 보건행정학회지
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    • 제29권4호
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    • pp.502-512
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    • 2019
  • Background: The purpose of this study was to identify role ambiguity of comprehensive nursing care unit nurses. Methods: A concept analysis method by Walker and Avant was used to understand role ambiguity of comprehensive nursing care unit nurses. Results: The antecedents of role ambiguity of nurses at comprehensive nursing units were shortage of nurses, unclear admission criteria, and demands for customized nursing care according to severity. Attributes include ambiguity in role delegation, patient placement ambiguity, and professional ambiguity among nursing staff. The consequences were diminished job satisfaction due to excessive workload, difficulty in resolving role ambiguity due to the lack of work analysis studies, and poor outcome of nursing indicators. Conclusion: Improvement of nationwide awareness for comprehensive nursing care unit is required. Clear division at scope of practice for nursing staff in accordance of each medical institution's characteristics is essential. Nurses at comprehensive nursing care unit should understand nature of role ambiguity that occurs as they work in large groups. Nurses should promote communications between nursing staff and they must have volition to improve status quo. An additional research of comprehensive nursing care on the causes of role ambiguity in the practice of nursing care for ward nurses is needed, and management measures should be sought at the organizational level.

중환자실 환자의 집중치료 경험 및 관련 요인: 이차분석 연구 (Intensive Care Experience of Critical Care Patients and Its Related Factors : A Secondary Analysis Study)

  • 강지연;우효정
    • 중환자간호학회지
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    • 제16권3호
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    • pp.11-23
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    • 2023
  • Purpose : This study investigates the experiences of patients in intensive care units (ICUs), and the factors influencing these experiences. Method : We used a cross-sectional survey design to analyze previously collected cohort data from 891 patients who spent over 24 hours in 19 ICUs across four university hospitals in Busan, South Korea between June 2019 and July 2020. Within a week of ICU discharge, participants completed the Korean version of the Intensive Care Experience Questionnaire, covering four areas: "awareness of surroundings," "frightening experiences," "satisfaction with care," and "recall of experiences." We used multiple linear regression to identify factors associated with the ICU experience. Results : Low income (𝛽 = -.08, p = .016), unplanned hospitalization (𝛽 = -.09, p = .006), sedation (𝛽 = -.16, p < .001), and delirium (𝛽 = -.15, p < .001) reduce patients' awareness of their surroundings. Frightening experiences are associated with being female (𝛽 = -.07, p = .027), experiencing delirium(𝛽= -.15, p<.001), and longer stays in the ICU (𝛽= -.14, p <.001). Using sedatives decreases satisfaction with care (𝛽 = -.08, p = .048). Living alone (𝛽 = -.08, p = .013) and using painkillers (𝛽 = -.08, p = .020) reduces recall of experiences. Conclusion : Negative ICU experiences are significantly associated with being female, living alone, lower income, unplanned admission, using sedatives and painkillers, delirium, and longer stays in the ICU. Thus, improving ICU experiences requires interventions that address modifiable factors, such as delirium, medication, and length of ICU stays.

흔한 질병(疾病)의 진료비분석(診療費分析) (A Study of the Analysis of Treatment Expenses of Selected Common Diseases Covered by Medical Care Inserance System)

  • 김진순
    • 농촌의학ㆍ지역보건
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    • 제14권1호
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    • pp.16-29
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    • 1989
  • The general objective of this study is to grasp the treatment expenses of common diseases by character of medical care institutions. The specific objective is to find out the treatment expenses for selected common diseases by type of medical care institutions and also by level of symptom. A record review method was employed to obtain required information for the analysis of expenses. A total of 40,000 cases treated by 85 medical care institutions were selected by the study team during the period 22 June to 14 July 1988. The 85 medical care institutions were sampled by stratified proportionate random sampling method. The major findings obtained from the information collected by the study team are as follows ; 1) Treatment expenses were composed of physical examination, medication, injection anesthesia, rehabilitation surgical intervention, lab test, X-ray and diagnosis. The highest expenses was for medication, accounted for 36.7% of the total: 13.9%, injection; Lab, tests respectively: 10.5%, physical examination : 8.6% surgical intervention; 7.9% admission : 6.3%, X-ray and diagnosis: 1.5%, rehabilitation. 2) Treatment expenses per case of common diseases were quite different from not only type of medical care institutions, such as university hospital, general hospital, hospital and clinic, but also from level of symptom. 3) Treatment expenses per case for the aged were higher than that of the young. The treatment cases for over 60 years of age accounted for 19.4% of the total, however the proportion of treatment expenses accounted for 23.8% of the total. 4) Duration of treatment and visits for same diseases varied from type of medical cara institutions. Based on these study findings, the following further research should be conducted: (1) Establishment of health care delivery system. (2) Feasibility of the development of health care programme for the aged. (3) Strengthening for primary health care approach.

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동영상 기반 간호정보제공이 중환자실 입원 환자 가족의 환경적 스트레스, 불안과 간호요구 만족도에 미치는 효과 (The Effects of Video-based Admission Education on Environmental Stress, Anxiety and Nursing Needs Satisfaction among Family members with Patient in ICU)

  • 이문경;이윤미
    • 중환자간호학회지
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    • 제5권1호
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    • pp.1-11
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    • 2012
  • Purpose:The purpose of this study was to examine the effects of video-centered information among family members intensive care unit (ICU). Methods: A quasi-experimental, nonequivalent control group, pretest-posttest design was used. Participants (n=86) were family members who were the main caregivers for the patient in ICU. An experimental group (n=43) watched a video while the control group (n=43) was provided a leaflet. Levels of environmental stress, anxiety and nursing need satisfaction were measured by questionnaires before and after the interventions. Data were analyzed with ${\chi}^2$ test, paired t-test, independent t-test, Fisher's exact test and ANCOVA. Results: There were no differences in environmental stress (F=1.88, $p$=.065), and anxiety (t=0.37, $p$=.711) between 2 groups, but there was a significant difference in nursing need satisfaction (t=3.01, $p$=.004). Conclusion: Providing video-centered information would be an effective nursing intervention by improving nursing need satisfaction among family, the main caregivers members of patients in ICU.

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산욕 초기 산모의 체중 및 체성분 변화에 대한 연구 (A Study about Change of Body Weight and Body Composition during Early Puerperium)

  • 박장경;김동일
    • 대한한방부인과학회지
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    • 제23권4호
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    • pp.95-108
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    • 2010
  • Purpose: This study was to investigate the correlation among body weight, body composition, delivery method, parity, weight gain during pregnancy and obesity before pregnancy of patients who received postpartum care in one oriental medicine hospital. Mothods: From September 1, 2009 to August 31, 2008, we included 34 postpartum patients who had body composition analysis when admission and discharge among 47 postpartum patients who were hospitalized and received postpartum care in $\bigcirc\bigcirc$ University $\bigcirc\bigcirc$ Hospital. We used SPSS 14.0 for window to test for statistical significance. Results: After postpartum care, body weight and BMI of mothers was significantly decreased and the weight loss was almost body water. Mothers who had cesarean section had relatively severe edema and mothers who had been overweight before pregnancy had high BMI, body fat and abdominal fat. After delivery, body fat percentage was increased highly and body weight retention lasted long in mothers who had gained over 12.5kg during pregnancy. Conclusion: Living habits including diet has a significant effect on weight change of mothers during early puerperium, therefore it is required to teach mothers about breast-feeding, diet, and exercise to help their weight return to normal.

유료 노인주거복지시설에 거주하게 된 이유에 관한 연구 (Main Reasons for Choosing to Stay in a Paid Elderly Residential Facility)

  • 이인수
    • 한국주거학회논문집
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    • 제14권2호
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    • pp.121-132
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    • 2003
  • This study has been performed to explore main reasons for staying in paid elderly residential care facilities among the residents. In this study, five males and seven females aged 65 to 82 were asked about main reasons for staying in the facilities. The answers of the qualitative interview were drawn as follows; first, some residents had suddenly decided to move into the facility due to critical life events such as bereavement, serious illness, or supporting problems. Second, some residents had taken a long period of considerations on whether staying home or in the facilities, because their health and family supports gradually diminished over the long life span. On the other hand, a few of them voluntarily chose to stay at the facilities, because they recognized supervised group activities, nutritionally well-planned meals, and health care as major inconveniences. In this study, suggestions were made as follows: first, guiding and settlement programs should be developed for the residents of the sudden events, particularly at early stage of admission. Second, intensive nursing care units should be in separation from healthy independent groups, so that the residents are relieved from stressful contacts with extremely ill patients in the residential area.