• Title/Summary/Keyword: Audit Recommendations

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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Oversight on the Bioethical Compliance of National R&D Projects or Research Personnel (국가 R&D 과제의 생명윤리 관리체계 구축에 대한 고찰)

  • Jang, Seong Mi;Jeong, Kyeong Hye;Kim, Bo Yeon;Kim, Young Nam;Cho, Hyeon In;Kim, Eun Young;Huh, Woo Sung
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.1
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    • pp.77-83
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    • 2016
  • Background: Oversight on the bioethical compliance of national R&D projects or research personnel is currently conducted exclusively by IRB (Institutional Review Board) within the relevant research institute. Considering current state of affairs in Korea, there is an imperative to establish a national oversight system for bioethical compliance, conduct comprehensive oversight on bioethical compliance of national R&D projects, and enhance subject protection system. Methods: We examined opinions from researchers and IRB personnels regarding ethical oversight system on R&D projects. Additionally, we looked at IRB assessment by KAIRB (Korea Association of Institutional Review Board) in order to identify status and problems with current IRB system in Korea. Assessment was also done for four other countries (US, UK, Germany, Singapore) through in-person visits as well as surveys in writing for a total of 6 months (2012.12.1~2013.5.31). The research comprised of two aspects: system management and R&D project audit. Based on this, we examined current status and problems of the existing system in Korea and made recommendations for improvement. Results: Regulatory objectives and backgrounds of biomedical researches are different from each country due to different characteristics of bioethical oversight system. This shows that each country sets up its own regulations and procedures to fit each situation. Bioethical compliance oversight system greatly varied between the countries. From this study, it can be seen that improvement of existing procedures and oversight system or establishment of new ones are essential in Korea. Conclusion: In terms of system management, a dedicated government organization need to be established for bioethical compliance, subject protection, IRB inspection, training, evaluation, and certification of systems, and also support for IRB e-system. Regarding R&D project oversight, it is essential to confirm IRB review results before start of a research, to conduct a review on ethical aspects of research plans, and to carry out continued oversight on bioethical compliance through interim reports.

The Comparative Analysis of the Internal Control According to Economic Changes in Korean Companies

  • Park, Cheol-Soo
    • Journal of Information Technology Applications and Management
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    • v.21 no.3
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    • pp.119-133
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    • 2014
  • Prior to the 2000s, internal control had not been among the high priority issues in the management's agenda. Since then, however, it has become one of the hottest issues, and has received a significant attention as the means of improving the transparency, sustainability, and competitiveness of a company. The objectives of this paper are to examine if there has been any noticeable changes in the level of internal controls of Korean companies before and after the 2010, and to analyze the underlying drivers and issues thereto. Accounting manipulation and moral hazard were among the factors to cause the Korean financial crisis in 1997 and 2008. Since then, the capital market has had a strong pressure on Korean companies to enhance the transparency of management and accounting while the government has made the laws, requirements, and recommendations to alleviate the moral hazard problems of management and enhance the accounting transparency. Both market and government have driven companies to put more priority on the reliability of financial reporting and the compliance of applicable laws and regulations. Thereby, the market and governmental forces has led companies to enhance the level of internal controls which contribute to the reliability of financial reporting and the compliance The pressure on companies to enhance the level of internal controls may be different across industries. The capital market and government experiencing the severe financial crisis in 1997 and 2008 put even more pressure on financial companies such as banks to upgrade the reliability of financial reporting and the compliance of regulations to the global level than on non-financial companies. A survey is performed on the changes in the level of internal controls of 54 major companies consisting of 10 financial and 44 non-financial companies in Korea. The survey results show that the average level of internal controls of Korean companies has noticeably improved and that the change in the level of control environment factor is higher than that of IT control factor. The analysis on the industry differences shows that financial companies increased the level of control environment factor more than non-financial companies did while non-financial companies upgraded the level of IT control factor more than financial companies did relatively. Among internal control categories, the most improved area since the economic crisis is "Risk Assessment." The global best practices for risk management have been developed primarily in the financial industry and then spread to other industries. The general level of control practices of Korean companies has been improving significantly, but still appears below the global advanced practices.