• Journal of Home Health Care Nursing
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• v.22 no.2
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• pp.216-227
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• 2015

Purpose: This study aimed at understanding terminal care provided in nursing homes. Method: An interview survey with staff in charge of terminal care was conducted in 97 nursing homes using questionnaires. The questionnaire was reviewed by 3 experts and pretested at 5 facilities. Data were analyzed using descriptive statistics, chi-square test, and Fisher's exact test. Result: Dyspnea was the most prevalent symptom predicting death. The most prevalent services were vital sign check for physical care, providing services by talking despite an unconscious state for psychosocial care, and respecting the faith of the elder for spiritual care. Employment of a registered nurse showed a significant difference in tube feeding (p=.035), analgesic administration (p=.022), informing the elder of end-of-life state (p=.020), helping an elderly person say good-byes through a visit with friends and acquaintances (p=.023), and helping express feelings related to death (p=.002). Lack of service was noticed for elderly resident, family, and staff after death of an elder. Problems related to terminal care were indifference of family members, difficulty in obtaining medical prescription, difficulty in predicting death, and so forth. Conclusion: Terminal care must be improved by making specific guidelines and it must become a part of nursing home evaluation.

• Journal of Korean Critical Care Nursing
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• v.11 no.2
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• pp.21-33
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• 2018

Purpose : To explore the person-centered care (PCC) experienced by critical patients. Method : This qualitative study deductively examined the attributes of the PCC model proposed by Jakimowicz and Perry. The participants were 16 patients who were recently discharged from intensive care units at a university hospital. Data were collected through in-depth interviews and were analyzed using the deductive method of content analysis. Results : A total of 4 categories, 16 subcategories, and 33 codes were generated from 171 meaningful statements. The final 4 categories were "compassionate presence," "professional interaction," "outstanding competency," and "patient identity." These were consistent with the main attributes of Jakimowicz and Perry's model. However, most of the codes belonged to the "compassionate presence" and "patient identity" categories. Among the attributes of the model, "continuity of nursing," "therapeutic relationship," "expert knowledge," "clinical knowledge," "evidence-based intervention," and "patient's rights" were not derived as codes. Conclusion : These findings deepen the understanding of the PCC model from the patient's point of view. The main attributes of PCC identified in the current study can be applied to the development of practical guidelines for intensive care nursing. In addition, we recommend the development of a PCC measurement tool for critical care patients.

• Journal of Hospice and Palliative Care
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• v.25 no.1
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• pp.50-54
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• 2022

Antibiotics are commonly prescribed medications in the hospice and palliative care setting, as well as in many other healthcare settings. The overuse or negligent use of antibiotics is associated with the harmful consequence of fostering the development of antibiotic-resistant pathogens. Thus, there is an urgent need to critically examine and audit antibiotic use in all aspects of healthcare. In the status quo, there is a lack of consistent standards and guidelines surrounding the use of antibiotics in hospice and palliative care settings, leading to significant variations in how antibiotics are prescribed and administered in end-of-life care. It is apparent that greater thought needs to go into antibiotic decisions for patients receiving hospice or palliative care, especially considering the harmful consequences of the overprescription of antibiotics. The literature suggests that many clinicians prescribe antibiotics inappropriately for patients who would not benefit from their use or prescribe them without adequate documentation. Clinicians should be deliberate about when they prescribe antibiotics and adhere to the appropriate documentation standards and procedures within their institution or community. Future research should seek to generate generalizable knowledge about which patients will benefit most from antibiotic therapy during end-of-life care.

• Quality Improvement in Health Care
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• v.17 no.1
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• pp.79-88
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• 2011

Background : Evidence-based guidelines are now used for enteral nutrition(EN) in neurosurgical intensive care unit patients who mostly depend on EN. This study compared and analyzed the nutritive conditions of patients before and after they underwent guideline based nutritional interventions in order to determine whether using these guidelines improved their calorie supply. Methods : Data on the patients' nutritional requirements, maximum calorie supply through EN, serum albumin level, and total lymphocyte count were collected and analyzed using SAS version 9.1.3. All the statistical analyses were performed at a significance level of P<0.05. Result : The maximum calorie supply through EN was $923.1{\pm}359.7$ kcal before the intervention and $1254.4{\pm}196.3$ kcal after the intervention; this difference was statistically significant(P<0.05). The ratio of nutritional requirements to maximum calorie supply through EN was $55.5{\pm}22.4%$ and $74.2{\pm}13.9%$ before and after the intervention, respectively; this difference was statistically significant(P<0.05). This indicates a 19% increase in the ratio after the nutritional intervention. The serum albumin level also significantly increased from $2.7{\pm}0.6g/dL$ before the intervention to $3.2{\pm}0.4g/dL$ after the intervention(P<0.05). The total lymphocyte count slightly increased from $1267.7{\pm}728.2cells/mm^3$ before the intervention to $1801.9{\pm}1211.5cells/mm^3$ after the intervention; this difference was not statistically significant. Conclusion : The results showed that using the evidence-based feeding guidelines for interventions increased the calorie supply and improved the patients' nutritive conditions from moderate malnutrition to mild malnutrition.

• Journal of Home Health Care Nursing
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• v.27 no.1
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• pp.102-113
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• 2020

Purpose: To demonstrate the importance of comprehensive skin observation as an effective intervention for pressure injury prevention in elderly long-term care hospital patients. Methods: The survey was conducted with 70 nursing staff members working at two long-term care hospitals with 200 beds or less in D city. Data were collected from October 16 to October 23, 2019 and analyzed using descriptive statistics, the chi-square test, and the independent t-test with the SPSS 25.0 program. Results: Nursing care knowledge for pressure injury was similar between the two groups. Conversely, nursing care performance for pressure injury degree of the nursing staff in the hospital using skin observation records performed better than those who did not (t=6.11, p<.001). Furthermore, comprehensive skin assessments in long-term care hospitals using skin observation records showed a lower incidence rate of pressure injury than that showed using general skin assessments (t=-5.28, p=.006). Conclusions: Comprehensive skin assessment is important for pressure injury prevention in elderly long-term care hospital patients. To implement this effectively, it is necessary to devise institutional regulations, guidelines, and systematic education programs.

• Journal of Families and Better Life
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• v.26 no.3
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• pp.101-114
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• 2008

Eater Seal, the child care experts, observes that children with disability significantly benefit from receiving appropriated care along side their peers. Typically developing children serve as role models from which children with disabilities learn age-appropriated communications and social behavior. Therefore the children with disability can actively participate in well-designed child care settings. But unfortunately in Seoul, Korea, only 2% of children with disability are taken care of in child care centers. And even the disabled children at the child care centers are mostly mentally or emotionally disabled because the building, programs and services of the centers are restrictive to the children with severe physical disabilities. This study reviewed Korean domestic physical environment of child care centers for children with disabilities. Questionnaire survey was conducted to 103 centers located in Seoul by mail. Our survey revealed that they need more areas for nursing room and special rooms and the accessibility to buildings has to be improved. Also, there are no elevators in all buildings surveyed. Accessibility to toilet is noted as significant problem, especially wet floors in toilets. In a nursing room, a space for psychological rest and special education is needed for children with mental disability. Technical specifications on how to make buildings and facilities accessible for the children with disability should be developed. The goal of this study is to provide basic information to develop domestic design guidelines to ensure that the child care centers are safe, convenient, and usable for everyone possible.

• The Journal of Korean Academic Society of Nursing Education
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• v.22 no.2
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• pp.115-124
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• 2016

Purpose: The purpose of this study was to examine the degree of intensive and critical care nursing competence in senior nursing students. Methods: The research method for this study comprised a descriptive survey study with a convenience sample of 113 senior nursing students from one university. The instrument entitled ICCN-CS-1, which measures intensive and critical care nursing competence, was translated by the authors following WHO guidelines for translation process. The data were collected using ICCN-CS-1. Results: The mean score of intensive and critical care nursing was above the intermediate level. The competence indices of knowledge, skill and attitude/value were also above the intermediate level, which suggests that their competence is good. For two intensive and critical care nursing domains, the nursing students' mean score of clinical competence is higher than that of professional competence. The competence of intensive and critical care is also influenced by nursing students' satisfaction in their major and clinical practice as well as their confidence in clinical practice. Conclusion: The senior nursing students' competence of intensive and critical care nursing is above the intermediate level. A consideration of the influencing factors of satisfaction of nursing major/ICU practice and confidence of ICU practice is needed in intensive and critical care nursing education.

• Journal of the Korean housing association
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• v.18 no.5
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• pp.121-131
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• 2007

Eater Seal, the child care experts, observes that children with disability significantly benefit from receiving appropriated care along side their peers. Typically developing children serve as role models from which children with disabilities team age-appropriated communications and social behavior. Therefore the children with disability can actively participate in well-designed child care settings. But unfortunately in Seoul, Korea, only 2% of children with disability are taken care of in child care centers. And even the disabled children at the child care centers are mostly mentally or emotionally disabled because the building, programs and services of the centers are restrictive to the children with severe physical disabilities. This study reviewed Korean domestic physical environment of child care centers for children with disabilities. 15 centers located in Seoul were surveyed. Our survey revealed that the accessibility to buildings is poor. There are many places with difference in height of floors. Also, there are no elevators in all buildings surveyed. Accessibility to toilet is noted as significant problem, especially wet floors in toilets. In a nursing room, a space for psychological rest and special education is needed for children with mental disability. Technical specifications on how to make buildings and facilities accessible for the children with disability should be developed. The goal of this study is to provide basic information to develop domestic design guidelines to ensure that the child care centers are safe, convenient, and usable for everyone possible.

• Journal of Home Health Care Nursing
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• v.15 no.1
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• pp.37-43
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• 2008

This paper provides the guidelines from which to develop a visiting health care program at the Public Health Center in Korea and involves an expanded payment compensation system of preventive services based on the new long-term health insurance system in Japan. The function and management methods to achieve the goals practiced in a community contact center for elderly support which have recently been established will guide the specific directions and strategies that the Public Health Center should pursue. That is to say, comprehensive and continuous efforts will be put forth in preventive home visiting care targeting the elderly in certain jurisdictions. At this point in time in which the visiting care nursing program has not yet started, visiting health care provided by the Public Health Center oversees chronic diseases of a vulnerable population. But after it has been developed nationwide, the visiting health care system at the Public Health Center will be distinctive and focused on health promotion and prevention.

• The Korean Journal of Health Service Management
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• v.7 no.1
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• pp.119-131
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• 2013

The purpose of this study is to analyze contents on media about the problems of long-term care facilities. For achieving this purpose, we reviewed 'KINDS(http://www.kinds.or.kr/)' from July, 2008 to May, 2012 which was an synthetic newspaper and TV news searching system. Among 320 articles, we finally analyzed 72 articles: 218 articles were duplicated and 30 articles did not directly related or were not objective. The results were divided with seven parts: 'long-term care facilities', 'employee' 'health care and accidents', 'providing and management of service', 'meals related problems', 'maltreatment of client', 'disorders & unfairness long-term care benefit. Among these seven parts, we could confirm specific and major problems, which were lack of safety management, incompleteness facilities & equipments, shortage of long-term care manpower, insufficient service providing low quality of service, hiding money from elderly's accounts, and providing some money to get national subsidies. For resolving these problems, the long-term service guidelines must be prepared and the related facilities must cooperate each other for providing high quality of service. In addition, the efficient systems must be made to find out long-term care problems and unfairness of service providing and strict management rules or sanctions must be needed.