• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.87-106
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• 2018

Objective: The objective of this study is to examine the association between process quality of inpatient care and risk-adjusted, thirty-day potentially preventable hospital readmission (PPR) rates. Data Sources/Study Setting: This was an observational cross-sectional study of nonfederal acute-care hospitals located in two states California and Florida, discharging Medicare patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia January through December 31, 2007. Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Database of the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services Hospital Compare database, and the American Hospital Association Annual Survey of Hospitals. Study Design: The dependent variable of this study is condition-specific, risk-adjusted, thirty-day potentially preventable hospital readmission (PPR). 3M's PPR software was utilized to determine whether a readmission was potentially preventable. The independent variable of this study is hospital performance for process quality of inpatient care, measured by hospital adherence to recommended processes of care. We used multivariate hierarchical logistic models, clustered by hospitals, to examine the relationship between condition-specific, risk-adjusted, thirty-day PPR rates and process quality of inpatient care, after taking clinical and socio-demographic characteristics of patients and structural and operational characteristics of hospitals into account. Findings: Better performance on the process quality metrics was associated with better patient outcome (i.e., low thirty-day PPR rates) in pneumonia, but not generally in two cardiovascular conditions (i.e., heart failure and acute myocardial infarction). Practical Implication: Adherence to the process quality metrics currently in use by CMS is associated with risk-adjusted, thirty-day PPR rates for patients with pneumonia, but not with cardiovascular conditions. More evidence-based process quality metrics closely linked to 30-day PPR rates, particularly for cardiovascular conditions, need to be developed to serve as a guideline to reduce potentially preventable readmissions.

• Journal of the Korean Society of Food Culture
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• v.34 no.6
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• pp.707-718
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• 2019

This study assessed the nutrient consumption of children from lunch at day care centers and kindergartens. A total of 184 lunch plates were selected in two child day care centers and two kindergartens in Seoul. Weights of the menus in planned meals were measured and amount of served and consumed lunches were calculated using a digital photography technique. Nutrients of the planned, served, and consumed lunches were assessed using CAN-Pro 4.0 and the Index of Nutritional Quality (INQ) was calculated for each meal. Compared with the estimated energy requirement for lunch for 3-5 year old children, the planned meals of the child day care centers and kindergartens contributed 42.8% and 98.8% of the daily energy requirements, respectively. At a child day care center, a served meal provided more nutrients than a planned meal since some children requested more servings after eating the served meals. This showed that the planned meal did not meet children's needs as well as the nutrient requirements. At the other child care center, children were served less than the planned meal by 6.8%, which resulted in serving less energy, calcium, potassium, and vitamin C than the required nutrients for lunch. Kindergarten A served meals with the energy requirement for lunch of 101.8%, but Kindergarten B served a meal with the energy requirement of 83.5%. Since the served portions were too small to meet nutrient requirements of the children, they consumed almost all the food served, and their nutrient consumption was similar to the nutrients served. Even though they consumed all the food served, their nutrient consumption did not meet their nutritional requirements. When assessed by INQ, the quality of the meal was good; children could consume enough nutrients when served proper quantity. Teachers who are responsible for serving meals need to be educated on proper portion sizes and how to encourage children to practice healthy eating. To promote healthy eating among children, parents need to provide children with messages consistent with what they have learned at institutions and to be a good role model in daily dietary life.

• Journal of Digital Convergence
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• v.18 no.4
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• pp.479-487
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• 2020

The purpose of this study is to identify a potential user's need for use and operational of the elderly day care center and to identify the problems and suggest development directions. The data collection was conducted on 320 ordinary people living in J-do through a questionnaire, and sought to understand the operational status of in-depth interview institutions for the heads and employees of six center. As a result of the analysis, a potential user's ware not aware of the functions and specific roles of day care center, the cost of facilities was covered by the government, and that facilities and the environment were important factors when using the center. In-depth interviews show that the current policy or system is far from reality and does not fit the status or role of the workers and the operational status of the agency, requiring the re-establishment of the on-site system. Based on the research results, the development direction of day care facilities requires active promotion and strengthening of family support for improving and enhancing awareness of day care facilities to citizens at the national level. Second, the quality of nursing services should be enhanced through improvements in facilities and the environment that reflect users' needs. Third, The government should improve the quality of nursing services by improving the poor employment conditions and treatment of workers to fit the reality.

• Korean journal of food and cookery science
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• v.7 no.4
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• pp.103-109
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• 1991

The purpose of this study was to evaluate the foodservice management practices in day care centers in order to provide basic information and guideline for development of foodservice facilities standard model and sanitation manuals. Basic survey and evaluation were done for 24 day-care centers categorized in four groups. General foodservice management practies, status of equipment, and hygienic conditions were evaluated. The results of the survey showed the followings: the cost of lunch and the cost of interim snack varied very much among each group; development of standard recipe as well as purchase of foods were not done by an expert; the hygienic condition of kitchens and dining-room needed more attention for improvement; the sanitary practies of employees showed potential problems; kitchen facilites were not standardized, especially only 20.8% of the facilities were equipped with the three-compartment sink, which was regarded as essential.

• Quality Improvement in Health Care
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• v.12 no.1
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• pp.6-16
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• 2006

Objectives : The purpose of this study was to identify the characteristics influencing consultation and waiting time in ambulatory patients. Methods : This study was conducted in a tertiary teaching hospital. Subjects were a total of 10,383 ambulatory patients. Consultation time was measured by time spent for meeting with his/her physician per patient. Waiting time was defined as the time difference between each patient's reserved time and time to meet with his/her physician for ambulatory care. Multiple regression analyses were performed to determine the factors influencing consultation and waiting time. Results : Consultation time was different according to patient' age, previous experience of clinic visit, recent admission history, medical department, specialist care, type of reservation, and day of the week. Significant factors influencing waiting time were patient' age, residential area, previous experience of clinic visit, recent admission history, medical department, specialist care, time spent after ambulatory care begins, and day of the week. Conclusions : The medical department was the strongest factor affecting both consultation time and waiting time. The ambulatory reservation management systems should take into account patient characteristics as well as care-related features.

• Perspectives in Nursing Science
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• v.9 no.1
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• pp.45-50
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• 2012

Purpose: Despite poor cognitive function in heart failure (HF), few studies have examined cognition and its probable implication in self-care among Korean HF patients. The purposes of this study were (1) to describe cognition in the domains of global, memory, and executive functions, (2) to explore the relationship between cognition and self-care, and (3) to determine the amount of dietary sodium intake among Korean HF patients. Methods: A pilot study was conducted: 7 HF patients (3 men, mean age 68 years) completed face-to-face interviews for neuropsychological tests of cognition and self-care including dietary sodium intake. Results: More than half of the patients had impaired global cognition, memory, or executive function; patients with more severe HF were at higher risk of poor cognitive function. Korean HF patients exhibited poor self-care, with a high dietary sodium intake (5.6 g/day), approximately twice more than the suggested guideline of 2~3 g/day for patients with stable HF. Conclusion: Cognitive dysfunction and inadequate self-care with noncompliance with dietary sodium restriction were evident in Korean HF patients. More studies are warranted that examine the prevalence of cognitive impairment and areas of deficit using neuropsychological tests in a larger sample and that examine how cognition affects self-care and compliance in salt-intake.

• Korean Journal of Culture and Social Issue
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• v.21 no.2
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• pp.227-252
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• 2015

This study was intended to examine child abuse experience, response to child abuse, perception of the cause of child abuse, and need for counseling to prevent and eliminate child abuse among 514 day care center teachers across the country. First, 17.9% (92) of the teachers had experience of witnessing child abuse at day care centers. After such witness, the teachers mostly "paid attention to abused children and provided them with warm treatment" when they were abused by other teachers and "took no actions" when they were abused by directors of the day care centers. The biggest reason of not taking any actions was: they "had no authority to intervene in child care of other teachers" in case of child abuse by other teachers and "were afraid of responsibilities or roles that could be placed on them after reporting" in case of child abuse by day care center directors. Second, the biggest reason of child abuse by teachers was job stress followed by excessive work and mental health of teachers. Third, necessary actions when child abuse cases were found and confirmed were suspension of involved teachers and psychological evaluation for involved children and parents. Fourth, 88.9% (457) of the teachers responded that they would use an organization specialized in child abuse if such organization was built and that the organization would help them to decide on whether to report child abuse and prevention of and intervention in child abuse. They also said that such organization should be installed in the Counseling Center in the Comprehensive Child Care Support Center. Fifth, 95.3% (490) of the teachers answered professional counselors specialized in development and counseling of infants and toddlers were needed to address child abuse at day care centers. They demanded that such counselors should be able to administer psychological evaluation for young children and assess child abuse cases. Qualification of the counselors was at least college graduates who majored in psychology and child care, three to five years of experience in the field, and appropriate certificates or licenses. Finally, the teachers said that training and professional counseling about child abuse were required to prevent and eliminate child abuse at day care centers. Implications and follow-up studies were provided and suggested based on these findings.

• Journal of Korean Academy of Nursing
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• v.12 no.2
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• pp.57-66
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• 1982

This study was undertaken to delineate the relationship between numerical score and the amount of nursing hours required in the nursing process. Score was a numerical description of the patients functional nursing needs. Therefore this study focused on standard nursing hours required by patient's self-care status. This study observed the 62 patients and 15 R.N. in H. university hospital from Aug. 7, 1982 to Aug. 13, 1982. 1. For the first time, each head nurse assessed self-care status by Schoening's self-care score-Minimal care patient (self-care score: 23, 24) was placed in Group Ⅰ, intermediate care patient (self-care score: 11∼22) was Group Ⅱ, and special care score: 0∼10) was Group Ⅲ. 2. We observed and recorded the nursing care received from nurses according to patient's group. (8AM∼4PM) 3. And, We observed and recorded the activities of nurses in order to determine standard nursing hours required. (8AM∼4PM) 4. If we apply the content of paragraph 3 to paragraph 2, we will predict the number of patient that nurse can care during day time by self-care status. The following results were obtained: 1) Patient's mean self-care score were Group I : 23.9 score Group Ⅱ：17.8 score Group Ⅲ : 1.6 score 2) Nursing hours required by patient's physical function(self-care status) status were Group I : 35 min. Group Ⅱ: 47.5 min. Group Ⅲ : 104.6 min. 3) Nurse's nursing time and distribution required in nursing activities during day duty were A.D.L. : 84.3min. (17.56％) Functional nursing activities : 279.9min. (58.31 ％) Education ＆ Emotional support : 11.3min. (2.35%) Task unrelated patients : 54min. (11.25%) Non Productive nursing care : 50. 5min. (10.52％) 4) Mean nursing hours required by each patient and the number of patient that nurse can rare during day duty by self-care status were Group I : 38.6min. 11.1 patients/1 nurse Group Ⅱ : 51.1min: 8.4 patients/1 nurse Group Ⅲ： 108.2min. 4 patients/1 nurse It seems reasonable that this could be done effectively as each-unit has an established standard for hours required, This not only allows time for planning of staff but helps to avoid the very human inclination to predict excessive staffing requirements by placing the majority of patients in high care group.

• Quality Improvement in Health Care
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• v.9 no.1
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• pp.34-51
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• 2002

Background : The purpose for this study is to develop a critical pathway of bullectomy for spontaneous pneumothorax patients. Methods : For this study a conceptual framework of critical pathway was developed through a review of the literature including five critical pathways which are currently being used in USA, and opinions of the critical pathway development team members at Y university hospital. In order to identify the service contents required by these patients and to draw up a preliminary critical pathway, 33 cases of medical records of patients who had received bullectomy for spontaneous pneumothorax between September, 2000 to August, 2001 at the Respiratory Center of Y university hospital in Seoul was analyzed. Results : In order to test the clinical validity of the preliminary critical pathway, it was applied to ten patients who had received bullectomy for spontaneous pneumothorax from October, 2001 to December, 2001. The average discharge day was 4.89th post operation day, six patients discharged on the fourth post operation day which was the expected day, one patients discharged one day earlier than the expected day, one patient discharged three days later than the expected day, and one patient discharged six days later than the expected day. There were variances between the critical pathway and the actual practice. The variances came from tests, medications, and treatments. One item that showed variance in clinical applications was complemented, and three items were decided not to be corrected for the final determination of the critical pathway. Conclusion : This critical pathway is applicable to the care of patients with bullectomy for spontaneous pneumothorax, but it needs more clinical applications to grasp varied variances.

• Journal of the Korean Home Economics Association
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• v.40 no.5
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• pp.195-210
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• 2002

The purpose of this study were to find out the difference of needs of caring between care-givers and non care-givers, and to suggest the way of lessening vigorous task of care-givers for the elderly with dementia. Data were collected from 130 nationwide respondents intentionally divided into two groups; care-givers and non care-givers in the middle aged with middle and upper income. Collected data were analyzed by frequency, percentage, t-test using SPSS package. Since the result of survey, unexpectedly, showed no difference between two groups, it could be explained as that these two groups commonly had same needs of caring for the elderly with dementia. Major findings were as follow; 1) Most Koreans stiff thought family should be the main care-giver for the elderly with dementia prior to nation or society. 2) Responsibility of caring for the elderly with dementia would be better to be shared with children instead of focusing to a child. 3) They thought ideal residential facilities for the elderly with dementia were small-scale professional dementia facility(group home) rather than home or general elderly housing. 4) Professional dementia care hospital was one of the most needed facilities for the elderly with dementia, followed by short-stay and dar-care center. 5) It was revealed care-giving task was vigorous showing that most care-givers spent 1-5 hours a day for caring, while 13% of respondents spent 11-24 hours a duty. 6) 90% of care-givers took the responsibility of main care-giver because of duty of offsprings or spouses, and wanted to be free from their current circumstances. From the result of this survey researchers would like to suggest the establishment of diverse facilities for professional dementia care to lessen the caring burden for the elderly with dementia: group home, chronic hospital, short-stay, day-care center. Financial support from the government for the housing renovation of the caring families should be considered seriously afterward. It is needed to give the opportunity to select proper paid dementia care facilities according to their income and situation of household.