• Title/Summary/Keyword: Home health nursing

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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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Effects of Service Quality on Knowledge & Skills of Service and Information Cognition for the Aged in Workers of Nursing Homes (노인요양시설 종사자의 노인의 정보파악, 노인 간호 지식과 기술 및 노인 서비스 질과의 관계)

  • Bae, Eun-Sook;Kim, Mi-Jung
    • Journal of Home Health Care Nursing
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    • v.19 no.1
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    • pp.55-62
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    • 2012
  • Purpose: This study was conducted to investigate the worker's service quality of the elders at a nursing home. Methods: A total of 371 workers, who were engaged in caring for the elders at a nursing home in B-Metropolitan city and Kyungnam, answered the questionnaires regarding the knowledge & skills of service, information cognition and service quality for the elders related to their clients. Results: Service quality for the elders was significantly correlated to the level of knowledge and skills, as well as the information cognition for the elders, and frequency of educational participation. Service quality for the elders was statistically significant predictors of knowledge and skills, and information cognition for the elders. These two variables accounted for 37% of the variance in service quality for the elders. Conclusion: In order to improve the worker's care level, the workers engaged in caring for the elders should make the efforts to be given a nursing education related to the knowledge & skills, as well as the information for the elders.

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Current State and the Future Tasks of Home Visit Nursing Care in South Korea (우리나라 가정방문간호의 현황과 향후 과제)

  • Park, Eunok
    • Journal of agricultural medicine and community health
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    • v.44 no.1
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    • pp.28-38
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    • 2019
  • Objectives: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in South Korea. Method: We searched and reviewed the literature including the laws or acts, statistics, guidelines, papers and conference proceedings related to home visit nursing care in Korea. Results: There are three types of home care nursing in Korea. Public health center provides home visit nursing to vulnerable population by registered nurses for free, based on community health act in public health center. As of 2017, 1,261,208 people were enrolled in the visiting health program of public health center. Health behavior and disease management has been improved and showed having cost-benefit effect among the enrolled people in visiting health program. Visiting nursing care in long-term care services is provided by registered nurses or nurse aid, based on long-term care act. The cost is paid as the unit price according to service time. 1,095,764 older people used long-term care services in 2017, only 0.2% of total cost used for home visiting nursing. Even though the number of user of home visiting nursing, it was reported that users spent less medical cost and hospitalized shorter. Hospital-based home care nursing is provided to patients and their families under the prescription of a doctor by family nurse specialists who are employed by medical institute based on medical law. Four hundred sixty family nurse specialists worked for hospital-based home care nursing and hospital-based home care services accounted for 0.038% of total medical expenses in 2017. Conclusion: Even though home visit nursing care services are different in aspect of legal basis, personnel, running institutes, and cost basis, home visit nursing care showed cost-benefit effect and good health outcomes. In order to advance home visit nursing care, the integrated home visiting care, improvement of working condition, and revision of legal basis should be considered.

Analysis on Home Care Services and Home Health Care Cost of CVA Patients in Korea (뇌혈관질환자의 가정간호 서비스 및 진료비 분석)

  • Kim, Eun-Kyung;Shin, Suk-Youn;Hwang, Jeong-Hae
    • Journal of Korean Academy of Nursing Administration
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    • v.12 no.2
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    • pp.225-232
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    • 2006
  • Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

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The Effect of Using Web-based Distance Program in Home Health Education for Nursing College Students in COVID-19 Special Disaster Area (COVID-19 특별재난지역의 일개 간호대학생을 위한 웹기반 원격 방문간호교육 프로그램의 효과)

  • Ha, Young-Sun;Sohn, Myung-Ji
    • Journal of the Korea Convergence Society
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    • v.11 no.11
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    • pp.461-473
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    • 2020
  • This study examined the effect of using web-based distance program in home health education for nursing college students in COVID-19 special disaster area. The study was carried out according a nonequivalent control group pretest-posttest design. The study subjects were 49 nursing college students from K City, Gyeongsangbuk-do. The web-based distance program was conducted for 2 weeks. The data collection period was from June 1, 2020 to June 12, 2020. Collected data were analyzed using SPSS PC+ 19.0 with the Fisher' exact test, Wilcoxon rank sum test, ANCOVA with pretest value as covariate. The experimental group had significantly different in knowledge related home health nursing, perceived motivation, and learning commitment in comparison to the control group. This suggests that the web-based distance program in the COVID-19 special disaster area can be applied as a way to increase nursing students' knowledge related home health nursing, perceived motivation, and learning commitment.

A Study on Home Care Service and the Level of Client Satisfaction in Community (일 지역사회의 가정간호서비스 내용 및 만족도 조사)

  • Kim, Jung-Soon;Kim, Myoung-Soo;Park, Nam-Hee
    • Journal of Home Health Care Nursing
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    • v.13 no.1
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    • pp.5-15
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    • 2006
  • Purpose : This study was done to examine the home care service provided by home care nurses and the level of client satisfaction in community. Method : Data were collected from 120 clients who received the home care service at the community home care service center in Pusan from 2th May. 2003 to 31th May 2003. The tool for measurement of satisfaction was composed of 16 items and was 4 score scale by Kim. Data were analyzed by using SPSS/WIN 10.5 program. Result: 1) 67.5% among 120 clients was over sixty years old and 30.6% of clients received home visits 20 times by home care nurse. 2) The total number of home care services was 15,783. And most of the clients received therapeutic nursing care. 3) The mean score of satisfaction on provided home care services was 3.31, among 16 items, "The home care nurses kept up the secret of patients and family" was the highest($3.67{\pm}0.48$). the total level of satisfaction of home care services was very high, with mean score $3.31{\pm}0.32$. Conclusion : The satisfaction level of home care services was very high. so we can expect that the prospect of home care services is very challengeable. Therefore we should try to expand the service recipients with promotional education to assure close ties with the public health centers for the continuous home care service linking and make more efforts to improve the quality of the service.

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Literature review on the domestic studies of the Outcomes of Home Care Service for 1981-1996 (국내 가정간호 사업의 성과 측정 연구의 고찰)

  • Yun, Soon-Nyoung;Cho, Myoung-Sook;Kim, Hong-Soo
    • Journal of Home Health Care Nursing
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    • v.4
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    • pp.41-52
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    • 1997
  • The purpose of this study is to identify the domestic research results related to the outcomes of home care services for 1981-1996. 12 studies were analized by the characteristics of the subjects, home care services provided, and outcome variables and tools during the period of Apirl-June, 1997. The results were as follows: the subjects of 8 studies conducted before 1993 were discharged patients comparing to early discharged patients of 2 studies conducted after 1994. The main home care service delivered to the clients and their families were education before 1993. The outcome variables were used the level of sat. isfaction of home care services, quality of care, cost-effectveness, health status, quality of life, and self -care ability. A variable, health status, were mainly measured by the global outcome measures such as quality of life, health hehelief, health perception, activity of daily living, health management pattern but also foused outcome measures that could be specified by the medical diagnoses.

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Development of the Home-Based Prenatal Care System via Information Superhighway (초고속 통신망을 이용한 재택산전간호관리 시스템 개발)

  • 김정은;박현애
    • Journal of Korean Academy of Nursing
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    • v.25 no.4
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    • pp.774-789
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    • 1995
  • Due to the rapid socioeconomic development and the introduction of the national health insurance system the general population's need for health care and utilization of health care services have increased dramatically. As a result of this change. Korea is experiencing a shortage of health care facilities and health manpower, and this leads long wailing line at doctor's offices. One of the solutions of this problem could be home health care system for those who have minor health related problems. With this background, this study was conducted to look at the feasibility of a home-based prenatal care system using information superhighway and nursing informatics specialists. With the home-based prenatal care system, the pregnant woman checks her blood pressure, tests her urine for sugar and protein, and measures her body weight at home and sends the information to a hospital computer via the information networks such as public telephone line and information superhighway. Nursing informatics specialist at the hospital will go through each patient record and screen those who have abnormal values and notify them to see a doctor as soon as possible. Besides telemonitoring features, the proposed system will include tole-education capabilities for the patients so that patient can learn whatever they need to know ragarding the prenatal care via information networks. If this system develops and operates, patient can save time in terms of travel to and from the hospital and waiting time in the hospital. And the health care institute can utilize its resource more efficiently.

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Quality of Life of Older Adult with Home Health Services - Applied PRECEDE Model - (취약계층 노인의 삶의 질에 영향을 미치는 요인 - PRECEDE 모형 적용 -)

  • Park, Kum-Hwa;Choi, Yeon-Hee
    • The Korean Journal of Rehabilitation Nursing
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    • v.13 no.1
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    • pp.32-43
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    • 2010
  • Purpose: The purpose of this study was to determine factors that affect poor quality of life (QOL) of older adults who received home health service. Method: The sample 492 older adults participated in the study. The QOL was measured using the scale of QOL of Ware and other data were collected through face-to-face interviews from September to August, 2009. Results: The level of QOL was moderate (Mean 24.4, SD 7.4). The QOL was poorer in older adults (p<.05) and in those living alone (p<.01) compared to older adults and those living with couple or family respectively. The QOL was positively correlated with a sense of mastery (r=.213, p<.05), connection of health (r=.160, p<.05) and a cognitive function (r=.119, p<.01), and negatively correlated with Activities of Daily Living (r=-.266, p<.01) and Instrumental Activities of Daily Living (r=-.339, p<.01). Sense of mastery, connection of health & welfare, and IADL were significant predictors of QOL. Conclusion: Finding suggest that home health service program should incorporate strategies for increasing sense of mastery and capability of performing IADL, and strengthening connection of health service that may improve QOL of older home health service recipients.

A Study on Effectiveness of the Home Care Services for the Low Income Inhabitants (일부 지역사회 저소득층 주민을 대상으로 한 가정간호사업의 효과에 관한 연구)

  • Lee Kunja;Kim Myongsoon;Yang Younghee
    • Journal of Korean Public Health Nursing
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    • v.6 no.2
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    • pp.70-107
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    • 1992
  • This study was intended to assess the need of home nursing care and analyze the effect of home nursing care, and find out the problems during the performance of home nursing care for the chronic patients among the low-income people in urban area. Data collection by interview was carried out from Nov. 1991 to Jul. 1992. The main results were as follows; 1) Total subjects for the need assessment of home nursing care were 123 households wi th 488 persons in a urban poor area. Over half of households $(57.7\%)$ was teenage family. The overall living conditions were poor and the average monthly income was 580 thousands won. $74.8\%$ of subjects was covered by medical care insurance and only $4.7\%$ was covered by public assistance. The morbidity rate was $8.2\%$ among 488 subjects and $27.5\%$ of them was not treated at all, $30\%$ was treated in utilizing pharmacies or local clinics. 2) The subjects of home nursing care were 46 with Hypertension or DM who agreeded the participation of study among registered patients at a public health center in Incheon. Home visiting was performed at intervals per one month for one year. Most of them were the elder(mean age=61 years) and long term patients(7.8 years continued). Home nursing care was effective. That is, blood pressure(including systolic and diastolic pressure) was significantly reduced (t(n=22)=2.31, P=.031, t(n=24)=4.16, P=.000 respectively) and knowledge of disease(t(N=46)=-7.63, P=.000), attitude of disease (t(N =46) = -4.92, P=.000), and self-care(t(N =46) = -4.89, P= .000) were significantly improved through home nursing care. But there was no difference in blood sugar for diabetics between the beginning and the end of visits. At the beginning of visit for home nursing care, sex$(\beta=-0414,\;t=-3.012)$ and nursing need({3=.310, t=2.164) were influencing self-care, and duration of disease$(\beta=.297,\;t=2.106)$ and nursing need $(\beta=.385, t=20417)$ were influencing blood pressure, blood sugar level. Namely, the subjects who were male and had higher nursing need showed better self-care and the longer duration of disease and the higher nursing need were relationship with the better blood pressure and blood sugar level. At the end of visit for home nursing care after one year, the blood pressure and blood sugar level was influenced by age $(\beta.320,\;t= 2.242)$, duration of disease ($(\beta.352,\;t= 2.395)$ and nursing need $(\beta=.350,\;t=2.623)$ and self-care had no influencing factor. The higher age and the longer duration of disease and the higher nursing need were relationship with the better blood pressure and blood sugar level. 3) The problems that were found out during the performance of home nursing care were the absent of useful protocols for services and the clear evaluation base, and the difficulty of teaching elders who were the major part of our subjects.

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