• Title/Summary/Keyword: Home-visit nursing

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Estimation of Home-visiting Care Costs for Low-income Elderly with Chronic Disease in a Metropolitan City Using the Severity Classification and ABC(active-based costing) (대도시 저소득층 만성질환 노인을 위한 가정.방문간호 원가산정 - 환자 중증도 및 활동기준원가계산법(ABC) 적용 -)

  • Kang, Sung-Ye
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.2
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    • pp.118-130
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    • 2008
  • Purpose: The purpose of this study was to estimate of home-visiting nursing costs for low-income elderly with chronic disease in a metropolitan city using the severity classification and ABC(active-based costing). Methods: First, the HHC activity pool was established. The performance time of each nursing activity were estimated. Second, nursing resources(labor costs, operating costs, and traffic expenses) were analyzed and nursing cost per minute was calculated. And then the cost of each activity was estimated. Third, 202 visiting cases were classified into three group by their severity. And then nursing cost per visit according to their severity was estimated. Results: 59 nursing activities were included in HHC activity pool. The average working time of 59 nursing activity was 6.7minutes and nursing cost per minute was 489 won. According severity, nursing cost per visit were in class I, 54,296 (won), class II 83,124(won), and class III 93,455(won).

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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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Development of Documentation System in Hospital-based Home Health - in one general hospital in the U.S.A. - (병원중심 가정간호 기관의 기록체계개발 - 미국 일개 종합병원을 대상으로 -)

  • Kang Chang-Hee
    • Journal of Korean Public Health Nursing
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    • v.6 no.2
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    • pp.58-69
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    • 1992
  • The purposes of this study were 1) to assess the currunt documentation system 2) to identify the problems in communication regarding to documentation 3) to develop new documentation system 4) to suggest effective communication channel using new documentation system Research was conducted by direct observation, chart review, staffs interview and servey. Results were as follows: 1) nursing care plans were not used in ongoing care 2) documentation format was primarily narrative and charting was time consuming 3) documentation did not reflect the nursing process 4) patient records were not used as effective communication tool between case manager and part time nurse 5) difficult access to patient record for nurse manager created inefficiency in coordinating 6) documentation of patient education did not describe the precise contents of education, and the responses of the patients and evaluation To solve these problems, new documentation format was developed. With new formats nurses : 1) use standardized care plan which contains nursing diagnosis, ecpected outcome, time frame for evaluation, flow sheet for updating the plans 2) leave one copy of care plan at patient home for mutual agreement with patent and communication among nursing staffs 3) carry one copy of care plan for updating 4) document and evaluate the patient education using education check list keeping in patient's home 5) document nursing process in focus charting visit report 6) carry one copy of visit report 7) have one copy of visit report which was deligated to part time nurses 8) use documentation in direct communication with part time nurse 9) use beeper and memo to promote communication

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A Study on Operation-Effectiveness Analysis of Clinical Nurse Specialists : Focused on Patient Satisfaction and Expected Profit (임상 전문간호사 운영 효과 분석)

  • Mo, Jin-A;Lim, Ji-Young
    • Journal of Home Health Care Nursing
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    • v.18 no.1
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    • pp.13-19
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    • 2011
  • Purpose: The aim of this study was to evaluate patient satisfaction and indirect marketing effects (recommendation, hospital re-visit intention) and additionally to calculate the expected incomes by clinical nurse specialists (CNS). Methods: Sixty-six patients who had lower varicose vein removal surgery performed at two general hospitals from August 1 to November 30, 2008, were recruited. The effects were evaluated by degree of patient satisfaction, the number of personal recommendations given, rate of hospital re-visit intention, and indirect marketing effects. Indirect marketing effects were calculated as the total cost of surgery multiplied by the score of other variables. Results: The patient satisfaction score was 0.82 for CNS and 0.43 for general nurses (GN). The number of personal recommendations given was 2.5 for CNS and 1.1 for GN. The rate of hospital re-visit intention was 0.31 for CNS and 0.21 fot GN. The ratio of expected incomes between CNS and GN is 2.07 to 1. Conclusion: We found that when a CNS serves a patient, satisfaction, number of personal recommendations, hospital re-visit intention, and indirect marketing effects were higher than those of GN. These results show that CNS have dominant roles and functions and that the effects of CNS employment can be measured using economics parameters.

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Development of a Standardized Education Protocol for Peritoneal Dialysis Patients (복막투석 환자를 위한 표준화된 간호교육 프로토콜의 개발)

  • Kang, Jeong-Hee;Kang, Ji-Yeon;Lee, Young-Ock
    • Journal of Korean Critical Care Nursing
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    • v.4 no.2
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    • pp.47-60
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    • 2011
  • Purpose: The purpose of this study was to develop a standardized education protocol for peritoneal dialysis patients. Methods: First, the demand for education was investigated from the 27 patients on peritoneal dialysis and 16 guardians, and later, the standardized nursing education protocol has been developed through the comprehensive literature review and the critical analysis of the related studies. Contents validity and applicability have been tested through the expert group survey. Results: The standardized peritoneal dialysis nursing education protocol with 9 areas and 20 items has been developed. The content validity for timing and duration, contents, method, and place of education proposed by the protocol were all above than 0.8. In terms of the applicability of the protocol, the experts scored between 4.20 to 4.93 for all items except one. The item on home visit education acquired the lowest applicability score, because there might exist potential restrictions in visiting patient's home. Conclusion: The standardized education protocol developed in this study turned out to be adequate by representing high content validity for all items and the applicability also was high except the item on home visit education. Further researches to test the effects of this education protocol should be done.

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A Study on the Necessity of Home Visit Rehabilitation Therapy by Rehabilitation Professionals Working at Social Welfare Facilities (사회복지시설에 종사하는 일부 재활전문가들의 방문재활에 대한 필요성 조사)

  • Lee, Jeong-Han;Kim, Gye-Yeop;Kim, Eun-Jung
    • The Journal of Korean Physical Therapy
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    • v.22 no.5
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    • pp.95-102
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    • 2010
  • Purpose: The purpose of this study was to analyze the necessity of home visit rehabilitation therapy by rehabilitation professionals working at social welfare facilities. Methods: The subjects of this study were 227 rehabilitation professionals (social worker, nurse, physical therapist, occupational therapist, speech-language therapist, special education teacher, and staff of institutions for the disabled who were working at community rehabilitation centers. The data were collected over 65 days (2008. 09. 10~11. 14). The results were analysed statistically by the Chi-square test. Results: The results are as follows: Long-term care service was established in Korea by the Ministry of Health in July, 2008. But there are limits to their being able to provide various rehabilitation services for chronic patients and old people. According to a recent survey, almost all rehabilitation professionals (N=227) stated that home visit rehabilitation therapy is necessary. Conclusion: In Korea, the long-term care service has a nursing service and a service supporting physical activities of daily living, but not physical therapy. So, home visit rehabilitation services should include physical therapy, rehabilitation exercise, and pain management.

Evaluation of Shortening the Stay Time of Patients in an Emergency Medical Center (EMC) (응급실 환자의 응급의료센터 체류시간 단축프로그램 개발 및 효과)

  • Kim, Eun-Joo;Lim, Ji-Young
    • Journal of Home Health Care Nursing
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    • v.17 no.1
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    • pp.21-27
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    • 2010
  • Purpose: The study evaluated a program to shorten EMC stay time. Methods: The subjects were EMC patients, and comprised a control group of 8,477 and an experimental group of 8,378. Data were collected from June 2006 to August 2007, and analyzed concerning stay time for doctor visit, decision making, and discharge. The data were analyzed by $X^2$-test and ANCOVA using SPSS14.0. Result: The stay time of doctor visit, decision making and discharge of the experimental group was significantly less compared to the control group. Using second and third grade triage criteria, the stay time of experimental group was statistically reduced from the control. Conclusion: The implemented shortening program was effective in reducing EMC stay time and increasing EMC effectiveness.

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Current Status of Costs and Utilizations of Hospital Based Home Health Nursing Care in Korea (전국 의료기관 가정간호이용 및 가정간호비용)

  • Ryu, Ho-Sihn
    • Journal of Korean Academy of Nursing
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    • v.36 no.7
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    • pp.1193-1203
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    • 2006
  • Purpose: The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. Method: A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. Result: The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequoia of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (${\fallingdotseq}$ 48 $, 1 $=960 Won). The costs ranged from 74,523 Won (${\fallingdotseq}$78 $, loss of chronic kidney function, N18) to 32,270 Won (${\fallingdotseq}$34 $, other cerebrovascular diseases, 167). Conclusion: Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

Needs assessment of a home-visit safety management training program for visiting nurses (지역사회 방문간호사의 가정방문 안전관리를 위한 실무교육 요구 분석)

  • Kim, Eunjoo;Kim, Hyori
    • The Journal of Korean Academic Society of Nursing Education
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    • v.29 no.2
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    • pp.138-147
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    • 2023
  • Purpose: This study aimed to identify the concrete educational needs of visiting nurses working in a community health setting in Korea. Methods: We conducted four focus group interviews from October 7 to October 18, 2021. Twenty-five visiting nurses who worked in public health centers were recruited through purposive sampling. A qualitative content analysis was used to analyze the interview data. Results: The demands of educational contents for visiting nurse safety management practical training were: (1) coping with physical and verbal violence, (2) coping with sexual violence, (3) infection control for infectious diseases with a high prevalence in the community, and (4) preventing and coping with animal bites during home visits. In addition, visiting nurses suggested training programs that comprised: (1) case-based learning, (2) short video clips, and (3) recurrent integrated education. Conclusion: Safety management training programs for visiting nurses should be implemented to the extent that they add no burden on their workload and are easily accessible at any time. In addition, training programs should be based on actual cases and be focused on contents that can be applied in home visit situations. A practical safety management training program should be developed based on the educational needs of visiting nurses, as identified through this study.

Cost-Effectiveness Analysis of Home Health Care Program for Cerebrovascular Accident Patients (뇌졸중환자 가정간호 및 방문간호서비스의 비용효과 비교)

  • June, Kyung-Ja;Park, Jeong-Young
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.22-31
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    • 2001
  • Purpose of this study is to compare the cost effectiveness of home care services for the cerebrovascular accident patients by the type of institution. The method is the secondary analysis using the patients' charts. 107 subjects and 1.417 visits were sampled from each type of home care institution such as one hospital based home care center. one KNA home care center, one urban health center, one rural health center and one health care post. Result: There were differences in the functional status of patients and the service contents and frequencies provided by the type of home care institution, The cost per visit for one unit of ADL by the hospital based home care was higher than by the community-based home care. Conclusion: It was suggested that the referral system among the home care institutions would be developed to improve the cost-effectiveness.

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