• 대한간호학회지
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• 제40권3호
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• pp.349-358
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• 2010

Purpose: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. Methods: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. Results: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). Conclusion: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.

• 간호행정학회지
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• 제20권1호
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• pp.95-105
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• 2014

Purpose: The purpose of this study was to examine trends in number of nursing staff and skill mix. Methods: Nursing staff and skill mix were measured using the number of nursing staff including nurse aids and registered nurses per bed. Descriptive and panel data regression analyses were conducted using data on long-term care hospitals which included yearly series data from 2006 to 2010 for 119 hospitals. Results: The number of nursing staff per bed increased significantly but percentage of registered nurses decreased significantly from 2007 to 2010. The regression model explained this variation as much as 34.9% and 43.8%. Conclusion: The results showed that in long-term care hospitals there were more nurse aids employed instead of registered nurses after the implemention of differentiated inpatient nursing fees. Thus clarifying the job descriptions for nurses and nurse aids is needed and appropriate hospital incentive policies should be implemented.

• 임상간호연구
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• 제29권3호
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• pp.249-260
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• 2023

Purpose: The study aimed to examine the effects of nurse staffing levels on patient outcomes in long-term care hospitals in South Korea using path analysis. Methods: We conducted a secondary analysis of national data, which included the 2021 hospital assessment results of long-term care hospitals from the Health Insurance Review and Assessment Service. Data collection was performed between June 19 and June 27, 2023. The study sample consisted of 1,215 hospitals, and we analyzed the data using SAS 9.4 and Mplus 8 software. Results: The average numbers of patients per registered nurse, certified nursing assistant, and nursing staff, including both registered nurses and certified nursing assistant, was 10.00, 7.43, and 4.00, respectively. Path analysis revealed that the number of patients per registered nurse had direct effects on improvements in activities of daily living and indirect effects on indwelling catheterization, pressure ulcer improvement, and weight loss. The number of patients per certified nursing assistant had direct effects on new pressure ulcer development and pressure ulcer improvement, with no indirect effects. The number of patients per nursing staff had direct effects on pressure ulcer improvement and no indirect effects on other patient outcomes. Conclusion: The findings suggest that establishing policies to evaluate staffing levels of registered nurse and certified nursing assistants separately is necessary in order to improve registered nurse staffing levels and patient outcomes in long-term care hospitals.

• 한국보건간호학회지
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• 제37권2호
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• pp.275-289
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• 2023

Purpose: This study developed a structural model for explaining and predicting terminal care performance in long-term care hospital nurses. The model was based on the stress integration model of Ivancevich and Matteson(1980) and the results of previous studies. Method: Data was obtained from August to September 2022 from 267 nurses in 13 long-term care hospitals in G-do. Results: Results of model verification for this study, revealed that factors directly affecting the terminal care performance of long-term care hospital nurses were nursing work environment(β=0.43, p<0.001), death anxiety(β=-0.29, p<0.001), and terminal care stress(β=0.22, p=0.003). However, the attitude toward nursing care of dying(β=0.07, p=0.287) had no effect on the terminal care performance. Conclusion: The results of this study, confirmed the necessity of improving an individual's perceived nursing work environment, continuous education related to terminal care to reduce death anxiety, and an interventional approach for enhancing terminal care performance.

• 한국병원경영학회지
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• 제28권3호
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• pp.58-67
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• 2023

Purpose: The purpose of this study was to analyze the factors associated with long-term hospitalized patients in long-term care hospitals using the quality assessment data for long-term care hospitals by the Health Insurance Review. Methods: Among 1,376 long-term care hospitals, frequency analysis and descriptive statistics were used to analyze the characteristics of these hospitals. Multiple linear regression was conducted to examine the associations between infrastructure characteristics, medical personnel characteristics, health outcomes and the proportion of long-term hospitalized patients. Results: The research findings indicate that the number of patients per doctor, the number of patients per nurse, and the number of patients per nursing staff were positively associated with the proportion of long-term hospitalized patients. Among health outcomes, a higher proportion of patients with more than a 5% weight loss compared to the previous month and the proportion of patients showing improvement in ADL, were more likely to have a lower proportion of long-term hospitalized patients. However the proportion of diabetic patients with HbA1c test results within the appropriate range was positively associated with the proportion of long-term hospitalized patients. Conclusion: The present study results provide fundamental data for the establishment of policies for long-term care hospitals. Based on this study, it is important to suggest screening methods for unnecessary long-term hospitalizations, such as sufficient medical personnel to improve the quality of care in long-term care hospitals. It is also necessary to clearly separate the roles of medical institutions and long-term care facilities and implement policies to support patients' social reintegration.

• 간호행정학회지
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• 제9권3호
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• pp.353-366
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• 2003

Purpose: This study was to define the care time of elderly in long-term care facilities and to compare and analysis the care time by staff and facility types. Method: The data were collected from 530 elderly over sixty, residing in two long-term care hospitals for dementia, three long-term care hospitals for the elderly and two skilled nursing facilities. Care time for individual residents was measured the total time spent by nurses, aides. Result: The average care time measured by nursing staff was 158.6 minutes a day. The average care time for one resident by nurse was 40.4 minutes, and by aides, 118.2 minutes. The difference of the care time showed statistical significance between long-term care facility types(p<0.001) : average care time for dementia hospital(199.1min) was twice as long as that of skilled nursing facility(94.1min). Conclusion: The results of the study showed that the care time differentiates care time provided to elderly in long-term care facilities in Korea. The study suggests the need to emphasize the importance of standardization of level of staff and service programs by the long-term facilities.

• 간호행정학회지
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• 제16권4호
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• pp.446-454
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• 2010

Purpose: This study was conducted to compare job satisfaction, self-esteem, and nursing task performance between registered nurses (RN) and nurse assistants (NA) in long-term care hospitals. Method: The sample consisted of 203 nursing personnel (RN 99 and AN 104), who were working in one of 5 long-term care hospitals in 5 different areas. Data were collected by structured questionnaires from March 15 to April 30, 2010, and analyzed using the descriptive statistics, independent t-test, One-way ANOVA, and Pearson correlation coefficients with SPSS/Win 17.0 program. Result: There was no significant difference between nurses and nurse assistants in job satisfaction and self-esteem. But nurses had higher levels of nursing task performance than nurse assistants. Conclusions: These findings demonstrate the necessity of developing programs that will help to improve job satisfaction and self-esteem in nurses and nursing task performance in nurse assistants. Strategies need to be developed to maximize the value of the existing workforce without impacting on the quality of care delivered.

• 문화기술의 융합
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• 제9권5호
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• pp.185-192
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• 2023

현재 우리나라 요양병원은 노인인구 증가와 함께 지속적으로 증가하고 있다. 요양병원에 입원하는 환자는 주로 만성질환을 가진 노인들로서 장기요양을 목적으로 하기 때문에 요양병원에서 임종하는 경우가 많아 요양병원에서의 임종간호 중요성이 점점 커지고 있다. 이러한 특징에도 불구하고 요양병원 간호사를 대상으로 임종간호에 대한 연구로는 주로 양적연구들로서 임종간호 경험에 대해 심층적으로 파악하기에 제한이 있다. 따라서 본 연구의 목적은 현상학적 방법을 통해 요양병원 간호사의 임종환자 간호경험의 의미가 무엇인지 이해하고 그 현상의 의미를 심층적으로 기술하고 이해하고자 함이다. 본 연구의 대상자는 C 시에 위치한 요양병원에서 6개월 이상 근무하고 있는 간호사 7명을 선정하였다. 연구방법은 심층 인터뷰로 2021년 12월부터 2022년 3월까지 자료를 수집하였다. 인터뷰 자료는 Giorgi의 현상학적 방법으로 분석하였다. 연구 결과 '임종간호에 대한 간호사의 태도', '연명에 대한 양가 감정', '요양병원의 임종간호에 대한 현실', '삶과 죽음에 대한 성찰'으로 나타났다. 따라서 요양병원 간호사의 임종간호 태도를 변화시키고 대처능력을 향상시킬 수 있는 임종간호 보수교육 및 중재 교육프로그램이 개발되어야 할 것으로 사료된다.

• 간호행정학회지
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• 제18권2호
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• pp.176-188
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• 2012

Purpose: The purpose of this study was to examine nurses' cognition of the diagnosis related group (DRG) in long-term care hospitals and changes in nursing care after application of the DRG system. Method: This study was a descriptive survey involving 161 nurses working in 12 long-term care hospitals located in Gwangju city and Chonnam area. Data were analyzed using the SPSS 18.0 version program. Data analyses utilized descriptive test, chi-square test, Fisher's exact probability test, t-test, and one-way ANOVA. Result: There was no change in cognition of DRG in 55.3% of the nurses, and 26.1% takes to 'change positively'. More than half of the respondents (57.8%) agreed to the application of DRG. After application of DRG, the nurses responded 'there were changes in nursing care' in 23 of the 25 care items. Two items had an increase in nursing care. Conclusions: No distinct changes in nursing care were evident after DRG application. Therefore, there is need to provide education programs related to DRG for nurse in long-term care hospitals.

• 한국노년학
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• 제39권4호
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• pp.903-920
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• 2019

본 연구는 요양병원 간호사의 간호행위 위임정도, 간호전문직관 및 이직의도를 파악하고 이들간의 관계를 확인함으로써 향후 간호행위 위임에 필요한 정책적 지침 및 절차에 관한 기초자료를 제공하고자 시도되었다. 본 연구는 서술적 조사연구로 구조화된 설문지를 이용하여 2개 광역도 소재 6개 요양병원의 간호사 146명을 대상으로 실시하였으며, 자료수집기간은 2016년 7월부터 8월까지이었다. 수집된 자료는 SPSS 22.0을 이용하여 기술통계, t-test, ANOVA, Pearson 상관분석을 실시하였다. 연구결과, 요양병원 간호사의 간호행위는 위임에 대한 명확한 지침이나 법적 절차가 없는 상태에서 7개 행위를 제외한 대부분의 간호행위가 간호보조인력에게 위임되고 있었다. 요양병원 간호사의 간호행위 위임정도와 간호전문직관, 이직의도와의 유의한 관련성은 없었으나 간호전문직관과 이직의도는 유의한 음의 상관관계를 보였다. 따라서, 요양병원 간호사의 이직의도를 낮추기 위해서는 개인적인 측면으로 긍정적인 간호전문직관을 확고히 하는 방안이 모색되어야 하며, 정책적인 측면에서는 요양병원의 적절한 간호인력배치 기준을 마련하여 간호행위 위임지침을 개발해야 한다.