• Safety and Health at Work
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• 제9권4호
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• pp.408-415
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• 2018

Background: Nursing home resident care is an ongoing topic of public discussion, and there is great interest in improving the quality of resident care. This study investigated the association between nursing home employees' job satisfaction and residents' satisfaction with care and medical outcomes. Methods: Employee and resident satisfaction were measured by questionnaire in 175 skilled nursing facilities in the eastern United States from 2005 to 2009. Facility-level data on residents' pressure ulcers, medically unexplained weight loss, and falls were obtained from the Centers for Medicare and Medicaid Services Long-Term Care Minimum Data Set. The association between employee satisfaction and resident satisfaction was examined with multiple and multilevel linear regression. Associations between employee satisfaction and the rates of pressure ulcers, weight loss, and falls were examined with simple and multilevel Poisson regression. Results: A 1-point increase in overall employee satisfaction was associated with an increase of 17.4 points (scale 0-100) in the satisfaction of residents and family members (p < 0.0001) and a 19% decrease in the incidence of resident falls, weight loss, and pressure ulcers combined (p < 0.0001), after adjusting for staffing ratio and percentage of resident-days paid by Medicaid. Conclusion: Job satisfaction of nursing home employees is associated with lower rates of resident injuries and higher resident satisfaction with care. A supportive work environment may help increase quality of care in the nation's nursing homes.

• 지역사회간호학회지
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• 제16권3호
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• pp.329-340
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• 2005

Purpose: The study was performed to compare the contents of jobs and job satisfaction of resident nurses at free elderly homes with nursing homes in Korea. Method: The subjects consisted of 138 resident nurses at free elderly homes and nursing homes. Data were collected from the 1st of January to the 22nd of February in 2005 using a structured questionnaire containing questions on general characteristics. contents of the nurses' daily tasks, health program. job satisfaction and pay satisfaction. Collected data were analyzed using SPSS (version 11.5) through descriptive statistics, $X^2-test$, t-test and ANOVA. Result: For nurses at free elderly homes and nursing homes. their daily tasks consisted of health assessment. medication care and eating care. The general job satisfaction of the nurses was similar between those at free elderly homes and those at nursing homes, but working conditions and pay were significantly different according to the sub content of job satisfaction. Job satisfaction was significantly different according to marital status in resident nurses at the free elderly home, and according to the experience of living with the elderly and the experience of receiving special training or lectures in elderly nursing in resident nurses at free nursing homes. Conclusion: Resident nurses at free elderly homes and nursing homes had various types of tasks, and it is necessary to differentiate tasks and payment systems for them according to their job.

• 성인간호학회지
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• 제18권3호
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• pp.488-499
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• 2006

Purpose: Behavioral symptoms in dementia (BSD) are one of the most disturbing behaviors to caregivers and a major reason for nursing home placement. Behavioral symptoms are often treated with psychotropic drugs (PD), however, the effect of such drugs for the frail elderly dementia patient is not certain because of their critical adverse effects. Theoretical model applicable to nursing practice for BSD in nursing homes, which is essential in guiding and evaluating such interventions, is absent. This article presents the process of developing a theoretical model of BSD in nursing homes. Method: Using Walker and Avants' theory synthesis method, three behavior models and two system models were incorporated into the proposed model to provide the theoretical and analytical explanation of the relationships between PD usage, its determinants, and BSD. Results: Resident variables and nursing home variables related to the two focal concepts (i.e., PD usage and BSD) were identified. Resident variables include demographical characteristics such as age and gender, and dementia-compromised functions such as cognitive and functional impairment. Nursing home variables include facility characteristics such as ownership type and size, and physical and psychosocial environment. Conclusion: The proposed model suggests that fulfillment of resident unmet needs through improvement of physical and psychosocial environment may produce better health outcomes of nursing home residents with BSD. Assessment and intervening environmental triggers of such behaviors are also suggested to be prior to the PD usage.

• 지역사회간호학회지
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• 제14권1호
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• pp.75-82
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• 2003

The purpose of this study was to develop an information system for home care service based on RAI(Resident Assessment Instrument). The standardization of service providing process was conducted using the steps of need assessment, triggers, application of CAPs, and care plan. The structure of MDsoft-HC was composed by MDS-CAPS system and system management system. A database on home care clients was accumulated by putting data, respectively, in general information, MDS-item, and MDS-result. Based on this data, the list of CAPs for the client was selected and monthly and annual statistics were calculated by problem result counts. It was suggested that standardization of a care plan would be integrated and short form of need assessment would be developed in the next stage.

• 가정∙방문간호학회지
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• 제12권1권
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• pp.117-135
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• 2005

Purpose: Expecting a new system of nursing security for elderly in operation in 2007, a substantial expansion of nursing facilities for elderly and quality management of those facilities are imperative now. Therefore. specific quality management measures or schemes which could be used for the operation of small-scale nursing homes are in urgent need. The purpose of this study was to develop a Quality Management Index(QMI) to guide Nursing Home management. Method: This study developed a QMI for small-scale nursing homes, which focused on quality management in structural dimensions such as environment, staffs, local community network, atmosphere, and quality management in process dimensions such as nursing, communication, resident satisfaction. The QMI developed in this study is based on extensive review of literature and the actual experiences of nursing home operation. It consists of 7 dimensions, 39 components and 148 indexes, which have been verified by three times validity tests of experts group. Then the QMI was used to evaluate the quality management levels of nursing homes in Korea. Result: In sum, after analyzing all nursing homes in Korea operated by nurses, this study found that there were significant differences of quality management level among facilities in several dimensions such as environment, staffs, local community connections, communication. In dimensions such as nursing, atmosphere, resident satisfaction, however, little differences of quality management level among facilities were reported. It is considered that this result has to do with several factors like the size of facilities, operation expenses, operation forms, the disposition of professional human resources, and philosophy and management policy of the owners. As far as generalization is concerned, however, it needs to be noted here that the sample size for this study is not statistically big enough to generalize the results. Conclusion: Having Developed a QMI for small-scale nursing home with 7 dimensions, 39 components and 148 indexes, this study is expected to be used in developing more elaborated quality evaluation tools for nursing homes, and also function as a practical guide of quality management for those who are opening and managing nursing homes. I hope this quality index could lead to further development of a standardized quality management index, and eventually contribute to quality improvement of nursing homes.

• 대한간호학회지
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• 제39권3호
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• pp.366-375
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• 2009

Purpose: To evaluate the effects of case management using Resident Assessment Instrument-Home Care(RAI-HC) in home health service for older people. Methods: All elders were assessed at baseline and 3 months later using RAI-HC. The change of function in the intervention group was compared with that of a conventional intervention group. Function was measured with Activities of Daily Living(ADL), Instrumental Activities of Daily Living(IADL), Cognitive Performance Scale(CPS), Depression Rating Scale(DRS), Pain and the number of Clinical Assessment Protocols(CAP). Results: Among ninety two elders participated in the program, 59 were allocated to the case management group and 33 to the conventional group. The intervention, home health service by a nurse over a 3 month period, consisted of comprehensive assessment, case conference for care plan, direct care, education and referral, and outcome evaluation. The percent of elders whose function improved in the intervention group was greater than the conventional group for depression(odds ratio [OR]: 10.941, confidence interval [CI]: 2.338-51.206), IADL(OR: 4.423, CI: 1.151-16.999) and the number of CAP(OR: 11.443, CI: 3.805-34.410). Conclusion: Case management was effective for older people in the community. The effect might have resulted from individual, systematic intervention, however, standards of service including eligibility criteria for case management and collaboration of multi-disciplines is required for more effective home health service programs.

• 동서간호학연구지
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• 제22권1호
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• pp.24-31
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• 2016

Purpose: The purpose of this study was to identify and compare the differences on perceived health status, Activities of Daily Livings (ADL), social support, and residential satisfaction between long-term care hospitals and nursing homes. Methods: Data was collected through questionnaires and interviews conducted from March 29 to April 22, 2011. The subjects were 66 old adults in 3 long-term care hospitals and 53 old adults in 6 nursing homes. Data were analyzed by Pearson's correlation analysis and t-tests. Results: ADL and subjective health status in nursing homes were worse than those in long-term hospitals, but it was not statistically significant (p>.05). Old adults in nursing homes received more emotional support from other residents and staff, and received more instrumental support from staff than those in long-term care hospitals (p<.001). The mean scores of resident satisfaction in long-term care hospitals and nursing homes were 3.53 ($SD={\pm}0.36$) and 3.97 ($SD={\pm}0.44$), respectively. Resident satisfaction in nursing homes significantly was higher than long-term care hospitals (p<.001). Conclusion: Health care personnels in long-term care hospitals should enhance resident satisfaction and social support and need to coordinate long-stay patients with nursing homes.

• 대한간호학회지
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• 제49권6호
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• pp.783-794
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• 2019

Purpose: This study identified factors related to the quality of care in nursing homes, and elicited consensus opinions from experts on nursing homes. Methods: A Delphi questionnaire was developed based on a review of the literature using the keywords "nursing homes," "workforce," and "quality of care." A total of two Delphi surveys were conducted with 14 experts. The important and urgent factors related to the quality of care for nursing home residents emerged. Results: A consensus was achieved on the important and urgent factors relating to the quality of care. The related factors were grouped into four sections: Organizational Characteristics, Staffing Characteristics, the Long-Term Care Market and Legal and Policy Issues, and Nursing Processes. In total, 23 items were important factors and 26 items were urgent factors relating to the quality of care. In addition, the unanimous advocacy by the experts for increased hours per resident day for registered nurses (RNs, 41 minutes 59 seconds) was much higher than the current hours per resident day of RNs in Korea. Conclusion: To provide optimal care for residents in nursing homes in Korea, the mandatory and essential placement of RNs with professional knowledge and skills is paramount.

• 대한간호학회지
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• 제35권4호
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• pp.745-753
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• 2005

Purpose. The purposes of this study were to 1) describe the type and frequency of aggressive behavior of cognitively impaired nursing home resident, 2) develop a caregiver training program on prevention and management of aggressive behavior, 3) examine the effects of caregiver training program on the incidence of aggressive behavior of cognitively impaired nursing home resident, and 4) examine the effects of caregiver training program on nursing staff's aggressive behavior management skills. Methods. One-group, time series, quasi-experimental design with a pre-test and two post- tests was used. Data were collected from cognitively impaired home residents (N = 32) and nursing staff (N = 36) in a proprietary nursing home using Ryden Aggression Scale I, II, and Aggressive Behavior Management Scale. Data were entered and analyzed by descriptive statistics and repeated measures ANOVA. Results. Incidence of aggressive behavior was high with a mean score of 3.09 (SD = 3.11) at baseline. Caregiver training program was developed based on Progressively Lowered Stress Threshold (PLST) model and gerontological and psychiatric literature. The mean scores of aggressive behavior at baseline, Post I, and II did not differ significantly although the difference approached to the significant level (F = 2.925, p = .066). Nursing staff's aggressive behavior management skills increased at Post I, and at Post II when compared to baseline, and the difference was significant (F=12.736, p=<.00l). Conclusion. Caregiver training program showed potential impact on reduction of aggressive behavior in elders with cognitive impairment and was effective in increasing nursing staff's aggressive behavior management skills.

• 한국디지털건축인테리어학회논문집
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• 제10권3호
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• pp.73-77
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• 2010

The study investigated the actual conditions of U.S. nursing-home facilities and Korean nursing homes and conducted a comparative analysis of those nursing facilities to propose the following suggestions for facility improvement: 1.) The number of sickbeds per nursing unit in Korea should be maintained a level of more than 30 beds like the United States, and each rest room in a residential facility should have an area of at least 4.2 square meters. 2.) Each room of a nursing home should be occupied by four or less persons for privacy. 3,) The minimum areas of residential rooms should be larger than 9.2 sq. meters for single rooms and 6.1 sq. meters for quadruple rooms. 4.) Nursing homes for the elderly need to improve rest room spaces and interior fishes to prevent them from falling down and getting hurt and thus help them live safely.