• 제목/요약/키워드: Patient Care

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중소병원 간호사의 사건보고태도와 환자안전간호활동의 관계에서 환자안전관리 중요성 인식의 매개효과 (Mediating Effects of Perceptions Regarding the Importance of Patient Safety Management on the Relationship between Incident Reporting Attitudes and Patient Safety Care Activities for Nurses in Small- and Medium-sized General Hospitals)

  • 박영미;남금희;강기노;남정자;윤연옥
    • 중환자간호학회지
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    • 제12권2호
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    • pp.85-96
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    • 2019
  • Purpose : The purpose of this study was to examine the mediating effect of perceptions regarding the importance of patient safety management in the relationship between incident reporting attitudes and patient safety care activities for nurses in small-and medium-sized general hospitals. The objective was to provide a basis for planning tailored training programs aimed at improving patient safety care activities. Methods : This study was conducted with 187 participants in small- and medium-sized general hospitals in K city in South Korea from March 15 to March 31, 2019. The data collected from participants were analyzed using descriptive statistics, a t-test, ANOVA, Pearson's correlation coefficients, and a multiple regression using IBM SPSS/WIN 21.0 software. Results : Patient safety care activities were found to be correlated with incident reporting attitudes (r=.27, p < .001) and perceptions of the importance of patient safety management (r=.59, p < .001). Further, perceptions of the importance of patient safety management had a complete mediating effect (${\beta}=.409$, p < .001) on the relationship between incident reporting attitudes and patient safety care activities. Conclusion : Based on the findings of this study, tailored training programs regarding patient safety care activities focused on boosting perceptions of the importance of patient safety management are highly recommended to improve nurses' patient safety care activities in small- and medium-sized general hospitals.

Providing End-of-Life Care in the Community: What Are the Challenges in Malaysia?

  • Leong, Yoke Yeng;Hamzah, Ednin;McCarthy, Sylvia;Lim, Zee Nee
    • Journal of Hospice and Palliative Care
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    • 제25권3호
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    • pp.133-137
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    • 2022
  • A 72-year-old woman with metastatic lung cancer to bone and brain and with left external iliac vein thrombosis was under the care of a community palliative care provider. She experienced an acute pain crisis due to acute limb ischemia of the left lower limb. Goals-of-care discussions were held with the patient and her family; she prioritized symptom control and end-of-life care at home. The family and patient were aware of her short prognosis. Her complex pain was managed by the community palliative team, and her family was empowered to give subcutaneous injections. We illustrate a case showing the importance of community health services with palliative care support in providing symptom management and support to patient and family caregivers throughout the course of a life-limiting illness. It also highlights family caregivers' potential psychological distress in delivering subcutaneous injections in terminal care for a patient at home.

일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정 (Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital)

  • 김경운
    • 간호행정학회지
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    • 제6권3호
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    • pp.389-404
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    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

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Notification of Terminal Status and Advance Care Planning in Patients with Cancer

  • Lee, Si Won
    • Journal of Hospice and Palliative Care
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    • 제25권1호
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    • pp.42-49
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    • 2022
  • As population aging increases the burden of cancer, the quality of death of patients with cancer is emerging as an important issue alongside their quality of life. To improve the quality of death, it is necessary to prepare for death, allowing patients to die comfortably and with dignity at the end. Considering these issues, I aim to discuss the practical aspects of notifying the patient of the terminal phase of cancer and planning for end-of-life care (i.e., advance care planning). When cancer treatment that can extend the patent's lifespan becomes difficult, the patient enters a treatment transition period. Treatment is shifted from life-prolonging care to life-enhancing care, and end-of-life care must be well planned. Medical providers often worry too much about whether the patient will be disappointed or psychologically traumatized when notified of the terminal phase of their cancer, thus delaying plans for end-of-life care. In fact, patients can accept their condition and prepare for end-of-life care better than we expect. During the treatment transition period, notification of terminal status should be given, and a well-prepared advance care plan should be established early when the patient has decision-making ability. In addition to conveying information, it is always necessary to be sensitive to whether the patient and caregiver understand the information and respond to their emotions.

뇌혈관질환 환자군의 가정간호 행위묶음 수가연구 (Estimation of Home Care Nursing Cost to the Patient with Cerebrovascular Disease based on a Bundle of Home Care Nursing Service)

  • 홍진의;윤순녕
    • 가정∙방문간호학회지
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    • 제7권1호
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    • pp.26-38
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    • 2000
  • The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

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응급 간호 서비스에 대한 환자만족도 (Patient Satisfaction with Nursing Care in the Center for Emergency Medicine)

  • 김영혜;김정순;이내영
    • 간호행정학회지
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    • 제13권4호
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    • pp.455-461
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    • 2007
  • Purpose: To examine patient satisfaction with nursing care and the difference of patient satisfaction by the characteristics of emergency care service in the center for emergency medicine. Method: We surveyed 145 patients who visited Pusan-Wide Emergency Medical Center from Nov 01, 2003 to Nov 30, 2003. Patient satisfaction was assessed by asking patients and medical records reviewed to obtain the characteristics of emergency care service. Results: The mean score of patient satisfaction with nursing care was 3.12. For patient satisfaction, 'The nurse seemed earnestly concerned about my pain, fear, and anxiety' represented highest score (3.58). Patient satisfaction according to the general characteristics of patients was revealed as significantly high for the higher educated and the older. Patient satisfaction by the characteristics of emergency care service was significantly higher in no-wait group. Conclusion: Also, the fundamental of nursing, like respect for human, was maintained in emergency setting, the hospital's administration has implemented service for a high level of satisfaction with nursing care up to the expectations of the patients for with the staff and medical equipment.

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병원 간호사가 지각하는 환자안전문화와 안전간호활동과의 관계 (Relationship between Hospital Nurses' Perceived Patient Safety Culture and Their Safety Care Activities)

  • 최정화;이경미;이미애
    • 기본간호학회지
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    • 제17권1호
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    • pp.64-72
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    • 2010
  • Purpose: This study was performed to measure hospital nurses' perceived patient safety culture and their safety care activities, and to investigate the relationship between these two factors. Method: This study was a cross-sectional survey. The participants were 301 nurses working at 4 general hospitals, and data collection was done from June 22 to June 30, 2009 by self-administrated questionnaires. Results: With a possible score of 5 points, the average score for nurses' perceived patient safety culture was 3.34, and for their safety care activities, 4.25. There were perceived differences in patient safety culture and safety care activities according to age, position, length of work experience and number of patient safety education sessions attended. All sub-factors in patient safety culture had a positive relationship with safety care activities. Factors influencing nurses' safety care activities were number of patient safety education sessions attended, hospital environment, and supervisor/manager. These factors explained 58.2% of the variance. Conclusion: The findings indicate that patient safety education is very important to improve nurses' safety care activity. So nursing supervisors/ managers should develop strategies encourage patient safety education, and make nurses' working environment safer.

3 차 의료기관에서의 영양업무 분석 : 업무수행 시간 및 적정인원 산출 (A Study for Dietetic Practitioner's Job Analysis : labor Time Spent and Staffing Need Indices)

  • 조미란;구정민;이혜옥;조여원
    • 대한영양사협회학술지
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    • 제7권1호
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    • pp.38-49
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    • 2001
  • This study was designed to analyze the dietetic practitioner's job in the over 600-ed hospitals in korea and to assess their labor time spent and staffing need indices. The actual time spent and expected labor time spent on dietitians' activities were investigated and the proper dietic staffing needs in the hospitals was also calculated. A job analysis questionnaires were developed and mailed to 20 hospitals. Completed questionnaires were received form 12 hospitals for a response rate of 60%. The followings are summary of the results. 1. The jobs dietitians at the hospitals were classified into the following 7 areas, direct patient care, indirect patient care, therapeutic patient care, education & counseling, meeting & research, delay & movement, and administration & food services. 2. The actual time spent on dietetic practice was 48.6 hours and expected labor time spent was 99.2 hours, Therefore, the proper time required to conduct classified jobs was 2.1 times higher than the time spent. Especially, the time required for performing clinical nutrition services including direct patient care, indirect patient care, therapeutic patient care was significantly higher than the time needed. 3. The average times required for the direct patient care was 1334.6min, for the indirect patient care was 796.3min, for the therapeutic patient care was 1634.5min, for the education & counseling was 265.2min, for the meeting & research was 366.7min, for the delay & movement was 327.3min, and for the administration & food services was 1170min. The staffing need indices was 12.3. As a conclusion, the standardized job descriptions for the dietitian to carry out their job at the hospital should be established. And the clinical dietitians as nutrition professionals have to be recruited to provide systematically hospitalized patients with medical nutrition therapy at each hospital.

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환자중심의료를 위한 병동디자인이 환자가족 및 의료진에 미치는 효과에 대한 연구 - 미국의 환자중심의료를 위한 중환자병동 사례를 중심으로 (A Study on the Effect of Unit Design for Patient-Centered Care on Family Members and Caregivers - A Case Study of the Intensive Care Unit (ICU) for Patient-Centered Care in the United States)

  • 최영선
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제21권3호
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    • pp.37-45
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    • 2015
  • Purpose: The main objective of this paper is, to evaluate the unit design for patient-centered care and to draw lessons-learned for further improvement. Methods: This study conducted a case study of the intensive care unit, designed to fulfill patient-centered care in the US. It evaluated the effectiveness of the unit by incorporating several study methods such as plan analyses, direct observations through nursing tracking and behavior mapping, and focus group interviews. Results: The major design decision made in this patient-centered unit was the use of patient rooms with designated family areas and distributed nursing stations. Both design features appeared to be a success on a variety of research metrics and outcomes. The study identified that the patient rooms ultimately help family members to spent more time with their loved ones, which leads to increased satisfaction of family members and nurses also report that they generally enjoy the distributed nurses' stations, which provide a comfortable environment to complete their regular lines of work such as charting, monitoring patients, and collaborating with their colleagues. Implications: Certain design features in intensive care units such as patient rooms with designated family areas and distributed nursing stations could appropriately support hospitals to fulfill patient-centered care.

간호·간병통합서비스병동과 일반병동 환자의 간호요구도, 간호만족도 및 간호사의 의사소통 유형 비교 (Comparison of Patient Needs, Patient Satisfaction, and Communication Type of Nurses between Integrated Nursing Care Service Ward and General Ward Patients)

  • 강연진;민정아;박창순;전은영
    • 가정∙방문간호학회지
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    • 제28권3호
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    • pp.317-328
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    • 2021
  • Purpose: The purpose of this study is to provide patient-centered nursing by comparing the patient needs, patient satisfaction, and communication type of nurses for patients admitted to integrated nursing care service ward and general ward. Methods: Data were collected by self-report questionnaires between September 7 and October 9, 2021. Patients were patients recruited from a hospital in D city, 100 each from comprehensive nursing care service ward and general ward. The data were analyzed using descriptive statistics, 𝜒2-test, t-test, ANOVA, and Pearson's correlation. Results: There was no significant difference in patient needs between the patients of integrated nursing care service ward and the general ward (t=-1.12, p=.263). However, patient satisfaction was higher among the patients in integrated nursing care service ward than in the general ward (t=-3.55, p<.001). Pertaining to the communication type of nurses, the informational communication type (t=-4.02, p<.001) and the friendly communication type (t=-3.92, p<.001) were stronger in the integrated nursing care service ward than the general ward. It was, hence, confirmed that the educational requirements were positively correlated with patient satisfaction in the reliability domain and technical-professional domain, and that the nurse informational communication type and friendly communication type had a significantly positive correlation with patient satisfaction. Conclusion: The expansion of the integrated nursing care service ward may be considered in the future, with an informational and friendly communication method as an effective response that can be adapted in practice as a reflection the type of communication among nurses.