• Title/Summary/Keyword: Patient care

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The Cost of Long-Term Care Alternatives for the Elderly (미국 노인환자들의 만성질환관리형태에 대한 비용분석)

  • Lee, Tae-Wha
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.2
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    • pp.351-361
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    • 1998
  • The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

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Patient Satisfaction with Advanced Practice Nurse in a Tertiary Hospital (일 상급종합병원의 전문간호사에 대한 환자만족도)

  • Choi, Eun Ju;Jang, In Sil;Hwang, Ji Hyeon;Kang, Young-Ah;Kim, Sung Reul;Nho, Ju-Hee;Kim, Jeong Hye
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.3
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    • pp.335-346
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    • 2015
  • Purpose: The purpose of this study was to identify patient satisfaction about nursing care provided by Advanced Practice Nurses (APN) using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). Methods: The investigation was conducted including 263 patients who experienced care provided by 41 APNs at a tertiary hospital in Korea. Patient satisfaction with nursing care was measured using 41-item LOPSS. We analyzed the data using descriptive statistics, independent t-test and one-way ANOVA. Results: Overall patient satisfaction with APN care was high. The LOPSS scores for APNs were 52.26 for good impression, 61.75 for interpersonal support, 81.32 for dissatisfaction and 195.93 for total score. "APNs talk down to me" was a reverse coding item which demonstrated the highest score for patient satisfaction. Among patients' characteristics, age and type of main caregiver were independent factors related to patients's satisfaction. Among APN's characteristics, work experience was significantly related to patients' satisfaction. Conclusion: This study identified patient satisfaction regarding nursing care provided by APNs. High patient satisfaction in APN services demonstrated APNs' contribution to quality improvement in health care services. It is recommended that various outcome research about APN service needs to be performed.

The Influences of the Awareness of Patient Safety Culture on Safety Care Activities among Operating Room Nurses (수술실 간호사의 환자안전문화에 대한 인식이 안전간호활동에 미치는 영향)

  • Lee, Kyung Hee;Lee, Young Shin;Park, Hae Kyung;Rhu, Jung Ok;Byun, In Seung
    • Journal of Korean Clinical Nursing Research
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    • v.17 no.2
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    • pp.204-214
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    • 2011
  • Purpose: This study was aimed to provide information on the awareness of patient safety culture and safety care activities among operating room (OR) nurses and to analyze the factors influencing the safety care activities. Methods: For this descriptive research, self-reported questionnaires were administered to 168 OR nurses who were working at the university-affiliated and general hospitals. The collected data were analyzed using descriptive statistics, t-test, ANOVA, $Scheff{\grave{e}}$ test, Pearson's correlation coefficient and Stepwise multiple regression with SPSS/WIN 17.0. Results: The mean score of the awareness on patient safety culture was 3.27 out of 5 points and that of safety care activity was 4.31 out of 5. The statistically significant difference was found between experience of safety education and the awareness on patient safety culture. Also, the scores of safety care activities were significantly different according to OR nurses' position, education levels, and experience of safety education. There was a positive correlation between the awareness of patient safety culture and safety care activity. Their explanatory power on safety care activity was 8.8%, which includes working environment in operating room 3.3% and nursing position 5.5%. Conclusion: Compared to the level of patient safety activities, the OR nurses' awareness on patient safety culture was low. Given the specific characteristics and conditions in each hospital, it needs to increase the OR nurses' awareness on patient safety culture and activities related to patient safety.

International Trends on Patient-Reported Outcome Measures for Improving Care Quality and Its Implication for South Korea: Focus on OECD PaRIS (의료의 질 향상을 위한 환자중심 건강결과 측정의 국제 동향과 국내 시사점 - OECD PaRIS를 중심으로)

  • Choi, Ji-Suk;Park, Young-Shin;Kim, Jee-Ae;Park, Choon-Seon
    • Quality Improvement in Health Care
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    • v.25 no.1
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    • pp.11-28
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    • 2019
  • Purpose: The purpose of this paper is to derive implication on the adoption of PROMs (Patient-Reported Outcome Measures) to improve quality of care in South Korea. With this purpose, the paper examines the status of PROMs in South Korea and other countries including OECD's PaRIS (Patient Reported Indicators Survey) initiative, and reviews policy cases that have adopted PROMs to improve performance of healthcare system. Methods: We conducted literature review on OECD reports on PaRIS, peer-reviewed journals, and information from the websites of relevant institutions such as ICHOM, NQF and OECD. Results: To identify healthcare services of best values and support patient-centered health system, OECD has initiated PaRIS which develops, collects and analyzes patient-reported indicators for cross-countries comparison. PaRIS is implemented on two work streams: 1) collect, validate and standardize PROMs in the areas where patient-reported indicators already exist such as breast cancers, hip and knee replacement, and mental conditions, 2) develop a new international survey on multiple chronic conditions. Countries like England, U.S., Sweden and Netherlands use PROMs for measuring performance of hospitals and performance evaluation at the national level, and provide the financial incentives for reporting PROMs. Conclusions: The use of PROMs can support the current policy agenda that is the patient-centered healthcare system which has been emphasized to reinforce the primary and the community-based care. For the use of PROMs, it is recommended to actively participate in PaRIS initiative by OECD, select appropriate instruments for PROMs, and continue on standardization of them. This will assure patients' involvement in improving health system performance, systemize information generated in the process of adopting PROMs, and develop a system to evaluate performance.

Development of a Care Robot for Lift and Transfer of Bedridden Patients (와상환자의 이승 및 이송 작업을 위한 돌봄로봇 개발)

  • Konchanok Vorasawad;Hyeokdong Kweon;Changwon Kim
    • The Journal of Korea Robotics Society
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    • v.18 no.4
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    • pp.403-408
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    • 2023
  • In this paper, we introduce the results of the development of a care robot for the safe lifting and transportation of bedridden patients with difficulty moving by themselves, especially, in medical facilities. The purpose of the developed patient transfer robot is to improve the convenience of care givers and enhance the safety and comfort of care recipients by facilitating patient lifting and patient transfer tasks by applying robot technology. In order to implement the lifting function, a hoist was designed and developed, and a sway control and rollover warning system were included in the hoist module as product differentiators. In addition, in terms of implementing the transfer function, an omnidirectional movement mechanism to improve operability in confined spaces and an active safety system to prevent collisions were developed. The function of the developed patient transfer robot was verified through performance evaluation by an authorized testing agency.

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care (간호·간병통합서비스 제공을 위한 간호인력 배치기준 개발)

  • Cho, Sung-Hyun;Song, Kyung Ja;Park, Ihn Sook;Kim, Yeon Hee;Kim, Mi Soon;Gong, Da Hyun;You, Sun Ju;Ju, Young-Su
    • Journal of Korean Academy of Nursing Administration
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    • v.23 no.2
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    • pp.211-222
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    • 2017
  • Purpose: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. Methods: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. Results: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. Conclusion: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

The Effect of Satisfaction Among Convalescent Hospital Staff Members on Patient Safety and Quality of Care After Medical Institution Certification (의료기관 인증 후 요양병원 종사자의 만족도가 환자의 안전과 질 향상에 미치는 영향)

  • Jeong, Yeon-Ja;Choi, Senog-Woo;Park, Jong;Han, Mi-Ah
    • The Korean Journal of Health Service Management
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    • v.13 no.3
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    • pp.39-51
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    • 2019
  • Objectives: This study aimed to investigate the effect of satisfaction among convalescent hospital staff members on patient safety and quality of care after the certification of the medical institution. Methods: A survey was conducted on seven convalescent hospitals in Gwangju, South Jeolla Province, and North Jeolla Province, which were certified as medical institutions for convalescent hospitals by the end of May 2017, The study period lasted from July 24, 2017 to August 22, 2017. Results: There was a statistically significant correlation between staff member satisfaction and patient safety and quality of care (r = 0.586, p<0.001). Regression analysis showed that staff member satisfaction (${\beta}=0.531$, p<0.001) had a statistically significant effect on patient safety and quality of care and showed 46.9% explanatory power. Conclusions: The satisfaction of the convalescent hospital staff after the certification of the medical institution positively affected patient safety and quality of care.

Performance and Impediments to Patient and Family Education among Home Health Care Nurses (가정전문간호사의 환자·가족교육 수행정도와 저해요인)

  • Seo, Yoo Jin;Lee, Mi Kyoung
    • Journal of Home Health Care Nursing
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    • v.26 no.3
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    • pp.329-340
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    • 2019
  • Purpose: This study aimed to provide basic data necessary to develop education programs and educational services for home care by investigating the degree of patient and family education among home health care nurses. Methods: Data collection was carried out with 145 people from 47 institutions that agreed to participate in the research. A total of 128 questionnaires were received, of which 122 were analyzed. Data were analyzed using SPSS 12.0. Results: The item on which education was most frequently delivered was intravenous injection speed control (66.4%), whereas the item requiring the longest teaching period was pressure ulcer care. The average degree of impediment perceived by home care nurses was 2.82 out of 5. Conclusion: Medical institutions should develop educational materials and programs that reflect the characteristics and degree of home health care needed. Repeated research, including that by medical institutions, on the degree and impeding factors related to patient and family education performance of home health care nurses should be conducted. Moreover, medical institutions should investigate the nursing and educational needs of patients and families who received home health care service.