• Title/Summary/Keyword: Process assessment (health care)

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Dimensions of Consumer Ratings of a Hospital Outpatient Service Quality (의료소비자가 인지하는 의료서비스 질의 구성 차원)

  • Yu, Seung-Hum;Cho, Woo-Hyun;Kim, Dong-Kee;Lee, Yun-Whan;Moon, Ki-Tae
    • Journal of Preventive Medicine and Public Health
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    • v.33 no.4
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    • pp.495-504
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    • 2000
  • Objectives : To examine various dimensions of consumer ratings of health care service with factor analysis and to find which factors influence the overall quality of health care service. Methods : A cross-sectional study was conducted on outpatients of a general hospital located in Sungnam City. A self-administered questionnaire was used to assess the consumer's ratings of health care service received. The response rate was 92.8% with a total of 537 persons completing the questionnaire. Factor analysis was performed on 34 items evaluating the quality of health care service. Items were grouped into 5 dimensions as a result of factor analysis and the reliability and validity of influence on patient service assessment were evaluated for each dimension. Results : The 5 dimensions were as follows, 1) physician services, 2) non-physician services, 3) process 4) facilities, and 5) cleanliness A positive correlation with the quality of health care service was found for the dimensions of non-physician services and process, while no significant correlation was found for the dimensions of physician services, facilities, and cleanliness. Conclusions : The result of this study may provide basic information for the development of future self-administered questionnaires of consumer ratings and for the evaluation of quality improvement activities in hospital outpatient settings.

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The Coping Process of Family Caregivers for Demented Elderly (치매노인을 돌보는 가족의 대처과정)

  • Kim, Chun-Mi
    • Research in Community and Public Health Nursing
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    • v.16 no.3
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    • pp.249-259
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    • 2005
  • Purpose: The purpose of this study was to understand the coping process that family caregivers experience during the process of care, to grasp coping behaviors used to solve problems and, finally, to develop a substantive theory by analyzing the coping process. Method: The methodology of collecting and analyzing data used in this study followed the ground theory of Strauss and Corbin(1998). Data were collected through in-depth interviews with open-ended and descriptive questions about the subjects' coping experiences, which were audio-taped and transcribed. The survey was conducted between February 2000 and February 2001. The subjects of this study were 17 women. Result: The result of the study is as follows. The coping process of family caregivers while taking care of the demented elderly was found to have six stages: problem recognition: undertaking care: struggling: mental control: burden mediation; and acceptance. These stages proceed with reciprocal action and in cycle. Conclusion: The result of this study is helpful for developing effective and individual nursing strategies suitable for each coping stage. It is necessary to develop an assessment tool that can judge caregivers' coping stage based on the result of this study. Moreover, we need continuous study to practice nursing mediation and to analyze the change about nursing effect and family members' adaptation.

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Quality and Affecting Factor of Care for Patients Hospitalized with Pneumonia (폐렴 입원환자 진료과정의 질적 수준과 이에 영향을 미치는 요인: 임상질지표를 중심으로)

  • Moon, Sangjun;Lee, Jin-Seok;Kim, Yoon;You, Sun-Ju;Choi, Yun-Kyoung;Suh, Soo Kyung;Kim, Yong-Ik
    • Tuberculosis and Respiratory Diseases
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    • v.66 no.4
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    • pp.300-308
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    • 2009
  • Background: The quality of care for patients with community acquired pneumonia needs to be improved; the factors affecting this care need to be analyzed. The objectives of this study were used to measure the performance of care processes of for patients with pneumonia and to determine those patient and hospital characteristics are associated with quality care. Methods: The analysis was performed using data from 21 hospitals that had over 500 beds for 1,001 patients, who were sampled randomly. All patients were born before 31 December 1989, and discharged between the two months' August 2006 and October 2006. Performance process indicators were measured by respective hospital, and multivariate logistic regression was used to calculate associations between patients and hospital characteristics using 4 process indicators. Results: Performance rates in timely assessment of oxygenation assessments and blood cultures, correct administration of antibiotic medications, and blood culture performed prior to initial antibiotics were 69.4%, 79.1%, 82.5% and 60.5%, respectively. Age had a positive affect on oxygenation assessment within 24 hours. Bed number, number of nurses per bed, annual number of emergency department visits, average percentage of beds filled, location and arrival time, and site were factors associated with process indicators. Conclusion: It is necessary to make up for the weak points in the process of care for patients with community acquired pneumonia, by enforcing quality assurance. To reduce performance rate variation among hospitals, improvement in care protocols is required for hospitals that have poor quality of care levels.

Development of Nursing Process Information System for the Home Health Care (가정간호를 위한 간호과정 정보시스템 개발)

  • Cho, Hyun;Kang, In-Soon
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.5
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    • pp.1126-1132
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    • 2009
  • We carried out this study to reduce the gaps between medical institutes and between medical personnels and help to improve medical service quality, by classifying diagnoses and related intervention through the development of standard nursing intervention and by computerizing protocols. We considered two processes: one is the development process of home nursing standard intervention, and the other is the process of computerizing its related protocols. For the former, research covered analysis of home health care practices, development of client assessment protocol, of patients diagnosis protocols, and of patients intervention protocol. For the latter, strategies for home health care information systems should be set up and it constituted four research contents of analysis, design, management and evaluation of the systems. We also trained and educated home nurses who work at home health service center, by making them use the manual of home health care information systems at a certain city of P. In this study, therefore, we developed elements of standard home health care mediation so that they could be included in the forms of home health information note, home health progress note, and home health progress summary, home health discharge summary. Because standard home health care intervention has been developed, it became easier to exchange information between different home heath service center offices, can prevent from missing or redundant information, and contribute to standardization of hospital terminologies when EMR and HMR are developed.

Evaluating the Primary Care Quality of a Public Health Center in a Rural Area (농촌 지역 보건소 일차의료의 질 평가)

  • Byeon, Young-Kwan;Choi, Yong-Jun
    • Journal of agricultural medicine and community health
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    • v.42 no.1
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    • pp.24-35
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    • 2017
  • Objectives: This study aimed to evaluate the primary care quality of a public health center in a rural area using the Korean Primary Care Assessment Tool (KPCAT). It also examined some methodological issues in applying the KPCAT and interpreting its results. Methods: Seventy-nine patients who had visited their doctor more than four times responded to the KPCAT questionnaire. Descriptive statistics and a radar chart were used in analyzing data. Sign test was used to test the KPCAT score difference by don't know option scoring methods. Results: Median and interquartile range of the public health center's KPCAT scores were forty-five and sixteen points, respectively. Only the median of the first contact domain reached the expected value of seventy-five points. The proportions of those who scored under the expected value were under fifty percent in two of four comprehensiveness items, all of three coordinating function items, two of five personalized items and all of four family/community orientation items. There were some methodological issues including, how to score don't know option and make sure response scale consistency. Conclusions: There was much room to improve the primary care quality of the rural public health center. Especially, improvement is needed in the domain of coordinating function and family/community orientation. We also hope that methodological improvement of the KPCAT contributes to more valid and reliable primary care assessment.

Comparative Analysis of Differences in Health Condition with Elderly Age Using the Customized Home Modification : Focusing on Community Care Projects (맞춤형 주거환경수정을 이용한 노인의 건강상태 차이비교 분석: 커뮤니티케어 사업을 중심으로)

  • Han, Sang-Woo
    • Journal of Convergence for Information Technology
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    • v.11 no.8
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    • pp.176-184
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    • 2021
  • The purpose of this study was to investigate the effects of home modification in the community care project on the fall risk environment and the health condition in elderly people aged 65 and over. HOME FAST and WHODAS-K 2.0 were used to evaluate, and it was conducted as a group pre-post experimental study. As a result of implementing the home modification service based on the assessment, the fall risk level showed a statistically significant decrease (p<.01), and in the case of health condition, mobility (p<.01) and social participation (p<.05) was confirmed that it was statistically significantly improved in the domain, showing a positive change in the overall health condition (p<.05). In the future, research using a comprehensive home assessment is needed for more subjects. and a process of selecting subjects prior, expansion of professional manpower infrastructure to providing a quality service is required.

Utilization of health insurance data in an environmental epidemiology

  • Ha, Jongsik;Cho, Seongkyung;Shin, Yongseung
    • Environmental Analysis Health and Toxicology
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    • v.30
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    • pp.12.1-12.7
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    • 2015
  • Objectives In South Korea, health insurance data are used as material for the health insurance of national whole subject. In general, health insurance data could be useful for estimating prevalence or incidence rate that is representative of the actual value in a population. The purpose of this study was to apply the concept of episode of care (EoC) in the utilization of health insurance data in the field of environmental epidemiology and to propose an improved methodology through an uncertainty assessment of disease course and outcome. Methods In this study, we introduced the concept of EoC as a methodology to utilize health insurance data in the field of environmental epidemiology. The characterization analysis of the course and outcome of applying the EoC concept to health insurance data was performed through an uncertainty assessment. Results The EoC concept in this study was applied to heat stroke (International Classification of Disease, 10th revision, code T67). In the comparison of results between before and after applying the EoC concept, we observed a reduction in the deviation of daily claims after applying the EoC concept. After that, we categorized context, model, and input uncertainty and characterized these uncertainties in three dimensions by using uncertainty typology. Conclusions This study is the first to show the process of constructing episode data for environmental epidemiological studies by using health insurance data. Our results will help in obtaining representative results for the processing of health insurance data in environmental epidemiological research. Furthermore, these results could be used in the processing of health insurance data in the future.

The Effect of Web-based Multimedia Contents for a Course of Physical Examination and Health Assessment (웹기반 건강사정 멀티미디어 컨텐츠의 학습효과)

  • O Pok-Ja;Kim Il-Ok;Shin Sung-Rae;Jung Hoe-Kyung
    • Journal of Korean Academy of Nursing
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    • v.35 no.5
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    • pp.810-816
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    • 2005
  • Purpose: This study was to test the effectiveness of Web-based multimedia contents for Physical Examination and Health Assessment on learning achievement. Method: Multimedia contents based on Jung's teaching and learning structure model were used to enhance learning achievement. Learning achievement was measured by the knowledge of Physical Examination and Health Assessment. The participants of this study were students in a BSN and RN-BSN program in a university located in Seoul. 59 students in the experimental group received lectures using web-based multimedia contents and 75 students in the control group received regular lectures. Results: The mean score of the degree of educational achievement in the experimental group(mean=31.09) was significantly higher than in the control group(mean=25.55)(t=-3.883, p=.000). Conclusion: These web-based multimedia contents were found to maximizethe effectiveness of the teaching process when used as a teaching aid, and yet kept the strength of a face to face teaching learning method. This program is recommended as part of a main text, vital teaching aid or cyber lecture materials in nursing schools and in health care educational institutions.

A study on educational need of nurses for home care (간호사의 가정간호를 위한 교육요구 분석)

  • Moon Jung-Soon
    • Journal of Korean Public Health Nursing
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    • v.5 no.2
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    • pp.5-25
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    • 1991
  • This study was conducted from July to December 1990, in order to diagnose nurses' educational need for home care. The study subjects consisted of 145 nursing educators, and the 3 groups of nurses, namely 250 senior nursing students of diploma and collegiate program, 235 health center nurses, 521 university' hospital nurses in Seoul. Four types of questionaires were formulated by Delphi method. Two questionaires for the nursing educators were designed to measure their expectations of nurses' knowledge and of their skill for home care, and another two questionaires for the nurses to measure their actual home care knowledge and skill. The results of the study were as follows : 1) The mean scores of educators' expectation for home care knowledge were 17.68 for the care of dependence on medical equipment, 17.44 for the care of mobility impairment patient, 16.56 for the care of cardiopulmonary impairment patient, 16.40 for the care of nutrition and elimination impairment patient, '1.20 for the care of psychiatric disorder patient and 9.03 for the care of cancer and terminally ill patient,. 2) The mean scores of nurses' home care knowledge tested by 20 items were 14.36 for the care of mobility impairment patient, 13.28 for the c8;re of dependence on medical equipment, 13.78 for the care of cardiopulmonary impairment patient, 12.92 for the care of nutrition and elimination impairment patient, and those of tested by 10 items were 7.08 for the care of psychologic disorder patient, 7.80 for the care of cancer and terminally ill patient. The sum of means marked 69.23. As for the nurses' home care knowledge categorized by tasks in terms of the group, significant difference were shown in the care of mobility impairment(P=0.00), cancer and terminally ill(P=0.03), nutrition and elimination impairment(P=0.00) and psychologic disorder patient(P=0.00). No significant difference were shown in the care of dependence on medical equipment and cardiopulmonary impairment patient. 3) Regard to educational need of nurses' home care knowledge categorized by task according to the group it was found that all sampled nurses had educational need in the care of mobility impairment, dependence on medical equipment, cardiopulmonary impairment, cancer and terminally ill patient. It was found that health center nurses had educational need in the care of psychologic disorder. No educational need were found in the health center nurses whose career less than 2 years, in the care of mobility impairment, cardiopulmonary impairment and psychologic disorder patient, and in those of career with 2-5 year in the care of psychologic disorder patient. No educational need were found in the hospital nurses whose career more than 15 years, in the care of cardiopulmonary impairment patient and in those of career with 11-15 year, in the care of cancer and terminally ill patient. 4) The mean scores of educators' expectation for home care skill measured by Likert 5 points scale were 4. 21 for assessing, 4.49 for planning, 4.29 for basic care, 4.42 for curative care, 4.40 for rehabilitative care, 4.36 for emergency care, 4.53 for medication, 4.31 for nutritional care, 4.32 for other means for care, and 4.38 for evaluation. 5) Regard to nurses' home care skill measured by Likert 5 points scale of self evaluation, there was a significant difference between the nurses' home care skill and group(P=0.00l). The higher scores reported by students were vital sign checking and basic care while the scores of below medium were curative care and emergency care. The higher scores reported by health center nurses were vital sign checking, other means for care and care of specimen while the scores below medium were curative, emergency and nutritional care. The higher scores reported by hospital nurses were vital sign checking, care of specimen and basic care, while the score below medium was emergency care. 6) Regard to educational need of nurses' home care skill by nursing process activity according to the group it was found that health center nurses had educational need in all nursing skills including vital sign checking, care of specimen, health assessment, socioeconomic assessment, nursing diagnosis, care plan, basic care, curative care, rehabiitative care, psychological care, emergency care, medication, nutritional care, other means for care and evaluation. And students had educational need in all nursing skills except vital sign checking, and hospital nurses had educational need in all nursing skills except vital sign checking, care of specimen and basic care. 7) In short, the result of this study suggests that the curriculum should be organized in accordence with nurses' educational background and their career for the education of nurses for home care. It should be considered to develop the short term educational program focused on curative and rehabilitative care for health center nurse or community health nurse practitioner and which was focused on family care for hospital nurse. Concerning about this field practice for home care nurse, they are required not only community practice but also . clinical practice including emergency, curative and rehabilitative care.

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Development of Oral Care Nursing Practice Guideline using the Guideline Adaptation Process (간호분야 실무지침의 수용개작 방법론에 따른 구강간호 실무지침의 개발)

  • Cho, Yong Ae;Eun, Young;Gu, Mee Ock;Kim, Kyung Sook;Kwak, Mi Kyong;Kim, Jeong Hye;Lee, Seon Heui;Park, Dong-Ah;Noh, Hwakyung
    • Journal of Korean Clinical Nursing Research
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    • v.21 no.2
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    • pp.154-168
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    • 2015
  • Purpose: This study aimed to adapt the previously developed, high-quality oral care guideline for the usage in clinical settings in Korea. Methods: Guideline adaptation process was undertaken according to the guideline adaptation manual version 2.0 developed by National Evidence-based Healthcare Collaborating Agency (Kim, et al., 2011) and the standardized methodology for nursing practice guideline adaptation (Gu, et al. 2012). Results: The adapted oral care guideline was consisted of 10 domains and 85 recommendations. The number of recommendations in each domain were: 4 general issues, 2 oral care indications, 10 oral assessment 16 general oral care, 15 oral care for critically ill, 15 oral care for cancer patients, 14 oral care for cancer patients withoral complications, 5 oral careeducation, 2 oral care referral, and 2 documentation and report. Ten point six percent of the recommendations were rated as grade A, 20.0% as grade B grade, and more than half (69.4%) were rated as grade C. Conclusion: The adapted oral care practice guideline is expected to included the evidence-based practice guidelines as fundamentalss of nursing practice. Dissemination of the developed guideline nationwide would contribute improving the efficiency of oral care practice.