• 제목/요약/키워드: care quality assurance

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Development of the DRG Adjust Index for Nursing Care Quality Assurance (간호의 질 보장을 위한 DRG 보정지수 개발)

  • Kim, Sea-Wha;Kim, Yun-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.10 no.1
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    • pp.1-9
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    • 2004
  • Korean health insurance has adopted preliminary DRG payment system through 8 DRGs from 1997. But present DRG payment system gives economic incentives for hospitals to hire less nurse. This study was attempted to develope DRG adjust index to differentiate DRG price by nurse staffing level for nursing care quality. Method: We analyzed inpatient care cost by medical institute and developed DRG adjust index to differentiate DRG price by nurse staffing level. Results: Among same medical institute, inpatient care cost are very different according to hospital's nurse staffing level. In the case of casarean section, inpatient care cost of the 1st grade general hospital are more expensive 85,732won than the 6th grade hospital. The cost difference are 8.24% of total casarean section DRG price and 16.48% of DTG variable price. We developed DRG adjust index-a to apply DRG variable price and index-b to apply DRG total price for compensation cost difference of hospitals. Conclusions: DRG price adjust index will give economic incentive for hospitals to hire more nurse and improve nursing care quality.

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An Exploratory Study on Quality of Care-Giving Service with Use of SERVQUAL -Targeting Inpatients of Long-Term Care Hospitals in Daejeon Region- (SERVQUAL을 이용한 간병서비스 질에 대한 탐색적 연구 - 대전지역 요양병원 입원환자를 대상으로 -)

  • Kim, Chang-Suk
    • The Korean Journal of Health Service Management
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    • v.5 no.1
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    • pp.45-60
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    • 2011
  • The purpose of this study is ultimately to contribute to enhancing quality of patients' life, by grasping quality level of care-giving service that is recognized by inpatients of long-term care hospital, and by pursuing a plan for improving quality of care-giving service based on this. For this, targeting 500 patients who entered 40 long-term care hospitals in Daejeon Metropolitan City, the quality of service was multi-dimensionally grasped by using SERVQUAL scale. As a result of research, the quality of care-giving service, which is recognized by patients as survey subjects, tended to be relatively high with about 4 points as a whole out of 5-point perfection. By item, reliability was indicated to be the highest with 4.56 points. The next was surveyed to be in order of tangibility, empathy, responsiveness, and assurance.

Radiation Doses and Quality Assurance in Cone Beam CT(CBCT) (임상가를 위한 특집 4 - CBCT 검사법의 정도관리 및 선량)

  • Choi, Yong-Suk;Kim, Gyu-Tae;Hwang, Eui-Hwan
    • The Journal of the Korean dental association
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    • v.52 no.3
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    • pp.153-163
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    • 2014
  • 3-dimensional information for anatomic stucture plays a role as integral part in clinical aspect of dental practice. CBCT(cone beam computed tomography) has been accepted as useful diagnostic tool offering Volume data and images for evaluating teeth and jaws in lower radiation dose than conventional CT. CBCT equipment is essential for the quality assurance of it to ensure continued satisfactory performance and result of adequate images. Dental practitioner and oral and maxillofacial radiologist should have a responsibility and critical thinking to deliver this technology to patients in a responsible way, so that diaganostic value is maximised and radiation doses kept as low as resonably achievable. CBCT imaging modality should be used only after a review of the patient's health and imaging history and the completion of a thorough clinical examination. Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances Dental practitioners should prescribe CBCT imaging only when they expect that the diagnostic yield will benefit patient care, enhance patient safety or improve clinical outcomes significantly. Knowledge of patient dose is essential for clinicians who are making the decision regarding the justification of the exposure. There are some limitation in the measurement of patient dose in CBCT for the approval and adaptation of conventinal methodolgy in CT. It is also important to ensure that doses are optimised and in line with any national and international guidelines. The higher radiation doses of CBCT compared with conventional radiography, mean that high standards must be maintained. The Quality Assurance(QA) programme should entail surveys and checks that are performed according to a regular timetable. QA programme should be maintained by staff to ensure adherence to the programme and to raise its importance among staff.

A Study about the current infra-structural status of the aged care worker to improve the quality of long-term care in Germany (독일 노인장기요양보험의 서비스 질 향상을 위한 인프라 구축 현황에 대한 연구)

  • Lee, Sang-Myung
    • 한국사회정책
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    • v.19 no.3
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    • pp.49-83
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    • 2012
  • Currently in Germany, there is talk of 'state of emergency care', which is addressed to the problems of quality assurance in aged care and shortage of aged care workers. In order to solve this problem in the aging German society, the federal government has set itself the goal of providing high qualified care givers through a systematic and on a high level of professional training opportunities. Various projects and measures have been carried out to improve the reputation of the primarily care profession in society and for the purpose of attracting especially young trainees for the aged care professions. The present work considers training and qualifications in the long-term care sector in Germany; it points out both the characteristics of aged care education and the learning content in the aged care education and attempts to highlight what roles and perception of tasks contained therein.

Content Analysis of Quality Nursing Care Perceived by Nurses (간호사가 지각한 질적간호에 대한 내용분석)

  • 권성복;지성애;백경선;유수옥;주숙남;김복자;이혜숙;안옥희
    • Journal of Korean Academy of Nursing
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    • v.31 no.3
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    • pp.380-390
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    • 2001
  • Purpose: This study was designed to explore the perceptions of quality nursing care among nurses. Method: The data were analyzed using content analysis. The data were collected from 19 nurses who worked at diverse clinical areas in 8 general and university hospitals with over 400 beds. Result: 1. The attributes of quality nursing care were categorized into 7 hierarchies in the order of 'caring' (40.65%), 'specialty' (29.03%), 'nurse attainments' (15.48%), 'patient- centered nursing management' (6.45%), 'sincerity' (5.16%), 'kindness' (2.58%), 'satisfaction' (0.65%). 2. The concept of quality nursing care were defined as 'giving a satisfaction both to patients and nurses through patient-centered nursing management with specialty and caring in the ground of the kindness and sincerity'. Conclusion: Based on there findings, we suggest that the study results should be used for development of a quality assurance tool in nursing practice, patient care in hospital setting, education of nurses and nursing students. In addition, further repeated studies need to be conducted.

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Study on patients of infectious diseases administered with vancomycin or teicoplanin - Assessment of fitness of antimicrobial administration - (감염증 환자에서 vancomycin, teicoplanin 투여례에 대한 연구 - 항균제 투여의 적응증 평가 -)

  • Chang, Chul Hun;Son, Han Chul;Hwang, Kyu Yon;Park, Kwang Ok;Yang, Ung Suk
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.26-35
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    • 1997
  • Background : Glycopeptide antibiotics are the only drugs for treatment of infections due to beta-lactam-resistant Gram-positive bacteria. As the incidence of infection and colonization with vancomycin-resistant enterococci(VRE) rapidly increases, the hospital infection control practices advisory committee(HICPAC) recommends prudent vancomycin use to detect, prevent and control infection and colonization with VRE. Methods : The inpatients admitted from September to December, 1996 in Pusan National University Hospital, with Gram-positive bacterial infections were evaluated retrospectively to see whether the administrations of glycopeptide antibiotics were appropriate or not, upon comparison with the recommendations for preventing the spread of vancomycin resistance by HICPAC. Results : Teicoplanin has been chosen more frequently than vancomycin of the glycopeptide antibiotics. The indications of administration of glycopeptides in patients with pneumonia, wound infections, sepsis, and in febrile or neutropenic patients with malignancies were appropriate, but the use of glycopeptides for elimination of merely colonized bacteria in the oral cavity could not be excluded. Inappropriate use of glycopeptides was 10.6%, and inappropriately long-term use without positive culture for beta-lactam-resistant Gram-positive organisms was about 40% of total days of drug use. Conclusion : It seems essential for the quality assurance committee to make a plan in teaching the HICPAC recommendations to the medical practitioners who prescribed the glycopeptides inappropriately or used for irrelevantly long to his patient, monitor and survey their use of glycopeptides prospectively and periodically, and if there are repeated inappropriate prescriptions, a certain penalty would be given to the practitioners.

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Relationship between structural characteristics and hospital mortality rates on tertiary referral hospitals in Korea (우리나라 3차진료기관의 구조적인 특성과 병원사망률의 관계)

  • Sohn, Tae-Yong;Yu, Seung-Hum
    • Journal of Preventive Medicine and Public Health
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    • v.29 no.2 s.53
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    • pp.279-294
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    • 1996
  • This study was to evaluate hospital characteristics as composition of manpower and facilities to the death rate of patient; and to earmark the factors affecting the overall hospital mortality rates. The data utilized were derived from survey material conducted by the Korean Hospital Association on 32 tertiary referral hospitals in Korea between 1986 and 1994. The findings are : 1. Those hospitals having the most capacity per bed had little difference to the mortality rates than the others. 2. Those hospitals having the most daily patients per specialist had significantly higher mortality rates than the others, but the number of daily patients per nurse had little effect on the mortality rates. 3. Those hospitals which had a relatively sufficient number of quality assurance activities revealed a lower mortality, and particularly in case where such effort was directed to the clinicians, the outcome was remarkable. We concluded that the major factor affecting the hospital mortality rates seems to be the number of specialists per number of beds, the degree of quality assurance assessment of the clinicians, the quality assurance activities of each hospital as a whole, and the number of daily patient per specialist. According to the findings of this study, the composition and quality of specialist and adequate quality assurance activities seemed to be the essential for the improvement of hospital care. Therefore, in this regard e proper implementation of policy and support is highly recommended. Due to lack of available research material, the personal characteristics of specialists haven't been considered in this study. However, this longitudinal observation of 32 tertiary referral hospitals over a nine year period has significant merit alone.

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