• Title/Summary/Keyword: day care quality

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Sleep Disturbance and Related Variables during Hospitalization for Hemopoietic Stem Cell Transplantation (조혈모세포이식 환자의 이식단계별 수면장애 영향요인)

  • Park, Hae-Ryung;Choi, So-Eun;Park, Ho-Ran;Park, Jin-Hee;Moon, Young-Im
    • Asian Oncology Nursing
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    • v.5 no.2
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    • pp.126-135
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    • 2005
  • Purpose: The present study was to investigate sleep disturbance and related variables in patients undergoing hemopoietic stem cell transplantation(HSCT) on the day of admission, before HSCT, and of discharge, respectively. Method: A total of 52 HSCT patients were recruited from an university hospital from August 2002 to August 2003. The patients were asked to complete a set of sleep disturbance questionnaires. Result: The scores of sleep disturbance-related physical and emotional subscales on the day before HSCT and on the day of discharge were significantly higher than that on the day of admission. However, the score of a emotional subscale was not significantly different during the hospitalization for HSCT. About 10% of the variance of sleep disturbance was explained by the length after diagnosis on the day of admission, and 59.4% was by the type of disease, religion, gender, educational level on the day before HSCT. About 40.7% was by family income, gender, and the frequency of administration on the day of discharge. Conclusion: Nursing staffs should care for HSCT patients with more interest to reduce variables disturbing sleep. Especially, more careful nursing interventions have to be considered at the time of the day before HSCT and the time of discharge.

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Foodservice Systems of Meal Service Programs for Mental Disorder Care Sites in Korea (한국 정신요양시설의 급식 서비스 현황 분석)

  • Lee, Jin-Mi
    • Journal of the Korean Dietetic Association
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    • v.7 no.1
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    • pp.80-86
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    • 2001
  • The purposes of this study were to: a) examine characteristics of foodservice management practices; b) investigate characteristics of recipients; c) analyze foodservice systems; and d) provide feedback for the efficient and effective foodservice management of mental disorder care sites in Korea. A total of 46 sites was analyzed by questionnaire survey. Statistical data analysis was completed using the SPSS package program for descriptive analysis. As results of site recipients' characteristics, 60% of total sites were males and 40% were female recipients. Average 60% of recipients were from 30 to 40 years old. Major diseases of recipients were mental disorder, high pressure, and obesity. According to the result of foodservice system analysis, the average meal cost per day was about 2,921 won and average food cost percentage was 39%. Average number of meals per day was about 600 meals. All sites had on dietitian and 88.3% of sites had one cook as a full-time employees. In the part of procurement, dietitians were major chargers of sites for purchasing foods. Major purchasing method was the order and delivery contract. About a half of sites used cycle menu system and standardized recipies. Most of sites had recipients survey systems for evaluating meal satisfaction. About 60% of sites provided liquid diets to recepients and 22% provided diabetic diets. Dietitians at sites had problems on low meal cost budget, lack of cooking professionals, and lack of information about treatment meals for mental disorders for providing higher quality of foods cure recipients. The results suggested that financial and systematical supports by the government would be very necessary to meet the goal of nutritional balanced meal services.

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The Effects of Floral Arrangement on the Stress Index of the Elderly with Chronic Diseases and Its Correlation with Cognition

  • Choi, Byung Jin;Kim, Yeon Hee;Yun, Suk Young
    • Journal of People, Plants, and Environment
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    • v.22 no.3
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    • pp.269-277
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    • 2019
  • This study aims to see what changes flower arrangement programs bring to the stress index of elderly people with chronic diseases and its correlation with cognition. Furthermore, seniors from a day care center and a nursing home were compared for the purpose of identifying the effectiveness of flower arrangement activities as a supplementary remedy designed to relieve the symptoms and improve the quality of life of patients with chronic diseases. In this study, 24 seniors with chronic diseases were divided into two groups: Group A consists of 15 seniors from a day care center and Group B consists of nine seniors from a nursing home. Both groups participated in simple flower arrangement activities in 10 sessions. In each session, red and green cut flowers that were preferred by the elderly were provided to elicit and develop their thoughts and behaviors. The results showed that the overall average stress index was significantly reduced from 58.0±11.6 before the program to 50.6±17.1 after the program (p = .037). This study examined that the program was more effective for Group A (p = .021) than for Group B (p = .678). Results of the correlation analysis showed that there was no correlation between cognitive function and stress index (p = .569), but that the activity was more effective for Group A. This study shows that arranging flowers effectively lowers the stress index of elderly people with chronic diseases. Also, sharing the outcomes of such activities with others or continuously caring for the flowers even after the activity can maximize the effectiveness of the therapy and rehabilitation. Thus, the study concluded that the program needs to be applied continuously, not in the short-term, in order to relieve or treat the symptoms of elderly patients with chronic diseases.

Veterinary management protocol for non-human primates: quarantine, anesthesia, and postoperative care for mastoidectomy at animal research institutions

  • Yoon Beom Lee;Woori Jo;Eui-Suk Jeong;Tae Ku Kang;Gwang-Hoon Lee
    • Korean Journal of Veterinary Research
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    • v.63 no.4
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    • pp.35.1-35.10
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    • 2023
  • Non-human primate (NHP) research faces challenges due to zoonosis risk and complex veterinary management yet lacks standardized guidelines for animal care. Therefore, we developed an advanced veterinary management protocol for NHP quarantine, anesthesia, and postoperative care. Three female 4 to 5-year-old cynomolgus monkeys were anesthetized and underwent various tests, including body weight, temperature, blood tests, urinalysis, microbiological monitoring, and physical and dental examinations. Ivermectin and medicated baths were administered to eradicate ectoparasites and endoparasites, and testing was repeated 30 days later. Following quarantine, we performed computed tomography and anesthesia maintenance for mastoidectomy. To relieve pain and maintain body weight, we administered tramadol intramuscularly 4 times/day for 3 days and meloxicam subcutaneously twice daily for 14 days. Feed replacements were provided. During the 33-day quarantine period, physical examinations revealed no abnormalities indicative of infectious diseases, and no specific clinical symptoms were observed. Through a preliminary test of anesthesia time, we selected ketamine 4 mg/kg + medetomidine 50 ㎍/kg for short experiments such as computed tomography, and ketamine 8 mg/kg + medetomidine 50 ㎍/kg for intubation. Ten days after mastoidectomy, NHPs consumed 100 kcal/kg and recovered their body weight. This study offers advanced veterinary management guideline for NHP research. Such protocols can lead to more standardized and ethical practices in NHP research, thereby enhancing the quality of studies on NHPs and the translation of findings to human health and disease.

Predicting Life Span for Terminal Colon Cancer using Clinical Symptoms (말기 대장암환자에서 중상을 통한 예후 측정 및 증상조절)

  • Lee, Do-Haeng;Choi, Youn-Seon;Hong, Myung-Ho;Kim, Jun-Suk;Lee, Kyung-Jin;Kim, Young-Soo
    • Journal of Hospice and Palliative Care
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    • v.2 no.2
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    • pp.138-143
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    • 1999
  • Accurately estimating survival times in terminal cancer patients is very difficult for palliative care clinicians. But a reasonably accurate estimate of survival would permit the medical team to : Plan the ideal therapeutic strategy between overtreatment and too early discontinuation of specific therapy. Answer any questions asked by the patient or family. Organize adequate assistance for the patient concerned. Decide on the eligibility of the patient for clinical trials and whether to begin a treatment, the effects of which will not be immediate. This case was a 79 year-old male patient with colon cancer. He complained of dry mouth, anorexia, weight loss and showed KPS $40{\sim}50$ on admission day. 40 days later he died. To improve patient/family quality of life, it is necessary to improve the ability to estimate accurately a patient's length of survival.

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Development of Case Management using Critical Pathway of Posterolateral Fusion for Lumbar Spinal Stenosis (사례관리를 위한 Critical Pathway 개발 : 요추협착증 환자의 융합술)

  • Park, Hae-Ok;Ro, Yoo-Ja
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.727-740
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    • 2000
  • It is well recognized that case management is required to survive in the rapidly changing medical environment. One of the case management is the critical pathway(CP) which is assumed to increase the quality of care and at the same time to decrease the length of stay in hospital. The purpose of the study was to develop a CP for the management of patients with postero-lateral fusion for lumbar spinal stenosis. Through review of literature and medical records of patients with spinal stenosis, a pilot CP was designed, including 8 different care components such as medication, laboratory tests, assessment etc., from one day before surgery to 6 days of postoperative care. Every item of the pilot CP was evaluated by a panel of experts to test the content validity. The items not agreed on by more than 4 out of 6 experts were deleted or modified to be integrated in the CP. To apply the modified CP to a clinical environment, the items reflecting treatment, medication and lab work were entered into an order communication system(OCS), and doctors and nurses were taught to use the CP. Finally, the development of CP for the patients with posterolateral lumbar fusion was completed after the application and variance analysis of the CP.

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Comparison of the Cognitive Function and Nutrient Intakes of Elderly Women with Dementia in a Long-Term Care Facility and a Day-Time Care Facility in Incheon (인천지역 장기요양시설과 주간보호시설 여성치매노인의 인지기능 및 영양섭취 비교)

  • Bae, Mi Ae;Lee, Young Whee;Kim, Hwa Soon;You, Jeong Soon;Chang, Kyung Ja
    • Journal of the Korean Society of Food Culture
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    • v.34 no.4
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    • pp.389-400
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    • 2019
  • In this study we compared the cognitive function (Mini-Mental State Examination for Dementia Screening: MMSE-DS) and nutrient intake of elderly women with dementia in a long-term care facility (EW-LCF) and a day-time care facility (EW-DCF). This survey was conducted from July 2015 to May 2017 on 73 elderly women with dementia (47 women in LCF and 26 women in DCF) in the city of Incheon. The data obtained from interviews with the subjects and caregivers were analyzed using the SPSS 20.0. The total score of the MMSE-DS and intakes of most nutrients in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). The nutrient adequacy ratios (NAR) of protein, vitamin A, C, $B_6$, $B_{12}$, thiamin, riboflavin, niacin, folic acid, calcium and phosphorus in the EW-LCF were significantly lower compared to the EW-DCF (p<0.05). However, the indexes of nutritional quality (INQ) of vitamin C, $B_6$, thiamine, niacin, calcium, magnesium, and iron in the EW-LCF were significantly higher compared to the EW-DCF (p<0.05). As a result, the subjects showed an unbalanced and insufficient nutrition intake status regardless of the type of care facility. Most nutrient intakes of the EW-LCF with lower cognitive function were very significantly lower compared to the EW-DCF (p<0.001). Therefore, it is necessary to assess the cognitive function and nutritional status regularly at care facilities for the elderly women suffering with dementia and to provide specialized individual nutritional management.

Optimizing the work process through improvement of reservation system (통합예약 프로그램 개선을 통한 업무 프로세스 최적화)

  • Seo, Eunhee;Chung, Yonghwan;Gu, Bonseung;Park, Jong Bin;Park, Youngjae;Park, Kyung Jin;Kin, Soo Mi;Kwoun, Soon Ahn;Dae, Chang Min;Min, Kwan Hong
    • Quality Improvement in Health Care
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    • v.19 no.1
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    • pp.64-72
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    • 2013
  • Objective: To improve customer satisfaction through accurate information using computerized automation of the test reservation system and by performing all fasting tests on the same day with one fasting. Methods: Quality improvement activities of the test reservation system of Seoul National University Bundang Hospital improves internal and external customer satisfaction at the time of test scheduling by having the reservation system reflect test order and test time automatically and making the system to increase the same day test reservation rate. Results: Test process was smooth due to accurate test reservation and information based on test priority due to the introduction of the computerized test reservation system. Internal and external customer satisfaction improved due to the marked reduction in time required for making a reservation thanks to the improvement of work process. Conclusion: Building a computerized test reservation system was an effective measure to improve external and internal customer satisfaction.

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Comparison of Nursing Activity Time According to the Change in Grade of Nursing Management Fee in One University Hospital (일개 대학병원의 간호관리료 등급변화에 따른 간호사의 간호활동시간 비교)

  • Park, Jeong Ok;Kim, Heai Yong;Roh, Gyeong Shik;Roh, Young Duck;Park, Myeong Bun;So, Ji Eun;Park, Mi Mi;Bang, Kyung Sook
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.1
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    • pp.95-105
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    • 2010
  • Purpose: The purpose of this study was to examine the difference between direct and indirect nursing activity times according to the grade of nursing management fee. Methods: The subjects of this study were 324 working nurses at the time of 3rd grade and 319 working nurses at the 2nd grade of nursing management fee in one university hospital. Nursing activity time was measured in April and May, and in September and October of 2008 for comparison. The data were analyzed by SPSS win using frequency and t-test. Results: Direct nursing care activity time per one patient was significantly higher at 2nd grade than 3rd grade in day shift (t=-2.55, p=.012). Direct nursing care workload per one nurse was significantly lower at 2nd grade than 3rd grade in evening shift (t=2.21, p=.030), whereas indirect nursing care workload was lower at 2nd level in night shift (t=2.43 p=.016). Conclusion: The findings from this study showed that higher nurse-to-patient ratio can provide greater amount of direct nursing care activity for the patient. Also, it decreased workload of nurses. The higher nurse-to-patient ratio will be beneficial for promoting quality of nursing care as well as decreasing nurse's heavy workload.

Adequacy of Medical Manpower and Medical Fee for Newborn Nursery Care (신생아실 의료인력의 적정성 및 신생아관리료의 타당성 분석)

  • Park, Jung-Han;Kim, Soo-Yong;Kam, Sin
    • Journal of Preventive Medicine and Public Health
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    • v.24 no.4 s.36
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    • pp.531-548
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    • 1991
  • To assess the adequacy of medical manpower and medical fee for the newborn nursery care, the author visited 20 out of 24 hospitals with the pediatric training program in Youngnam area between July 29 and August 14, 1991. Total number of newborn, both normal and sick, admission and discharge in 1-30 June 1991 was obtained from the logbook of nursery. Head nurse and staff pediatrician of the nursery were interviewed to get the current staffing for the nursery and their subjective opinion on the adequacy of nursery manpower and the difficulties in recruiting manpower. Average medical fee charged for the maternity and normal newborn nursery care was obtained from the division of self-audit of medical insurance claim of each hospital. Average minimum requirement of nursing care time for one normal newborn per day was 179.5 (${\pm}58.6$) minutes; 202.3(${\pm}50.7$) minutes for the university hospitals and 164.2(${\pm}60.5$) minutes for the general hospitals. The ratio of minimum requirement of nursing care time and available nursing time was 1.42 on the average. Taking the additional requirement of nursing care for the sick newborns into consideration, the ratio was 2.06. The numbers of R. N. and A. N. in the nurserys of study hospitals were 31%, and 17%, respectively, of the nursing manpower for the nursery recommended by the American Academy of Pediatrics. These findings indicate that the nursing manpower in newborn nursery is in severe shortage. Ninety percent of the head nurses and 85% of the staff pediatrician stated that the newborn nursery is short of R.N. and 75% of them said that the nurse's aide is also short. Major reason for not recruiting R.N. was the financial constraint of hospital. For the recruitment of nurse's aide, short supply was the second most important reason next to the financial constraint. However, limit of quarter in T.O. was the mar reason for the national university hospitals. Average total medical fee for the maternity and newborn nursery cares of a normal vaginal delivery who stayed two nights and three days at hospital was 219,430won. Out of the total medical fee, 20,323won(9.3%) was for the newborn nursery care. In case of C-section delivery who stayed six nights and seven days, total medical fee was 732,578won and out of the total fee 76,937won (12.0%) was for the newborn care. Cost for a newborn care per day by cost accounting was 16,141won for the tertiary care hospitals and 14,576won for the all other hopitals. The ratio of cost and the fee schedule of the medical insurance for a newborn care per day was 5.0 for the tertiary care hospitals and 4.9 for the all other hospitals. Considering the current wage level of the medical personnel, capital investment for the hospital facilities and equipments, and the cost for hospital maintenance, it is hard to expect adequate quality care in the newborn nursery under the current medical insurance fee schedule.

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