• Korea Journal of Hospital Management
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• v.23 no.1
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• pp.87-106
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• 2018

Objective: The objective of this study is to examine the association between process quality of inpatient care and risk-adjusted, thirty-day potentially preventable hospital readmission (PPR) rates. Data Sources/Study Setting: This was an observational cross-sectional study of nonfederal acute-care hospitals located in two states California and Florida, discharging Medicare patients with a principal discharge diagnosis of heart failure, acute myocardial infarction, or pneumonia January through December 31, 2007. Data were obtained from the Healthcare Cost and Utilization Project State Inpatient Database of the Agency for Healthcare Research and Quality, Centers for Medicare and Medicaid Services Hospital Compare database, and the American Hospital Association Annual Survey of Hospitals. Study Design: The dependent variable of this study is condition-specific, risk-adjusted, thirty-day potentially preventable hospital readmission (PPR). 3M's PPR software was utilized to determine whether a readmission was potentially preventable. The independent variable of this study is hospital performance for process quality of inpatient care, measured by hospital adherence to recommended processes of care. We used multivariate hierarchical logistic models, clustered by hospitals, to examine the relationship between condition-specific, risk-adjusted, thirty-day PPR rates and process quality of inpatient care, after taking clinical and socio-demographic characteristics of patients and structural and operational characteristics of hospitals into account. Findings: Better performance on the process quality metrics was associated with better patient outcome (i.e., low thirty-day PPR rates) in pneumonia, but not generally in two cardiovascular conditions (i.e., heart failure and acute myocardial infarction). Practical Implication: Adherence to the process quality metrics currently in use by CMS is associated with risk-adjusted, thirty-day PPR rates for patients with pneumonia, but not with cardiovascular conditions. More evidence-based process quality metrics closely linked to 30-day PPR rates, particularly for cardiovascular conditions, need to be developed to serve as a guideline to reduce potentially preventable readmissions.

• Child Health Nursing Research
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• v.17 no.2
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• pp.74-83
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• 2011

Purpose: The purpose of this study was to develop a child health care protocol for teachers in child day care centers. Methods: The ADDIE model with 10 Kid Keys was applied to develop this child health care protocol. All contents were developed through content validity test by 7 professionals and need assessment and evaluation by child day care center teachers. Results: This protocol consisted of 10 keys, as follows: "Health Examination/Growth & Development", "Practice of Health Life", "Management of Communicable Disease", "Negligent Accident", "Coping with Emergency and Transference", "Child Abuse", "Nutrition/Obesity", "Quality Assurance of Staff", "Parent Education", "Guidance & Supervision of Child Day Care Centers". The contents contained goals, objectives, teaching content, suggested activities for children, writing forms related to each subject, and self-evaluation sheet. Conclusion: This protocol can be practical and effective for child health care in child day care centers and it is hoped that it will be utilized in more child day care centers.

• Korean Journal of Child Studies
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• v.24 no.3
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• pp.135-149
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• 2003

This study aimed to develop an observation scale for assessing the quality of day care programs and to examine reliability and validity of the scale. Instruments included 3 self-assessment scales, the Evaluation Scale for Early Childhood Programs and an observation scale completed by 8 trained observers in 89 day care sites. Item analysis indicated that most items were acceptable in terms of item discrimination and item response distribution. Cronbach ${\alpha}^{\prime}s$ and inter-observer reliability were relatively high. Validity of the scale was evidenced by correlations between the observation scale and the criterion measure and inter-correlations among sub-areas of the observation scale. Scores on the observation scale were validated by quality ratings from self-assessment scores.

• Safety and Health at Work
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• v.6 no.3
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• pp.240-248
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• 2015

Background: Recovery from fatigue is important in maintaining night workers' health. This study compared the course of self-reported recovery after 2-week 12-hour schedules consisting of either night shifts or swing shifts (i.e., 7 night shifts followed by 7 day shifts) to such schedules consisting of only day work. Methods: Sixty-one male offshore employees-20 night workers, 16 swing shift workers, and 25 day workers-rated six questions on fatigue (sleep quality, feeling rested, physical and mental fatigue, and energy levels; scale 1-11) for 14 days after an offshore tour. After the two night-work schedules, differences on the $1^{st}$ day (main effects) and differences during the follow-up (interaction effects) were compared to day work with generalized estimating equations analysis. Results: After adjustment for confounders, significant main effects were found for sleep quality for night workers (1.41, 95% confidence interval 1.05-1.89) and swing shift workers (1.42, 95% confidence interval 1.03-1.94) when compared to day workers; their interaction terms were not statistically significant. For the remaining fatigue outcomes, no statistically significant main or interaction effects were found. Conclusion: After 2-week 12-hour night and swing shifts, only the course for sleep quality differed from that of day work. Sleep quality was poorer for night and swing shift workers on the $1^{st}$ day off and remained poorer for the 14-day follow-up. This showed that while working at night had no effect on feeling rested, tiredness, and energy levels, it had a relatively long-lasting effect on sleep quality.

• Journal of Families and Better Life
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• v.21 no.1
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• pp.1-12
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• 2003

Day care center for the elderly is an alternative for community care for frail elderly who need social participation and physical cares and services outside the family. The purpose of this study was to identify the present situation of day care center for the elderly and to suggest desirable interior space plans for elderly day care center. Data were collected by two ways; a mail survey and case studies of existing day care centers. Five cases of day care centers were analyzed to find out Physical and space problems, available programs and services. Also, the staffs in 96 day care centers for the elderly in nationwide were selected for a mail survey and 68.8 percentage of all was collected and analyzed. From the result of case studies, narrow space and lack of accessibility features for wheelchair or other prosthetic devices were the major problems. From the result of a mail survey analysis, the elderly users were over 73 years old, and high proportion had suffered from dementia and apoplexy Also, staffing ration was 1:7 In other words, one staff was caring of 7 old people, and supporting staff was insufficient. Therefore, supportive, therapeutic environment Was more important issue to improve quality of care. Separate program room and outdoor space, lounging space, treatment room by gardening, separate counselling room, bedroom, a simple kitchen unit, staff office, separate physical treatment room, resting room for staff was indicated more necessarily. When priority of planning interior space was safety followed by accessability and convenience, it was also reported that sire of each room was generally narrow. The most serious problem in interior space was the lack and narrowness of space, and accessible features for mobility. Based on the literature review and the findings of this study, two types of floor plans for elderly day care center were suggested;‘a mixed type for the elderly with and without dementia’and‘a separate type for the elderly with dementia.’The main goals for designing interior space for two types of elderly day care center were to provide safe environment, encouraging environment for remaining abilities of users, sanitary environment, therapeutic environment, familiar environment, and socially-encouraging environment. The recommendations for further studies were suggested.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.18-31
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• 2000

Background : This study is to identify the inappropriate hospital services for elderly inpatients over 65 years in general hospital with acute care functioning. Consequently elderly inpatient care and the management of long-term care facilities are key issues for current government health policy. Method : The survey was conducted for two months for all inpatients over 65 in 7 general hospitals, 6 work sampling days randomly selected. In each survey day, the subjective judgement by medical staff on the degree of acute care needs and by nursing unit manager on hospital services of each inpatients was also conducted. Result : The total number of cases collected are 2,541 elderly inpatients, according to subjective judgements by medical staff on inpatient condition. However 46.8% of cases are turned out to be non-acute care group. The frequency of medical services provided to non-acute group are 2~3 vital sign checks per day 78.2%, IV injection 40.1%, antibiotics medication 20.2%. Conclusion : Lots of elderly patients' who are staving in acute hospitals, at present need to be transferred to long-term care facilities. However, there was been shortage of long-term care facilities. It is expected to identify the need of elderly inpatients and therefore, to provide cost-effective, appropriate and good quality health services to elderly inpatients depending on their needs.

• Journal of odor and indoor environment
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• v.17 no.4
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• pp.337-345
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• 2018

In this study, we measured the concentration of Particulate Matter($PM_{10}$), Formaldehyde(HCHO), and Total Bacteria Count (TBC) at two facilities: day care centers, and postnatal care centers located in the cities of Gyeonggi, Gangwon, Jeolla and Gyeongsang from January 1, 2012 to December 31, 2015. $PM_{10}$ concentration was similar to the day care centers and postnatal care centers. HCHO concentration was the highest in the postnatal care centers. TBC concentration was the highest in the day care centers. Comparing the different cities, $PM_{10}$ concentration was the highest in Gyeonggi, HCHO concentration was the highest in Gyeonggi, and TBC concentration was the highest in Gyeonggi. As a result of HCHO's risk assessment, it was found that adults exceeded the carcinogenicity tolerance of $10^{-6}$ specified by the US EPA. This study is expected to be helpful in preventing damage to health from the contaminated indoor air at sensitive facilities, and can be used as basic data for indoor air quality management.

• Korean Journal of Human Ecology
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• v.17 no.1
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• pp.45-56
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• 2008

The purpose of this study was to provide data for the stress and difficulty of the principal on the day-care centers. For this purpose, we had interviewed with 154 principals on the day-care centers in Daejeon and Chungcheong-do. The principals reported that they had stress about administration of day-care center normally. Their stress was different by the type of the center, the number of the class and their sex. They had difficulties in administrating teachers, managing the center, relating with the authorized officials, and finances. For the governing their center expertly, they needed to improve the quality of teachers, to amplify the financial support, and so on.

• Korean Journal of Human Ecology
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• v.18 no.4
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• pp.857-867
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• 2009

The purpose of this study was to examine the relationships among principal's transformational and transactional leadership, subjective quality of life of teacher, and organizational commitment of teacher in kindergarten and day care center based on the survey data from 203 teachers working in kindergarten and day care center in Kyoungbuk province. The collected data were analyzed by Simple Regression, Multiple Regression in SPSS Win program(15.0 version). The main results of this study were as follows. First, principal's transformational and transactional leadership each exerted positive effects on teacher's subjective quality of life and organizational commitment. Second, teacher's subjective quality of life had a positive influence on organizational commitment. Finally, each effect of principal's transformational and transactional leadership on teacher's organizational commitment was mediated by teacher's subjective quality of life.

• Journal of the Korean Home Economics Association
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• v.42 no.6
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• pp.123-136
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• 2004

The purposes of this study were to investigate the qualities of infant day-care centers and the caregivers' interactions with infants. Forty-six day-care centers from Seoul, Daejeon, and Daegu were enrolled in this study. Two kinds of methods were used for data collection; one was the Assessment Scale for Infant/Toddler Care Center developed by Choi and the other was the Qualitative Rating Scale for Caregiver used in the NICHD Early Child Care Project. Frequency, percentile, Crollbach's, one-way ANOVA, and Pearson's correlation were calculated for data analysis. Qualities on 5 factors of infant day-care centers were ranged from 3.44∼4.35, the highest with health managing and the lowest with support system in the Likert 5-point scales. Sensitivity, developmental stimulation and positive regard to child, which are the caregiver's positive interactions with infants were rated minimally or usually characteristic. In addition, intrusiveness, detachment, negative regard to child and flatness, which are negative interactions with infants were rated never or minimally characteristic. Finally, some suggestions for good quality and facilitation of infant care were made.