• Title/Summary/Keyword: home care nursing diagnosis

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Analysis on Nursing Diagnosis Classifications and Assessment Tools in Home Care (가정간호분야 간호진단 분류체계 및 사정도구 분석)

  • So, Ae-Young
    • Research in Community and Public Health Nursing
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    • v.12 no.1
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    • pp.3-21
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    • 2001
  • Nursing diagnosis classification is needed to define nursing phenomena and set up nursing plans. The purpose of this study is to develope common nursing diagnosis by comparing and analysing nursing diagnosis classification systems and assessment tools in home care. The target home care nursing diagnosis classifications and tools are HHCC. NANDA. OMAHA. MDS_HC 2.0. OASIS-Bl. Results of this study are as follows: - The number of components of nursing diagnosis classifications and tools is HHCC 4. NANDA 9. OMAHA 4. MDS_HC2.0 6. OASIS-B1 10. - The number of common nursing diagnosis in home care is summed up 51 which are physical heal th 17. social health 5. psychological health 11. health related behavior 13. environment 3.

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A Comparison of NANDA and CCC used in Hospital-based Home Health Care

  • Park, Hyeoun-Ae;Lee, Jin-Kyung;Lee, Hyun-Jung
    • Perspectives in Nursing Science
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    • v.5 no.1
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    • pp.1-15
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    • 2008
  • Background: Recent changes in the medical environment have increased the need for the home health care nursing in Korea. Even though the number of home health care patients is increasing, the major nursing problems have not been identified due to lack of a standardized nursing diagnosis. Aim: An investigative study was conducted to determine the frequency and appropriateness of nursing problems in hospital-based home health care patients in Korea using two internationally standardized nursing diagnosis classification systems. Methods: Nursing records of 249 hospital-based home health care patients were reviewed and nursing problems were identified using the North American Nursing Diagnosis Association Nursing Diagnosis Taxonomy I (NANDA) and the Clinical Care Classification of Nursing Diagnoses (CCC). Findings: Out of 463 nursing problems. 403 nursing problems were described using the NANDA whereas 427 nursing problems were described using the CCC. Nursing diagnoses not captured by the NANDA classification include nausea/vomiting, anorexia, risk for nutrition deficit, decreased blood pressure, dying process, blood sugar impairment. infection unspecified, and disuse syndrome. Nursing diagnoses not captured by the CCC include nausea/vomiting and anorexia. Conclusions: In describing nursing problems of home health care patients, it was found that the CCC was able to represent more diagnoses than the NANDA.

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A Study on the Classification on Nursing Diagnosis through Home Visiting Nursing Care (가정간호사업을 통한 간호진단 분류연구)

  • Lee, Soo-Woo;Chung, Ki-Soon;Nham, Young-Ihm
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.98-110
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    • 1996
  • As the health of people is a integral element of the public well-being, the government adopted and put the home visiting nurse system into practice from Jan. 1990, so that the public might get the necessary health service at the low cost and at home. Thus, it resulted in a rapid increase of the public need for the quality of life. The increasing demand for home care created a necessity for an increased man-power like home care nurse. Since the demand of the publics‘ home care has increased, Seoul Nurses’ Association, one of the branches of Korean Nurses Association has developed for the project team of Home Visiting Nurses Activities. The purpose of this study will analyzed and classified home nursing care activities of home visiting nurse according to the criteria of nursing diagnosis Korean Nurses‘ Association. The subject of the study was 54 patients in 1993 and 148 patients in 1994. All patients received home care at home from visiting nurses were living in Seoul city. The results of the study were as follows; 1) With regard to the nursing diagnosis, 24 items were classified. 2) The patients and families wanted to increase the number of time for home visiting. 3) Main sources of request to visit the patients at home were mainly from the families through nurses or doctors who cared for the patients. 4) In comparison of the characteristics visiting activities between 1993 and 1994, the number of the classification of nursing diagnosis and the number of visiting activities in 1994 were relatively increased than the outcomes in 1993.

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A Case Study of Home Health Care for Postpartum Women and their Newborns (산욕부와 신생아의 가정간호 사례연구)

  • Jun, Eun-Mi
    • 모자간호학회지
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    • v.4 no.1
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    • pp.3-11
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    • 1994
  • Presently there is an increasing demand for home health care services due to changes in the demographic structure as a result of an increasing elderly population, socio-economic improvements, and changes in the family structure, as well as the growing number of people with degenerative diseases. In addition to these reasons, rising medical costs and there a shortage of patient beds space in the hospital, particularly since introduction of national medical insurance. There has been an increasing demand for health care health care services. This study was done to identify the basic data for home health care management. It focused on developing client selection criteria, assessment tools, and recording methods. This was accomplished by the researchers visiting the patients in their homes. The research process included preparation investigation, tool development, training of the project researcher, and visiting the clients in their homes. The research tools are as follows : 1. Record development : a) The selection criteria tool for home health care of postpartum women was a structured tool and consisted of four parts. b) The structured assessment tool consisted of a general items, obstetric history, past medical history, methods of feeding, medications taken before admission, laboratory test results, discharge instructions, discharge medications, family tree, economic status, environmental status, a map, health assessment of postpartum women and their newborns. c) The visit note I consisted of the frequency of visits. Visit note II consisted of the date ; nursing problems ; nursing process including the initial assessment ; nursing goal ; visit plan ; postpartum women and their neonate health status, diagnosis, goal, implementation, evaluation, summary, next plan, for visit revision. d) Problem note consisted of the date, problem numbers, nursing diagnosis, problem appearance date problem resolution date. The research results are as follows : 1. Nursing problems : The nursing problems of the postpartum women and their neonates were evaluated by the number of nursing diagnoses and the change in the pattern of nursing diagnosis related to the number of visits. a) Nursing diagnosis The nursing diagnosis was classified according to physical function, psychosocial function, family system maintained function. b) The changes of nursing diagnosis related to the number of visits. As the type of nursing diagnosis changed related to the number of visits the number of nursing diagnoses decreased. 2. Contents of home health care : The content was categorized according to assessment, direct care, counseling, education, family care, reporting to with the attending doctor. The recommendations based on the research results are as follows : 1. Tool development Replication of this study is needed to test the validity of the assessment tools used. 2. Home visit a) Home health care nurses should be licensed and qualified. A referral form from the attending doctor is needed for legal protection of nurses. b) The first home visit need to be within 24 hours of discharge from the hospital to decrease the anxiety of frightened postpartum women. c) When the changes occur in the newborn's status, home health care nurses should consult a pediatrician. Communication within the home healthcare team is essential and needs to consistent and done smoothly. 3. Home health care A Study is required to develop protocols for education of staff and for operation of all aspects of this program.

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A Study on post-hospital Home health Care Needs in a General Hospital (일 종합병원 퇴원환자의 가정간호요구조사)

  • Choi, Hwa-Young;Lee, Myung-Ha
    • Journal of Home Health Care Nursing
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    • v.9 no.2
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    • pp.138-152
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    • 2002
  • The purpose of this study is to provide a basic data of home health care nursing centered in the hospital by analyzing home health care needs. Data were collected from June 15. 2000 to June 23. 2000 through questionnaires taken by 208 patients to be discharge in a general hospital. The Home Health Care Need instruments used for collecting data was developed by the researcher. The data obtained were analyzed using frequency. percentage. mean. standard deviation. Chi-square test. t-test. one-way ANOVA. Pearson's correlation coefficients. Cronbach's alpha coefficients and Factor Analysis. The results of the study were as follows: 1. The perception of home health care nursing were 65.4% of subjects had never heard about home health care service and 2.4% of subjects knew about the methods & contents in detail. About the demands of home health care, 58.2% of the subjects were willing to use home health care and 41.8% weren't. 2. Regarding the areas of home health care needs. basic nursing care area was the highest. Education/ counselling, exercise/ hygiene. therapeutic nursing care was orderly. Injection and medication management of basic nursing care area were the highest. 3. In relation to characteristic-related diseases and home health care needs. as for the discharge type, the existence of sores, paralysis showed significant differences with home health care needs in the area of exercise/ hygiene(p<,05). Home health care needs in the area of therapeutic nursing care and exercise/ hygiene showed significant differences with the existence of pain. Home health care needs in the area of therapeutic nursing and basic nursing areas were significantly different in the use of catheter/ assistant instrument(p<.05). Home health care needs in the area of therapeutic nursing. exercise/ hygiene and basic nursing care showed significant difference with diagnosis(p<,05). In conclusion, awareness about home health care nursing were very low, home health care needs in the area of basic nursing was the highest. Home health care needs showed significant difference with discharge type, sores, paralysis, existence of pain, use of catheter/ assistant instrument and diagnosis.

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Development of a Home Health Care Nursing Intervention List through Analysis of Home Health Care Nursing Records (가정간호대상자의 간호기록 분석을 통한 가정간호중재 목록구축)

  • Park Hyoun-Kyoung;Kim Cho-Ja;Kang Kyu-Suk;Shin Hye-Sun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.8 no.3
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    • pp.402-415
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    • 2001
  • The purpose of this study was to identify nursing diagnoses and nursing interventions that are found in the home health care patients, and to establish a basis for a standardized Nursing Intervention List that would help nurses doing home health care nursing. For this study, the records of 150 home health care clients who were discharged, from the Home Health Care Center at Yonsei Medical Center, between January to July. 2001 were analyzed. Of the 43 nursing diagnoses recorded for these clients are 43, the most frequent diagnoses were in the area of Exchanging. There were 2.814 nursing interventions which is a mean of 4.73 nursing interventions Per diagnosis. We confirmed that most of the interventions were related to 'education' and 'advice'. We present a Home Health Care Nursing Intervention List that was developed based on the results of this study. It has the five 5 criteria of the ICNP classification, Observing, Management, Performance, Caring, and Informing.

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Application of NANDA and HHCC to Classification of Nursing Diagnosis in a Hospital-Based Home Health Care (일개 종합병원중심 가정간호 간호진단분류를 위한 NANDA와 HHCC의 적용 비교)

  • Lee, Jin Kyung;Park, Hyeoun Ae
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.507-516
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    • 2000
  • This study examines that North American Nursing Diagnosis Association(NANDA) and Home Health Care Classification(HHCC) is appropriate to classify home health care client's nursing problems and suggests a modified nursing diagnosis classification system. Two hundred and forty-nine clients' records at a general hospital were reviewed and nursing problems were diagnosed according to each classification system. Results of this study are as follows. The major client's medical diagnosis are pregnancy, childbirth and puerperium, malignant neoplasm, and benign neoplasm. Of four hundred and sixty-three nursing problems, all nursing problems made a diagnos according to HHCC, while three hundred and eighty-five made a diagnosis according to NANDA. The HHCC diagnosis included 78 more nursing problems than NANDA. The discrepancy in the results may indicate a significant advantage to HHCC diagnosis because HHCC nomenclature was created empirically from hard data. However, this may be due to limitations in the data collection method so determination of which classification system is more useful is difficult to judge. However, nursing components of the HHCC are more concrete and clearer than human response patterns of the NANDA. Also the HHCC facilitates the documentation of patient care by computer, while using a conceptual framework consisting of 20 Care Components based on the nursing process: assessment, diagnosis, outcome identification, planning, implementation and evaluation. Accordingly, the practical application of HHCC is more useful than NANDA. Limitations of this study include a retrospective data collecting method and universality of samples. Further research for various samples that use prospective data collection method is recommended.

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Development of a Home Care Nursing Management System for Computerization of Home Care Nursing Practice (가정간호업무 전산화를 위한 가정간호관리 시스템 개발)

  • Yoo, Ji-Soo;Kim, Cho-Ja;Shin, Hye-Sun;Choi, Hee-Jai
    • Journal of Home Health Care Nursing
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    • v.8 no.1
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    • pp.62-73
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    • 2001
  • This study was conducted to develop a home care nursing management system based on the validated and useful data base found through literature review. The contents and structure according to a development procedure for a computer system were as follows. 1. A data base on home care nursing patients was accumulated by putting data respectively in both steps and fields - from selection criteria. basic information. prescription. plan of home visits. to application of nursing process. 2. Accumulated data was classified and designed to search by basic information. drug/injection prescription. examination prescription, treatment prescription. supply. and a record of the nursing process. 3. Various forms of retrieval including graphs were elaborated in terms of diagnosis and intervention aspects.

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An Analysis of Referrals, Nursing Diagnosis, and Nursing Interventions in Home Care - Wonju Christian Hospital Community Health Nursing Service - (가정간호 기록지 분석 - 원주기독병원 가정간호 보건활동을 중심으로 -)

  • Suh, Mi-Hae;Huh, Hae-Kyung
    • Journal of Home Health Care Nursing
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    • v.3
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    • pp.53-66
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    • 1996
  • Home Health Care is one part of the total health care system. It includes health care services that link the hospital to the community. While it is important for early discharge patients, home care is also important for people with chronic illnesses or handicapping conditions. In 1989 the Korean government passed a law that opened the way for formal development of home health care services beginning with education programs to certify nurses for home care, and then demonstration home care services. Part of the mandate of the demonstration projects was evaluation of home care services. This study was done in order to provide basic data that would contribute to the development of records that could be used for evaluation through a retrospective audit and to examine the care that had been given in Home Care at Wonju Christian Hospital over a twenty year period from 1974 to 1994. The purposes of the study were : to identify to characteristics of the clients who had received home care, to identify the reasons for client referrals, to identify the nursing problems of these clients, to identify the nursing care provided to these clients, and to identify differences in these areas over the twenty year period. The study was a descriptive study involving a retrospective audit of the client records. Demographic data on all clients were included : 4,171 clients from 2,564 families. Data on referrals, nursing diagnosis and nursing interventions were from even numbered records which had a patient problem list included in the record, 2,801 clients, Frequencies and ANOVA were used in the analysis. The results of the study showed that the majority of the clients were from Wonju city /county. There were more women than men related to the high number of postpartum clients(1,300). The high number of postparttum clients and newborns was also evident in the age distribution. An the number of maternal-child clients decreased over the 20 years, the mean age of the clients increased significantly. Other factors also contributed to this change ; as increasing number of clients with brain injuries or with cancer, and fewer children with burns, osteomyelitis and tuberculosis. There was a decrease in the mean number of visits and mean length of coverage, reflecting a movement towards a short term acute care model. The number of new clents dropped sharply after 1985. The reasons for this are : the development of other treatment alternatives for clients, the establishment of an active wellbaby clinic, many more options plus a decreasing number of new cases of Hansen's Disase, and insurance that allows people with burns to be kept in hospital until skin grafts are healed. Socioeconomic changes have resulted in an increase in the number of cases of cancer, stroke, head injuries following car accidents, and of diabetes. Of the 2,801 client records, 2,541(60.9%) contained a written referral but for 1,802 it contained only the medical diagnosis. The number of records with a referral requesting specific nursing care was 739(29.1%). Many family members who were identified as in need of nursing care had no written referral. Analysis of the patient problem list showed that 41.9% of the enteries were nursing diagnoses. Others incuded medical diagnosis, symptoms, and plans. The most frequently used diagnoses were alteration in nutrition, less than body requirements(115 entries), alteration in skin integrity(114), knowledge deficit(111), pain(78), self-care deficit(66), and alteration in pattern of urinary elimination(50). These are reflected in the NANDA categories for which the highest number of diagnosis was in the Exchanging pattern(446), followed by Moving(178), Feeling(136) and Knowing (115). Analysis of the frequency of interventions showed that exercise and teaching about exercise was the most frequent intervention, followed by teaching concering the need for follow-up care, checking vital signs, managing nutritional problems, managing catheters, giving emotional support, changing dressings, teaching about medication, teaching (subject not specified), teaching about diet, IM and IV medications or fluid, and skin care, in that order. Recommendations included: development of a record that would allow for efficient recording of frequently used nursing diagnoses and nursing interventions: expansion of the catchment area for Home Care at Wonju Christian Hospital ; expansion of the service to provide complication prevention, rehabilitation services, and support to increase the health maintenance /health promotion of the people being served as well as providing client dentered care ; and development of a clinical record that will allow efficient data collection from records, even though the recording is done by a variety of health care providers.

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Development of a Home Care Need Assessment Tool - Focused on Home Care Nursing Diagnoses based on Self Care - (우리 나라 가정.방문간호 사업을 위한 가정간호요구 사정도구 개발 - 자가간호개념에 근거한 가정간호진단을 중심으로 -)

  • So, Ae-Young;Cho, Byong-Hee
    • Research in Community and Public Health Nursing
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    • v.13 no.3
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    • pp.433-443
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    • 2002
  • Objectives; The purpose of this study was to develop a framework for home care and a Home Care Need Assessment Tool. Method 1. Identifying common domains in the provision of home care. 2. Charts of 253 home care clients were reviewed to obtain a classification of the nursing diagnoses. 3. A focus group methodology was used to develop the domains. 4. The tool was applied to 439 home care clients.(Kappa value=0.460-1.000, sensitivity, 0.444-1.000: specificity, 0.743-1.000). 5. Some refinements and extractions of the defining characteristics and related factors were made based on the results of the focus group. Results Home Care Need Assessment Tool consists of three parts; -Part I : factors related to basic conditions -Part II : a screening component that enables home care nurses to assess 30 multiple domains of 53 nursing diagnoses. -Part III : summative nursing diagnoses and nursing need intensity for the clients. Conclusion This tool provides a comprehensive assessment that helps the recognition of many strengths as well as problems of the clients. It will be usefully utilized in scheduling home care nursing plans and evaluating client outcomes.

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