• 제목/요약/키워드: quality nursing care

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환자간호의 질평가를 위한 전산 프로그램 개발;위장관계 수술 환자간호를 중심으로 (Development of a computer program for the evaluation of quality of nursing care)

  • 이병숙;박정호;조현
    • 간호행정학회지
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    • 제5권1호
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    • pp.181-195
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    • 1999
  • This study was done to develope a computer program for the evaluation of quality of nurisng care. Because the professional nursing care should be evaluated consistantly, computer program for the measurement of quality of nursing care is necessary for the effective and efficient management of nursing quality. In this study, a computer program for gastrointestinal surgery patients was developed as a module. Visual basic 4.0 was used as a basic program for the development of this program, and Access 7.0 was used for the data base construction of the program. The systems of evaluation criteria were hierarchical. and the titles of the hierarchical criteria were evaluation area-evaluation item-indicator. Each evaluation area contained several items and each evaluation item contained several indicators. The numbers of the evaluation criteria for gastrointestinal surgery patients were 7 evaluation areas, 32 evaluation items. and 71 indicators. Content validity of the evaluation criteria(in this case, 32 evaluation items) was .95. Scoring could be possible with the evaluation items. For the scoring types of this program were two. norm-referenced type(option 1) and criterion-referenced type(option 2), the user can choose the type according to the purpose of the evaluation. With this computer program. accurate and consistant evaluation of the quality of nursing care could be expected. Also. by the rapid feedback to nursing care practice. quality of nursing practice could be improved rapidly. and the systems of the evaluation criteria developed in this study could be used for the development of other moduls for various kinds of patient groups. Because this computer program was developed only for the purpose of research, it is necessary to be refined commercially to be used in real nursing situation.

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요양보호사의 서비스 질에 미치는 영향요인 (Influencing Factors on Service Quality of Care Helpers Working for the Elderly in Long Term Care)

  • 이여진;박광희
    • 한국직업건강간호학회지
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    • 제21권2호
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    • pp.145-153
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    • 2012
  • Purpose: The purpose of this study was to verify influencing factors on service quality provided by care helpers working for the elderly in long term care. Methods: The data were collected using self-reported questionnaire from 221 care helpers working in long-term care facility or home care service center. The data were analyzed using multiple regression with the SPSS/WIN 17.0 program. Results: There were significant differences in service quality depending on the health status, intimacy level, pleasure level, job education, and turnover intention. Factors influencing service quality were gender, intimacy level with elderly, type of working place and job satisfaction with $R^2$ value of 17.3%. The most influencing factor was intimacy level (${\beta}$=.249), followed by job satisfaction (${\beta}$=.208), gender (${\beta}$=.170), and type of working place (${\beta}$=.146). Conclusion: The results of this study indicate that the effort to improve the service quality of care helper should be focused on helping intimacy building between the elderly and the care helper. Also, a more effective way to improve service quality would be intervening for care helpers providing institutional care.

간호의 질 평가도구 개발에 관한 일 연구 (A Study on the Development of an Instrument for Evaluating the Quality of Nursing Care)

  • 유지수
    • 대한간호학회지
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    • 제7권2호
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    • pp.11-21
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    • 1977
  • Many in nursing look back on Nursing Research history and proudly point to the fact that emphasis in nursing research has changed from studying the nurse to studying nursing practice. In recent years, much emphasis has been placed on seeking a method of evaluating the quality of nursing care. In spite of these attempts, however, an instrument for evaluating the quality of nursing care that is actually applicable in the clinical area has not been found. The Purposes of this study are as follows: 1) To develop the instrument to be used in evaluating the quality of nursing care provided in the Neuro - Surgery Constant Care Unit of Severance Hospital 2) To evaluate the quality of nursing care in the clinical area. 3) To provide the necessary information for improvement of quality of nursing care. The instrument for evaluating the quality of nursing care, developed by the investigator, was composed of 7 nursing goals and divided into 65 standards of nursing performance. The 7 nursing goal are as follows : 1) Maintenance of airway 2) Maintenance of fluid at electrolyte balance 3) Maintenance of elimination 4) Personal hygiene 5) Optimum activity 6) Prevention of accidents 7) Emotional care The study population defined was composed of all the case (51) who were admitted in the Neuro- Surgery Constant Care Unit of Severance Hospital from May 7-13, 1976. The observation method was used and the data was subjected to the %, X²-test, T-test, F-test and Correlation. The results of tile study were as follows : 1. Levels of nursing performance regarding nursing goals. Seven different nursing care indices were constructed in terms of nursing goals. The index scores were grouped arbitrarily into ,j categories such as "excellent", "good", "moderate", "incomplete", and "poor"based upon the investigator′s personal judgement. a. The nursing index of maintaining airway showed that 78% of the patients fell within the "excellent" and 22% of the patients, fell within the "good" category. b. The nursing index of maintaining fluid & electrolyte balance showed that 95% of the patients fell within the "excellent" and 5 % of the patients fell within the "good" category. c. The nursing index of maintaining elimination showed that 100% of the patients fell within the "excellent" category. d. The nursing index of personal hygiene revealed that 49% of the patients fell within the "excellent" and 51% of the patients fell within the "good" category. e. The nursing index of optimum activity showed that 63% of the patients fell within the "excellent" and 32% of the patients fell within tile "good" and 5% of patients fell within the "moderate" category. f. The nursing index of prevention of accidents showed that 100% of the patients foil within the "excellent" category. g. The nursing index of emotional cart revealed that 27% of the patients fell within the "excellent", 24 % of the patients fell within tile "good", 29 % of the patients fell within the "incomplete" category. From these findings it is disclosed that the quality of nursing care provided in the Neuro- Surgery Constant Care Unit of Severance Hospital was excellent. h. There were statistically significant differences between the nursing index of physical care and emotional care. (t=8.73, D. F. =100. p<0.01) It is revealed that more physical care then emotional care was carried out by nurses. 2. Levels of nursing performance regarding general characteristics of the patients. No significant differences were observed statistically with the nursing indices of nursing goals according to the sex (t=0.084, D. F. =12, p>0.05). Age (F=0.1251, D. F. : 3.18. p 〉0.05), absence or presence of operating experiences (t=0.6032, D. F. =12, p〉0.05, levels of consciousness (F=0.31, D. F. :3. 18, p >0.05) 3. Relationship between the levels of consciousness and the nursing index of each nursing goal. There was negative correlation between the levels of consciousness and the nursing index of maintaining airway (r=-0. 5449, p<0.01) and personal hygiene (r= -0.4075, p<0.01) There was positive correlation between the levels of consciousness and the nursing index of optimum activity (r=0.3936, p <0.01) and emotional care (r=0.7819, p〈0.01). There was slight correlation between the levels of consciousness and the nursing index of maintaining fluid & electrolyte balance (r=-0.3418, 0.010.05) and preventing accidents (r=0.1441, p>0.05.

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노인 주 부양자의 부양부담감, 소진감 및 삶의 질에 대한 연구 (A Study of Care Burden, Burnout, and Quality of Life among Family Caregivers for the Elderly)

  • 주경복;김귀분
    • 여성건강간호학회지
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    • 제14권4호
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    • pp.278-289
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    • 2008
  • Purpose: This study was a survey to provide basic data about nursing interventions for improving the quality of life among family caregivers for the elderly by examining their care burden, burnout, and quality of life, and by confirming the correlation between each of them. Method: The subjects were 215 people in Seoul and Gyeonggi Province who understood the purpose of this study and participated voluntarily from April 1 to June 4, 2007. Data was analyzed by the SAS program. Result: 1. Concerning primary caregivers of the elderly, it was found that their care burden was slightly high, burnout was high and quality of life was good on the whole. 2. When it comes to the correlation among care burden, burnout, and quality of life among family caregivers, it was found that burnout increases in proportion to care burden, quality of life decreases as care burden increases, and bigger burnout leads to a lower quality of life. Conclusion: The quality of life among primary caregivers should be improved by reducing their care burden and burnout. Thereby, a priority might be considered for admission to nearby, comfortable nursing homes or failing that, home visiting services, rather than family support in the home.

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의료기관 가정전문간호사의 직무분석 (Job Descriptions of Hospital Based Home Care Nurse Practitioners in Korea by DACUM Technique)

  • 황문숙;이승자;임난영;이미경
    • 가정∙방문간호학회지
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    • 제18권1호
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    • pp.48-57
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    • 2011
  • Purpose: The aim of this study was to develop and to analyze the task of hospital based home care nurse practitioners in Korea. Method: The definition of home care nurse practitioners and job description was developed based on developing a curriculum(DACUM) by 7 panels who have experienced in home care nursing. One hundred fifty four nurses who were working at hospital based on home care were participated. Result: Fourteen kinds of duties were identified : the selection of home care patients; basic home care nursing; advanced home care nursing; patient/family education and counseling; medical decision making and coordination of patient service; management of home care supplies and drugs for patients; management of medical records; management of home care the agency; management of home care personnel; management of the home care supplies for agency; home care public relations; improvement of home care quality; management of long-term care service; and self-improvement. Ninety-six tasks were classified. Conclusion: The abilities for quality improvement and the advanced nursing practice of home care nurses should be empowered.

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위절제술환자의 간호실무표준 사용이 간호의 질에 미치는 영향 (A study of the impact of using a nursing care standards on the quality of nursing care in gastrectomy patients)

  • 우영자
    • 간호행정학회지
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    • 제2권2호
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    • pp.97-107
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    • 1996
  • Nursing standards determine the type and extent of services that are delivered to the patients and define quality care and communicate the institution's expectations of care. Thus, taking the standard of care and incorporating it into a welldefined indicator of excellent patient care becomes one of the first activities in setting up the nursing service's quality assurance process. The purpose of this study was to determine the impact of using a nursing care standards for the quality of nursing care in gastrectomy patients. The subjects were composed of fourty-two under going gastrectomy patients with stomach cancer in general surgery nursing care unit of K University Hospital in Pusan. The data was collected from January 3 to April 13,1996. The subjects were divided into a control group - those admitted from Jan.3 to Feb.12 and an experimental group those admitted from Feb.18 to April 13. The instruments used for this study were a nursing care standards in gastrectomy patients developed by the investigator and an evaluation tool for the quality of nursing care in abdominal surgery patients developed by Byoung-Sook Lee in 1995. The data was analized by means of chi-square test, t-test and Cronbach-alpha test with the SAS System. The result was as follows : The hypothesis, that scores of the quality of nursing care in the experimental group would be higher than that of the control group. was supported(t=-6.12, p=0.00). The detailed results of each standards of evaluation tool were as follows : The mean score of the experimental group was significantly higher than that of the control group in audit standard 1:'Collection of basic data of the patients', (t=-3.76, p=0.00). The mean score of the experimental group was significantly higher than that of the control group in audit standard 2 : 'Defining nursing diagnoses(or nursing problems)', (t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit standard 3:'Estabilishment of nursing care plan according to nursing diagnoses(or nursing problems)',(t= (-), p= (-) ). The mean score of the experimental group was significantly higher than that of the control group in audit stndard 4:'Implimentation of nursing care plan', (t=-2.38, p=0.01). The mean score of the experimental group was significantly higher than that of the control group in audit standard 8 : 'Increase of the knowledge of health related to surgery',(t=-2.40, p=0.01). No significant differences between the mean scores of the experimental group and that of the control group in audit standard 5 : 'Recover and maintain of the physical function', audit standard 6:'Prevention of the post-operative complication', audit standard 7 : 'Decrease of discomfort caused by operation', and audit standard 9 : 'Patient satisfaction in nursing care' were found. The standards of evaluation tool were devided into two dimension. One was process dimension which contains four standards(audit standard 1 to 4), the other was outcome dimension which contains five standards(audit standard 5 to 9). The mean score of the experimental group was significantly higher than that of the control group in process dimension (t=-12.30, p=0.00), but no significant difference between the mean scores of the experimental group and that of the control group in outcome dimension was found. From these results, it is concluded that using a nursing care standards in gastrectomy patients promotes quality of nursing care and nursing care standards of various fields are necessary for effective nursing care.

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가정호스피스 간호중재 표준서에 의한 임상간호활동 분석 (Analysis of Clinical Nursing Activities Using Home Hospice Nursing Intervention Standards)

  • 용진선
    • 성인간호학회지
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    • 제20권6호
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    • pp.960-972
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    • 2008
  • Purpose: The purpose of this study was to validate the nursing intervention standards of home care to home care setting for a guide in giving quality care to home hospice patients. Methods: The developed nursing standards were applied to 79 home hospice patients at K hospital, C university. Data were collected through the developed nursing intervention standards of home care with 19 selected nursing interventions and 418 associated nursing activities from January to June in 2006. Results: The performance frequency was 509 times for total nursing interventions and 7,815 times for total associated nursing activities. The most frequently used nursing activity was 722 times(9.24%) on teaching prescribed medication, followed by surveillance(718 times, 9.18%), and vital signs & neurologic monitoring nursing intervention(701 times, 8.97%). The highest mean nursing activity performance rate showed on Intravenous therapy(82%), followed by dying care(81%), and vital signs & neurologic monitoring (80%). Among 418 nursing activities, there were three classifications: 168 as core activities, 165 as major, and 85 as accessory activities. Conclusion: The final validated nursing intervention standards can guide home care nurses to perform quality care and contribute to computerized nursing services and request of nursing fees.

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노인장기요양시설 서비스의 질 평가 탐색 : 포커스 그룹 연구 (Evaluation of Service Quality in Aged Care Facilities : A Focus Group Study)

  • 이정석;이용미;황라일
    • 한국보건간호학회지
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    • 제31권1호
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    • pp.19-33
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    • 2017
  • Purpose: This study was conducted to explore the meaning and contents of high-quality aged care facilities and provide basic data for evaluation of service quality in such facilities. Methods: The focus group interviews and participants consisted of two user groups, for a total of 16 family caregivers of the elderly living in facilities and four service provider groups, for a total of 26 chief managers and caregivers working in aged care facilities. All interviews were recorded and transcribed as they occurred. Content analysis was used and debriefing notes were referred to in order to analyze the data. Results: Four themes of a high-quality aged care facility emerged from the analysis; 1) a place to rest for comfortable later years; 2) systematic value-based management; 3) providing professional care; 4) comprehensive service provision in response to diverse needs. Conclusion: The findings of the study showed the importance of client centered care and ethical mindset of providers, which had not been included in the existing quality evaluation programs. Based on these results, medical treatments, end-of-life care and more comprehensive and extended services including family care need to be provided in facilities to ensure good quality aged care.

복부수술 환자간호의 질평가 도구 개발 (Development of an evaluation tool for the quality of nursing care in abdominal surgery patients)

  • 이병숙
    • 간호행정학회지
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    • 제4권1호
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    • pp.107-127
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    • 1998
  • The purpose of this study was to develop an evaluation tool for the quality of nursing care in abdominal surgery patient. The target subjects of the tool were adult patients having abdominal surgery under general anesthesia. Process-outcome framework was selected for the development of the tool in this study. The results were as follows. 1. Nine standards. 40 criteria and 88 indicators were developed. A standard was summary statement of the ideal level of excellencein a dimension of quality of nursing care. which could be evaluated by criteria. Several criteria indicated a specific standard and each criterion could be measured by observable and measurable indicators. 2. The standards were divided into two dimensions. One was process dimension which contained four standards(23 criteria), the other was outcome dimension which contatined five standards(17 criteria). 3. Average CVI was .985 at 9 standards. .947 at 40 criteria. and .987 at 88 indicators. 4. The evaluation tool for the quality of nursing care in abdminal surgery patients was a criterion-referenced tool. And data collection methods of the tool were investigation of patient's record and interview( or questionnaire) with the patients. 5. Interrater reliabilities of the tool were ; r= .7572 (agreement between two raters), and pI=.8487 (intraclass correlation between five raters who rated the 84 patients). 6. Internal consistency reliability ${\alpha}$ was .6194, which was obtained from 32 criteria. Eight criteria were missed in the analyzing process because of data omission. 7. Scores of the process and the outcome dimensions showed significant. but low correlation(r= .3759, p < .001). 8. There were significant differences in total scores between the hospitals and the departments of surgery(F = 15.233. p .0001). There was also significant interaction effect between hospitals and departments to total score(F = 8.396. p = .0001). Construct validity of the toool was verified by the known-group method. these kinds of difference were expected by the nursing experts participated in the study. From these results, more specific patient classification is suggested for the development of evaluation tool of the quallity of nursing care. And indicators to be used for objective measurement for the quality of nursing care must be developed.

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