• Title/Summary/Keyword: quality nursing care

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Increasing the use of nursing staff in hospitals instead of relying on family members' assistance (보호자없는 병원과 간호인력 활용방안)

  • You, Sun-Ju
    • Perspectives in Nursing Science
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    • v.6 no.1
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    • pp.77-83
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    • 2009
  • The number of nurses per bed at acute-stage hospitals is quite low in Korea compared with other OECD countries. In order to prevent the degradation of the quality of inpatient nursing services due to insufficient nurse staffs, the national health insurance introduced the differentiated nursing care fee system. This did not work as a motive for inducing the employment of nursing staff due to insufficient cost compensation. Because of insufficient nursing staff, family members have to stay with the patient or patients have to hire a personal care attendant. This increases the burden and cost to families. For the activation of hospitals without guardians, there should be policies for raising additional nursing staff such as standardizing jobs among nursing staff, particularly between nurses and nursing assistants, setting adequate standards of staffing in nursing according to medical service, substantiating the cost of nursing under the differentiated nursing care fee system, improving the medical fee system of hospitals without guardians including health insurance payment, supplying nursing staff stably through improving their working conditions such as providing child rearing services and salary increase, clarifying the qualification of personal care attendants working at acute.stage hospitals, developing indexes for assessing the quality of nursing care services, and monitoring for the management of uniform quality.

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Effects of Job Stress, Depression and Fatigue on Sleep Quality of Care Workers in Long-term Care Facilities (요양보호사의 직무스트레스, 우울과 피로가 수면의 질에 미치는 영향)

  • Hwang, Eun Hee;Lee, Hyun Bae
    • Journal of Korean Public Health Nursing
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    • v.33 no.2
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    • pp.163-174
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    • 2019
  • Purpose: The purpose of this study was to identify the effects of job stress, depression and fatigue on sleep quality of care workers employed in long-term care facilities. Methods: The participants were 213 care workers who worked in 11 long-term care facilities. The collected data was analyzed by descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple linear regression with using the SPSS 23.0 program. Results: We found that patient-related job stress was the greatest stressor among care workers' job stresses. A significant difference in sleep quality was observed according to the self-perceived health status of the care workers. The care workers' sleep quality was negatively correlated with job stress (r=-.16, p=.018), depression (r=-.31, p<.001) and fatigue (r=-.29, p<.001). The influencing factors of sleep quality were depression (${\beta}=-0.22$, p=.001) and fatigue (${\beta}=-0.15$, p=.047). Conclusion: It is necessary to improve the health status and sleep quality of care workers by developing and applying health promotion programs to reduce the depression and fatigue of the care worker. This will ultimately improve the quality of service care for the patients.

Effects of an Empowering Program on Health Quality of Life, Decision Making Self-efficacy, Self-care Competency, and Reasonable Medical Care Utilization among Low Income Women Households (일 지역 저소득층 여성가구주를 위한 임파워링 프로그램이 건강 삶의 질, 의사결정 자기효능, 자가관리 능력 및 합리적 의료이용에 미치는 효과)

  • Ahn, Yang-Heui;Kim, Ki-Kyong;Kim, Gi-Yon;Song, Hee-Young
    • Journal of Korean Public Health Nursing
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    • v.24 no.2
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    • pp.237-248
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    • 2010
  • Purpose: The study assessed the effects of a 12-session empowering program to promote health quality of life, decision making self-efficacy, self-care competency, and reasonable medical care utilization among low income women households in one rural area. Methods: A quasi-experimental, one-group pre-posttest design was employed. A total of 28 women enrolled as medicaid recipients in the Public Health Center of W city agreed to participate. The empowering program consisted of 12 sessions addressing health education for self-care of disease, medication management, and counseling for psycho-social support. The intervention was delivered by five nurses and one social worker. Women completed a structured questionnaire measuring the study variables with demographic characteristic before and after the intervention. Data were analyzed by PAWS Statistics 17 utilizing descriptive statistics and paired t-test. Results: After the intervention, significant increases were evident in participant health quality of life (t=-5.83, p<.001), decision making self-efficacy (t=-4.86, p<.001), self-care competency (t=-8.16, p<.001), and reasonable medical care utilization (t=-3.97, p<.001). Conclusion: The 12-session empowering program on health quality of life as well as self-care competency was effective when delivered to low income women households. Further studies with larger numbers of participants and a control group are necessary to validate the results.

Palliative Care Models in Intensive Care Units and Nurses' Roles in the Models (중환자실 완화의료 모델과 간호사의 역할)

  • Koh, Chin-Kang
    • Journal of Korean Critical Care Nursing
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    • v.7 no.1
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    • pp.40-46
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    • 2014
  • Purpose: In Korea, about 30,000 people die in intensive care units annually. However, their quality of life at the end-of-life seems very low. The purpose of this study was to describe palliative care models that could be applied in intensive care units and examine nurses' roles in the models. Methods: A conventional literature review was performed focusing on palliative care in intensive care units and nursing roles in the approaches identified. Results: There are two different models regarding the implementation of palliative care approaches in the intensive care unit. Those are the consultative model and the integrative model. Each model has advantages and disadvantages. Therefore, an appropriate model must be chosen according to the setting. Nurses' roles could vary depending on the setting. Conclusion: Palliative care in the intensive care unit is important to improve patients' quality of life. Moreover, nursing roles are important in providing comprehensive palliative care in intensive care units.

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ICU Nurses' Compliance with Standards for Critical Care Nursing Practice (중환자실 간호사의 중환자간호 실무표준 이행에 대한 조사)

  • Yi, Young-Hee;Jung, Yoen-Yi;Kim, Mi-Soon;Kim, Soon-Hee
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.17 no.4
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    • pp.478-486
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    • 2010
  • Purpose: To explore nurses' compliance with standards for critical care nursing practice in intensive care units (ICUs) and to provide basic data for high quality of critical care nursing. Method: A total of 616 participants from 61 ICUs which are graded from 1 to 7 throughout the nation were surveyed. Data were collected from February 9 to February 27, 2009 using a questionnaire consisting of 58 questions including 50 nursing activities as indicators. Results: The rate of ICU nurses' compliance with standards for critical care nursing practice was high. As for individual standards, compliance with the standard of assessment was the highest, followed by implementation, diagnosis, and planning in that order. There were differences in compliance according to nurses' ICU experience, work place (unit), and ICU grade. A shortage of manpower was considered as a main cause for noncompliance. Conclusion: The present compliance rate with standards for critical care nursing practice by ICU nurses was identified. Therefore, compliance rate can be used to promote quality of critical care nursing and development of educational programs for ICU nurses.

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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Factors Influencing Quality of Life in Patients with Hepatocellular Carcinoma Receiving Transarterial Chemoembolization (간동맥 화학색전술을 받은 간세포암 환자의 삶의 질 영향요인)

  • Park, Hyoung-Sook;Lee, Hyun-Ju;Ha, Jae-Hyun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.22 no.1
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    • pp.69-78
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    • 2015
  • Purpose: The purpose of this study was to examine the relationship among family support, self-care and quality of life(QOL) in Patients with hepatocellular carcinoma receiving transarterial chemoembolization, including the effects of these variables on QOL. Methods: The research was a cross-sectional, descriptive design. Participants were 103 patients with hepatocellular carcinoma who were receiving transarterial chemoembolization. Data were analyzed using descriptive statistics, t-test, one way ANOVA, and hierachial multiple regression analysis with SPSS 18.0 program. Results: QOL had a significant correlation with family support(r=.60, p<.001) and self-care(r=.38, p<.001). Family support had a significant correlation with self-care(r=.41, p<.001). Hierarchial multiple regression analysis for QOL revealed that the most powerful predictor was family support followed by self-care. Family support, self-care, gender, and occupation explained 50% of the variance in quality of life. Conclusion: These results indicate that various factors are related to the quality of life of these patients. Further, nursing strategies to improve the family support and self-care of patients with hepatocellular carcinoma are needed.

Factors Influencing Quality of Life in Type II Diabetes Mellitus Patients Registered at Public Health Center (일개 시 보건소에 등록한 제2형 당뇨병 대상자의 삶의 질 영향요인)

  • Ryu, Soon-Hang;Park, Yeon-Sook
    • Research in Community and Public Health Nursing
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    • v.13 no.4
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    • pp.679-688
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    • 2002
  • Purpose: The purpose of this study was to examine the relationships among self-care, self-care agency, self-efficacy, and quality of life in type II diabetic patients registered at a public health center. Method: The study subjects were 128 type II diabetic patients who were living in G city. The data were collected from March 2001 to February 2002. The instruments used for this study were the self-care scale developed by Jeung(1997) and designed by Park (1984) based on the original scale, the self-care agency scale developed by So (1992), the self-efficacy scale developed by a Jeung (1997) and designed by Paek (1996) based on the original scale, and the quality of life scale developed by Ro (1988). The data were analyzed using descriptive statistics, pearson correlation coefficient, and stepwise multiple regression. Results: 1. The relationships among self-care, self-care agency, self-efficacy, and quality of life were significant. Self-care was significantly related to self-care agency (r=.609. p<.01), self-efficacy (r=.763. p<.01), and quality of life (r=.493. p<.01). 2. The stepwise multiple regression analysis was performed to identify factors influencing quality of life of the subjects. The most powerful predictor was self-care agency (48.4%). The combination of self-care, complication status, age, education level, and self-efficacy accounted for 88.7% of the variance of quality of life in type II diabetic patients. Conclusion: The results suggest that self-care, self-care agency, self-efficacy, and quality of life are important variables for development of nursing intervention programs for patients with diabetes.

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Social Network, Self-Care Agency and Quality of Life of High-risk Beneficiaries in Case Management of Medicaid (의료급여 사례관리 고위험군의 사회적 관계망, 자가간호역량과 삶의 질)

  • Park, Ju Young;Son, Jung Tae
    • Research in Community and Public Health Nursing
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    • v.28 no.4
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    • pp.421-430
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    • 2017
  • Purpose: This study investigates the social network, self-care agency, and quality of life of high-risk beneficiaries in case management of Medicaid and the correlations between these variables. It also identifies influencing factors on their quality of life. Methods: The subjects included 187 individuals chosen from the high-risk beneficiaries in case management of Medicaid in D Metropolitan City. Data was collected through direct interviews based on a structured questionnaire on home visits. Results: The perceived health status was the most influential factor in their quality of life, followed by self-care agency, mutual support network, and natural support network in order. These factors explained 40.6% of their quality of life. Conclusion: These findings raise a need to develop a nursing intervention program to increase the self-care agency of the high-risk beneficiaries in case management of Medicaid.

Validity and Reliability of the Korean Version of the Observable Indicators of Nursing Home Care Quality Evaluation Instrument (한국형 노인요양시설 질 관찰평가도구의 타당도와 신뢰도 분석)

  • Lee, Ji-A
    • Journal of Korean Academy of Nursing
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    • v.38 no.3
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    • pp.474-482
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    • 2008
  • Purpose: The purposes of this study were; 1) to test the validity and reliability of the Korean version of Rantz's Observable Indicators of Nursing Home Care Quality Instrument (ONHQ) and 2) to evaluate the quality of Korean nursing homes. Methods: The study employed a three-phase methodological research design. 1) The original instrument of Rantz's. ONHQ was translated into Korean and modified by Korean nursing home experts. 2) A pilot study using the modified instrument was done in 20 nursing homes to examine inter-rater reliability. 3) The validity and reliability were tested.in 98 nursing homes. Results: Seven factors were extracted through factor analysis: 'communication', 'care delivery', 'grooming', 'odor, 'environment-basics', 'environment-access', and 'environment-homelike'. These factors explained 86.07% of the total variance. Cronbach's alpha coefficient of the 30 items was .97 indicating a high internal consistency of the instrument. Inter-rater reliability according to Kappa was .82. The average score of nursing home quality was 112.07 indicating an average range of quality level. Conclusion: The Korean version of the ONHQ was identified as a tool with a high degree of validity and reliability. This tool can be effectively used to assess the quality of nursing homes by professions as well as family members.