• Journal of Korean Academy of Nursing
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• v.45 no.5
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• pp.742-751
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• 2015

Purpose: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. Methods: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Results: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. Conclusion: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.

• Korean Journal of Health Education and Promotion
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• v.19 no.2
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• pp.155-167
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• 2002

This study was carried out to grasp visiting nurses' perception of the service referral between health and welfare with a view to providing the basic data for the visiting nursing activities. A questionnaire survey was conducted on public health nurses in 25 health centers in Seoul from Feb. 12, 2001 to Mar. 15, 2001. A total of 151 questionnaires were collected and they were analysed by use of SPSS/WIN 7.5. The results of the survey are as follows. 1. In general, visiting nurses were burdened with heavy workloads. On average, a visiting nurse covered 5 ‘dong's(the smallest administrative unit), 564 households, and 1223 persons. They spent almost a quarter of their working hours moving from home to home and recording the charts after home visiting. They took 30-60 minutes to provide their services when visiting homes. As for the frequency of home visiting, they were following the instructions recommended by the government. However, their services were still wasteful, not skill-oriented, in that they spent more time assessing ‘subjects’ rather than providing their ‘services’ for them. 2. As for the degree of service performance, visiting nurses scored average 2.94 and 2.28 on the four-point scale in the area of health and welfare respectively. The Pearson coefficient between the two variables was high(.56). According as the health services increased, the welfare services increased as well, which showed that the service referral between the two areas should be essential. 3. ‘The necessity of cooperation with social welfare staff’ scored average 4.49, and ‘the degree of cooperation with social welfare staff’ scored average 3.16 on the five-point scale; There was a statistically significant difference (average 1.33) between the two variables. Such a big difference between perception and practice results from the lack of political support that connects the two service areas comprehensively. Therefore it is recommendable to establish a so-called ‘Visiting Nursing Center’ in the ‘dong’ office in order to provide integrated services of health and welfare at once in cooperation with social welfare staff. That's the way to meet the public needs directly and it's more efficient as well in terms of cost-saving.

• Journal of Home Health Care Nursing
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• v.28 no.2
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• pp.111-123
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• 2021

Purpose: This study aimed to present the management strategies necessary to improve the operational efficiency of visiting nurse centers and evaluate their effectiveness. Methods: The subjects of this study were visiting nurse centers registered as long-term care centers. Based on value chain analysis, cost information analysis, and data envelope analysis, the study was carried out according to the Magerison's management consulting procedure, for six months. This procedure comprised eight sub-steps of approach and application. Results: The following management strategies were agreed upon: establishment of a cooperative network with other visiting care centers, creation of high satisfaction of external customers by providing practical training to care workers, and making rehabilitation and exercise services as the core nursing activities to be focused on. Conclusion: The management consulting process and analysis method applied in this study can referred to as a useful methodological framework for revitalizing visiting nursing centers in the future.

• Journal of Home Health Care Nursing
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• v.25 no.2
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• pp.209-218
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• 2018

Purpose: This study is to identify the health promoting behaviors, health belief, and self-efficacy of visiting nurses working for the Health Visiting Project in Seoul and to determine the predictors of influencing health promoting behaviors. Methods: Data were collected from an online survey of 496 visiting nurses form 25 districts in Seoul. Using SPSS ver. 24, the study performed descriptive statistics, t-test, one-way ANOVA, correlations, and stepwise multiple regression. Results: The mean scores for health promoting behaviors and self-efficacy were slightly higher than that of the median, whereas health belief showed in the median. The factors influencing health promoting behavior were perceived barriers, perceived sensitivity, self-efficacy, and age. These variables explained 36.0% of health promoting behaviors(F=60.62, p<.05). Conclusion: To prevent illness and to promote the health of the population, the visiting nurse mainly performs health screening, health education and counseling. To fulfill these responsibilities, the visiting nurse should be healthy and perform health promoting behaviors well, effectively serving as a model for their clients. Most of the visiting nurses were middle-aged, thus, it is necessary to strengthen health promotion activities that manage physical and psychological health at the individual level.

• Journal of Korean Academy of Nursing
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• v.36 no.3
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• pp.503-513
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• 2006

Purpose: This study focused on analysing costs per home health care nursing visit based on home health care nursing activities in medical institutes. Method: The data was collected in three stages. First, the cost elements of home health care nursing services were collected and 31 home care nurses participated. Second, the workload and caseload of home care nursing activities were measured by the Easley-Storfjell Instrument(1997). Third, the opinions on improving the home health care nursing reimbursement system were collected by a nation-wide mailing survey from a total of 125 home care agencies. Result: The cost of home health care nursing per visit was calculated as 50,626\. This was composed of a basic visiting fee of $35,090{\\}({\fallingdotseq}355$)$ and travel fee of $15,536{\\}({\fallingdotseq}15$)$. The major problems of the home care nursing payment system were the low level of the cost per visit, no distinction between first visit and revisits, and the limitations in health insurance coverage for home health care nursing services. Conclusion: This study's results will contribute as a baseline for establishing policies for improvement of the home health care nursing cost and for applying a community-based visiting nursing service cost.

• Journal of Korean Academy of Nursing Administration
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• v.14 no.2
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• pp.118-130
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• 2008

Purpose: The purpose of this study was to estimate of home-visiting nursing costs for low-income elderly with chronic disease in a metropolitan city using the severity classification and ABC(active-based costing). Methods: First, the HHC activity pool was established. The performance time of each nursing activity were estimated. Second, nursing resources(labor costs, operating costs, and traffic expenses) were analyzed and nursing cost per minute was calculated. And then the cost of each activity was estimated. Third, 202 visiting cases were classified into three group by their severity. And then nursing cost per visit according to their severity was estimated. Results: 59 nursing activities were included in HHC activity pool. The average working time of 59 nursing activity was 6.7minutes and nursing cost per minute was 489 won. According severity, nursing cost per visit were in class I, 54,296 (won), class II 83,124(won), and class III 93,455(won).

• Journal of Home Health Care Nursing
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• v.4
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• pp.30-40
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• 1997

The change in health care environment increases the importance of Visiting Nursing Services Program. It has been performed by nurses of district health centers in Seoul since 1991. The Achievement of Visiting Nursing Services Program will be dependent upon their activities. The purpose of this study was to identify the Performance of Visiting Nurses and Job satisfaction of district health centers in Seoul. Therefore, it was to provide the fundamental data development of Visiting Nursing Services Program. The subjects were 214 Visiting Nurses of district health centers in Seoul. The data was collected by self reporting questionnaire from April 15 to April 30, 1997. Their performances and various supportive factors were measured with the instruments developed by the researcher. Job satisfaction were also measured by the instrument developed by Slavitt et al. (1978) was used. The data were, analyzed by Cronbach Alpha, mean, standard deviation, percentage, t -test, ANOVA Duncan test, Correlation Coefficient, and Stepwise Multiple Regression with SAS program. The results of this study were as follows: 1. The average of budget of Visiting Nursing Services Program of district health centers was 0.9% and the average of visiting nursing services personnel of district health centers was 10.1%. 2. With regard to the job satisfaction of Visiting Nurses the mean score was 2.92 out of 5. While the level of Job prestige / status presented as a mean score of 3.48 which was the largest among the 7 components of job satisfaction, the level of administration was the lowest showing 2.57 scores respectively. There were significant differences in the job satisfaction by age, working career of health centers(p<0.01, 0.001). 3. The average of the performance level of Visiting Nurses variables was 2.29; The variable with highest degree of performance was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was the directive nursing services. The significant difference was found in performance level according to age, structure type of visiting nursing services, working career of health centers and working career of visiting nursing services(p<0.05). 4. With regard to the perception of the performance expertise by the Visiting Nurses the mean score was 2.37 : The variable with highest degree of performance expertise was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was management of home-environment. The significant difference was found in performance expertise according to working career outside of health centers(p<0.05). 5. With regard to the perception of the performance necessity by the Visiting Nurses the mean was 2. 40 : the variable with highest degree of performance necessity was the teaching & consultation, establishment of performance plan, whereas the on with the lowest degree was directive nursing services. The significant difference was found in performance necessity according to working career of visiting nursing services(p<0.05). 6. A positive correlation was found between job satisfaction and performance level(r=.3731, P<0.001). Also, a weak positive correlation was found between the components of job satisfaction and performance level. 7. Stepwise multiple regression analysis revealed that the most powerful predictor was the variance of job satisfaction(R=.3557, $R^2$=.1265). Structure type of visiting nursing services and working career of visiting nursing services accounted for 19.0% of the variance in performance level in nurses. In conclusion, Job satisfaction, Structure type of visiting nursing services and Working career of visiting nursing services variables had influenced on performance level in health centers. Further research is required to confirm these findings.

• Research in Community and Public Health Nursing
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• v.15 no.2
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• pp.308-322
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• 2004

Purpose: 'The purpose of the present study was to understand students' experiences from their standpoint, to identify relevant variables and to examine into their relations by analyzing and describing what phenomenon 'nursing students' visiting ambulatory bathing service' is, what are the reasons for the phenomenon, and what interactions are in the phenomenon. Method: The subjects were thirteen students. Data were collected through in-depth interviews and analyzed by Strauss and Corbin's analysis method. Result: With regard to ambulatory bathing service, participants responded 'lack of education', 'inexperienced personal relations' and 'disappointment with recipients families'. They recognized 'burden' and 'compassion'. The intensity of generated 'burden' and 'compassion' was determined by volunteering persons, the degree of health care service, recipients' response and interaction of climate. When 'burden' and 'compassion' were generated, participants selected their own coping strategies. Strategies in the situation of 'burden' and 'compassion' were significantly influenced by 'burden' and 'compassion' and structural situation - 'mutual relation structure,' 'volunteers' capability,' 'the degree of volunteering guidance,' 'community participation,' 'recipients' environment,' 'information sharing,' 'special vehicle equipment' and 'economical burden.' Strategies include' service training,' 'receiving volunteering training,' 'preliminary service preparation,' 'volunteering.' 'connection to local medical center,' 'intention,' 'information sharing,' 'passive response to recipients' appreciation' and 'the understanding of publicity'. The results of selected 'burden' and 'compassion' are described with 'worthiness' and 'cohesion' as follows. Conclusion: This study is significantly meaningful in that it examined bathing service welfare in its initial stage. There are not much outcome from previous studies. However. it is meaningful that this study intended to develop theories on the nature of experiences and the relations among concepts derived from the visiting ambulatory bathing service process of nursing students. Professors who taught social volunteering in universities understood the experience of nursing students who did the visiting ambulatory bathing service. Consequently, professors will provide an effective instruction to enable these students to carry out visiting ambulatory bathing services efficiently in order to meet demands when they conduct the services. For the volunteering service activity in major-related fields among college students' social volunteering activities, they recognized the necessity of systematic education and preparation.

• Journal of Korean Academy of Nursing
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• v.31 no.4
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• pp.656-668
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• 2001

Purpose: This study aims to identify the ADL and IADL of bed-ridden elderly. Also it is used to show fuctional status, and to investigate the content and the level of nursing services provided. Method: The subjects were 191 elderly who received visiting nurse service through public health centers in the Seoul Metopolitan and Chungnam Province. Data collection was conducted by public health center nurses during four months in 2000. Result: As for daily living activities, 100% of subjects had at least one difficulty in ADL and IADL. Among them, only 0.5% had moderate disabilities and 99.5% had severe disabilities by HFS, 27.9% were in a semi bed-ridden state and 72.1% were completely bed-ridden by JABC. The major service provided was a visiting nurse service which was preferable to the social welfare service. In the visiting nurse service, there was no significant difference according to the elderlys' functional status. In addition there was no standadization about the qualification of the visiting nurse, and single entry point for the nursing service. Conclusion: The researchers urgently suggest that a community based comprehensive service model has to be developed to respond to the needs of the elderly in Korea.

• Journal of Home Health Care Nursing
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• v.26 no.2
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• pp.180-188
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• 2019

Purpose: To investigate the duration of each nursing activity performed by home care nurses for non-cancer patients and the relationship between patients' palliative prognostic index (PPI) and duration of each nursing activity. Methods: Nursing activities performed for six non-cancer terminal patients were timed using a stopwatch, and 18 parameters were measured by visiting each patient thrice. The mean and standard deviations of duration for each category of nursing activities were computed. The relationship between category-specific duration of nursing activities and PPI was analyzed with Spearman's correlation and multiple regression analysis. Results: Among nursing activities, the highest greatest duration of time was spent on traffic time (11.91 min), followed by urinary catheter management (10.65 min) and insertion and management of nasogastric tube (9.03 min). In terms of nursing categories, after excluding movement time, the greatest duration of time was spent on excretion care (5.48 min), nutrition care (5.40 min), and medication (3.82 min). PPI correlated with hygiene care, excretion care, and patient and information management. Multiple regression analysis revealed that PPI increased with increasing duration of hygiene care. Conclusion: These study findings provide grounds for the increased nursing time of hygiene care for people reaching the end of life.