Journal of Korean Clinical Nursing Research (임상간호연구)

Hospital Nurses Association (병원간호사회)
권호 표지
DOI QR코드

DOI QR Code

Performance of Comprehensive Nursing Care Service in an Acute Care Hospital: Focusing on Accidental Falls and Pressure Injuries

급성기병원에서의 간호 · 간병통합서비스 운영 전후 낙상 및 욕창 발생 변화

  • Nam, Seung Nam (Department of Nursing, SMG-SNU Boramae Medical Center) ;
  • Ryu, Hye Ran (Department of Nursing, SMG-SNU Boramae Medical Center) ;
  • Kim, Se Hyun (Department of Nursing, SMG-SNU Boramae Medical Center) ;
  • Seo, Su Ryang (Department of Nursing, SMG-SNU Boramae Medical Center) ;
  • Oh, Yoon Hee (Department of Nursing, SMG-SNU Boramae Medical Center) ;
  • Choi, Sun Mi (Department of Nursing, SMG-SNU Boramae Medical Center) ;
  • Chung, Eun Jin (Department of Nursing, SMG-SNU Boramae Medical Center)
  • Received : 2022.09.30
  • Accepted : 2023.02.20
  • Published : 2023.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: This study aimed to investigate whether the comprehensive nursing care service positively affected accidental falls and pressure injuries. Methods: This study was a retrospective study that analyzed the accidental falls and pressure injuries cases in an acute care hospital located in Seoul and compared the rates of accidental falls and pressure injuries before and after the comprehensive nursing care service was operated. Results: Comparing the accidental fall incidence rates per 100 person-months between a comprehensive nursing care ward and a general ward, it showed fewer accidental falls by 0.44 in comprehensive nursing care wards, but the result was not statistically significant. In the case of pressure ulcers, the incident rate per 100 person-month was 6.17 in general wards and 4.77 in comprehensive nursing care wards, which showed that the number of pressure ulcer patients was lower in comprehensive nursing care wards, however it was also not statistically significant. Conclusion: It is not confirmed that the operation of the comprehensive nursing care service contributes to the reduction of accidental hospital falls or pressure injuries. Follow-up studies are recommended to determine the effectiveness of comprehensive nursing services in quality indicators.

Keywords

Acknowledgement

We would like to thank Dr. Choi Jimi for giving us statistical advice and nurse managers who participated in the initial work.

References

  1. National Health Insurance Service. Comprehensive Nursing Care Service Operational Guidlines. Wonju: National Health Insurance Service; 2016.
  2. Ministry of Health and Welfare. Comprehensive nursing care service operation status as of the end of december 2021 [Internet]. Sejong: Ministry of Health and Welfare; 2021 Jan 15 [cited 2022 Sep 26]. Available from: https://www.mohw.go.kr/react/gm/sgm0704vw.jsp?PAR_MENU_ID=13&MENU_ID=1304080306&page=1&CONT_SEQ=371080&PAR_CONT_SEQ=369749.
  3. Son J, Park BK, Lee CH, Ahn KH, Kim JN, Park MH, et al. Incidence rate and ch aracteristics of falls in patients using comprehensive nursing care service. Health Policy and Management. 2019;29(2):172-183. https://doi.org/10.4332/KJHPA.201 9.29.2.172
  4. Korea Institute for Healthcare Accreditation. Accreditation standards Korea institute for healthcare accreditation [Internet]. Seoul:Korea Institute for Healthcare Accreditation; 2018 Sep 27 [cited 2022 Sep 26]. Available from: https://www.koiha.or.kr/web/kr/library/establish_board.do.
  5. Joint Commission International. International patients safety goals [Internet]. Oakbrook (IL): Joint Commission International; 2011 [cited 2022 Sep 26]. Available from: http://www.jointcommissioninternational.org/improve/international-patient-safety-goals.
  6. Jeong IS, Kim S, Jeong JS, Hong EY, Lim EY, Seo HJ, et al. Development of pressure ulcer management guideline by adaptation process. Journal of Korean Clinical Nursing Research. 2014;20(1):40-52. https://doi.org/10.22650/JKCNR.2014.20.1.40
  7. Chaboyer W, Gillespie BM. Understanding nurses' views on a pressure ulcer prevention care bundle: A first step towards successful implementation. Journal of Clinical Nursing. 2014;23(23-24):3415-3423. https://doi.org/10.1111/jocn.12587
  8. Shin KR, Kim M, Kang Y, Jung D, Eom JY, Kweon YR. Pressure ulcers in long-term care hospitals in Korea: Prevalence and risk factors. Journal of the Korean Gerontological Society. 2012;32(1):115-127.
  9. Lake ET, Shang J, Klaus S, Dunton NE. Patient falls: Association with hospital Magnet status and nursing unit staffing. Research in Nursing and Health. 2010;33(5):413-425. https://doi.org/10.1002/nur.20399
  10. Boo EH, Ahn KH, Park BK, Hong NS, Son JL, Park MH, et al. Service outcome of comprehensive nursing care and policy direction. Goyang: National Health Insurance Service Ilsan Hospital, Institute of Health Insurance & Clinical Research; 2015. Report No.: 2015-20-029.
  11. National Health Insurance Service; Korea University College of Medicine. Report on monitoring and evaluation of comprehensive nursing care. Wonju: National Health Insurance Service; 2015.
  12. Park JH, Lee MH. Effects of nursing and care=giving integrated service on nursin g work performance, nurses' job satisfaction and patient safety. Journal of Korea n Academy Society of Home Health Care Nursing. 2017;24(1):14-22. https://doi.org/10.22705/jkashcn.2017.24.1.014
  13. Park BK, Boo EH, Park YS, Jang JB, Kim MR, Ahn KH, et al. Measures to improv e the quality of comprehensive nursing care. Goyang: National Health Insurance Service Ilsan Hospital, Institute of Health Insurance & Clinical Research; 2017. Report No.: 2017-20-001.
  14. Kim J, Choi HS. Research trends in Korea on integrated nursing care service: A scoping review. Korean Journal of Adult Nursing. 2020;32(5):455-471. https://doi. org/10.7475/kjan.2020.32.5.455
  15. Kim JH, Kim SJ, Park ET, Jeong SY, Lee EH. Policy issues and new direction for comprehensive nursing service in the national health insurance. Journal of Korean Academy of Nursing Administration. 2017;23(3):312-322. https://doi.org/10.111 11/jkana.2017.23.3.312 https://doi.org/10.11111/jkana.2017.23.3.312
  16. Park JY, Hwang JI. Relationships among non-nursing tasks, nursing care left undone, nurse outcomes and medical errors in integrated nursing care wards in small and medium-sized general hospitals. Journal of Korean Academy of Nursing. 2021;51(1):27-39. https://doi.org/10.4040/jkan.20201
  17. Hoe JY, Kim HJ. Relationship of risk factors, knowledge and attitude to falls in elderly inpatients. Journal of Korean Gerontological Nursing. 2009;11(1):38-50.
  18. Kim KS, Kim JA, Choi YK, Kim YJ, Park MH, Kim HY, et al. A comparative study on the validity of fall risk assessment scales in Korean hospitals. Asian Nursing Research. 2011;5(1): 28-37. https://doi.org/10.1016/S1976-1317(11)60011-X
  19. Kim YK. Evaluation of predictive validity for the pressure ulcer risk assessment tool. Nursing Science. 1998;10(2):1-12.
  20. European Pressure Ulcer Advisory Panel; National Pressure Injury Advisory Panel; Pan Pacific Pressure Injury Alliance. Prevention and treatment of pressure ulcers/injuries: Clinical practice guideline: The international guideline [Internet]. 3rd ed. London: EPUAP/NPIAP/PPPIA; 2019 [cited 2022 Sep 26]. Available from: https://www.biosanas.com.br/uploads/outros/artigos_cientificos/127/956e02196892d7140b9bb3cdf116d13b.pdf.
  21. Song KJ, Kim EH, Yoo CS, Park HA, Song MS, Park KO. Verification of reliability and validity of KPCS-1 and estimation of nursing time conversion index. Journal of Korean Clinical Nursing Research. 2010;16(2):127-140. https://doi.org/10.22650/JKCNR.2010.16.2.127
  22. Ah YO, You KY, Park BJ, Kim DH, Bae JM, Kang DH, et al. Epidemiology: The principles and applications. Seoul: Seoul National University Press; 2005.
  23. Korea Patient Safety Reporting & Learning System. Patient safety alert system no. PSA_4-Ma_20180002 falls in hospital. Seoul: Korea Patient Safety Reporting & Learning System; 2018.
  24. Korea Institute for Healthcare Accreditation. 2019 patient safety statistical yearbook [Internet]. Seoul: Korea Institute for Healthcare Accreditation; 2020 May 29 [cited 2022 Sep 26]. Available from: https://www.kops.or.kr/portal/board/news/boardDetail.do?bbsId=news&nttNo=20000000000486.
  25. Yoon SJ, Lee CK, Jin IS, Kang JG. Incidence of falls and risk factors of falls in in patients. Quality Improvement in Health Care. 2018;24(2):2-14. https://doi.org/10. 14371/QIH.2018.24.2.2 https://doi.org/10.14371/QIH.2018.24.2.2
  26. Choi EH, Ko MS, Yoo CS, Kim MK. Characteristics of fall events and fall risk factors among inpatients in general hospitals in Korea. Journal of Korean Clinical Nursing Research. 2017;23(3):350-360. https://doi.org/10.22650/JKCNR.2017.23.3.350
  27. Gallardo MA, Asencio JM, Sanchez JC, Banderas AM, Suarez AB. Instruments for assessing the risk of falls in acute hospitalized patients: A systematic review prot ocol. Journal of Advanced Nursing. 2013;69(1):185-193. https://doi.org/10.1111/j.1 365-2648.2012.06104.x
  28. Choi EJ, Lee YS, Yang EJ, Kim JH, Kim YH, Park HA. Characteristics and risk factors for falls in tertiary hospital inpatients. Journal of Korean Academy of Nursing. 2017;47 (3):420-430. https://doi.org/10.4040/jkan.2017.47.3.420
  29. Lee YH, Kim MS. Risk Factors according to fall risk level in general hospital inpatients. Journal of Korean Academy of Fundamentals of Nursing. 2022;29(1):34-44. https://doi.org/10.7739/jkafn.2022.29.1.35
  30. Yun HS, Park JY. Pressure ulcer preventive intervention and risk factors for pressure ulcers: A review of the literature. Journal of Digital Convergence. 2020;18(2):323-331. https://doi.org/10.14400/JDC.2020.18.2.323