• Title/Summary/Keyword: Direct care index

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A Study on the Validity Test of Patient Classification System for Optimal Nursing Manpower of Hospital in China (중국 일 종합병원에서 적정 간호인력 추정을 위한 환자분류체계의 타당성 검증)

  • Song, Young-Sun;Lee, Dong-Mei
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.2
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    • pp.209-218
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    • 2005
  • Purpose: This study was to setup the basis on hospital and national nursing manpower estimation accurately according to apply patient classification system of Song's study to China hospital system. Method: This study was surveyed to 964 patients at surgical and medical ward on Yanbian University Hospital in China from 17th to 31th January, 2005. Results: There was study results to test hypotheses for estimating optimal nursing manpower as follows. First, a trimodel classification scheme was developed which suggested three categories of patients as minimal care(category 1), moderate care(category 2), intensive care(category 3). Second, there was not significant difference with nursing time by sex. Third, there was not significant difference with nursing time by medical wards. Fourth, there was not significant difference with average nursing care time for each category of patients. Category 1 was estimated to spend average 19.59minutes for patients, Category 2 was about 35.68 minutes, Category 3 was 72.07minutes respectively. Total nursing hours was 62,610 minutes. Conclusion: Patient classification system of Song's study is validity for optimal nursing manpower of hospital in China.

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A Structural Model for Paternal Stress of Handicapped Children (장애 아동 아버지의 스트레스와 적응에 관한 구조 모형)

  • Lee, Kyung-Hee
    • The Korean Nurse
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    • v.31 no.5
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    • pp.72-87
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    • 1992
  • This study was designed to develop and lest a structural model for paternal adaplation and family stress in the families with the handicapped children. A hypothetical model was constructed on the basis of family stress theory developed by McCubbin etc. The model included 6 theoretical concepts and 11 paths. For the purpose of the model testing, empirical data were collected from May to August, 1992. The subject of the study constituted 190 mothers whose children admitted in the five special schools and one privale institutes in Seoul and Choong Nam. In data analysis, SPSS PC+ and PC-LISREL 7.13 computer program were utilized for descriptive and covariance structure analysis. The results of lhe study were as follows. (1) Hypothetical model showed a good fit to the empirical data [Chi-square = 21.19 (df = 7, P = o. 003), Goodness of Fit Index=O.986, Adjusted Goodness of Fit Indes=0.946, Root Mean Square lesidual=0.048), Non Normed Fit Index = 0.80, Normed Fit Index=0.91]. (2) The results of Hypothesis testing indicated: 1) Social support(${\gamma}_11=.238$, T=2.352), Family Functioning(${\gamma}_12=.729$, T=5.957) had direct effects on situational definition. 2) life event stress(${\gamma}_23=.284$, T=5.220) had direct effects on the effect of the handicapped chid on the family. 3) Family functioning(${\gamma}_32=-.239$, T= -3.370) had direct effects on paternal adapation. From the above results, the significance of this study can be delineated as follows : The construction and testing of the comprehensive model seem to be the first trial in Korea. The model was supported by empirical dala. Thus it was suggested that model could be adequately applied to framily nusing care with the handicapped.

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Development of Patient Classification System in Long-term Care Hospitals (요양병원 환자분류체계 개발)

  • Lee, Ji-Yun;Yoon, Ju-Young;Kim, Jung-Hoe;Song, Seong-Hee;Joo, Ji-Soo;Kim, Eun-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.14 no.3
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    • pp.229-240
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    • 2008
  • Purpose: To develop the patient classification system based on the resource utilization for reimbursement of long-term care hospitals in Korea. Method: Health Insurance Review & Assessment Service (HIRA) conducted a survey in July 2006 that included 2,899 patients from 35 long-term care hospitals. To calculate resource utilization, we measured care time of direct care staff (physicians, nursing personnel, physical and occupational therapists, social workers). The survey of patient characteristics included ADL, cognitive and behavioral status, diseases and treatments. Major category criteria was developed by modified delphi method from 9 experts. Each category was divided into 2-3 groups by ADL using tree regression. Relative resource use was expressed as a case mix index (CMI) calculated as a proportion of mean resource use. Result: This patient classification system composed of 6 major categories (ultra high medical care, high medical care, medium medical care, behavioral problem, impaired cognition and reduced physical function) and 11 subgroups by ADL score. The differences of CMI between groups were statistically significant (p<.0001). Homogeneity of groups was examined by total coefficient of variation (CV) of CMI. The range of CV was 29.68-40.77%. Conclusions: This patient classification system is feasible for reimbursement of long-term care hospitals.

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Pathway Analysis on the Effects of Nursing Informatics Competency, Nursing Care Left Undone, and Nurse Reported Quality of Care on Nursing Productivity among Clinical Nurses (간호정보역량, 미완료간호, 환자간호의 질이 간호생산성에 미치는 영향에 관한 경로분석)

  • Yu, Mi;Kim, Se Young;Ryu, Ji Min
    • Journal of Korean Academy of Nursing
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    • v.53 no.2
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    • pp.236-248
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    • 2023
  • Purpose: Nursing informatics competency is used to manage and improve the delivery of safe, high-quality, and efficient healthcare services in accordance with best practices and professional and regulatory standards. This study examined the relationship between nursing informatics competency (NIC), nursing care left undone, and nurse reported quality of care (NQoC) and nursing productivity. A path model for their effects on nursing productivity among clinical nurses was also established. Methods: Data were collected using structured questionnaires answered by 192 nurses working in a tertiary hospital located in J city, Korea, and analyzed using SPSS/WIN 23.0 and AMOS 21.0 program. Results: The fit indices of the alternative path model satisfied recommended levels χ2 = .11 (p = .741), normed χ22 /df) = .11, SRMR = .01, RMSEA = .00, GFI = 1.00, NFI = 1.00, AIC = 18.11. Among the variables, NIC (β = .44, p < .001), NQoC (β = .35, p < .001) had a direct effect on nursing productivity. Due to the mediating effect of NQoC on the relationship between NIC and nursing productivity, the effect size was .14 (95% CI .08~.24). Meanwhile, nursing care left undone through NQoC in the relationship between NIC and nursing productivity, has a significant mediation effect (estimate .01, 95% CI .00~.03). The explanatory power of variables was 44.0%. Conclusion: Education and training for enhancing NIC should be provided to improve nursing productivity, quality of care and to reduce missed nursing care. Furthermore, monitoring the quality of nursing care and using it as a productivity index is essential.

Effects of changing position on cardiac output & on patient's discomforts after cardiac surgery (개심술을 받은 환자의 체위에 따른 심박출량 및 불편감에 관한 연구)

  • Yu Mi;Kwon Eun-Ok;Choi Yun-Kyoung;Kang Hyun-Ju;Oh Se-Eun
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.7 no.2
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    • pp.256-270
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    • 2000
  • Invasive hemodynamic monitoring has become a valuable assessment parameters in critical care nursing in patients undergoing open heart surgery patients. During cardiac surgery, the Swan Ganz catheter is placed in the pulmonary artery. Critical care nurses routinely obtain cardiac output, cardiac index, and pulmonary arterial pressure in these patients. Traditionally, patients are positioned flat and supine for cardiac output measurement. Numerous studies have dealt with the effects of changing position on the hemodynamic variables. However, there are a few studies dealing with patients who undergo cardiac surgery in Korea. Thus, the purpose of this study was to determine the effects of changing position on cardiac output, PAP, CVP, BP, HR and discomfort in patients after cardiac surgery. A sample of 21 adults who had CABG and/or valve replacement with Swan Ganz catheters in place was studied. The data were collected in the cardiac ICU of a university hospital in Seoul during the period from July 28, 1999 to August 30. 1999. In this study, the independent variable is patient position in the supine, 30 degree, and 45 degree angles. Dependent variables are C.O., C.I., CVP, PAP, MAP, HR and patients' perceived discomforts. Subject discomfort was measured subjectively by visual analogue scale. Other hemodynamic data where collected by the thermodilution method and by direct measurement. The data were analyzed by percentile, t-test, ANOVA, Linear regression analysis using SPSS-/WIN program. The results are as follows : 1) Changes in cardiac output were absent in different angle positions, 0, 30. 45 degrees(F=.070, P=.932). Changes in cardiac index were absent in different angle positions, 0. 30, 45 degrees(P>.05). 2) Changes in central venous pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 3) PAP had no change in different angle 0, 30, 45 degree positions; systolic PAP(P>.05), diastolic PAP(P>.05). 4) Changes in systolic blood pressure were absent in different angle positions, 0, 30, 45 degree(P>.05). 5) Changes in heart rates were absent in different angle positions, 0, 30, 45 degree(P>.05). 6) Patients' perceived discomfort was absent in different angle positions, 0, 30, 45 degree(p<.05). In conclusion, critical care nurses can measure C.O., C.I., PAP, BP, & CVP in cardiac surgery patients at 30 degree or 45 degree positions. This can improve the patients' comfort.

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Development and Validation of a Korean Nursing Work Environment Scale for Critical Care Nurses (한국형 중환자실 간호근무환경 측정도구 개발 및 평가)

  • Lee, Hyo Jin;Moon, Ji Hyun;Kim, Se Ra;Shim, Mi Young;Kim, Jung Yeon;Lee, Mi Aie
    • Journal of Korean Clinical Nursing Research
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    • v.27 no.3
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    • pp.279-293
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    • 2021
  • Purpose: The purpose of this study was to develop a Korean nursing work environment scale for critical care nurses (KNWES-CCN) and verify its validity and reliability. Methods: A total of 46 preliminary items were selected using content validity analysis of experts on 64 candidate items derived through literature reviews and in-depth interviews with critical care nurses. 535 critical care nurses from 21 hospitals responded to the preliminary questionnaire from February to March 2021. The collected data were analysed using construct, convergent and discriminant validities, and internal consistency and test-retest reliability. Results: The 23 items in 4 factors accounted for 55.6% of the total variance were identified through item analysis and exploratory factor analysis (EFA). EFA was performed with maximum likelihood method including direct oblimin method. In the confirmatory factor analysis, KNWES-CCN consisted of 21 items in 4 factors by deleting the items that were not meet the condition that the factor loading over .50 or the squared multiple correlation over .30. This model was considered to be suitable because it satisfied the fit index and acceptable criteria of the model [𝒳2=440.47 (p<.001), CMIN/DF=2.41, GFI=.86, SRMR=.06, RMSEA=.07, TLI=.90, CFI=.91]. The item total correlation values ranged form .32 to .73 and its internal consistency was Cronbach's α=.92. The reliability of the test-retest correlation coefficient was .72 and the intra-class correlation coefficient was .83. Conclusion: The KNWES-CCN showed good validity and reliability. Therefore, it is expected that the use of this scale would measure and improve nursing work environment for critical care nurses in Korea.

Verification of Reliability and Validity of KPCS-1 and Estimation of Nursing Time Conversion Index (한국형 환자분류도구-1(KPCS-1)의 신뢰도와 타당도 검증 및 간호시간 환산지수 산출)

  • Song, Kyung Ja;Kim, Eun Hye;Yoo, Cheong Suk;Park, Hyeoun Ae;Song, Mal Soon;Park, Kwang Ok
    • Journal of Korean Clinical Nursing Research
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    • v.16 no.2
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    • pp.127-140
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    • 2010
  • Purpose: This study was performed to verify reliability and validity of Korean Patient Classification System for nurses(KPCS-1), to estimate nursing time conversion index, and to classify patients into groups according to KPCS-1 scores. Methods: KPCS-1 was revised from KPCS by a professional review team. Interrater reliability and construct validity of KPCS-1 were verified by data from 433 patients. Direct and indirect nursing time of 204 patients were measured by stopwatch observation and self reports for 24 hours. Nursing time conversion index was calculated. Results: KPCS-1 consisted of 12 area, 50 nursing activities, and 73 items. The interrater reliability was tested between two nurse group (r=.88, p<.001) and construct validity was verified according to medical department (F=10.97, p<.001) and patient pattern (F=5.54, p=.001). The correlation of nursing time and classification score was also statistically significant (r=.56, p<.001). The nursing time conversion index was 9.03 minutes per 1 classification score. The patients were classified into 4 groups by the classification scores. Conclusion: KPCS-1 can be a useful factor type patient classification system for general ward. Further study is needed to evaluate validity and reliability for refining KPCS-1 and to develop ways connecting the scores with nursing outcomes.

Development of Key Indicators for Nurses Performance Evaluation and Estimation of Their Weights for Management by Objectives (목표관리를 적용한 간호사 성과평가 핵심 지표개발과 가중치 산정)

  • Lee, Eun-Hwa;Ahn, Sung-Hee
    • Journal of Korean Academy of Nursing
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    • v.40 no.1
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    • pp.69-77
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    • 2010
  • This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. Methods: The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using $X^2$-test, factor analysis, and the Analytical Hierarchy Process. Results: Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. Conclusion: PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.

Correlation between dental caries experience, oral health promotion behaviors, and knowledge of oral health in children and adolescents (일부 소아·청소년의 영구치우식경험도 및 구강건강증진행위, 지식에 관한 연구)

  • Shin, Seon-Haeng
    • Journal of Korean society of Dental Hygiene
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    • v.13 no.4
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    • pp.615-622
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    • 2013
  • Objectives : The aim of the study is to estimate the dental caries experience and the factors influencing the dental caries in children and adolescents and to provide the data for effective management of oral health in children and adolescents. Methods : Subjects were 446 students randomly recruited in primary, middle, high school students located in Seoul from April 1 to May 31 2011. The data were collected by a questionnaire survey and direct oral examination. The collected data were analyzed with the SPSS WIN 14.0 program. Results : DMF in male accounted for 88.8% and that in female accounted for 89.1%. The oral promotion behaviors in female was significantly higher than those in male (p<0.001). Aged (p<0.05) and well-educated parents(p<0.001) tended to have better oral promotion behaviors. The higher oral health knowledge, the better oral health promotion behaviors. Better oral health promotion behaviors tended to have lower DMFT and DT index (p<0.01). In regression analysis, age, oral health promotion behavior in children and adolescents were related to the dental caries experience (p<0.001). Poor oral health promotion behaviors increased the dental caries experience. Conclusions : The active oral health care can prevent dental caries in children and adolescents. The concern for oral health care is important to maintain healthy dental hygiene.

Nutritional status of Korean elderly with dementia in a long-term care facility in Hongseong

  • Lee, Ji-Yeon;Hyun, Yeong-Soon;Kim, Hee-Seon
    • Nutrition Research and Practice
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    • v.13 no.1
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    • pp.32-40
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    • 2019
  • BACKGOUND/OBJECTIVES: This study investigated nutritional status of the elderly with dementia in a care facility with the aim of improving the meal quality of the facility. SUBJECTS/METHODS: Data were collected from 30 dementia patients aged more than 65 years in a long-term care facility in Hongseong. The data were obtained from questionnaires and medical records. The food intake data was obtained using food photographs and the nutrient intakes were calculated using the CAN-Pro 5.0. The data were compared with the dietary reference intakes for Koreans (KDRIs). The nutrient density, diet quality such as nutrient adequacy ratio (NAR), mean adequacy ratio (MAR), and index of nutritional quality (INQ), as well as dietary diversity score (DDS) were evaluated. The data were analyzed using SPSS statistical programs. RESULTS: The average daily energy intakes for men and women were much lower than the estimated energy requirements of the KDRIs. The average intakes of energy and most nutrients in the general diet group were significantly higher than those of the other two groups. Significant differences in diet quality and diet diversity were observed according to the meal type groups. The NARs of some minerals (calcium, iron, and zinc) and vitamins (vitamin $B_6$ and folic acid) were less than 0.5 in all study groups. The NARs of protein, iron and MAR of the general diet group were significantly higher than those of the liquid diet group. The DDS scores of meats, fruits and diary food group were very low in all meal type groups, meaning that the diet qualities of the study subjects were not appropriate in all meal type groups. CONCLUSIONS: The food intakes of the study groups showed some limitations by a direct comparison with KDRIs because of the very low physical activities of the study subjects. The diet quality and diet diversity indices suggest the need for improvements in the nutritional quality in all types of diet. Overall, new intervention strategies targeting facility residents with dementia in Korea are needed as soon as possible.