• 제목/요약/키워드: Health care delivery system

검색결과 312건 처리시간 0.026초

사전의사결정 제도에 있어서의 전문간호사 역할 (Advance Directives and the Roles of Advanced Practice Nurses)

  • 고진강
    • 중환자간호학회지
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    • 제3권2호
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    • pp.91-99
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    • 2010
  • Purpose: The purpose of this literature review was to describe the roles of advanced practice nurses related to advance directives. Methods: A comprehensive literature review was conducted utilizing Pubmed, Ovid, and CINAHL. The key words for search were 'advance directives', 'living wills', 'durable power of attorney', 'advanced practice nursing', 'advanced practice nurse', 'nurse practitioner', and 'nurse specialist'. Research articles published between January 1990 and September 2010 and written in English were included. Review papers and expert's opinion were excluded. Results: Five articles were yielded and analyzed. Among them, two focused on the advanced practice nurses' role during the process of advance directives. The other three presented the outcomes depending on the type of nurses' involvement in each health care delivery system. Conclusion: Recently, Korea established advance directives and expanded to diverse sites. Advanced practice nurses' role in the advance directive decision-making process should be examined and developed in research and practice.

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파라과이 농촌지역의 보건소 건립 후 접근성과 이용만족도에 관한 연구 (A study on the accessibility and utilization satisfaction of health centers in rural area, Paraguay)

  • 김지언;정민아;남은우
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제29권2호
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    • pp.17-26
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    • 2023
  • Purpose: The purpose of this study is to identify policy implications for the construction of public health facilities in the field of international cooperation, by examining the case of establishing a health care delivery system using a public health center in a rural area of Paraguay. Methods: Firstly, to map the capacity of the 20 public health centers that were studied, we used the WHO Capacity Mapping tool to select and analyze relevant items. Secondly, to assess the utilization of public health centers, we conducted a direct visit survey and analyzed the results using the M-survey tool. Results: The floor plan of each public health center, the structure of the health center, the size of the population served by each health center, the number of monthly visitors, medical human resources, and the budget were classified by health center for comparative analysis. In addition, by utilizing the M-survey tool, we analyzed the general characteristics of the respondents, their perceptions of the purpose and accessibility of public health centers, their satisfaction with using public health centers, and the level of demand for public health centers to play a role in promoting community health. Implications: The results of this study suggest that access to public health facilities for residents in the research area was improved. By classifying public health centers into two types, these centers can perform the functions and roles of primary health facilities. A patient request and evacuation system was established in the research area. Finally, a network, such as a social prescribing program, is needed so that public health centers can function as a "setting" for community members to live together.

Patients' and General Practitioners' Views About Preventive Care in Family Medicine in Switzerland: A Cross-sectional Study

  • Cohidon, Christine;Imhof, Fabienne;Bovy, Laure;Birrer, Priska;Cornuz, Jacques;Senn, Nicolas
    • Journal of Preventive Medicine and Public Health
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    • 제52권5호
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    • pp.323-332
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    • 2019
  • Objectives: The aim of this study was to describe general practitioners (GPs)' opinions and practices of preventive care and patients' opinions, attitudes, and behaviors towards prevention. Methods: The data stemmed from a cross-sectional national survey on prevention conducted in Switzerland from 2015 to 2016. In total, 170 randomly drawn GPs and 1154 of their patients participated. The GPs answered an online questionnaire and the patients answered a questionnaire administrated by fieldworkers present at their practices. Results: Both patients and GPs agreed that delivering preventive care is the dedicated role of a GP. It appeared that beyond classical topics of prevention such as cardiovascular risk factors, other prevention areas (e.g., cannabis consumption, immunization, occupational risks) were scarcely covered by GPs and reported as little-known by patients. In addition, GPs seemed to use a selective approach to prevention, responding to the clinical context, rather than a systematic approach to health promotion. The results also highlight possibilities to improve prevention in family medicine through options such as more supportive tools and public advertising, more time and more delegated tasks and, finally, a more recognized role. Conclusions: Despite an unfavorable context of prevention within the healthcare system, preventive care in family medicine is reasonably good in Switzerland. However, some limitations appear regarding the topics and the circumstances of preventive care delivery. A global effort is needed to implement necessary changes, and the responsibility should be broadened to other stakeholders.

유휴간호인력 활용방안에 관한 연구 (An Action Research Study on Measures to Mobilize Inactive Nurses)

  • 김수지
    • 대한간호학회지
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    • 제27권4호
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    • pp.880-891
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    • 1997
  • The purpose of this study was (1)to undertake a survey to identify the profile of inactive nurses, who account for 42.2% of the 130,000 RN(Registered Nurses) in Korea, (2)to identify factors related to the inactivation of these nurses, (3)to identify reasons behind the high turnover rate of nurses, and (4)to delineate measures for inactive nurses to participate in professional nursing activities so as to upgrade the quality of the health care delivery system in Korea. For these purposes, this study surveyed existing literature on the turnover of nurses and, used the nominal group technique of action research, to collect ideas from hospital/nurse administrators, inactive nurses, nurses on the job, graduate students in nursing, part-time nurses, patients, and their families to formulate strategies to mobilize inactive nurses. The findings are as follows : Frist, institutional supports should be provided to mobilize inactive nurses. To be more specific : (1) A data-base needs be created at the Korean Nurses Association to link inactive nurses with jobs available. (2) Retraining programs need be established to equip inactive nurses for new jobs. (3) Comprehensive information related to employment needs should be made available. Second, a conducive environment needs to be created to draw in inactive nurses to the job market. To be more specific : (1) A system of part-time work needs to be introduced in hospitals. (2) Nurse-specialists need to be promoted. (3) Potential jobs need to be created. (4) Working environment and terms and conditions for nurses need to be improved. (5) Competent nurses need to be secured in the health care delivery system. To achieve the goals presented above, this paper presented 55 specific strategies that may help mitigate the turnover rate of nurses and, in turn, help make the Korean Nurses Association effective in implementing its policies.

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노인 케어매니저 양성을 위한 교육과정(안) (Development of the Curriculum for Care Manager of the Elderly)

  • 한숙정;윤순호;김영혜;김일옥;신성례;이경순;오복자
    • 한국간호교육학회지
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    • 제11권2호
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    • pp.240-251
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    • 2005
  • Purpose: The purpose of this study was to develop a curriculum for care manager based on the results of professional workshops and through the analysis of the roles and curriculums of care managers in other countries. Method: The process of this study included a review of literature, getting advice from various experts, a review of the present state of education programs at abroad. Result: This study revealed the basic content of care manager education which includes understanding health care and welfare delivery system. process of care manager, resource management, legal and ethical issues, management of health and a life style of elderly, communication, stress management. The major roles of care manager was revealed as the one who assess the needs of elders, making a care plan, evaluator, supporter, coordinator and a risk manager who coordinates, validates and reassesses various services needed by elderly. Conclusion: These results can be utilized in care manager educational program for raising the quality of care manager and care management services.

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외래 및 퇴원환아 부모의 전화상담요구와 간호중재에 대한 조사연구 (An investigational study on telephone calls to the pediatric nursing unit)

  • 강화자;한경자;최명애;박승현;김영미;권원경;김선구;안혜영;허미영
    • Child Health Nursing Research
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    • 제2권1호
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    • pp.112-126
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    • 1996
  • The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.

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건강보험 보장성 강화 및 지속가능성 제고 방안 연구 (A Study on Strengthening of Health Care Protection and Sustainability Plan)

  • 정용주
    • 한국콘텐츠학회논문지
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    • 제21권4호
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    • pp.96-110
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    • 2021
  • 우리나라는 세계에서 가장 빠른 속도의 저출산·고령화와 저성장·저금리의 시대에 적응해야 하는 직면해 처해 있다. 저출산, 고령화로 인하여 건강보험 재정수입 요인은 감소하고 있으며, 국민의 건강에 관한 관심, 고비용 의료기술 및 의약품의 개발은 건강보험 재정 지출은 증가하게 있다. 본 연구에서는 건강보험의 보장성 강화와 재정의 안정화, 의료의 형평성에 대하여 검토해보고자 한다. 첫째, 국내의 정책보고서, 국내외 문헌, 선행연구를 통해 건강보험의 현황과 한계를 파악하였다, 둘째, 외국의 건강보험정책인 재정 안정화 대책에 대하여 구분하여 검토하였다. 이 연구를 근거로 건강보험의 보장성 강화와 재정 안정화를 통하여 지속 가능한 건강보험을 유지하기 위해서는 현재 건강보험의 재정수입 구조를 혁신하여야 할 것이다. 또한, 정부지원금의 확대, 새로운 조세 수입을 발굴하여야 할 것이다. 진료비 지불제도, 의료전달체계를 개편하여 재정을 절감하는 정책도 필요할 것이다.

요양병원 간호사의 낙상예방행위에 미치는 영향요인 (Factors Affecting Fall-Prevention Behavior of Long-Term Care Nurses)

  • 최주연;이가언;전혜정
    • 한국직업건강간호학회지
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    • 제31권4호
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    • pp.157-166
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    • 2022
  • Purpose: The purpose of this study was to identify factors influencing fall-prevention behaviors of nurses working in long-term care hospitals. Methods: Participants included 147 nurses working in 10 long-term care hospitals in B city. Data were collected from September 20-October 12, 2016. SPSS/WIN 21.0 was used for analysis with t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression. Results: It was found that attitude toward fall (r=.29, p<.001) and patient safety culture (r=.25, p=.002) had a significant positive correlation with fall-prevention behaviors of nurses working in long-term care hospitals. The factors influencing fall-prevention behaviors in participants were clinical career and patient safety culture (β=.21, p=.012), contributing to 19% of the total variance in fall- prevention behaviors. Conclusion: The findings showed that systematic delivery of differentiated fall prevention education is preferred to nurse's clinical career as a private factor to improve fall-prevention behaviors of nurses in long term care hospital. Particularly, it is imperative to conduct periodical and practical fall-prevention education for nurses to prevent career discontinuity. An independent report system and open communication system as well as a scheme that can disseminate patient safety culture in individual departments to implement patient direct nursing are required to encourage patient safety culture in organizations.

찾아가는 동 주민센터 방문건강관리사업에 대한 방문간호사의 인식 (Nurses' Perception of Home Visit Nursing Care Services at the Outreach Community Center)

  • 양혜경
    • 문화기술의 융합
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    • 제7권4호
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    • pp.227-236
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    • 2021
  • 본 연구는 찾아가는 동 주민센터 방문간호사의 사업에 대한 인식 및 참여경험을 파악하여 방문간호사업의 효율적 운영 및 사업의 발전 방향을 마련하고자 방법론적 트라이앵귤레이션 연구방법을 적용하여 시도하였다. 방문건강 관리사업의 전달체계, 간호사의 인식 및 참여경험을 파악한 결과, 방문의 효율성을 위해 방문현장 상황을 고려한 방문간호 관리인원, 건강평가, 정보시스템 등 사업기준의 보완이 필요한 것으로 나타났다. 본 연구에서 제기된 주요 이슈를 공유함으로써 정책적 대안이 개발되어야 함을 제언한다.

The threat of Monkeypox in the Philippines: another problematic preparation and management for the healthcare system?

  • Dalmacito A. Cordero Jr.
    • Clinical and Experimental Vaccine Research
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    • 제12권1호
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    • pp.77-79
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    • 2023
  • The Philippines is still in a tight battle with the coronavirus disease 2019 pandemic since many cases are detected daily. With the continuous spread of another disease worldwide-monkeypox, many Filipinos are alarmed if the country's healthcare system is prepared enough, especially with the detection of its first case. Learning from the unfortunate experiences of the country during the current pandemic is essential in facing another health crisis. With this, recommendations for a robust healthcare system are proposed centered on: a massive digital information campaign about the disease; training healthcare workers to raise awareness about the virus and its transmission, management, and treatment; an intensified surveillance and detection procedure to monitor cases and execute contact tracing properly; and a persistent procurement of vaccines and drugs for treatment, with a well-designed vaccination program.