• 한국보건간호학회지
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• 제29권3호
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• pp.403-411
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• 2015

Due to lack of an information system regarding the status of using home-visit nursing (HVN), it has barriers of providing improvement of the HVN for management of elderly health care in Korea. The twofold aims of the current review are to expose the existing agendas for HVN and to suggest the political implications for HVN of Korea based on the transition process and revised HVN system of Japan. This review suggests that an information evaluation system has to precede for HVN services in detail. And, the service provided per manpower should be assessed by separating the code of manpower (registered nurse, nurse aide, dental hygienist) as well as securing detailed and precise information on the HVN services. The other suggestion, development of a community-based home health care nursing model in order to provide necessary services for long-term health insurance beneficiaries. In addition, a master plan for health care for elderly should be established at the national level in order to establish an effective home health nursing delivery system.

• 가정∙방문간호학회지
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• 제18권2호
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• pp.88-98
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• 2011

Purpose: This study was done to develop and test a maternal role strengthening program based on home care nursing. Methods: A quasi-experimental design was employed. Changes in the variables(maternal identity and confidence of maternal role) were evaluated to test the effects of the developed program. Participants were first-time mothers receiving home care nursing from S Medical Center following normal spontaneous vaginal delivery(experimental group 29; control group 29). Data collection was conducted from December 2008 to February 2009. $X^2$-test, Fisher's exact test and t-test were used to analyse the data. Results: Hypothesis 1, that the experimental group receiving this program would experience a stronger maternal identity than the control group, was supported(t=-7.990, p=<.001). Hypothesis 2, that the experimental group would have higher confidence in their maternal role than the control group, was also supported(t=-10.109, p=<.001). Conclusion: The maternal role strengthening program based on home care nursing developed in this study was found to be an effective means of improving maternal identity and confidence of maternal role. As these traits are developed once the baby is born, active nursing programs which provide continuous training and demonstrations to mothers are needed prior to hospitalization and following hospital discharge.

• 가정∙방문간호학회지
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• 제17권1호
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• pp.28-35
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• 2010

Purpose: The study compared the hypertension care efficacy of a case management intervention program for registered clients. Methods: The nonequivalent control group pretest-posttest design involved 53 registered hypertensive patients of a customized visiting health care service in S-city(n=28 experimental group, n=25 control group). Data collection and case management intervention were carried out from April to July, 2009. The experimental group had six home visits and two phone calls, and the control group had two home visits during the 8-week period. Outcome variables for test hypotheses were changes in physiologic index (blood pressure and total cholesterol) and degree of self-management performance and confidence. Results: Repeated measure ANOVA and t-test of means revealed significant differences before and after program for systolic and diastolic blood pressure and self-management performance and confidence, but no significant difference concerning total cholesterol. Conclusion: A case management program can have positive effects on blood pressure control and self management. However, research is needed to create a more effective case management for vulnerable patient populations.

• 가정∙방문간호학회지
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• 제25권2호
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• pp.165-174
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• 2018

Purpose: The study investigated the knowledge and compliance on hand hygiene moments among nursing care workers in geriatric hospitals. Methods: A total of 143 nursing care workers at geriatric hospitals were selected. Data collection was conducted from February 20 to March 20, 2017. Results: For all hand hygiene scenarios, the total correct answer rate was 71.5%. On the necessary hand hygiene moments, the compliance rate was 68.3%. With respect to the general characteristics of the participants, knowledge on hand hygiene moments showed a statistically significant difference according to clinical career(p=.001), and existence of infection controller or infection control office in the nursing home(p=.038). Compliance showed differences according to clinical career(p=.023), existence of infection controller or infection control office in the nursing home(p=.033), and training experience in hand hygiene(number of times/year)(p=.035). Knowledge and compliance showed a statistically significant positive correlation(r=.90, p<.001). Conclusions: It is necessary to develop and operate an infection control education program that can improve the knowledge and awareness of hand hygiene moments and considers the individual characteristics geriatric hospitals's nursing care workers.

• 지역사회간호학회지
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• 제20권4호
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• pp.443-452
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• 2009

Purpose: The purpose of this study were to examine the need of community care services and the influencing factors of the need in the family care givers of hospital-based home care patients. Methods: Data were collected from 256 family caregivers, who were recruited from 10 hospitals in a metropolitan city. A structured questionnaire on the characteristics of caregivers, resources, and patients was administered. Also, questions on the need of community care services were added. Logistic regression analysis was used to identify the influencing factors of the need for community care services. Results: The participant needed more transportation service, lease of health care devices, visiting bath, caring, visiting hair dressing than that of housekeeping, short-term care, and day care service. Various variables from the three factors were found to be influenced on the need of community care services. Conclusion: The accessibility of the higher need of community care services should be increased for hospital-based home care users. Also, the factors of Family care giver, Resource, and Patient might be considered to provide community care services of hospital-based home care users.

• 농촌의학ㆍ지역보건
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• 제44권1호
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• pp.28-38
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• 2019

본 연구에서는 우리나라 보건소 방문건강관리사업과 노인장기요양보험의 방문간호, 의료기관의 가정간호사업 등 가정방문간호사업 현황을 살펴보고, 향후 발전과정을 모색하고자 수행되었다. 본 연구를 위하여 각 가정방문간호사업의 관련 법령, 통계자료, 지침과 안내서, 연구논문과 학술대회 자료집 등을 검색하여 관련 문헌을 고찰하였다. 연구결과 보건소 방문건강관리사업은 지역보건법에 근거하여 주로 취약계층을 대상으로 간호사에게 의해 비용부담 없이 제공되고 있으며, 2017년 12월을 기준으로 1,261,208명 등록 관리되는 것으로 나타났다. 보건소 방문건강관리사업 등록 대상자는 흡연율, 걷기 실천율, 혈압조절율, 혈당조절률 등이 향상되는 것으로 나타나, 건강행위와 질병관리 측면에서 긍정적인 효과가 있고, 비용-편익이 있다고 보고되었다. 노인장기요양보험에서의 방문간호는 노인장기요양보험법에 근거하여 간호사 또는 간호조무사에 의해 재가장기요양기관에서 방문간호를 제공하고 있으며, 시간당 정해진 수가에 따라 비용을 받고 있는데, 2017년에 전체 요양급여비의 0.2%만이 방문간호로 이용하는 것으로 나타났다. 재가장기요양보험 방문간호 이용자는 비이용자에 비해 의료비도 더 적게 쓰고, 입원일도 적다고 보고되었다. 의료기관 가정간호는 의료법에 근거하여 2명 이상의 가정간호사(가정전문간호사)를 고용한 의료기관에서 의사의 처방 하에 가정간호서비스를 제공하는데, 2017년 460명의 가정간호사가 가정간호서비스를 제공하고, 전체 의료비의 0.038%가 가정간호비용으로 지불된 것으로 나타났다. 우리나라 가정방문간호 유형은 관련법이나 인력, 사업 대상이 다르지만, 서비스 이용자의 건강관리에 효과가 있고, 비용-편익이 상당히 높은 것으로 나타났다. 우리나라 가정방문간호를 발전과 활성화를 위해 세 개 유형의 가정방문간호 서비스가 통합적으로 제공될 수 있는 방안을 모색하고, 근로 조건의 개선, 가정방문간호서비스 제공인력기준이나 방문간호수가 체계의 개선과 같은 법령의 개정 등을 고려할 필요가 있다고 본다.

• 가정∙방문간호학회지
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• 제28권2호
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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.

• 간호행정학회지
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• 제12권2호
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• pp.225-232
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• 2006

Purpose: The purpose of this study was to analyze the services and cost of CVA patients in hospital-based home health care and compare the differences of home health care cost by hospital types. Methods: The subjects of this study were 5,756 home care patients with cerebrovascular disease. Data were collected by using home health care medical expense claims from 127 hospitals in 2004. Results: The home care service 'indewelling catheterization' was the highest(19.28%), and then 'nasogastric tube insertion and change(16.72%)', 'bladder irrigation(15.98)', 'wound management(simple dressing)(10.42%)' followed. Average home health care cost per visit was 39,943 won, and the highest 46,058 won in general hospitals and the lowest 33,922 won in tertiary hospitals, so there were statistically significant among the types of hospitals(F=1112.47, p<0.0001). Conclusions: The number of home health care patients has been rapidly growing with the increase of aged population and demand for home care services is rising. So, it could be urgent to develop a reasonable cost reimbursement system for home health services and to expend scopes of the roles of home care specialist nurses. Amid the demand of more detail understanding the present status of home care, our study can be contributed to provide fundamental information of home care in Korea.

• 가정∙방문간호학회지
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• 제27권2호
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• pp.137-145
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• 2020

Purpose: This study aimed to identify the training system and current status of home health nurses and to examine ways to retain sufficient number of advanced practice nurses (APNs) in the home health nursing field. Methods: This study analyzed the adequacy of the supply of home health nurse by reviewing the existing research literature and statistical data. Results: Discussions on how to revitalize the home care business have been ongoing since the beginning of 2001. However, despite home health nurses being oversupplied, discussions on the adequacy of supply have always been excluded from the focus of revitalization. The recent expansion of the home care business has resulted in a shortage of workforce, which can be inked not only to the continuous reduction of the designated quota of programs but also to the regional imbalance of educational institutions. The serious imbalance between supply and demand has caused fears that the home care business would drastically reduce. Conclusion: It is necessary to not only increase designated quotas for APNs programs but also integrate those programs of the similar curricula, thus lowering supply shortages in home health nurses.

• 지역사회간호학회지
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• 제9권1호
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• pp.181-199
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• 1998

This study was designed to examine Home Nursing Care in Hospital-based and Community-based programs. This study investigates actual conditions of nursing needs and demands of clients and their family and the state of home nursing services. We hope that this study will improve upon the current home nursing care system. In Korea Home-Nursing Care programs are still developing and only now becoming a part of the health care delivery system. The data was collected by a questionaire the clients developed and modified through literature review by this writer and through 10 nurses who are members of 4 hospital and 3 community- based agencies. In this study 173 clients were selected. The study lasted from Oct. 1997 to March of 1998. The results show that the average age was 64.3, years older than most women clients (63.0%), the average age of a caregiver was 50.9 years old and most were female(77%). Two types of agency clients with a significant difference between social conditions [25.7%] used some form of insurance; 54.3% had the spouse pay expenses; pay 58.5% son and daughters of Hospital-based agencies: patients of social workers were 24.0%, the highest in the community agency. The condition of patients was 63.2% of the foley and nelaton catheter insertion at hospital based agencies. The range of nursing services offered is one of the highest among the 34 kinds of servies including nasogastric tube management basic nursing, ROM exercise, bladder irrigation, wound and sore dressing. For an effective care service factors that disturb each program such as a non-cooperatative family as well as patients themselves need to be lessened. Further more, the following must be emphasized, supportive counsel 27.0%, steady care for patient, 13.3%maintain a sense of security(11.7%), dressing sores and nutrition(10.0%). Although there were a large number of home nursing care services in the community, policy changes have gathered momentum. Fortunately, the scope and level at legal support will be increased in the future. The program should intergrate and link the district or community together. A project to develop a community based home nursing system as soon as possible should be developed. In conclusion, home nursing care nurses training curriculum should be strengthened.