• Title/Summary/Keyword: Home Nursing

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Home Care Nursing: An Economic Analysis (가정간호의 경제성 평가에 관한 문헌분석)

  • Lim, Ji Young;Kim, Ji Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.20 no.2
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    • pp.141-151
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    • 2013
  • Purpose: The purpose of this study was to examine the economic effectiveness of by conducting a literature review of published articles, masters theses, and doctoral dissertations. Method: Prior to the literature review, inclusion-exclusion criteria were established. We then reviewed 1,029 CINAHL, MEDLINE, and Cochrane DB papers, and 153 RISS papers collected between Results: A total of 12 studies met the inclusion-exclusion criteria.-effectiveness: 6 cost-effectiveness studies, 1 cost-utility studies, and 5 cost-benefit studies. Each of the 12 reviewed studies concluded that home care nursing had greater economic benefits than other compared healthcare services. Conclusion: Home care nursing has significant economic benefits in multi health care service settings and for various patient groups. Therefore these results will be used a critical evidence for the development of economically effective home based health care systems for future policy making.

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Knowledge on Infection Control for Home Care (가정간호과정생의 가정간호에서의 감염관리에 대한 지식)

  • Jeong, Ihn-Sook;Jeong, Jae-Shim;Shin, Yong-Ae;Kang, Kyu-Sook;Kim, Myung-Ja;Jo, Bok-Hee;Kim, Keum-Soon;Hwang, Sun-Kyng
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.9 no.1
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    • pp.5-13
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    • 2002
  • This study was conducted to assess need for education on the infection control by examining the knowledge on infection control in home care of the home care trainees who had completed an infection control course. Using 64 items questionnaire. home care trainees of eight home care education institutions who took classes related with infection control. The level of knowledge evaluated subjectively was 4.24point (full mark: 5 point). The correct answer rates for handwashing and gloving. cleaning patients' rooms. preventing sharp injury, preventing exposure to potential infectious agents, home care bag technique were 84.5% 86.4% 70.7% 65.3% 76.2% representatively. For the knowledge on the infection control principles to prevent catheter related infection, indwelling catheter related infection, tracheal tube related pneumonia. L-tube related infection, oxygen therapy related infection. and wound infection were 62.8% 27.8% 39.1% 87.8% 76.5% 80.5% representatively. The correct answer rates varied depending upon the educational institutes (p< = .0001), educational levels (p= .001), workplaces (p<.0001), and the experience of infection control education (p= .001). Considering these results. a standardized curriculum must be developed and implemented after analyzing the existing infection control curricula of the home care education institutes. and guide books for infection control in home care should be developed and distributed. In addition. continuous infection control education be provided to the home care nurses through reeducation so they can acquire new knowledge needed for carrying out infection control activities effectively.

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Case-based Learning through Home Care Nursing Specialists' Critical Reflection: Application with Patients Using Home Mechanical Ventilator (가정전문간호사의 비판적 성찰을 통한 사례기반 학습: 가정용 인공호흡기 적용대상자)

  • Park, Hak Young;Hwang, Moon Sook;Kim, Yeon Hee
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.25 no.3
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    • pp.153-163
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    • 2018
  • Purpose: This study is know the home care nursing specialists' copying method for life-threatening emergency situation occurred while changing the tracheotomy tube in the patient's home through case-based learning. Methods: Two cases were analyzed using structured critical reflection while changing the tracheal tube. In the first case, the patient presented with dyspnea, cyanosis, and low oxygen saturation when connected to home mechanical ventilator after replacement of the tracheotomy tube. In the second case, replacement of the tracheal tube was difficult due to a narrowed airway from proliferated granulation tissue. Results: From the case-based learning. using a critical reflection instrument, home care nursing specialists indicated that it was important to explain the possibility of danger to the client and that nurses must check the operation of the ambu-bag to prepare for an emergency when replacing a tracheotomy tube. Moreover, they stated a need for two nurses during client visits when there is the possibility of an emergency. Conclusion: Case-based learning through critical reflection provides actual practice-focused knowledge that is helpful to home care nurse specialists who face emergency situations in a restricted environment. Therefore, we hope that home care nursing specialists will use this method to strengthen their professional knowledge.

Behavioral Symptoms in Nursing Home Residents with Dementia: Developing a Nursing Practice Model

  • Kim, Hyo Jeong
    • Korean Journal of Adult Nursing
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    • v.18 no.3
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    • pp.488-499
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    • 2006
  • Purpose: Behavioral symptoms in dementia (BSD) are one of the most disturbing behaviors to caregivers and a major reason for nursing home placement. Behavioral symptoms are often treated with psychotropic drugs (PD), however, the effect of such drugs for the frail elderly dementia patient is not certain because of their critical adverse effects. Theoretical model applicable to nursing practice for BSD in nursing homes, which is essential in guiding and evaluating such interventions, is absent. This article presents the process of developing a theoretical model of BSD in nursing homes. Method: Using Walker and Avants' theory synthesis method, three behavior models and two system models were incorporated into the proposed model to provide the theoretical and analytical explanation of the relationships between PD usage, its determinants, and BSD. Results: Resident variables and nursing home variables related to the two focal concepts (i.e., PD usage and BSD) were identified. Resident variables include demographical characteristics such as age and gender, and dementia-compromised functions such as cognitive and functional impairment. Nursing home variables include facility characteristics such as ownership type and size, and physical and psychosocial environment. Conclusion: The proposed model suggests that fulfillment of resident unmet needs through improvement of physical and psychosocial environment may produce better health outcomes of nursing home residents with BSD. Assessment and intervening environmental triggers of such behaviors are also suggested to be prior to the PD usage.

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Incidence of Medical Services and Needs for Hospital-based Home Care Nursing in Elder Care Institutions (노인요양시설 내 의료서비스 발생빈도와 병원중심 가정간호 요구도 조사)

  • Kim, Jae-Seung;Lee, Joo-Young;Song, Chong-Rye;Lee, Mi-Gyeong;Hwang, Moon-Sook
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.16 no.1
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    • pp.49-58
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    • 2009
  • Purpose: This study aimed to clarify the needs for hospital-based home care nursing medical services in elder care institutions by analyzing the details and frequency of medical services provided by, and the needs for, hospital based home care nursing in select institutions in Korea. Methods: Seventy-seven staffs at elderly care institutions located throughout the country completed self-report questionnaires between February 1 and May 31, 2009. SPSS ver. 14.0 was used for data analysis regarding frequency and percentage, mean and standard deviation. Results: Forty-eight hospital-based home care nursing medical services in eight domains were identified as being needed in elderly care institutions. The most commonly used medical services were providing instruction in oral drug administration, checking drug beneficial/adverse effects, and administering blood glucose test, while the most needed medical services requiring hospital based home care nursing were complex pressure ulcer care, followed by diabetic foot ulcer management and nutrient injection. Conclusion: The present results should provide fundamental data for better healthcare services with hospital based home care nursing at elderly care institutions as part of a 'win-win' strategy through which medical expenses are reduced, insurance costs are kept stable, and safe and high-quality medical services are provided for residents of elder care institutions. Political decisions intended to promote visits by hospital based home care nurses to elder care institutions would be a prudent course.

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Urinary Tract Infections in Catheterized Patients Receiving Home Care Nursing (도뇨관 관리를 위해 가정간호에 의뢰된 환자의 요로감염실태)

  • Park, Min-A;Lee, Jong-Eun;Cho, Young Yi;Jang, Jung Sook;Choi, Ji Yeon
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.28 no.2
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    • pp.178-185
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    • 2021
  • Purpose: In this study, we aimed to explore the risk factors for catheter-associated urinary tract infections (CAUTI) in patients receiving home care nursing. Methods: A total of 117 participants registered for home care nursing provided by the University of C hospital in Seoul were included in the study. Data were based on a survey and urine examination results from June to July 2018. Results: Asymptomatic bacteriuria was identified in 96 (82%) patients. Age, sex, activity, diabetes mellitus, mental status, presence of other diseases, catheter material type, catheter size and fixation, hand washing (care giver), gloving (care giver), perineal care, and bladder irrigation were not recognized as risk factors for CAUTI. Age and catheterization duration were associated with CAUTI. Conclusions: Old age was found to be a risk factor for CAUTI (p=0.048). CAUTI incidence decreased as catheter use exceeded 70 months (p=0.028).

An Evaluation Study on Home Care Clinical Practicum (일 가정간호 실습교육 평가 연구)

  • Kang, Kyu-Sook;Kim, Cho-Ja;Seo, Mi-Hye;Baek, Hee-Chong;Margaret, Storey
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.6
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    • pp.78-87
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    • 1999
  • From 1990 to 1997 Home Care Education Programs have been offered at 11 Home Care Education Institutes. But there have been no revisions in the program. Especially in the clinical practicum, the Ministry of Health and Welfare proposed 248 hours as 'Family Nursing and Practice'. But each of institutes has developed their own program, and the clinical practicum is very different. Institutions for home care practice have been very limited and even now only 40 hospitals started home care in the second demonstration project. A few community-based institutions have also been offering home care services. This study was conducted to analyze home care clinical practicum offered at Y university, and plan for a revised home care clinical practicum. Y university clinical practicum was revised to include 'visits to community institutions', 'laboratory practice', 'hospital practice', 'discharge planning and home care practice', and 'home care specialty practice'. The results of the evaluation and plan for a revision are as follows: 'Visits to community institutions' is a practice that helps the students understand community resources which are available to home care nurses, and as an orientation to institutions for practice. 'Laboratory practice' is to used to improve nursing skills that are applicable to home care. Problems that the students identified in the laboratory practice were 'lack of opportunity for individual practice', and 'inadequate theoretical preparation for practice'. To address these problems the basic nursing skills laboratory was open and could be used freely by the home care students, and practice could be done after the theoretical lectures. 'Hospital practice' is a practicum in which the students apply nursing skills to patients and to obtain assessment skills for discharge planning. Using a preceptorship, five days for hospital practice should be offered. 'Discharge planning and home care practice' was done at Wonju Christian Hospital. This institute is too far away that this practice should be provided at different institutions as soon as it is possible to contract with home care institutions. Patients groups in different home care institutions are very different, so the 'Home care specialty practice' should be done after analyzing patient groups and choosing specialty areas. These areas are' care of patients with respiratory dysfunction', 'care of patients with neurologic dysfunction', 'care of cancer patients', 'care of patients on dialysis', and 'wound care'. This practice should be offered with a preceptorship, so preceptors, clinical directors, and students should meet for home visit orientation.

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Development of Nursing Intervention Standards for Home Hospice Patients (가정호스피스 대상자를 위한 간호중재 표준서 개발)

  • Yong, Jin-Sun;Kim, Nam-Cho;Kang, Jin-Hyeong
    • Korean Journal of Adult Nursing
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    • v.18 no.1
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    • pp.102-114
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    • 2006
  • Purpose: The purpose of this study is to develop a set of standardized nursing interventions and their associated nursing activities according to the NIC system to guide home care nurses in performing nursing intervention activities for hospice patients. Method: This study was a descriptive survey that first identified frequently used & specialized hospice nursing interventions based on the NIC systems and next validated a set of standardized nursing interventions and their associated nursing activities. One hundred chart records of home hospice patients were used to identify nursing interventions. Also, thirty-nine hospice specialized nurses participated twice using the Delphi technique to test the content validity of the standards. Results: Among the nursing interventions, 19 important nursing interventions and 418 associated nursing activities were selected after two rounds of Delphi technique by hospice specialized nurses. The mean content validity of the final nursing activities was 0.82. In this paper, only the 3 most frequently used nursing interventions and 3 hospice specialized nursing interventions with their associated nursing activities are presented since space is limited. Conclusion: The nursing intervention standards will be a basis for home hospice nurses to improve quality of hospice care for hospice patients.

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A Survey of Hospital-Based Home Healthcare Utilization in Patients using Home Mechanical Ventilator (가정용 인공호흡기 적용 환자의 가정간호서비스 이용실태)

  • Lee, Mi Kyoung;Song, Chong Rye;Oh, Eun Kyung;Yoon, Young Mi
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.24 no.2
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    • pp.210-220
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    • 2017
  • Purpose: The study aimed to describe the utilization of home healthcare in patients using home mechanical ventilator(HMV) Method: A descriptive cross-sectional design was used in this study. A Questionnaires were sent to nation wide home healthcare agencies to assess their utilization status of home healthcare. A convenience sample of 158 patients data was reviewed. Result: A total of 88(55.7%) men with the mean age of 51.94(${\pm}19.52$) years were included in the study. Approximately 55.1% of patients at the outpatient department were referred to the home healthcare services after discharge. The underlying diseases were as follows : 129 amyotrophic lateral sclerosis and 27 muscular dystrophies. A total of 155 patients have invasive HMV. Efficient home healthcare nursing activities provided by a highly skilled home healthcare advanced practice nurses(HHCAPN) were tracheotomy and gastrostomy tube management and urinary catheterization. The average frequency of home visit for one patient was 2.52times per month. The duration of home healthcare utilization with >1 year was 82.9%. HHCAPNs have limited knowledge and skill for HMV. Conclusion: The government support is required to provide sufficient home healthcare services to the patients discharged with HMV. HHCAPNs should be properly educated on the effective HMV care.