• Title/Summary/Keyword: Home care nursing need

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A Study for the Enhancement of Accessibility to Community Home Nursing Care Services - The Home Nursing Care Program of Seoul Nurse Association - (지역사회에서의 가정간호 접근성 제고 방안 - '서울시간호사회' 가정간호사업 분석을 토대로 -)

  • Hwang, Na-Mi;Park, Sung-Ae;Kim, Yun-Ok;Moon, Young-Im;Park, Jeong-Sook;Ryu, Ho-Sihn;Rhee, Kae-Sook
    • Journal of Home Health Care Nursing
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    • v.10 no.1
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    • pp.5-14
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    • 2003
  • Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.

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A Comparison of NANDA and CCC used in Hospital-based Home Health Care

  • Park, Hyeoun-Ae;Lee, Jin-Kyung;Lee, Hyun-Jung
    • Perspectives in Nursing Science
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    • v.5 no.1
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    • pp.1-15
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    • 2008
  • Background: Recent changes in the medical environment have increased the need for the home health care nursing in Korea. Even though the number of home health care patients is increasing, the major nursing problems have not been identified due to lack of a standardized nursing diagnosis. Aim: An investigative study was conducted to determine the frequency and appropriateness of nursing problems in hospital-based home health care patients in Korea using two internationally standardized nursing diagnosis classification systems. Methods: Nursing records of 249 hospital-based home health care patients were reviewed and nursing problems were identified using the North American Nursing Diagnosis Association Nursing Diagnosis Taxonomy I (NANDA) and the Clinical Care Classification of Nursing Diagnoses (CCC). Findings: Out of 463 nursing problems. 403 nursing problems were described using the NANDA whereas 427 nursing problems were described using the CCC. Nursing diagnoses not captured by the NANDA classification include nausea/vomiting, anorexia, risk for nutrition deficit, decreased blood pressure, dying process, blood sugar impairment. infection unspecified, and disuse syndrome. Nursing diagnoses not captured by the CCC include nausea/vomiting and anorexia. Conclusions: In describing nursing problems of home health care patients, it was found that the CCC was able to represent more diagnoses than the NANDA.

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Estimation of nursing home needs in elderly people (노인인구의 간호요양원(Nursing Home) 필요예측에 관한 연구)

  • Kang, Im-Ok
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.2
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    • pp.195-209
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    • 2000
  • The purpose of this study is to estimate the population requiring nursing home services among elderly people in Korea. This study identifies the need of nursing home services determined by health care professionals and estimates the proportion of elderly people requiring nursing home service according to the admission criteria. Surveys were conducted on health care professionals including medical doctors, home care nurses, and nurse practitioners. They were asked to assess nursing home need based on four content areas: Physical function (Activities of Daily Living), chronic disease, Physical symptoms (incontinence), mobility, eating, and sensory function. Based on the professionally determined need criteria the proportion of elderly people requiring nursing home services was estimated using secondary data from the 1994 Survey on the Living Status of the Korean Elderly. The number of study subjects to estimate nursing home need who were 60 and older totaled 2,058. The most important factor contributing to the admission eligibility criteria was the elderly living alone. Other factors related were the elderly being unable or having difficulty carrying out activities, and having insufficient help from other our activities, and having insufficient help from other members of the household. Using only physical function, the proportion of elderly people requiring nursing home was $8{\sim}9%$. When only chronic disease was used, proportions varied widely; for the doctor's group, the proportion was over 30%. Using all areas, the proportions of elderly people requiring nursing home were between 13% and 38%. The estimate using chronic disease and physical function was similar to the on using all areas.

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Home Health Care Nursing Service Satisfaction and Needs in Cancer Patients (재가 암환자의 가정간호서비스 만족도 및 요구도 조사)

  • Jung, Kyoung Ae;Han, Suk Jung
    • Journal of Home Health Care Nursing
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    • v.19 no.2
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    • pp.139-149
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    • 2012
  • Purpose: The purpose of this study is to provide the basic data required for quality improvement of home health care nursing and development of nursing services for cancer patients by examining the frequency of practices, level of service needs and satisfaction for nursing services. Methods: The subjects were 231 patients who agreed in participating on this study and were receiving home health care nursing services by the home health care advanced practice nurse from two national hospitals and four subsidiary general hospitals, located in Seoul from September 30, 2008 to February 28, 2009. Data were analyzed by frequency, percentage, t-test and ANOVA, using SPSS WIN 12.0 program. Results: The most frequent practices were 'checking vital sign' and 'explaining what patient want to know.' Total service need had an average of 3.03 point and emotional domain showed the highest average of 3.44 point. Total satisfaction had an average of 4.23 point and satisfaction along diseases had the highest average of 3.65 point in case of non-metastasis cancer. Conclusion: The subjects were highly satisfied with home health care nursing services which gave positive effect to them. It will be helpful to give cancer patients physical and spiritual care complementally when home health care nurses provide nursing services.

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Identifying the Needs of Home Care Patient's Family Caregivers (가정간호 가족 돌봄 제공자의 요구도)

  • Baek, Hee-Chong;Choi, Yun-Jung
    • Journal of Home Health Care Nursing
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    • v.15 no.2
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    • pp.115-121
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    • 2008
  • Purpose: The purpose of this study was to identify the needs of family caregivers of home care patients. Methods: A total of 40 caregivers had been selected from a hospital-based home care agency in Gyunggi province. The instrument developed by Hileman, Lackey, & Hassanein(1992) was modified to 55 items and used in this study. The instrument consists of 6 categories: informational, household, patient care, personal, spiritual, and psychological needs. Out of 29 analysed with descriptive statistics, Mann-Whitney U test, and Spearman correlation test using SPSS 14.0. Results: Most caregivers were females, with a mean age of $60.0{\pm}15.5$, 32.1% were spouses, and 92.9% were living with patients. Patient's activities of daily living score was very low, and 44% of patients had cerebrovascular disease. Caregiver's needs were moderate, and the greatest being personal need. There was a significant difference between caregiver's monthly income and needs. Conclusion: Home care nurses need to teach and support family caregivers with specific programs and services to meet the identified and unmet needs of caregivers of home care patients. In-home respite and institutional respite are recommended for family caregivers taking care of patients with chronic disease.

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Risk Factors for Mutidrug-Resistant Organisms Carriage Among Home Health Nursing Patients (의료기관 가정간호 대상자의 다제내성균 보유 위험요인)

  • Park, Min-A;Jang, Jung Sook;Cho, Young Yi;Choi, Ji Yeon;Lee, Jong-Eun
    • Journal of Home Health Care Nursing
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    • v.30 no.2
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    • pp.155-162
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    • 2023
  • Purpose: This study was conducted to identify the status and risk factors for the carriage of multidrug-resistant organisms carriage in home health nursing patients. Methods: This retrospective study enrolled 122 participants who received home health nursing and analyzed the data obtained from chart review and diagnostic tests for multidrug-resistant organisms carriage from January 2019 to January 2021. Results: Multivariate analysis revealed that surgical procedures in the preceding year, injectable antibiotic use in the preceding month, pressure ulcer, and indwelling nasal tubes were significantly associated with multi-drug resistant infection. Conclusions: Infection-control strategies need to be developed and customized for use in the home health-nursing service for patients who are carriers of multidrug-resistant organisms.

The Relationship between Home-Visit Nursing Services and Health Care Utilization among Nursing Service Recommended Beneficiaries of the Public Long-Term Care Insurance (노인장기요양보험 방문간호 권고군의 방문간호 이용과 의료 이용의 관계)

  • Kang, Sae Bom;Kim, Hongsoo
    • Health Policy and Management
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    • v.24 no.3
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    • pp.283-290
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    • 2014
  • Background: This study aimed to examine the relationship between home-visit nursing services and health care utilization under the public long-term care insurance program in Korea. Methods: We analyzed the long-term care need assessment database and the long-term care and the health insurance claim databases of National Health Insurance Service between July 2011 and June 2012. The sample includes a total of 20,065 home-visit nursing recommended-older beneficiaries who use home-visit nursing and/or home-visit care, based on a standard benefit model developed by the Health Insurance Policy Institute of National Health Insurance Service. The beneficiaries were categorized into home-visit nursing use and non-use groups, and the home-visit nursing use group was again divided into high-use and low-use groups home-visit nursing, based on their total annual home-visit nursing expenditure. Two-part models and negative-binomial regression models were used for the statistical analysis. Results: The home-visit nursing use was negatively associated with the number of outpatient visit and cost, while adjusting for all covariates. The home-visit nursing use was also negatively associated with the inpatient cost among the high home-visit nursing use group. Conclusion: The findings implies home-visit nursing use prevents health care utilization. Further studies and policy strategies that can promote and strengthen home-visit nursing services under the public long-term care insurance are necessary in Korea.

Need Assessment for Home Nursing of Stroke Patients (뇌졸중 환자의 가정간호요구)

  • 강현숙
    • Journal of Korean Academy of Nursing
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    • v.27 no.3
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    • pp.550-562
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    • 1997
  • Since patients with strokes occupy a high priority among patients for home nursing, the development of guidelines for such nursing is required and the needs of these patients should be reflected in the guidelines. Therefore, this study was done to identify the content and levels of home nursing for patients with strokes and to utilize the data in developing the most effective home nursing guidelines for these patients. The level of A, D. L. and the ability to control upper extremities were measured, and through a questionnaire. the needs for home nursing and related variables were also evaluated. The subjects for the study were 121 patients, 58 inpatients and 63 home care patients who had had a Stroke. Data collection was done from September 1996 to January 1997. The collected data were analyzed utilizing SPSS /PC, and the results are as follows : 1. Home nursing need of inpatients The priority order of home nursing needs for inpatients was : "Training in emergency treatments and how to cope with a stroke"(2.28+1.06), next, "Explanation of diets as limited or recommended", and last, "Nursing care for sleeping Problems". 2. Home nursing need home of patients The priority order of home nursing needs for home patients was : "Care for the paralyzed side" (2, 89+.34), next, "Maintenance of right posture and how to change position" (2.87+.34), and last, "Counseling on sex". 3. Comparison of the levels of home nursing needs between in patients and home patients The results of analyses of home nursing needs according to causes were grouped into seven categories : and t-tests of the seven categories showed significant differences between the two groups in all categories, that is, the level of home nursing needs were significantly higher for home patients than for inpatients in all categories of home nursing. 4. Level of home nursing needs by characteristics The variables that have affected the level of home nursing needs for these patients were sex, profession, level of education, accompanying diseases, paralyzed position. A.D.L. levels and ability levels in coordinating upper extremities. There variables, displayed a reverse correlation with the level of home nursing needs, and the degree of correlation was high. In conclusion, the above results, show there were differences in the priority order of home nursing needs between inpatients and home patients : but the content of home nursing needs wanted by these patients was similar. Meanwhile, the levels of demand for home nursing was exceptionally higher on the part of home patients than inpatients. Although it is realized that nursing guidelines for home nursing needs in all items need to be developed, there is also a necessity to guidelines in accordance with priority orders, and with consideration of the factors that affect the level of home nursing needs. of the factors that affect the level of home nursing needs.

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A Comparative Study on the Care Services According to Care Levels in the Korean and German Home Care System (한국과 독일 방문요양의 등급별 급여 비교 연구)

  • Park, Jong Duk
    • Journal of Home Health Care Nursing
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    • v.23 no.2
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    • pp.243-252
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    • 2016
  • Purpose: This study aims to classify multiple forms of home care services from a service user's perspective. By comparing the German system to the Korean one, this study seeks to find better ways of enhancing client-centered care. Methods: The data of 121 home care users were collected from six home care centers that had under the management of nursing managers for more than five years. The researcher used a German instrument to estimate the level of care. Results: High correlation was found between German and Korean assessment criteria (r=0.81, p<.001). However, compared to their German counterparts, Korean home care providers allocated more time towards provision of domestic help per daily visit. German home care providers allocated more time towards services relating to provision of support for physical activities, including personal hygiene. It was confirmed that the level of care in Korea does not correlate with either the categories of home care services and duration. Conclusion: Therefore, care services should be offered according to long-term care needs. This study suggests a need for systematic care aimed at strengthening the client's autonomy which should be properly planned, implemented, and managed.

Current Status of Home Visit Programs: Activities and Barriers of Home Care Nursing Services (재가간호서비스 제공자의 업무 수행 현황과 장애요인)

  • Oh, Eui Geum;Lee, Hyun Joo;Kim, Yukyung;Sung, Ji Hyun;Park, Young-Su;Yoo, Jae Yong;Woo, Soohee
    • Journal of Korean Academy of Nursing
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    • v.45 no.5
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    • pp.742-751
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    • 2015
  • Purpose: The purpose of this study was to examine the current status of home care nursing services provided by community health nurses and to identify barriers to the services. Methods: A cross-sectional survey was conducted with three types of community health care nurses. Participants were 257 nurses, 46 of whom were hospital based home care nurses, 176 were community based visiting nurses, and 35 were long term care insurance based visiting nurses. A structured questionnaire on 7 domains of home care nursing services with a 4-point Likert scale was used to measure activities and barriers to care. Data were analyzed using SPSS WIN 21.0 program. Results: Hospital based home care nurses showed a high level of service performance activity in the domain of clinical laboratory tests, medications and injections, therapeutic nursing, and education. Community based visiting nurses had a high level of service performance in the reference domain. Long term care insurance based visiting nurses showed a high level of performance in the service domains of fundamental nursing and counseling. Conclusion: The results show that although health care service provided by the three types of community health nurse overlapped, the focus of the service is differentiated. Therefore, these results suggest that existing home care services will need to be utilized efficiently in the development of a new nursing care service for patients living in the community after hospital discharge.