• Title/Summary/Keyword: Home care services, Hospital-based

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A Narrative Inquiry of Experience of the Elderly's Living with Chronic Disease in Hospital-based Home Care Services (병원중심가정간호를 받는 만성질환 노인의 삶의 경험에 관한 내러티브 탐구)

  • Shin, In-Ju;Lee, Chung-Sook
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.18 no.1
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    • pp.20-31
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    • 2011
  • Purpose: The purpose of this study is to document the experiences of elderly persons with chronic diseases who are under hospital-based home care services and to find out how they describe the experiences using a narrative inquiry method. Methods: The participants are 7 elderly patients over the age of 70. Data collection and analysis were conducted through Jeong Gwang Soon's six-stages: observing phenomena, selecting participants, talking, talking again, writing, and confirming. Results: The results of data analysis were classified into 4 themes of overall experience related to chronic diseases: response to home health care, overcoming chronic disease, life reconstruction, and 22 categories as common denominators extracted from the elderly persons' lives. Conclusion: This research makes the experiences of the elderly living with chronic diseases more understandable, and it can be utilized as a effective nursing praxis to improve the quality of elderly persons with chronic diseases in hospital-based home care services.

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A Study on Practical Approaches of Home Care Services - Based on Home Care Services in Japan- (가정간호사업의 실천적 방법론에 관한 고찰 -일본의 사례를 중심으로-)

  • 조유향
    • Korean Journal of Health Education and Promotion
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    • v.7 no.2
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    • pp.78-88
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    • 1990
  • The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.

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Recognition of Home Care Services for Nurses and Physicians (일 지역 의료인의 가정간호사업 및 서비스 제공 가능성에 대한 인식 조사)

  • Ko Young Aie;Baek Hee Chong;Park Jin Kyung;Kim Mi Ju
    • Journal of Korean Public Health Nursing
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    • v.19 no.1
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    • pp.108-116
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    • 2005
  • The purpose of this study is to determine the level of recognition of home care services and to provide basic data for implementation of home care services. Data collection was carried out between December 2004 and January 2005 by surveying 88 nurses and 40 physicians working at a general hospital and 28 physicians working at different clinics in the Seoul metropolitan city area. The results of this study were as follows: 1. Home care services were recognized by $94.2\%$ of nurses, $77.5\%$ of physicians and $92.9\%$ of clinic physicians. The main sources of information for most of them were medical and nursing journals. 2. The percentages of staff regarding find home care services as necessary for the institutions were $88.6\%$ of nurses, $74.4\%$ of physicians and $57.1\%$ of clinic physicians. All of them anticipated that home care services would maintain 'continuous care' and 'long-term patient care'. 3. The percentages of staff willing to refer their patients to home care were $95.5\%$ of nurses, $100\%$ of physicians and $87.1\%$of clinic physicians. However, only $7.1\%$ of clinic physicians were willing to refer actively. 4. Most nurses and physicians replied that a majority of test-related services is suitable for home care services. However, among medication-related services, intravenous injections were not suitable for home care services. Among treatment-related services, most nurses and physicians replied that Levin tube feeding, oral and nasal suction, simple dressing, perineal care, and enema were suitable for home care services, but incision and drainage, and tracheostomy tube change were not suitable for home care services. In conclusion, for the implementation of hospital-based home care services, it is necessary to educate nurses and physicians on the present condition and precedent at other hospitals.

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The Development of Client-centered and Integrated Home Nursing Care Model in Rural Areas (농어촌 지역의 대상자 중심 통합방문형 간호서비스 모형 개발)

  • Yang, Sook Ja;Han, Young Ran;Ham, Ok Kyung;Lee, Guna;Kim, Seo Hyeon;Ha, Jae Young
    • Journal of Korean Public Health Nursing
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    • v.35 no.1
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    • pp.5-18
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    • 2021
  • Purpose: This study aimed to develop a client-centered integrated home nursing care model for rural areas by analyzing public health nursing, hospital-based home care services, and long-term nursing care in Korea. Methods: The literature review performed included data from the National Assembly Library, DBpia, RISS, and KISS, Google Scholar, the Ministry of Government Legislation, Statistics Korea, and the Ministry of Health and Welfare. Results: The client-centered and integrated home nursing care model in a rural area was opened as the Home Nursing Care Center in a public health center operating directly or on consignment. This model provides both a hospital-based home care services as well as long-term care, in accordance with the health status of the client and difficulty of nursing services. Moreover, the nurse who worked in a sub-organization (Centers for Supporting Healthy Living, Public Health Units, and etc.) of the public health center as care coordinator and case manager facilitates to connect home nursing care services and social welfare services. Conclusions: Our data indicates that the client-centered integrated home nursing care model in rural areas effectively combines professional services, regional accessibility, and social welfare services.

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.

Current Status of Costs and Utilizations of Hospital Based Home Health Nursing Care in Korea (전국 의료기관 가정간호이용 및 가정간호비용)

  • Ryu, Ho-Sihn
    • Journal of Korean Academy of Nursing
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    • v.36 no.7
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    • pp.1193-1203
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    • 2006
  • Purpose: The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. Method: A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. Result: The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequoia of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won (${\fallingdotseq}$ 48 $, 1 $=960 Won). The costs ranged from 74,523 Won (${\fallingdotseq}$78 $, loss of chronic kidney function, N18) to 32,270 Won (${\fallingdotseq}$34 $, other cerebrovascular diseases, 167). Conclusion: Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

Nutritional Assessment of Patients Receiving Hospital-based Home Care Services (가정간호대상자의 영양상태 평가)

  • Kim, Kyoung-Rye;Kim, Mi-Ye;Kim, Gwang-Suk
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.15 no.2
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    • pp.99-105
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    • 2008
  • Purpose: We evaluated patient nutritional status in a home care setting. Method: We recruited 81 patients who received in-home care using a screening sheet. The level of nutrition-related serum marker (albumin) was checked via medical records and data analyzed using descriptive analysis, t-tests, and $X^2$-test. Results: Nutritional status varied according to the primary medical diagnosis. Poor nutritional status was significantly higher in cancer patients than in other diseases. Serum albumin levels were significantly lower in the malnutrition group than the good nutrition group. Conclusions: Nutrition screening can determine the nutritional status in home care patients. Home care nurse practitioners should consider nutritional status when assessing patient health.

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An Evaluation of the Home Care Nursing Services Conducted jointly by Catholic Churches and Hospital (일부 가톨릭교회와 연계된 병원중심 가정간호사업의 평가)

  • Kim, Hye-Dan;Kim, Soon-Lae
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.12 no.1
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    • pp.41-69
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    • 2005
  • Purpose: This study was performed to evaluate the outcomes of the home care nursing program conducted jointly by thirty two catholic churches and C hospital in Seoul. Method: The subjects included 173 patients who registered for the program during a 4 month-period from November 1, 2004 to February 28, 2005 and received home care services for more than 4 times and 32 professional nurses participating in the program. Using the concept of medical outcome study (MOS), the structure, process, outcome elements were analyzed. Result: 1) A Catholic homecare nursing center and nurses of the C hospital played a central role in providing nursing care, and each church operated its own vehicle from its own office. Home care nurse's job satisfaction was 2.8 out of total score of 4. The major illness was cerebrovascular disease including stroke followed by skeletomuscular disease including degenerative arthritis cancer, and diabetes. Among reasons for accessing the home care nursing program, hypertension management was most prevalent. More than half of the registration was done through catholic churches. Most people who referred the patient to the program was through the church. Most patients received home care nursing 1-2 times a week for 30 to 60 minutes in average and the most frequent type of service provided was basic nursing. 3) The most frequent reason for terminating home care services was death. The change in PPS(Palliative Performance Scale) level from the time of registration and after 4 visits was the same in 45%, decreased in 30%, and improved in 25%. Patient satisfaction was very high, showing 3.4 out of total score of 4. Conclusion: These results proved that the home care nursing program was highly appreciated by subjects and nurses were providing professional care. Thus the two parties involved in the program were actively supporting the program to fulfill their mission. However, several areas needed to be improved such as relating with local community, relating with family doctor, and issue of improving the working conditions for home care nurses.

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A Review on Home Health Care in Korea - Hospital, Community, and Public Health Center Based Home Health Care Nursing- (한국의 가정건강관리 연구에 관한 고찰 -의료기관 및 지역사회 가정간호와 보건소 방문보건을 중심으로 -)

  • Ryu, Ho-Sihn;Kim, Eun-Young;Park, Chai-Soon
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.14 no.2
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    • pp.65-75
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    • 2007
  • Purpose: This study was conducted to provide fundamental information for policy integration of the home health care system. Methods: Focused review was performed from 8 studies out of 48 literature related to home care needs. Results: Females utilized home care based on hospital and public health centers at a higher rate than males. While there had been more rate of the elderly above 60 year-old at hospital and community based home care, on the other hand below 45 year-old at public health center. The most common disease amongst users in all three types was cerebrovascular disease, the second was cancer based at hospitals, hypertension and arthritis at public health centers. There were more needs for those using artificial respiratory equipment, cancer patients, and puerpera. However, the needs for hospital and community based home care were very similar. Conclusions: Due to similar disease characteristics but varied severity at the three home care based settings, they should be managed with flexibility. Home care curriculum should be developed according to common disease type, and home care services should be strengthened for its expertise.

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Job Descriptions of Hospital Based Home Care Nurse Practitioners in Korea by DACUM Technique (의료기관 가정전문간호사의 직무분석)

  • Hwang, Mun-Suk;Lee, Seung-Ja;Lim, Nan-Young;Lee, Mi-Kyoung
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.18 no.1
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    • pp.48-57
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    • 2011
  • Purpose: The aim of this study was to develop and to analyze the task of hospital based home care nurse practitioners in Korea. Method: The definition of home care nurse practitioners and job description was developed based on developing a curriculum(DACUM) by 7 panels who have experienced in home care nursing. One hundred fifty four nurses who were working at hospital based on home care were participated. Result: Fourteen kinds of duties were identified : the selection of home care patients; basic home care nursing; advanced home care nursing; patient/family education and counseling; medical decision making and coordination of patient service; management of home care supplies and drugs for patients; management of medical records; management of home care the agency; management of home care personnel; management of the home care supplies for agency; home care public relations; improvement of home care quality; management of long-term care service; and self-improvement. Ninety-six tasks were classified. Conclusion: The abilities for quality improvement and the advanced nursing practice of home care nurses should be empowered.

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