Purpose: The purpose of this study was to suggest the projected workforce of home health care specialists in Korea. Method: Need model. ratio methods and expert opinion were used for projecting the number of home health care specialists. Result: 1) In 2002. there are 13 programs which offer one year home health specialist training. From those programs. they produced 3860 registered home health care specialists. 2) In 2002. there are 89 hospitalbased home health service units and 220 active home health care specialists. 3) In case of hospital- based home health service. average of 4 services per month for average of 3 months was assumed as workforce standard. 4) In case of community-based home health service. average of 4 services per month for 12 months was assumed as workforce standard. 5) The number of home health care specialists required to meet the demands for home health care population in 2000 and 2005 was estimated at minimum of 20.361 to maximum of 31.360 and 21.989 to 34.080. respectively. Conclusion: Community home health care agencies are needed to meet the demands of home health care.
Purpose: This study is to identify the types of role awareness of home health care specialists working at medical institutions, to understand their role awareness correctly by grasping the quality of each type, and to provide useful help in the education of home health care specialists. Method: Q-methodology is used to objectify role awareness of medical institution specialists who may recognize situations differently according to their individual experience and comprehension based on the view of behavior. Q-classification was carried out on 30 home health care specialists working at medical institutions using 30 selected questions. Collected data were examined through factor analysis using QUANL PC program. Results: Three different types of role awareness of home health care specialists working at medical institutions were identified. Type I is 'educational-function-centered', Type II 'patient-centered' and Type III 'professional-service-centered'. Conclusion: Regardless of these types, home health care specialists commonly had a high pride as a specialist and a sense of mission regarding themselves as important persons responsible for patients' health.
Purpose : The purpose of this study is to present the desirable level of home health care services by identifying the roles and activities by task of home health nursing specialists as well as to raise the level of professionalism in home health care services. Method : This is a methodological study. The roles and activities by task were identified through a review of literature and a state-of-the-practice survey, and were structured into a questionnaire after being reviewed and modified through a consensus of experts. The field survey was conducted on 136 home health nursing specialists at medical institutions, public health centers. public medical institutions, non-governmental organizations, and religious institutions in Seoul, Gyeonggi Province. Incheon, Busan, Daegu, and Gwanggju from June 4 to August 4. 2004. Seven roles. 34 tasks and 130 activities were identified in association with home health nursing specialists. Result : The roles of home health nursing specialists were identified as professional nursing service provider, advisor, educator, administrator, case manager, researcher and leader. Under these roles. 34 tasks and 134 task-specific activities were identified. Conclusion : The the roles and activities of home health nursing specialist identified in this study can be used in various home health care settings. These the roles and activities should provide the evaluation criteria of home health care services for institutions with existing home health care programs. An evaluation tool should be developed in order to ensure the hish quality of home health care services.
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.
The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.
Kim, Hae-Young;Chung, Hyun-Suk;Jeon, Byoung-Hak;Shin, Mi-Hyeon
Journal of Home Health Care Nursing
/
v.17
no.2
/
pp.135-143
/
2010
Purpose: The study analyzed continuing educational needs with the aim of developing continuing education program for home healthcare nurse specialists. Methods: A convenience sample of 101 home healthcare nurse specialists affiliated with 89 home health care agencies in Seoul, Busan, Dae-gu, Inchon, Jeonnam, Keongnam was used. Data was collected with a self-report questionnaire from May 10-31, 2010, and analyzed with descriptive statistics using SAS 9.13 program. Results: Of the participants, 88.1% reported that continuing education was necessary and 58.2% reported that the education was needed for peak job performance. The participants also reported that it would be proper if continuing education is given on a Saturday(56.4%) by home healthcare institute(49.5%) or homecare nurses association (38.6%) for 1-3 months(56.4%). The participants scored more than 3.0 in the current performance at six of the seven home healthcare nurse specialist roles, and scored more than 3.5 in the necessity of continuing education for seven roles in 47 jobs. Conclusion: Various programs for continuing education have to be developed and need to focused on the jobs needed for home healthcare nurse specialist and the most frequent disease. For this purpose, every home healthcare organization has to select their unique area and develop their own educational program. Furthemore, home healthcare nurses association has to build an education operating system that incorporates all program aspects.
Due to the rapid socioeconomic development and the introduction of the national health insurance system the general population's need for health care and utilization of health care services have increased dramatically. As a result of this change. Korea is experiencing a shortage of health care facilities and health manpower, and this leads long wailing line at doctor's offices. One of the solutions of this problem could be home health care system for those who have minor health related problems. With this background, this study was conducted to look at the feasibility of a home-based prenatal care system using information superhighway and nursing informatics specialists. With the home-based prenatal care system, the pregnant woman checks her blood pressure, tests her urine for sugar and protein, and measures her body weight at home and sends the information to a hospital computer via the information networks such as public telephone line and information superhighway. Nursing informatics specialist at the hospital will go through each patient record and screen those who have abnormal values and notify them to see a doctor as soon as possible. Besides telemonitoring features, the proposed system will include tole-education capabilities for the patients so that patient can learn whatever they need to know ragarding the prenatal care via information networks. If this system develops and operates, patient can save time in terms of travel to and from the hospital and waiting time in the hospital. And the health care institute can utilize its resource more efficiently.
Today, home health care services needs a linkage plan of the customized home visiting health service in public health center, the medical institute home health care service, and home visiting nursing service based on long term care insurance for the elderly program which acknowledges the independence and professionalism of the home health care services while minimizing overlap through linking the projects. So, this study was performed by applying the Delphi technique, which draws agreement from professional opinion, to determine a method to link home health care services in Korea. The results of this study are as follows. Specialists agreed on 24 important items within the two domains of institutional linkage and medical linkage. And the significance of this study is as follows. The 24 items deduced for the approved nursing service linkage plan are expected to improve the home health care service business system, enhance the quality of home health care service, and bring increased satisfaction for service recipients. Also, seeking ways to minimize overlap in service can increase the effectiveness of health care and public health management at a national level. In addition, it is considered that this will ultimately reduce public medical costs as well as improve home health care service.
Purpose: This study was aimed to evaluate the performance of a community-based home care services model. Method: The subjects were 138 patients who have been enrolled during a 6 month's period, nursing records and nursing service bills. The data was collected by self report and chart review. The mean cost per visit was compared with those of hospitalization & clinic visit in the data from National Health Insurance Corporation. Result: A significant number of patients were bed ridden(63.8%) and unconscious (27.5%), and most of the patients had complex chronic diseases. Except nursing assessment, bed sore care was the most frequent nursing treatment(25.1%) in home care services. The mean cost per visit of home care services was 34,665 won, which was lower than those of hospitalization & clinic visit for medical aid. The patients were highly satisfied with the services by visiting nurse specialists. Conclusion: Community-based home care services provided cost-effective and satisfied services. Community-based home care services needs systematic supports to expand it's domain for promoting community health.
The article reports the process, contents and strategies in the development of community based-heath care management program for high-risk infants and family, which was based on literature review, empirical needs assessment from pilot study. The program was divided into two emphasis areas: (1) identification and home visiting nursing care program, and (2) the construction of self-supporting group. The contents of home visiting nursing care were developed from the pilot study of the direct home visiting to premature infants after discharge. The documentation form for home care was standardized, including the demographic data, birth history, home care services, education and counsels, and visiting schedules. The integrated education protocol was elaborated to enhance the body of knowledge as well as clinical competency in caring high-risk infants and family by the supports of neonatologists, nursing scholar, and clinical specialists. In addition, the process and strategies in developing self-supporting group, consisting the high-risk infants and family, and any significant others were addressed. Emphases were given to the role of public health center and the recycling health care referral system to maximize the growth and development of high-risk infants on the community-base, which in turn, contributing to decrease the postneonatal mortality rate.
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