• Journal of Korean Clinical Nursing Research
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• v.16 no.1
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• pp.131-143
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• 2010

Purpose: The purpose of this survey was to identify a set of performance indicators for Korean APNs (Advanced Practice Nurses). Methods: A convenience sample of 78 APNs working in 2 leading hospitals in south Korea participated in the three-round Delphi survey. In the first round, subjects were asked to propose performance indicators to evaluate the effectiveness of their practice. They rated the relevancy of each indicator during the second round. In the final round of survey, subjects rated the relevancy of indicators again in the light of second round's overall results and they also were asked to check on current and future use of indicators. Results: After 5 months of three-round Delphi survey, 60 performance indicators were identified. In regard to relevancy, the 10 highly ranked indicators were patient satisfaction, self-care ability, expertise of service, family satisfaction, nurse satisfaction, satisfaction in nursing education, advanced nursing service count, education for patient/ family, education for nurse, and compliance. Advanced nursing service count, education for patient/ family, and education for nurse are currently used as indicators by more than 70% of respondents. Conclusion: Additional research is needed to identify subsets of performance indicators for specialized areas and to determine the validity and sensitivity of indicators.

• 한국노년학
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• v.38 no.1
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• pp.15-26
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• 2018

This study was aimed to investigate the influencing level of nursing staff's recognition for the health care accreditation on patient safety managing activities by identifying the relationship between them and other factors affecting on patient safety managing activities. Subjects of this study were 182 nursing staffs working in six geriatric hospitals accredited for health care in Seoul metropolitan area. Data was collected during April, 2016 by structured questionnaires. And SPSS/WIN 15.0 program with t-test, ANOVA, Pearson's correlation, and stepwise multiple regression analysis were employed for analyzing them. 96.2% of the subjects have recognized the accreditation and 31.8% of them have acknowledge it in detail. The average level of recognition for the health care accreditation and patient safety managing activity were 3.60 and 4.39 point (max.5.0) respectively. Correlation between them was positive(r=.339, p<.001). Significant factors influencing patient safety managing activity were internal service quality promotion (t=5.292, p<.001) and academic background (t=2.836, p=.005). Education program or information on health care accreditation system, and action plans for promoting internal service quality for the nursing staffs including job standardization of the jobs are recommended for the better patient safety managing activities.

• Journal of Korean Academy of Nursing Administration
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• v.6 no.1
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• pp.123-134
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• 2000

This study intended to analyze the effectiveness to obtain by developing the critical pathway presented as the method to improve the quality-betterment and cost effectiveness the through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. This study was designed to develop and effect the critical pathway for hysterectomy patients in the way to be possible the intergrated in patient management. It was adopted the process of seven phase to develop a critical pathway. To analyze the application effect of the developed critical pathway, this author offered health care service applying the critical pathway to the hysterectomy patient from July. 20 to Oct. 19. 1999. The study method had been done by investigating the experimental group and control group through the questionnaire on 40 patients who had been inpatient hysterectomy. Dependent variables were measured by modified from satisfaction, and cost and length of hospital stay. The data anlyzed by frequency, x2-test, t-test. The results of this study was as follows; 1. It was decided that the vertical line of the critical pathway was made up of eight items such as monitoring/assessment, treatment, activity, medication, consult. Lab test, diet, patient teaching and horizontal line was 7days from admission to discharge. 2. After the verifying the validity of the expert group about the critical pathway, the horizontal line was amended from hospitalization to five postoperative days and taking their consensus, some contents of the horizontal line was amended and deleted. 3. There was no significant differences in the experimental group and control group in the satisfaction, and significant differences in the cost, the length of hospital stay.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.10 no.1
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• pp.9-21
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• 2014

This study aims to help utilize the dental treatment institutions for the disabled and provide high quality of medical services in the future by identifying the satisfaction factors for the patients of the dental clinics for the disabled. As a study method, surveys were completed 200 patients who visited the dental hospital for the disabled. Among these, the surveys from 187 patients were statistically analyzed. The main findings of this study are as follow. Since the study showed that there were differences in the satisfaction factors between the disabled and non-disabled people, subsequent studies needs to be done to develop measuring tools to accurately accommodate the satisfaction factors of the disabled. In addition, as the low spatial accessibility in terms of distance and location was found in this study, more dental treatment institutions for the disabled are required. In the meantime, the survey results found that the most satisfactory aspect was the lower treatment cost compared to other clinics, and that the most important factor when choosing a clinic was also treatment. In addition, given the fact that the group that took a prosthetic treatment, which was non-insured treatment, showed higher satisfaction compared to the group that did not, it suggests that the economic burden plays an important role for the dental treatment of the disabled.

• Journal of the Korean Dietetic Association
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• v.14 no.1
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• pp.36-50
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• 2008

The purpose of this study was to develop the oriental therapeutic menu(Yak-sun) through the recognition and necessity of oriental medicine diet in stroke patients admitted to K Oriental Medical Hospital. From May to July 2007, the 73 stroke patients were surveyed for the recognition and necessity of oriental therapeutic menu. The oriental therapeutic menu was developed on the basis of literature of oriental medicine books and research papers. The developed two week cycle of menus were then reviewed by the experts and specialists. The sensory evaluation and nutritional analysis of the menu were followed. The stroke patients who participated in the survey did not know about the oriental medical diet, however, 61.6% of the patients had interest. Most of the patients expected the efficacy of oriental therapeutic diets. Total of forty three medical herbs and ten herb-combined prescriptions were used in the menu. The daily average calorie of developed menu was 2,031 $\pm$ 57.6 kcal and the most of nutrients met Dietary Reference Intakes for Korean(KDRIs). The caloric ratios of carbohydrates, protein, and lipid were 61.3%, 18.7%, 20.0%, respectively. The average values of cholesterol(194 $\pm$ 57.5 mg/day), sodium(3,078 $\pm$ 678.5 mg/day), calcium(1,099 $\pm$ 140.1 mg/day), and dietary fiber(33 $\pm$ 7.0 g/day) were met Korean dietary guide line for stroke patients. Oriental therapeutic diet might be unfamiliar to the hospital patients even though they had interest in and favorable thought about it. Implements of oriental therapeutic diet to the hospital patients might be useful to improve the quality of service in the hospitals.

• Health Policy and Management
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• v.23 no.2
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• pp.124-131
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• 2013

Background: This study aimed to measure the opportunity income by identifying the economic length of stay (ELOS) which is the intersection point of daily revenue and cost on appendectomy and pneumonia cases. Methods: The research subjects were 460 patients of appendectomy and 606 patients of pneumonia, discharged from a general hospital between July 1, 2009 and June 30, 2010. ELOS calculated with both of total revenue on diagnosis-related group (DRG) and fee-for service (FFS). The cost is calculated by activity-based costing system of the hospital. Results: Average length of stay (ALOS) of appendectomy was 4.48 days and its average revenue per case were 1,710,215 (1,989,105) won by DRG (FFS). The variable cost was 491,262 won which was 28.7% (24.7%) of DRG (FFS) total revenue. And 97.2% of the total variable cost was incurred within 2 days from admission. The ELOS was 4 (5) days in DRG (FFS). Shortening three days (two days) would increase opportunity income 52.0% (82.2%) in DRG (FFS). ALOS of pneumonia case was 4.86 days and its average revenue per case were 489,448 (761,426) won by DRG (FFS). The variable cost was 27,230 won which was 5.6% (3.6%) of DRG (FFS) total revenue. Thirty-eight point nine percent of the daily variable cost was incurred in discharge date. The ELOS was 2 (4) days in DRS (FFS). Shortening three days (one day) would increase opportunity income 27.6% (37.2%) in DRG (FFS). Conclusion: The ELOS would be used by strategic index for achieving minimum profit and developing the ways to get there. But we also should not pass over that the opportunity income obtained by the reducing ALOS may cause some problem of quality.

• Health Policy and Management
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• v.9 no.1
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• pp.72-109
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• 1999

This study is conducted to investigate the current status on the utilization of health care and plan for solving this problem. The claims data of the fiscal tear 1995 obtained from the regional health insurance society are used for the study. The main findings of the study are summarized as follows. Indexes(The Extremal Quotient(EQ), coefficients of variance(CV's))which represent the regional difference in the admission rate of the tertiary medical diagnosis group report that there is difference in quantity and quality of utilization of health care. The admission rate is lower in the big city areas, Kyoungkido, Kangwondo and Chunlapukdo. Even after age-sex adjustment, the admission rate is still low in Kangwondo, Chunlapukdo and Kyoungsangpukdo. The big city areas tend to have higher rates in the expenses per claim, hospital days per claim, and daily expenses but the rates are still low in some area in Kangwondo, Chunlanamdo and Kyoungsangpukdo. This result remains as same after age-sex adjustment. There is a large regional difference in average utilization rate for the tertiary hospital of the tertiary medical diagnosis group: 57.2%(SD 11.53). The utilization rates for the tertiary hospital in their large catchment area are 96.34%, 83.19% and 73.22% in each Kyoungin, Kyoungnam and Kyoungpuk areas whereas it is lower in a Chungpuk and Chungnam areas. The regional differences of health care utilization of the tertiary medical diagnosis group gave some relationships with their geographical characteristics such as socio-economic characteristics and supply factors of medical services. It is important that many medical policies should be developed in order to minimize and balance out the regional differences of health care utilization. The service allocation policy should include the reconstruction of manpower policy, developing the resource allocating formula, finding the self-sufficient catchment area and reforcing of public health services. Moreover, in order to achieve the balanced development by region, they should investigate and consider each county's microscopic properties under the consistent macrocopic policy. The further studies to find causes of regional difference are needed.

• The Korean Journal of Rehabilitation Nursing
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• v.19 no.1
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• pp.43-54
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• 2016

Purpose: This study attempted to understand patients' and nurses' perspectives on the priority of rehabilitation nursing services using Importance-Performance Analysis (IPA). Methods: This study used descriptive research design. Data were collected from 121 patients and 144 nurses using self-reported questionnaires. Statistical analysis included an independent t-test, analysis of variance (ANOVA), and IPA conducted using SPSS/WIN 21.0 version. Results: There were no statistical differences between the patients' and nurses' mean scores on perceptions of the importance (t=-0.83, p=.409) and performance (t=-0.32, p=.751) of rehabilitation nursing services. The IPA matrix showed a difference between patients and nurses in terms of their perceived priority of nursing services. Regarding the perception of patients, "helping a patient to continue to practice bedside physiotherapy and occupational therapy", "providing information on the proper care agency and community resources", and "providing education for the prevention of complications" fell in the "concetrate here" area (2nd quadrant). Conclusion: The results showed that the priorities of patients and nurses did not match in terms of some of the rehabilitation nursing services. Thus, rehabilitation nursing services need to be provided based on the patients' needs. Allocation of resources for the service items that fell in the "concentrate here" area of the IPA need be reconsidered for the quality in nursing care.

• Korea Journal of Hospital Management
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• v.8 no.4
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• pp.121-148
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• 2003

This study is designed to evaluate the contents of the separation of prescribing and dispensing roles(SPD) policy based on the theoretical backgrounds. The results are as follows; Considering the purpose of SPD policy, 'increasing the efficiency in manpower management by separating the role of medical doctor and pharmacist and improving the quality of SPD service through specialization of function' as a policy objective is valid and very important agenda in health care. But the objectives are not working well by no keeping the detail means to actualize it. Also, some policy objectives are unclear or inappropriate and it makes the focus of that policy obscure or misleads inadequate policy alternatives. In terms of means of policy, it is evaluated to have some limits in effectiveness, efficiency, equity, rationality, technical feasibility, economic feasibility, administrative feasibility, social and time feasibility. In conclusion, it's necessary to investigate the some problem mentioned in this paper with empirical evidence. Also, it should be needed to improve the validity of policy by correcting policy objectives and means in execution of policy.

• Journal of Korean Clinical Nursing Research
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• v.21 no.3
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• pp.335-346
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• 2015

Purpose: The purpose of this study was to identify patient satisfaction about nursing care provided by Advanced Practice Nurses (APN) using the La Monica-Oberst Patient Satisfaction Scale (LOPSS). Methods: The investigation was conducted including 263 patients who experienced care provided by 41 APNs at a tertiary hospital in Korea. Patient satisfaction with nursing care was measured using 41-item LOPSS. We analyzed the data using descriptive statistics, independent t-test and one-way ANOVA. Results: Overall patient satisfaction with APN care was high. The LOPSS scores for APNs were 52.26 for good impression, 61.75 for interpersonal support, 81.32 for dissatisfaction and 195.93 for total score. "APNs talk down to me" was a reverse coding item which demonstrated the highest score for patient satisfaction. Among patients' characteristics, age and type of main caregiver were independent factors related to patients's satisfaction. Among APN's characteristics, work experience was significantly related to patients' satisfaction. Conclusion: This study identified patient satisfaction regarding nursing care provided by APNs. High patient satisfaction in APN services demonstrated APNs' contribution to quality improvement in health care services. It is recommended that various outcome research about APN service needs to be performed.