• Journal of Korean Clinical Nursing Research
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• v.15 no.3
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• pp.143-155
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• 2009

Purpose: This study was conducted to develop and evaluate the collaborate transitional care program for improving continuity of care in patients transferred to general wards from ICUs. Methods: 18 years and older who were hospitalized in adult intensive care units at A university affiliated medical center was recruited for the study. The experimental group for patients transferred from an ICU consisted of 33 patients and family caregivers; 34 patients and family caregivers for the control group. This study was utilized a quasi-experimental research design. The collaborative transitional care program was administered in transfer process. Data were collected two times by interviews, medical records, and telephone using questionnaires. Results: There were statistically significant differences between the two groups on relocation stress (p<.001), perceived health status (p<.001), satisfaction of caring (p=.011), physical domain (p=.022) and mental domain (p<.001) of the QOL. There were significant differences between the families of the two groups on burden (p<.001) and satisfaction of caring (p<.001). Conclusion: The collaborative transitional care programs administered in transfer process to general wards from an ICU have positive effects on patients and families' intrinsic and extrinsic factors. This program will be able to be utilized in clinical fields to improve continuity of care for patients and families between ICUs and general wards.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.16 no.1
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• pp.21-29
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• 2009

Purpose: The purpose of this study was to identify the nutritional status and to compare nutritional indicators by caloric intake for intensive care unit patients, Methods: The participants for this descriptive investigation were 62 patients who were admitted to medical and surgical ICUs and started on enteral feeding. Data were collected in a tertiary hospital and the patients were followed for 7 days after enteral feeding was initiated. For analysis, patients who received 80% less calories than their required level were categorized as the underfed group and patients who received more than 80% to their required level, as the adequately fed group. Results: Compared to daily requirements, the prescribed calories and protein for patients overall were 77.39% and 64.75% respectively. The level of calories and protein given was less than their prescription. However, a comparison of the underfed group and the adequately fed group, showed that there was no significantly difference in albumin, prealbumin and transferrin. Only body weight was significantly different between the groups. C-reactive protein had a significant correlation with prealbumin and transferrin. Conclusion: Underfeeding is a common phenomenon among ICU patients. Nutritional indicators such as prealbumin, albumin and transferrin may not sensitive indicators to assess nutritional status of ICU patients.

• International Journal of Advanced Culture Technology
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• v.7 no.1
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• pp.8-13
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• 2019

Despite technical advances in healthcare, the rates of hospital-acquired pressure injury (HAPI) are still high although many are potentially preventable. The purpose of this study was to determine whether tree-based prediction modeling is suitable for assessing the risk of HAPI in ICU patients. Retrospective cohort study has been carried out. A decision tree model was constructed with Age, Weight, eTube, diabetes, Braden score, Isolation, and Number of comorbid conditions as decision nodes. We used RStudio for model training and testing. Correct prediction rate of the final prediction model was 92.4 and the Area Under the ROC curve (AUC) was 0.699, which means there is about 70% chance that the model is able to distinguish between HAPI and non-HAPI. The results of this study has limited generalizability as the data were from a single academic institution. Our research finding shows that the data-driven tree-based prediction modeling may potentially support ICU sensitive risk assessment for HAPI prevention.

• Journal of Korean Public Health Nursing
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• v.3 no.2
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• pp.5-46
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• 1989

The current medical payment Insurance Rates in Korea stipulate charges for medical treatment by the doctor, pharmaceutist, medical technician and maternity nurse. But unfortunately didn't specify those charges for nursing done by the professional nurse. Only basic nursing fee is accounted insufficiently in current medical insurance fee schedule. therefore, Being face with covering entire people by medical insurance by 1991, It seems that the problems pertaining to operating the hospital and medical insurance system would be incessantly expanded in that no mention is made of medical charges rendered by major medical producer service in the current system, For that reason, this study made an attempt to clarify the importance the professional nursing puts of the current medical payment. The purpose of this study was to accounting nursing fee which diveded into the current medical fee schedule. (Method) 1. Data collection; Importance and difficulties in nursing activities was conducted in 'S' National University Hospital. Total nursing activities were selected 72 items which included direct care and indirect care. This study was conducted to evaluating the degree of importance and difficulties according to nursing activities through questionnaire to 204 RN. and so relative difficulties (acuity) were computered because the nursing cost level of each nursing service was differently established by the equivalent coefficient according to degree of relative difficulty and time required. 2. Calculation of cost according to nursing activities; After 47 nursing activities were selected in General surgery nursing units, calculation of nursing cost was as follows Cost of Nursing activity = (relative difficulty X Average hourly wage and benefits of nurse) + material cost of nursing -t- Average nursing administration cost So, Calculated cost by nursing activities was compared to current non-insured and insurance rate. 3. Calculation of nursing cost by K - DRG ; Total of 578 patients who were hospitalized in General Surgery units from January to March 1988 ware classified by K - DRG After estimation of total nursing cost based on the K-DRG, verified the appropriateness of basic nursing fee in medical insurance rate (Results) 1. Analysis of degree of importance and difficulties were 4.16 and 3.67 based on 5 point scale. This score were judged that it is worthy specifying the nursing fee 2. The nursing cost of 47 nursing service items in general surgery patients showed that the average cost of nursing activity was \1374.5 and The lowest cost was \217 of 'oral administration nursing' item, The highest cost was \11,025 of 'saline enematill clear' item 3. The result of comparison between the calculated cost by nursing activities against the current non-insured and insurance rate showed that 13 items(27.7%) involved to payment of insurance rate, 9 items(19.1%) involved to non-insured rate, remainder 25 items (53.2%) were not charged anywhere of total 47 nursing activities 4. When calculated cost by nursing activities was 100. current insurance rate was 62.3, non-insured rate was 176.6. Therefore this showed that most of non-insured rate were higher than calculated nursing cost. The insurance rate, however, were lower than it. Reim-bursement was imputed to non-insured patients. So the current rate system became estrainged from cost system. When Remainder 25 items of nursing activities compared' to \1390 of daily basic nursing fee per patient belonged to payment as a insurance fee schedule, basic nursing fee schedule was 1-2% of calculated cost of nursing activities. Therefore it showed that nursing fee was not counted adequately in it. 5. Nursing cost by K-DRG estimated in chart review based on counting number of nursing activities and length of stay The result showed that average amount of total nursing cost was \183828.1 Comparison of nursing cost calculated by K- DRG and basic nursing fee schedule showed that only 12.3% of nursing cost was charged (Conclusion) From the above research result, It is fact that nursing prime cost should be estimated more accurately and included adequately in current medical payment system. The payment system of nursing activities should be introduced not only nursing activities of drug administration and injection fee belonged to insurance fee schedule but also most nursing activities belonged not to mekical fee schedule. Even if introducing payment system of nursing activities, It should be estimated scientific method of Accounting nursing cost So nurses could offer nursing care of good quality, thereby they could make a great contribution not merely to the convalescence of the patient but to the promotion of the people's health.

• Health Policy and Management
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• v.15 no.3
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• pp.94-113
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• 2005

The purpose of this study was to determine the level of appropriateness in hospital stays and factors influencing inappropriate hospital stays. The study was conducted at fifteen general care units in a tertiary university hospital. Appropriateness of hospital stay was assessed using Appropriateness Evaluation Protocol by trained head nurses. The total of 447 patient records were reviewed. Among them, 352 patient data were included in the final data set. A unit of observation was patient day. A rate of appropriate hospital stay was calculated per patient as a unit of analysis. Multiple regression analysis was performed to determine the factors affecting inappropriate hospital stay. The eighty-three percent (2030/2651) of hospital stays were evaluated as appropriate. There were significant differences in appropriateness of hospital stay according to patient's age, type of health insurance, medical specialty, and length of stay(p<0.05). In the multiple regression analysis, medical speciality was the most significant factor to predict the inappropriate hospital stay. The study showed a substantial proportion of hospital stay was found to inappropriate. Level of appropriateness was significantly different from medical specialty. Interdepartmental approach should be required to coordinate and improve appropriate resource utilization.

• Journal of Korean Academy of Nursing Administration
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• v.11 no.4
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• pp.449-467
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• 2005

Purpose: This study aims to offer the fundamental data in order to cost the nursing service on the basis of the NIC and a close examination of the interventions that are contained in the health insurance cost list under the system of the current health insurance. Methods: The data is handled with the SPSS 10.0 program. The participants' general peculiarity is calculated in terms of the real number and the percentage, and the performing frequency of the nursing interventions is calculated in terms of the mean and the standard deviation. the correlation between the participants' general peculiarity and the performing frequency of the nursing interventions is analysed with t-test or one way ANOVA of SPSS. Results: In the performing frequency of the nursing interventions, the domain of "the physiological: basic" was the highest as 2.69${\pm}$1.21, the domain of "the behavioral" was the lowest as 2.11${\pm}$1.12. There were 50 core interventions in the medical unit, 48 in the surgical unit, 24 in the MICU and 33 in the SICU. The health insurance cost items contained commonly in the core interventions of each unit were 12, and the health insurance cost items except 12 items contained commonly in the core interventions of each unit were appeared 14 items in the medical unit, 6 in the surgical unit, 7 in the MICU and 2 in the SICU. The core interventions contained commonly in four units of the medical unit, the surgical unit, the MICU & the SICU are 18. And among these, the core interventions contained in the health insurance cost items are 10; pain management, hyperglycemia management, analgegic administration, medication administration: intravenous, oxygen therapy, pressure ulcer prevention, fluid management, fluide monitoring, intravenous(IV) insertion, intravenous(IV) therapy. As the result of the comparison & analysis between the core interventions of the NIC and the health insurance cost items, the core interventions contained in the health insurance cost list are 21(29 as the health insurance cost items). Conclusion: In the performing frequency of the nursing interventions, the domain of "the physiological: basic" is being performed most frequently, and in the performing frequency of the core interventions, the interventions of the domain of "the physiological: complex" is being performed most frequently. On the basis of these results, the writer hopes that the attempts to interlink the nursing interventions into the nursing cost by using of standard terms and the efforts to cost the nursing services would also be made in the future constantly.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.2
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• pp.31-38
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• 2022

Purpose: This study presents the results of the analysis on space utilization of kidney dialysis units in regional public hospitals, which plays a key role in local public medical services. The result aims to achieve safety from infection, allow comfort for the dialysis environment, and stability for medical support. The purpose of this study is to present fundamental data for architectural plans for the kidney dialysis unit, as well as to alleviate potential infectious diseases such as COVID-19. Methods: For research purposes, the investigation and analysis of space utilization were based on architectural floor plans, research papers and literature, related legal systems, and public statistics. Of the main 35 regional public hospitals, in regards to data accessibility, 15 facilities were selected to conduct the survey and analysis for the objective. Results: The space composition by area research results of kidney dialysis units in public hospitals are as follows: Firstly, most targets do not have required rooms in the access and support area, except for the hemodialysis beds in the treatment section. Secondly, the access area requires necessary room and space design that took into consideration of convenience and accessibility for patients. Thirdly, in regards to infection prevention and control, proper circulation and room plan is essential for storage and disposal of contaminated products and linen after use. For the treatment area, the arrangement plan needs to establish a visual connection between the isolation room, the nursing station, and the bed area. Additionally, consideration of circulation in the preparation, treatment, observation, examination, and all other rooms in the facility is required. Lastly, for the support area, the room is designed to consider adequate working and meeting spaces for the medical staff, consultation space for patients or guardians, separate storage and disposal of clean and contaminated items, and the storage of various equipment for dialysis. Implications: In preparation for the increase in chronic kidney failure patients and the spread of infectious diseases, such as COVID-19, the researched data demonstrates the basic guidelines for space composition of kidney dialysis units and the significant role of regional public hospitals.

• Quality Improvement in Health Care
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• v.8 no.1
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• pp.22-42
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• 2001

Background : A study comparing unit dose drug distribution system(UDS) versus traditional drug distribution system(TDS) was conducted in Seoul National University Hospital. The objectives of this study were to identify safer drug distribution system and to measure the efficiency of both systems in utilizing nursing and pharmacist's time. Methods : The study was designed to compare the data on medication errors, nursing time and pharmacists' time before and after implementation of the UDS in the internal medicine and otorhinolaryngology care units. The data on actual medications administered to patients were obtained by a disguised observer during the study period. The data collected were then compared with the physicians' orders to determine the rate of medication errors. In addition, using ten-minute interval work-sampling method nursing and pharmacists' time were measured. Results : About 6% of medications were administered incorrectly in the TDS, in comparison to 1.6% in the UDS. The rate of medication error decreased significantly in the UDS compared with the TDS. Mean times spent on medication-related activities by nurses were 34.1% in the TDS and 28.5% in the UDS. In the internal medicine care unit, nursing time associated with medications decreased significantly after the implementation of the UDS, but the reduction in medication-related nursing time in the otorhinolaryngology care unit was not significant. Pharmacist's medication-related work activities, increased from 2% in the TDS to 20% in the UDS. Pharmacist's time spent on therapy-related activities increased significantly. Conclusion : The rate of medication errors in the UDS decreased significantly compared with the TDS. Time spent on medication-related activities decreased for nurses while it increased for pharmacists. In summary, the UDS was estimated to be safer and to utilize of pharmacists' and nursing time more efficiently than the TDS.

• Perspectives in Nursing Science
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• v.10 no.2
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• pp.151-157
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• 2013

Purpose: The purpose of this study was to identify difficulties that working mothers face and solutions to the identified problems. Methods: The study design was a cross-sectional, descriptive survey. A survey with 8 items rated on a 5-point scale (1~5) and 5 open-ended questions was administered to 48 married nurses and nurse aides working in 5 nursing units of a teaching hospital in South Korea in April 2013. Results: The score of satisfaction with childrearing patterns (mean=$3.31{\pm}0.79$) was higher than that of satisfaction with spousal support (mean=$3.08{\pm}0.85$). The score of working mother's turnover intention (mean=$2.40{\pm}1.03$) was lowest among the 8 items, but partners did not want their wives to quit work (mean=$3.60{\pm}1.22$). Satisfaction with company employment benefits for childrearing (mean=$2.90{\pm}0.72$) had the lowest score among the 4 satisfaction types analyzed. The turnover intention and satisfactions with childrearing (r=-.51, p<.001), spousal support (r=-.43, p=.002), supervisor's support (r=-.36, p=.013), and company benefits (r=-.37, p=.009) showed significant negative correlations. Conclusion: According to these results, familial support for childrearing is highly correlated with employed mothers' turnover intention. So improvement of familial support for childrearing will reduce married nurses' turnover intention. In addition, well-organized nursery facilities are recommended for enabling working mothers to continue their careers. Furthermore, more family-friendly welfare policies such as a flextime systems or compulsory paternity leave should be reinforced in the workplace.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.24 no.3
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• pp.255-263
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• 2017

Purpose: This study was conducted to assess the incidence and characteristics of pressure ulcer in relation to the type of equipment and supplies(EnS) in intensive care unit(ICU). Method: By using secondary data analysis and descriptive investigation, 29 patients of pressure ulcers caused by EnS were examined from January 2013 to December 2015, at the advanced general hospital located in Gyeongsangnam-do. The subjects were aged 19 years and above and had been in the ICU for more than 3 days. The data were analyzed using the SPSS WIN 23.0 with frequency, percentage, and mean and standard deviation. Result: The incidence of EnS-related pressure ulcers was 3.71%. The EnS-related causes for pressure ulcers were endotracheal tube(31.03%), restraint(20.69%), and neck brace(10.34%). The longest use of EnS was oxygen tube(29 days). EnS that were possibly causing pressure ulcer for one day were restraint(upper extremities), endotracheal tube(oral and face), and oxygen mask(ear and nose). Conclusion: This study has been limited to secondary data analysis that may result in missing records of pressure ulcers related to EnS in ICU. However, the analysis of this research is expected to contribute to the development of nursing interventions to clarify the guidelines for the prevention of pressure ulcers related to EnS in ICUs.