• Title/Summary/Keyword: Inpatient group

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Impact of Nurse, Nurses' Aid Staffing and Turnover Rate on Inpatient Health Outcomes in Long Term Care Hospitals (요양병원의 간호사와 간호조무사 확보수준과 이직률이 입원환자의 건강결과에 미치는 영향)

  • Kim, Yunmi;Lee, Ji Yun;Kang, Hyuncheol
    • Journal of Korean Academy of Nursing
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    • v.44 no.1
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    • pp.21-30
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    • 2014
  • Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.

Feasibility of Use of a Barbed Suture (V-Loc 180) for Quilting the Donor Site in Latissimus Dorsi Myocutaneous Flap Breast Reconstruction

  • Thekkinkattil, Dinesh Kumar;Hussain, Tasadooq;Mahapatra, Tapan Kumar;McManus, Penelope Louise;Kneeshaw, Peter John
    • Archives of Plastic Surgery
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    • v.40 no.2
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    • pp.117-122
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    • 2013
  • Background Latissimus dorsi (LD) myocutaneous flap is a popular method of breast reconstruction which can be associated with high incidence of seroma formation. Quilting sutures at the harvest site are used to reduce this. Barbed sutures are self anchoring sutures which avoid multiple knotting and can be useful in quilting. Methods A retrospective analysis of prospectively maintained database of patients who underwent LD flap breast reconstruction between January 2009 and January 2011 was carried out. Seroma formation at the harvest site, wound related complications, inpatient stay and duration of surgery were analysed and a comparison was made between two groups where quilting was done with barbed (V-Loc) suture and conventional polydioxanone (PDS) II sutures. Results Fifty-seven patients were included of which 33 had quilting by V-Loc sutures and in 24 patients PDS II suture was used. Median age in the PDS group was 55 years (interquartile range [IQR)], 45 to 61 years) which was comparable to the V-Loc group (53 years [IQR, 48 to 59 years]; P-value 0.948). Sixteen patients (28%) had significant seroma formation and 5 (9%) patients developed superficial wound dehiscence. Incidences of seroma or wound complications were comparable (P-value 0.378 and 1.00, respectively). Secondary outcomes such as total duration of surgery, total inpatient stay, total amount of drain at the donor site were also similar in two groups. Conclusions Use of barbed sutures for quilting the donor site in LD flap reconstruction is a feasible option and the associated seroma formation and wound complications are comparable with conventional sutures.

Comparison of Medical Care Cost between Hospice Care and Conventional Care in the Last Year of life (호스피스케어와 전통적 의료서비스 이용간의 사망전 의료비용 비교)

  • Choi Kui Son;You Chang Hoon;Lee Kyoung Hee;Kim Chang Yup;Heo Dae Seog;Yun Young Ho
    • Health Policy and Management
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    • v.15 no.2
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    • pp.1-15
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    • 2005
  • The aim of this study was to compare medical cost of hospice care and that of conventional care during the last year of life, and identify factors that influenced the cost. From January to August 2003 592 terminal cancer patients receiving care from 5 hospice care units and 2 hospice care teams in general hospitals were enrolled to case group. Two hundreds and seventy two terminal cancer patients receiving conventional care from 7 general hospitals were enrolled to hospital-based control group, and 1,636 terminal cancer patients from 122 general hospitals located in same regions with the 7 hospitals were enrolled to community-based control. We used characteristics and medical cost from data of National Health Insurance Cooperation. Total medical cost per beneficiary in cases was about 10 millions won, 14.5 millions in hospital-based controls and 11.1 millions in community-based controls. The hospice care saved $45\%$ over the last year of life compared with hospital-based controls (p<0.0001). Saving of inpatient cost account for approximately $80\%$ of saving per beneficiary. Hospice care saved $29\%$ of medical cost per hospitalization day compared with hospital­based controls and $17\%$ compared with community-based controls (p<0.0001). Multiple regression analyses showed that hospice care significantly saved the medical cost. This study suggest that hospice care save medical cost compared with hospital-based control and community-based control. Most of saving of inpatient cost account for approximately $80\%$ of saving of medical cost.

Convergence correlation of oral health behavior and planned behavior theory variables before and after oral health education (구강건강교육 전후에 구강건강행동과 계획된 행동이론 변수들과의 융합적 상관관계 연구)

  • Kim, Han-Hong;Kim, Seon-Rye
    • Journal of the Korea Convergence Society
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    • v.10 no.4
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    • pp.51-56
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    • 2019
  • This study was performed to determine correlation on oral health behavior and variables of planned behavior theory before and after oral health education. 62 male inpatient alcoholics conducted the structured self-administered questionnaires, and subjects were taken oral health education for 4 weeks. To analysis data, the correlation analysis was conducted. The education group showed a significant positive correlation with oral health behavior and behavior intention, attitude toward behavior, subjective norm, perceive behavior control after oral health education. The relevant variables after the oral health education displayed a higher correlation coefficient and relation in the education group. It suggested an evidence that regular oral health education should be applied to promote oral health for alcoholic inpatients.

An Analysis of Tasks of Nurses Caring for Patients with COVID-19 in a Nationally-Designated Inpatient Treatment Unit (국가지정 입원치료병상에 입실한 COVID-19 환자를 돌보는 간호사의 업무분석)

  • Jung, Minho;Kim, Moon-Sook;Lee, Joo-Yeon;Lee, Kyung Yi;Park, Yeon-Hwan
    • Journal of Korean Academy of Nursing
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    • v.52 no.4
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    • pp.391-406
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    • 2022
  • Purpose: The purpose of this study was to provide foundational knowledge on nursing tasks performed on patients with COVID-19 in a nationally-designated inpatient treatment unit. Methods: This study employs both quantitative and qualitative approaches. The quantitative method investigated the content and frequency of nursing tasks for 460 patients (age ≥ 18 y, 57.4% men) from January 20, 2020, to September 30, 2021, by analyzing hospital information system records. Qualitative data were collected via focus group interviews. The study involved interviews with three focus groups comprising 18 nurses overall to assess their experiences and perspectives on nursing care during the pandemic from February 3, 2022, to February 15, 2022. The data were examined with thematic analysis. Results: Overall, 49 different areas of nursing tasks (n = 130,687) were identified based on the Korean Patient Classification System for nurses during the study period. Among the performed tasks, monitoring of oxygen saturation and measuring of vital signs were considered high-priority. From the focus group interview, three main themes and eleven sub-themes were generated. The three main themes are "Experiencing eventfulness in isolated settings," "All-around player," and "Reflections for solutions." Conclusion: During the COVID-19 pandemic, it is imperative to ensure adequate staffing levels, compensation, and educational support for nurses. The study further propose improving guidelines for emerging infectious diseases and patient classification systems to improve the overall quality of patient care.

CHARACTERISTICS OF UNRULY & DELINQUENT ADOLESCENTS ADMITTED TO A PSYCHIATRIC INPATIENT UNIT (청소년 병동에 입원한 비행 청소년의 특성에 관한 연구)

  • Lee, Young-Sik;Kim, Wun-Jung;Carey, Michael
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.70-82
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    • 1997
  • Objective:This study was performed to identify and understand the characteristics of adolescents who had a history of police arrest and/or were adjudicated unruly/delinquent by the juvenile court. Method:The study employed a retrospective reivew of coumputer-recorded data set on 210 consecutive admissions to an adolescent psychiatric inpatient unit. Three groups(No Police Contact, N=115;Police Contact Only, N=60;Adjudicated, N=35) were compared on the areas of a) cognitive and educational performance b) emotion:anxiety, depression, suicidality c) personality d) family and life experiences. Standardized assessments were administered to all subjects using WISC-Ⅲ, Kaufman Test of Educational Achievement, Millon Adolescent Personality Inventory, Reynolds Adolescent Depression Scale, Revised-Chilren’s Manifest Anxiety Scale, Suicide Ideation Questionnarie, Suicide Behavior Interive, Life Events Checklist, and Family Environmental Scale. A subgroup of the subjects, 60 cases also received a standardized interview by Child Assessment Schedule. Results:The characteristic findings of the delinquent group(the police contact only and adjudicated subjects combined) included (1) a high rate of adoption, sexual promiscuity, out of home placement, and repeated psychiatric hospitalization, (2) low verbal IQ scores and educational achievements, (3) high impulsivity, low social conformity, and high forcefulness in personality inventory, (4) low activityrecreation orientation and low moral religious emphasis in family environment, (5)a high frequency of adverse life experiences, (6) among 3 groups, the Police Contact Only group showed the lowest depression, anxiety and suicidal ideation scores, (7) a high diagnostic frequency of conduct disorder, ODD, and ADHD. Conclusions:The adolescent psychiatric inpatients with a delinquent history presented with a certain clinical, family, psychometric characteristics that warrant specific clinical intervention strategies for their cognitive deficits, an impulsive personality style, family dysfunction with adverse life experiences and disruptive behavioral disorders, different from the rest of adolescent psychiatric inpatients.

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The Effect of integrated health and welfare services on the control of medical use and medical expenses in Korean Veteran's Hospitals (보훈병원 통합의료복지서비스가 의료이용과 의료비 절감에 미치는 효과 분석)

  • Koo, Gilhwan;Dong, Jaeyong;Lee, Kyeonghwa;Seo, Youngjoon
    • Korea Journal of Hospital Management
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    • v.26 no.2
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    • pp.1-16
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    • 2021
  • This study aims to examine the effect of integrated health and welfare(IHW) services on medical use and medical expenses in Korean Veteran Hospitals. Data on the volume of medical use and medical expenses were collected from two patient groups of 5 Veterans' Hospitals: the beneficiary group who has received IHW services and the non-beneficiary group who has not. Each group was composed of 265 patients respectively. The results of the study revealed that the volume of home nursing services, home rehabilitation services, ambulatory services have increased significantly, whereas the average length of stay, number of using emergency services, and average medical expenses have decreased after receiving integrated health services in the beneficiary group. In contrast, the non-beneficiary group showed much more increase both in the volume of inpatient and outpatient services, as well as the average medical expenses, compared to those of the beneficiary group. This results imply that the provision of IHW services have positive impacts on the enhancing the effectiveness of the medical resources utilization for the veteran patients.

The Characteristics of Korean Smoker, Enrolled in '5 day Smoking Cessation School' and The Effect of Inpatient Smoking Cessation Program (서울 위생 병원 5일 금연 학교를 방문한 우리나라 흡연자의 특성 및 입원 금연 교육 프로그램의 효과)

  • Lee, Byung Soo;Kang, Ki Hoon;Chae, Eun Ha;Kim, Myung Chan;Jung, Jae Il;Chang, Hee Jong;Lee, Sang Hoon;Cho, Dong Sik;Shin, Jai Gyu;Kim, Hui Jung
    • Tuberculosis and Respiratory Diseases
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    • v.57 no.5
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    • pp.411-418
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    • 2004
  • Background : Cigarette smoking is the single biggest avoidable cause of death and disability in most countries. Effective prevention of cigarette Smoking and help for those wishing to quit can therefore yield enormous health benefits for populations and individuals. Although most of smokers try to stop smoking for themselves, the success rate of quitting smoking is very low. Promoting and supporting smoking cessation should be an important health policy priority for healthcare professionals in all clinical settings. In this study, we tried to evaluate the effect of the educational program for smoking cessation of our hospital, the smoking pattern, and characteristics of adult smokers enrolled in the program. Methods : We enrolled 640 smokers, who has visited the '5 day stop smoking school' for smoking cessation from Jan 1998 to 2001. we evaluated the characteristics of the smokers based on the self report questionnaire at the beginning of the program and we also checked 100 smokers, enrolled in Inpatient Smoking Cessation Educational program, their smoking behavior and the cessation rate with postal questionnaire after finishing this program from Nov 2002 to Jan 2003. Results : The health was most common motivation for smoking cessation. The stress was the most important motivation of smoking. The overall smoking cessation rate of the smokers enrolled in inpatient smoking cessation school was 60%. The age of starting smoking and the kind of occupation have a significant difference between the success group and failure group of smoking cessation. Conclusion : The inpatient smoking cessation program was effective smoking cessation intervention in the adult smokers who enrolled in '5 day stop smoking school'.

The Effect of Education Program by Illness on Perception of Illness and Knowledge of Medication in Psychiatric Inpatients (질환별 교육프로그램이 정신질환자의 질병인식 및 약물지식에 미치는 효과)

  • Jun, Won-Hee;Park, Jeong-Soon;Jeong, An-Soon
    • Journal of East-West Nursing Research
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    • v.17 no.2
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    • pp.110-116
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    • 2011
  • Purpose: This study aimed to examine the effects of education program by illness on perception of illness and knowledge of medication in psychiatric inpatients. Methods: The research design was a non-equivalent and non-synchronized control group design. For this research, a total of 50 subjects was selected at a psychiatric unit of C university hospital in U-city. The experimental group consisted of 24 subjects and they received education program by illness 1 session per a week for 4 weeks. The remaining 26 subjects were assigned to the control group and they received standard services except the education program by illness. In data analysis, SPSS/WIN 15.0 program was used. Results: The experimental group significantly improved compared to the control group in perception of illness and knowledge of medication. Conclusion: This study results suggest that education program by illness could be effective to improve perception of illness and knowledge of medication in psychiatric inpatients.

General Health Status and Physical Care Burdens of Patients Groups in Long-Term Care Hospitals (요양병원 환자분류군별 전반적 건강수준 및 육체적 수발부담 차이)

  • Chin, Young-Ran;Lee, Hyo-Young
    • The Korean Journal of Health Service Management
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    • v.12 no.1
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    • pp.81-93
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    • 2018
  • Objectives : This cross-sectional study aims to investigate the differences in general health status (GHS) and physical care burdens (PCB) of inpatient groups in long-term care hospitals (LTCH). Methods : The data of 228 patients were analyzed by integrating the electronic medical record (EMR) data of 2016, recorded by the nurses of hospitalized patients in the hospital. Results : There was a statistically significant difference in the GHS between the high-medical demand group and the other groups, but there was no difference in the GHS among other groups. The overall PCB was higher in the high-medical demand group than in the middle-medical demand, and cognitive impairment groups, but not in the problem behavioral group. Conclusions : The current classification of patient groups has shown limitations in terms of the basis of differential benefits of the groups. In particular, the PCB of the problem behavior group was not different from that of any group; hence, it should be adjusted through further study. To control the surge of medical care costs, it is necessary to improve the irrationality of the LTCH pay system in terms of the integration and continuity for elderly care.