• 간호행정학회지
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• 제21권2호
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• pp.174-183
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• 2015

Purpose: This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs). Methods: Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients. Results: Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level. Conclusion: In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.

• 간호행정학회지
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• 제20권1호
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• pp.95-105
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• 2014

Purpose: The purpose of this study was to examine trends in number of nursing staff and skill mix. Methods: Nursing staff and skill mix were measured using the number of nursing staff including nurse aids and registered nurses per bed. Descriptive and panel data regression analyses were conducted using data on long-term care hospitals which included yearly series data from 2006 to 2010 for 119 hospitals. Results: The number of nursing staff per bed increased significantly but percentage of registered nurses decreased significantly from 2007 to 2010. The regression model explained this variation as much as 34.9% and 43.8%. Conclusion: The results showed that in long-term care hospitals there were more nurse aids employed instead of registered nurses after the implemention of differentiated inpatient nursing fees. Thus clarifying the job descriptions for nurses and nurse aids is needed and appropriate hospital incentive policies should be implemented.

• Journal of Korean Biological Nursing Science
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• 제20권3호
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• pp.141-149
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• 2018

Purpose: This study was conducted to examine the effects walking program with dance on gait, cognition, and risk of falls of elderly with dementia in a long-term care hospital. Methods: Subjects consisted of 42 elderly with dementia in a long-term care hospital (21 elderly with dementia in an experimental group and 21 elders with dementia in a control group). Data were collected from March 14 to April 30, 2016. Subjects in the experimental group performed walking program with dance (three times a week, 30-50 minutes session, 18 sessions). Data were analyzed using descriptive statistics, Chi-square test, Fisher's exact test, independent t-test, paired t-test, repeated measures ANOVA with the SPSS/WIN 21.0. Results: The participants in the experimental group showed significantly increased scores of cadence (F= 8.36, p= .007) and improved scores of cognition (F= 9.95, p= .003) compared the control group. Conclusion: The findings indicate walking program with dance is recommend a regular exercise program to enhance the cadence associated with walking speed and cognitive function elderly.

• 기본간호학회지
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• 제17권1호
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• pp.26-34
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• 2010

Purpose: The purpose of this study was to compare long-term hospital and general hospital for delirium prevalence and precipitating factors in elderly patients. Method: The participants were 184 patients aged 65 or older from one general hospital and 4 long-term facilities. Delirium was assessed using the Confusion Assessment Method and precipitating factors for delirium were classified as demographic, physical condition, disease and drug factors associated with delirium found in a literature analysis. Results: Delirium prevalence was 5.4% and there was no significant difference according to hospital type. Most of the patients with delirium were male, dependent and dehydrated and had sleep disturbances, diseases and drugs associated with delirium and, had multi-drugs prescriptions. Non-delirious patients also had two or more delirious symptoms and several precipitating factors. Delirious patients were more dependent, urinary incontinent and had sleep-disturbances compared to the non-delirious group. The participants in the long-term hospitals were found to have frequently previous delirium history. Conclusion: Even though the prevalence rate of delirium was not high, most elderly patients, regardless of delirium, are a very high risk group and dependent ADL, sleep disturbances, and/or urinary incontinence could be used predictive factors for delirium.

• 한국산학기술학회논문지
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• 제21권3호
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• pp.353-359
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• 2020

본 연구는 감정노동, 회복 탄력성이 요양병원 간호사의 소진에 미치는 영향을 파악하기 위해 시도된 서술적 조사연구이다. 자료수집 기간은 2019년 5월 23일에서 6월 5일까지이며 D시,B시,G도 소재의 요양병원에 재직 중인 간호사 195명을 본 연구대상으로 하였다. 자료의 분석을 위하여 SPSS 21.0 통계 프로그램의 평균과 표준편차, Pearson correlation coefficients, t-test, ANOVA 및 Multiple regression을 이용하였다. 분석 결과 감정노동과 소진(r=.476, p<.005), 회복 탄력성(r=-.416, p< .005)은 유의한 상관관계를 보였다. 회귀분석 결과 감정노동(β= .37, p<.001)과 회복 탄력성(β= .17, p< .048)은 요양병원 간호사 소진에 통계적으로 유의한 영향을 미치는 변수로 파악되었으며, 이들 변인은 요양병원 간호사의 소진에 25.5%의 설명력을 가지고 있었다(F=23.51,p<.001). 이에 본 연구결과를 기반으로 감정노동을 낮추고, 회복 탄력성을 강화할 수 있는 프로그램을 요양병원 간호사 직무교육에서 개발하고 적용 및 활용으로 요양병원 환자를 이해하고, 질적인 간호서비스를 제공할 수 있는 노력이 필요하다. 또한, 본 연구결과를 기반으로 요양병원 간호사의 소진에 영향을 미치는 다양한 요인을 파악하고 이를 기반으로 한 프로그램 개발이 필요하다.

• 보건행정학회지
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• 제32권4호
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• pp.347-355
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• 2022

Background: Since November 2019, long-term care hospitals have been able to provide patients with discharging programs to support the elderly in the community. This study aimed to identify both patient- and hospital-level factors that affect successful community discharge from long-term care hospitals. Methods: A multilevel logistic regression model was performed using hospitals as a clustering unit. The dependent variable was whether a patient stayed in the community for at least 30 days after discharge from a long-term care hospital. As for the patient-level independent variables, an agreement between a patient and the family about discharge, length of hospital stay, patient category, and residence at discharge were included. The number of beds and the ratio of long-stay patients were selected for the hospital-level factors. The sample size was 1,428 patients enrolled in the discharging program from November 2019 to December 2020. Results: The number of patients who were discharged to the community and stayed at least for 30 days was 532 (37.3%). The intraclass correlation coefficient was 22.9%, indicating that hospital-level factors had a significant impact on successful community discharge. The odds ratio (OR) of successful community discharge increased by 1.842 times when the patients and their families agreed on discharge. The ORs also increased by 3.020 or 2.681 times, respectively when the patients planned to discharge to their own house or their child's house compared to those who didn't have a plan for residence at discharge. The ORs increased by 1.922 or 2.250 times when the hospitals were owned by corporate or private property compared to publicly owned hospitals. The ORs decreased by 0.602 or 0.520 times when the hospital was sized over 400 beds or located in small and medium-sized cities compared to less than 200 bedded hospitals or located in metropolitan cities. Conclusion: The results of the study showed that the patients' and their family's willingness for discharge had a great impact on successful community discharge and the hospital-level factors played a significant role in it. Therefore, it is important to acknowledge and support long-term care hospitals to involve active in the patient discharge planning process.

• 성인간호학회지
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• 제26권6호
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• pp.642-652
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• 2014

Purpose: The purpose of this study was to compare the role-expectations of gerontological nurse practitioners and performance of gerontological nursing by nurses in long term care hospitals and general hospitals. Methods: Subjects were 200 nurses; 100 nurses from long term care hospitals where as 100 nurses from general hospitals. The subjects completed a questionnaire on general characteristics, role-expectations of gerontological nurse practitioners, and performance of gerontological nursing by nurses. Data were collected from February to March 2013 and analyzed using SPSS/WIN 18.0 version program in order to perform descriptive statistics, independent t-test, and one-way ANOVA. Results: Results indicated that there were significant differences in the role-expectations of gerontological nurse practitioners and performance of gerontological nursing between nurses from long term care hospitals and those from general hospitals. Conclusion: Nurses in general hospitals showed significantly higher role expectations than nurses in long term care hospitals. Therefore it is necessary to spread the knowledge on the roles of gerontological nurse practitioners and the nurse practitioners system to nurses in long term care hospitals.

• 보건의료산업학회지
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• 제5권3호
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• pp.13-23
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• 2011

This paper investigated the operating environment for the representative of each agency and the facility workers on the basis of analytical result of recognition changes of the operating environment changes under the operating the long-term care insurance. It was described plans to take positive effect on the operating as follows. The first, on the result of regression analysis, the service administrative range takes the biggest effect on the general recognition of executing the long-term care insurance off and on. The affirmative recognition of the service administrative range had the general recognition on the system be positive effect. But the operator of facility asserts that the care manager's professionalism related quality of service be strengthened. The second, on the result of regression analysis, in the financial accounting administrative it is revealed the more positive recognition it is, the more positive effects it has. From the difference verification of an operation size from operation subject, the small operation size and personal facility recognize the long term care insurance positively. On the other side the facilities where the operation size is big recognize the system negatively. The long-term care facility should rearrange a support program newly and the government needs to promote the donation activity, because it is needed to reduce the financial burden of facilities.

• 대한간호학회지
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• 제34권2호
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• pp.372-378
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• 2004

Purpose: The purpose of this study was to measure the functional status of stroke patients cared for in different long-term care settings. Method: We assessed all stroke patients in two home health care agencies, four nursing homes and one geriatric hospital in Korea (n=171) using the Resident Assessment Instrument (RAI), which comprises Activity of Daily Living (ADL), urine incontinence, bowel incontinence, a Cognitive Performance Scale (CPS),and being understood and understanding others. Data was collected by face-to-face surveys with patients. Results: The mean ADL score, urine incontinence score, bowel incontinence score, CPS, and being understood score and understanding others score were lowest for the patients receiving home health care, and highest for the patients in nursing homes. Low scores described poor and high scores good functional status. The results showed significant differences in physical and cognitive function scores between the three groups of patients. Conclusion: This study suggests that there may be large differences between the patients in these three types of long-term care settings. These findings can be used to help develop and implement efficient long-term care programs.

• 한국병원경영학회지
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• 제21권3호
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• pp.65-70
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• 2016

The Long-Term Care Hospital (LTCH) accreditation system was initiated in 2013 in the form of mandatory accreditation system in order to improve patient safety and the quality of medical service at LTCHs. By June 2016, the accredited LTCHs were 76.2%. This research was conducted to review the implementation process in the first cycle and to promote development of the second cycle of LTCH accreditation system. There are some changes which reinforced the accreditation standards, accreditation survey, and public access to accreditation results in order to strengthen patient safety in the first cycle LTCH accreditation system. LTCHs which participated in the accreditation system achieved certain outcomes in respect to patient safety and employee satisfaction. However, there are several urgent problems in placement criteria of night duty health care providers, reinforcement plans in the accreditation system, and incentives for accredited hospitals. In order to solve these problems, the most important thing is to clearly recognize the fact that the healthcare accreditation system is not the means for control and regulate hospitals but a system to induce hospitals to continue to strive for improvements in patient safety and medical service quality. In addition, it is required that LTCHs, accrediting agency and the Ministry of Health and Welfare compromise and cooperate to seek solutions every time issues related to the accreditation system arise.