• The Journal of the Korea Contents Association
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• v.20 no.10
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• pp.308-325
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• 2020

This study examines factual facilites safety of long-term care facilities for eldery, for improvement of Korean policy. So, This study reviewed policies of facilites safety of long-term care facilities on main OECD countries. We analyzed factual survey of facilites safety of long-term care facilities in Seoul metropolitan area. The results of the study were as follows: First, There were differences of law and rule of facilites safety of long-term care facilities in comparison with those of social welfare facilities, child day-care center, hospital. Second, it was the result of location condition analysis. Long-term care facilities in the Seoul metropolitan area were located on more than six floors of buildings. The location conditions of private facilities are weak compared to those of corporations and local governments. Third, there were the result of internal structure of facilities. Overall, the placement status was insufficient. For instance, there are smokeproof masks/fireproof blankets, smoke windows(fire safety windows), smoke smothering. In addition, there were places where legal essential installation structures were insufficient. Private facilities were generally insufficient in facility structures compared to those of local governments and welfare corporations. Fourth, there were the result of safety management. It was confirmed that private facilities were insufficient compared to local government facilities. For instance, there are safety management analysis, response manuals, fire preparedness training, etc. Finally, implications and future directions policies of facilites safety of long-term care facilities were discussed based on the finding of the study.

• Journal of Korean Academy of Nursing
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• v.39 no.3
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• pp.409-421
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• 2009

Purpose: In this research multi-level analysis was done to identify factors related to quality of services. Patient characteristics and organizational factors were considered. Methods: The data were collected from the Health Insurance Review and Assessment Service(HIRA) data base. The sample was selected from 17,234 patients who had been admitted between January 2007 and May 2008 to one of 253 long-term care hospitals located in Seoul, six other metropolitan cities or nine provinces The data were analyzed with SAS 9.1 using multi-level analysis. Results: The results indicated that individual level variables related to quality of service were age, cognitive ability, patient classification, and initial quality scores. The organizational level variables related to quality of service were ownership, number of beds, and turnover rate. The explanatory power of variables related to organizational level variances in quality of service was 23.72%. Conclusion: The results of this study indicate that differences in the quality of services were related to organizational factors. It is necessary to consider not only individual factors but also higher-level organizational factors such as nurse' welfare and facility standards if quality of service in long term care hospitals is to be improved.

• Journal of Home Health Care Nursing
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• v.30 no.1
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• pp.26-36
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• 2023

Purpose: This study investigated the organizational culture in hospital for infection control, moral sensitivity, and the degree of infection control among long-term care hospital nurses, and to identified the factors associated with infection control perfomance. Methods: 186 nurses who directly care for patients at seven Long-Term Care Hospitals in D Metropolitan City participated in the survey. Data were collected using self-reported questionnaires and analyzed using the IBM SPSS 26.0 software. Results: Moral sensitivity showed statistically significant differences in age (F=5.473, p=.065), clinical experience (F=8.890, p=.031), nursing hospital work experience (F=6.520, p=.038), religion (t=-2.01, p=.046) and position (t=-2.96, p=.003). Correlation analysis revealed that with moral sensitivity and effect of organizational culture on infection control, there was a positive correlation between infection control and patient-centered nursing (r=.201, p<.006), professionalism (r=.149, p<.042), benevolence (r=.303, p<.001), infection control organizational culture (r=.556, p<.001). Benevolence of moral sensitivity (β=.21, p=.001) and infection control organizational culture (β=.54, p<.001) were associated with infection control perfomance. Moral sensitivity (including patient-centered nursing, professionalism, and benevolence) and infection control organizational culture explained 33.8% of the variance in infection control (F=24.57, p<.001). Conclusion: It is important to improve the moral sensitivity of nurses and a positive organizational culture for better infection control. We need to develop intervention strategies and establish systematic and administrative support.

• Health Policy and Management
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• v.31 no.2
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• pp.173-179
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• 2021

Background: In Korea, the length of stay and medical expenses incurred by medical aid patients are increasing at a rate faster than the national health insurance. Therefore, there is a need to create a management strategy for each type of hospitalization to manage the length of stay of medical aid patients. Methods: The study used data from the 2019 National Health Insurance Claims. We analyzed the factors that affect the length of stay for 186,576 medical aid patients who were hospitalized for more than 31 days, with a focus on the type of hospitalization in long-term care hospitals. Results: The study found a significant correlation between gender, age, medical aid type, chronic disease ratio, long-term care hospital patient classification, and hospitalization type variables as factors that affect the length of hospital stay. The analysis of the differences in the length of stay for each type of hospitalization showed that the average length of stay is 291.4 days for type 1, 192.9 days for type 2, and 157.0 days for type 3, and that the difference is significant (p<0.0001). When type 3 was 0, type 1 significantly increased by 99.4 days, and type 2 by 36.6 days (p<0.0001). Conclusion: A model that can comprehensively view factors, such as provider factors and institutional factors, needs to be designed. In addition, to reduce long stays for medical aid patients, a mechanism to establish an early discharge plan should be prepared and concerns about underutilization should be simultaneously addressed.

• Korean Journal of Occupational Health Nursing
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• v.31 no.4
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• pp.157-166
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• 2022

Purpose: The purpose of this study was to identify factors influencing fall-prevention behaviors of nurses working in long-term care hospitals. Methods: Participants included 147 nurses working in 10 long-term care hospitals in B city. Data were collected from September 20-October 12, 2016. SPSS/WIN 21.0 was used for analysis with t-test, ANOVA, Scheffé test, Pearson correlation coefficients, and multiple regression. Results: It was found that attitude toward fall (r=.29, p<.001) and patient safety culture (r=.25, p=.002) had a significant positive correlation with fall-prevention behaviors of nurses working in long-term care hospitals. The factors influencing fall-prevention behaviors in participants were clinical career and patient safety culture (β=.21, p=.012), contributing to 19% of the total variance in fall- prevention behaviors. Conclusion: The findings showed that systematic delivery of differentiated fall prevention education is preferred to nurse's clinical career as a private factor to improve fall-prevention behaviors of nurses in long term care hospital. Particularly, it is imperative to conduct periodical and practical fall-prevention education for nurses to prevent career discontinuity. An independent report system and open communication system as well as a scheme that can disseminate patient safety culture in individual departments to implement patient direct nursing are required to encourage patient safety culture in organizations.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.112-129
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• 1996

Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

• Nutrition Research and Practice
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• v.6 no.1
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• pp.35-44
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• 2012

This study was conducted to assess improvements in nutritional status following the application of nutrition education to elderly patients in a long-term care hospital. The study was carried out from January to May 2009, during which a preliminary survey, a pretest, the application of nutrition education, and a post-test were applied in stages. The number of subjects at pretest was 81, and the number of participants included in the final analysis was 61 (18 men, 43 women), all of whom participated in both the nutrition education program and the post-test. The survey consisted of general demographic items, health behaviors, dietary behaviors, the Nutrition Screening Initiative checklist, and nutrient intake assessment (24 hour recall method). The nutrition education program lasted for four weeks. It included a basic education program, provided once a week, and mini-education program, which was offered daily during lunch times. The survey was conducted before and after the education program using the same assessment method, although some items were included only at pretest. When analyzing the changes in elderly patients after the nutritional education program, we found that, among subjective dietary behaviors, self-rated perceptions of health (P<0.001) and of depression (P<0.001) improved significantly and that dietary behavior scores also improved significantly (P<0.001), while nutritional risk levels decreased. In terms of nutrient intake, subjects' intake of energy, protein, fat, carbohydrate, calcium, phosphorus, iron, vitamin A, thiamin, riboflavin, niacin, and vitamin C all increased significantly (P<0.001). These results indicated that nutritional education is effective in improving the nutritional status of elderly patients. We hope that the results of this study can be used as preliminary data for establishing guidelines for nutrition management tailored to elderly patients in long-term care hospitals.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.6
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• pp.4048-4055
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• 2015

The purpose of this study is to examine the awareness of biomedical ethics of long-term care hospital nurses. A survey research was conducted in this study with 183 nurses that worked for over five months at long-term care hospitals located in Gwangju and Jeonnam region. Using SPSS 21.0 program, collected data were analyzed through descriptive statistics, independent t-test and one-way ANOVA. $Scheff{\acute{e}}$ test and Pearson's correlation analysis were also used for post hoc test. In terms of the awareness of biomedical ethics of the research participants, it was at an above average level. Among the sub-categories of biomedical ethics, awareness of right of life of fetus and awareness of artificial abortion showed most meaningful correlation. It would be necessary to provide bioethics education to new nurses or university students majoring in Nursing at related organizations or college of nursing to help them establish ethical values to seek patients' well-being.

• Journal of Digital Convergence
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• v.17 no.9
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• pp.231-240
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• 2019

The purpose of this study was to explore and describe the relationship of the perception of patient safety culture, knowledge of standard precaution and performance of standard precaution among long-term care hospital nurses. Participants were 134 nurse in long-term hospital. Data were collected with structured questionnaires from January 2 to June 4, 2018. Data were analyzed by SPSS/WIN 21.0 program for descriptive statistics t-test, ANOVA, Scheffe's test and Pearson's correlation coefficient. The perception of patient safety culture were significantly correlated with knowledge of standard precaution(r=.192, p=.027), performance of standard precaution(r=211, p=.014). Therefore, in order to enhance the perception of patient safety culture and performance of standard precaution of long-term care hospital nurses, it would be necessary to enable health-care associated infections by themselves by cultivating standard precaution knowledge through systemic education and by enabling the establishment of affirmative patient safety culture.

• Journal of Korean Clinical Nursing Research
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• v.29 no.3
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• pp.249-260
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• 2023

Purpose: The study aimed to examine the effects of nurse staffing levels on patient outcomes in long-term care hospitals in South Korea using path analysis. Methods: We conducted a secondary analysis of national data, which included the 2021 hospital assessment results of long-term care hospitals from the Health Insurance Review and Assessment Service. Data collection was performed between June 19 and June 27, 2023. The study sample consisted of 1,215 hospitals, and we analyzed the data using SAS 9.4 and Mplus 8 software. Results: The average numbers of patients per registered nurse, certified nursing assistant, and nursing staff, including both registered nurses and certified nursing assistant, was 10.00, 7.43, and 4.00, respectively. Path analysis revealed that the number of patients per registered nurse had direct effects on improvements in activities of daily living and indirect effects on indwelling catheterization, pressure ulcer improvement, and weight loss. The number of patients per certified nursing assistant had direct effects on new pressure ulcer development and pressure ulcer improvement, with no indirect effects. The number of patients per nursing staff had direct effects on pressure ulcer improvement and no indirect effects on other patient outcomes. Conclusion: The findings suggest that establishing policies to evaluate staffing levels of registered nurse and certified nursing assistants separately is necessary in order to improve registered nurse staffing levels and patient outcomes in long-term care hospitals.