• Journal of Korean Academy of Nursing
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• v.40 no.3
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• pp.349-358
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• 2010

Purpose: The purpose of this study was to estimate nursing costs and to establish appropriate nursing fees for long-term care services for community elders. Methods: Seven nurses participated in data collection related to visiting time by nurses for 1,100 elders. Data on material costs and management costs were collected from 5 visiting nursing agencies. The nursing costs were classified into 3 groups based on the nurse's visit time under the current reimbursement system of long-term care insurance. Results: The average nursing cost per minute was 246 won. The material costs were 3,214 won, management costs, 10,707 won, transportation costs, 7,605 won, and capital costs, 5,635 won per visit. As a result, the average cost of nursing services per visit by classification of nursing time were 41,036 won (care time <30 min), 46,005 won (care time 30-59 min), and 57,321 won (care time over 60 min). Conclusion: The results of the study indicate that the fees for nurse visits currently being charged for long-term care insurance should be increased. Also these results will contribute to baseline data for establishing appropriate nursing fees for long-term care services to maintain quality nursing and management in visiting nursing agencies.

• Journal of Korean Academy of Nursing Administration
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• v.20 no.1
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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 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.

• Journal of Korean Public Health Nursing
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• v.37 no.2
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• pp.275-289
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• 2023

Purpose: This study developed a structural model for explaining and predicting terminal care performance in long-term care hospital nurses. The model was based on the stress integration model of Ivancevich and Matteson(1980) and the results of previous studies. Method: Data was obtained from August to September 2022 from 267 nurses in 13 long-term care hospitals in G-do. Results: Results of model verification for this study, revealed that factors directly affecting the terminal care performance of long-term care hospital nurses were nursing work environment(β=0.43, p<0.001), death anxiety(β=-0.29, p<0.001), and terminal care stress(β=0.22, p=0.003). However, the attitude toward nursing care of dying(β=0.07, p=0.287) had no effect on the terminal care performance. Conclusion: The results of this study, confirmed the necessity of improving an individual's perceived nursing work environment, continuous education related to terminal care to reduce death anxiety, and an interventional approach for enhancing terminal care performance.

• Korea Journal of Hospital Management
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• v.28 no.3
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• pp.58-67
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• 2023

Purpose: The purpose of this study was to analyze the factors associated with long-term hospitalized patients in long-term care hospitals using the quality assessment data for long-term care hospitals by the Health Insurance Review. Methods: Among 1,376 long-term care hospitals, frequency analysis and descriptive statistics were used to analyze the characteristics of these hospitals. Multiple linear regression was conducted to examine the associations between infrastructure characteristics, medical personnel characteristics, health outcomes and the proportion of long-term hospitalized patients. Results: The research findings indicate that the number of patients per doctor, the number of patients per nurse, and the number of patients per nursing staff were positively associated with the proportion of long-term hospitalized patients. Among health outcomes, a higher proportion of patients with more than a 5% weight loss compared to the previous month and the proportion of patients showing improvement in ADL, were more likely to have a lower proportion of long-term hospitalized patients. However the proportion of diabetic patients with HbA1c test results within the appropriate range was positively associated with the proportion of long-term hospitalized patients. Conclusion: The present study results provide fundamental data for the establishment of policies for long-term care hospitals. Based on this study, it is important to suggest screening methods for unnecessary long-term hospitalizations, such as sufficient medical personnel to improve the quality of care in long-term care hospitals. It is also necessary to clearly separate the roles of medical institutions and long-term care facilities and implement policies to support patients' social reintegration.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.3
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• pp.353-366
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• 2003

Purpose: This study was to define the care time of elderly in long-term care facilities and to compare and analysis the care time by staff and facility types. Method: The data were collected from 530 elderly over sixty, residing in two long-term care hospitals for dementia, three long-term care hospitals for the elderly and two skilled nursing facilities. Care time for individual residents was measured the total time spent by nurses, aides. Result: The average care time measured by nursing staff was 158.6 minutes a day. The average care time for one resident by nurse was 40.4 minutes, and by aides, 118.2 minutes. The difference of the care time showed statistical significance between long-term care facility types(p<0.001) : average care time for dementia hospital(199.1min) was twice as long as that of skilled nursing facility(94.1min). Conclusion: The results of the study showed that the care time differentiates care time provided to elderly in long-term care facilities in Korea. The study suggests the need to emphasize the importance of standardization of level of staff and service programs by the long-term facilities.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.4
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• pp.446-454
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• 2010

Purpose: This study was conducted to compare job satisfaction, self-esteem, and nursing task performance between registered nurses (RN) and nurse assistants (NA) in long-term care hospitals. Method: The sample consisted of 203 nursing personnel (RN 99 and AN 104), who were working in one of 5 long-term care hospitals in 5 different areas. Data were collected by structured questionnaires from March 15 to April 30, 2010, and analyzed using the descriptive statistics, independent t-test, One-way ANOVA, and Pearson correlation coefficients with SPSS/Win 17.0 program. Result: There was no significant difference between nurses and nurse assistants in job satisfaction and self-esteem. But nurses had higher levels of nursing task performance than nurse assistants. Conclusions: These findings demonstrate the necessity of developing programs that will help to improve job satisfaction and self-esteem in nurses and nursing task performance in nurse assistants. Strategies need to be developed to maximize the value of the existing workforce without impacting on the quality of care delivered.

• The Journal of the Convergence on Culture Technology
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• v.9 no.5
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• pp.185-192
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• 2023

Currently, the number of Long-Term Care Hospital in Korea is continuously increasing with the increase in the elderly population. Patients admitted to Long-Term Care Hospital are mainly elderly with chronic diseases, and because they are for long-term care, they often die in Long-Term Care Hospital, and the importance of end-of-life care is gradually increasing. In spite of these characteristics Studies on end-of-life care for nurses in Long-Term Care Hospital are mainly quantitative studies, and there is a limit to in-depth understanding of end-of-life care experiences. Therefore, The purpose of this study is to understand the meaning of Long-Term Care Hospital nurses' nursing experienceof end-of-life patients through a phenomenological method, and to describe and understand the meaning of the phenomenon in depth. The subjects of this study were 7 nurses who had worked for more than 6 months at a nursing hospital located in C city. The research method was in-depth interviews, and data were collected from December 2021 to March 2022. The interview date were analyzed by Giorgi's phenomenological method. As a result of the study, 'nurses' attitude toward end-of-life care', 'ambivalence toward life prolongation', 'reality of end-of-life care in Long-Term Care Hospital', and 'reflection on life and death' were found. Therefore, it is thought that End-of-life nursing Continuing educationand interventional education programs should be developed to change Long-Term Care Hospital nurses' end-of-life care attitudes and improve coping skills.

• Journal of Korean Academy of Nursing Administration
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• v.18 no.2
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• pp.176-188
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• 2012

Purpose: The purpose of this study was to examine nurses' cognition of the diagnosis related group (DRG) in long-term care hospitals and changes in nursing care after application of the DRG system. Method: This study was a descriptive survey involving 161 nurses working in 12 long-term care hospitals located in Gwangju city and Chonnam area. Data were analyzed using the SPSS 18.0 version program. Data analyses utilized descriptive test, chi-square test, Fisher's exact probability test, t-test, and one-way ANOVA. Result: There was no change in cognition of DRG in 55.3% of the nurses, and 26.1% takes to 'change positively'. More than half of the respondents (57.8%) agreed to the application of DRG. After application of DRG, the nurses responded 'there were changes in nursing care' in 23 of the 25 care items. Two items had an increase in nursing care. Conclusions: No distinct changes in nursing care were evident after DRG application. Therefore, there is need to provide education programs related to DRG for nurse in long-term care hospitals.

• 한국노년학
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• v.39 no.4
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• pp.903-920
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• 2019

This study was aimed to prepare the evidences for establishing policies on nursing manpower by identifying the relationship among delegation level of nursing activities, nursing professionalism and turnover intention in long-term care hospital nurses. The study was a descriptive survey research that used a structured questionnaire. 146 nurses agreed to take part in the research. They worked in six long-term care hospitals located in A and B province. Data were collected from July to August 2016 and analyzed through SPSS 20.0 program, using descriptive statistics, t-test, ANOVA and pearson's correlation coefficients. As a results, first, as for the delegation of nursing activities by long-term care hospital nurses, the levels of delegation of direct nursing activities were 34.63±14.12, and the level of delegation of indirect nursing activities were 1.71±1.75. Second, the mean score of nursing professionalism and the turnover intention of long-term care hospital nurses were 3.62±0.77 and 2.71±0.97, respectively. Third, the delegation of direct nursing activities by long-term care hospital nurses significantly differed depending on the number of nurses in the ward and the number of caregivers in the ward. The delegation of indirect nursing activities significantly differed depending on the number of nurses in the ward, the presence of conflicts and stress related to delegation. Forth, there was no significant correlation of the delegation of nursing activities by long-term care hospital nurses with nursing professionalism and with turnover intention. Most of nursing activities, were delegated to nurse aids, since there were no clear guidelines or legal procedures on nursing activities in long-term care hospital nurses. Therefore it is required to find how to clearly establish positive nursing professionalism and to develop a proper nursing manpower arrangement and the guidelines for the delegation of nursing activities in a long-term care hospital in terms of policy.