• Journal of Korean Academy of Nursing
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• v.20 no.3
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• pp.368-380
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• 1990

A central issue in the development of nursing practice is to describe the phenomenon with which nursing is concerned. To identify the health problems which can be diagnosed and managed by the nurse is the first step to organize and ensure the development of nursing science. Therefore the academic world has been discussing the application of the nursing diagnosis in nursing practice as a means of improving quality of care. The objectives of this study were to develop a standardized nursing care plan for ten selected nursing diagnoses to form a database for computerized nursing service. The research approach used in the study was (1) the selection of the ten nursing diagnoses which occur most frequently on medical-surgical wards, (2) the development of a standardized nursing care plan for the ten selected nursing diagnoses, (3) application of the plan to hospitalize patients and evaluation of the content validity by the nurses, and (4) evaluation of the clinical effects after the use of the standardized nursing care plans. The subjects were 56 nurses and 395 hospitalized patients on two medical and two surgical unit. The results of this study were as follows ; 1) The ten selected nursing diagnoses for the development of the standardized nursing care plans were “PAIN, SLEEP DISTURBANCE, ALTERED HEALTH MAINTENANCE, ALTERATION IN NUTRITION, ANXIETY, CONSTIPATION, ALTERED PATTERNS OF URINARY ELIMINATION, DISTURBANCE IN BODY IMAGE, POTENTIAL FOR ACTIVITY INTOLERANCE AND ACTIVITY INTOLERANCE”. 2. The developed standardized nursing care plans included the nursing diagnosis, definition, defining characteristics, etiologic or related factors that contribute to the condition, recording pattern, desired outcomes and nursing orders (nursing interventions). 3. The plan was used with hospitalized patients on medical - surgical wards to test for content validity. The patient's satisfaction with the nursing care and nurses' job satisfaction were investigated to evaluate the clinical effects after the use of the standardized nursing care plans. A comparison of patient satisfaction with nursing care before and after the introduction of the standardized nursing care plans showed a statistically significant higher level of satisfaction with the standardized care plans. There was no difference in the level of job satisfaction expressed by the nursing staff before and after the standardized nursing care plans were introduced. However, when opinions about the use of the standardized nursing care plans were examined it was found that there was a positive effect on clarity in defining the nursing problems, determining nursing cost, more feasible goal setting, effective and systematic nursing records and indications for nursing research. The results of this study suggest that in order to increase the use of nursing diagnoses in the clinical area, it would be effective to select some wards as a pilot project, give the nurses training in the use of nursing diagnosis and develop and use the standardized nursing care plans. In addition to the ten diagnosis used in this study it is recommended that continual development of nursing diagnoses be done using diagnoses that are appropriate to Korea and testing them for validity through standardized care plans.

• Journal of Korean Academy of Nursing Administration
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• v.4 no.2
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• pp.351-361
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• 1998

The purpose of this study was to explore whether there is a point within the range of physical impairment after which the cost of home care exceeds the cost of nursing home care among the elderly who require long-term care. The provision of long-term care for the elderly is a major health policy issue, in part due to the aging of the American population and dramatic increase in health care costs. The framework for this study was guided by Pollak's(1973)model of costs of alternative care settings for the elderly. This study used a retrospective, descriptive correlational design. Physical impairment was measured by the modified Index of Activities of Daily Living(Katz et al. 1963). Cost of care was measured by the average cost per patient per day. The sample for this study included 67 patients receiving long-term care at home from the Long-term Home Health Care Programs (LTHHCPs) and 67 patients receiving long-term care in nursing homes. Data were collected on patient characteristics. including activities of daily living and cognitive impairment. and on the number of physician visits. emergency room visits. and hospitalization from the patient records. For each patient. Medicaid cost data for home care services/or nursing home services were collected from the financial department of each home care agency or nursing home. The living costs and informal care costs were estimated for home care patients. The results indicated that the home care sample and the nursing home sample were similar in terms of gender. ethnic background. and marital status. The elderly patients in the home care sample were: however. younger and less physically impaired than those in the nursing home sample. The hypotheses of this study were supported: For elderly persons with physical impairment scores below 12(possible range of 0 to 14), cost of care was lower in home care than in the nursing home care setting. However, for elderly persons with physical impairment scores above 12. the cost of care was higher in home care than in the nursing home care setting. Thus. in this sample for elderly patients with extreme physical impairment, the cost of home care exceeded the cost of nursing home care.

• Perspectives in Nursing Science
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• v.5 no.1
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• pp.1-15
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• 2008

Background: Recent changes in the medical environment have increased the need for the home health care nursing in Korea. Even though the number of home health care patients is increasing, the major nursing problems have not been identified due to lack of a standardized nursing diagnosis. Aim: An investigative study was conducted to determine the frequency and appropriateness of nursing problems in hospital-based home health care patients in Korea using two internationally standardized nursing diagnosis classification systems. Methods: Nursing records of 249 hospital-based home health care patients were reviewed and nursing problems were identified using the North American Nursing Diagnosis Association Nursing Diagnosis Taxonomy I (NANDA) and the Clinical Care Classification of Nursing Diagnoses (CCC). Findings: Out of 463 nursing problems. 403 nursing problems were described using the NANDA whereas 427 nursing problems were described using the CCC. Nursing diagnoses not captured by the NANDA classification include nausea/vomiting, anorexia, risk for nutrition deficit, decreased blood pressure, dying process, blood sugar impairment. infection unspecified, and disuse syndrome. Nursing diagnoses not captured by the CCC include nausea/vomiting and anorexia. Conclusions: In describing nursing problems of home health care patients, it was found that the CCC was able to represent more diagnoses than the NANDA.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.24 no.2
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• pp.181-188
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• 2017

Purpose: The aim of this study was to compare between performance and requirements of visiting nursing care in long-term care insurance using the OMAHA system. Methods: The subjects were 72 nurses who had worked in a visiting nursing care center in long-term care insurance. Data were collected from December 5, 2016 to January 31, 2017 using self-recorded questionnaires. The collected data were analyzed using descriptive statistics and paired t-tests. Results: Four dimensions of the OMAHA system showed statistically significant differences between performance and requirements of visiting nursing care in long-term care insurance. The requirements of visiting nursing care were higher than was performance on all 40 items of the OMAHA system. The greatest difference was in environmental domain and then the psychosocial domain. Conclusion: Based on the results, we found that the environmental and psychosocial domains were the largest gap areas. Therefore, with the reality of elderly people living alone and the increase in elderly couples, active intervention connected with the community is needed in residential areas. Further, we suggest that the OMAHA system can be utilized as an integrated conceptual framework for developing and enhancing visiting nursing care in long-term care insurance.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.8 no.3
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• pp.402-415
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• 2001

The purpose of this study was to identify nursing diagnoses and nursing interventions that are found in the home health care patients, and to establish a basis for a standardized Nursing Intervention List that would help nurses doing home health care nursing. For this study, the records of 150 home health care clients who were discharged, from the Home Health Care Center at Yonsei Medical Center, between January to July. 2001 were analyzed. Of the 43 nursing diagnoses recorded for these clients are 43, the most frequent diagnoses were in the area of Exchanging. There were 2.814 nursing interventions which is a mean of 4.73 nursing interventions Per diagnosis. We confirmed that most of the interventions were related to 'education' and 'advice'. We present a Home Health Care Nursing Intervention List that was developed based on the results of this study. It has the five 5 criteria of the ICNP classification, Observing, Management, Performance, Caring, and Informing.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.8 no.1
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• pp.62-73
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• 2001

This study was conducted to develop a home care nursing management system based on the validated and useful data base found through literature review. The contents and structure according to a development procedure for a computer system were as follows. 1. A data base on home care nursing patients was accumulated by putting data respectively in both steps and fields - from selection criteria. basic information. prescription. plan of home visits. to application of nursing process. 2. Accumulated data was classified and designed to search by basic information. drug/injection prescription. examination prescription, treatment prescription. supply. and a record of the nursing process. 3. Various forms of retrieval including graphs were elaborated in terms of diagnosis and intervention aspects.

• Korean Journal of Adult Nursing
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• v.20 no.6
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• pp.960-972
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• 2008

Purpose: The purpose of this study was to validate the nursing intervention standards of home care to home care setting for a guide in giving quality care to home hospice patients. Methods: The developed nursing standards were applied to 79 home hospice patients at K hospital, C university. Data were collected through the developed nursing intervention standards of home care with 19 selected nursing interventions and 418 associated nursing activities from January to June in 2006. Results: The performance frequency was 509 times for total nursing interventions and 7,815 times for total associated nursing activities. The most frequently used nursing activity was 722 times(9.24%) on teaching prescribed medication, followed by surveillance(718 times, 9.18%), and vital signs & neurologic monitoring nursing intervention(701 times, 8.97%). The highest mean nursing activity performance rate showed on Intravenous therapy(82%), followed by dying care(81%), and vital signs & neurologic monitoring (80%). Among 418 nursing activities, there were three classifications: 168 as core activities, 165 as major, and 85 as accessory activities. Conclusion: The final validated nursing intervention standards can guide home care nurses to perform quality care and contribute to computerized nursing services and request of nursing fees.

• The Journal of Korean Academic Society of Nursing Education
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• v.4 no.2
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• pp.249-263
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• 1998

The competence of newly graduated nurses is based on various clinical expriences gained when they were students. Therefore, instructors of nursing students, professors in nursing schools or directors in hospitals must play a critical role in assisting them to obtain various knowledge and experienced nursing skills. The purpose of this study was to investigate nursing care activities and nursing care hours practiced by nursing students in a general hospital. The subject students were total 214 nursing students, 2nd graders(sophomores) and 3rd graders(juniors) from 5 Junior Nursing Colleges in Seoul and they practiced at S general hospital to gain clinical experience. The data were collected for 4 days. The tools for this study were the direct nursing care activity list consisted of 15 nursing areas and the indirect nursing care activity list consisted of 9 nursing areas. The subject students were supposed to record their own score. The results of this study are ; 1. The nursing care hours per nursing student 1) The average total nursing care hours a day per each nursing student are 362.65 mins(6.04hr), the direct nursing care hours per each nursing stuent are 202.09 mins(direct nursing care rate 56.0%) and it is higher than the indirect nursing care hours, 159.75mins(indirect nursing care rate 44.0%). The direct nursing care rate of each student by a team approach in the evening shift(56.3%) is higher than that in the day shift(55.8%). 2) The hours of checking vital signs are the longest(47.35mins) among the direct nursing care activites and next is in order of counseling 8l emotional support, nurse rounds, and accompaning a patient during examination. The hours of reporting are the longest(32.39mins) among the indirect nursing care activites, and next is the activities related to education such as reviewing chart, looking up references, etc. 3) The freqency of checking vital signs practiced by nursing student is the highest(the average of 55.7 times) among the direct nursing care activities and next is in order of nurse rounds, assistance of feeding, and counseling & emotional support. The required time for nursing students to accompany their patient during examination is the longest(20.7mins) and next are in order of restriction on patient' activity, orientated by a head nurse, skin care, sitz bath, bathing & hair shampoo, and assisting with patients' exercise. 2. The nursing care hours per grader 1) The average hours of total nursing care per a nursing student are 369.2mins(6.2hrs) to 2nd graders, 355.9mins(5.9 hrs) to third graders. The direct nursing care rate per each nursing student to 3rd graders(59.3%) was higher than that to End graders(52.8%). 2) For 2nd graders, the highly marked nursing activities are teaching associated with direct nursing care activities such as drawing up papers, looking up references, reviewing charts, and being orientated by staff nurses. For 3rd graders, measurments, observations, and nurse rounds in indirect nursing care activities are taken highly 3) The most frequent practice of the nursing care activites is checking vital signs : 65 times to 3rd graders and 46.5 times to 2nd graders. Our suggestions based on the results of this study are : 1. It is recommanded to repeat the same designed study in a variety of clinical fields for further study. 2. It is recommanded to collect data not by self-record method but by observated method. 3. It is needed for nursing instructors in Nursing Schools and in hospitals to develop the guidelines and check-list of clinical practice courses.

• The Korean Journal of Emergency Medical Services
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• v.13 no.1
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• pp.73-85
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• 2009

Purpose : The purpose of this study was to analyze the nursing care needs which can properly cope with patients' needs in emergency room, and grasp the patients' satisfaction level which can assess the care quality. It was aimed to check the level of today's care and provide basic data for care performance and care standard. Method : Data were collected from 192 patients in general hospitals in Daegu. The results are as followed. Results : First, the result of analysis conducted on the degree of overall patients' need for nursing care revealed that the need for nursing information (4.21+57) was the highest, followed by the order of information of patient's condition (4.05+53), emotional support (3.98+47), and nursing participation (3.65+54). Secondly, our study revealed that there was a significant negative correlat interrelation between care need and care satisfaction (r=.516, p<.01), indicating the higher the overall emergency room patients' nursing care need, treatment and nursing information, patient's condition, emotional support and nursing participation were, the lower the actual feeling of their satisfaction turned out. Conclusion : The study shows that treatment and nursing related information is the most highly needed and the patients' satisfaction level relies on actual care participation.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.29 no.1
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• pp.5-17
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• 2022

Purpose: This study aimed to investigate the role of hospital-based home health nursing in community care by examining the institutional progress of hospital-based home health nursing and the current status of home health nursing in Korea. Methods: Korean research data, national statistical data, government press releases, and related laws were investigated to clarify the role of hospital-based home health nursing in community care. Results: Korean visiting medical care services, including hospital-based home health nursing, was not found to be sufficient nationwide. The supply of home health nursing did not increase due to the nature of the visiting services that required transportation time, poor profitability due to insufficient insurance fees, and increase in acute beds. Conclusion: The nature of the Korean medical environment and visiting medical care makes it challenging to establish a visiting medical supply system for community care. Therefore, hospital-based home health nursing is an important infrastructure for visiting medical care, and will be a valuable resource to link discharged patients returning to the community when moving health care services. Hence, laws and institutional supplementation to expand the role of home health nursing agencies nationwide are needed along with addressing the limitations in the supply of home health nurses.