Song, Kyung Ja;Kim, Eun Hye;Yoo, Cheong Suk;Park, Hyeoun Ae;Song, Mal Soon;Park, Kwang Ok
Journal of Korean Clinical Nursing Research
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v.16
no.2
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pp.127-140
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2010
Purpose: This study was performed to verify reliability and validity of Korean Patient Classification System for nurses(KPCS-1), to estimate nursing time conversion index, and to classify patients into groups according to KPCS-1 scores. Methods: KPCS-1 was revised from KPCS by a professional review team. Interrater reliability and construct validity of KPCS-1 were verified by data from 433 patients. Direct and indirect nursing time of 204 patients were measured by stopwatch observation and self reports for 24 hours. Nursing time conversion index was calculated. Results: KPCS-1 consisted of 12 area, 50 nursing activities, and 73 items. The interrater reliability was tested between two nurse group (r=.88, p<.001) and construct validity was verified according to medical department (F=10.97, p<.001) and patient pattern (F=5.54, p=.001). The correlation of nursing time and classification score was also statistically significant (r=.56, p<.001). The nursing time conversion index was 9.03 minutes per 1 classification score. The patients were classified into 4 groups by the classification scores. Conclusion: KPCS-1 can be a useful factor type patient classification system for general ward. Further study is needed to evaluate validity and reliability for refining KPCS-1 and to develop ways connecting the scores with nursing outcomes.
For the purpose of integrating nursing diagnosis into the nursing curriculum, a descriptive survey research was done using the inductive method with questionnaires and a literature review. Research subjects included nurse educators, textbooks of adult nursing published in Korea, and the course outline for adult nursing used in one college of nursing. The Results show that there was common agreement on 39 nursing diagnosis which should be in cluded in the adult nursing curriculum, textbooks of adult nursing, and patient care on the medical-surgical units. The two existing nursing diagnosis classification systems(NANDA and Gordon's Human Response Patterns) show different basic frameworks and difficulties were discovered in integration of nursing diagnosis into the curriculum. To develop a conceptual framework for a nursing diagnosis classification system, diagnosis were classified into three categories ; health promotion, high risk problem, and actual problem on the basis of the framework used in adult nursing textbooks and Gordon's 11 Functional Health Patterns. Subconcepts for actual problems were classified as ; activity and rest, nutrition and elimination, perception and coordination, stress and coping. Progress in this study supports further development of a conceptual framework of nursing based on a nursing diagnosis classification system, from which improvement in nursing education and clinical practice can be expected.
Nursing Intervention Classification(NIC) includes the 433 intervention lists to standardize the nursing language. Efforts to standardize and classify nursing care are important because they make explicit what has previously been implicit, assumed and unknown. NIC is a standardized language of both nurse-initiated and physician-initiated nursing treatments. Each of the 433 interventions has a label, definition and set of activities that a nurse does to carry it out. It defines the interventions performed by all nurses no matter what their setting or specialty. Principles of label, definition and activity construction were established so there is consistency across the classification. NIC was developed for following reasons; 1. Standandization of the nomen clature of nursing treatments. 2. Expansion of nursing knowledge about the links between diagnoses, treatments and outcomes. 3. Devlopment of nursing and health care information systems. 4. Teaching decision making to nursing students. 5. Determination of the costs of service provided by nurses. 6. Planning for resources needed in nursing practice settings. 7. Language to communicate the unigue function of nursing. 8. Articulation with the classification systems of other health care providers. The process of NIC development ; 1. Develop implement and evaluate an expert review process to evaluate feedback on specific interventions in NIC and to refine the interventions and classification as feedback indicates. 2. Define and validate indirect care interventions. 3. Refine, validate and publish the taxonomic grouping for the interventions. 4. Translate the classification into a coding system that can be used for computerization for articulation with other classifications and for reimbursement. 5. Construct an electronic version of NIC to help agencies in corporate the classifiaction into nursing information systems. 6. Implement and evaluate the use of the classification in a nursing information system in five different agencies. 7. Establish mechanisms to build nursing knowledge through the analysis of electronically retrievable clinical data. 8. Publish a second edition of the nursing interventions classification with taxonomic groupings and results of field testing. It is suggested that the following researches are needed to develp NIC in Korea. 1. To idenilfy the intervention lists in Korea. 2. Nursing resources to perform the nursing interventions. 3. Comparative study between Korea and U.S.A. on NIC. 4. Linkage among nursing diagnosis, nursing interventions and nursing outcomes. 5. Linkage between NIC and other health care information systems. 6. determine nursing costs on NIC.
Purpose: This study was performed to identify the variations of nursing care cost depending on nursing care requirement and calculate nursing care cost per one day and one care requirement point. Methods: Nursing care requirement was measured by classifying 3,855 patients according to KPCS-1(Korean Patient Classification System for nurses-1). Nursing care cost was calculated from personnel expenses and nursing care requirement. Nursing cost factors were identified by multiple regression analysis. Results: Average nursing cost per patient per day was 33,588 won, Average nursing care cost per 1 patient classification score was 3,558 won. The nursing cost per 1 patient classification score was different depending on the types and levels of the hospitals. The 4th patient classification group revealed the highest nursing care cost. Nursing cost factors included the number of beds in the hospitals, seniority, number of nurses and first grade in nurse personnel accreditation ($adj-R^2$ 74.0%. p<.05). Conclusion: Nursing care requirements expressed by patient classification scores don't directly correlate with nursing care cost. Further research is needed to evaluate validity and reliability for refining KPCS-1 and to apply variable criteria to nurse personnel accreditation.
Purpose: This study was performed to compare the costs of nursing interventions implemented for the obstetrical and gynecological patients using Korean Reimbursement System and ABC codes system developed in the US for costing out interventions performed by health care professional. Methods: First, the narrative data on nursing interventions were extracted from electronic medical record system of a tertiary university and mapped with Nursing Intervention Classification (NIC) by two researchers until 100% consent was reached. Narrative nursing interventions mapped with NIC were then remapped with ABC codes system using the electronic program developed in the research. The mapping data were analyzed with real numbers, frequency, percentage, mean, and standard deviation. Results: More nursing interventions were mapped with ABC codes than Korean reimbursement system. Total of 97 different types of narrative interventions could be mapped with NIC, 43 NIC interventions could be reimbursed by ABC code but only 16 NIC interventions were reimbursed by Korea Reimbursement System. Conclusion: Korean medical insurance fee system needs amendment to include more comprehensively interventions performed by nurses which are very important to patient outcomes. Further study is needed to develop strategies to costing out nursing interventions.
Journal of Korean Academy of Nursing Administration
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v.12
no.1
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pp.14-22
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2006
Purpose: The purpose of this study is developing the nursing information system which contains the core elements of nursing practice, the Nursing Minimum Data Set (NMDS) that should be collected and documented all the settings in which nursing care is provided. Method: The program was developed under the hospital information system by TCP/IP protocol and used NANDA, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC) to fill out the elements of NMDS. The Oracle was used as DBMS under the Windows 98 environment and Power Builder 5.0 was used as a program language. Results: This study developed linkage among the NANDA-NOC-NIC to facilitate choosing correct nursing diagnosis, interventions, and outcomes and stimulate nurses' critical thinking. Also the system developed includes nursing care sensitive patient outcomes, so nurses can actively involve in nursing effectiveness research by analyzing the data stored in the database or by making relational databases with other health care related databases. Conclusion: The program developed in this study ultimately can be used for the nursing research, policy development, reimbursement of nursing care, and calculating staffing and nursing skill mix by providing tool to describe and organize nursing practice and measure the nursing care effectiveness.
Journal of Korean Academy of Nursing Administration
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v.6
no.3
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pp.375-388
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2000
This study was attempted to help in explore new direction about Clinical Classification System of the pediatric patients visiting emergency center. Data were collected from 276 patients who visited emergency center of E University Hospital during 3 months period form March 1, to May 31, 1999. The results were as follows: 1. Distribution of pediatric patients according to Clinical Classification System, class I(59.9%) topped followed by class II(23.9%), class III(14.1%), class IV(2.0%). Average score of pediatric patients according to Clinical Classification System showed class I.00, class II .02, class III .05, class IV .07. and total mean score of items lowed averaged .01. 2. With the resepect to the Clinical Classification System according to the pediatric patients visiting emergency center, there were stastically significant difference in visiting time($x^2=27.839$, P=.023), experience of admission($x^2=11.365$, p=.010), disease classification($x^2=89.998$, p=.000), state of airway patency($x^2=18.781$, p=.000), consciousness level($x^2=59.774$, p=.000), period of symptom manifestation($x^2=34.112$, p=.000), pediatric patients protector's thinking about pediatric patients state($x^2=49.998$, p=.000), treatment outcome($x^2=72.278$, p=.000), duration of stay at emergency center($x^2=103.062$, p=.000). 3. There were significant correlation between the state of pediatric patients and Clinical Classification System(r=.530, p=.000).
Purpose: This study was performed to develop a valid and reliable Korean Patient Classification System for Neonatal care nurses (KPCSN). Methods: The study was conducted in tertiary and general hospitals with 1~2 grade according to nursing fee differentiation policy for NICU (neonatal intensive care unit) nurse staffing. The reliability was evaluated for the classification of 218 patients by 10 nurse managers and 56 staff nurses working in NICUs from 10 hospitals. To verify construct validity, 208 patients were classified and compared for the type of stay, gestational age, birth weight, and current body weight. Nursing time was measured by nurses, nurse managers, and nurse aids. For the calculation of conversion index (total nursing time divided by the KPCSN score), 426 patients were classified using the KPCSN. Data were collected from September 5 to October 28, 2015, and analyzed using t-test, ANOVA, intraclass correlation coefficient, and non-hierarchial cluster analysis. Results: The final KPCSN consisted of 11 nursing categories, 71 nursing activities and 111 criteria. The reliability of the KPCSN was r=.83 (p<.001). The construct validity was established. The KPCSN score was classified into four groups; group $1:{\leq}57points$, group 2: 58~80 points, group 3: 81~108 points, and group $4:{\geq}109points$ in the KPSCN score. The conversion index was calculated as 7.45 minutes/classification score. Conclusion: The KPCSN can be utilized to measure specific and complex nursing demands for infants receiving care in the NICUs.
Park, Hyeoun Ae;Cho, In Sook;Hwang, Jee In;Keun, Hyo Keun
Korean Journal of Adult Nursing
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v.12
no.2
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pp.256-266
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2000
The purpose of this study was to develop and test the validity of the standardized Korean nomenclature of Nursing Outcomes Classification (NOC), developed by Johnson & Maas at the University of Iowa. The four phases of the study were: (1) translation of the NOC into Korean by the research team, (2) four nursing professors and eight nurses with various clinical backgrounds reviewed each nomenclature taking into consideration definitions and nursing activities. The modified Delphi method was used to determine the most appropriate nomenclature for each term; (3) Twenty four academic and clinical experts in nursing were given a questionnaire to rate each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate; (4) the team determined the most appropriate Korean nomenclature for each class of the NOC. The mean validity score of 190 items was 4.54, but several nursing outcome had a score lower than 4.0. They included 'adherence behavior(3.3)', 'ambulation : walking(3.57)', 'transfer performance (3.57)', 'caregiving endurance potential(3.57)'.
Journal of Korean Academy of Nursing Administration
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v.8
no.3
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pp.475-488
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2002
Purpose : The purpose of this study is to establish a basis of patient classification in the ICU by selecting the determination critical indicator of special nursing activities that show high interrilation with daily total nursing care time. Method : This study is composed of the six steps. The first step is the listing direct nursing activities in the ICU. The last step is the determination indicator of each group were selected on the basis of their relationship to the daily total nursing care time of each patient classification group and each nursing activity. Result : Result shows that: 1. direct nursing activities in the ICU are 149 items of 13 territories. 2. the average time and frequency for each direct nursing activities 3. total direct nursing care time of 42 patients in ICU for 2 days. According to the results of the Cluster analysis, the first group is 10 people, the second group is 13 people, the third group is 16 people, the fourth group is 3 people. 4. Determination critical indicator is the item that is r>0.6(p<0.05) of Pearson Correlation between each patient daily total nursing care time and 149 items of nursing activities. The nursing activities selected were as follows: 2 items in the first group, 17 items in the second group. 16 items in the third group, 8 items in the fourth group. Conclusion : This study can help future studies which measure nursing activities standard time or assigns value to nursing activities time.
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