• Title/Summary/Keyword: Nursing care/classification

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Development of home nursing care classification and home nursing care costs of the free-standing home nursing care agency (독립형 가정간호시범사업소의 가정간호행위분류체계 개발과 수가 연구)

  • Yun, Soon-Nyoung;Park, Jung-Ho;Kim, Mae-Ja;Hong, Kyung-Ja;Han, Kyung-Ja;Park, Sung-Ae;Hong, Jin-Eui
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.6
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    • pp.19-32
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    • 1999
  • The purpose of this study was to develop of home nursing care classification and home health care costs of the free-standing home nursing care agency. This study was done through 3 steps The First stage, home nursing care classification was identified and classified by literature, review-committee and expert meeting. The second stage, cost elements for home nursing care visit were identified and accounted. That were divided into direct nursing care cost, indirect nursing care cost, management cost and transportation cost. Third stage, total cost of per visit was produced. Data were collected from 810 visits of 120 patients received home dare and from January. 1999 to November, 1999, and analysed with EXCEL program. The obtained results are as follows : 1. Home nursing care classification was consisted of 6 high level classification domain and 10 low level classification domain and 163 home nursing care behavior. 2. The cost of home nursing care per visit was 30,638 won which were direct and indirect nursing care cost(16.305won), management cost(5,255won) and transportation cost (9,098won). In conclusion. Home nursing behavior care classification developed in this study would be used as home health care standard. And the home nursing care costs can be used as a fundamental data for the further development of home health care costs in Korea.

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A Descriptive Study for Nursing Care Cost According to the Level of Care Requirement (간호요구도에 따른 간호비용 실태에 관한 조사연구)

  • Song, Kyung Ja;Yoo, Cheong Suk;Kim, Eun Hye;Kim, Jin Hyun;Kim, Myung Ae
    • Journal of Korean Clinical Nursing Research
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    • v.18 no.2
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    • pp.183-195
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    • 2012
  • 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.

A Comparison of NANDA and CCC used in Hospital-based Home Health Care

  • Park, Hyeoun-Ae;Lee, Jin-Kyung;Lee, Hyun-Jung
    • 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.

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Evaluating Nursing Needs in the Neonatal Intensive Care Unit with the Korean Patient Classification System for Neonatal Intensive Care Nurses (한국형 신생아중환자간호 분류도구를 이용한 간호요구도 평가)

  • An, Hyo nam;Ahn, Sukhee
    • Journal of Korean Critical Care Nursing
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    • v.13 no.2
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    • pp.24-35
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    • 2020
  • Purpose : This study aimed to determine whether the Korean Patient Classification System for Neonatal Care Nurses (KPCSN) properly measures neonatal intensive care needs and to compare the scale's results with those of the Workload Management System for Critical Care Nurses (WMSCN). Methods : Data were collected from the medical records of 157 patients who were admitted to the NICU of a university hospital, in D city. Two types of patient classification systems were applied to investigate the total points and distributions to investigate the total points and distributions by categories and compare relationships and classification groups between two scales. Finally, the score distribution among the classification groups was analyzed when the KPCSN was applied. Results : Scores on the KPCSN for the feeding, monitoring, and measure categories were 19.16±15.40, 16.88±3.52, and 9.13±4.78, respectively. Classification group distribution of the KPCSN was as follows : 1.9% for the first group, 24.2% for the second group, 58% for the third group, and 15.9% for the fourth group. The classification group distribution of the WMSCN was as follows: 35.7% for the third group, 61.1% for the fourth group, and 3.2% for the fifth group. Finally, the scores by categories were analyzed according to KPCSN classification group, and the characteristics of the patients' nursing needs were identified for each classification group. Conclusion : Results of this study indicate that the KPCSN effectively measures feeding needs, which account for many nursing activities in neonatal intensive care. Comparisons between the KPCSN and WMSCN classification group scores and distribution ratios verified the correlation and significance of nursing requirements.

Development of Patient Classification System based on Nursing Intensity in Stroke Unit (뇌졸중 전문치료실의 간호강도에 근거한 환자분류도구 개발)

  • Kim, Eunjung;Kim, Heejung;Kim, Miyoung
    • Journal of Korean Academy of Nursing Administration
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    • v.20 no.5
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    • pp.545-557
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    • 2014
  • Purpose: The purpose of this study was to develop a patient classification system based on nursing care intensity for patients with acute stroke-related symptoms and verify its validity and reliability. Methods: Data were collected between November, 2013 and February, 2014. The verification for content validity of the patient classification system was conducted by a group of seven professionals. Both interrater reliability and concurrent validity were verified at stroke units in tertiary hospitals. Results: The intensive nursing care for acute stroke patients consisted of 14 classified domains and 56 classified contents by adding 'neurological assessment and observation' and 'respiratory care': 'hygiene', 'nutrition', 'elimination', 'mobility and exercise', 'education or counselling', 'emotional support', 'communication', 'treatment and examination', 'medication', 'assessment and observation', 'neurological assessment and observation', 'respiratory care', 'coordination between departments', and 'discharge or transfer care'. Each domain was classified into four levels such as Class I, Class II, Class III, and Class IV. Conclusion: The results show that this patient classification system has satisfactory validity for content and concurrent and verified reliability and can be used to accurately estimate the demand for nursing care for patients in stroke units.

A Study on the Validity Test of Patient Classification System for Optimal Nursing Manpower of Hospital in China (중국 일 종합병원에서 적정 간호인력 추정을 위한 환자분류체계의 타당성 검증)

  • Song, Young-Sun;Lee, Dong-Mei
    • Journal of Korean Academy of Nursing Administration
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    • v.11 no.2
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    • pp.209-218
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    • 2005
  • Purpose: This study was to setup the basis on hospital and national nursing manpower estimation accurately according to apply patient classification system of Song's study to China hospital system. Method: This study was surveyed to 964 patients at surgical and medical ward on Yanbian University Hospital in China from 17th to 31th January, 2005. Results: There was study results to test hypotheses for estimating optimal nursing manpower as follows. First, a trimodel classification scheme was developed which suggested three categories of patients as minimal care(category 1), moderate care(category 2), intensive care(category 3). Second, there was not significant difference with nursing time by sex. Third, there was not significant difference with nursing time by medical wards. Fourth, there was not significant difference with average nursing care time for each category of patients. Category 1 was estimated to spend average 19.59minutes for patients, Category 2 was about 35.68 minutes, Category 3 was 72.07minutes respectively. Total nursing hours was 62,610 minutes. Conclusion: Patient classification system of Song's study is validity for optimal nursing manpower of hospital in China.

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A Study on the Classification of ICU Patients by K-DRG and the Nursing Care Hours and Costs of Craniotomy Patients (중환자실에서의 K-DRG 분류와 개두술환자군의 간호시간과 간호원가연구)

  • Cho, Jung-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.4 no.1
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    • pp.229-246
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    • 1998
  • This dissertation classifies sample patients by a measure of K-DRG to identify the most frequent group. and investigates the differences in the dependency of nursing by patient classification system in the SICU of Seoul National University Hospital in Korea. It also calculates the mean nursing care hours and costs per craniotomy patient, who is shown to be the most frequent patient group. The results of the research can be used as basic data for the development of relevant nursing cost system in the future. The results of the research are as follows: 1. Using data from 97 sample patients, as many as 26 groups are identified when the patients are classified by K-DRG. KDRG-001 (craniotomy) is found to be the most frequent group(43.30%). 2. The result from patient classification system grouping in craniotomy patients shows homogeneity in terms of dependency of nursing with 35 patients in the 4th group, 145 patients(74.36%) are in the 5th group. and 15 patients are in the 6th group among the total 195 sample patients. 3. The direct nursing care hours for the 4th, 5th, and 6th patient classification system groups are found to be 381 minuites. 483 minuites, and 519 minuites, respectively, which shows that the nursing care hours increases as the dependency of nursing is intensified. The indirect nursing care hours are found to be 454 minuites(7.57 hours). The total mean nursing care hours, which is the sum of the direct nursing care hours(467 min.: 7.78 hours) and the indirect nursing care hours (454 min.: 7.57 hours), is 921 minuites(15.35 hours) per patient a day. 4. The nursing care cost is calculated to be 123,297 won per patient a day. Considering the average duration in the ICU, we can find the total nursing care cost is 610,318 won.

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The Trend and Prospect of the Nursing Intervention Classification (간호중재분류의 동향과 전망)

  • Park, Sung-Ae
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.3
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    • pp.75-85
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    • 1996
  • 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.

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Estimation of Nurse Staffing Based on Nursing Workload with Reference to a Patient Classification System for a Intensive Care Unit (중환자의 중증도에 따른 적정 간호인력 수요 산정)

  • Park, Young Sun;Song, Rhayun
    • Journal of Korean Critical Care Nursing
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    • v.10 no.1
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    • pp.1-12
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    • 2017
  • Purpose: This study aimed to estimate the appropriate nurse staffing ratio in intensive care units (ICUs) by measuring nursing workload based on patient's severity and needs, using the Korean Patient Classification System for critical care nurses. Methods: The data were collected from January 18 to February 29, 2016 using a standardized checklist by observation or self-report. During the study period, 723 patients were included to be categorized from I to IV using the patient classification system. Measurement of total nursing workload on a shift was calculated in terms of hours based on the time and motion method by using tools for surveying nursing activities. The nursing activities were categorized as direct nursing care, indirect nursing care, and personal time. Total of 127 cases were included in measuring direct nursing time and 18 nurses participated in measuring indirect and personal time. Data were analyzed using descriptive statistics. Results: Two patients were classified into Class I (11.1%), 5 into Class II (27.8%), 9 into Class III (50%), and two into Class IV (11.1%). The amount of direct nursing care required for Class IV (513.7 min) was significantly more than that required for Class I (135.4 min). Direct and indirect nursing care was provided more often during the day shift as compared to the evening or night shifts. These findings provided the rationale for determining the appropriate ratio for nursing staff per shift based on the nursing workload in each shift. Conclusions: An appropriate ratio of nurse staffing should be ensured in ICUs to re-arrange the workload of nurses to help them provide essential direct care for patients.

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Application of NANDA and HHCC to Classification of Nursing Diagnosis in a Hospital-Based Home Health Care (일개 종합병원중심 가정간호 간호진단분류를 위한 NANDA와 HHCC의 적용 비교)

  • Lee, Jin Kyung;Park, Hyeoun Ae
    • Korean Journal of Adult Nursing
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    • v.12 no.4
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    • pp.507-516
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    • 2000
  • This study examines that North American Nursing Diagnosis Association(NANDA) and Home Health Care Classification(HHCC) is appropriate to classify home health care client's nursing problems and suggests a modified nursing diagnosis classification system. Two hundred and forty-nine clients' records at a general hospital were reviewed and nursing problems were diagnosed according to each classification system. Results of this study are as follows. The major client's medical diagnosis are pregnancy, childbirth and puerperium, malignant neoplasm, and benign neoplasm. Of four hundred and sixty-three nursing problems, all nursing problems made a diagnos according to HHCC, while three hundred and eighty-five made a diagnosis according to NANDA. The HHCC diagnosis included 78 more nursing problems than NANDA. The discrepancy in the results may indicate a significant advantage to HHCC diagnosis because HHCC nomenclature was created empirically from hard data. However, this may be due to limitations in the data collection method so determination of which classification system is more useful is difficult to judge. However, nursing components of the HHCC are more concrete and clearer than human response patterns of the NANDA. Also the HHCC facilitates the documentation of patient care by computer, while using a conceptual framework consisting of 20 Care Components based on the nursing process: assessment, diagnosis, outcome identification, planning, implementation and evaluation. Accordingly, the practical application of HHCC is more useful than NANDA. Limitations of this study include a retrospective data collecting method and universality of samples. Further research for various samples that use prospective data collection method is recommended.

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