• Title/Summary/Keyword: Nursing care time

Search Result 1,038, Processing Time 0.025 seconds

Estimation of Home Care Nursing Cost to the Patient with Cerebrovascular Disease based on a Bundle of Home Care Nursing Service (뇌혈관질환 환자군의 가정간호 행위묶음 수가연구)

  • Hong, Jin-Ui;Yun, Soon-Nyoung
    • Journal of Korean Academic Society of Home Health Care Nursing
    • /
    • v.7 no.1
    • /
    • pp.26-38
    • /
    • 2000
  • The purpose of this study was to estimate home care nursing cost for the patient with Cerebrovascular Disease based on a bundle of home care nursing services This study was conducted through four steps. The first step was to investigate home care nursing activities that were offered to the patient with Cerebrovascular Disease(CD) by home care nurse. The second step was to investigate the time spent on home care nursing service and to calculate labor and manufacturing cost. The third step was to calculate home care nursing cost per minute. And at the fourth step, home care nursing cost for a patient with Cerebrovascular Disease based on a bundle of home care nursing service was calculated. The results of the study were as follows: 1) The number of direct home care nursing activities for the patient with CD was 108, and the time of each activity was spent from 1 to 10 minutes. 2) Average time per visit was 51 minute, and the firs visit time were spent 1.6 times higher than 2nd visit time. 3) Nursing cost per minute(cost per visit ${\\}\;22,565\;\div\;$ average time per visit 51 minutes) was ${\\}\;442$. The cost per visit was calculated on Basic visiting cost(nurse's labor cost ${\\}\;15,760$ + management cost ${\\}\;6,805$) divided by average time per visit(51 minutes). 4) Home care nursing cost to the patient with CD based on bundle of home care nursing service was consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit. and transportation fee. Basic home nursing cost(the time spent on basic home nursing service 20 minutes ${\times}$ nursing cost per minute ${\\}\;442$) was ${\\}\;8,840$. The cost of the bundle of home care nursing services to the patient with CD was calculated as self care ${\\}\;2.898$, Tracheostomy care ${\\}\;10,166$, immobility care ${\\}\;6,188$, sore care ${\\}\;6,188$. Foley care ${\\}\;6,630$, and Levin tube or Gastrostomy care ${\\}\;7.514$. Transportation fee which was composed of the labor cost for transportation(${\\}\;5,122$) and the car management cost(${\\}\;3.876$) was ${\\}\;8,998$. Home care nursing cost to the patient with CD based on bundle of home care nursing services consisted of basic home care nursing cost, the cost of a bundle of service practiced on visit, and transportation fee. It will contribute to improve quality of home care service, because of giving appreciate incentives to home care nurses. And it will be more efficient than current cost of hospital based home care. But it need to management than calculation of the current fee-for-services of home care.

  • PDF

A Time Study of Nursing Activities by Home Care Nurses for Non-Cancer Terminal Patients (가정전문간호사의 비암성 말기환자 간호행위 시간 분석)

  • Lee, Hanul;Lee, Jong-Eun
    • Journal of Korean Academic Society of Home Health Care Nursing
    • /
    • v.26 no.2
    • /
    • pp.180-188
    • /
    • 2019
  • Purpose: To investigate the duration of each nursing activity performed by home care nurses for non-cancer patients and the relationship between patients' palliative prognostic index (PPI) and duration of each nursing activity. Methods: Nursing activities performed for six non-cancer terminal patients were timed using a stopwatch, and 18 parameters were measured by visiting each patient thrice. The mean and standard deviations of duration for each category of nursing activities were computed. The relationship between category-specific duration of nursing activities and PPI was analyzed with Spearman's correlation and multiple regression analysis. Results: Among nursing activities, the highest greatest duration of time was spent on traffic time (11.91 min), followed by urinary catheter management (10.65 min) and insertion and management of nasogastric tube (9.03 min). In terms of nursing categories, after excluding movement time, the greatest duration of time was spent on excretion care (5.48 min), nutrition care (5.40 min), and medication (3.82 min). PPI correlated with hygiene care, excretion care, and patient and information management. Multiple regression analysis revealed that PPI increased with increasing duration of hygiene care. Conclusion: These study findings provide grounds for the increased nursing time of hygiene care for people reaching the end of life.

Nursing Time Use in a Newborn Intensive Care Unit (NICU) (신생아중환자실 간호사의 간호업무량 분석)

  • Jun, Eun-Kyoung
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.6 no.1
    • /
    • pp.55-81
    • /
    • 2000
  • This study examined nursing care in a Newborn Intensive Care Unit (NICU) by reviewing nursing activities for the newborns. Through direct observation, time used for nursing care according to the nursing activity, shift, day of the week, and position of the nurses was measured. This study was done on November 15, 21, 24, 1999 at a university medical center hospital and included eight nurses and 179 newborns as the study subjects. The data were collected from the medical records, and by using a nursing activity record for the NICU, and a nursing activity time record for the NICU. The first step in the data collection process was to develop a list of nursing activities which was done through a literature review, examination of medical affairs and duty records. Content validity was measured by a panel of three professors who were experienced clinicians. In the second step two pre-training sessions were held with three sophomore student nurses who then measured the time for each nursing activity using a stopwatch. The data were analyzed using frequencies for nursing activities, averages, percentages and ANOVA for differences between shift and between days of the week, and percentages and t-test for differences according to position of the nurse. The results are as follows: 1) The total number of activities was 156, direct or indirect nursing activities. Direct nursing activity classified according to physical, educational, emotional/social/economic/spiritual needs. There were 109 direct nursing activities in 16 fields. 2) The order of nursing activities, according to time required, was record keeping, nutritional care, measurement/observation, medication, hygiene care, examination and specimen collection, and checking supplies, and according to frequency, measurement/ examination, record keeping, nutrition care, hygiene care, elimination care and medication. 3) According to shift, direct care during the night shift at 313.4 minutes was the longest time and indirect nursing care during the night shift at 252.2 minutes was the highest time. 4) For days of the week, Monday had the highest time for direct care 275.8 minutes (34.6%) and Wednessday had the highest time for indirect nursing care 269.6 minutes (36.1%). 5) For nursing time according to position of nurse, general nurses had the highest for direct care (330.7 minutes), nurse managers for indirect nursing activities (239.0 minutes) and general nurses for individual private time (63.9 minutes). The results of this study show that the major nursing time consuming activities included record keeping, nutrition care and measurement/examination. For newborns, time needs to be allowed for care to be sensitive, sophisticated and specialized rather than concentrated on indirect nursing tasks such as record keeping. Therefore, it is imperative to develop computerized systems that support a systematic approach to record keeping which is more efficient. Moreover, nursing needs according to shift, day or position of nurse can be utilized in assessing nursing resources through a computerized process.

  • PDF

Estimation of Nursing Costs Based on Nurse Visit Time for Long-Term Care Services (노인장기요양 방문간호서비스의 소요시간별 방문당 원가 분석)

  • Kim, Eun-Kyung;Kim, Yun-Mi;Kim, Myung-Ae
    • Journal of Korean Academy of Nursing
    • /
    • v.40 no.3
    • /
    • pp.349-358
    • /
    • 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.

Impact of Computerization on Direct and Indirect Nursing Time (병원전산화에 따른 직접 및 간접간호 양상의 변화)

  • Hwang, Jee-In
    • Journal of East-West Nursing Research
    • /
    • v.11 no.1
    • /
    • pp.58-64
    • /
    • 2005
  • The purpose of this study was to examine impact of hospital computerization on the nursing practice. The study was conducted using the repeated measured design. The subjects were 166 nurses working at surgical nursing care units in a tertiary teaching hospital. A questionnaire was developed based on the Burke's study, and reviewed by a committee for content validity. Eighty-eight nurses responded the questionnaire throughout the study. Indirect nursing care time significantly decreased(p<0.05) after the computerization. These decrease related to time saving in checking physicians' order and writing nursing records. However, the change in direct nursing care time was not clear. In conclusion, the computerization led to the decrease in indirect nursing care time but it did not link to increase in direct nursing care time. Therefore, nurse managers should take into account redesign of the nursing works after computerization.

  • PDF

Care Time of Elderly in Long-Term Care Facilities (장기요양시설 노인에 대한 간호서비스 제공시간 분석)

  • Kim, Eun-Kyung
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.9 no.3
    • /
    • pp.353-366
    • /
    • 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.

  • PDF

Predictors of Nursing Service Need for Nursing Homes Residents (장기요양시설 노인의 기능상태에 따른 간호서비스 필요도 예측)

  • Lee, Tae-Wha;Cho, Soon-Yung;Jang, Yoon-Kyung
    • Journal of Korean Academy of Nursing
    • /
    • v.39 no.1
    • /
    • pp.95-106
    • /
    • 2009
  • Purpose: The purposes of this study were to explore the functional status of elderly residents and to analyze time use, and finally identify factors to predict nursing care needs in relation to functional status and health related variables. Methods: In this study a descriptive-correlational design was used. Functional status of participants was obtained through interviews, and nursing care time was examined using a 1 min time-motion study with a standardized instrument developed by Korea Long-Term Care Planning Committee (2005). Results: The mean total functional score was 65 (range 28-125) and mean total nursing care time was 144.15 min per day. There were significant positive relationships between total nursing care time, marital status, back pain, dementia, and vision impairment. Multiple regression analyses showed that a liner combination of number of illnesses, types of primary disease, ADL, IADL, cognitive function, nursing demand, and rehabilitation demand explained 42.8% of variance of total nursing time. ADL (${\beta}$=-.533) was the most significant predictor of nursing service need. Conclusion: Identifying factors that result in variations of service need has implications for adequate nursing service, estimation of optimum nurse to patient ratio, quality of care and patient safety.

Development of Staffing Levels for Nursing Personnel to Provide Inpatients with Integrated Nursing Care (간호·간병통합서비스 제공을 위한 간호인력 배치기준 개발)

  • Cho, Sung-Hyun;Song, Kyung Ja;Park, Ihn Sook;Kim, Yeon Hee;Kim, Mi Soon;Gong, Da Hyun;You, Sun Ju;Ju, Young-Su
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.23 no.2
    • /
    • pp.211-222
    • /
    • 2017
  • Purpose: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. Methods: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. Results: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. Conclusion: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

Perceptions of Spiritual Nursing Care Nurses and Nursing Students (간호사 및 간호학생의 영적간호 인지조사 연구)

  • 권혜진
    • Journal of Korean Academy of Nursing
    • /
    • v.19 no.3
    • /
    • pp.233-239
    • /
    • 1989
  • This study was designed to clarify how nurses and nursing students perceive their clients' needs for spiritual nursing care, it's practices, and problems. The purpose was to suggest directions for the development of spiritual nursing practice. The major findings are as follows : Respondents primarily perceived spiritual nursing as nursing care designd to help terminally ill patients accept death. Many of the respondents showed a high level of awareness of spiritual nursing care and its necessity. Few of them, however, bad actual experience in spiritual care. Those with experience in spiritual nursing care tend of take either a religious approach or perceived it as the therapeutic use of the self. The greatest problem related to the practice of spiritual care was found to be lack of time. Most of nurses and nursing students were found to be well aware of the needs for spiritual nursing care but were hindered from practising it because of the lack of time. To resolve the problem it was recommended that the scope of nursing practice be readjusted and that pre-and in-service programs should be developed to further heighten nursing students' interest in spiritual nursing care.

  • PDF

Determination of Cost and Measurement of nursing Care Hours for Hospice Patients Hospitalized in one University Hospital (일 대학병원 호스피스 병동 입원 환자의 간호활동시간 측정과 원가산정)

  • Kim, Kyeong-Uoon
    • Journal of Korean Academy of Nursing Administration
    • /
    • v.6 no.3
    • /
    • pp.389-404
    • /
    • 2000
  • This study was designed to determine the cost and measurement of nursing care hours for hospice patients hostpitalized in one university hospital. 314 inpatients in the hospice unit 11 nursing manpower were enrolled. Study was taken place in C University Hospital from 8th to 28th, Nov, 1999. Researcher and investigator did pilot study for selecting compatible hospice patient classification indicators. After modifying patient classification indicators and nursing care details for general ward, approved of content validity by specialist. Using hospice patient classification indicators and per 5 min continuing observation method, researcher and investigator recorded direct nursing care hours, indirect nursing care hours, and personnel time on hospice nursing care hours, and personnel time on hospice nursing care activities sheet. All of the patients were classified into Class I(mildly ill), Class II (moderately ill), Class III (acutely ill), and Class IV (critically ill) by patient classification system (PCS) which had been carefully developed to be suitable for the Korean hospice ward. And then the elements of the nursing care cost was investigated. Based on the data from an accounting section (Riccolo, 1988), nursing care hours per patient per day in each class and nursing care cost per patient per hour were multiplied. And then the mean of the nursing care cost per patient per day in each class was calculated. Using SAS, The number of patients in class and nursing activities in duty for nursing care hours were calculated the percent, the mean, the standard deviation respectively. According to the ANOVA and the $Scheff{\'{e}$ test, direct nursing care hours per patient per day for the each class were analyzed. The results of this study were summarized as follows : 1. Distribution of patient class : class IN(33.5%) was the largest class the rest were class II(26.1%) class III(22.6%), class I(17.8%). Nursing care requirements of the inpatients in hospice ward were greater than that of the inpatients in general ward. 2. Direct nursing care activities : Measurement ${\cdot}$ observation 41.7%, medication 16.6%, exercise ${\cdot}$ safety 12.5%, education ${\cdot}$ communication 7.2% etc. The mean hours of direct nursing care per patient per day per duty were needed ; 69.3 min for day duty, 64.7 min for evening duty, 88.2 min for night duty, 38.7 min for shift duty. The mean hours of direct nursing care of night duty was longer than that of the other duty. Direct nursing care hours per patient per day in each class were needed ; 3.1 hrs for class I, 3.9 hrs for class II, 4.7 hrs for class III, and 5.2 hrs for class IV. The mean hours of direct nursing care per patient per day without the PCS was 4.1 hours. The mean hours of direct nursing care per patient per day in class was increased significantly according to increasing nursing care requirements of the inpatients(F=49.04, p=.0001). The each class was significantly different(p<0.05). The mean hours of direct nursing care of several direct nursing care activities in each class were increased according to increasing nursing care requirements of the inpatients(p<0.05) ; class III and class IV for medication and education ${\cdot}$ communication, class I, class III and class IV for measurement ${\cdot}$ observation, class I, class II and class IV for elimination ${\cdot}$ irrigation, all of class for exercise ${\cdot}$ safety. 3. Indirect nursing care activities and personnel time : Recognization 24.2%, house keeping activity 22.7%, charting 17.2%, personnel time 11.8% etc. The mean hours of indirect nursing care and personnel time per nursing manpower was 4.7 hrs. The mean hours of indirect nursing care and personnel time per duty were 294.8 min for day duty, 212.3 min for evening duty, 387.9 min for night duty, 143.3 min for shift duty. The mean of indirect nursing care hours and personnel time of night duty was longer than that of the other duty. 4. The mean hours of indirect nursing care and personnel time per patient per day was 2.5 hrs. 5. The mean hours of nursing care per patient per day in each class were class I 5.6 hrs, class II 6.4 hrs, class III 7.2 hrs, class IV 7.7 hrs. 6. The elements of the nursing care cost were composed of 2,212 won for direct nursing care cost, 267 won for direct material cost and 307 won for indirect cost. Sum of the elements of the nursing care cost was 2,786 won. 7. The mean cost of the nursing care per patient per day in each class were 15,601.6 won for class I, 17,830.4 won for class II, 20,259.2 won for class III, 21,452.2 won for class IV. As above, using modified hospice patient classification indicators and nursing care activity details, many critical ill patients were hospitalized in the hospice unit and it reflected that the more nursing care requirements of the patients, the more direct nursing care hours. Emotional ${\cdot}$ spiritual care, pain ${\cdot}$ symptom control, terminal care, education ${\cdot}$ communication, narcotics management and delivery, attending funeral ceremony, the major nursing care activities, were also the independent hospice service. But it is not compensated by the present medical insurance system. Exercise ${\cdot}$ safety, elimination ${\cdot}$ irrigation needed more nursing care hours as equal to that of intensive care units. The present nursing management fee in the medical insurance system compensated only a part of nursing car service in hospice unit, which rewarded lower cost that that of nursing care.

  • PDF