• Title/Summary/Keyword: Nursing cost

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Development of a Critical Pathway for the Chemotherapy of Non-small Cell Lung Cancer Patients and Its Effects (비소세포성 폐암 환자의 항암화학요법을 위한 Critical Pathway개발과 적용효과)

  • Choe, Ja-Yun;Jang, Geum-Seong;Choe, Eun-Yeong
    • Journal of Korean Academy of Nursing Administration
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    • v.8 no.1
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    • pp.85-95
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    • 2002
  • The purpose of this study was to develope a critical pathway for the chemotherapy of non-small cell lung cancer patients and to identify its effects after implementation. Critical pathway was developed through 5 steps including content and clinical validity tests with collaborative efforts of nurses, clinicians, and other allied healthcare professionals with the aim of improving the quality of patient care, while minimizing cost to the patients. This paper was described an evaluation of the impact of a developed critical pathway on complication rate, length of stay, costs, the interval of treatment and patient satisfaction by nonequivalent control group posttest-only non-synchronized research design.Results were compared between the two groups of patients. There were no significant differences in demographic variables and the occurrence of bone marrow suppression between experimental group and control group(t=-0.01, p=0.992). There were statistically significant decreases in the average length of stay(t=-10.45, p=0.000), in the average cost(t=-2.988, p=0.004), and in the interval of treatment(t=-6.75, p=0.000) after implementation of the critical pathway compared to control group. Also, there was a statistically significant improvement of the patient satisfaction after implementation of the critical pathway compared to control group(t=4.57, p=0.000). This paper concludes that critical pathway in chemotherapy for lung cancer, implemented in the context of an general hospital, is the useful tool to shorten the hospital stay, reduce treatment costs, and improve the quality of life in cancer patients. Further study needs to be conducted to identify other clinical outcomes including job satisfaction, collaboration among health professionals and potential for use in education. Also, it is recommended that nurses should revise continuously the developed critical pathway through clinical implementation and maintain their role of patient advocacy through monitoring pathway compliance.

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Stress and Emotional Status of Patients Undergone Hematopoietic Stem Cell Transplantation and Their Families (조혈모세포이식 환자와 가족의 스트레스와 정서 상태에 대한 연구)

  • Kang, Hye-Ryeong;Hong, Yun-Jin;Hwang, Kyung-A;Park, Mi-Ra;Chun, Sung-Sook;Lim, Nan-Young
    • The Korean Journal of Rehabilitation Nursing
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    • v.7 no.2
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    • pp.115-126
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    • 2004
  • Purpose: This study was carried out to accumulate basic data for nursing intervention development by evaluating the stress and emotional status of patients and their families after receiving hematopoietic stem cell transplantation (HSCT), illucidating and analysing related factors in order to decrease the negative effects of HSCT on their emotion. Methods: Data were collected using a questionnaire to 53 HSCT patients and 50 families, who were older than 18 at tertiary-care institutions in Seoul, from January, 2000 to August, 2003. Results: There was a significant score difference in stress (t=-2.302, P<0.05). Correlation between stress and emotional status was statistically significant (r=0.486, P<0.01; r=0, P<0.05). Economical burden of cost had significant effects on stress of patients (F=4.194, P<0.05). The series of emotional status of patients without jobs were higher (T=-2.583, P<0.05). The emotional status of families were influenced by monthly income (F=4.036, P<0.05) and patients' diagnosis (F=3.088, P<0.05). Conclusion : These results suggest that the cares for families should be considered with great concern as well as the ones for patients. In addition, such factors as economical burden by medical cost, monthly income and job status should not be excluded in transplantation nursing plans.

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Development of Key Indicators for Nurses Performance Evaluation and Estimation of Their Weights for Management by Objectives (목표관리를 적용한 간호사 성과평가 핵심 지표개발과 가중치 산정)

  • Lee, Eun-Hwa;Ahn, Sung-Hee
    • Journal of Korean Academy of Nursing
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    • v.40 no.1
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    • pp.69-77
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    • 2010
  • This methodological research was designed to develop performance evaluation key indicators (PEKIs) for management by objectives (MBO) and to estimate their weights for hospital nurses. Methods: The PEKIs were developed by selecting preliminary indicators from a literature review, examining content validity and identifying their level of importance. Data were collected from November 14, 2007 to February 18, 2008. Data set for importance of indicators was obtained from 464 nurses and weights of PEKIs domain was from 453 nurses, who worked for at least 2 yr in one of three hospitals. Data were analyzed using $X^2$-test, factor analysis, and the Analytical Hierarchy Process. Results: Based upon Content Validity Index of .8 or above, 61 indicators were selected from the 100 preliminary indicators. Finally, 40 PEKIs were developed from the 61 indicators, and categorized into 10 domains. The highest weight of the 10 domains was customer satisfaction, which was followed by patient education, direct nursing care, profit increase, safety management, improvement of nursing quality, completeness of nursing records, enhancing competence of nurses, indirect nursing care, and cost reduction, in that order. Conclusion: PEKIs and their weights can be utilized for impartial evaluation and MBO for hospital nurses. Further research to verify PEKIs would lead to successful implementation of MBO.

Evaluation of Government Assisted Visiting Nursing Services of Health Center in 2000 (2000년 보건소 공공근로 방문간호사업 평가)

  • 고일선;김조자;이태화;이경자;김의숙;마희경;이영숙;박경민
    • Journal of Korean Academy of Nursing
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    • v.32 no.3
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    • pp.344-354
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    • 2002
  • This study is a fact-finding research to understand the status of visiting nursing services operated by health centers in Korea and it aims to provide basic information for policy development on operation and management of visiting nursing services in health centers. Method: This study investigates the results of visiting nursing services in 242 health centers from Jan. 10 through Dec. 30, 2000, where 3,106 visiting nurses were employed by the public work program. Result: In 2000, 129,401 new household as service recipients was identified and that was 0.9% of Koreas total households (15,137,000), and 5.8% of low income households (2,242,000). The highest high risk group was dementia patients(aver. 55.2/1,000 person). Average number of households visited by visiting nurse were 4.5 households per day and the first-visited houses per visiting nurse were 1.1 households per day. The re-visiting rate was 71.3%. Total 4,059,130 service items were provided and assessment ranked the highest with 33.7%. The satisfaction level of clients on the nurses was an average of 3.17 points in the scale of 4 and the nursing service was a 2.60 points in a scale of 3. Conclusion: Visiting nursing service should continue to provide comprehensive healthcare services in cost-effective ways while cooperating with others

Reviewing Articles Related to Recent Advances in Non-invasive Prenatal Testing and Nursing Implications (최신 비침습적 산전 유전 검사(NIPT)의 임상 적용과 간호학적 의미)

  • Jun, Myunghee;Shin, Gyeyoung;Hur, Myung Haeng;Choi, Kyung-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.19 no.4
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    • pp.675-683
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    • 2013
  • Purpose: Nineteen articles were analyzed to gather opinions and nursing implications about NIPT recently launched. Methods: Nineteen articles were selected from EBSCO (eBook business collection), Google Scholar, and two Korean academic d-bases with key words 'prenatal screening testing', 'prenatal genetic diagnostic testing', NIPT or 'cell free DNA (cfDNA)'. Authors developed a framework for analyzing the 19 articles including opinions and suggestions for future implications. Results: Eleven articles written by the first author affiliated with medicine or genetics, viewed NIPT as promising because of safety, accuracy, early detectability and cost effectiveness. Articles written by journalists or authors affiliated with history and ethics were concerned with the possible risk of ELSI (ethical, legal, social issues), erratic interpretation of test results, and lack of genetic counseling service. Conclusion: With consideration of Korean clinical, and legal circumstances, not only pregnant women and families but also health professionals must prepare for clinical NIPT implications including updating prenatal genetic testing, counseling services, protecting ELSI and amulticultural team approach.

Korean Critical Care Advanced Practice Nurses' Work Experience: A Focus Group Study (중환자전문간호사들의 실무경험: 포커스 그룹 연구)

  • Kim, Keum-Soon;Kim, Bok-Ja;Yi, Young-Hee;Kang, Ji-Yeon
    • Journal of Korean Critical Care Nursing
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    • v.4 no.2
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    • pp.1-14
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    • 2011
  • Purpose: This study was aimed to understand and describe the Korean critical care advanced practice nurses' work experience. Methods: Data was collected through 2 focus group interviews that were held in two different university hospitals in Seoul, Korea. All interviews were recorded and transcribed, and data were analysed using modified qualitative content analysis. Results: Ten themes were drawn from data analysis. They are "Various and complex tasks", "Excellency of advanced nursing practice", "Pressure and responsibility accompanied with pride", "Role identity confusion", "Role conflict", "Leaping and evolving role", "Gap between role and outcome evaluation", "Underestimated outcomes", "Where are my outcomes?" "Searching for outcomes: publicize the role". Conclusion: The results of this study help to understand the role of Korean critical care advanced practice nurses and to guide to outcome evaluation of their role effectiveness. Developing qualitative outcome indicators, cost-effectiveness ananlysis of Korean critical care advanced practice nurses' role, and accumulation of evidences through researches on outcome evaluation will be needed to successfully settle down advanced practice nursing in Korea.

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Development of ND (Doctor of Nursing) Program: Focused on the RN-BSN Students and Professors (간호학 전문대학원(ND: Doctor of Nursing) 프로그램 개발에 관한 연구 : RN-BSN과정의 학생과 교수를 중심으로)

  • Lee, Won-Hee;Kim, Cho-Ja;Cho, Won-Jung;Yoo, Ji-Soo;Lee, Eun-Hyun
    • The Journal of Korean Academic Society of Nursing Education
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    • v.6 no.1
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    • pp.77-91
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    • 2000
  • Recent changes in health problems as well as the health delivery system demand expanding nursing roles to improve quality care and at the same time provide cost-effective health services. Nursing leaders of the future will be expected to be excellent care givers who are well prepared as researchers and managers and administrators. The purpose of developing an ND program is to train nursing leaders for the future. The program objective are to demonstrate the role as 1) an advanced practitioner who will provide theory based practice 2) a researcher and manager The target population of the ND program is as follows : 1) Nurses with a BSN degree who are seeking to advance on the career ladder 2) Non-nursing BS, BA graduates who are seeking nursing as a second career 3) Transfer students who are mature and motived to be nursing leaders It is believed that the ND program would meet the diverse needs for potential students, for their role in nursing and the health delivery system and create a meaning and challenging position in the profession of nursing. A task force team was organized to develop the ND program and its activities are as follows; 1) Information on ND programs were collected from 3 universities and reviewed 2)An advanced education needs assessment was completed and it was found that 87.6% of the subjects responded positively about advanced degree work. 3) A tentative curriculum for an ND program was developed. It is a great challenge to develop a new program for nursing however, it is also our task and responsibility to further the development of nursing.

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A Study on Effectiveness of the Hospital-based Home Nursing Care of the Early Discharged Surgical Patients and its Cost Analysis (조기퇴원 수술환자의 병원중심 가정간호 효과 및 비용분석에 관한 연구)

  • 박경숙;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.545-556
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    • 1994
  • Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate Its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wound, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic enpenses, and food expenses. The results were as fellows. 1. On effectiveness of home nursing careThere were n significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5 P=0.001, #6 P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money Saved by it in a year Will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows : 1. For the welfare of patients and the increased rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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A Study on Middle-Aged People's Preparation for Old Age Life and Their Perception of Long-term Care Facilities (중년의 노후 생활준비도 및 요양시설 인식에 대한 연구)

  • Kim, Kwuy-Bun;Park, Min-Suk;Sok, So-Hyune R.
    • Research in Community and Public Health Nursing
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    • v.19 no.3
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    • pp.480-494
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    • 2008
  • Purpose: The study was to got basic data on the well-being of middle-aged people concerning their preparation for their upcoming old age and their quality of life. Methods: The subjects were 440 people aged between 40 and 59 living in Seoul and Gyeonggi-do. Results; First, Physical Preparation for old age was affected by religion, children, health, monthly income, and economical status, and these factors were shown statistically significant. Emotional preparation and spiritual Preparation were also related to the above-mentioned factors. Secondly, in the subjects' mental picture, a nursing home was a place for the aged without anyone who is going to take care of them and without abilities to care of themselves. Preference for nursing home was based on two factors. i.e., nursing and treatment care. and the cost was about one million won per month. Also they wanted that the government should pay a certain amount for private users. Conclusion: Therefore, people should lead a life of good health-related habits along with economical preparation for their old age.

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Economic Value of Platelet Glycoprotein IIb/IIIA Receptor Blocker (Abciximab) for Percutaneous Coronary Intervention (PCI시술시 혈소판 당단백 GP IIb/IIIA 억제제(Abciximab) 투여의 경제적 가치)

  • Kim, Jin-hyun;Shin, Sang-Jin;Kim, Eun-Ju;Lee, Young-Hee
    • YAKHAK HOEJI
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    • v.51 no.3
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    • pp.186-193
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    • 2007
  • This study was performed to analyse the economic value of abciximab which is used in PCI to prevent high-risk patients with ischemic complications. The effectiveness of abciximab was extracted from published clinical trials by search-ing CCIS, and the direct medical costs relevant to using abciximab were estimated from the NHI claims database. The results in terms of cost per life-year gained (LYG) and cost per QALY gained showed that abciximab was cost-effective enough to deserve its cost. Social net benefit resulting from abciximab in PCI was estimated to be 60-70 billion Won per year.