• 한국보건간호학회지
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• 제29권3호
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• pp.403-411
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• 2015

Due to lack of an information system regarding the status of using home-visit nursing (HVN), it has barriers of providing improvement of the HVN for management of elderly health care in Korea. The twofold aims of the current review are to expose the existing agendas for HVN and to suggest the political implications for HVN of Korea based on the transition process and revised HVN system of Japan. This review suggests that an information evaluation system has to precede for HVN services in detail. And, the service provided per manpower should be assessed by separating the code of manpower (registered nurse, nurse aide, dental hygienist) as well as securing detailed and precise information on the HVN services. The other suggestion, development of a community-based home health care nursing model in order to provide necessary services for long-term health insurance beneficiaries. In addition, a master plan for health care for elderly should be established at the national level in order to establish an effective home health nursing delivery system.

• 여성건강간호학회지
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• 제8권3호
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• pp.402-411
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• 2002

Purpose: The objective of this study was to identify the effectiveness of continued breast feeding and maternal identity between rooming-in and not rooming-in groups of mothers in post partum care. Method: The subjects were selected by convenient sampling, with 95 women in childbirth completing a questionnaire. The data were collected on the 2nd day after delivery by questionnaire, and after the 4th and 8th weeks by telephone interview. Measures used in this study included general characteristics, breast feeding related characteristics, and the maternal identity scale revised by Koh(1996). The data were analyzed with the SPSS program, and the Chi-test and t-test were used to identify the effect on breast feeding and maternal identity. Results: Continued breast feeding up to 4 weeks after deliverly was not statistically significant between rooming-in and not rooming-in group, but beyond 8 weeks of deliverly, it was significantly different in rooming-in group(p<.01). Maternal identity was significantly higher in rooming-in group than in not rooming-in group(<.01). Conclusion: Mothers preferred rooming-in system because it helped breast feeding and baby care. Rooming-in system provides self confidence in taking care of baby, knowledge about breast feeding and stimulates early phase lactation. We recommend rooming-in system in hospitals to promote breast feeding and maternal identity. Nurses are encouraged to discuss prenatal breast feeding before delivery and rooming-in care should be planned individually for continuation of breast feeding and formation of maternal identity.

• Child Health Nursing Research
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• 제2권1호
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• pp.112-126
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• 1996

The purpose of this study was to investigate the current status of the need of telephone call and to identify the status of nursing intervention through telephone. Head nurses of the pediatric nursing unit and a nurse of pediatric outpatient clinic wrote down the telephone record of calls by parents of children discharged from hospital from 7 am to 3 pm during the period of March to June, 1995. Content of 120 telephone calls but for 26 calls with incomplete record among 146 calls were analyzed into frequency of general characteristics, needs and nursing intervention. The needs of telephone call were identified and classified into 11 areas and analyzed into frequency of detailed content by 11 areas. Nursing intervention was identified and classified into 10 categories, and analyzed into frequency of detailed content by 10 categories. The findings of this study were as follows ; The need of telephone call was identified with nutritional state, medication, vital signs, language retardation, personal hygiene, vaccination, administration procedure, physical symptoms, follow up care management and others. The most frequent needs were physical symptoms and vaccination. A kind of food among nutrition dose of drugs among medication, fever among vital signs, cough among physical symptoms, and content of vaccination among vaccination was the most frequent needs. Nursing intervention through telephone was identified with instruction, knowledge offer, information offer, judgement, solicitation, referral and instruction, referral, connection, reassurance, reservation, and regulation. Instruction, knowledge offer and information offer was the most frequent nursing intervention by telephone call. Instruction was about a visit to hospital, a visit to nearby clinic, instruction about symptoms,, instruction about nursing care procedure, retelephoning and vaccination. Knowledge offer was about vaccination, knowledge related to medication, and dental care. Information offer and judgement was about vaccination and medication. Referral and instruction delivery was about instruction delivery following consultation to doctor, visit to emergency room and a visit to hospital following consultation to doctor. These results suggest that telephone call intervention program should be established as a field of extended pediatric nursing role in health care delivery system for the children.

• 가정간호학회지
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• 제5권
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• pp.20-31
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• 1998

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of College of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. This study has been supported by the Korean Sience Foundation. We organized Committee of rules, and Clinical specialist consultant group for more efficient running of the home care center. In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operations, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases. We tried to overcome the limitations of hopital -based home care, and to provide more accessible, efficient, safe, and stable home care nursing. Therefore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system and assessment-intervention algorithm for various diseases for quality control and standardization. Also, we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses. As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for trasnsportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. And finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.

• 지역사회간호학회지
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• 제21권4호
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• pp.512-521
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• 2010

Purpose: The remarkable progress in information and communication technology has had a great effect on the healthcare delivery system. The development of smart phone applications is a new field. The aim of our research was to provide assistance in developing smart phone applications for community health nursing. Methods: Based on an informative approach, this study developed persona and site maps, followed by a storyboard as a way of analyzing users' requirements and designing responses in the context of smart phone application development methodology. Results: We developed persona, user interface and database design successfully, and then seven nurses selected four nursing problems (income, residence, pain, and digestion hydration). The search time in seconds for the 2005 English OMAHA guidelines to find three nursing interventions for these problems was used to evaluate the effectiveness of the smart phone application. The results showed that smart phone applications' search was 21 times faster on the average than book guidelines. Conclusion: An English version of the OMAHA system application was developed for the Android smart phone market. It is hoped that smart phone applications such as this will be used internationally for nursing education.

• 대한간호
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• 제15권4호통권84호
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• pp.12-14
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• 1976

• 지역사회간호학회지
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• 제9권1호
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• pp.163-180
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• 1998

The purpose of this study is to evaluate the community based home care service, and make reorientation for better service. The data was collected from the public health center, which was operated for one year, 1997. This case is evaluated and reoriented according to five elements of public health care system; system of resources for public health, organization and administration, health care delivery system of financing, management. In resources for public health, available health personnels are 15 physicians, 17 nurses, 11 nurse aides and 2 other persons. One professional health personnel take care of 609 clients, The equipments used for elderly and the disabled are 6 wheelchairs, 4 walkers, 1 hairwashers and 30 viberations. But these equipments are not enough to deal all clients. In organization and administration, planning and setting goals for community home care are made by the director, supervisor of family department and public health nurse. So there is no regular commitee for home care services in this community. The form of delivery of health care is focused on preventive health care. The important works of public health nurse are health education, preventive care for hypertension, D.M. and vaccination of communicable desease. In finaning system, funds come from central government(8.3%), local goverment(16.7%) and health center itself(3.8%), The services consist of health education, vaccination, clinical test and equipment. There are several local volunteers, which are local hospitals, a college, a christian association, a catholic association, a drivers association and a disabled association. The volunteer groups give physical and mental support to the clients. In management, this health center has three evaluation methods. One is done by local government, one is done by health center itself, and the other is done by clients with questionair. But the evaluation tools are deferent between agency. Home care services must be planned and evaluated. This public health center has to have more personnel, equipments, education for professional kowledge and meetings with community volunteer agencies.

• 대한간호
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• 제35권3호
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• pp.61-76
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• 1996

The purpose of this study was to develop a nursing care delivery system which can provide patient focused care and increase satisfaction for both patients and nurses. This study was a quasi-experimental study to test the effectiveness of direct / indirect nursing care hours, patient satisfaction, nurse's job satisfaction, and the difference of the length of stay between model and control group. Control group data were collected from 100 patients who had lumbar disease in the neuro-surgical unit and model group data were from 66 patients who didn't have family residents from August 21, 1995 to February 29, 1996. Model unit was operated by modified PPM(Professional Practical Model) system for 3 months from December 1, 1995 to February 29, 1996. Working committee empowered nurses to make a decision to provide increased opportunities for autonomy, accountability, and control over the environment in which they deliver care. Satisfaction survey was done twice and analyzed by the SPSS program. The results of the study were as follows; 1. Mean direct nursing care hours of the model group was 90.47 minutes as it was 28.04 in the control group which shows significant statistical difference (t=-18.0, P=0.000). 2. Patient satisfaction to nursing care of in the model group was significantly higher than the control group (t=-6. 77, P=0.000) and it apples to the all subcategories, too. 3. Nurse's job satisfaction shows the significant increase in the model group than the control group(Z=-3.0405, p=0.0024). 4. There was no statistical difference between 2 groups in average length of stay except for the post-op patient which shows 5.4 days less in the model group. This study shows that patient satisfaction and nurse's job satisfaction were increased and length of stay was decreased in the model group. Even though this new developed Patient - Nurse Oriented Model can provide nursing with the opportunity to improve patient care to increase productivity and highly valued, it is very difficult to practice due to the limited nursing resources, higher acuity levels and nursing care cost. It is strongly recommended that the government needs to look at the unreasonable reimbursement system and recognize the nursing care costs to the high acuity level patients. Otherwise, make the patient responsible for the nursing care cost so that we can provide more efficient and patient focused care.

• 간호행정학회지
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• 제8권2호
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• pp.309-321
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• 2002

Purpose: A cost analysis for nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing unit was performed using patient classification system by nursing intensity in order to determine an appropriate nursing fee schedule. Method: The data were collected from 4 secondary hospitals and 5 tertiary hospitals from November 14th 2000 to January 15th 2001. The study was conducted through four phases as follows: 1) Nursing hours of each nursing service in special nursing units were measured using three kinds of patient classification systems by nursing intensity. 2) The nursing cost of nursing services in operative nursing unit, emergency nursing unit, and ambulatory nursing units was estimated based on patient classification system by nursing intensity. Results: As a result, nursing hours by nursing intensity of each special nursing unit were measured, and every nursing cost by nursing intensity in operation room and emergency room was estimated, meanwhile, the cost of nursing services in ambulatory care units was estimated only per visit as shown in chapter 4. Conclusion: Future research on nursing cost should be extended to other special nursing units such as various intensive nursing care units, delivery room, and so on. In addition, the patient classification system should be refined for its appropriateness to apply all levels of medical institutions.

• 한국보건간호학회지
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• 제9권1호
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• pp.83-102
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• 1995

As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.