• Research in Community and Public Health Nursing
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• v.10 no.1
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• pp.80-92
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• 1999

The purpose of this study was to survey appropriateness of admission and days of care for the cerebral ischemia patients as a basis to provide an effectiveness of hospitalization. The authors retrospectively reviewed the medical records of cerebral ischemia patients in two hospitals from November 1997 to February 1998. Of 194 medical records reviewed, there were 2108 medical days. I t is used a 'Appropriateness Evaluation Protocol' previously developed by Gertman and Restuccia (1981) and translated by Department of Health Management, Seoul National University and Korea Institute for Health Services Management (1993), It was found that the 'Appropriateness Evaluation Protocol' had a high inter-rater reliability(k=.92), Statistical significant was tested by using the percentage, mean, and logistic regression by SAS 6.12. The results were as follows; 1. The appropriate admissions were 87.6%, days of care 63.4%, and the average length of stay $10.9{\pm}6.7$ days. 2. The reasons of inappropriate admissions were for work-up(75.0%) and conservative care (25.0%). Major reasons of inappropriate days of care were 'cases in which the medical purpose of hospitalization has been accomplish or can be addressed in a less setting(45.0%)', and 'cases in which there is a delay in performing the work-up or treatment which required patients is hospitalized (44.4%)'. 3. Appropriate days of care were higher as ageing. Appropriate days of care were higher in patients with lower accademic back ground than those of upper college graduates, and in the patients who enter a hospital via emergency room than out-patients department. Appropriate days of care were higher in the patient with MCA infarction, and lower in the patient with cerebellar infarction than the patient with lacunar infarction. Appropriate days of care were higher in attack first than attack above second, in nomortension patients than hypertensive, and lower in groups who engaged in semi-private room and public room than private room in hospital. Appropriate days of care were higher in shorter length of stay than longer length of stay. 4. Diagnosis, admission path, and appropriate days of care explained appropriate admissions. Diagnosis, appropriate admissions, hypertension explained appropriate days of care. According to the above results, author confirms the substantial amount of inappropriate hospital bed utilization. To reduce inappropriateness, it is necessary to develop some alternative services such as home care services or nursing home with which can be replaced inpatient services and to introduce policy such as case management which includes Critical Pathway for consistent management. And, it should be followed the further study for the effectiveness.

• Quality Improvement in Health Care
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• v.18 no.1
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• pp.1-14
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• 2012

Two years have passed since hospital accreditation was introduced in Korea by the Korean Institute of Healthcare Accreditation (KOIHA), which takes, as its mission, continuously improving healthcare quality and patient safety for the public. KOIHA also has a plan to impose on outcomes in management of patient care. With a view to enhance the practice of accreditation in terms of quality as well as quantity, and to help improve healthcare quality and patient safety in Korea, this paper reviews some issues on healthcare policies which are expected to be adopted in 2013 by the forthcoming government. A few suggestions are added.

• Quality Improvement in Health Care
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• v.25 no.1
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• pp.52-65
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• 2019

Purpose: Outbreaks resulting from medication injections have recently been on the rise in Korea despite various established guidelines. The objective of this study was to assess the degree to which healthcare professionals are aware of safe injection practice guidelines and to account for the adherence to and the deviation from safe injection guidelines formulated by healthcare providers. Methods: In November 2016, a cross-sectional anonymous questionnaire covering general characteristics of injections, patient safety culture, awareness of safe injection practices, and adherence to and barriers to safe injection guidelines was issued to healthcare providers who administer medication injections or manage and supervise these injections (N=550). Multivariate logistic regression analysis via enter method was performed to define the influencing factors of adherence of safe injection practices. Results: On average, respondents adhere to 17 of the 24 guidelines. Multivariate logistic regression found that those who were more likely to adhere to safe injection guidelines either underwent a patient safety training experience within the last year, provided care in a setting characterized by a highly developed patient safety culture, or were employed as physicians or nurses, as opposed to some other type of care provider. Barriers to safe injection guidelines were attributable to; thoughts of waste to discard leftover medicine, provisions that made adherence cumbersome, a weak culture of compliance, and insufficient amounts of injectable medicine, products, and education. Conclusions: The results of this study indicate that controllable factors like training experience of healthcare providers and patient safety culture were positively associated with adherence to safe injection practices. It was suggested that the training of healthcare providers on safe injection practices be a continuous process to promote patient safety. Additionally, there should be an increased focus on developing and implementing policies to improve patient safety culture from a prevention rather than post-management perspective.

• Research in Community and Public Health Nursing
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• v.11 no.1
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• pp.231-244
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• 2000

Parish nursing is a community health nursing role developed in 1983 by Lutheran Chaplain Granger Westberg. An increasing emphasis on holistic care, personal responsibility for a healthy lifestyle, and changes in healthcare delivery systems have undoubtedly facilitated the establishment of an innovative nursing role in the community. Parish nurses are functioning in a variety of church congregations of various denominations. The parish nurse is a educator, a personal health counselor, a coordinator of volunteers. The parish nurses helps people relate to the complexed medical care system and assists people to integrate faith and health. The purpose of this study is to investigate what the korean parishioners want in parish nursing and what type of role expectation from parish nurse. The subjects were 1138 parishioners of 23 churches of various denominations in nationwide Korea. Data were collected by self-reported question naires from Feb 4 to June 25. 1999. The data were analyzed by using percentage. frequency. $x^2-test$. multiple Response set with SPSS program. The results are as follows: 1. Desired parish nursing contents by parish nurses are: psychological counselling(23.4%) out of private counselling. stress management(21.1 %) out of private health education. Emergency care(14.1%) out of group health education. Blood Pressure check-ups (19.0%) out of Health check ups. home visiting(44.9%) out of patient visiting method. B T. pulse, respiration and blood pressure check(15.0%) in Care to serve in home visiting. spiritual preparation to accept the death(41.7%) in hospice care, advices to choice of medical treatment using guide(50.1%) in introducing and guiding of health care facilities, pray(21.7%) in spiritual care' faith support. 2. Desired Health Teaching Content According to Period of Clients by Parish Nurse are: Vaccination(22.5%) in infant and toddler health management. sexual education(25.3%) in adolescent health management. prenatal care (29.5%) in pregnant health management. osteoporosis prevention and management (22.4%) in Middle aged health management. dementia prevention and management(25.5%) in elderly health management. 3. The expectant role from parish nurse is spiritual care faith support(14.1%). patient visiting care(13.2%), hospice care(12.9%), private counseling(12.8%), health check ups (11.1 %), volunteer organization and training out of believer(11.0%), private health education (9.3%), group health education (8.3%). 4. In Necessity of Performing Parish Nursing according to Region, Most(over 95%) responded that nursing program is needed. so there is no significance between regions. In Performing Parish Nursing in their church, Most(92.2%) responded they want to perform program. 5. In case of performing parish nursing, 52% out of the subjects responded they want to participated in parish nursing volunteer's activity, for example. to be in active to be a companion to chat(42.1%), necessity support (25.3%), donation support(25.0%), exercise support(18.2%), vehicles support (9.9%). As a result. in holistic care and spiritual care, the need of parish nursing and the role expectation from parish nurse are very high among korean believers. Therefore, I suggest parish nursing centering around Taegu and Kyungbuk province should be extended to nationwide. For extending parish nursing program. more active advertisement and research is needed. After performing parish nursing program through out the country, further comparative research between regions should be practiced and Korean parish nursing program will be developed and activated.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.6 no.2
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• pp.228-239
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• 1999

In 1990 Home Care Education Programs started when legislation established certification for Home Care Nurses. The Ministry of Health and Welfare proposed a home care education curriculum which has 352 class hours and 248 hours of 'family nursing and practice'. Though Home Care Education Programs have been offered in 11 home care educational institutes, there has been no formal revision for the home care education programs. Also a first and second home care demonstration projects have been carried out, but there has been no research on outcomes for home care education as applied in home care practice. The purposes of this study were to identify the important content areas for home care nursing as perceived by home care nurses, and to identify their clinical competence in each of these areas, and from these to identify the education needs. The sample was 107 home care nurses who were working in home care demonstration hospitals and community-based institutions which have been offering home care services. Responses were received from 88 nurses, comprising a 82.2% return rate, and 86 were included in the final analysis. The instrument used was a modification of the instrument developed by Caie-Lawrence et(1995) and Moon's(1991) instrument on home care knowledge. The instrument's Cronbach's coefficient was 0.982. Among the respondents, 64% were working at home care demonstration hospitals and 36% were working at community-based institutions. Their home care experiences were from one month to six years, with a mean of 20.6 months. The importance rating for home care education content was 3.42 0.325, which means importance was rated relatively high. Technical aspects of home care were identified the most important. Five items 'education skill', 'counseling skill', 'interview skill', 'wound care skill', 'bed sore care skill' received 100% importance ratings. The competency rating was 2.87 0.367 and 'technical aspects of home care' was the highest, and 'application to home care skill' was the lowest. Home care nurses' education needs were identified and compared to the importance ratings and competency ratings. Eleven items were identified as the highest in the importance areas and eleven items were in the lowest competency areas. High importance ratings matched with low competency ratings determined training needs, but there was no matching items in this study. In the lowest competency areas four items were excluded, because of not being applicable in current home care practice. Therefore total eighteen items were identified as home care education needs. These items are 'bed sore care skill', 'malpractice', 'wound care skill', 'general infection control', 'change and management of tracheostomy tubes', 'CVA patient care', 'Hospice care', 'pain management', 'urinary catheterization and management', 'L-tube insertion and managements', 'Respirator use and management skill', 'infant care', 'prevention to burnout', 'child assessment', 'CAPD', 'infant assessment', 'computer literacy', and 'psychiatry patient care'.

• Korea Journal of Hospital Management
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• v.5 no.2
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• pp.59-77
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• 2000

There are increasing interest and need for information on health care consumer with the significance of hospital marketing and strategic planning being increasingly emphasized. This study was conducted to investigate the criteria for selection of medical facilities according to the characteristics of cataract patient. In order to investigate the major factors affecting selection of medical facilities by cataract patient, 300 subjects of cataract patients who was operated at 5 various medical care facilities were selected. Questionnaires are given on March, 2000 and 273 questionnaires were collected. Two types of hospitals(Eye Hospital and University hospital) were combined and analyzed. The main results of this research is as following; 1. In general characteristics of the patients, the variables shown statistically a significant difference between Eye Hospital and University Hospital; The6 educational level and average income are significantly higher in University Hospital Patient. 2. University Hospitals were preferred by the factors of social relationship, social reputation. The critical factors in reference for Eye hospital were kindness, service speed and convenience. This study can be used as a baseline data for marketing planning of hospital management. But the study may be limited in that the results cannot be generalized due to its small sample size and not being able to reflect demographic variables and life style. Further studies to investigate the hospital consumer behavior will be needed.

• Health Policy and Management
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• v.32 no.2
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• pp.154-163
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• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• Journal of Korean Public Health Nursing
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• v.33 no.3
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• pp.379-389
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• 2019

Purpose: The study investigated the factors associated with compassion satisfaction of nurses in long-term care hospitals with a focus on the culture of patient safety. Methods: This study was conducted using a descriptive survey. The participants were nurses in 1 metropolitan city and 2 other cities (N=164). The data was collected in October, 2018 and analyzed using the SPSS Win 25.0 program. Results: The factors associated with compassion satisfaction were job satisfaction, work attitude, management practice, leadership of the managers of patient safety culture, and clinical career (F=21.66, p<.001). These variables explained 49.3% of the variance in compassion satisfaction of long-term care hospital nurses. Conclusion: These results highlight the importance of long-term care hospital nurses' compassion satisfaction and can be used as meaningful data for intervention to promote a culture of patient safety, and nurses' job satisfaction.

• Korean Journal of Clinical Pharmacy
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• v.24 no.4
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• pp.272-281
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• 2014

Objective: The provision of pharmaceutical care service in compliance with good pharmacy practice (GPP) standards is important, but there is lack of studies to investigate the barriers that significantly hinder community pharmacies in Korea from adhering to the standards. This study was aimed to identify the major barriers to provision of pharmaceutical care service in compliance with the proposed pharmacy practice standards which have been developed based on the GPP standards recommended jointly by WHO and FIP. Methods: Questionnaires reviewed by the expert committee were posted for 32 days on the website which is most frequently accessed by community pharmacists. The respondents completed them by checking the scores (Max=5, Min=1) for major barriers to provision of pharmaceutical care service focusing on patient information management and drug use review process in prescription fillings. The answered scores were automatically collected using online data processing. Mean differences between scored data were assessed by ANOVA. Results: Total 321 pharmacists participated in the survey. Results indicated that 'difficulty of diagnosis identification' (m=3.92, SD=1.21), 'lack of time' (m=3.48, SD=1.22) and 'lack of updated clinical information' (m=3.17, SD=1.10) were the major barriers to provision of pharmaceutical care service in patient information management. The main barriers to drug utilization review were 'lack of time' (m=3.32, SD=1.21), 'lack of updated clinical information' (m=3.11, SD=1.17), and 'negative feedbacks or refusals from prescribers' (m=3.00, SD=1.38). There were significant differences among the groups by location, employed number of pharmacists and acceptability to the proposed GPP standards. Conclusion: Difficulties in managing patient clinical information and lack of time were found to be the major barriers in providing pharmaceutical care services in community pharmacies in Korea. Further research is recommended to determine ways to reduce these barriers in order to provide quality pharmaceutical care service that is in compliance with the internationally recognized GPP guidelines.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.4 no.2
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• pp.175-192
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• 1997

The purpose of this study was to identify the care needs of family-caregivers to the patients with stroke. Subjects were 115 family-caregivers caring for the patients while they were in-patients or out-patients with stroke in two general hospitals and one oriental medicine hospital located in Seoul and Kwang-Ju. The instrument used for this study was made by the researcher on the basis of results of literature review and interviews with family-caregivers, composed of 35 items. Internal validity by calculation of cronbach's alpha with data of respondents was 0.91, which was regarded as high. The Data were analyzed by SAS program, with percentage, mean, t-test, and ANOVA. Factor structures of care needs of family-caregivers were elicited by factor analysis(PCA, Varimax rotation). Datum collection had been from July 1 to August 14, 1997. The results of this study were as follows : 1. The mean score of the sum of the care needs of family-caregivers was 3.96 and the highest-mean item was 'need for immediate care(M=4.77)', and the lowest-mean item was 'need for chaplian's visit (M=2.82)'. 2. Care needs of the family-caregivers were : Need to be informed of the disease, treatment and care ; need of education and assistance related to physical functional level ; need of social support and consultation ; need of management of nursing problem related to immobility ; need of appreciation ; need of the way to communicate with patients ; need of immediate care and help. The highest mean factor was the 'need for immediate care and help(M=4.74)', and the lowest mean factor was the 'need of appreciation(M=3.58)'. 3. The variables influencing the degree of care needs perceived by family-caregivers to the patients with stroke were as follows : There were significant differences between need to be informed of the disease, treatment and care and general characteristic factors, which were family caregiver's sex (p=.0178), caring period(p=.0223) and patient's suffering period(p=.0244). There were significant differences between need of education and assistance related to physical functional level and general characteristic factors, which were patient's paralysis(p=.0177), patient's ADL dependency(p=.0032). There were significant differences between need of social support and consultation and general characteristic factors, which were family caregiver's sex(p=.0055), occupation(p=.0159), religion(p=.0093) and patient's sex(p=.0134). There was significant difference in the degree of need of management of nursing problem related to immobility, according to the patient's ADL dependency(p=.0493). There were significant differences between need of appreciation and general characteristic factors, which were family caregiver's age(p=.0107), sex(p=.0133), and patient's age(p=.0338). There were significant differences between need of the way to communicate with patient and general characteristic factors, which were patient's paralysis(p=.0002) and aphasia(p=.0001). There were significant differences between need of immediate care and help and general characteristic factors, which were family caregiver's caring period(p=.0162) and patient's suffering period(p=.0116). 4. The mean score of patient's ADL dependency was 3. 38 and the highest-mean item was 'ascending and descending stairs(M=4.12)', and the lowest-mean item was 'drinking(M=2.60)'. There was no significant difference in the degrees of care needs related to the patient's ADL dependency. 5. The highest information source of family-caregivers was from the doctors about the disease, treatment and care(26.1%). The second highest one was from mass media(20.8%), and the third one was from the nurses. The above findings may be used as the basic data to seek more efficient way of elevating nursing practice and quality for family-caregivers to the patients with stroke.