• Journal of Korean Academy of Nursing
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• v.31 no.3
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• pp.380-390
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• 2001

Purpose: This study was designed to explore the perceptions of quality nursing care among nurses. Method: The data were analyzed using content analysis. The data were collected from 19 nurses who worked at diverse clinical areas in 8 general and university hospitals with over 400 beds. Result: 1. The attributes of quality nursing care were categorized into 7 hierarchies in the order of 'caring' (40.65%), 'specialty' (29.03%), 'nurse attainments' (15.48%), 'patient- centered nursing management' (6.45%), 'sincerity' (5.16%), 'kindness' (2.58%), 'satisfaction' (0.65%). 2. The concept of quality nursing care were defined as 'giving a satisfaction both to patients and nurses through patient-centered nursing management with specialty and caring in the ground of the kindness and sincerity'. Conclusion: Based on there findings, we suggest that the study results should be used for development of a quality assurance tool in nursing practice, patient care in hospital setting, education of nurses and nursing students. In addition, further repeated studies need to be conducted.

• Journal of muscle and joint health
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• v.26 no.1
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• pp.35-45
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• 2019

Purpose: This study aimed to investigate perception of patient safety culture, incident reporting, and safety care activities among clinical nurses and to identify factors associated with the safety care activities. Methods: Structured questionnaires were used to collect data from 155 nurses who were involved in direct patient-care. Results: Descriptive statistical anaylses revealed that the mean score of patient safety culture was $3.26{\pm}0.32$ and $4.19{\pm}0.41$ was for the safety care activities. In incident reporting, reporting intention ($3.56{\pm}0.68$), belief in improvement ($3.42{\pm}0.60$), worry about appraisal ($3.37{\pm}0.65$) and reporting knowledge ($3.36{\pm}0.72$) respectively. Correlational analyses showed that perceived patient safety culture (r=.36), reporting intention (r=.34), belief in improvement (r=.32), and the knowledge (r=.38) in incident reporting were positively correlated with safety care activities, while the worry about appraisal in incident reporting attitude was negatively correlated. The factors associated with safety care activities were incident reporting knowledge (${\beta}=.31$, p<.001), supervisor/managers' attitudes toward patient safety culture (${\beta}=.29$, p<.001), belief in improvement of incident reporting attitude (${\beta}=.16$, p=.041). Conclusion: These results suggest that to improve safety care activities among hospital nurses, it is necessary to educate nurses on incident reporting. Also, a system-level approach is needed to support leadership in patient safety and to provide positive feedback on incident reporting.

• Journal of Korean Academic Society of Home Health Care Nursing
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• v.28 no.3
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• pp.285-294
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• 2021

Purpose: The study examined the effects of knowledge, attitude, and confidence on the education needs of nursing students with respect to patient safety management. The participants were 119 students from nursing college. Data were analyzed using descriptive statistics, t-test, analysis of variance(ANOVA), Pearson's correlation coefficient, and multiple regression analysis with the SPSS program. Results: The student's educational needs with respect to patient safety management differed significantly by experience of patient safety accidents (p=.026) and experience of reporting medical errors (p<.001). Additionally, the educational needs with respect to patient safety management were found to have statistically significant positive relationships with both attitude (r=.39) and confidence (r=.37). Further, a total of 23% of the education needs with regard to patient safety management were explained by attitude and confidence. Conclusion: These results can be used to develop nursing students' education programs to enhance patient safety management competence be emphasizing the experience of patient safety accidents and reporting medical errors as well as improving the attitude and confidence of the students.

• Quality Improvement in Health Care
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• v.17 no.1
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• pp.69-78
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• 2011

Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

• Health Policy and Management
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• v.18 no.1
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• pp.85-107
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• 2008

This study aims to describe levels and distribution of the continuity of primary care among children and adolescent patients who are 2-19 years old, and analyze the effects of it on the risk of hospitalization. Study population was 2-19 year old child and adolescent patients as of 2002, who had more than three ambulatory care visits in the years of 2002-3 and whose most frequent provider was the primary care practices (189,660 persons). Association of levels of primary care with the risk of hospitalization was evaluated using multiple event survival analysis. Outcome variables were whether the patient had hospitalized or not, and whether the patient had hospitalized due to ambulatory care-sensitive conditions or not. Multiple event survival analysis revealed statistically significant association of the levels of primary care with the risk of hospitalization. Hazard ratio was 1.34 [1.27-1.41] at the medium level of continuity and 1.47 [1.39-1.55] at the lower level where outcome variable was whether the patient had been hospitalized or not. Hazard ratios were 1.35 [1.21-1.50] at the medium level of continuity and 1.60 [1.44-1.78] at the lower level, where outcome variable was whether the patient been had hospitalized due to ambulatory care-sensitive conditions or not. This study produced some evidences on the benefits of continuity of care, which will in turn support the introduction of personal doctor registration program in the future.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.130-145
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• 1996

Purpose : the management of University Hospital is being challenged in maintenance of reasonable level of income and high ranked reputation by domestic competition with each other and emergence of enterprised owned hospitals. It is imperative that University Hospitals have to make management for patient satisfaction. Furthermore, increased patient's requirement for qualified hospital services (quality assurance) and low-estimated service fee also repress the hospital management condition as well as medical markets open following with Urguay Connection. Due to these unforable conditions surrounding hospital management, -University Hospitals are being pressed to seek improved management strategies. To develope the strategies, we need to have basic understanding about the problems on hospital management and detail information for various patient's requirement. Methods: For this study, we have analysed out-patients from five different University Hospitals located in Seoul, Korea. To obtain the data, we have carried out personal interviews with patients who patients who visit the Out-Patient Clinics of five different University Hospitals using a previously prepared questionnaire. Result: Around 65.7 percent of the visits to University Hospitals were indwelt in the vicinity of 1 hour and motuvation of visiting University Hospital was expending high wuality medical csre in 49.3 percent. The 79.3 percent of the patients have experienced inconvenience during medical care in University Hospital. The most inconvenient condition was waiting for doctors. The 57.2 percent of total patient have experienced rudness. The most rudness condition was registration and receipt desk in 44.4 percent. Patient expect that doctors working in University Hospitals as professors have high and updated medical knowledge(50.4%) and University Hospitals have a high quality medical care system(79.4%). The patient satisfaction was relatively low in 61.1 percent of total patient and revealed high frequency of again visit University Hospital in satisfaction group. Comparison of interhospital analytical study showed quite difference on various problems. Conclusion: Almost patients who visit to Out-Patient Clinic of University Hospital havevisiting motivation to high quality medical care. University Hospitals have several different unsatisfactorial factors and revealed different degree of patient satisfaction. In a future day, University Hospitals have to make use of another University Hospital's merits for approach of Benchmarking and also should be studied decision factors of patient satisfaction and interhospital difference of them.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.4
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• pp.381-388
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• 2010

Purpose: The purpose of the study was to compare recipients' health behavior, attitude to using medicaid, medication compliance, and the changes in hospital cost and visit-day of in-patient and out-patient care between tele-care regions (TCR) and general care regions (GCR) in Korean medicaid. Method: The design of the study was ex-post facto comparing recipients in TCR and GCR. The sample included 625 persons in TCR and 410 persons in GCR. To collect materials, the case manager interviewed recipients of medicaid and filled out questionnaires which were analyzed through SAS/PC 9.1. Results: In studying health behavior and medication, compliance was not significant. However, the attitude to using medicaid was significantly more positive in TCR than in GCR. In out-patients, the change of hospital visit-day was not significant between TCR and GCR, but TCR showed a reduction in hospital cost compared to GCR. For in-patient recipients, GCR showed a greater reduction in changes in hospital cost and visit-day compared to TCR. Conclusions: The results of the study show that attitudes to using medicaid via telephone are positive and results are more effective than hospital visit consultation, and the cost of out-patient care could be reduced.

• Health Policy and Management
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• v.15 no.2
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• pp.16-36
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• 2005

Due to the existence of asymmetry of information between doctor and patient, it has been believed that doctor might affect patient's decision making process of purchasing medical care. Based on this notion, doctor's reimbursement method has been suggested as an effective policy device of improving efficiency of patient's medical care use by way of its affecting doctor's practice pattern. By using the Community Tracking Study (CTS) household and physician data set, which includes not only various information on patient's medical care use, but doctor's practice arrangements and sources of practice revenue, this paper investigates the effect of community doctor's characteristics of reimbursement method on community patient's medical care use under the control of patient's socio-demographic characteristics and community doctor's practice type. In the process of estimating econometric model, the endogeneity problem of individual health insurance purchase was corrected by using 2818. And due to the existence of sample selection problem, Heckman's two-step estimation method was used for strengthen the robustness of estimation which was adversely affected by sample selection problem The empirical results show that as the average value of community doctor's portion of practice revenue determined by prospective method out of total revenue increases, the community patient's total out-of-pocket medical cost decreases. This results suggest, as doctor's practice revenues are mainly determined by prospective method, such as capitation, doctors would be more conscious about practice cost, which might affect doctor's practice pattern and by which his/her patient's use of medical care would decrease.

• Health Policy and Management
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• v.5 no.2
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• pp.18-34
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• 1995

To clarify the relationship between the medical supply(medical persons and goods) and the use of bed, the author has made comparison among OECD 24 countries. Per Capita Bed-days can be divided into Average Length of Stay and Admission Rate, and these three variables were regressed upon both In-patient Care Beds of all medical institutions including acute somatic, psychiatric, special, nursing homes and other long-term care and Share of Total Health Employment in Total Employment. The result of regression analysis shows a statistically significant positive relationship between In-patient Care Beds and Average Length of Stay, and negative relationship between Share of Total Health Employment and Admission Rate. In addition to Ordinary Least Square(OLS) estimation, amended Bounded Influence Estimation(BIE) was also made to adjust the influence of outliers. Japan shows a very large number of In-patient Care Beds and a very low Share of Total Health Employment, and this medical situation is judged to have close relation to her long Average Length of Stay and low Admission Rate.

• Journal of Korean Academy of Fundamentals of Nursing
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• v.7 no.1
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• pp.122-136
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• 2000

Stroke patient needs rehabilitation after receiving an acute treatment in a hospital. When stroke patient gets involved in an early discharge program, home care nurse plays a pivotal role to make them to gain a full strength and to come back to his/her prior life before he/she is sick. In spite of the importance of home care nursing intervention protocol for home care nurses to perform home care nursing autonomously, home care nursing intervention protocol for stroke patient is rarely developed. Therefore this study was conducted to develop home care nursing protocol that is applicable for stroke patients in home care nursing area. 41 home care nursing charts for stroke patients registered in home care nursing agencies from December 1st 1994 to August 31st 1999 at Y hospitals in Seoul and Won-Ju city were analyzed. 44 home care nurses who were having over three years' experience on stroke patients were participated in this study as a user validity validation group. The results of this study are as follows. 1. 28 nursing diagnoses were selected on the basis of evaluation of nursing diagnoses of stroke patients presented in a previous literature and case studies on home care nursing. 2. 17 nursing diagnoses were classified through the frequency analysis of home care nursing charts for 41 stroke patients who had received home care nursing. The order of sequence was like these: impaired skin integrity, risk for infection, nutritional deficit, impaired physical mobility, constipation, knowledge deficit, ineffective airway clearance, anxiety in family members, risk for aspiration, self care deficit, altered urinary elimination, ineffective individual coping, social isolation, risk for injury, self-esteem disturbance, impaired verbal communication, fatigue of family caregiver. 3. Based on validation on expert and user validities, 44 nursing interventions which were above ICV=.80 were chosen. 4. Nursing intervention protocols which showed above ICV=.90 were developed and were like these; pressure ulcer care, position change, preventive care for circulatory dysfunction, tube care : catheter, vital sign monitor, constipation/impaction management, artificial airway management, suction of airway secretion, environmental management : safety, and fall prevention.