• Title/Summary/Keyword: Quality nursing care

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Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center (응급의료센터 내원환자 진료시 소요시간과 관련된 요인)

  • Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.138-155
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    • 2000
  • Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

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A systematic Review on the Effects of Occupational Reminiscence Therapy in Dementia Offered National Long Term Care Insurance (국내 장기요양보험서비스를 제공 받는 치매 환자 대상 작업 중심 회상치료 효과에 대한 체계적 고찰)

  • Jung, Hae-In
    • Therapeutic Science for Rehabilitation
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    • v.3 no.1
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    • pp.31-37
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    • 2014
  • Objective : The purpose of this study was to look at a systematic review on the effects of occupational reminiscence therapy in Dementia offered National Long term care Insurance. Through this comprehensive study, we have to compare the studies. Methods : We systematically examined papers published in journal from 2009 to 2013, using KERIS. Main words to examine are Dementia, Long term care service, Day care center, reminiscence therapy, occupational centered, etc. Results : 6 studies were selected, All of them were occupational reminiscence therapy. Reminiscence therapy can be devided into communication centered reminiscence therapy and occupational reminiscence therapy. The results demonstrated that the intervention significantly affected the maintenance cognitive skills and reminiscence skills, decreased depression, behavioral changes, improvement of communication and interaction skills and quality of life etc. of elderly people with dementia (p<.05). Conclusions : If occupational therapists can obtain knowledge and make a program for occupational reminiscence therapy, research in this field will be further developed. In the future study, the use of occupational reminiscence therapy applied to a variety of interventions and majority of patients is needed on occupational therapy.

Convergence awareness of basic emergency treatment by private ambulance drivers (민간구급차 운전자의 기본 응급처치 지식에 관한 융복합적 의식조사)

  • Kim, Soo-Tae;Lee, Young-Hee;Shin, Dong Min
    • Journal of the Korea Convergence Society
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    • v.8 no.8
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    • pp.127-136
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    • 2017
  • The purpose of the study was to investigate the awareness of basic emergency care by private ambulance drivers. A self-reported questionnaire was completed by 300 private ambulance drivers in Seoul, Gyeonggi, and Incheon from February 20 to April 1, 2013. The questionnaire consisted of basic life support related airway management(3 items), respiratory management(9 items), circulation(4 items), consciousness(4 items), and infection control(3 items). The awareness of infection control accounted for 87% and emergency care including airway, breathing, consciousness, and respiration was 60%. The knowledge of emergency care was 15.20(maximum 23.0 points). Consciousness was 2.55(maximum 4.0), airway management was 2.08(maximum 3.0), respiration was 5.35(maximum 9.0), circulation was 2.56(maximum 4.0), and infection control was 2.64(maximum 4.0). In order to improve the quality of private ambulance drivers, it is important to develop the emergency care program and expansion.

Institutionalization of a Patient-Sitter Program in Acute Care Hospitals (보호자 없는 병원 제도화 방안)

  • You, Sun-Ju;Choi, Yun-Kyoung
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.370-379
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    • 2013
  • In an effort to resolve the burden of patients hiring patient sitters, this study sought to review the Ministry-of-Health-and-Welfare-initiated pilot program of running hospitals without patient-sitter to identify its background, operation method, performance results, and limitations. Based on the review, the study derived the necessity of introducing a hospital system without patient-sitter as well as its operation and systemization methods. The ministry-initiated pilot programs were conducted twice: in 2007, and in 2010. A review of the 2007 pilot program revealed that the patients and families' satisfaction score with nursing services was 9.1 points (on a 10-point scale), their intention to reuse the service was 97.8%, and their intention to recommend the service was 98.0%, all high scores. Appropriate nursing manpower, derived from the 2007 pilot project, indicated 2.3 patients per nurse and 4.0 patients per nurse aid. The 2010 pilot project results indicated that the patients and families' satisfaction was high at 8.0-9.1 points (on a 10-point scale), and that the intention to reuse and recommend the service was also high. Compared with the 2007 pilot project, however, the types of medical institutions and the nurse to patient ratios were diverse, offering limitations. In conclusion, to systemize hospitals without patient-sitter, it is necessary to develop policies designed to establish criteria for the appropriate nurse to patient ratio and skill-mix, to standardize the work, to prepare finances for securing nursing staff, to evaluate the nursing demands, and to monitor the quality management.

A Study on Service Satisfaction of Users' Family in Charged Recuperation Facilities Specializing in the Old (유료노인전문요양시설 이용자 가족의 서비스 만족도 및 요구조사)

  • Chung, Yeon-Kang;Han, Seung-Eui;Lee, Young-Mi
    • Research in Community and Public Health Nursing
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    • v.14 no.3
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    • pp.397-406
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    • 2003
  • The purpose of this study is to provide the basic data in order to improve the quality of charged recuperation facilities which are specialized in the old. after finding out the satisfaction degree for the services which are provided in the current charged recuperation facilities specialized in the old and surveying the services which are demanded by users. As for the research method. the subjects were 88 family members of the users in the five charged recuperation facilities, which are specialized in the old and located in Seoul and Incheon. The survey research was executed from 27th July to 15th September, 2002. Then the collected data were analyzed by using the SPSS 10.0 for windows program. The research results are as follows. Firstly, in the satisfaction degree of the user's family about the daily service showed the highest satisfaction degree for the kind service of the staff to the users. In the satisfaction degree about the specialized service of the user's family, the satisfaction degree was high in bedsore prevention, periodical health care, proper medical treatment, family counsel, and adequate disease management. In the satisfaction degree about the facility and environmental service, the satisfaction degree about the surrounding environment of the facility or safety facility, and the comfort condition was high. In the satisfaction degree about the services related to the local society, it was high in the hospital and medical-related field. Secondly, in the demanded services, the demanding degree for worship, mental and spiritual nursing, hospice, funeral service, family meeting, and support for the special vehicle were not so high, but it was shown that they were generally demanded. Thirdly, it was shown that the provided services had an overall high satisfaction degree. In the service satisfaction degree according to the general characteristics of the user's family, it was recognized that there was a significant difference between the distinction of sex and local society related services. Also, there was a significant difference in the satisfaction degree between age and specialized service. Through the above research results, detailed rehabilitation programs such as linguistic treatment and working treatment should be more and more compensated in order to supplement the insufficient points of the services provided by the charged recuperation facility specialized in the old. Additionally, the correlation with the local society such as education and training for specialized human labor, close cooperation among the facilities, and positive participation in local society events are thought to be reinforced.

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Effect of Self-help Tai Chi for Arthritis on the Quality of Life, Health Perception, Joint Flexibility, Grasping Power, and Balance (자조타이치 프로그램이 삶의 질, 건강지각, 관절 유연성, 악력 및 균형감에 미치는 효과)

  • Lee, Eun-Hee;Lee, Kyung-Sook;So, Ae-Young;Choi, Jung-Sook;Lee, In-Oak;Lee, Jun-Dong
    • Journal of muscle and joint health
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    • v.14 no.2
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    • pp.127-136
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    • 2007
  • Purpose: There has been a need to integrating the self-help program for arthritis with the TaiChi for arthritis patient. The purpose of this study was to develop and to examine the effect of the Self-help and Tai Chi for arthritis (SHTCA) program for arthritis. Method: This study was designed non equivalent control group pre-post test, quasi-experimental design. A total 40 participants were recruited in W-city, 29 participants(14-experimental group and 15-control group) completed post test. The experimental group participated in the SHTCA once a week for 8 weeks. SHTCA program was consisted of understanding of the arthritis, contracting of the promise, exercise for muscle strength and joint flexibility and 8 movements of Tai Chi exercise. Coloring plus program to cellular phone was used to encourage the exercise and participation by the KT-SHUT twice a week. Measures used to examine the effect of the SHTCA were EQ-5D standardized five dimensions(mobility, self-care, usual activities, pain & discomfort, and anxiety & depression), and health perception, joint flexibility, grasping power, and balance. Collected data was analyzed by SPSS WIN 14.0. Results: The experimental group had significantly increased the EQ-mobility(p=.033), health perception(p=.000), right shoulder flexibility(p=.007), and left shoulder flexibility(p=.002) compared to the control group. In addition, pain was decreased(p=.052) and right grip was increased(p=.052) after 8 weeks program in the experimental group. Conclusion: This SHTCA using coloring plus program was found partially effective and satisfactory. We recommended further research on the effect of this SHTCA effects.

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A Comparison of Needs for Hospice Care between Families of Children and Adult with Cancer (암 환아 및 암 환자 가족의 호스피스 요구도 비교)

  • Kang, Kyung-Ah;Kim, Shin-Jeong
    • Journal of Hospice and Palliative Care
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    • v.8 no.2
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    • pp.216-223
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    • 2005
  • Purpose: The purpose of this study was to compare the need for hospice care between families of children and adults with cancer. Methods: The data was collected from 190 families of children and adult with cancer using self-rating questionnaires from December, 2004 to February, 2005. Data was analyzed using SPSS/Win program by Mean, SD and t-test. Results: The mean score of the need for hospice care in families of children with cancer was greater significantly than in families of adults with cancer (t=-2.126, P=.035). The scores of two factors among the five factors evaluated for the need for hospice care were different significantly. The mean score of control of major terminal physical symptoms' in families of children with cancer was greater significantly than the mean score of adults with cancer (t=-2.165, P=.032). The mean score of 'spiritual care to prepare for death' in families of adults with cancer was greater significantly than the mean score of children with cancer (t=-2.380, P=.018). Conclusion: For improving the quality of life for both patients and families, the hospice service program needs to consider the life cycle of patients.

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Activity to reduce the record missing for nursing care charge (간호수가 누락률 감소활동)

  • Kim, Nan Ja;Lee, Yong Kyo;Kim, Hye Jin;Cheung, Ok Ju;Song, Nam Gyoung;Jun, Mi Sun
    • Quality Improvement in Health Care
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    • v.15 no.1
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    • pp.73-78
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    • 2009
  • 문제: 오늘날 간호사는 과거와 달리 현대적 보건의료 요구를 해결할 수 있는 체계적인 이론과 기술을 습득하도록 훈련된 고급 전문 인력이고, 간호행위를 생산하기 위해서는 서비스의 생산원가 뿐만 아니라 전문 인력으로서의 훈련 및 유지비용 등도 투입되어야만 가능하게 함으로서 2008년 7월부터 시행한 중환자실 간호등급에 따른 간호수가 책정으로 인해 중환자실 내에서 이루어지고 있는 많은 간호행위 중 수가를 받을 수 있는 부분이 생기게 되었고 간호행위의 중요성과 더불어 간호를 시행 후 받을 수 있는 수가에 대한 간호사들의 입력에 대한 의무도 늘어나게 되었다. 이에 빈번히 누락되고 있는 간호수가 관리를 통한 경제적 손실을 방지해야 할 필요성을 느껴 개선활동을 하고자 한다. 목적: 2008년 7월부터 시행한 중환자실 간호등급에 따른 간호수가 책정으로 인해 중환자실내에서 이루어지고 있는 간호 행위의 중요성을 인식하고 구체적인 문제 분석과 간호 현장에서의 개선안을 도출함으로써 경제적 손실을 방지할 수 있는 간호수가 누락률을 감소시키고자 함이다. 의료기관: 대구파티마병원 내과 중환자실. 질 향상 활동: 업무개선의 방법으로 환자 개인별 간호수가 입력 누락 방지 체크 리스트 사용 및 처방 전달 시스템의 간호수가 재입력 화면을 이용하여 입력의 용이성 도모하였고 입력된 간호수가를 처방 전달 시스템 간호수가 조회 프로그램을 이용해 익일 누락여부를 매일 모니터링 하였다. 교육 및 홍보활동으로는 간호수가 입력누락 방지를 위한 간호수가 입력 지침을 제작하여 전체간호사는 년 2회, 신규간호사는 개별 교육을 실시하였으며, 월별 간호수가 누락통계를 실명 공고 하여 간호수가 다 빈도 누락 간호사는 추가 개별교육을 실시하였다. 개선효과: 간호수가 입력 프로세스 개선을 통해 간호수가 평균 누락률이 개선 전 6.5%, 개선 후 1.2%로 5.3%의 누락 감소율을 보였으며 역치 5%를 달성하였고 간호수가 누락금액은 개선 전 2,992,752원, 개선 후 590,787원으로 2,401,965원의 누락 효과 비용을 구할 수 있었다. 본 QA활동으로 중환자실 간호수가 전산입력에 대한 체계적인 교육부재와 신규간호사들의 잦은 전산누락이 있어왔으나 표준화 된 체크리스트 지침과 입력확인 작업으로 전산입력 누락률이 감소하는 효과를 가져왔다. 추후 심평원 청구 작업을 하는 부서와 연계되어 실제 청구 누락률에 대한 비교와 간호사 근무연수와 간호수가 입력 누락률에 대한 상관관계 조사를 제언 해 본다.

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Convergent Effects of Anxiety, Depression, Uncertainty, and Social support on Quality of Life in Women with Thyroid cancer (여성 갑상선암 환자의 불안, 우울, 불확실성, 사회적 지지가 삶의 질에 미치는 융복합적 영향)

  • Lee, Insook;Park, Chang-Seung
    • Journal of the Korea Convergence Society
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    • v.8 no.8
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    • pp.163-176
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    • 2017
  • The purpose of this study was to examine the anxiety, depression, uncertainty, social support, and QoL and to identify the factors influencing QoL in women with thyroid cancer. A descriptive survey was performed from April to October in 2014 with self-reporting questionnaires for depression, uncertainty, social support, and QoL. Participants were 106 women with thyroid cancer who visited a outpatient department of endocrine surgery in a hospital. Data were analyzed using SPSS 22.0. As the results of this study, the mean scores of global QoL were moderate. Anxiety was significantly influenced physical functioning, emotional functioning, and social functioning. Uncertainty was significantly influenced physical functioning and cognitive functioning. Therefore, from the results of this study, nursing practice focused on anxiety and uncertainty relieving care for female thyroid cancer patients to improving QoL. And also, in order to understand the QoL of women with thyroid cancer, it is necessary to deeply understand the QoL through qualitative and quantitative research to determine the QoL by treatment period and treatment type.

Gender Difference in Influencing Factors on Health related Quality of Life among the Elderly in Community (노인의 성별에 따른 건강관련 삶의 질 영향요인)

  • Lee, Seung-Hee
    • Journal of Digital Convergence
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    • v.11 no.12
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    • pp.523-535
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    • 2013
  • Purpose: This study was to investigate the socio-demographic and health factors affecting on the health related quality of life (HRQoL) in elderly by gender. Methods: Data of the study were derived from the fifth Korean National Health and Nutrition Examination Survey (KNHANES V-2, 2011). The subjects were older adults aged 65 years or more (673 male and 925 female) and the number of the sample was 1,598. The authors analyzed the data with the SPSS/WIN 21.0 program. Results: For male, the affecting factors on the HRQoL were education level, monthly income, and number of chronic disease. For female, affecting factors on the HRQoL were depression, stress, and age. The activity limitation and subjective health showed statistically significant relationship with the HRQoL for both male and female. Conclusion: Health care providers should consider the gender difference when they plan to design program for the improvement of HRQoL for elderly in community.