• Title/Summary/Keyword: Standard of Care

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The National Hospice Care Service Development in Korea (한국형 호스피스 케어 개발을 위한 기초 조사 연구)

  • Lee, Soo-Woo;Lee, Eun-Ok;Ahn, Hyo-Seog;Heo, Dae-Seock;Kim, Dal-Sook;Kim, Hyun-Sook;Lee, Hiye-Ja
    • The Korean Nurse
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    • v.36 no.3
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    • pp.49-69
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    • 1997
  • The urgent needs to establish hospice care systems in Korea arise from the following reasons: 0) a drastic increase in chronically ill patients with the increase of aged population: (2) rapid changes in living environment from the traditional habitation (e. g., Many Koreans living in apartment complexes, which is the most popular form of modern residence in recent years, prefer to die in the hospital.): the overall increase in patients with advanced cancer: (4) recent trends in early discharge of terminally ill patients from the limited hospital facilities to accomodate other medical insurance beneficiaries; (5) easy acceptance of euthanasia owing to the recent social atmosphere that belittles the dignity of human life; (6) medical and nursing care of AIDS patient in terminal stage; (7) and the problem associated with inhumane medical care system, overtreatment, and groundless fears against narcotics. Terminally ill patients were used to be treated in the hospital in the past. In these days, however, they are forced to have home cares with little assistance from the qualified medical personnel because of insufficient hospital facilities, which are even short for the need of emergency patients and provide priority cares to medical insurance beneficiaries with other acute problems. And yet, neither are there any administrative organizations nor systematic medical studies that deal with the level of terminally ill patient's need, their family's problems and resources of hospice care systems in Korea. Thus, most patients are not able to get appropriate medical care at the terminal stage of their lives. The objective of this study is to make comprehensive database for various hospice care organization currently in operation, link them through medical information system, and develop an easily accessible hospice care model that meets the need of most Korean people. Our survey results may be summarized as follows: Nationally there are 40 organizations that provide partial or full hospice care. However, these organizations are not linked to any formal medical service network. Furthermore, the objective of hospice care, care principles, personnel with appropriate training, educational programs, standard for care, costs, consulting service to patients' family members, the extent of medical care from professional staff members, status of hospice facility, and management of those institutions are neither clearly defined nor organized compared to the international hospice care standards. The surveys on patients of terminal stage. grouped in hospice and non-hospice care patients. reveal what they want visiting nursing care to help their pain control. psychological. social and spiritual demands. While the more than 90% of hospice care patients want to reduce their pains. the non-hospice care patients. in addition to their desire for pain control. demanded more psychological. social and spiritual helps as well. The results of this research could be utilized to 0) define the standard of hospice care. (2) provide the guidance for hospice medical care costs. (3) establish the database of hospice care systems. (4) develop softwares. (5) build communication network through Medinet. and (6) provide an organized visiting home nursing care system. These information should be a valuable resource to many medical staffs who are involved in cancer therapy. nursing care. and social welfare programs.

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Characteristics and Knowledge of Needlestick Injuries and Compliance with Standard Precautions in Healthcare Workers (의료종사자의 주사침 자상 관련 특성과 지식 및 표준주의 이행도)

  • Yu, Ji Won;Yang, Nam Young
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.24 no.3
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    • pp.275-283
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    • 2017
  • Purpose: This study was conducted to examine the characteristics and knowledge of needlestick injuries, and compliance with standard precautions, in healthcare workers. Method: The participants were 185 healthcare workers working at university hospitals. Data were collected in May 2016 and analyzed using descriptive statistics, t-test, ANOVA, and Pearson correlation coefficients using SPSS 18.0 program. Results: It was found that 45.4% of the subjects had experienced needlestick injuries. The most common rate of getting injured was 1 or 2 times, and the most common reason for the occurrence of needlestick injuires was carelessness(66.6%). The mean scores for knowledge of needlestick injuries and compliance with standard precautions were above average. Significant correlations were found between knowledge of needlestick injuries and compliance with standard precautions in health workers, and Characteristics were related to the significant differences seen in both. Conclusion: These findings indicate that standard precautions and guidelines for the use of sharp instruments should be emphasized in order to prevent needlestick injuries in healthcare workers.

Nurse Staffing Levels and Proportion of Hospitals and Clinics Meeting the Legal Standard for Nurse Staffing for 1996~2013 (의료법에 의거한 의료기관 종별 간호사 정원기준 충족률 추이 분석)

  • Cho, Sung-Hyun;Lee, Ji-Yun;June, Kyung-Ja;Hong, Kyung Jin;Kim, Yunmi
    • Journal of Korean Academy of Nursing Administration
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    • v.22 no.3
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    • pp.209-219
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    • 2016
  • Purpose: To analyze the proportion of medical institutions meeting the legal standard for nurse staffing. Methods: Data collected from 29,282 institutions between 1996 and 2013 were analyzed. Nurse staffing was measured as daily patient census per registered nurse (RN). The standard for general hospitals, hospitals, and clinics is 2.5 or less, and that for long-term care hospitals is 6.0 or less of the daily patient census per RN. Clinics may substitute nursing assistants for RNs by 50% or 100% depending on their daily inpatient census; long-term care hospitals may substitute nursing assistants for RNs by two thirds of the required number of RNs. Results: The proportion of general hospitals, hospitals, clinics, and long-term care hospitals meeting the standards was 63%, 19%, 63%, and 94%, respectively, in 2013. While general hospitals had an increase in the proportion during the 1996-2013 period, small changes were found in hospitals and clinics. In 2013, nurses were estimated to care for 16 (interquartile range: 12~24) patients per shift in general hospitals. Three quarters of clinics had no RNs in 2013. Conclusion: Many medical institutions did not meet the legally mandated minimum staffing level. The government must implement policy actions for all medical institutions to meet the legal standards.

Impact of Changes in Medical Aid Status on Unmet Need and Catastrophic Health Expenditure: Data from the Korea Health Panel

  • Kim, Woo-Rim;Nam, Chung-Mo;Lee, Sang-Gyu;Park, So-Hee;Kim, Tae-Hyun;Park, Eun-Cheol
    • Quality Improvement in Health Care
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    • v.25 no.2
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    • pp.44-55
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    • 2019
  • Purpose: To investigate whether changes in Medical Aid (MA) status are associated with unmet need and catastrophic health expenditure (CHE). Methods: Data from the 2010 to 2014 Korea Health Panel (KHP) were used. The impact of changes in annual MA status ('MA to MA,' 'MA to MA Exit,' 'MA Exit to MA,' and 'MA Exit to MA Exit') on unmet need (all-cause and financial) and CHE (10% and 40% of household capacity to pay) were examined using the generalized estimating equation (GEE) model. Analysis was conducted separately for MA type I and II individuals. Results: In 1,164 Medical Aid type I individuals, compared to the 'MA to MA' group, the 'MA to MA Exit' group had increased likelihoods of all-cause and financial unmet need. This group also showed higher likelihoods of CHE at the 10% standard. The 'MA Exit to MA Exit' group showed increased likelihoods at the 10% and 40% CHE standards. In 852 type II recipients, the 'MA to MA Exit' group had higher likelihoods of CHE at the 10% standard. Conclusions: Type 1 MA exit beneficiaries had higher likelihoods of all-cause and financial unmet need, along CHE at the 10% standard. Type I 'MA Exit to MA Exit' beneficiaries also showed higher likelihoods of CHE at the 10% and 40% standards. In type II recipients, MA exit beneficiaries had higher likelihoods of CHE at the 10% standard. The results infer the importance of monitoring MA exit beneficiaries as they may be vulnerable to unmet need and CHE.

The Effects of Child Care Teachers' Role Conflict and Organizational Commitment on Sensitivity (보육교사의 역할갈등과 조직몰입이 민감성에 미치는 영향)

  • Jang, Eun-young;Shin, Nary
    • Korean Journal of Childcare and Education
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    • v.14 no.6
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    • pp.1-18
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    • 2018
  • Objective: The purpose of this study was to investigate relationships among child care teachers' role conflict, organizational commitment and teacher's sensitivity. It also aimed to test the mediating effect of organizational commitment on the pathway from child care teachers' role conflict on teacher's sensitivity. Methods: A self-report survey was conducted on 301 child care teachers in Chungbuk. Descriptive, means, standard deviations, correlations using SPSS 18.0, and Structural Equation Modeling using AMOS 18.0 were all conducted in order to analyze the collected data. Results: The results indicated that child care teachers' role conflict and organizational commitment had significant direct effects on teacher's sensitivity. This study also confirmed the significant mediating role of organizational commitment on the pathway from child care teachers' role conflict to sensitivity. Conclusion/Implications: The significance of role conflict and organizational commitment suggests that the integration of individuals with less conflict and more dedication will contribute more qualitative child care services by improving sensitive interactions with young children.

Attitudes towards Death, Perceptions of Hospice Care, and Hospice Care Needs among Family Members of Patients in the Intensive Care Unit

  • Oak, Yunha;Kim, Young-Sun
    • Journal of Hospice and Palliative Care
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    • v.23 no.4
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    • pp.172-182
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    • 2020
  • Purpose: This study aimed to identify the relationships among attitudes towards death, perceptions of hospice care, and hospice care needs as perceived by family members of patients in the intensive care unit (ICU). Methods: This study used a descriptive correlational method. A structured questionnaire was used to collect data from 114 participating families in the ICU at Dong-A University Hospital, from October 10 to November 1, 2019. The data were analyzed in terms of frequency, percentage, and mean and standard deviation. The t-test, one-way analysis of variance, and Pearson correlation coefficients were also conducted. Results: Perceptions of hospice care showed significant differences according to age (F=3.06, P=0.031) and marital status (t=3.55, P=0.001). However, no significant differences in attitudes towards death or hospice care needs were found. A significant positive correlation was found between perceptions of hospice care and hospice care needs (r=0.49, P<0.001). Conclusion: In order for families to recognize the need for hospice care and to receive high-quality palliative care at the appropriate time, it is necessary to increase public awareness of hospice care through various educational and awareness-raising efforts, thereby providing opportunities for families of terminally ill patients to request hospice care.

Prospect of Family Day-care with regard to the National Policy of Child-rearing Support (육아지원정책에 따른 가정보육시설의 운영방향)

  • Han You-Me
    • The Korean Journal of Community Living Science
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    • v.17 no.1
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    • pp.23-37
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    • 2006
  • As the fertility rate of Korea has recently decreased to the lowest level in the world, the recognition of the needs for social support for the child-care has been increased. This resulted in the announcement of National Policy of Child-Rearing Support in 2004. This study attempted to propose the activation of the family child-care for the preparation of the introduction of the National Policy of Child-Rearing Support. Using literature review and interview, the following research questions were addressed. Firstly, the actual situation of the family child-care was compared with that of the other types of child-care. Secondly, the policies of child-rearing support and the family child-care systems in other countries such as United Kingdom, Sweden and Japan were introduced. Finally, activations of the family child-care were discussed in terms of the introduction of the National Policy of Child-Rearing Support. The results of this study implies that the family child-care in Korea is different from that of other countries as well as other types of child-care in Korea. Also, it suggests that key factors of the activation of the family child-care in Korea are to identify as the small, informal and family-like child-care, to differentiate as the infant-care and non-standard time child-care from other types of child-care, and to increase the level of professionalization. In conclusion, family child-care should become an alternative for the low fertility problem.

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Regionalization of neonatal care and neonatal transport system (신생아 괸리의 지역화 및 전원시스템)

  • Sin, Jong Beom
    • Clinical and Experimental Pediatrics
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    • v.50 no.1
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    • pp.1-6
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    • 2007
  • In the United States, The concept of designation for hospital facilities that care for newborn infants according to the level of complexity of care provided was first proposed in 1976. The extent of perinatal health care regionalization varies widely from one area to the other. facilities that provide hospital care for newborn are classified into three categories on the basis of functional capabilities; level I-primary or basic care, level II-secondary or specialty care, level III-tertially or subspecialty care. These facilities should be organized within a regionalized system of perinatal care. The transport system of newborn infants should be organized for referral of high risk newborn to centers with the personnel and resources needed for their degree of risk and severity of illness. In Korea, The korean society of neonatology was established and articulated in the 1994. During the past decade, the number of neonatologist has increased and neonatal intensive care units have proliferated in Korea. However, no standard definitions exist for the graded levels of complexity of care that neonatal intensive care units provide and no uniform guideline or recommendation for regionalization and referral system of high risk neonate have been established. With the rapid changing neonatal care system in Korea, the optimal neonatal care demands regionalization of care in utilization of manpower resources and in efficient use of advanced technology and facility.

A Study on the space standards of daycare facilities with the introduction of Care Insurance in Germany (독일의 수발보험제도 도입에 따른 주간보호시설의 공간계획 기준에 관한 연구)

  • Nam, Youn-Ok
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.13 no.4
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    • pp.25-35
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    • 2007
  • In Germany, community based daycare facilities has been supported by long term care policies since the 1970s. With the legislation of Care Insurance, those policy has been developed further. As the use of daycare facilities decreased and the financial burden for consumers increased, administrators of facilities has been seeking for innovative programs and management methods in order to improve the service. For the same reason, policy makers have been pursuing new regulations of architectural standards of facilities. By looking at legislations (i.e., Law of Care Insurance, Law of Heim, and DIN18025) that stipulate architectural standard of facilities in Germany, this study will identify the development process of architectural change of daycare facilities. In addition, the study aims to contribute to the discussion on the use of day care facilities in Korea in terms of the legislation of Care Insurance soon to be introduced.

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Prevalence of Cognitive Impairment and Related Factors Among the Elderly in Rural Communities of Jeju Province

  • Ko, Keumja;Jung, Min;Hong, Sungchul
    • Journal of Korean Academy of Nursing
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    • v.33 no.4
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    • pp.503-509
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    • 2003
  • Purpose. The purpose of this study was to survey the prevalence rate of cognitive impairments and to identify the factors influencing cognitive impairment in the elderly in rural communities of Jeju Province. Methods. 590 elderly in 6 rural communities of Jeju Province were interviewed, using a questionnaire consisting of sociodemographic characteristics, health behavior, quality of life, and MMSE-K Results. Prevalence of cognitive impairment was 33.1 % (39.1 % of females, 16.76% of males). Prevalence of dementia was 12.4% (16.3% of females, 2.87% of males). Factors related to cognitive impairment were age, sex, education, standard of living, employment status, and subjective health state. Conclusions. In community health care for the elderly, factors relating to cognitive impairment have to be considered. When planning community health care, priority should be given to the elderly; who need care but live alone; who lack social support; who have a low standard of living; who experience discomfort in the activities of daily living; who believe they are not in a good state of health; or whose life satisfaction is low.