Purpose: To analyze the home care services provided to the elderly aged 65 and older by a hospital-based home care agencies and to investigate the effects of long-term care insurance for the elderly. Method: The subjects were the home care service recipients aged 65 and older in 172 hospital-based, home care agencies registered in Health Insurance Review & Assessment Service in January, 2007. The data were collected using a questionnaire from March 16 to April 15, 2007. The questionnaire return rate was 43.8%. Result: The hospital-based home care agencies were able to visit 66.5% of the national administrative districts. Of the home care service recipients, over 50% were 65 years old and older. About 43% of the agencies reported that over 50% of their patients would be subject to the long-term care insurance. They expressed concern that home care services would be withdrawn once the insurance system is initiated. Conclusion: This study suggests that hospital-based home care agencies need to manage home care services with long-term care insurance. It also recommends developing guidelines for the use of services and referrals.
Purpose: The purpose of this study was to develope nursing activities record to improve home care nursing for postpartum women following a Cesarean section and newborns. Method: This study for instrument development had three phases: first, selection of nursing activities according to intervention, second, validation of the preliminary home care nursing activities, and third. application of the home care nursing activities. The subjects for validaton were 137 home care nurses and clinical nurses in department of maternity. Result: By Fehring's method, 116 nursing activities according to 19 interventions were included in the preliminary nursing activities record. Among them, 51 critical nursing activities and 65 supporting nursing activities were chosen. During the final process of validation, 121 nursing activities were included. Conclusion: In order to have systemic standardization of this record forms, replication and application in the various home nursing area is need in the future.
Client(patient) satisfaction has been used for a variety of purposes in different settings, yet, those receiving home care services have been the focus of few satisfaction studies. Satisfaction is considered an indicator of quality of care and is also being used to assess the performance of home care providers and home health care delivery at multiple levels. The aim of this study was to develop the tool for evaluating client satisfaction in several aspects with home care service while maintaining or achieving acceptable reliability and validity. Firstly, Client Satisfaction Instrument made preliminary of 43 items composed basic 6 criteria and 7 indicators, based on a review of literature, quality improvement and client satisfaction findings in home care. Secondly, there were consisted in two expert panel groups who were made in professionals of research and practice in home care field. The tool was modified to 6 criteria and 7 indicators, 25 items after reviewing by two expert panel groups. The content validity index of the tool was above 0.8 and the results of internal consistency was more than 0.8 in all items. Finally. The Client Satisfaction Instrument in Home Care Service was made up 6 criteria such as client satisfaction of nurses's instruction of home care educational need. knowledge/technique/attitude of homecare nurses's performance. interpersonal relationship and emotional support of nurse. easiness of homecare accessibility, continuity of homecare service. overall efficacy of homecare use, 7 indicators. and 25 items. The results of evaluating client satisfaction will be able to contribute in quality improvement and service marketing in home care.
Recently, there has been an increasing need for long-term care and comprehensive health care services in community settings. The Ministry of Health and Welfare introduced the Hospital-Based Home Nursing Care Program in 2000. Before this initiative, there was a Home Nursing Demonstration Center, affiliated with the Seoul Nurse Association, had offered home nursing services with the financial support from the local government. since 1993, the Center's nursing staff has been engaged in a general hospital in an effort to provide home nursing care services within Korea's health care system. The purpose of this study was to analyze and identify characteristics of community-based home nursing care supplied by a community-based home nursing team engaged in a general hospital. Also. visit nursing care services provided by public health centers were evaluated in terms of accessibility and supply versus demand, to enhance the accessibility of low-income patients living in Seoul to home nursing care services. Data were collected from home nursing insurance reimbursement claims submitted by the community-based home nursing care team from March 1 to October 30 in 2001 and a questionnaire survey on home-visit nursing services of 25 public health centers in Seoul. The subjects consisted of 197 patients and 12 public health centers. The result were as follows. First, medical institution's community-based home nursing care program was better in technical quality than health-center-based home-visit nursing care. In addition. the pattern of the subject patients was similar to that of hospital-based home nursing care program. Second, there was a high demand for community-based home nursing care while only a small number of home-visiting nurses served at public health centers in Seoul. As a result, many patients could not receive adequate care. Finally, we suggest that community-based home nursing care program should be introduced in the national health system to meet the at-home care needs of severely ill low-income patients. Furthermore, to better utilize home nursing and visit-nursing care resources and offer continued care for patients in community settings, an efficient referral network should be built among related institutions. This would require improvement of reimbursement system and amendment of the law related to health insurance system and community-based home nursing care services.
The objectives of this research are (1) to identify characteristics and needs of the recipients of home care, and type of services (2) to examine the factors that predicts the degrees of recipients' satisfaction. This study uses the data based on the responses of 490 recipients selected randomly from 22 home care centers. The results show that recipients have higher frequencies in age of 60+, disabled status, difficulty with ADL, IADL items, no family, and lowest class. And the type of services offered by home care centers have highest frequencies in home maker services. Recipients' attitude toward home care services is "helpful," but they are not satisfied with the frequency of visit. The study found that disabled status, difficulty with ADL, IADL, health services, and home maker services are negatively related with degrees of recipients' satisfaction. Based on the findings, the study would conclude that home care policy should be recipients' need-based, developing systematic: need assessment tool. Expanded home health caring must be required for the disabled elderly.
The subject of this study is to review the practical approaches of Home Care Services. Included is a brief overview of its nature, providers of Home Care Services, recent history of Home Care Services, and the impact of the national movement toward cost containment in health care. The data used in this study are obtained from the Elderly Program of the Medical Services and other data on the Home Care Services in Japan. With the growing elderly population in Japan, it is to be expected that the medical care expenditure for this sector will continue to increase. With the aim of keeping expenditure for medical care within reasonable bounds, it is essential that this increasing expenditure on the elderly be used effectively. With the Health and Medical Services Law for the Aged was enforced, therefore, remuneration for medical treatment of the elderly and what is known as the staff placement standard at hospital for the elderly were rationalized. In addition to rationalization from the point of view of medical care supply, it is necessary to guarantee the appropriate treatment within the community and at home for those elderly who are bedridden but not in need of hospital care. For this it is required that Home Care Services, such as health services like visiting guidance by public health nurse in hospital of Health Center. So that the elderly can feel secure in receiving treatment within the community and at home, allowances for guidance on leaving hospital and for intermittent nursing and guidance thereafter are to be newly introduced. Home care Services in one aspect of comprehensive health care, it is comprised of health services provided to individuals and families in their homes. Its purposes include promoting, maintaining and restoring health, specifically maximazing independent functioning and minimizing the disabling effects of illness, including terminal illness. Services appropriate to the needs of clients and their families are planned, coordinated, and delivered by providers organized for the delivery of home health care through the use of contractual arrangement, employed staff, or a combination of the two.
Purpose: This study aimed to investigate the hospital nurses' knowledge, emergency coping ability and educational need about nursing care for patients applied the home mechanical ventilator (PaHMV) and to compare the variables between yes or not experienced on that. Methods: Participants were 91 hospital nurses who worked at the wards where PaHMV can be highly admitted such as respiratory internal medicine, rehabilitation medicine, neurology and emergency room. Data were collected by questionnaires. The analytic methods were $n(%)/M{\pm}SD$, t-test/ANOVA and $X^2-test/ANCOVA$. Results: Knowledge and emergency coping ability were low as $2.27{\pm}0.52$(4 points) and $78.72{\pm}8.06$(100 points) respectively. But educational need was high as $3.10{\pm}0.34$(4 points). Knowledge and emergency coping ability showed the significant differences between two groups (p<.001, p=.048), and the scores of experienced nurses were higher. But the educational need didn't show the significant difference (p=.974). Conclusion: These findings indicate that education on nursing care of PaHMV is needed for hospital nurse. So we have to develop the educational program on nursing care of PaHMV and then operate it with practice and site education.
Park, Min-A;Jang, Jung Sook;Cho, Young Yi;Choi, Ji Yeon;Lee, Jong-Eun
Journal of Home Health Care Nursing
/
v.30
no.2
/
pp.155-162
/
2023
Purpose: This study was conducted to identify the status and risk factors for the carriage of multidrug-resistant organisms carriage in home health nursing patients. Methods: This retrospective study enrolled 122 participants who received home health nursing and analyzed the data obtained from chart review and diagnostic tests for multidrug-resistant organisms carriage from January 2019 to January 2021. Results: Multivariate analysis revealed that surgical procedures in the preceding year, injectable antibiotic use in the preceding month, pressure ulcer, and indwelling nasal tubes were significantly associated with multi-drug resistant infection. Conclusions: Infection-control strategies need to be developed and customized for use in the home health-nursing service for patients who are carriers of multidrug-resistant organisms.
Background: Recent changes in the medical environment have increased the need for the home health care nursing in Korea. Even though the number of home health care patients is increasing, the major nursing problems have not been identified due to lack of a standardized nursing diagnosis. Aim: An investigative study was conducted to determine the frequency and appropriateness of nursing problems in hospital-based home health care patients in Korea using two internationally standardized nursing diagnosis classification systems. Methods: Nursing records of 249 hospital-based home health care patients were reviewed and nursing problems were identified using the North American Nursing Diagnosis Association Nursing Diagnosis Taxonomy I (NANDA) and the Clinical Care Classification of Nursing Diagnoses (CCC). Findings: Out of 463 nursing problems. 403 nursing problems were described using the NANDA whereas 427 nursing problems were described using the CCC. Nursing diagnoses not captured by the NANDA classification include nausea/vomiting, anorexia, risk for nutrition deficit, decreased blood pressure, dying process, blood sugar impairment. infection unspecified, and disuse syndrome. Nursing diagnoses not captured by the CCC include nausea/vomiting and anorexia. Conclusions: In describing nursing problems of home health care patients, it was found that the CCC was able to represent more diagnoses than the NANDA.
Purpose: The purpose of this study is to examine the status of care-giving for the demented elderly and to find out the need of community in-house care services-day care services, short-term care services, home help services, and home care services. Method: It analyzed the data of 186 old people having dementia, and caregivers. Data were collected for five days, in September 2002. Results: The caregivers were mostly women and the burden for the care giving was high (87.5%). They used community care services, that is, day care services (26.5%), home care services (21.6%), home help services 00.8%), short-term care services (6.2%). Caregivers' age and education level were significant factors in the demand for day care services. Caregivers' education level was a statistically significant factor in the demand for short-term care services and home help services. Caregivers' age and education level were significant factors in the demand for home care services. Conclusions: It is necessary to expand the financial aid for the active implementation of daytime protection for dementia-patients under medical treatment at home and to promote patients' recovery. It is necessary to enhance home help services and home care services, and to establish many day care centers and short term care centers. Through this, it will prevent caregivers from becoming burnt out due to the burden of care giving.
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