• Title/Summary/Keyword: care management

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Identification and delegation of indirect care interventions (간접간호중재의 수행 및 위임에 관한 분석)

  • Yom, Young-Hee;Kim, So-In;Cha, Boo-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.5 no.2
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    • pp.197-207
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    • 1999
  • The purpose of this research was fourfold: (a) to identify the use rate of the indirect care interventions performed by nurses, (b) to estimate the time to perform each intervention, (c) to identify the indirect care interventions to be delegated to others, and (d) to determine the level of provider preparation needed to delegate indirect care interventions. The sample consisted of 199 nurses working in three hospitals. The Indirect Care Survey developed by the Iowa Intervention Project team was used for data collection. The instrument was translated to Korean and validated by nurse experts. Each of the 26 indirect care interventions were used several times a day. Four interventions (i.e.. Documentation, Shift Report, Specimen Management, and Transport) were performed several times a day by 50% or more of the nurses. The most frequently used intervention was Documentation, followed by the interventions Shift report. Environmental Management, Transport, and Examination Assistance. The least used intervention was Quality Monitoring, followed by the interventions Order Transcription, Referral, Health Care Information Exchange, Multidisciplinary Care Conference, and Product Evaluation. The intervention taking the most time to per-form was Technology Management (155.3 minutes), followed by the interventions Documentation, (122.2 minutes), Delegation (84.4 minutes), Supply management (83.4 minutes), and Preceptor: Student (79.9 minutes), Overall, the nurses reported that they would not delegate to others the majority of the interventions. More than 50% of the nurses would not delegate 21 interventions. Shift Report would not be delegated by 95% of the nurses and Documentation would not be delegated by 92% of the nurses. Caregiver Support would be delegated by 68% of the nurses to family. Three interventions (i.e.. Environmental Management, Examination Assistance, and Transport) would be delegated by more than 50% of the nurses to Nursing Assistant. This study will contributes to determining costs of nursing services and enhancing quality of nursing care. Replication study will be needed with large sample.

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A study of the Nursing Interventions performed by the ICU nurses to the patients with Cerebrovascular disorders (중환자실 뇌혈관질환자에게 수행된 간호중재분석)

  • Park, Young-Rye;Choi, Kyung-Sook
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.1
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    • pp.94-104
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    • 2001
  • The purpose of this study was to analysis of nursing interventions performed by the ICU nurses to the patients with cerebrovascular disorder practically from one university hospital in Seoul. The data were collected from 15 nurses with 86 cerebrovascular disorder cases from one ICU with the questionaire to write frequency of nursing care done by the surveyee from May, 2, 2000 to July, 3, 2000 and the list of 66 nursing interventions selected out of 433 NIC(Nursing Interventions Classification) of Iowa University which were translated into Korean (44 items) and core nursing interventions by ICU nurses (22 items; KIm, Su-Jin, 1997). The data were analysed with SPSS program. The results are as follow : 1. The most frequently used nursing interventions were vital sign monitoring, fall prevention, cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care, communication enhancement, technology management, bed rest care, respiratory monitoring in rank. 2. The most frequently used nursing intervention domains were 'Physiological : Complex', 'Physiological : basic', 'Behavior', 'Safty', 'Health system' in rank. In the domain of physiological : basic, the most frequently used nursing interventions were bed rest care, urinary elimination management, tube care : urinary, physical restraints in rank. In the domain of physiological : complex, the most frequently used nursing interventions were cerebral edema management, dysreflexia management, neurologic monitoring, cardiac care in rank. In the domain of behavior, the most frequently used nursing interventions were communication enhancement, touch, active listening in rank. In the domain of safty, the most frequently used nursing interventions were vital sign monitoring, fall prevention in rank. In the domain of health system, the most frequently used nursing interventions were technology management, specimen management in rank. 3. some difference of the frequency practicing the nursing interventions according to the shift of duties was found. For example, medication administration was common at day duty, touch was practiced at evening duty, temperature regulation was performed.

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A study on care, infection management and education for quality management of dental care of elderly patients by dental hygienists (치과위생사의 노인환자 치과치료 질 관리를 위한 케어, 감염 관리 및 교육에 관한 연구)

  • Hye-Mi, Lee;Seol-Hee, Kim
    • Journal of Korean Academy of Dental Administration
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    • v.10 no.1
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    • pp.22-32
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    • 2022
  • This study investigated factors affecting care for elderly patients, management of systemic disease, infection management, improvement of medical care quality, and educational requirements, and provide basic data for quality care for elderly patients with systemic diseases. An online survey was conducted among dental hygienists working at dental institutions and data of 172 individuals were analyzed using the SPSS 21.0 program. Descriptive statistics was performed for general characteristics. For factor analysis by general characteristics, t-test and ANOVA were performed. For differences between groups Scheffe verification was performed. A correlation analysis between factors was performed using Pearson's correlation analysis, and a factor analysis affecting the improvement of healthcare quality was performed using multiple linear regression analysis. Care for elderly patients was 52.33/75, management of systemic disease was 12.65/17, and infection management was 96.92/130. Improvement of medical quality (institutional effort) was 22.87/35, and improvement of medical quality (personal effort) was 22.72/35. The most common educational needs were "necessary". Analysis revealed a positive correlation between factors.. Factors affecting improvement of medical quality (personal effort) were age, final academic background, place of work, and the presence or absence of annual medical examinations. The findings of this study indicate that there is a significant correlation between factors. For the qualitative care of elderly patients, education programs related to elderly characteristics, systemic diseases, and infection management should be actively conducted by dental hygienists, and interest and research on geriatric dental hygiene is needed, centering on associations and educational institutions.

A Study on Nutrition Knowledge, Dietary Attitudes and Nutrition Education Needs among Child-Care Teachers (일부 보육교사의 영양지식과 식생활태도 및 영양교육 요구 조사)

  • Choi, Kyung-Suk
    • Korean Journal of Community Nutrition
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    • v.15 no.1
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    • pp.137-148
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    • 2010
  • This study was conducted on 175 child-care teachers, who participated in in-service education, to research the methods to improve child-care teacher's nutrition management capability for infants and children. Investigated results of child-care teachers' nutrition knowledge, dietary attitude status, and needs on nutrition education in child-care centers are as follows: The score of child-care teachers' nutrition knowledge was 10.83 points out of 15, which is about 72%. Total score increased as teachers' age but not significantly different from their career duration, since teachers who have a child-care career less than 5 years acquired 10.91 points, which is higher than 10.64 points of teachers having more than 5 years of child-care career. Teachers' average recognition to the nutrition knowledge was 90.6%, increased significantly by the older they are, and decreased according to the accumulation of their career. The average accuracy of the nutrition knowledge was 79.7%, increased in proportion to the teachers' age. The marks of child-care teachers' dietary attitude were 41.3 points (possible score range 5-50) and 83%, older teachers tended to have more desirable dietary attitude. As indicated by the increment of child-care career, the score of emotional attitude tended to be increased but which of cognitive and behavioral attitude showed a declining tendency. Nutrition information which child-care teachers were mainly interested in were correct selection of food (58.1%), obesity and weight management (52.7%), and nutrient content of food (44.9%). Nutrition education contents which child-care teachers needed were 'nutritious food and menu for child' (72.2%), 'health management of child' (69.2%) and meal management of child (40.2%). Nutrition education methods, which child-care teachers considered as of desirable ones, were cooking class of small scale (31.8%), visiting class at child-care center (26.5%). In consequence, the nutrition knowledge and dietary attitude of child-care teachers were not good and showed different issues by age and career duration. Therefore, it is requisite to intensify nutrition management courses in child-care teachers' qualification and in-service education courses which has actual necessity and suitability based on teachers' age, career, and the type of child-care center, and to disseminate these through public health centers and child-care & education information centers to pursue the efficient balance of nutrition education programs.

Job Analysis of the Staff Nurse in Cardiac Surgery Intensive Care Unit (심장외과 중환자실 일반간호사의 업무분석)

  • Ko, Yu-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.9 no.2
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    • pp.265-282
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    • 2003
  • Purpose : This study was conducted to provide for a basic resource, which can be used to set up a efficient management system in Cardiac Surgery Intensive Care Units(CSICU). Method: 1) Questionnaires were administered and observation methods were used, to examine the nursing activities performed in the CSICU after having reviewed related literatures and a review by the experts. Thus, the nursing activities were designating 254 activities and classified into 28 categories. 2)The 22 nurses in the 2 CSICUs filled out questionnaires about nursing activities from 12 April, 2002 to 17 April, 2002. The frequency of the nursing activities in the 28 categories counted and new nursing activities added by directly observing 12 nurses by two trained research staffs for 4 day. 3)In terms of validity, the 264 nursing activities were analysed by the 25 experts. As a result, 231 nursing activities were found valid and remained as appropriate nursing activities to be used for the careful analysis of the nursing activities in CSICUs. Result: The 22 categories are as below: assessment, monitoring, respiration management, nutrition management, elimination/drainage management, mobility management, sanitation management, safety management, temperature management, specimens collection, preparation and assistance of treatment, skin/wound management, infection management, medication management, education/support, dying patient care, recording/keeping, supplies management, environment management, communications, evaluations, professional development Conclusion : The manifest job description of the staff nurse will contribute to improving the efficiency of the nursing activities and to reducing the role conflicts among the medical staffs.

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Study on the Development of Home Care Nursing Intervention Protocol for Stroke Patients (뇌졸중 환자의 가정간호중재 프로토콜 개발)

  • Yoo Ji-Soo
    • 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.

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The status nursing care delivery system and the influencing factors on quality of nursing care (간호전달체계 현황 및 간호서비스의 질에 영향을 미치는 요인)

  • Kim, Ji-Yeun;Park, Bo-Hyun;Ko, Yu-Kyung
    • Korea Journal of Hospital Management
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    • v.21 no.2
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    • pp.24-36
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    • 2016
  • The aims of this study is to investigate the status of nursing care delivery systems and nurse staffing levels and to analyze differences in the quality of nursing care by the type of nursing care delivery system. This research was based on data from 723 nurses working in 55 medical and surgical units in 26 general hospitals. Descriptive statistics on nurse staffing levels and the nursing care delivery system, and multi-level logistic regression were used to estimate the determinants of quality of nursing care. The number of patients per nurse is 17.74 patients in functional nursing care and 15.56 patients in total nursing care. In comparison to hospitals adopting total nursing care, hospitals with functional nursing care had greater patients. The nurses rated units using total nursing care as significantly better quality of nursing care than the units with functional nursing care. Total nursing care or modified total nursing care, rather than functional nursing care, could lead to improvement in the quality of care(total nursing care OR=3.895, modified total nursing care OR=2.475). Patient-centered approaches under proper circumstances can be successfully implemented and the positive effects demonstrated.

Activation plan of community care focused on a municipal hospital (시립병원을 중심으로 한 커뮤니티 케어 활성화 방안)

  • Noh, Jin-Won;Lee, Yejin;Kim, Jae-Hyun;So, Ye-Kyoung;Hong, Hyun-Suk;Lee, Yunhwan
    • Korea Journal of Hospital Management
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    • v.24 no.3
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    • pp.38-47
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    • 2019
  • Purposes: Rapid aging and increase of high chronic diseases of the elderly are increasing the needs for expanding elderly care beyond the concept of treatment in medical institutions. This study is to discuss the core values, functions, and roles of municipal hospitals and suggest a suitable community care model. Methodology: The survey was collected twice derived from the domestic expert groups. This study analyzed experts' responses using Delphi method and Analytic Hierarchy Process, using Microsoft Excel 2016. Findings: Among the core values of the municipal hospitals, it was shown that community linkage had the highest priority. The publicity had the highest priority among the functions and roles of the municipal hospitals. In the community care models presented in this study, the model focused on 'Community Care Integration Center' showed highest relevance, suitability and applicability. Practical Implications: This study suggested three different community care models and derived the most suitable model for community care, which is focused on the municipal hospitals. It suggested effective application of the community care model to promote community care in each community.

Choices of Medical Services and Burden of Health Care Costs: Japanese Prohibition of Mixed Treatment in Health Care (의료서비스 선택과 비급여 의료비 부담: 일본 혼합진료금지제도 고찰)

  • Oh, Eun-Hwan
    • Health Policy and Management
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    • v.31 no.1
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    • pp.17-23
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    • 2021
  • With the introduction of national health insurance, the burden of health care costs decreased and choices of medical services widened. However, because of the rapid expansion of non-covered medical services by health insurance, financial security for health care expenditure is still low. This gives patients barriers to choose medical services especially for non-covered medical services, and it becomes narrower. Compared to Korea, Japan has high financial protection in health care utilization, but there exists a limitation using covered and non-covered medical services both together. This is called a prohibition of mixed treatment in health care. This study reviews the Japanese health care system that limits choosing medical services and the burden of health care costs. The prohibition of mixed treatment can alleviate the out-of-pocket burden in the non-benefit sector, but it can be found that it has a huge limitation in that it places restrictions on choices for both healthcare professionals and patients.

Pain Management Knowledge and Attitude of Internal Medicine and Surgery Stream Nurses (내.외과계 간호사의 통증 관리에 대한 지식 및 태도)

  • Song, Seung-Sun;Park, Chai-Soon
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.17 no.1
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    • pp.55-62
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    • 2010
  • Purpose: This study investigated the sought to identify the pain management knowledge and attitude of nurses in internal medicine and surgery stream wards and intensive care units to obtain basic information needed for improved pain control. Method: Data was collected through self-reported questionnaires and analyzed by descriptive statistics, t-test and ANOVA using SPSS Win 12.0. Results: Pain management knowledge score averaged 51.1 out of 100, with significant differences evident depending on age, marital status, educational level, position, total work career, working department and cancer care-giving experience. Pain management attitude score averaged 2.9 out of 4, and significant differences were evident depending on age, marital status, educational level, position, total work career, working department, cancer care-giving experience, education experience and number of patients treated. Conclusion: Further studies are necessary to develop effective nursing knowledge and attitude education programs and evaluation such as discussion by cases, workshops, system of expert help for uncontrollable pain or a multi-disciplinary pain management task force. In addition, patient satisfaction level with pain management should be assessed and the responses reflected practically.

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