• Journal of Korean Critical Care Nursing
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• v.10 no.2
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• pp.14-23
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• 2017

Purpose: The purpose of this study was to evaluate the effectiveness of a ventilator-associated pneumonia (VAP) bundle. Methods: This was a retrospective study that was carried out between June 2010 and October 2015. In this study, 3,224 intubated patients were included. The VAP bundle which was applied to Group 1 patients (n=470) included head-of-bed elevation to 30 degrees, cuff pressure monitorization, prophylaxis of peptic ulcer, and prophylaxis of deep vein thrombosis. The VAP bundle for Group 2 patients (n=1,914) included all the elements of the VAP bundle for Group 1 patients and one additional element which was oral care with 0.12% chlorhexidine. The VAP bundle for Group 3 patients (n=870) added sedative interruption and assessment of readiness to extubate to the VAP bundle for Group 2. Results: The numbers and incidences of VAP were significantly different among the three groups. Moreover, there were significant differences among groups in ICU length of stay and mortality. Conclusion: Three different VAP prevention bundles made different effects in patient outcomes.

• Journal of Korean Clinical Nursing Research
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• v.14 no.1
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• pp.5-14
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• 2008

Purpose: To examine the current fees for nursing care and propose the strategies for improvement. Method: The number of subjects for this study was 86, including 36 chief executives of the nursing department, 14 of the health insurance department and 33 nursing managers. Data were analyzed by SPSS WIN 12.0 program. A researcher-developed questionnaire with 30 items was utilized. Results: 61% hospital had improved the nursing management fee grade after adoption of the differentiated nursing management fee schedules. After grade improvement, the time for direct nursing care increased. Also, the patient health outcome, nurse's job satisfaction were improved and more nurses were employed in general nursing units. Many subjects addressed that ICU and more nursing units were needed to adopt the differentiated nursing management fee schedules and "bed to nurse ratio" needed to be changed to "patients to nurse ratio" and specialized by the nursing units. Conclusion: The health policy in reference to fees for nursing care needs to get improved further in order to provide the quality-assured nursing care.

• Women's Health Nursing
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• v.2 no.1
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• pp.25-39
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• 1996

The Korean government has a new system for charging patient care for patients in hospital, on hold for the present(9 / 1995) but to start implementation in certain areas of patient care next year. From the latter half of next year the Ministry of Health and Welfare would like to start demonstration projects for hospitals who want to start using DRGs for frequently seen medical diagnosis and for patients with a course that is predictable and for whom non-insurance costs are minimal : such as the patient who has a delivery, cesarean deliveries, cataract surgery, tonsillectomy or an appendectomy, and apply the DRG system of payment for hospital care for these patients. The purpose of this study was to establish a recording system to give effective home health care to postpartum women and their newborns. Recently the government announced a DRG system to apply to postpartum women for pilot purposes starting next year. This gives impetus to the need to develop home care records that will allow for systematic recording and provide continuity and consistency in care across all health professionals and with in-depth communication between the professions to assure high quality care. There has been a rise in medical costs and a shortage of patient bed space in hospitals, particularly since the introduction of national medical insurance. The study focused on developing client selection criteria, a primary assessment tool, progress notes and nursing diagnoses applicable to postpartum and newborn clients. Selection criteria for home health care, assessment tool content, nurses progress notes and diagnoses were developed through a review of the literature, advice from professionals who are expert in home health care and actual practice in the use of recording tools through workshops. The recommendations based on the research results are as follows : 1) Replication and application of these tools is needed to test the validity of the tools 2) In order to have systematic nursing records standardization of records has to be done after nurses have had experience using them. 3) Reliability and validity of the tools has to be established through applicability to actual care situation.

• The Journal of Korea Robotics Society
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• v.18 no.4
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• pp.392-402
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• 2023

The purpose of this study was to conduct an exploratory and descriptive survey study design to examine 1) the physical difficulty by care task, 2) overall occupation-related physical burden by the characteristics of caregivers and care receivers, and 3) the level of help by the use of care robots and devices among formal caregivers working in facilities for older adults. In this study, 308 formal caregivers working in facilities were recruited from 8 nursing homes and 5 geriatric hospitals between Aug. 2021 and Sept. 2022 in South Korea. There were significant differences in ADLs between nursing homes and geriatric hospitals: eating, dressing, hygiene, transfer to bed, transfer to the toilet and walking. For each care item, the items the caregivers had the most difficulty ranked first were bathing, excretion assistance, and mobility support. The difference in occupation-related physical burden according to general characteristics was found to have statistically significant differences in female and bad perceived health. Among the 205 caregivers who had experience using care robots and devices, pressure ulcer prevention was the most experienced one, and those also were the most helpful and exercise aids were the least helpful. In order to reduce the physical burden on care providers, it is necessary to develop and introduce a care robots centered on the care site. Furthermore, national level public support systems are required to enable facilities to actively utilize care robots and devices.

• Health Policy and Management
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• v.27 no.2
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• pp.149-156
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• 2017

Background: This study was conducted to evaluate the performance of the Hierarchical Condition Category (HCC) model, identify potentially high-cost patients, and examine the effects of adding prior utilization to the risk model using Korean claims data. Methods: We incorporated 2 years of data from the National Health Insurance Services-National Sample Cohort. Five risk models were used to predict health expenditures: model 1 (age/sex groups), model 2 (the Center for Medicare and Medicaid Services-HCC with age/sex groups), model 3 (selected 54 HCCs with age/sex groups), model 4 (bed-days of care plus model 3), and model 5 (medication-days plus model 3). We evaluated model performance using $R^2$ at individual level, predictive positive value (PPV) of the top 5% of high-cost patients, and predictive ratio (PR) within subgroups. Results: The suitability of the model, including prior use, bed-days, and medication-days, was better than other models. $R^2$ values were 8%, 39%, 37%, 43%, and 57% with model 1, 2, 3, 4, and 5, respectively. After being removed the extreme values, the corresponding $R^2$ values were slightly improved in all models. PPVs were 16.4%, 25.2%, 25.1%, 33.8%, and 53.8%. Total expenditure was underpredicted for the highest expenditure group and overpredicted for the four other groups. PR had a tendency to decrease from younger group to older group in both female and male. Conclusion: The risk adjustment models are important in plan payment, reimbursement, profiling, and research. Combined prior use and diagnostic data are more powerful to predict health costs and to identify high-cost patients.

• Journal of Korean Biological Nursing Science
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• v.9 no.2
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• pp.135-142
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• 2007

Purpose: This study was conducted to investigate degree of stress level in CCU patients, and to give a baseline data in developing nursing intervention program to reduce the stress. Method: Subjects of this study were the 100 hospitalized patients of C University Hospital in Seoul City from February to December 2003. The collected data was analyzed by using the SAS program: t-test, Scheff$\acute{e}$ test, and ANOVA analysis were employed to find differences in stress level. Result: The highest stress factor was 'Concern', and next were 'Dependency & limitation', 'Uncertainty', 'Treatment procedure', 'Sleep disturbance', 'Environment' in order. The perceived stress level of CCU patients was 1.65 scores; the highest scored item was 'have to void urine and feces on the bed', next were 'have to use the toilet bowel lying on the bed' in order. The stress level according to characteristics of the subjects was significantly different with the marital status, the presence of religion, the hospitalized days, the economic status, and the admission experience. Conclusion: The stress level of patients in the coronary care unit was high in concern of a disease, family and economic state, in limitation and dependency, and in uncertainty about prognosis of a disease. Further researches are necessary to develop and apply the intervention method of reducing stress level of CCU patients. In addition studies on family members of CCU patients are also recommended.

• Journal of the Korea Furniture Society
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• v.25 no.4
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• pp.304-318
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• 2014

Bed for elderly and disabled, including the United States developed the industry Americas, and European countries, mainly in the production of products has dominated the world market. In large hospitals, and dependent products are sold at high prices. On the other hand, improvement of living standards of our country and to the advancement of residential culture of the demand for luxury products is increasing. The study of elderly Edition mattresses have been developed mainly in Europe to maximize the use of sleep can increase the efficiency of products has been studied. Due to the increase in elderly population Elderly Hospital, which is installed in the elderly silver town Edition requires the dissemination of the mattress in the bedroom several times a day resting and sleeping, eating, etc. Designing a variety of actions are needed. Edition of the elderly in Korea developed the design of bed with bed design and the manufacturer and the Institute for Ergonomics, welfare agencies and to build organic cooperation system under the direction of a professional designer to develop and you need to configure the space and the results of such actions by the distribution of cheap materials, ergonomic mattress for optimal development of behavior analysis to the need to promote the convenience of the user.

• Journal of The Korea Institute of Healthcare Architecture
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• v.25 no.2
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• pp.27-35
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• 2019

Purpose: This study is to address the spacial composition of a standard ward and bedroom size for sake of infection control and efficient medical service. Methods: Spacial composition of a standard ward has been proposed by comparative analysis of 5 big hospitals' wards. Bedroom sizes have been explored on the ground of Health care facility regulations from Korea, USA, Australia and Canada. Of course, Literature and field survey have been conducted in order to draw out various bedroom sizes. Results: 16 basic and some other additional spaces have been proposed for the composition of hospital standard ward. Area of Single bedroom is $11.6m^2$, and that of multi-beded room is $7.4m^2$. Bed to bed Clearance is 1.5m, spacing between bedsize and hard wall is 0.9m in 1~2 beded room, 0.75m in 4-beded room. Space clearance between Foot side of bed and curtain is proposed as 0.3m and additional 0.9m is necessary for the circulation. Implications: The result of this study can be applied to the new cons.

• Journal of the Ergonomics Society of Korea
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• v.31 no.2
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• pp.379-388
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• 2012

Objective: This study developed a new shower carrier prototype to reduce caregivers' muscle burden and to increase use convenience by reflecting the needs of domestic long-term care institutions. Background: In the long-term care institutions, one of the ADL(Activities of Daily Life) factors is bathing/showering. Recently, bath/shower-assisting equipment is actively being introduced in care institutions to reduce the caregivers' care cost, but most of the domestic equipment was designed to imitate foreign products and rarely reflected the needs of care institutions. Method: Based on Korean elderly people's body information, the bed size(length: 1,900mm, width: 650mm) was set-up, and a variable headrest with a newly designed headform was developed to provide the comfort for the elderly and convenience for caregivers. To reduce caregivers' muscle burden on transferring and showering activities, a 3-step column lifting module equipped with dual actuators(lowest/highest levels from the ground: 600/1,100mm, Stroke: 500mm) was developed, and the wheelbase parameter(length: 1,250mm, width: 580mm) was defined securing the turn-over safety of the shower carrier. The drivability tests were performed for the prototype and foreign product, and the male and female subject's muscle activities were measured through the tests. Results: The structural stability of the shower carrier prototype was secured by finite element analysis, and the muscle activities of the subjects through the drivability tests largely decreased in the prototype, compared to the foreign product. Conclusion: In this study, a new shower carrier prototype was developed to possibly reduce caregivers' muscle burden and to increase use convenience based on the needs of long-term care institutions. It was expected that the drivability performance of the prototype could be relatively superior to that of the foreign product. Application: The results obtained from the study can be applied for the optimal development of a shower carrier including other equipment to effectively care for the elderly.

• Journal of the Korean Dietetic Association
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• v.2 no.2
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• pp.199-215
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• 1996

In Korea, the majority of hospital dietitians expend most of their time performing food management related activities, and only a few carry out nutrition care activities in full-time. This study was designed to measure productivity of the clinical nutrition team and assess the role of clinical dietitians in the only 2200-bed teaching hospital in Korea. Six full-time clinical dietitians collected time data for four weeks according to the nutrition care activities outlined. Three clinical dietitians assigned to 7 units recorded how often physicians implemented their recommendations for two months. Two kinds of survey questionaire were developed and sent to the patients and the health care team. The followings are a summary of the results. 1. The clinical nutrition team of 6 full-time dietitians expended 75% of their time performing patient care activities, 20% in non-patient care activities and 5% in delay and transit. 2. Each clinical dietitian assigned to the units carried out 56 patient care activities on daily basis. 3. The average time required for the clinical nutrition services was 60.2 minutes for outpatient counseling, 89 minutes for inpatient counseling, 72.5 minutes for nutrition management, 95 minutes for malnutrition consult and 121 minutes for dysphagia diet management. 4. Physicians' implementation of clinical dietitians' recommendations was 98.5%. 5. Most physicians and nurses viewed the clinical dietitians on the units assertive, contributing to the quality improvement of medical services, and helpful to the patients as well as the health care team. 6. Most patients viewed the clinical dietitians on the units considerate, attentive and helpful. Based on these results, it is suggested that (1) daily meal round and nutrition care monitoring are effective tools for nutrition intervention in the hospital setting. (2) unit assignment of clinical dietitians enhances the patients' satisfaction in the nutrition services provided as well as the perceptions of health care team on clinical dietitian's expertise.