• Journal of Korean Academy of Nursing
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• v.40 no.1
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• pp.110-118
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• 2010

Purpose: To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea. Methods: The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals. Results: The inter-rater reliability of items was high (Kappa range: 0.66- 0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month. Conclusion: This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

• Journal of Korean Dental Hygiene Science
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• v.6 no.1
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• pp.13-25
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• 2023

Background: This study was conducted to confirm the service quality management of care workers, who are direct service personnel of long-term care insurance for the elderly, using unstructured big data. Methods: Using a textome, this study collected and analyzed unstructured social data related to care workers' service quality. Frequency, TF-IDF, centrality, semantic network, and CONCOR analyses were conducted on the top 50 keywords collected by crawling the data. Results: As a result of frequency analysis, the top-ranked keywords were 'Long-term care services,' 'Care workers,' 'Quality of care services,' 'Long term care,' 'Long term care facilities,' 'Enhancement,' 'Elderly,' 'Treatment,' 'Improvement,' and 'Necessity.' The results of degree centrality and eigenvector centrality were almost the same as those of the frequency analysis. As a result of the CONCOR analysis, it was found that the improvement in the quality of long-term care services, the operation of the long-term care services, the long-term care services system, and the perception of the psychological aspects of the care workers were of high concern. Conclusion: This study contributes to setting various directions for improving the service quality of care workers by presenting perceptions related to the service quality of care workers as a meaningful group.

• Korean Journal of Childcare and Education
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• v.16 no.6
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• pp.253-272
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• 2020

Objective: This study aimed to analyze the counseling contents of daycare center teachers by using text mining and semantic network analysis methods to find the necessary support directions for daycare teachers and to improve the quality of child-care. Methods: Five hundred thirteen cases of counseling recorded on the open bulletin board of online counseling (Naver Bands for Nursery Teacher Counseling) were collected, and frequency analysis, centrality solidarity analysis, and machine learning-based topic analysis were conducted using the NetMiner4.3 program. Results: First, 'teacher-to-child ratio' was highest in the frequency. Second, 'colleagues' were all high in all centrality analysis. Third, machine learning-based topical analysis shows that the topics were categorized as subjects about 'childcare and education', 'working environment that supports professional development' and 'working condition', and among them, 'first-time teacher concerns' accounted for 44% of the total counseling content. Conclusion/Implications: This study implied that it is necessary to provide high-quality child-care and education to infants by lowering the 'teacher-to-child ratio', and a systematic program is needed to help improve effective communication skills in interpersonal relationships such as between parents, fellow teachers, and principals. In addition, self-development and efforts to improve teachers expertise should be prioritized in order to improve infant care quality and quality of teachers.

• Journal of Korean Academy of Nursing
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• v.53 no.2
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• pp.236-248
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• 2023

Purpose: Nursing informatics competency is used to manage and improve the delivery of safe, high-quality, and efficient healthcare services in accordance with best practices and professional and regulatory standards. This study examined the relationship between nursing informatics competency (NIC), nursing care left undone, and nurse reported quality of care (NQoC) and nursing productivity. A path model for their effects on nursing productivity among clinical nurses was also established. Methods: Data were collected using structured questionnaires answered by 192 nurses working in a tertiary hospital located in J city, Korea, and analyzed using SPSS/WIN 23.0 and AMOS 21.0 program. Results: The fit indices of the alternative path model satisfied recommended levels χ² = .11 (p = .741), normed χ² (χ² /df) = .11, SRMR = .01, RMSEA = .00, GFI = 1.00, NFI = 1.00, AIC = 18.11. Among the variables, NIC (β = .44, p < .001), NQoC (β = .35, p < .001) had a direct effect on nursing productivity. Due to the mediating effect of NQoC on the relationship between NIC and nursing productivity, the effect size was .14 (95% CI .08~.24). Meanwhile, nursing care left undone through NQoC in the relationship between NIC and nursing productivity, has a significant mediation effect (estimate .01, 95% CI .00~.03). The explanatory power of variables was 44.0%. Conclusion: Education and training for enhancing NIC should be provided to improve nursing productivity, quality of care and to reduce missed nursing care. Furthermore, monitoring the quality of nursing care and using it as a productivity index is essential.

• Quality Improvement in Health Care
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• v.4 no.1
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• pp.50-63
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• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

• Journal of the korean veterinary medical association
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• v.47 no.6
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• pp.498-509
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• 2011

2003년 미국동물병원협회(American Animal Hospital Association, 이하 AAHA)에서는 반려동물병원 경영에 있어서 매우 기념비적인 조사결과를 발표했다. "The Path to High-Quality Care"로 명명된 보고서는 동물병원의 경쟁심화와 수익성 정체로 고민하던 미국 반려동물 수의계에 새로운 희망과 이정표를 제시하였다. 이번 호에서는 상기 보고서의 내용을"최고의 동물병원으로 가는 길"이라는 제목으로 요약, 정리하고 한국 반려동물병원 경영에의 착안사항을 살펴 본다.

• Korea Journal of Hospital Management
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• v.22 no.1
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• pp.10-20
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• 2017

Purposes: This study analyzed activities for improvement of quality of care in nursing units to identify group-level success factors of quality improving efforts. Methodology/Approach: Research subjects were 31 general wards of C university hospital, which has 1,200 beds. Data were collected through survey and focus group interview. The mean value of nurses in a ward was converted to unit-level variable value of the ward. The SPSS 24.0 version was used to analyse the data. The units were classified into two groups, high performing and low performing, by the subjective level of quality improvement performance. Findings: The main findings are as follows: 1. The high performing groups participated more in education related to quality improvement and showed more quality improvement cases in progress than that of their counterpart. 2. The high performing group's nurses show more positive perception and attitude on quality improvement activities, and they have positive assessment on the necessity, effect, satisfaction about the quality improvement activities. 3. Middle managers' ability, attitude, motivation, and effective communication across members of the ward played pivotal roles in boosting the quality improvement activities of wards.

• Journal of Technologic Dentistry
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• v.33 no.4
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• pp.441-452
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• 2011

Purpose: Identify the factors that influence following up control and reuse intention of patient who used dental health care institution after dental heath care service and in order to prepare the method which improve the quality of dental health service which dental heath care institution service afford. Methods: Data were collected through random sampling from June 20th to August 20th 2010 (for 60 days). Once we explained the purpose of our survey to people who experienced the dental service within one year, we distributed the questionnaires to someone who volunteered to respond and they answered all questions by themselves based on the actual experience of dental health care organizations. Even if the survey was conducted for 610 people, only 585 properly answered questionnaires were analyzed because responses which had many unanswered questions and had errors in responsive way were excluded. Results: Result of multiple regression analysis, the value of dental clinic service, the following up control after dental treatment, the technique and kindness of dentist, the environment of treatment, type of dental service and the kindness of dental staff is significant main cause to intention of reuse dental clinic. Conclusion: In order to increase the rate of patient reuse, enhance the value of service with following up control after health treatment and the high quality of dental health service.

• Journal of the Korean Home Economics Association
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• v.43 no.12 s.214
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• pp.97-111
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• 2005

Early Head Start (EHS) can provide services to a child and family from pre-birth until the child is three years old. Services are comprehensive, intensive, individualized and flexible according to child and family needs, and integrated with community service delivery systems. The local program designs and operations were developed and carried out within the framework of the Head Start Revised Performance Standards, which included specific provisions for services to pregnant women, infants and toddlers and emphasized prevention, early intervention, safety, and health education. As with preschool Head Start, EHS programs are required to make available 10 percent of their enrollment for infants and toddlers with disabilities as defined by Part C regulations of the state in which the program operated. Quality child care has become a priority for EHS. A majority of EHS children need child care, and the quality is important to their development. An evaluation of EHS in 17 programs selected from the first program cohorts showed that the program had significant and positive impacts on a wide range of parent and child dimensions, some with implications for children's later school success. Among the issues for policy attention identified by American EHS for the Korean system are: - The need to create a comprehensive infant/toddler care system - The need to address access of teachers for young children - The need to improve quality.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.56-71
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• 1996

Background : Review of readmissions in health care facilities is necessary from the viewpoint of both economic concerns and quality considerations. To identify the characteristics, factors, and causes of multiple admissions in comparison with single admissions is essential for both providers and payers in order to assure quality care and efficient use of medical resources. Methods: All discharges from an university hospital in 1993 were analyzed, and the characteristics of multiple admissions were identified and were compared with those of single admissions by using the data bases of the discharge abstract and billing for reimbursement. Medical records of patients readmitted within 6 days after the previous discharge were reviewed to identify the reasons for such prompt readmission. Statistical analysis between groups of patients were performed by using SPSS. Result : The mean age was higher in multiple admissions than those of single admissions, and the average length of stay was longer in multiple admissions than in single admissions. The hospital cost per day is higher in single admissions while the cost per case is higher in multiple admissions. More than half of readmissions occurred within one month after the preceding discharges. Above 15% of the readmission within 6 days after the preceding discharges seemed to have close relationship with quality of care provided during the preceding hospitalization. The death rate of the patients readmitted within 6 days was the highest in comparison with multiple admissions and single admissions. Conclusion : Potential preventable readmissions should be reduced by identifying characteristics of multiple admissions, especially unplanned readmission, and by applying some interventions such as standard predischarge assessment or careful follow-up care after discharge for high risk readmission groups. As the results of these efforts, health care facilities could achieve quality improvement in medical care, and effective use of hospital resources.