• 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.

• Research in Community and Public Health Nursing
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• v.12 no.2
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• pp.329-337
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• 2001

Purpose: This study was to develop a critical pathway for COPD clients in home health care. Method: Review of literature. Analysis of 10 cases of home health records of COPD clients without other major chronic illness, and Contents validity test Results 1. Vertical axis(l4 activities) physical and mental assessment, family assessment. environment assessment, rights and duties of client, oxygen use and safety, education of disease process and symptom, medication, nutrition and elimination, tests, activities, respiratory exercise, sleeping pattern. consultations and discharge planning. 2. Horizontal axis was set by the number of visits(average number of visits is 6.4) and vertical axis was set with 14 activities and the contents which should have occurred, according to the time frames of the horizontal axis. 3. According to the contents validity test, among the total of 234 items, 176 items showed over 83% agreement and 58 items showed less than 83% agreement. Those items with less than 83% agreements were either deleted or revised. Conclusion this critical pathway is applicable to the home health care of COPD clients to provide quality home nursing care services at lower cost.

• Journal of Korean society of Dental Hygiene
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• v.16 no.3
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• pp.373-381
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• 2016

Objectives: The purpose of the study is to investigate the awareness toward use and service contents of long term care for the elderly. Methods: A self-reported questionnaire was completed by 296 adults from August 13 to October 20, 2014. The questionnaire consisted of general characteristics of the subjects, awareness toward long term care insurance for the elderly, awareness toward long term oral health care services, use of long term care service and use intention for the long term care insurance. Data were analyzed by SPSS 18.0 program. Results: Those who were aware of the long term care insurance accounted for 55.4 percent. Approximately 50 percent of the respondents recognized long term care service items, home visit care, home visit bathing, and home visit nursing. Most of the respondents had information of long term care services by way of mass media and direct contact. Only 13.4 percent of the respondents were aware of the oral health service in the long term care insurance. The subjects were aware of denture cleaning, oral cleaning and oral health education out of oral health service in order; and oral health services that needed to be offered were denture cleaning, oral health education and professional toothbrushing. They reported that dental hygienists were the most important manpower that offered the efficient oral health care services. They answered that professional manpower and financial support are required for oral health services. The positive thinking to long term care insurance accounted for 89.2 percent and 91.3 percent had use intention for oral health services. Conclusions: Many elderly people have mastication or dysphagic problems due to systemic diseases. Therefore, it is necessary to announce the long term care insurance and long term care services for the elderly people.

• Research in Community and Public Health Nursing
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• v.11 no.2
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• pp.423-440
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• 2000

This research was conducted to identify the following: the home care needs of patients with dementia and the burden on the primary family care giver: to provide basic data required to develop nursing intervention for the care giver: and to suggest recommendations for medical institutions and social services that could reduce the burden on the families of people suffering from dementia. subjects of this research were 53 patients of the two Public Health Centers of Cheju Province who are suffering from dementia and their families. The instrument used in the research was Kuen. Jung Don (1994)' s assessment tool of burden in the primary family care giver who has parents with senile dementia and Yoo. Young Mi(1998)'s assessment tool of home care need. modified by the researcher in the questionnaire by a Likert rating scale. The period of data collection was from February 8. 2000 to March 10. 2000. Collected data was analyzed by SPSS, using mean, standard deviation. ANOVA, t-test and Pearson correlation coefficient. The result of this research was that there was not a significant correlation between the burden on the care giver and the level of dementia, its duration, the patient's ability to perform daily tasks, the period of care giving. and the use of social services, although the lower the patient's ability to perform daily tasks. and the worse the care giver's own health situation, the higher the burden on the primary family care giver. The following suggestions are made based on the results of this research. 1. More than half of the subjects don't use social facilities and services. More publicity and referral efforts are needed about medical institutions. nursing institutions and other facilities that specialize in services for dementia sufferers and their families. 2. Nursing services should include intensive education for the primary care giver in the most important aspects of home care. 3. Further research should be done, and should include data from all parts of Cheju Province.

• Journal of agricultural medicine and community health
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• v.21 no.1
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• pp.47-60
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• 1996

Home health care is one of the important components of health care services. Today, the need and demand for the home health care is increasing. To assess the effects of home visit health services by public health nurses in health center on the stat of health, use of medical services and quality of life by elderly people living at home, a randomized controlled trial was implemented for 65 years or more old people randomly allocated to intervention(93) and control(118) group. Intervention group received 2 visits a month over 6 months. Control group received no home visits. The data was collected in a one-year follow-up survey conducted at Kyongju before and after the intervention which composed of health risk assessment, risk factor education and health related behavior counseling. The prevalence rate of chronic illness was more decreased in intervention group than control group after intervention. The intervention group visited medical facilities less frequently than control group. And the home visit health services encouraged the elderly to practice regular exercise. After the intervention, the score of ADL(activities of daily living), LSI(life satisfaction index) and SSI(social support index) in intervention group were more increased than control group. And the increase of scores was more prominent in 70 years or more old people, female, non-smoker and non-chronic illed elderly rather than others. In conclusion, the regular home visit health services provided by public health nurses were beneficial for the elderly in terms of health promotion and quality of life.

• Korean Journal of Clinical Pharmacy
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• v.32 no.1
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• pp.27-36
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• 2022

Background: Medication-related problems (MRPs) frequently occur during the discharge period. Elderly patients, particularly, are at high risk for these problems due to polypharmacy and the use of potentially inappropriate medications. The purpose of this study was to build and implement collaboration between general hospital and community pharmacies to address MRPs among high-risk elderly patients before/after discharge. Methods: This retrospective study was conducted between June and December of 2020. The inclusion criteria were patients with aged ≥65 years; residents of Jeonju; discharged from Jeonbuk National University hospital; either on medication of exceeding 10 medications (or high-risk medications) after hospitalization through the emergency room, or having severe illness. Patients received medication reconciliation and counselling by hospital pharmacists before discharge and home-visit pharmaceutical care as follow-up by community pharmacists after discharge. Results: Twenty-two patients agreed to home-visit pharmaceutical services. Fifteen and 11 patients completed the first and second home-visit pharmaceutical care service, respectively. Forty-two MRPs were identified in 15 patients. The types of high-frequency MRPs were incorrect administration of drug, adverse drug reactions, medication non-compliance, drug-drug interactions, lifestyle modifications, and expired medication disposal. After consultation with the pharmacist, 34 out of 42 MRPs were resolved. Conclusions: Transitional care for high-risk elderly patients before and after discharge was successfully built and implemented through a collaboration between general hospital and community pharmacies. This study suggests that home-visit pharmaceutical services may have positive effects on the safe use of drugs during the transition period; however, additional research is needed to expand on these findings.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.10 no.5
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• pp.1126-1132
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• 2009

We carried out this study to reduce the gaps between medical institutes and between medical personnels and help to improve medical service quality, by classifying diagnoses and related intervention through the development of standard nursing intervention and by computerizing protocols. We considered two processes: one is the development process of home nursing standard intervention, and the other is the process of computerizing its related protocols. For the former, research covered analysis of home health care practices, development of client assessment protocol, of patients diagnosis protocols, and of patients intervention protocol. For the latter, strategies for home health care information systems should be set up and it constituted four research contents of analysis, design, management and evaluation of the systems. We also trained and educated home nurses who work at home health service center, by making them use the manual of home health care information systems at a certain city of P. In this study, therefore, we developed elements of standard home health care mediation so that they could be included in the forms of home health information note, home health progress note, and home health progress summary, home health discharge summary. Because standard home health care intervention has been developed, it became easier to exchange information between different home heath service center offices, can prevent from missing or redundant information, and contribute to standardization of hospital terminologies when EMR and HMR are developed.

• Tuberculosis and Respiratory Diseases
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• v.83 no.1
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• pp.81-88
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• 2020

Background: Use of appropriate antibiotics for the treatment of pneumonia is integral in patients admitted to intensive care units (ICUs). Although it is recommended that empirical treatment regimens should be based on the local distribution of pathogens in patients with suspected hospital-acquired pneumonia, few studies observe patients admitted to ICUs with nursing home-acquired pneumonia (NHAP). We found factors associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the emergency room (ER). Methods: We performed a retrospective cohort study of 83 pneumonia patients with confirmed causative bacteria admitted to ICUs via ER March 2015-May 2017. We compared clinical parameters, between patients who received appropriate or inappropriate antibiotics using the Mann-Whitney U, Pearson's chi-square, and Fisher's exact tests. We investigated independent factors associated with inappropriate antibiotic use in patients using multivariate logistic regression. Results: Among 83 patients, 30 patients (36.1%) received inappropriate antibiotics. NHAP patients were more frequently treated with inappropriate antibiotics than with appropriate antibiotics (47.2% vs. 96.7%, p<0.001). Methicillin-resistant Staphylococcus aureus was more frequently isolated from individuals in the inappropriate antibiotics-treated group than in the appropriate antibiotics-treated group (7.5% vs. 70.0%, p<0.001). In multivariate analysis, NHAP was independently associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via ER. Conclusion: NHAP is a risk factor associated with the use of inappropriate antibiotics in patients with pneumonia admitted to the ICU via the ER.

• Journal of the Korean Society of Physical Medicine
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• v.7 no.3
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• pp.241-250
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• 2012

Purpose : The this study was performed to purpose the data basis of medical law revision for home visiting physical therapy established as a legal system in hone visiting health care by researching the need, satisfaction, intention to use, management, expected effects. Methods : We were surveyed for 105 patients who was participated business from home visiting health care in community health center. We choose and modified the questionnaire that was used in previous study about home visiting physical therapy and home visiting program for nurses. The questionnaire was consisted of 4 questions of general characteristics of subject, 6 questions of satisfaction, 4 questions of satisfaction of service status, 2 questions of management. And frequency analysis, ANOVA were used for statically analysis. Results : In general satisfaction, satisfaction of service status, the result were very optimistic, but there were no difference by age. In management, participations of 64.8% was answered to within three years of clinical experence and trained in home visiting physical therapy ask on qualification criteria of physical therapists, and participations of 93.3% was answered to once a week ask on desired number of therapy. Conclusion : In our conclusion, home visiting physical therapy is very useful and effective health care system for satisfaction and need, so home visiting physical therapy expected to have great potential in home visiting health care. In addition, by train to home visiting physical therapist for provide professional physical therapy service provide an institutional base which can be expanded and invigorated home visiting physical therapy.

• Korean Journal of Clinical Pharmacy
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• v.26 no.1
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• pp.13-23
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• 2016

Background: South Korea is rapidly being an aging-society and the demand of long-term care insurance services for elderly patients is rising. In addition, because the elderly taking multiple medicines, the adherence is lowered and the adverse events are easily occurred. Therefore, many are interested in introducing the geriatric pharmacy specialist to manage this situation. Purpose: By applying a similar program such as the geriatric pharmacy specialist working in nursing home, we conducted this study to evaluate the potential contribution to both the health insurance services and financial savings for the elderly patients. Methods: We conducted a trial in an elderly nursing home to collaborate between doctor and pharmacist making a checklist for improving medication adherence and establish a consultation system. Also we applied a smart phone application in the pharmaceutical care processes. Results: Thereby completing the drug therapy related checklist apply to nursing facilities in South Korea. And we got a performance that improves medication adherence when used in the clinical practice settings. Conclusion: By introducing a training program of pharmacy care managers and geriatric professionals such as the United States and Japan, we revealed the elderly nursing home residents and vulnerable elderly people living alone were improved the medication adherence and it will contributed to the health and quality of life of the patients.