Journal of the Korean Data and Information Science Society

The Korean Data and Information Science Society (한국데이터정보과학회)
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Nursing outcomes of inpatient on level of nursing staffing in long term care hospitals

요양병원 간호인력 확보수준에 따른 입원환자의 간호결과

  • Kim, Eun Hee (Department of Nursing, Taegu Science University) ;
  • Lee, Eunjoo (College of Nursing, Research Institute of Nursing Science, Kyungpook National University)
  • 김은희 (대구과학대학교 간호학과) ;
  • 이은주 (경북대학교 간호대학, 경북대학교 간호과학연구소)
  • Received : 2015.02.23
  • Accepted : 2015.04.09
  • Published : 2015.05.31
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Abstract

This study was conducted to explore the impact of nursing staffing on inpatient nursing outcomes in long term care hospitals. A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals. Patients per RN was a significant indicator of foley catheter ratio in high risk group and low risk group. Patients per RN&NA was a significant indicator of decline in ADL for patients with dementia, non dementia, urinary incontinence and new pressure ulcer development in the high risk group. The average nursing outcome of inpatient in high grade was higher than that low grade in long care hospital. This higher level of nursing staffing and the higher the grade shown a positive effect on the nursing outcomes of the inpatient. We therefore recommend modifying the above nurse staffing policy so as to make it more effective in improving nursing outcomes.

본 연구는 우리나라 요양병원의 간호인력 확보수준과 간호결과의 관련성을 파악하고 간호에 민감한 환자 결과를 알아봄으로써 요양병원의 적정 간호인력 확보에 대한 근거를 제공하기 위해 시행되었다. 자료는 건강보험심사평가원의 2012년 '요양병원 병원평가정보'를 바탕으로 분석하였다. 연구결과, 간호사 1인당 환자 수가 평균보다 많은 그룹에서 유치도뇨관 비율 (고위험군/저위험군)이 통계적으로 유의하게 높았다. 간호인력 1인당 환자 수가 평균보다 많은 그룹에서 일상생활수행능력이 감퇴한 환자비율 (치매환자군/비치매환자군), 요실금, 욕창이 새로 발생한 환자 (고위험군)비율이 통계적으로 유의하게 더 높았다. 그리고 요양병원의 등급이 향상될수록 입원환자의 간호결과가 더 좋아지는 것으로 나타났다. 이는 간호인력 확보수준이 높을수록 그리고 요양등급이 높을수록 환자의 간호결과에 긍정적인 영향이 나타난다는 결과이다. 따라서 요양병원에서 간호인력 수를 적정화시킬 수 있는 보다 강력한 정책적 접근이 필요하다는 것을 제안하는 바이다.

Keywords

References

  1. Aiken, L. H., Sloane, D. M., Cimiotti, J. P., Clarke, S. P., Flynn, L., Seago, J. A., Spetz, J. and Smith, H. L. (2010). Implications of the California nurse staffing mandate for other states. Health Services Research, 45, 904-921. https://doi.org/10.1111/j.1475-6773.2010.01114.x
  2. Arling, G., Kane, R. L., Mueller, C., Bershadsky, J. and Degenholtz, H. B. (2007). Nursing effort and quality of care for nursing home residents. The Gerontologist, 47, 672-682. https://doi.org/10.1093/geront/47.5.672
  3. B ostick, J. E. (2004). Relationship of nursing personnel and nursing home care quality. Journal of Nursing Care Quality, 19, 130-136. https://doi.org/10.1097/00001786-200404000-00010
  4. Castle, N. G. and Anderson, R. A. (2011). Caregiver staffing in nursing homes and their influence on quality of care: Using dynamic panel estimation methods. Medical Care, 49, 545-552. https://doi.org/10.1097/MLR.0b013e31820fbca9
  5. Cho, S. J., Lee, H. J., Oh, J. Y. and Kim, J. H. (2011). Inpatient outcomes by nurse staffing grade in Korea. Korean Journal of Health Policy & Administration, 21, 195-212. https://doi.org/10.4332/KJHPA.2011.21.2.195
  6. Cho, S. J. and Kim, J. H. (2014). Determinants of registered nurse skill mix & staffing level in Korea. Journal of Korean Academy of Nursing Administration, 20, 10-21. https://doi.org/10.11111/jkana.2014.20.1.10
  7. Decker F. H. (2008) The relationship of nursing staff to the hospitalization of nursing home residents. Research in Nursing & Health, 31, 238-251. https://doi.org/10.1002/nur.20249
  8. Harrington, C., Choiniere, J., Goldmann, M., Jacobsen, F. F., Lloyd, L., McGregor, M., Stamatopoulos, V. and Szebehely, M. (2012). Nursing home staffing standards and staffing levels in six countries. Journal of Nursing Scholarship, 44, 88-98. https://doi.org/10.1111/j.1547-5069.2011.01430.x
  9. Health Insurance Review & Assessment Service. (2010). Healthcare benefits, Health Insurance Review & Assessment Service, Seoul.
  10. Health Insurance Review & Assessment Service. (2012). Evaluation report of long term care hospitals in third year, Health Insurance Review & Assessment Service, Seoul.
  11. Health Insurance Review & Assessment Service. (2014). Evaluation report of long term care hospitals, Health Insurance Review & Assessment Service, Seoul.
  12. Hickey, E. C., Young, G. J., Parker, V. A., Czarnowski, E. J., Saliba, D. and Berlowitz, D. R. (2005). The effects of changes in nursing home staffing on pressure ulcer rates. Journal of the American Medical Directors Association, 6, 50-53. https://doi.org/10.1016/j.jamda.2004.12.003
  13. Kane, R. L., Shamliyan, T., Mueller, C., Duval, S. and Wilt, T. J. (2007). Nurse staffing and quality of patient care. Evidence report/technology assessment, 151.
  14. Kim, D. H. and Lee, H. J. (2014). Effects on long-term care hospital staff mixing level after implementing differentiated inpatient nursing fees by staffing grades. Journal of Korean Academy of Nursing Administration, 20, 95-105. https://doi.org/10.11111/jkana.2014.20.1.95
  15. Kim, J. K. (2010). A study on nursing diagnoses, interventions, outcomes frequently used and linkage to NANDA-NOC-NIC in major nursing departments. Journal of Korean Academy of Nursing Administration, 16, 121-142. https://doi.org/10.11111/jkana.2010.16.2.121
  16. Kim, J. S., Jeong, S. Y., Kim, S. H. and Kim, J. O. (2014). Predictors of emotional labor and job stress on burnout of nurses in long-term care hospitals. Journal of Korean Gerontological Nursing, 16, 130-140. https://doi.org/10.17079/jkgn.2014.16.2.130
  17. Kim, M. O. and Kim, K. H. (2014). Effects of recognizing long-term care hospital certification system on job performance after evaluation for certification in nursing staff of long-term care hospitals. Journal of Korean Gerontological Nursing, 16, 68-76. https://doi.org/10.17079/jkgn.2014.16.1.68
  18. Kim, M. S. and Lee, S. H. (2008). Prevalence rate and associated factors of urinary incontinence among nursing home residents. Journal of Korean Academy of Nursing, 38, 92-100. https://doi.org/10.4040/jkan.2008.38.1.92
  19. Kim, Y. M., Lee, J. Y. and Kang, H. C. (2014). Impact of nurse, nurses' aid staffing and turnover rate on inpatient health outcomes in long term care hospitals. Journal of Korean Academy of Nursing, 44, 21-30. https://doi.org/10.4040/jkan.2014.44.1.21
  20. Ko, Y. K. and Pack, B. H. (2014). The relationship of the nursing work environment and nursing outcome among it's nurses and content analysis of nurses' workload. Korean Journal of hospital management, 19, 54-67.
  21. Korean Hospital Nurses Association. (2012). Survey on the current nurse deployment, A report of hospital nurses association 2012 , Hospital Nurses Association, Seoul.
  22. Korea Institute for Healthcare Accreditation. (2014). Long-term care hospital accreditation standards, Korea Institute for Healthcare Accreditation, Seoul.
  23. Lee, J. Y., Kim, E. Y. and Cho, E. H. (2011). Factors impacting the physical function of older adults in Korean long-term care hospitals. Journal of Korean Academy of Nursing, 41, 780-787. https://doi.org/10.4040/jkan.2011.41.6.780
  24. Lee, E. J. and Choi, S. H. (2011). Identification of nursing diagnosis-outcome - intervention (NANDANOC- NIC) linkages in surgical nursing unit. Korean Journal Adult Nursing, 23, 180-188. .
  25. Lee, S. H. (2009). Multi-level analysis of factors related to quality of services in long-term care hospitals. Journal of Korean Academy of Nursing, 39, 409-421. https://doi.org/10.4040/jkan.2009.39.3.409
  26. Mark, B. A., Harless, D. W., McCue, M. and Xu, Y. (2004). A longitudinal examination of hospital registered nurse staffing. Health Services Research, 39, 279-300. https://doi.org/10.1111/j.1475-6773.2004.00228.x
  27. Ministry of Health and Welfare (2014). OECD(Organization for Economic Cooperation and Development) health data 2014, Retrieved from http://www.mw.go.kr/front_new/sch/index.jsp.
  28. Moorhead, S., Johnson, M., Mass, M. L. and Swanson, E. (2007). Nursing outcomes classification, Mosby, St. Louis.
  29. National Health Insurance Service. (2013). Health insurance key statistics, Retrieved from http://www.nhis.or.kr/menu/retriveMenuSet.xx?menuId=F3322.
  30. Needleman, J., Buerhaus, P., Mattke, S., Stewart, M. and Zelevinsky, K. (2002). Nurse-staffing levels and the quality of care in hospitals. The New England Journal of Medicine, 35, 1715-1722.
  31. Pack, S. H. (2003). Analysis of direct nursing activity and patient outcomes related to graded fee of nursing management for inpatient. Journal of Korean Academy of Nursing, 33, 122-129. https://doi.org/10.4040/jkan.2003.33.1.122
  32. Porell, F., Caro, F. G., Silva, A. and Monane, M. (1998). A longitudinal analysis of nursing home outcomes. Health Services Research, 33, 835-865.
  33. Robinson, J. P. (2000). Managing urinary incontinence in the nursing home: Residents' perspectives. Journal of Advanced Nursing, 31, 68-77. https://doi.org/10.1046/j.1365-2648.2000.01258.x
  34. Sim, M. R. and Kim, K. H. (2010). Job satisfaction, self-esteem, and nursing task performance among registered nurses and nurse assistants in long-term care hospitals. Journal of Korean Academy of Nursing Administration, 16, 446-454. https://doi.org/10.11111/jkana.2010.16.4.446
  35. Song, H. J. (2013). Long-term care hospital systems in developed countries and the implications for Korea. Journal of the Korean Geriatrics Society, 16, 114-120.
  36. Spilsbury, K., Hewitt, C., Stirk, L. and Bowman, C. (2011). The relationship between nurse staffing and quality of care in nursing homes: A systematic review. International Journal of Nursing Studies, 48, 732-750. https://doi.org/10.1016/j.ijnurstu.2011.02.014
  37. Yang, Y. S. and Kim, D. H. (2013). Nurses' Professionalism and job satisfaction on the level of delegation of nursing activities in long-term care hospitals. Journal of Korean Gerontological Nursing, 15, 175-184.
  38. Yoon, J. Y., Lee, J. Y., Bowers, B. J. and Zimmerman, D. R. (2012). The impact of organizational factors on the urinary incontinence care quality in long-term care hospitals: A longitudinal correlational study. International Journal of Nursing Studies, 49, 1544-1551. https://doi.org/10.1016/j.ijnurstu.2012.07.011
  39. Zhang, X. and Grabowski, D. C. (2004) Nursing home staffing and quality under the nursing home reform act. The Gerontologist, 44, 13-23. https://doi.org/10.1093/geront/44.1.13

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