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KMID : 0922319980050010020
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Journal of Korean Academic Society of Home Care Nursing
1998 Volume.5 No. 1 p.20 ~ p.31
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An Operations Study on the Home Care Nursing Delivery System
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Park Jung-Ho
Kim Mae-Ja
Hong Kyung-Ja
Han Kyung-Ja
Park Sung-Ae
Yun Soon-Nyung
Lee In-Sook
Cho Hyun
Bang Kyung-Sook
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Abstract
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The purpose of this study was to develop the framework of community -based home care nursing delivery system, and to examine the validity of it. For these, home care nursing study team of college of Nursing, Seoul National University has studied home care nursing system since September, 1996, and has operated home care center since August, 1997. this study has been supported by the Korean Science Foundation. We organized Committee of rules. and Clinical specialist consultant group for more efficient running of the home care center, In nursing station, research assistant controlled general work, and 5 home care nurses were hired for home visiting. We developed the Standards for operation, that included criteria for clients, central supply system of nursing materials, central management of nursing care cost, advertisement, patient referral system, and so forth. In our center, 108 patients enrolled, and neurologic disorders including cerebrovascular accident, and cancer were the most prevailing diseases.
We tried to overcome the limitations of hospital-based home care, and to provide more accessible, efficient, safe, and stable home care nursing. There-fore, we were referred clients from patients and families, public health care center, industries, as well as from hospitals. Meanwhile, we developed home care recording system assessment-intervention, and standardization. also we did continuing education, and tried to detect problems and to find solutions by regular meeting between the committee of rules and home care nurses.
As the results of this study, several limitations of operation were found. First, it was difficult to manage and communicate with the doctor in the emergency situation, Second, we spent too much time for transportation, because only five nurses covered all areas of Seoul and nearby cities. Third, preparation for special care of home care nurses were lacked. Forth, criteria for termination of care and frequency of home visit were ambiguous. Fifth, some difficulties were found in retrospective payment system. and finally, interconnection with home care machinery company were needed. Strategies for solving these problems were suggested.
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KEYWORD
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Home care, Operations study
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