Kanhohak t'amgu最新文献

Nosocomial infection is an infection associated with admission to health care facility. It is not known to be present or incubating at the time of admission. HIV(Human Immunodeficiency Virus) transmission spreads through parenteral exposure, sexual contact and perinatal exposure. HIV virus has been isolated from all body fluid. However only blood and blood products have been linked to the transmission of HIV. Every hospital should prospectively address the policy and management issues raised by treatment of patients with AIDS or HIV infection. Police and practices that reduce health care worker and patients in hospital exposure to blood and body fluids of all patients should be developed. Precautions and guidelines for all situations should documented. There are include in ward, ambulatory setting, dialysis unit, clinical laboratories, house keeping, laundry and waste disposal etc. We grouped for management of HIV infection in the hospital referred to AHA(American Hospital Association), CDC(Centers for Disease Control), OSHA(Occupational Safety and Health Administration) and guideline for AIDS in Severance hospital aspect of nosocomial infection control.

This study was done to clarify the types of health care that should be offered. It focus on developing client selection criteria based on the needs of inpatients with cerebral vascular diseases, head injuries and spinal cord injuries. Two research methods were adopted. One was a methodological approach for developing client selection criteria and the other was analytical approach to clarify the types of services to be offered. From the research findings, the following summarized conclusions have been drawn. 1. The problem and item criteria used to select patients requiring home health care, namely, a prototype evaluation tool, consisted of 12 items in four areas; physiological status, functional status, psychological status and environmental status. After assessing each item at three levels, the categorization was done according to the classification criteria. The item internal consistency of the completed tool was .8358, .8390, the interrater reliability was in the range of 84 percent-98 percent and the classification consistency was 92 percent. As external criteria, the relationship of the prototype tool to the Health Status Scale, the Barthel Index of Functional Status Assessing Devices and the number of health problems of the patient was examined and all were found to be statistically significant, verifying the validity of the tool. 2. Using the tool to classify the inpatients according to the established client selection criteria, 84.2 percent were classified as patients requiring home health care, 8.8 percent were assessed as suitable for outpatient care and 7.0 percent were assessed as patients needing to be hospitalized. 3. Clients assessed as requiring home health care had 72 different kinds of health problems, which could be classified into four categories; 54 types of physiological status problems, 8, psychological, 6, functional and 4, environmental status problems. For each problem, the percentage of patients who suffered from the disorders ranged from 2.1 percent-66 percent. More than half of the subjects had problems related to urination, paralysis, contracture or locomotion. For the physiological category, many of the health problems were due to disorders of muscles and bone, whereas skin and breathing disorders were relatively low. The mean number of health problems in this category as 11.1. 4. Reviewing the literature, it was found that home health care consisted of 10 activity areas, namely, sanitation, nutrition, breathing, skin, body temperature maintenance, medication, assessment and observation, education and counselling.(ABSTRACT TRUNCATED AT 400 WORDS)

Since the first case of AIDS was found among male homosexuals, the AIDS related problem has been in the male homosexual population, but the AIDS trend is changing from homosexuals to heterosexuals, with the majority of cases in the general population. Even though currently the reported HIV/AIDS cases in Korea are only 324 in Korea, the number of people infected with HIV/AIDS is projected to increase greatly over the next few years. As the number of these cases increases, there will be a major strain on nursing care resources. Since there is no known cure, the only way of halting this epidemic is through the prevention of further infection. In various stages of HIV infection, different problems occur, calling for various specific services and nursing skills. Nurses must develop a strategy to alleviate the negative attitudes related to care of AIDS patients and anxiety and dislike for care of terminally ill patients. Also, nurses must be prepared for teaching the general population about prevention of AIDS, counseling individuals in risk of HIV infection, HIV testing, and transmission risks, and caring for AIDS patients using Hospice concepts in various settings.

The reimbursement system for nursing services needs to be set up before beginning of the home health care system. One thing we should consider as a premise in developing a reimbursement system for home health care is that the fee-schedule of home health care should be based on the cost of unit service, since the medical reimbursement system in Korea basically depends upon the concept of 'fees for service'. A model for the development of the fee schedule was designed to make some contribution to the reimbursement system for home health care, which should be prepared before the enhancement of a new system. The model is composed of three processes as follows: cost finding of the home health care department, cost computation by service of health care, development of the fee-schedule. 1. Cost finding of the home health care department The home health care department can be defined as a major cost center producing revenues. The costs of home health care department consist of the individual costs produced in more than two departments at the same time and, therefore, should be distributed to the home health care department by certain distribution rate, and the costs which are distributed from the auxiliary departments. 2. Cost computation by service of health care The services where the costs are finally aggregated to should be defined. The direct costs which can be found by service are rendered directly to the corresponding services and the indirect costs which cannot be recognized by service should be distributed to by the distribution rate. Lastly, the costs which were passed over from the auxiliary are added to. 3. Development of the fee-schedule The costs per unit service should be transformed into the relative values. The price of the unit value is produced by dividing required revenues needed to perform the home health care activities with what aggregated relative values. The formula to produce the fees of home health care is as follows: Fi = RVi x P P = NR/sigma RVi x ni Fi: the fee of service i RVi: relative values of service i P: unit price of RV i NR: required revenues Ni: expected number of cases of service i in a year.