Current Status and Barriers to Health Care Services for Nursing Home Residents: Perspectives of Staffs in Korean Nursing Homes

Park, Yeon Hwan; Bang, Hwal Lan; Kim, Ga Hye; Oh, Seieun; Jung, Young Il; Kim, Hongsoo

doi:10.7475/kjan.2015.27.4.418

Cited by 4 publications

(5 citation statements)

References 17 publications

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“…There are several possibilities that may explain the positive outcomes of the SPEC program. First, the intervention study was designed and implemented based on rich and concrete evidence from earlier studies by the research team on the care needs of the target population ( Kwon et al, 2013 ), the challenges facing care staff in delivering health and wellness services ( Park et al, 2015 ), factors associated with several key QIs ( Bae et al, 2020 ; Chun & Kim, 2018 ; Yoo & Kim, 2016 ), and also psychometric tests of the assessment tools in the Korean nursing home context ( Kim et al, 2013 ; Lee, Jung, & Kim, 2017 ). Second, the SPEC, an ICT-enhanced, CGA-based care management intervention, was well targeted and addressed a gap in care: the current lack of health and functional care in public LTCI-funded nursing homes, which mainly deliver assistance in daily living through personal care assistants ( KNHIS, 2016 ).…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of a Technology-Enhanced Integrated Care Model for Frail Older People: A Stepped-Wedge Cluster Randomized Trial in Nursing Homes

et al. 2020

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Background and Objectives The objective of this study was to evaluate the impact of an information and communication technologies- (ICT-) enhanced, multidisciplinary integrated care model, called Systems for Person-centered Elder Care (SPEC), on frail older adults at nursing homes. Research Design and Methods SPEC was implemented at ten nursing homes in South Korea in random order using a stepped-wedge design. Data were collected on all participating older residents in the homes before the first implementation and until six months after the last implementation. The 21-month SPEC intervention guided by the chronic care model (CCM) consists of five strategies: comprehensive geriatric assessment, care planning, optional interdisciplinary case conferences, care coordination, and a cloud-based ICT tool along with free messaging app. The primary outcome was quality of care measured by a composite quality indicator (QI) from the interRAI assessment system. Usual care continued over the control periods. Nursing home staff were not blinded to the intervention. Results There were a total of 482 older nursing home residents included in the analysis. Overall quality of care measured by the composite QI was significantly improved (adjusted mean difference: -0.025 [95% CI: -0.037 ~ -0.014, p <.0001]). The intervention effect was consistent in the subgroup analysis by cognition and activities of daily living. There were no important adverse events or side effects. Discussion and Implications The SPEC, a CCM-guided, ICT-supported, multidisciplinary integrated care management intervention, can improve quality of care measured by health and functional outcomes for frail older persons residing in nursing homes with limited healthcare provision. Trial registration ISRCTN11972147; ethical approval: Seoul National University University Institutional Review Board

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Section: Discussionmentioning

confidence: 99%

Effectiveness of a Technology-Enhanced Integrated Care Model for Frail Older People: A Stepped-Wedge Cluster Randomized Trial in Nursing Homes

et al. 2020

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“…Terefore, mealtime difculties might increase in large-size facilities with many people with low daily performance. In the previous study, the higher the nursing demand is, the more direct care workers are needed [38]. Terefore, proper stafng is necessary to adequately assist older adults with high nursing demands and difculties in mealtime due to low ADL.…”

Section: Discussionmentioning

confidence: 95%

Factors Affecting Mealtime Difficulties in Older Adults with Dementia Living in Long-Term Care Facilities: A Multilevel Model Analysis

Jung

Gagné

Lee

et al. 2023

Journal of Nursing Management

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Aim(s). This study conducted a multilevel analysis of mealtime difficulties in older adults with dementia based on the social-ecological model. Background. Mealtime difficulty in this population should be examined from an extensive perspective, rather than approaching it as an individual problem. Method(s). This was a cross-sectional study involving 342 participant dyads from 57 long-term care facilities; 114 direct care workers; and 342 older adults with dementia. A multilevel regression analysis was conducted using the MPlus 8.0 program. Results. Among intrapersonal factors, age, cognitive function, activities of daily living, and number of beds in the facility were identified as affecting mealtime difficulty. Environmental factors included meal assistant education experience and whether an environment suitable for eating had been established. Conclusion(s). The results show that intrapersonal factors exert a large influence on the mealtime difficulties of older adults with dementia in long-term care facilities and support the need to improve environmental factors, which are modifiable. Implications for Nursing Management. This study provided useful information about the influence of leaders on mealtime difficulties in older adults with dementia. Leaders should establish an environment in the facility for reduced mealtime difficulties.

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“…In particular, evidence acknowledging the aspects of structures affecting IPC processes hardly exists. LTCFs in Korea are generally regarded as under-resourced, under-staffed, and uncaring environments, especially where nurses are concerned [6]. Thus, understanding their perceptions regarding challenges or considering their suggestions for improvement in relation to their role in IPC practices may be beneficial for advocating for nurses and maximizing optimal outcomes for LTCF residents.…”

Section: Nurses' Views On Infection Controlmentioning

confidence: 99%

“…Further, these studies have not sufficiently accounted for how nurses perceive IPC practices in their daily working environment. In Korea, some studies have explored qualitative approaches to nursing practices related to LTCFs, and several of the factors identified have been shown to interfere with the provision of healthcare services in what were described as "unsupportive institutional conditions" [6,12,13]. However, these studies have limited themselves to describing current nursing practices without focusing on features of infection control, offering no explanation of nurses' perceptions of conditions regarding their management of infection control in LTCFs.…”

Section: Nurses' Views On Infection Controlmentioning

confidence: 99%

Nurses' Views on Infection Control in Long-Term Care Facilities in South Korea: A Focus Group Study

Lee

et al. 2018

Korean J Adult Nurs

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Purpose: Nurses' infection prevention and control responsibilities have been emphasized owing to the increasing infection rate in long-term care facilities in South Korea. The aim of this study was to explore nurses' perspectives on challenging situations and the areas of improvement related to their role in infection management. Methods: An exploratory descriptive qualitative study was conducted with a purposive sample of 15 nursing staff from five long-term care facilities. A focus group interview with semi-structured questions was conducted between January and May 2017. The study participants' discussions were analyzed using conventional content analysis with line-by-line coding. Results: The participants discussed the breadth of challenges interfering with their ability to provide optimal infection care, from practical human resource management issues to organizational and environmental barriers, and laid a foundation based on which lacking areas can be improved. The analysis produced key themes centered on healthcare personnel-related professionalism, professional role boundaries, daily workflow and management, interdisciplinary collaboration, standards and protocols, and technological infrastructure. Conclusion: Although participants expressed negative feelings toward the constraints in long-term care facilities, they demonstrated the willingness to create a positive change and offered suggestions for improvement and support to improve resident safety and care management. Therefore, special attention should be paid to nurses' perspectives on their work and roles regarding infection control practices and supporting them with available sources.

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Current Status and Barriers to Health Care Services for Nursing Home Residents: Perspectives of Staffs in Korean Nursing Homes

Cited by 4 publications

References 17 publications

Effectiveness of a Technology-Enhanced Integrated Care Model for Frail Older People: A Stepped-Wedge Cluster Randomized Trial in Nursing Homes

Effectiveness of a Technology-Enhanced Integrated Care Model for Frail Older People: A Stepped-Wedge Cluster Randomized Trial in Nursing Homes

Factors Affecting Mealtime Difficulties in Older Adults with Dementia Living in Long-Term Care Facilities: A Multilevel Model Analysis

Nurses' Views on Infection Control in Long-Term Care Facilities in South Korea: A Focus Group Study

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