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Park and Jung: Development of Evaluation Indicators for Integrated Home Care
Original Article

Korean J Adult Nurs 2014;26(5):543-552.

Published online: NaN October 2014

DOI: https://doi.org/10.7469/kjan.2014.26.5.543

Development of Evaluation Indicators for Integrated Home Care

Jong Duk Park1, Dukyoo Jung2,

1National Health Insurance Service, Seoul

2Division of Nursing Science, College of Health Sciences, Ewha Womans University, Seoul, Korea

Corresponding author: Jung, Dukyoo Division of Nursing Science, College of Health Sciences, Ewha Womans University, 52 Ewhayeodae-gil, Seodaemun-gu, Seoul 120-750, Korea. Tel: +82-2-3277-6693, Fax: +82-2-3277-2875, E-mail: dyjung@ewha.ac.kr

Received 12 May 20143 October 2014       Accepted 8 October 2014

Copyright © 2014 Korean Society of Adult Nursing

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to develop integrated evaluation indicators of home care services in the hope that the increasing group of long-term home care patients could receive quality care services.

Methods

The development involves a methodological study on a development phase and a verification phase. The main survey at a verification stage was conducted by the staffs at 146 institutions who agreed to participate on this study.

Results

The evaluation index for the integrated home visit care consisted of five categories and 57 indicators including Managing Institution (12), Environment and Safety (3), Right and Responsibility (7), Process of Care (31) and Results of Care (4). The criterion-related validity was verified in regard to the participation in the 2010 evaluation of long-term home-care institutions by the National Health Insurance Corporation.

Conclusion

The evaluation index of the integrated home visiting care developed in this study is considered suitable to utilize as evaluating indicators in managing and evaluating the way of how institutions integrate and provide home visit care services as well as home nursing care services.

Keywords: Long-term care, Quality assurance, Healthcare, Home care services, Quality indicators

REFERENCES

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Table 1.
Evaluation Indicators for Integrated Home Care
Nr. Indicator M±SD %†
Category I: Managing institution
1 The institution prepares and equips guidelines to service offer. 3.87±0.49 91.8
2 The institution prepares and equips a manual of service criteria. 3.64±0.69 74.5
3 Employees of the institution have certificates needed for job performance. 3.90±0.53 97.3
4 There is more proportion of service-providing employees who have worked one year or more in relevant institutions. 3.65±0.86 75.9
5 The institution conducts a medical check-up for employees every year and runs reward or welfare system. 2.83±1.19 46.6
6 The institution signs labor contracts with its employees and pay wages to them accordingly and gets them insured for five major insurances. 3.86±0.46 89.0
7 The institution conducts training for new comers in the institution according to staff training program. 3.14±1.21 65.1
8 According to its annual training program, the institution conducts supplementary training needed for service offer, among service-providing staff. 3.12±1.25 65.8
9 The institution gets prior consent for collection and use of personal information, and protects personal information. 3.24±1.17 69.1
10 The institution establishes and carries out a quality improvement plan according to the result of self-appraisal. 2.73±1.28 43.8
11 The institution conducts satisfaction survey among subjects (protected persons) at least once a year and reflects its results. 2.96±1.34 61.0
12 The institution identifies job satisfaction level of service-providing staff as well as the problems. 3.10±1.26 65.1
Category II: Environment & safety
13 The institution is equipped with facilities and furnishings needed for bathing and nursing. 3.51±0.91 74.5
14 The institution provides service in a hygienic way. 2.78±1.08 38.6
15 The institution safely deals with an emergency and the circumstance in which subjects are not able to open the door (entrance or room). 2.35±1.14 26.2
Category III: Right & responsibility
16 Super indent of the institution (administrator) periodically visits subjects for consultation in connection with their conditions and service content. 2.93±1.12 45.2
17 The institution is insured for business liability insurance and professional liability insurance. 3.36±1.23 73.3
18 The institution prepares lists of current work state of service-providing staff. 3.59±1.04 86.9
19 The institution provides subjects/family with the duplicate of service offer contract and a bill of costs for LTC service. 3.73±0.78 89.0
20 The institution receives subjects' sharing as stipulated in the contract. 3.38±1.22 79.5
21 The institution posts the current state of workforce and facilities at homepage of the public corporation and modifies immediately if any change occurs. 3.45±1.10 79.5
22 The institution has a flak-catcher, who records details from receipt of grievances to their settlement. 2.34±1.50 44.5
Category IV : Process of care
23 Employees conduct assessment of subject's desires prior to beginning of service. 3.51±1.04 78.6
24 The institution reflects standard long-term care utilization plan at the time of signing service contracts. 3.29±1.16 71.9
25 Employees provide service by explaining service content to subjects at the same time. 3.86±0.58 95.1
26 Employees provide service to maintain and enhance physical function of subjects. 3.72±0.73 84.9
27 Employees make service offer records immediately after service has been done. 3.59±0.86 73.3
28 Employees regularly assess the effects of provided services. 2.90±1.23 45.2
29 Employees guide family members of subjects so that they can take care of subjects safely. 3.12±1.17 61.8
30 Employees observe subjects' conditions before and after bathing. 3.36±1.43 68.1
31 Employees check individual ability and problems in regard to fluid intake. 3.02±1.31 61.0
32 Employees check individual ability and problems in regard to caloric intake. 3.64±0.69 74.5
33 Employees check individual ability and problems in regard to incontinence/ constipation. 3.25±1.24 70.5
34 Employees periodically assess risk factors of bedsores. 2.96±1.21 54.8
35 Employees work so that they can ascertain dehydration prevention service. 2.84±1.37 54.8
36 Employees work so that they can ascertain caloric intake assistance service. 3.18±1.25 67.1
37 Employees work so that they can ascertain defecation assistance service. 3.12±1.28 64.8
38 Employees help subjects change their posture or move so that their skin may not be peeled (to prevent bedsores) 3.23±1.20 67.1
39 Employees explain risk of dehydration to subjects (family) and provide data to them. 3.14±1.19 62.3
40 Employees explain risk of malnutrition to subjects (family) and provide data to them. 2.84±1.37 55.5
41 Employees explain risk of bedsores to subjects (family) and provide data to them. 3.35±1.08 70.3
42 Employees explain fall prevention to subjects (family) and provide data to them. 3.35±1.07 70.5
43 Employees explain to families, prevention of elder abuse and agencies to report for protection of the old, and provide data to them. 3.28±1.14 68.5
44 Employees explain to families, dementia prevention and methods responding with subjects with dementia, and provide data to them. 3.19±1.18 65.1
45 Employees offer service in consideration of individual special circumstances of subjects with dementia. 3.32±0.95 65.8
46 When employees impose restrictions to protect subjects, they record the causes and explain those to guardians to get consent. 2.60±1.40 43.6
47 Employees perform and record nursing treatment according to visiting nursing directions. 3.86±0.57 94.7
48 Bedsores nursing treatment of employees complies with latest level of nursing. 3.65±0.91 87.1
49 Employees, fully aware of information related with administration of subjects, manage administration. 3.35±1.04 65.9
50 Employees take necessary steps according to the measuring results of blood pressure, blood sugar. 3.80±0.64 89.5
51 For subjects essentially requiring oxygen therapy, employees take right measures to prevent contamination of Tunica mucosa oris, parotid and pneumonia. 2.90±1.34 59.0
52 Employees communicate with doctors as for the results of nursing treatment and subjects' conditions. 2.99±1.41 61.9
53 Employees check subjects' conditions using appropriate tools. Category V : Results of care 3.51±0.93 75.9
54 By linking with social resources of the local community, the institution has offered necessary service to subjects or families. 3.42±0.85 62.2
55 Employees, reflecting individual desires, have maintained clean physical conditions of subjects. 2.72±1.35 49.3
56 The ratio of subjects suffering bedsores has dropped. 3.24±1.41 73.4
57 The ratio of subjects inserted with indwelling catheter has dropped. 2.57±1.60 57.7

† Performs rate.

Table 2.
Difference of Mean between Categories according to the Participation 2010 (N=144)
Evaluation's categories Participants (n=98) Not Participants (n=46) x2 p
M±SD† M±SD†
Managing institution 85.32±4.74 45.20±6.30 29.08 ＜.001
Environment & safety 79.35±2.31 57.90±1.79 8.46 .004
Right & responsibility 77.97±3.73 60.85±3.83 5.33 .021
Process of care 80.10±16.13 56.30±23.28 10.20 .001
Results of care 78.60±3.32 59.51±3.53 6.70 .010

† Kruskal-wallis test.

Table 3.
Grade Changes between the Evaluations Results 2010 and the Results of the Study (N=56)
Evaluation's categories Result 2010 Study Z p
M±SD M±SD
Home-visit nursing 1.79±0.83 1.84±0.87 -0.441 .659
Home-visit care† 1.95±0.92 1.82±0.88 -1.169 .242

Note. 3=A Class, 2=B Class, 1=C Class.

† Support for activity of daily life.

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