Purpose
This study aimed to analyze the differences in medical care use and patient outcomes between patient groups in the general ward (GW) and integrated nursing care ward (INCW).
Methods
Among all patients admitted from January 1 to December 31, 2020, 430 patients (total 860) were selected in the GW and INCW using propensity score matching. The differences in the two groups were analyzed using t-test and x 2 test. Multiple and logistic regression were used to investigate the effect of admission to the INCW or GW on medical use and patient outcomes.
Results
The total medical expenses, urinary tract infection rate, and pneumonia rate of the two groups did not show significant differences; however, the length of stay for the INCW group was approximately 3 days longer and unplanned readmissions were 5.4% lower for the INCW group than that for the GW group. Multiple and logistic regression analysis showed similar results.
Conclusion
Patients in the INCW group had longer hospitalization days and lower rates of unplanned readmission than those in GW group. Additional studies related to longer hospital stays are needed, and measures should be taken to prevent social hospitalization.

PURPOSE
This study was conducted to identify the effect of crowding and nurse staffing on time to antibiotic administration for pneumonia patients in an emergency department (ED).
METHODS
The sample included pneumonia patients visiting an ED from November 1, 2014 to February 28, 2015. Crowding was measured using ED occupancy rate, nurse staffing was measured as total length of stay per nurse and number of patients per nurse and the time duration was measured for the following processes: from patient arrival to prescription, from prescription to blood culture and antibiotic administration, and from blood culture to antibiotic administration. Data collected from the electronic medical records were analyzed using multivariate analyses.
RESULTS
The mean times from arrival to antibiotics administration, from prescription to antibiotic administration, and from blood culture to antibiotic administration were 128.31, 47.29, and 15.60 minutes, respectively. Crowding, nurse staffing, work experience of the nurse and severity of the patient influenced the time duration of each process from patient arrival to antibiotic administration.
CONCLUSION
The results reveal that crowding and nurse staffing affect length of time to antibiotic administration in pneumonia patients. Guidelines for safe nurse staffing in ED are required to improve patient outcomes.

Citations

• Factors affecting the length of stay in the emergency department for critically Ill patients transferred to regional emergency medical center
  Hyungbok Lee, Sangrim Lee, Hyeoneui Kim
  Nursing Open.2023; 10(5): 3220.     CrossRef
• Factors associated with the undertriage of patients with abdominal pain in an emergency room
  Boo Young Oh, Kisook Kim
  International Emergency Nursing.2021; 54: 100933.     CrossRef

PURPOSE
This study was conducted to explore the impact of nurse staffing level and oral care on pneumonia in elderly inpatients in long-term care hospitals (LTCHs).
METHODS
Data were obtained from the Health Insurance Review and Assessment Services (HIRA) including the profiles of LTCHs, monthly patient assessment reports and medical report survey data of pneumonia patients by HIRA in the fourth quarter of 2010. The sample consisted of 37 LTCHs and 6,593 patients.
RESULTS
Patient per nurse staff (OR=1.43, CI=1.22~1.68) and no oral care (OR=1.29, CI=1.01~1.64) were significantly related with hospital acquired pneumonia. The difference in percent of oral care by hospital was not significant between high and low group in nurse staffing level.
CONCLUSION
In order to reduce the occurrence of pneumonia in eldery patients, effective nursing interventions are not only required but also nurse staffing levels that enable nurses to provide the intervention.

Citations

• The Level of Performance, Frequency and Educational Needs of Nursing Activities in Long-term Care Hospital
  Sun-Sook Moon, Yeon Ok Suh, Kyung-Woo Lee, Jasung Gu
  The Korean Journal of Rehabilitation Nursing.2018; 21(2): 110.     CrossRef