장기요양시설 규모별 간호서비스 요구 및 제공현황 비교
Residents’ Nursing Care Needs and Provision of Nursing Care by the Size of Long Term Care Facilities
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목적 : 전국 노인장기요양 입소 시설을 대상으로 시설 규모별 간호처치 요구 및 간호서비스 제공 현황, 그리고 간호책임자의 의료 및 간호서비스 제공에 대한 인식도를 비교함으로써 향후 입소 노인 대상 연속적이고 통합적인 간호서비스 제공 모델을 개발하기 위한 기초자료를 제공하는데 목적이 있다. 연구방법 : 전국에 분포한 노인장기요양 입소 시설을 유형별, 소재지역별, 정원규모별로 비례층화표본추출한 2017 년 8 월 16 일부터 9 월 30 일까지 설문조사한 총 1,041 개 기관을 대상으로 분석하였다. 연구결과: 30인 이상 노인요양시설은 노인요양공동생활가정에 비해 간호사 배치율, 의료연계율 및 전문적 간호 서비스의 요구를 수행할 가능성이 더 높은 것으로 나타났다. 또한 간호책임자는 입소 시설 규모가 작을수록 간호인력 부족, 의료 및 간호처치 요구에 대처하는데 더 큰 어려움을 겪고 있었으며, 모든 입소 시설에서 응급 대처에 필요햔 간호사 배치가 필요하다고 인식하는 것으로 나타났다. 결론 : 본 연구에서는 노인요양공동생활가정의 간호처치 및 의료적 요구를 충족시킬 방안의 마련과 함께 입소 시설 내 간호 인력 수준을 높이고 의료 연계 및 서비스의 접근성을 향상시키기 위한 제도적 방안 모색이 필수적임을 확인하였다.
Abstract
Purpose: The aim of this study was to provide information on the extent and variations of elderly residents’ nursing care needs, and provision of nursing care across long term care facilities. Methods: A nationwide survey was conducted on nurse managers from 1,041 long term care facilities, by e-mail or fax, from August 16 to September 30 in 2017. A self-reported questionnaire consisting of 5 domains was used to collect data. Results: Facilities with more than 30 residents were more likely to need skilled nursing services and to obtain the nursing staff such as a registered nurse and a nurse’s aide. Awareness and satisfaction of hospital-based home nursing care was high in all facilities. In addition, there are some differences in nurse managers’ perceptions of the level of healthcare resources and required action by facility size. Nurse managers of senior congregate housings were more likely to have considerable difficulty in dealing with healthcare needs of residents and recognizing the healthcare resource shortage. A majority of nurse managers agreed on the need to employ a registered nurse. Conclusion: This study confirmed that it is essential to increase nurse staffing level and to reform the long term care insurance for enhancing the accessibility of healthcare services, especially for the residents in small long term care facilities. There is also a need to provide diverse education and training opportunities for nursing staff working in long term care facilities.
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