Medical insurance and health care delivery system enabled Korean people to get the necessary medical service, but it caused increased needs for medical service, and resulted in the occurence of some problems such as a lack of manpower and medical facilities. In order to solve these problems, many countries, which already had medical insurance system had developed home care system and it has been regarded effective both in reducing costs and in increasing the rates of turnover of bed. Recently, Korea has included home nursing care in its health care delivery system, and some models of the hospital based home nursing care had been tried and its effects had been evaluated. So, author tried to run a home nursing care for the Cesarean section mothers and evaluate its effects both in the mother's health and costs. This study was designed as a Quasi-experimental study. Subjects were thirty mothers who got Cesarean section operation in hospital in Seoul. Experimental group consisted of 15 volunteers, and control group were selected by means of matching technique. Data were gathered from February 1st to March 26th by two assistants who were trained by author. Experimental group were discharged on the 4th day after their operation, and got nursing care and assessment about their home three times on the 5th, 6th, and 7th day. Control group stayed in the hospital until 7th day as usual and were checked on the same day as above mentioned. To evaluate the state of physiological recovery, vital signs, H.O.F, presence of edema in the legs, bathing, appetite, sleep, presence of pain or discomfort in the breasts, amount of lochia, color of lochia, defecation, urination. To compare incidence of complication in experimental group with that in control group, specific assessment was done such variables as smell of lochia, presence of inflammation of operation wourd, dizziness, and presence of immobilization in the extremities. The activities of daily living were checked Satisfaction of nursing were checked. To calculate costs, author asked subjects to specify expenditure including hospital charge, traffic expenses, and food expenses. The results were as follows. 1. On effectiveness of home nursing care There were no significant differences between experimental and control group in incidence of abnormal symptoms and any complication. The number of taking a bath [POD #5P=0.001, #6P=0.0003, #7 P=0.001] and the degree of appetite [POD #5 P=0.03, #6 P=0.02, #7 P=0.013] were significantly higher in experimental group than in control group. Contrary to author's expectation, the degree of the activities of daily living in experimental group was not higher than that of control group. All of the experimental group said they were satisfied with the home nursing care. 2. Cost analysis 1) Hospital charge of experimental group was lower than that of control group. [P=0.009] By taking home nursing care, average period of hospitalization was shortened to 3.1 days, and family members could save 22.8 hours. Total amount of money saved by early discharge was 3,443,093 Won. It is estimated that total amount of money saved by early discharge in a year will be 40,398,956 Won. 2) Home nursing care charge of 15 mothers was 1,781,633 Won. It is estimated that total amount of money saved by it in a year will be 20,904,493 Won. It was lower altogether than hospital charge of the three days which is 5th, 6th, 7th day of operation. The average cost of single home visit was calculated 10,940 Won. It took 87 minutes per round and it costed 1,017.3 Won. The average hour of home care was 39.0 minutes. 3) It is expected that early discharge can bring forth the increase of hospital income. On the condition that the rate of running bed is 100%, the expected increase of hospital income will be 202,374, 026 Won in a year. Suggestions for further study and nursing practice are as follows: 1. For the welfare of patients and the increasd rates of running bed, home nursing care system should be included in the hospital nursing care system. 2. Studies to test effect of home nursing care on the patients with other diseases are needed. 3. Establishment of law on the practice of home nursing care is strongly recommended.

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• An Economic Evaluation of the Home Nursing Care Services: Public Health Center Versus Private Hospital
  Jinhyun Kim, In Sook Lee, Mee Kyoung Joo
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• Introducing Economic Evaluation as a Policy Tool in Korea: Will Decision Makers get Quality Information?
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The purpose of this study was to analyze the appraising frame and the accreditation system of universities in both Korea and the United Sates, as well as developing a standard plan to appraise 4 year nursing education institutions in Korea. Research design of this study was descriptive comparative research. The results of the research can be divided into six fields, educational purposes, educational courses, students, faculty, facility equipments and administration finance in Korea. Then the results were further categorized into seven fields : mission and governance, faculty, students, curriculum and instruction, resources, educational effectiveness and integrity. Thus Korean appraising frames were suggested to have eight fields of standard. The fields are philosophy and purposes of educational institution, educational courses and instruction, students, faculty, facility equipments, adminstration finance, educational effectiveness and integrity.

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• Faculty Perceptions of the Improvement and Effort for the Achievement of Quality in Nursing Education through Accreditation in Baccalaureate Nursing Programs
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• Development of Standards and Criteria for Accreditation of Baccalaureate Nursing Education Program
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• Nursing Education on Women’s Health Care in Australia, Japan, South Korea, and Thailand
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Sleep is a necessity for survival, Disruption of sleep leads to numerous adverse physiological and psychological consequences. These could be particularly undesirable for older patients, who are subject to many additional factors. But there is limited research related to hospitalized elderly in Korea. The purpose of the study is to explore sleep patterns and disturbing factors of before and after hospitalization, in order to present basic information regarding elderly sleep to develop nursing intervention. The sample consisted of 32 elderly men and women between the ages of 60 and 87 years. Data collection was done from September to November 1997. Measures of sleep patterns and related factors were obtained from self-reported sleep questionnaires. Analysis of data was done by use of t-test, paired t-test, ANOVA, and Pearson Correlation Coefficient. The results of this study were summarized as follows : 1. In comparison between before and after admission of their sleep pattern, "sleep onset" tends to be delayed and nocturnal sleep time was significantly reduced. So, hospitalized elderly reported less total sleep time than before admission. 2. Regarding the sleep disturbing factors, medication(hypnotics : 37.5%), physiological factor(snoring : 59.4%) environmental factor(pillow : 78.1%), emotional factor(anxiety related to disease : 37.5%), and illness factor(fatigue : 34.7%) were reported. 3. Significant differences in gender were found. Men had more disturbances in sleep than women owing to difficulty in falling a sleep and lack of nocturnal sleep. Women consumed more sleep inducing drugs. Significant increase was reported in napping during the day with increasing age. 4. Significant differences between good sleepers and poor sleepers were found for the following variables : nocturnal sleep time, total sleep time, bed time, sleep onset latency time, sleep latency time after nocturnal awakening, time spent in bed upon arousal, environmental factors, and emotional factors. In conclusion, it was found that the quantity and quality of sleep were significantly altered in hospitalized elderly, but adequate strategies for better sleep were not practiced. Further research is needed to develop intervention strategies to promote sleep and to prevent sleep problems.

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This study was designed to develop a basic plan for computerization of nursing records. The subjects were 7 nursing record forms, 58 charts, 23 nurses, 2 nurses managers, a nurse and computer specialist, 16 master course students and 3 professors. Data collection was conducted through questionnaire, observation and interview. The collected data were analyzed for problems, plan of improvement and needs for computerization. Based upon these results, it is recommended that nursing record computerization was needed a basic plan to integrate needs of nursing record computerization. The basic plan as follows: 1. To illustrate a data flow path of nursing record and data dictionary that show nurse's work and record process. 2. To establish a system in order to use multi-tasking and graphic user interface. 3. To establish hardware and software in order to embody integrated management of computer based system through structured walk through. 4. To choose effective database management system and to achieve Log as record unit.

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Ostomates have suffered from many difficulties due to their physical, psychosocial handicaps and changes of life style to include ostoma management that influences their daily and quality of life. An appropriate nursing education for ostoma management is very important. Practical education materials needs revision because those were developed by pharmaceutical companies and hospital institutions. The purpose of this study is to provide more practical and resonable education materials for ostomates by doing analysis and survey of educational materials now being used. We surveyed 8 types of educational materials used in 23 university hospitals and medical centers used in 23 university hospitals and medical centers in Seoul ; four of them were developed by department of nursing and the remainder by an Ostomy Company. Data, collected from July 14, 1997 through July 31, 1997 were analyzed. The results are as follows ; 1. The analyzed of education guide, on ostomate included 14 subcategories ; introduction, structure and fuction of gastrointestinal tracts, definition of stoma, types of ostomy, definition of peristalsis, methods of defection management, selection of instrument, resolution of problems and general situations following surgery, daily life, where to ask for help, explanations for terms, information about where to buy instrument, explanations for enterostomal therapist, a matter of consultation with doctor, etc. 2. Introduction contained specific contents on practical ostomate management that ostomates would experience through their lives. Ostomate education guides were developed 3 hospitals except one which missed this point. 3. Most ostomate education guides, except one hospital, helped ostmates to understand their physical structure change with specific explanation on gastrointestinal tracts with figures. 4. Six institution did not talk about the definition of peristalsis. 5. All institutions, except two, helped ostomates to understand types of ostomy with figures. 6. More detailed explanations in natural defecation are needed. The benefits and pitfalls in natural defection should be more specified. 7. No psychosocial difficulties of ostomy management were addressed. 8. The efficiency off enema can be better understand through all explanations with figures. Some institutions did not mention items about definition, benefits, pitfalls of enema, sequency of enema, how to wash, cautions performing and enema, skin management, cleaning instrument after enema proper time to spend. 9. There were no detailed contents and what to do in case of not being able to do enema. 10. Only one educational material mentioned emotional aspects after the surgery. 11. Most institution explained sucategory of daily life but did not provide specific contents on the difficulties of physical, psychological, and sociocultural controls. 12. The subcategory of ureterostomy education guides included explanations in normal structure and function of urinary tracts, types of ureterostomy, how to management skin, usage and types instrument, commercial urostomy, how to manage instrument, daily life, introduction the general contents. However, more specific explanations were needed.

The purpose of this research was to identify nursing interventions performed by MICU and SICU nurses. For data collection this study used the taxonomy of the Nursing Interventions Classification(NIC: 433 nursing interventions) which was modified by McCloskey and Bulecheck(1996). Each of the 433 interventions were identified as used by MICU and SICU nurses. More than 50% of the ICU nurses performed 280 nursing interventions at least monthly. Rarely used interventions included 26 nursing interventions in the childbearing care class. Overall, both MICU and SICU nurses used interventions in the Physicological : Complex domain most often on a daily basis and the interventions in the Family domain least often. The most frequently reported interventions as being used daily in the MICU were chest physioterapy, airway suctioning and coughing enhancement and, in the SICU, documentation and airway suctioning. There were significant differences between MICU and SICU nurses differences interventions childbearing care, cognitive therapy, communication enhancement, coping assistance, elimination management, lifespan care, health system mediation, immobility management, medication management, neurologic management, patient education psychological comfort promotion, physical comfort program, respiratory management, risk management and information management. The SICU nurses performed there interventions more frequently than the MICU nurses. These findings will help in building of a standardized language for the MICU and SICU and enhance the quality of nursing care.

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