Journal of Korean Academy of Nursing

Original Articles

Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals: Ju Young Yoon, Ji Yun Lee; J Korean Acad Nurs 2010;40(1):110-118. Published online February 28, 2010; DOI: https://doi.org/10.4040/jkan.2010.40.1.110

Purpose

To develop outcome indicators of urinary incontinence to measure quality of care in long term care hospitals in Korea.

Methods

The draft indicators of urinary incontinence were developed from a literature review and clinical expert panel. A survey of medical records of 280 patients in 20 hospitals was conducted to test inter-rater reliability. Statistical analysis was done to test risk adjustment criteria, variation between hospitals, and stability of indicators, using assessment data from 77,918 patients in 623 hospitals.

Results

The inter-rater reliability of items was high (Kappa range: 0.66-0.92). Severe cognitive impairment (odds ratio [OR]: 3.15, confidence interval [CI]: 3.03-3.26) and total mobility activities of daily living (ADLs) dependency (OR: 4.85, CI: 4.72-4.98) increased the prevalence of urinary incontinence, thus they proved to be significant criteria to stratify high and low risk groups. The prevalence for low risk showed more substantial variation than the high risk group. The indicators were stable over one month.

Conclusion

This study demonstrated the feasibility of outcome indicators of urinary incontinence. Improving the reliability of the patient assessment tool and refining the indicators through validation study is a must for future study.

Citations

Citations to this article as recorded by

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Mobility is the key! Trends and associations of common care problems in German long-term care facilities from 2008 to 2012
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The impact of organizational factors on the urinary incontinence care quality in long-term care hospitals: A longitudinal correlational study
Ju Young Yoon, Ji Yun Lee, Barbara J. Bowers, David R. Zimmerman
International Journal of Nursing Studies.2012; 49(12): 1544. CrossRef

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Multi-level Analysis of Factors related to Quality of Services in Long-term Care Hospitals: Seon-heui Lee; J Korean Acad Nurs 2009;39(3):409-421. Published online June 29, 2009; DOI: https://doi.org/10.4040/jkan.2009.39.3.409

Abstract PDF

Purpose

In this research multi-level analysis was done to identify factors related to quality of services. Patient characteristics and organizational factors were considered.

Methods

The data were collected from the Health Insurance Review and Assessment Service (HIRA) data base. The sample was selected from 17,234 patients who had been admitted between January 2007 and May 2008 to one of 253 long-term care hospitals located in Seoul, six other metropolitan cities or nine provinces The data were analyzed with SAS 9.1 using multi-level analysis.

Results

The results indicated that individual level variables related to quality of service were age, cognitive ability, patient classification, and initial quality scores. The organizational level variables related to quality of service were ownership, number of beds, and turnover rate. The explanatory power of variables related to organizational level variances in quality of service was 23.72%.

Conclusion

The results of this study indicate that differences in the quality of services were related to organizational factors. It is necessary to consider not only individual factors but also higher-level organizational factors such as nurse' welfare and facility standards if quality of service in long term care hospitals is to be improved.

Citations

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Development of Outcome Indicators of Urinary Incontinence for Quality Evaluation in Long Term Care Hospitals
Ju Young Yoon, Ji Yun Lee
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