Quality Care Strategy for Long-term Care Hospitals and Nursing Homes - Focusing on Patient (Resident) safety

Abstract

In 2017, Korea became “Aged Society” where the proportion of the elderly among total population is equal or more than 14%. The objectives of this study were to examine the current status of patient safety in long-term care hospitals and resident safety in nursing homes and explore the policy measures to improve the patient (resident) safety in long-term care hospitals or nursing homes. Long-term care hospitals should obtain accreditation and patient safety law applies to them. Nursing homes under the long-term care insurance should be audited by long-term care insurer. Fall, soar, medication error, and healthcare associated infection is the important issues for patient or resident safety in long-term care services. We conducted Focus Group Interview (FGI) to examine the experiences and perceptions among users and workers of long-term care hospitals and nursing homes. Six persons with parents or parents-in-law who were hospitalized within 1 year and 11 staffs (6 registered nurses, 4 nurse-aids, 1 care worker) in long-term care hospitals participated in FGI. Participants of FGI identified the occurrence of falls in long-term care hospitals and thought that the lack of care givers and the frailty of the patients would influence the occurrence of falls. FGI for nursing home was also conducted, and 6 persons with parents or parents-in-law who have lived in nursing home within 1 year and 13 staffs (2 nurse-aids, 11 care workers) in nursing homes participated in FGI. There were quite a differences among nursing homes for size, location, workforce, management, and so on. Staffs said that they tried to reduce the occurrence of falls, but falls were also frequently observed in nursing homes. Policy measures for the improvement of patient (resident) safety of long-term care services were studied using expert survey. For long-term care hospitals, respondents placed high priority on the increased employment of nurse, reinforcement of criteria for long-term care hospitals, and for nursing home, on shift work and improved care conditions of care workers, the linkage between hospitals and nursing homes, the reporting of resident safety accidents. Both systematic approaches for manpower, equipment, information and practical approaches for fall, soar, medication error, healthcare related infection should be required for quality care for long-term care hospitals and nursing homes.