Abstract
Abstract Background Korean comprehensive nursing-caregiving service, which is covered by national insurance, has been officially initiated in 2016. Following interim analysis presented at JSMO 2018, we report our 1-year experience of cancer-oriented comprehensive nursing-caregiving unit´s outcomes and issues. Methods and Results Our institution is a general hospital (827 beds) with 246 doctors and 703 RNs. We are running cancer-oriented comprehensive nursing-caregiving service (46 beds with 25 RNs and 12 nurses aides) since December 2017. This special ward is caring only medical oncology patients. For 12 months, 11,946 inpatients (average 32.4 patients/day, bed turnover rate 85.7%) and 5,682 patients received chemotherapy in our unit. We evaluated our Results in three categories: structure, process, and outcome. First, structural (environmental) improvements were found in more interval between beds (1.5m), fully automatic beds with fall prevention sensors, comfortable patient lounge. Second, process improvements such as nursing time, quality of oncologic nursing is improved. For example, missed nursing care has been improved (nursing caregiving ward vs. general ward: 0.1 vs. 1.3 events/month). Finally, patient and nurse outcome are much improved when compared with general wards. Patient satisfaction (will to revisit: 91.7% vs. 78.4%, will to recommend to others: 95.0% vs. 76.8%) have been increased. Safety indicators such as pressure ulcer (0.3 vs. 0.8 events/month), falls (1.6 vs. 1.5 events/month) have dropped. Nurse outcomes such as resignation rate have been stabilized (resignation rate: 0 vs. 14.9%). Issues during unit operation were found in still heavy workloads for nursing staff and low compensation by the government compared with other countries. Conclusion Comprehensive nursing-caregiving service for medical oncology patients is a key to success in both improved quality of cancer care and nursing staff´s job satisfaction.
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