1.Relationship between Patient Classification System and APACHE II Scores, and Mortality Prediction in a Surgical Intensive Care Unit
Journal of Korean Academy of Nursing Administration 2024;30(1):67-78
Purpose:
To explore the relationship between nursing care needs and acuity based on the Korean Patient Classification System for Critical Care Nurses (KPCSC) and APACHE II, and to identify their prognostic value in predicting mortality.
Methods:
A total of 617 patients admitted to a surgical intensive care unit in a tertiary hospital from January 1 to June 30, 2021 were included. The correlation between KPCSC and APACHE II scores, and their predictive power regarding mortality were examined.
Results:
KPCSC and APACHE II scores showed a significant, positive correlation (r=.32, p<.001). The KPCSC score was significantly correlated with 10 out of 11 KPCSC categories and 2 out of 3 APACHE II domains, whereas the APACHE II score had a significant correlation with all APACHE II domains and only 4 out of 11 KPCSC categories. Both KPCSC and APACHE II demonstrated moderate discriminatory performance in predicting ICU and in-hospital death, and their AUC values were not significantly different.
Conclusion
KPCSC, reflecting the severity of illness, predicted mortality as well as APACHE II. However, KPCSC was found to consider factors other than severity, such as patient dependency, which substantiates its value as an assessment tool for nursing care needs.
2.Relationship between Patient Classification System and APACHE II Scores, and Mortality Prediction in a Surgical Intensive Care Unit
Journal of Korean Academy of Nursing Administration 2024;30(1):67-78
Purpose:
To explore the relationship between nursing care needs and acuity based on the Korean Patient Classification System for Critical Care Nurses (KPCSC) and APACHE II, and to identify their prognostic value in predicting mortality.
Methods:
A total of 617 patients admitted to a surgical intensive care unit in a tertiary hospital from January 1 to June 30, 2021 were included. The correlation between KPCSC and APACHE II scores, and their predictive power regarding mortality were examined.
Results:
KPCSC and APACHE II scores showed a significant, positive correlation (r=.32, p<.001). The KPCSC score was significantly correlated with 10 out of 11 KPCSC categories and 2 out of 3 APACHE II domains, whereas the APACHE II score had a significant correlation with all APACHE II domains and only 4 out of 11 KPCSC categories. Both KPCSC and APACHE II demonstrated moderate discriminatory performance in predicting ICU and in-hospital death, and their AUC values were not significantly different.
Conclusion
KPCSC, reflecting the severity of illness, predicted mortality as well as APACHE II. However, KPCSC was found to consider factors other than severity, such as patient dependency, which substantiates its value as an assessment tool for nursing care needs.
3.Relationship between Patient Classification System and APACHE II Scores, and Mortality Prediction in a Surgical Intensive Care Unit
Journal of Korean Academy of Nursing Administration 2024;30(1):67-78
Purpose:
To explore the relationship between nursing care needs and acuity based on the Korean Patient Classification System for Critical Care Nurses (KPCSC) and APACHE II, and to identify their prognostic value in predicting mortality.
Methods:
A total of 617 patients admitted to a surgical intensive care unit in a tertiary hospital from January 1 to June 30, 2021 were included. The correlation between KPCSC and APACHE II scores, and their predictive power regarding mortality were examined.
Results:
KPCSC and APACHE II scores showed a significant, positive correlation (r=.32, p<.001). The KPCSC score was significantly correlated with 10 out of 11 KPCSC categories and 2 out of 3 APACHE II domains, whereas the APACHE II score had a significant correlation with all APACHE II domains and only 4 out of 11 KPCSC categories. Both KPCSC and APACHE II demonstrated moderate discriminatory performance in predicting ICU and in-hospital death, and their AUC values were not significantly different.
Conclusion
KPCSC, reflecting the severity of illness, predicted mortality as well as APACHE II. However, KPCSC was found to consider factors other than severity, such as patient dependency, which substantiates its value as an assessment tool for nursing care needs.
4.Relationship between Patient Classification System and APACHE II Scores, and Mortality Prediction in a Surgical Intensive Care Unit
Journal of Korean Academy of Nursing Administration 2024;30(1):67-78
Purpose:
To explore the relationship between nursing care needs and acuity based on the Korean Patient Classification System for Critical Care Nurses (KPCSC) and APACHE II, and to identify their prognostic value in predicting mortality.
Methods:
A total of 617 patients admitted to a surgical intensive care unit in a tertiary hospital from January 1 to June 30, 2021 were included. The correlation between KPCSC and APACHE II scores, and their predictive power regarding mortality were examined.
Results:
KPCSC and APACHE II scores showed a significant, positive correlation (r=.32, p<.001). The KPCSC score was significantly correlated with 10 out of 11 KPCSC categories and 2 out of 3 APACHE II domains, whereas the APACHE II score had a significant correlation with all APACHE II domains and only 4 out of 11 KPCSC categories. Both KPCSC and APACHE II demonstrated moderate discriminatory performance in predicting ICU and in-hospital death, and their AUC values were not significantly different.
Conclusion
KPCSC, reflecting the severity of illness, predicted mortality as well as APACHE II. However, KPCSC was found to consider factors other than severity, such as patient dependency, which substantiates its value as an assessment tool for nursing care needs.
5.Relationship between Nurse Staffing and Critical Nursing Activities in Intensive Care Units : Analysis of National Health Insurance Claims Data from 2009 to 2020
Journal of Korean Critical Care Nursing 2024;17(2):25-41
Purpose:
: This study aimed to investigate changes in critical nursing activities from 2009 to 2020 and explore the relationship between nurse staffing and such activities in intensive care units.
Methods:
: A total of 446,445 adult patients admitted to intensive care units in tertiary and general hospitals from 2009 to 2020 were identified using the National Health Insurance claims database. The Critical Nursing Activities Index was calculated based on the following critical nursing activities: ventilator, extracorporeal membrane oxygenation (ECMO), and continuous renal replacement therapy (CRRT). Trend analysis was performed to analyze changes in critical nursing activities over 12 years and to assess linear trends across different staffing levels.
Results:
: The annual utilization days for ventilators, ECMO, and CRRT, as well as the Critical Nursing Activities Index significantly increased over the study period (p-for-trend<.001) in tertiary and general hospitals, except for ventilator use in general hospitals. Ventilator, ECMO, and CRRT utilization exhibited a significant upward trend with higher nurse staffing levels (Bonferroni adjusted p-for-trend<.001). The Critical Nursing Activities Index was significantly higher in hospitals with higher staffing levels compared to those with lower staffing levels (Bonferroni adjusted p <.05).
Conclusion
: The findings underscore the need for improved nurse staffing levels in intensive care units. Government policies should ensure that staffing levels align with critical nursing activities among critically ill patients to uphold the quality of care.
6.Changes in Nurse Staffing Grades and Nursing Fee Revenues Based on the Amendment of the Resource-Based Relative Value Scale:Intensive Care Units
Eun Hye KIM ; Sung-Hyun CHO ; U Ri GO ; Jung Yeon KIM
Journal of Korean Clinical Nursing Research 2025;31(1):35-48
Purpose:
This study aimed to examine changes in nurse staffing grades and nursing fee revenues in intensive care units (ICUs) following the third amendment of the resource-based relative value scale, which was implemented in January 2024.
Methods:
Changes in staffing grades from the fourth quarter of 2023 to the first quarter of 2024 were analyzed among 588 general ICUs, 94 neonatal ICUs, and 13 pediatric ICUs. Annual nursing fee revenues per nurse were estimated based on the new nursing fee structure for each grade.
Results:
In general ICUs, the highest grade (grade S) and the second-highest grade (grade A) accounted for 7.3% and 41.5%, respectively, in tertiary hospitals, whereas 3.8% were grade S and 11.5% were grade A in general hospitals. In neonatal ICUs, the proportion of higher grades (S, A, and 1) was greater in general hospitals (54.3%) than in tertiary hospitals (38.6%). In pediatric ICUs, 30.8% were grade S and 61.5% were grade A. When applying the same grading criteria (i.e., beds per nurse) across both quarters, staffing levels remained unchanged in most ICUs. Nursing fees and their revenues did not increase proportionally to staffing requirements (i.e., the number of nurses required per patient).
Conclusion
Revisions to staffing grade and nursing fee systems are necessary to induce medical institutions to improve their ICU staffing levels.
7.Changes in Nurse Staffing Grades and Nursing Fee Revenues Based on the Amendment of the Resource-Based Relative Value Scale:Intensive Care Units
Eun Hye KIM ; Sung-Hyun CHO ; U Ri GO ; Jung Yeon KIM
Journal of Korean Clinical Nursing Research 2025;31(1):35-48
Purpose:
This study aimed to examine changes in nurse staffing grades and nursing fee revenues in intensive care units (ICUs) following the third amendment of the resource-based relative value scale, which was implemented in January 2024.
Methods:
Changes in staffing grades from the fourth quarter of 2023 to the first quarter of 2024 were analyzed among 588 general ICUs, 94 neonatal ICUs, and 13 pediatric ICUs. Annual nursing fee revenues per nurse were estimated based on the new nursing fee structure for each grade.
Results:
In general ICUs, the highest grade (grade S) and the second-highest grade (grade A) accounted for 7.3% and 41.5%, respectively, in tertiary hospitals, whereas 3.8% were grade S and 11.5% were grade A in general hospitals. In neonatal ICUs, the proportion of higher grades (S, A, and 1) was greater in general hospitals (54.3%) than in tertiary hospitals (38.6%). In pediatric ICUs, 30.8% were grade S and 61.5% were grade A. When applying the same grading criteria (i.e., beds per nurse) across both quarters, staffing levels remained unchanged in most ICUs. Nursing fees and their revenues did not increase proportionally to staffing requirements (i.e., the number of nurses required per patient).
Conclusion
Revisions to staffing grade and nursing fee systems are necessary to induce medical institutions to improve their ICU staffing levels.
8.Changes in Nurse Staffing Grades and Nursing Fee Revenues Based on the Amendment of the Resource-Based Relative Value Scale:Intensive Care Units
Eun Hye KIM ; Sung-Hyun CHO ; U Ri GO ; Jung Yeon KIM
Journal of Korean Clinical Nursing Research 2025;31(1):35-48
Purpose:
This study aimed to examine changes in nurse staffing grades and nursing fee revenues in intensive care units (ICUs) following the third amendment of the resource-based relative value scale, which was implemented in January 2024.
Methods:
Changes in staffing grades from the fourth quarter of 2023 to the first quarter of 2024 were analyzed among 588 general ICUs, 94 neonatal ICUs, and 13 pediatric ICUs. Annual nursing fee revenues per nurse were estimated based on the new nursing fee structure for each grade.
Results:
In general ICUs, the highest grade (grade S) and the second-highest grade (grade A) accounted for 7.3% and 41.5%, respectively, in tertiary hospitals, whereas 3.8% were grade S and 11.5% were grade A in general hospitals. In neonatal ICUs, the proportion of higher grades (S, A, and 1) was greater in general hospitals (54.3%) than in tertiary hospitals (38.6%). In pediatric ICUs, 30.8% were grade S and 61.5% were grade A. When applying the same grading criteria (i.e., beds per nurse) across both quarters, staffing levels remained unchanged in most ICUs. Nursing fees and their revenues did not increase proportionally to staffing requirements (i.e., the number of nurses required per patient).
Conclusion
Revisions to staffing grade and nursing fee systems are necessary to induce medical institutions to improve their ICU staffing levels.
9.Changes in Nurse Staffing Grades and Nursing Fee Revenues Based on the Amendment of the Resource-Based Relative Value Scale:Intensive Care Units
Eun Hye KIM ; Sung-Hyun CHO ; U Ri GO ; Jung Yeon KIM
Journal of Korean Clinical Nursing Research 2025;31(1):35-48
Purpose:
This study aimed to examine changes in nurse staffing grades and nursing fee revenues in intensive care units (ICUs) following the third amendment of the resource-based relative value scale, which was implemented in January 2024.
Methods:
Changes in staffing grades from the fourth quarter of 2023 to the first quarter of 2024 were analyzed among 588 general ICUs, 94 neonatal ICUs, and 13 pediatric ICUs. Annual nursing fee revenues per nurse were estimated based on the new nursing fee structure for each grade.
Results:
In general ICUs, the highest grade (grade S) and the second-highest grade (grade A) accounted for 7.3% and 41.5%, respectively, in tertiary hospitals, whereas 3.8% were grade S and 11.5% were grade A in general hospitals. In neonatal ICUs, the proportion of higher grades (S, A, and 1) was greater in general hospitals (54.3%) than in tertiary hospitals (38.6%). In pediatric ICUs, 30.8% were grade S and 61.5% were grade A. When applying the same grading criteria (i.e., beds per nurse) across both quarters, staffing levels remained unchanged in most ICUs. Nursing fees and their revenues did not increase proportionally to staffing requirements (i.e., the number of nurses required per patient).
Conclusion
Revisions to staffing grade and nursing fee systems are necessary to induce medical institutions to improve their ICU staffing levels.
10.A Multi-Classifier Based Guideline Sentence Classification System.
Mi Hwa SONG ; Sung Hyun KIM ; Dong Kyun PARK ; Young Ho LEE
Healthcare Informatics Research 2011;17(4):224-231
OBJECTIVES: An efficient clinical process guideline (CPG) modeling service was designed that uses an enhanced intelligent search protocol. The need for a search system arises from the requirement for CPG models to be able to adapt to dynamic patient contexts, allowing them to be updated based on new evidence that arises from medical guidelines and papers. METHODS: A sentence category classifier combined with the AdaBoost.M1 algorithm was used to evaluate the contribution of the CPG to the quality of the search mechanism. Three annotators each tagged 340 sentences hand-chosen from the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC7) clinical guideline. The three annotators then carried out cross-validations of the tagged corpus. A transformation function is also used that extracts a predefined set of structural feature vectors determined by analyzing the sentential instance in terms of the underlying syntactic structures and phrase-level co-occurrences that lie beneath the surface of the lexical generation event. RESULTS: The additional sub-filtering using a combination of multi-classifiers was found to be more effective than a single conventional Term Frequency-Inverse Document Frequency (TF-IDF)-based search system in pinpointing the page containing or adjacent to the guideline information. CONCLUSIONS: We found that transformation has the advantage of exploiting the structural and underlying features which go unseen by the bag-of-words (BOW) model. We also realized that integrating a sentential classifier with a TF-IDF-based search engine enhances the search process by maximizing the probability of the automatically presented relevant information required in the context generated by the guideline authoring environment.
Data Mining
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Humans
;
Hypertension
;
Imidazoles
;
Joints
;
Knowledge Bases
;
Natural Language Processing
;
Nitro Compounds
;
Search Engine