환자안전문화에 대한 병원종사자들의 인식 : 일개 대학병원을 중심으로

다국어 초록 (Multilingual Abstract)

Abstract

Hospital workers' perception of patient safety culture in a university hospital

The purpose of this study is to grasp the level of perception of hospital workers on the patient safety culture, and to investigate the perception on the patient safety culture in accordance with the titles, service careers at the hospitals and types of occupation. As for the tool for this study, the questionnaires adapted in Korean alphabets for the hospital survey on patient safety culture developed by Jeongeun Kim, Kyungeh An, Sook-Hee Yun(2004) at the Agency for Healthcare Research and Quality were used after modification. As for the data, the analysis on the frequency, t-test, ANOVA and Scheffe test were carried out by using SPSS 10.0. Total 298 persons of subjects were targeted at the 73 doctors, 152 nurses, 29 pharmacists and 44 medical technicians working in a university hospital.
The results of this study are as follows:
1. The results of comparison among the positive response ratios on the patient safety culture of hospital workers showed that the subjects had perceived the teamwork within units most positively(81.2%), and perceived most negatively on the non-punitive response to error(22%) and the staffing(25%). They responded that the hospital management were fostering working atmospheres to improve the patient safety(71.5%), but did not place it in top priority(46%). 69.6% of the subjects answered that the medical errors were mostly or always reported. 59.5% of them stated that the patient safety grade was very good or excellent, and 38.2% of them evaluated that it was acceptable.
2. In the comparison of perception on the patient safety culture in accordance with the titles and service careers at the hospitals, the persons with more than eleven(11) years of service perceived most positively in the areas of organizational learning, teamwork within units and the communication openness. The persons with more than eleven(11) years of service perceived errors as punitive culture compared with those under one(1) year of service.
3. There were significant statistical differences in the perception on the patient safety culture by type of occupation(F=10.274, p<0.001). As for the patient safety culture, the medical technicians perceived it most positively, and it was shown in the order of nurses, pharmacists and doctors. As for the staffing, the pharmacists perceived it negatively in comparison with nurses, and as for the supervisor/manager expectations & actions promoting patient safety, the nurses and medical technicians perceived positively in comparison with doctors. As for the hospital management support for patient safety, the medical technicians were more positive than doctors and pharmacists, and as for the teamwork across hospital units, the pharmacists were more negative than doctors, nurses and medical technicians. The pharmacists perceived errors as punitive culture in comparison with doctors, and the reports on the medical errors by doctors were perceived to be made less than those by the nurses and pharmacists.
In conclusion, though the hospital workers perceived that they were respecting each other, working together as a team, and forming good assistance to provide best medical treatments for the patients, they perceived that there was the possibility of occurrence in potential problems of patient safety due to the insufficient personnel. Besides, the more careers managers have, the more positively they perceived on the patient safety culture. The subjects perceived that the organization had the punitive culture against errors. To settle down the patient safety culture, it is required to make efforts to form the correct safety culture through the establishment of reporting system to prevent errors systematically in advance and open discussion.


Key Words : Patient safety Culture, Hospital workers' Perception

목차 (Table of Contents)

• Ⅰ. 서 론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 3
• 3. 용어의 정의 4
• 4. 연구의 제한점 5
• Ⅱ. 문헌고찰 6
• 1. 환자안전문화 6
• 2. 환자안전문화에 관한 선행 연구 8
• Ⅲ. 연구방법 11
• 1. 연구 설계 11
• 2. 연구 대상 및 자료 수집 11
• 3. 연구 도구 11
• 4. 자료 분석 방법 12
• Ⅳ. 연구결과 13
• 1. 대상자의 일반적 특성 13
• 2. 병원 종사자들의 환자안전문화에 관한 인식 15
• 3. 직위 및 병원 경력에 따른 환자안전문화 인식 비교 22
• 4. 직종별 환자안전문화 인식 비교 33
• Ⅴ. 논 의 41
• 1. 병원 종사자들의 환자안전문화에 관한 인식 41
• 2. 직위 및 병원 경력에 따른 환자안전문화 인식 43
• 3. 직종별 환자안전문화 인식 44
• Ⅵ. 결론 및 제언 48
• 참고문헌 52
• 부 록 57
• Abstract 67