혈액투석실 간호사의 근거중심 혈액투석간호에 대한 지식과 수행도

다국어 초록 (Multilingual Abstract)

This study was to investigate the level of knowledge and performance of evidence based practice for hemodialysis among nurses in dialysis units. Nurses play an important role in hemodialysis care as they are the ones near the patients and more responsive to patient’s concerns or needs than other hemodialysis professionals. Descriptive research was conducted to obtain information concerning the current knowledge level of hemodialysis nurses and their adherence to hemodialysis nursing procedure. Self administered questionnaire was used that data were collected for 24 days from September 1st 2013. The sample consisted of 173 nurses who work in hemodialysis units located in three different district areas in Korea with at least a year of experience as hemodialysis nurses. The survey items were carefully chosen from the evidence based hemodialysis to measure the knowledge and performance of nurses in hemodialysis units. Other pre-existing guidelines were also reviewed to find recommendations that best fit to hemodialysis practice in Korea. All the reviewed guidelines were published by international organizations thus the selected items were then translated to Korean by professional translator. The types of hospitals that the participants work vary from clinics to tertiary hospitals. Using SPSS/WIN 20.0, t-test, ANOVA and Scheffe’s analysis were performed.

The study results were as follows;

1. About 98.8% of nurses in dialysis units had received education mostly from dialysis conferences or symposium. In each areas of the survey questionnaire, ‘somewhat’ in knowledge about hemodialysis, ‘very much’ in necessity of hemodialysis nursing, ‘somewhat’ in awareness of evidence based nursing hemodialysis guidelines, ‘a little’ in performance of evidence based nursing, ‘a lack of time due to work overload’ in reason for poor adherence to evidence based protocols and ‘sufficient nursing staff is required’ in strategies to implement evidence based hemodialysis guidelines were chosen most frequently by participants of this study.

2. The mean score regarding Evidence Based Practice (EBP) was 15.77 (68.5%) out of 23 that the highest score was obtained in knowledge area with 4.36 (72.6%) out of 6. The participants had highest score in anemia management followed by blood vessel management and nutrition management. In regards with adherence to evidence based hemodialysis protocols, there were statistically significant differences were found among participants with more than 8 years of work experience, master’s degree and those working in tertiary hospital. Conducting Scheffe’s test, significantly higher scores were recorded when participants were ‘very well’ in knowledge about hemodialysis and ‘very well’ in performance of evidence based nursing hemodialysis guideline.

3. The performance of EBP in hemodialysis nursing was scored 4.01 out of 5 that the highest score was obtained in hemodialysis management followed by nutrition management and anemia management. In analysis of knowledge of EBP according to general characteristics of participants, statistically significant differences were found among participants with work experience of 8 years and above and those practicing in tertiary hospitals. Conducting Scheffe’s test, significantly higher scores were recorded when participants were ‘very well’ in knowledge about hemodialysis, 'heard about' in awareness of evidence based hemodialysis guidelins and ‘very well’ in performance of evidence based nursing hemodialysis guideline.

Despite that there are internationally developed evidence based guidelines for hemodialysis nursing practice the actual adherence to guidelines varies by experience and education level of participants and types of hospital. The findings of this study can be baseline data for further research into development of strategies to enhance knowledge of hemodialysis nurses and utilization of EBP guidelines.

목차 (Table of Contents)

• I. 서 론 1
• 1. 연구의 필요성 1
• 2. 연구의 목적 4
• 3. 용어의 정의 4
• II. 문헌고찰 6
• 1. 근거중심 혈액투석간호 6
• 2. 혈액투석간호에 대한 지식과 수행도 11
• Ⅲ. 연구방법 14
• 1. 연구설계 14
• 2. 연구대상 14
• 3. 연구도구 15
• 4. 자료수집 방법 및 절차 18
• 5. 자료분석 18
• Ⅳ. 연구결과 19
• 1. 대상자의 특성 19
• 1) 대상자의 일반적 특성 19
• 2) 근거중심 혈액투석간호지침에 대한 인식 19
• 2. 대상자의 근거중심 혈액투석간호에 대한 지식 22
• 1) 대상자의 근거중심 혈액투석간호에 대한 지식 22
• 2) 대상자의 특성에 따른 근거중심 혈액투석간호에 대한 지식 24
• 3. 대상자의 근거중심 혈액투석간호에 대한 수행도 27
• 1) 대상자의 근거중심 혈액투석간호에 대한 수행도 27
• 2) 대상자의 특성에 따른 근거중심 혈액투석간호에 대한 수행도 28
• Ⅴ. 논의 34
• Ⅵ. 결론 및 제언 47
• 참고문헌 51
• 부록 58
• 1. 설문지 58
• 2. 생명윤리심의결과통지서 67
• Abstract 68