종합병원 간호사의 안전문화인식과 피로가 환자안전관리활동에 미치는 영향 = Influences of Perception of Patient Safety Culture and Fatigue on Safety Management Activities of General Hospital Nurses

다국어 초록 (Multilingual Abstract)

Purpose: The purpose of this descriptive study is to identify general hospital nurses' perception of patient safety culture, fatigue, and safety management activities. This study is implemented to offer basic data in establishing strategies to promote safety management activities.

Participants and methods: The participants of this study are 230 nurses who are currently working at C general hospital in G city. The data are collected through a self-reported survey. The data collection period is from 17th, July to 23th, July of 2018. The collected data are analyzed by using SPSS PC+24.0 for Windows and through descriptive statistics, independent sample t-test, one-way ANOVA, Pearson correlation, and multiple stepwise regression analysis.
Results: All of the survey questions consist of 5-point Likert scale. The mean score of general hospital nurses' fatigue degree was 3.17, perception of patient safety culture was 3.12, and the mean score of safety management activities was 4.39. The fatigue degree was differed according to the participants' individual features; working duration(F=6.53, 𝘱<.001) and subjective health condition(F=24.13, 𝘱<.001). Perception of patient safety culture was significantly differed according to the department(F=3.27, 𝘱=.022). The safety management activities were also significantly differed according to the department(F=5.15, 𝘱=.002). There was a negative correlation between safety management activities and fatigue(r= -0.176, 𝘱= 0.008), while there was a significantly positive correlation between safety management activities and perception of patient safety culture(r= 0.213, 𝘱= 0.001). To identify the factors that affect safety management activities, the researcher implemented a multiple stepwise regression analysis of the following factors; fatigue and perception of patient safety culture which showed a significant correlation; place of work which showed a significant difference according to the participants' general features. As a result of this analysis, the most essential predictive factor of safety management activities was place of work (β= 0.230, 𝘱<0.001), followed by perception of patient safety culture(β= 0.217 ,𝘱=0.001), and fatigue(β= -0.155, 𝘱=0.014). On the performance of safety management activities, the total explanation power of these variables was 11.7%.

Conclusion: The research results show that perception of patient safety culture, fatigue, and place of work affect general hospital nurses' performance of safety management activities. Therefore in establishing strategies to promote safety management activities, each department's features should be first considered to develop educational programs for safety management activities. And, fatigue should be considered and reduced through appropriate working hours, breaks, and work schedules. Strategic plans and activities are also required to enhance the nurses' perception of patient safety culture.

Key words: Perception of patient safety culture, Fatigue, Place of work, Safety management activities

국문 초록 (Abstract)

목적: 본 연구는 종합병원 간호사를 대상으로 환자안전문화인식, 피로도 및 환자안전관리활동에 대해 파악하고 환자안전관리활동을 향상시키기 위한 전략 수립에 필요한 기초자료를 제공하고자 시도된 서술적 조사연구이다.

대상 및 방법: 연구대상은 G시 소재 C종합병원에 재직하고 있는 간호사 230명으로 자가 보고식 설문지로 자료를 수집하였다. 자료수집 기간은 2018년 7월 17일부터 7월 23일까지였으며, 수집된 자료는 SPSS PC+24.0 for Windows를 이용하여 기술통계, 독립표본 t-test, 일원배치 분산분석, 피어슨의 상관관계, 단계적 다중 회귀분석을 통해 분석하였다

결과: 설문지 모두 5점 척도로 종합병원 간호사의 피로도는 3.17점, 환자안전문화인식은3.12점, 환자안전관리활동은 4.39이었다. 대상자의 특성에 따른 피로도는 근무경력(F=6.53, 𝘱<.001),주관적 건강상태(F=24.13, 𝘱<.001)에 따라 유의한 차이가 있었으며, 환자안전문화인식은 근무부서(F=3.27, 𝘱=.022)에 따라 유의한 차이가 있었으며, 환자안전관리활동 역시 근무 부서에 따라 통계적으로 유의한 차이가 있었다(F=5.15, 𝘱=.002). 대상자의 환자안전관리활동은 피로와 음의 상관관계가 있었으며(r= -0.176, 𝘱= 0.008). 환자안전관리활동과 환자안전문화인식은 유의한 양의 상관관계가 있었다(r= 0.213, 𝘱= 0.001). 대상자의 환자안전관리활동에 영향을 미치는 요인을 파악하기 위하여 유의한 상관관계를 보인 피로, 안전문화 인식과 대상자의 일반적 특성에서 유의하게 차이가 나타난 변수인 근무지를 단계적 다중회귀 분석한 결과 대상자의 환자안전관리활동의 가장 주요한 예측 요인은 근무지(β= 0.230, 𝘱<0.001)이었고, 그 다음으로는 환자안전문화 인식(β= 0.217 ,𝘱=0.001), 피로(β= -0.155, 𝘱=0.014)이었다. 이들 변인들의 환자안전관리활동 수행 정도에 대한 설명력은 11.7%이었다.

결론: 이상의 연구결과 환자안전문화인식과 피로, 근무지등이 종합병원간호사의 환자안전관리활동 수행 정도에 큰 영향을 미치는 것으로 밝혀져 환자안전관리활동을 증진시키는 전략을 개발할 때 부서 특성에 맞는 환자안전관리활동 교육프로그램의 개발이 필요하며, 환자안전관리활동을 높이는 노력으로 적정근무시간에 적당한 휴식 및 업무분담으로 피로를 낮추고, 환자안전문화인식을 높이도록 근무지 차원에서 전략적인 계획과 활동이 필요하다.

주제어: 환자안전문화인식, 피로도, 근무지, 환자안전관리활동

목차 (Table of Contents)

• 국문초록 1
• Ⅰ. 서론 3
• Ⅱ. 연구대상 및 방법 6
• Ⅲ. 연구결과 11
• Ⅳ. 고찰 25
• Ⅴ. 결론 30
• 참고문헌 31
• 영문초록 34
• 부록 37