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      한국 노인요양시설의 감염관리 현황과 과제: 선진사회 감염관리 체계와의 비교 = Current Satus and Tasks of Infection Control in Elderly Care Facilities in Korea: Comparison with Advanced Society's Infection Control System

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      https://www.riss.kr/link?id=A108316847

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      다국어 초록 (Multilingual Abstract)

      The purpose of this study was to point out the backwardness of infection control in elderly care facilities in our society and to derive tasks for its improvement. To this end, the infection control system of six advanced countries was set as a reference standard, and the institutional conditions of infection control in our society, infection control capacity, and awareness and practice of infection control were compared with them. As a result of analyzing the current status of infection control using both legal and institutional data for diagnosing the institutional conditions for infection control and questionnaire data for diagnosing the infection control capabilities of facilities and the awareness and practice of infection control, ① it was found that the institutional conditions for infection control were very weak. The supervisory agency did not properly exercise the institutionalized supervisory function, and it showed limitations that the facility evaluation index and infection control manual were too limited to the practical level. ② The infection control capacity was found to be very weak. There was no infrastructure establishment including infection managers, the infection control monitoring, and infection education was limited to superficial education centered on in-house education. ③ It was found that the awareness and practice of the importance of infection control among employees was very low. This tendency was stronger in large facilities with more than 30 people. Based on these results, this study discussed future tasks for improving the infection control system in elderly care facilities in our society.
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      The purpose of this study was to point out the backwardness of infection control in elderly care facilities in our society and to derive tasks for its improvement. To this end, the infection control system of six advanced countries was set as a refere...

      The purpose of this study was to point out the backwardness of infection control in elderly care facilities in our society and to derive tasks for its improvement. To this end, the infection control system of six advanced countries was set as a reference standard, and the institutional conditions of infection control in our society, infection control capacity, and awareness and practice of infection control were compared with them. As a result of analyzing the current status of infection control using both legal and institutional data for diagnosing the institutional conditions for infection control and questionnaire data for diagnosing the infection control capabilities of facilities and the awareness and practice of infection control, ① it was found that the institutional conditions for infection control were very weak. The supervisory agency did not properly exercise the institutionalized supervisory function, and it showed limitations that the facility evaluation index and infection control manual were too limited to the practical level. ② The infection control capacity was found to be very weak. There was no infrastructure establishment including infection managers, the infection control monitoring, and infection education was limited to superficial education centered on in-house education. ③ It was found that the awareness and practice of the importance of infection control among employees was very low. This tendency was stronger in large facilities with more than 30 people. Based on these results, this study discussed future tasks for improving the infection control system in elderly care facilities in our society.

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      국문 초록 (Abstract)

      본 연구는 우리사회 노인요양시설의 감염관리 낙후성을 지적하고, 그 증진에 필요한과제도출에 목적을 두었다. 이를 위해 선진 6개국의 감염관리 체계를 준거기준으로 설정하고, 이들 대비 우리사회의 감염관리 제도적 여건, 감염관리 역량, 감염관리 인식과실천도를 비교하였다. 감염관리 제도적 여건 진단을 위한 법・제도적 자료와 시설의 감염관리 역량과 감염관리 인식 및 실천도 진단을 위한 설문자료를 병용한 감염관리 현황분석결과, ① 감염관리 제도적 여건이 매우 취약한 것으로 나타났다. 감독기관이 제도화된 감독기능을 제대로 행사하지 않고, 시설평가 지표와 감염관리 매뉴얼이 지나치게실무차원에만 한정되어 있다는 한계를 보였다. ② 감염관리 역량이 매우 미약한 것으로나타났다. 감염관리자 지정을 비롯한 인프라 구축이 없고, 감염관리 모니터링 기능이미흡하며, 감염교육이 사내교육 중심의 피상적 교육에만 그치고 있었다. ③ 직원들의감염관리 중요성에 대한 인식과 실천도가 매우 낮은 것으로 나타났다. 이러한 성향은30명 이상의 대규모 시설에서 보다 강하게 나타났다. 이러한 결과를 토대로 본 연구는우리사회 노인요양시설의 감염관리 체계 개선을 위한 향후 과제에 대해 논의하였다.
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      본 연구는 우리사회 노인요양시설의 감염관리 낙후성을 지적하고, 그 증진에 필요한과제도출에 목적을 두었다. 이를 위해 선진 6개국의 감염관리 체계를 준거기준으로 설정하고, 이들 대비 ...

      본 연구는 우리사회 노인요양시설의 감염관리 낙후성을 지적하고, 그 증진에 필요한과제도출에 목적을 두었다. 이를 위해 선진 6개국의 감염관리 체계를 준거기준으로 설정하고, 이들 대비 우리사회의 감염관리 제도적 여건, 감염관리 역량, 감염관리 인식과실천도를 비교하였다. 감염관리 제도적 여건 진단을 위한 법・제도적 자료와 시설의 감염관리 역량과 감염관리 인식 및 실천도 진단을 위한 설문자료를 병용한 감염관리 현황분석결과, ① 감염관리 제도적 여건이 매우 취약한 것으로 나타났다. 감독기관이 제도화된 감독기능을 제대로 행사하지 않고, 시설평가 지표와 감염관리 매뉴얼이 지나치게실무차원에만 한정되어 있다는 한계를 보였다. ② 감염관리 역량이 매우 미약한 것으로나타났다. 감염관리자 지정을 비롯한 인프라 구축이 없고, 감염관리 모니터링 기능이미흡하며, 감염교육이 사내교육 중심의 피상적 교육에만 그치고 있었다. ③ 직원들의감염관리 중요성에 대한 인식과 실천도가 매우 낮은 것으로 나타났다. 이러한 성향은30명 이상의 대규모 시설에서 보다 강하게 나타났다. 이러한 결과를 토대로 본 연구는우리사회 노인요양시설의 감염관리 체계 개선을 위한 향후 과제에 대해 논의하였다.

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      참고문헌 (Reference)

      1 박연환 ; 이성현 ; 이유미 ; 이지영 ; 이민혜, "한국형 노인요양시설 근거중심 감염관리 가이드라인 개발" 대한근관절건강학회 25 (25): 135-147, 2018

      2 김두리 ; 이미향, "코로나바이러스 감염증-19 사태를 통한 노인장기요양시설의 감염관리 개선 방향" 한국직업건강간호학회 29 (29): 202-207, 2020

      3 정부합동 부패척결 추진단, "장기요양기관 실태 점검결과 및 개선방안" 2016

      4 보건복지부, "의료관련감염 예방관리 종합대책 ‘18-’22"

      5 동아일보, "수도권 노인 요양시설 18명 무더기 확진...가장 우려했던 상황"

      6 이희창, "노인요양시설의 감염관리 영향요인 분석" 한국공공관리학회 34 (34): 213-237, 2020

      7 청년의사, "공단, ‘장기요양기관 감염관리체계’구축 방안 마련한다"

      8 한국데일리, "경기도 코로나19(사망자 78%)가 의료기관・요양원 집단감염과 관련 있어"

      9 한겨레, "감염 노인에 목아픈데 찬물...요양원에 돌봄이 사라졌다"

      10 厚生労働省, "高齢者介護施設における 感染対策マニュアル"

      1 박연환 ; 이성현 ; 이유미 ; 이지영 ; 이민혜, "한국형 노인요양시설 근거중심 감염관리 가이드라인 개발" 대한근관절건강학회 25 (25): 135-147, 2018

      2 김두리 ; 이미향, "코로나바이러스 감염증-19 사태를 통한 노인장기요양시설의 감염관리 개선 방향" 한국직업건강간호학회 29 (29): 202-207, 2020

      3 정부합동 부패척결 추진단, "장기요양기관 실태 점검결과 및 개선방안" 2016

      4 보건복지부, "의료관련감염 예방관리 종합대책 ‘18-’22"

      5 동아일보, "수도권 노인 요양시설 18명 무더기 확진...가장 우려했던 상황"

      6 이희창, "노인요양시설의 감염관리 영향요인 분석" 한국공공관리학회 34 (34): 213-237, 2020

      7 청년의사, "공단, ‘장기요양기관 감염관리체계’구축 방안 마련한다"

      8 한국데일리, "경기도 코로나19(사망자 78%)가 의료기관・요양원 집단감염과 관련 있어"

      9 한겨레, "감염 노인에 목아픈데 찬물...요양원에 돌봄이 사라졌다"

      10 厚生労働省, "高齢者介護施設における 感染対策マニュアル"

      11 厚生労働省, "第三者評価制度・情報公表制度について"

      12 Henderson, J., "Why Do Nurses Miss Infection Control Activities? A Qualitative Study" 27 : 11-17, 2020

      13 Stone, P. W., "Understanding Infection Prevention and Control in Nursing Homes : A Qualitative Study" 36 (36): 267-272, 2015

      14 National Center for Emerging and Zoonotic Infectious Diseases, "The National Healthcare Safety Network(NHSN). Long Term Care Facility Component:Tracking Infectious in Long-Term Care Facilities"

      15 Takahashi, I., "The Current Status of Hand Washing and Glove Use among Care Staffin Japan : Its Association with the Education, Knowledge, and Attitudes of Staff, and Infection Control by Facilities" 14 : 336-344, 2009

      16 Sinkowitz-Cochran, R. L., "The Associations between Organizational Culture and Knowledge, Attitudes, and Practices in a Multicenter Veterans Affairs Quality Improvement Initiative to Prevent Methicillin-Resistant Staphylococcus Aureus" 40 : 138-143, 2012

      17 Australian Aged Care Quality Agency, "Result and Processes Guide"

      18 Accreditation Canada, "Required Organizational Practices"

      19 Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen, "Qualitätsprüfungs-Richtlinien Transparenzvereinbarung, Grundlagen der Qualitätsprüfungen nach den §§ 114 ffSGB XI Teil 2 -"

      20 European Centre for Disease Prevention and Control, "Point Prevalence Survey of Helthcare-Associared Infections and Antimicrobial Use in European Long-Term Care Facilities"

      21 Travers, J., "Perceived Barriers to Infection Prevention and Control for Nursing Home Certified Nursing Assistants : A Qualitative Study" 36 : 355-360, 2015

      22 Bono, S.D., "Organizational Culture and Its Implications for Infection Prevention and Control in Healthcare institutions" 86 : 1-6, 2014

      23 Mitchell, B. G., "Organisation and Governance of Infection Prevention and Control in Australian Residential Aged Care Facilities : A National Survey" 24 : 187-193, 2019

      24 Wolf, R., "Nursing StaffPerceptions of Methicillin-Resistant Staphylococcus Aureus and Infection Control in a Long-Term Care Facility" 5 : 342-346, 2008

      25 Centers for Disease Control And Prevention, "National Healthcare Safety Network - Long Term Care Facility Component : Annual Facility Survey" 2017

      26 Herrick, S., "Minding our Business : Designing an Infection Control Program" 1 (1): 153-156, 1996

      27 Damani, N., "Manual of Infection Control Procedures" Greenwich Medical Media Limited 2003

      28 Herzig, C. T., "Infection Trends in US Nursing Homes, 2006-2013" 18 (18): 635.e9-635.e20, 2017

      29 Robert Koch Institut, "Infection Prevention in Long Term Care Facilities"

      30 Nova Scotia, "Infection Prevention and Control: Guideline for Long-Term Care Facility"

      31 IPAC Canada, "Infection Prevention and Control(IPAC) Program Standard"

      32 Felemban. O., "Infection Prevention and Control Programs in Community -Based Home Visiting Nursing in Southeast Queensland, Australia: A Case Study" Griffith University 2014

      33 Centers for Disease Control And Prevention, "Infection Prevention and Control Assesment Tool for Long-Term Care Facilities"

      34 Rhinehrt, E., "Infection Control in Home Care and Hospice" Jones and Bartlett Publisher 2006

      35 Gamage, B., "Identifying thr Gaps in Infection Prevention and Control Resources for Long-term Care Facilities in British Columbia" 40 : 150-154, 2012

      36 Roup, B. J., "How Maryland Increased Infection Prevention and Control Activity in Long-Term Care Facilities, 2003-2008" 39 (39): 292-295, 2011

      37 Tarantini, C., "Healthcare Workers’ Attitudes towards Hand-Hygiene Monitoring Technology" 102 : 413-418, 2019

      38 Care Quality Commission, "Essential Standards Of Quality & Safety Outcome 8 - Regular 12 - Cleanliness Care Quality Self Assessment"

      39 Lee, M. H., "Effectiveness and Core Components of Infection Prevention and Control Programmes in Long-Term Care Facilities : A Systematic Review" 102 : 377-393, 2019

      40 Makris, A. T., "Effect of a Comprehensive Infection Control Program on the Incidence of Infections in Long-Term Care Facilities" 28 (28): 3-7, 2000

      41 Rosenthal, V. D., "Effect of Education and Perormance Feedback on Handwashing : The Benefit of Administrative Supprt in Argentinean Hospitals" 31 (31): 85-92, 2003

      42 Kariya, N., "Current Prevention and Control of Health Care-Associated Infections in Long-Term Care Facilities for the Elderly in Japan" 24 : 347-352, 2018

      43 Baldwin, N. S., "Cluster Randomised Controlled Trial of an Infection Control Education and Training Intervention Programme Focusing on Metacillin-Resistant Staphylococcus Aureus in Nursing Homes for Older People" 76 : 36-41, 2010

      44 Agarwal, M., "Change in US Nursing Home Infection Prevention and Control Program From 2014 to 2018" 21 (21): 97-103, 2020

      45 Nguyen, L. K. N., "Challenges of Infection Prevention and Control in Scottish Long-Term Care Facilities" 22 : 1-3, 2020

      46 Centers for Medicare & Medicaid Services, "CMS Manual System"

      47 National Health and Medical Research Council, "Australian Guidelines for the Prevention and Control of Infection in Healthcare"

      48 Aged Care Standards and Accreditation Agency Ltd, "Agency Resources and Planned Performance"

      49 강정희, "A Study on the Infection Control System of Medical Welfare Facilities for the Elderly: Comparison between Korea and the Six Advanced Countries" 한국공공관리학회 33 (33): 191-217, 2019

      50 Zoutman, D. E., "A Cross-Canada Survey of Infection Prevention and Control in Long-Term Care Facilities" 37 (37): 358-363, 2009

      51 보건복지부, "2019년도 장기요양 실태조사" 2019

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