소독간호사 비기술적 술기의 측정요소별 행동 목록 개발 : SPLINTS를 중심으로 = Development of a Behavioral Checklist for Non-Technical Skills of Scrub Nurses : Focusing on SPLINTS

국문 초록 (Abstract)

본 연구는 소독간호사의 비기술적 술기 행동 목록을 SPLINTS에 기반하여 개발하고 개발된 행동 목록의 타당도와 신뢰도를 검증하기 위해 시행된 서술적 조사 연구이다.
소독간호사 업무는 무균술의 준수와 같은 기술적 술기와 함께 인간요소로 설명할 수 있는 비기술적 술기로 이루어진 복합적 형태이다. 수술실에서 일어나는 오류 사건은 의사소통 능력의 부재와 같은 비기술적 술기의 향상을 통해 예방 가능한 것으로 보고되었다. 소독간호사의 비기술적 술기 9개 요소를 평가하는 SPLINTS는 각 요소에 해당하는 행동에 대한 명확한 구분이 없어 정확한 평가를 위해 비기술적 술기 각 요소에 해당하는 행동 목록 개발이 필요하다.
SPLINTS를 한국어로 번안한 K-SPLINTS 교안에 제시된 행동 서술문과 포커스 그룹과의 경험적 진술을 토대로 74개의 행동 목록을 수집 하였다. 수술실 근무 경험 10년 이상인 간호사와 관리자, 간호학 교수로 이루어진 7인의 전문가 집단이 74개 행동 목록의 내용타당도 검증을 실시 하였다. 검증 결과 I-CVI 값이 .78 이하인 문항을 삭제하고, 수정 및 통합 과정을 거쳐 총 54개의 예비 문항을 확정하였다.
확정된 54개의 예비 문항에 대한 내용타당도를 재평가 하기 위해 근무경력 10년 이상의 간호사와 관리자 총 10인으로 이루어진 전문가 집단을 구성하였다. 내용타당도 검증 결과 54개의 예비 문항의 모든 I-CVI 값이 .80 이상, S-CVI/ave 값은 .94로 나타나 모든 문항이 채택되었다. 확정된 예비 문항의 문항 분석 및 신뢰도 검정을 위해 2024년 1월 25일부터 4월 30일 까지 서울 및 경기 지역 소재 3개 대학병원 수술실에서 근무하고 있는 수술실 간호사를 대상으로 온라인 설문을 통하여 자료를 수집하였다. 수집된 자료중 응답이 불성실한 자료 2개를 제외한 43개의 자료를 분석을 위해 사용하였다. 자료분석은 SPSS 29.0 과 Microsoft Excel 365를 이용하여 서술 통계, 문항 분석, Cronbach α 값을 산출하여 타당도와 신뢰도를 검정하였다. 문항분석과 Cronbach α 검증결과 3개 범주의 각 항목-전체 상관계수가 .30 이상으로 나타났고, Cronbach α 값은 각각 .940, .942, .871로 나타났다.
본 연구를 통해 개발된 소독간호사의 비기술적 술기 행동 목록은 SPLINTS에서 제시한 비기술적 술기 3개 범주, 9개의 요인에 대하여, 총 54개 문항으로 구성되었다. 개발된 행동 목록은 K-SPLINTS 도구를 이용한 소독간호사의 비기술적 술기를 정확하고 일관성 있게 측정 할 수 있도록 사용 될 수 있을 것이다. 또한, 소독간호사의 비기술적 술기 교육과 역량 개발을 위한 기초 자료로 사용 될 수 있을 것이다.

목차 (Table of Contents)

• 국문초록 ············································································································································ ⅰ
• Abstract ··········································································································································· iii
• 목차 ···················································································································································· vi
• 표 목차 ··········································································································································· viii
• 그림 목차 ·········································································································································· ix
• I. 서론 ································································································································· 1
• 1. 연구의 필요성 ·························································································································· 1
• 2. 연구 목적 ·································································································································· 4
• II. 이론적 배경 ··················································································································· 5
• 1. 비기술적 술기 ·························································································································· 5
• III. 연구 방법 ····················································································································· 8
• 1. 연구 설계 ·································································································································· 8
• 2. 연구 절차 ·································································································································· 8
• 3. 연구 과정 ·································································································································· 9
• 1) 포커스 그룹 미팅을 통한 행동 서술문 수집 ····································································· 9
• 가. 포커스 그룹 선정 ············································································································· 9
• 나. 행동 서술문 수집 ············································································································· 9
• 2) 예비 문항 개발 ···················································································································· 10
• 가. 예비 문항 수립 ············································································································ 10
• 나. 예비 문항의 내용타당도 검증 ······················································································ 10
• 다. 예비 문항 확정 ·············································································································· 11
• 3) 확정된 예비 문항의 내용타당도 검증 ·············································································· 11
• 4) 확정된 예비 문항의 문항분석 및 신뢰도 검증 ······························································· 11
• 가. 확정된 예비 문항 ··········································································································· 11
• 나. 윤리적 고려 ···················································································································· 11
• 다. 연구대상자 ······················································································································ 11
• 라. 자료수집 방법 ················································································································ 12
• 마. 자료분석 방법 ················································································································ 12
• IV. 연구 결과 ··················································································································· 13
• 1. 포커스 그룹 미팅을 통해 수집한 행동 서술문 ································································· 13
• 2. 예비 문항 개발 ······················································································································ 13
• 1) 예비 문항 수립 ·················································································································· 13
• 2) 행동 서술문의 내용타당도 검증 ······················································································ 16
• 3) 예비 문항 확정 ·················································································································· 19
• 3. 확정된 예비 문항 내용타당도 검증 ···················································································· 23
• 4. 확정된 예비 문항의 문항분석 및 신뢰도 검증 ································································· 25
• 1) 연구대상자 ·························································································································· 25
• 2) 연구대상자의 인구학적 특성 ··························································································· 25
• 3) 문항분석 및 신뢰도 검증 ································································································· 28
• 5. 소독간호사의 비기술적 술기 평가 요소별 행동 목록 확정 ············································ 32
• V. 논의 ······························································································································ 35
• 1. 소독간호사의 비기술적 술기 행동 목록 ············································································ 35
• 2. 소독간호사의 비기술적 술기 평가와 교육 및 역량 개발 ················································ 36
• 3. 연구의 제한점 ························································································································ 37
• 4. 연구의 의의 ···························································································································· 38
• VI. 결론 및 제언 ············································································································· 39
• 1. 결론 ········································································································································· 39
• 2. 제언 ········································································································································· 40
• 참고문헌 ··········································································································································· 41
• 부록 ·················································································································································· 47