간호단위 관리자의 간호관리역량

Abstract

본 연구는 간호단위 관리자의 간호관리역량 향상을 위한 방안을 모색하기 위해 양적 자료를 이용하여 간호단위 관리자가 인지하는 간호관리역량에 대한 중요도 정도 및 대상자의 개인적, 조직적, 환경적 특성에 따른 간호관리역량의 차이를 파악하고, 질적 자료를 이용하여 간호관리역량의 증진 및 저해 경험을 탐색하고자 시도되었다. 양적 자료를 위한 대상자는 간호단위 관리자 200명으로 편의표집방법을 사용하였으며, SPSS/WIN 27.0 프로그램을 활용하여 기술통계, 독립표본 t-test, 일원분산분석, 단계회귀분석을 수행하였다. 질적 자료를 위한 대상자는 설문조사에 응한 간호단위 관리자의 하위집단에서 할당표집방법을 사용하여 총 24명이 선정되었다. 자료는 개별 면담을 이용하여 수집되었으며, 질적내용분석 방법을 적용하여 분석되었다. 본 연구에서 간호단위 관리자는 대인적 역량과 기술적 역량에 대해 중요하게 인지하고 있는 반면 재무관리 역량에 대한 중요성은 가장 낮게 인지하고 있었다. 간호관리역량에 영향을 미치는 요인은 연구경험, 관리하는 직원의 수와 단위의 수, 간호근무환경이었으며, 이 중 연구경험은 가장 중요한 예측변수이었다. 특히 연구경험이 있는 간호단위 관리자는 없는 군에 비해 기술적, 개념적, 대인적, 리더십, 재무관리 역량 모두 유의하게 높은 점수를 나타냈다. 질적 자료에서 간호관리역량의 촉진요인으로 간호단위 관리자의 임상실무능력과 컴퓨터 활용능력, 조직적 분위기, 선임관리자의 역할모델 등 개인적, 조직적 차원에서 주로 제시되었고, 방해요인으로 물질적, 인적 자원의 부족, 멘토 제도와 신임관리자 트레이닝 과정의 부재, 모호한 업무의 범위 등 조직적, 환경적 차원에서 제시되었다. 따라서 간호단위 관리자의 간호관리역량을 향상시키기 위해서는 개인, 조직, 환경 차원에서의 접근이 요구되며, 무엇보다 개인 차원에서의 연구역량을 높이기 위한 방안을 강조하였다는데 의의가 있다. ;The study aimed to identify the factors that affected the knowledge and implementation ability of managerial competencies and provide a deeper explanation of the managerial competencies among nurse unit managers (NUM). The author recruited 200 NUM who worked for tertiary care hospitals by using a convenience sampling method in the quantitative phase. Data were collected via individual interviews. A subset of 24 participants was for the qualitative phase by using quota sampling method based on their managerial competencies scores. Descriptive statistics, an independent t-test, ANOVA, Pearson correlation, and stepwise linear regression were conducted to analyze the quantitative data. Content analysis was employed to analyze the data by focusing on facilitators and inhibitors of managerial competencies. The key results of this study were: 1. The mean score of the knowledge of managerial competencies was 3.12±0.41. There were significant differences in the knowledge of managerial competencies based on education (t=3.40, p<.001), research experience (t=6.44, p<.001), total number of staff members that reported to the NUM (t=2.08, p=.030), number of units managed (t=4.75, p<.001), and manager training status (t=3.84, p=.022). The mean score of the ability to implement managerial competencies was 3.05±0.44. There were significant differences based on education (t=4.07, p=.045), research experience (t=5.46, p=.085), total number of staff members who reported to the NUM (t=2.08, p=.018), number of units (t=3.26, p=.001), and manager training status (t=3.99, p=.021). 2. The factors that influenced the knowledge of managerial competencies were research experience (ß=.26, p<.001), total number of staff members who reported to the NUM (ß=.12, p=.039), number of units (ß=.18, p=.003), nursing foundations for quality of care (ß=.21, p=.002), nurse manager ability, leadership and support for nurses (ß=.22, p=.003). The input variables explained 47% of the knowledge of managerial competencies. The factors that influenced the ability to implement managerial competencies were research experience (ß=.23, p<.001), total number of staff members who reported to the NUM (ß=.15, p=.018), and staffing and resource adequacy (ß=-.23, p=0.10). The input variables explained 51% of ability to implement managerial competencies. 3. As a result of the qualitative analysis, the facilitators and inhibitors of managerial competencies were categorized as technical competency, human competency, conceptual competency, leadership competency, and financial management competency. The author uncovered 13 themes for facilitators and 13 themes for inhibitor of managerial competencies. Education of administrative procedures and paperwork of hospital, mentoring, and a systematic handover was needed for novice NUM. Experienced NUM suggested that education on the latest nursing trends, communication, legal issues, and business management was needed. Legal and statistical advice, customer management systems, and sufficient resource of material and human were factors that promoted management competence. Overall, NUM were most concerned about human and technical competencies, and were least aware of the importance of financial management competency. The most important predictor of managerial competencies was research experience. Factors that facilitated the acquisition of managerial competencies were practical clinical skills, computer literacy, an organized atmosphere that promotes change and improvement, and role models. Obstacles against to gaining managerial competencies included a vague scope of work, and a lack of material and human resources, mentor systems, education, training programs for novice NUM, and pre-training programs for registered nurses. Therefore, efforts at an individual, organizational, and environmental level are needed to enhance managerial competencies. This study was useful in finding ways to improve managerial competencies by examining factors that affect managerial competencies and determining the facilitators and inhibitors to improve managerial competencies.