병원간호사의 표준주의 지식 및 간호전문직관, 감염관리 조직문화가 표준주의지침 수행에 미치는 영향

Abstract

본 연구는 병원간호사의 표준주의 지식, 간호전문직관, 감염관리 조직문화, 표준주의지침 수행 정도를 파악하고 표준주의지침 수행의 영향요인을 파악하기 위한 서술적 상관관계 조사연구이다. 자료수집은 2022년 8월 18일부터 8월 28일까지 서울시 소재의 일개 종합병원에 재직 중인 간호사를 대상으로 원내 모집공고문을 통해 자발적으로 연구에 참여한 179명을 선정하였다. 대상자의 일반적 특성, 표준주의 지식, 간호전문직관, 감염관리 조직문화, 표준주의지침 수행 정도를 조사하여 independent t-test, one-way ANOVA로 분석하고 Scheffe's test로 사후 검정하였다. 표준주의 지식, 간호전문직관, 감염관리 조직문화, 표준주의지침 수행의 관련성은 Pearson's correlation coefficients로 분석했으며 표준주의지침 수행의 영향요인을 확인하기 위해 Hierarchial multiple regression으로 분석하였다. 본 연구의 결과는 다음과 같다. 1. 본 연구의 표준주의 지식 정도는 30점 만점에 평균 27.65±1.78점, 간호전문직관은 5점 만점에 평균 3.63±0.52점, 감염관리 조직문화는 7점 만점에 평균 5.33±0.82점, 표준주의지침 수행 정도는 5점 만점에 4.63±0.32점이었다. 2. 본 연구에서 표준주의 지식은 성별(t=3.526, p=.002), 감염관리 교육 횟수(F=4.337, p=.014)에 따라 유의한 차이가 있었다. 간호전문직관은 일반적 특성의 성별(t=3.390, p=.001), 감염관리 교육 경험 유무(t=2.213, p=.028), 감염관리 교육 횟수(F=3.886, p=.022)에 따라 유의한 차이가 있는 것으로 나타났다. 감염관리 조직문화는 성별(t=3.407, p=.001), 감염관리 교육 경험 유무(F=4.070, p<.001), 감염관리 교육 횟수(F=13.793, p<.001), 교육 시간(F=9.090, p<.001)에 따라 유의한 차이가 있었다. 표준주의지침 수행 정도는 성별(t=4.130, p=.001), 임상근무기간(F=3.141, p=.046), 감염관리 교육 횟수(F=3.688, p=.027) 및 시간(F=3.176, p=.026)에 따라 유의한 차이가 있었다. 3. 표준주의 지식(r=.323, p<.001), 간호전문직관(r=.321, p<.001), 감염관리 조직문화(r=.474, p<.001)는 모두 표준주의지침 수행과 통계적으로 유의한 양의 상관관계가 있는 것으로 확인되었다. 4. 대상자의 표준주의지침 수행에 영향을 미치는 요인을 확인하기 위해 위계적 다중회귀분석을 시행하였다. ModelⅠ에 일반적 특성을 투입하였고, ModelⅡ에 표준주의 지식, 간호전문직관, 감염관리 조직문화를 투입하였다. 연구결과 감염관리 조직문화(β=.287, p=.001), 표준주의 지식(β=.231, p=.001), 임상근무기간 5년 이상(β=-.152, p=.029)이 표준주의지침 수행의 영향요인으로 나타났고 ModelⅡ의 표준주의지침 수행 설명력은 28.7%으로 나타났다(F=9.936, p<.001). 본 연구 결과 병원간호사의 감염관리 조직문화가 긍정적이고, 표준주의 지식이 높고 임상근무기간이 길수록 표준주의지침 수행 정도가 높음을 확인하였다. 본 연구는 기존에 연구가 되지 않았던 병원간호사의 개인적 특성인 표준주의 지식, 간호전문직관 및 조직적 특성인 감염관리 조직문화와 표준주의지침 수행 간의 관계를 규명한 것에 의의가 있다. 따라서 체계적인 감염관리 교육을 통해 표준주의 지식을 함양하고, 긍정적인 감염관리 조직문화를 조성하며 임상근무기간이 긴 경력 간호사가 업무 역량을 발휘하여 표준주의지침 수행으로 이어질 수 있도록 간호사 개인뿐만 아니라 조직 차원의 노력이 요구된다. 본 연구결과로 의료관련감염 관리 개선의 근거 및 병원간호사의 표준주의 이행을 높일 수 있는 기초자료로 활용될 수 있을 것이다.;This descriptive research study was conducted to examine hospital nurses’ knowledge of standard precautions, nursing professionalism, and organizational culture for infection control and the performance to guidelines for the standard precaution as well as to identify factors influencing the performance to guidelines for the standard precaution. Study participants were 179 nurses with more than 6 month of experience working at a general hospital. A structured self-report questionnaire was used to measure the general characteristics of the participants, knowledge of standard precautions, nursing professionalism, organizational culture for infection control, and performance to guidelines for the standard precaution. Data were collected from August 18 to 28, 2022. Participants’ general characteristics, knowledge of standard precautions, nursing professionalism, organizational culture for infection control, and performance to guidelines for the standard precaution were analyzed via descriptive statistics using real numbers, percentages, means, and standard deviations. Differences in knowledge of standard precautions, nursing professionalism, organizational culture for infection control, and performance to guidelines for the standard precaution according to the general characteristics of the participants were analyzed using an independent t test and one-way analysis of variance, and Scheffé’s test was performed as a post hoc test. Correlations between knowledge of standard precautions, nursing professionalism, organizational culture for infection control, and performance to guidelines for the standard precaution were analyzed using Pearson’s correlation coefficient. Factors influencing performance to guidelines for the standard precaution was identified by hierarchical multiple regression analysis. The results of this study are as follows. 1. The mean score of knowledge of standard precautions was 27.65±1.78 points (perfect score=30) and that of nursing professionalism was 3.63±0.52 points (perfect score=5). The infection control organizational culture averaged 5.33±0.82 points (perfect score=7), and performance to guidelines for the standard precaution was 4.63±0.32 points (perfect score=5). 2. There was a statistically significant difference in the knowledge of standard precautions depending on the general characteristics of the participants, including gender (t=3.526, p=.002) and numbers of infection control training (F=4.337, p=.014). A statistically significant difference was also observed in nursing professionalism depending on gender (t=3.390, p=.001), experience in infection control training (t=2.213, p=.028), and numbers of infection control training (F=3.886, p=.022). There was a statistically significant difference in infection control organizational culture depending on gender (t=3.407, p=.001), experience in infection control training (F=4.070, p<.001), numbers of infection control training (F=13.793, p<.001), and training time (F=9.090, p<.001). Finally statistically significant, gender-dependent differences were seen in performance to guidelines for the standard precaution (t=4.130, p=.001), clinical experience (F=3.141, p=.046), numbers of infection control training (F=3.688, p=.027), and training time (F=3.176, p=.026). 3. Knowledge of standard precautions (r=0.323, p<.001), nursing professionalism (r=0.321, p<.001), and infection control organizational culture (r=.474, p<.001) were found to be significantly positive correlated with performance to guidelines for the standard precaution. 4. Hierarchical multiple regression analysis was performed to identify the factors affecting performance to guidelines for the standard precaution. In Model I, general characteristics were put, and in Model II, knowledge of standard precautions, nursing professionalism, and infection control organizational culture were put into Model II. As a result of the study, it was found that infection control organizational culture (β=.287, p=.001), knowledge of standard precautions (β=.231, p=.001) and clinical experience (β=-.152, p=.029) had a statistically significant effect on the performance to guidelines for the standard precaution. ModelⅡ showed 28.7% of total explanatory power than ModelⅠ(F=9.936, p<.001). The results of this study confirm that a greater nursing professionalism of hospital nurses, higher infection control organizational culture, and longer clinical experience are associated with a higher degree of performing standard precautions. This study is significant in examining the relationship between organizational characteristics, including the individual characteristics of hospital nurses, knowledge of standard precautions, nursing professionalism, organizational culture of infection control, and performance to guidelines for the standard precaution, an association that has not been previously explored. Therefore, to improve the performance of standard precautions, efforts must be made by both individual nurses and organizations through systematic infection control education, to improve knowledge of standard precautions, create a positive infection control organizational culture, and enable experienced nurses to demonstrate their work competency. The results of this study can be used as the basis for improving the management of medical-related infections and as basic data to enhance the implementation of standard precautions by hospital nurses.