본 연구결과를 기반으로 다음과 같이 제언한다.
1. 대상자의 범위를 넓히고, 대상자의 수를 확대하여 다양한 응급의료센터에서 근무하는 응급실 간호사를 대상으로 환자안전간호활동에 영향을 미치는 요 인에 대한 반복연구를 제언한다.
2. 간호사는 다양한 영역에서 간호활동을 수행하는 만큼 각 영역에 맞는 환자 안전간호활동 측정도구 개발과 관찰의 형태를 활용한 객관적인 평가도구 개 발을 제언한다.
3. 응급실의 특수성을 고려하여 팀워크와 환자안전문화인식을 증진시킬 수 있 는 환경 조성과 교육을 제공하여 환자안전간호활동의 향상에 대한 효과를 평가하는 연구를 제언한다.
4. 응급실 간호사를 대상으로 환자안전간호활동을 향상시키기 위한 프로그램을 개발하여 임상에 적용하고, 그 효과에 대해 지속적으로 연구할 것을 제언한 다.
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부록 1. 대상자 설명문
부록 2. 연구도구
-ABSTRACT-Teamwork, Perception of Patient Safety Culture and Safety Care Activity among Emergency Department
Nurses
Hwang, Seo Rim
Department of Nursing Science The Graduate School, Ajou University
(Supervised by Professor Park, Jin Hee, RN., Ph.D.)
This study is a cross-sectional survey conducted to understand the level of teamwork, perception of patient safety culture, and safety care activity among emergency department nurses, and to determine factors affecting safety care activity. The data were collected from January 1, 2020, to March 15, 2020. The subjects were 144 nurses with clinical experience of more than six months in the emergency rooms of two tertiary care hospitals and one general hospital located in the metropolitan area. Teamwork was measured using a scale developed by Larson and LaFasto (1989) and modified and supplemented by Kim Tae-baek (2006). Perception of patient safety culture was measured using the Hospital Survey On Patient Safety Culture (HSOPSC), which was developed by the Agency for Healthcare Research and Quality (2004) and translated by Kim Jeong-eun et al. (2007).
Safety care activity was measured using a scale developed by Lee Gum-ok
(2009) and modified by Chai Woo-ree (2017) for emergency department nurses. Using the SPSS 22.0 program, the collected data were analyzed based on descriptive statistics, independent t-test, one-way analysis of variance, Pearson’s correlation coefficient, and hierarchical multiple regression.
The results of this study were as follows:
1. Teamwork among emergency department nurses averaged 3.72 out of five points. The highest component score was 3.74 points for mutual cooperation, followed by 3.72 points for goal sharing and 3.70 points for results-oriented.
2. Perception of patient safety culture among emergency department nurses averaged 3.33 out of five points. The highest component score was 3.66 points for supervisor/manager’s attitude toward safety, followed by 3.64 points for frequency of events reported, 3.47 points for communication, 3.28 points for patient safety level at work unit, 3.24 points for hospital environment, and 3.22 points for environment of work unit.
3. Safety care activity among emergency department nurses averaged 137.97 out of 170 points and 4.06 out of five points. The highest component score was 4.26 points for infection control, followed by 4.24 points for medication administration, 4.13 points for procedure/surgery, 4.12 points for verbal orders, 4.11 points for fall prevention, 4.08 points for emergency preparedness, 3.49 points for pressure ulcer prevention, and 3.48 points for safety environment.
4. The difference in safety care activity according to the general characteristics of emergency department nurses was statistically significant according to position. In addition, nurses who had experience
in activities, such as safety committees related to patient safety in hospitals, were higher.
5. A significant positive relationship was found between teamwork and safety nursing activity. A significant positive relationship was also found between the perception of patient safety culture and safety care activity.
6. Hierarchical multiple regression analysis was performed to identify factors that affect safety care activity among emergency department nurses. The results showed that the general characteristics of position and experience in activities such as safety committees related to patient safety explained 8% of safety care activity. When teamwork and six composite measures of the perception of patient safety culture were also entered, 40% of safety care activity was explained, which means that those additional factors increased the explanatory power of the model by 32% of those factors. Of those factors, teamwork, hospital environment related to patient safety, and experience in activities such as safety committees related to patient safety, had a statistically significant influence on safety care activity.
Based on the results of this study, considering the special working environment of the emergency department, emergency department nurses should be provided with the environment to improve teamwork and the perception of patient safety culture. In addition, education and training programs are necessary for reinforcing safety care activity among emergency department nurses.
Key words: emergency department, nurses, teamwork, perception of patient safety culture, safety care activity