임상간호사의 직무만족도 및 환자안전문화 인식이 환자안전간호 활동에 미치는 영향

Abstract

This research is a descriptive research study conducted on clinical nurses in order to provide the preliminary data that can enhance patient safety management activities by finding out how Job satisfaction and patient safety culture perception have influenced on patient safety nursing care activities. A survey, using a constructed questionnaire, was conducted among 226 nurses who have been working at hospital B located in city S. the period of the data collection was from December, 20, 2021 to January, 7, 2022. A measurement tool of the Job satisfaction devised by Song Misean(2005) consists of 25 statements to determine overall Job satisfaction. Agency for Heathcare Research and Quality (2004), which is publicly available without official authorization and made up of 44 statements of patient safety culture perception, is revised by Kim Jeongeun(2007). The measurement of safety nursing care activities comprising of 72 statements of safety nursing care is utilized by Park Sojeong (2009), who in order to concentrate on nursing care activity, revised safety evaluation indicators (the Korea Health Industry Development Institute, 2007) developed by Korea Institute for Healthcare Accreditation under the Ministry of Heath and Welfare. Collected data was analyzed by using an approach known as SPSS Statistics27 in addition to other ones such as Frequency, Percentage, Means, Standard deviation, Independent t-test, one-way ANOVA, Scheffe’test, Pearson's correlation coefficients, multiple linear regression analysis. The outcomes of the research are as follows. 1. Based on the results, Job satisfaction of nurses is 3.27 points out of 5 points. In the case of colleague relations, it can be said that the subjects considered the colleague relations crucial, resulting in 3.80 points. On the other hand, they rate working environments and welfare benefits much lower at 23.9. The difference regarding general personalities of subjects is a statistically significant on the basis of the ages, total career as nurses, and experience in the present departments. 2. It can be seen that the patient security of nursing units received the hightest points, 3.69 out of 5, followed by patient safety culture perception in nurses, which has 3.23, followed by the environmental assessment in hospitals at 2.95 out of 5. the gap from the perception of patients safety culture by general characteristics with regard for the status is considerable. 3. Patient safety nursing activities of nurses were 4.58 out of 5, and identification of the subjects was the highest with 4.67 points while the fire safety education was the lowest with 4.35 points. Differences in patient safety nursing activities according to the general characteristics of the subjects were significant according to age, education level, marital status, position, total nursing experience, work department, and safety education. 4. After analyzing the results of mutual relation between the Job satisfaction, patient safety culture perception, and patient safety nursing activities, there shows a positive correlation with both patient safety culture perception and Job satisfaction (r=.51, p<.001). In other words, it can be said that the higher the perception of patient safety culture is, the higher Job satisfaction becomes. Patient safety nursing activities has also a positive interrelation with both Job satisfaction (r=.20, p=.002) and patient safety culture perception (r=.25, p<.001). Namely, it is shown that as the patient safety culture perception is higher, Job satisfaction is anticipated to perform the patient safety nursing activity better. 5. As a result of multiple regression analysis of the factors that have influenced on patient safety nursing activities, it is estimated that a medical ward (β=-.44, p<.001) within current departments, a surgical ward (β=-.40, p<.001), more than three times of safety training (β=.32, p=.015), and working environment of the nursing units as a subordinate scope of patient safety culture perception (β=.17, p=.044) have impacts on patient safety nursing activities and it is considered that the explanatory power of these factors is 20.3%. It is indicated that in this study, the rise of both job satisfaction and patient safety culture perception affects patient safety nursing activity in a positive way. For this, it requires to figure out the discrepancy depending on the departmental features and to develop the patient safety intervention program that takes departmental features into consideration. Moreover, it is considered that systematic and constant edication that gets down to the subjects' level will be helpful to improve patient safety nursing activity. As nureses' working condition can be determined and patient safety cultural perception can be higher by improving the working environment in the aspects of organization and culture, the quality of nursing care will be enhabced via patient safety nursing activity.

Key words : Job Satisfaction, Patient Safety Culture Perception, Patient Safety Nursing Activities, Clinical Nurse| 본 연구는 임상간호사를 대상으로 직무만족도 및 환자안전문화 인식이 환자안전간호 활동에 미치는 영향을 파악함으로써 환자안전간호 활동을 증진시킬 수 있는 기초자료를 제공하기 위한 서술적 조사연구이다. S 시에 소재한 B 병원에 6개월 이상 근무 중인 간호사 226명을 대상으로 구조화된 설문지를 사용하여 자료수집하였고, 기간은 2021년 12월 20일부터 2022년 1월 7일까지였다. 직무만족도는 송미선(2005)이 개발한 직무만족도 도구 25문항을 사용하여 측정하였고, 환자안전문화 인식은 미국 AHRQ(2004)에서 개발되고 별도의 허가 없이 공개된 설문지를 김정은 등(2007)이 번안한 44문항의 도구를 사용하여 측정하였으며, 환자안전간호 활동은 복지부 산하 의료기관 평가원에서 개발한 안전평가항목(한국보건산업진흥원, 2007)중 박소정(2009)이 간호활동 중심으로 개발한 안전 간호활동 도구 72문항을 사용하여 측정하였다. 수집된 자료는 SPSS /WIN 27을 이용하여 빈도, 백분율, 평균, 표준편차 Independent t-test, one-way ANOVA, Scheffe’test, Pearson’s correlation coefficients, Multiple linear regression 으로 분석하였다. 본 연구의 주요 결과는 다음과 같다. 1. 임상간호사의 직무만족도는 5점 만점에 3.27점이며, 동료 관계 요인 점수가 3.80점으로 가장 높았고, 업무환경 및 복리후생 요인 점수가 2.79점으로 가장 낮았다. 대상자의 일반적 특성에 따른 직무만족도의 차이는 연령, 총 임상경력, 현 부서 경력이 통계적으로 유의한 차이가 있었다. 2. 임상간호사의 환자안전문화 인식 점수는 5점 만점에 3.23점이었으며, 간호단위의 환자의 안전도 점수가 3.69 점으로 가장 높았고, 병원 환경 점수가 2.95점으로 가장 낮았다. 대상자의 일반적 특성에 따른 환자안전문화 인식의 차이는 직위에 따라 환자안전문화 인식 점수가 통계적으로 유의한 차이가 있었다. 3. 임상간호사의 환자안전간호 활동은 5점 만점에 4.58점이었으며, 대상자의 식별이 4.67점으로 가장 높았고, 소방이 4.35점으로 가장 낮았다. 대상자의 일반적 특성에 따른 환자안전간호 활동의 차이는 연령, 교육정도, 결혼 상태, 직위, 총 임상경력, 근무부서, 안전교육에 따라 유의한 차이가 있었다. 4. 임상간호사의 직무만족도, 환자안전문화 인식, 환자안전간호 활동 간의 상관관계를 분석한 결과, 직무만족도(r=.51, p<.001)와 환자안전문화 인식 간에 정적인 상관관계를 보였다. 즉 직무만족도가 높을수록 환자안전문화 인식이 높은 것으로 나타났다. 또한 환자안전간호 활동은 직무만족도(r=.20, p=.002), 환자안전문화 인식(r=.25, p<.001)과 정적인 상관관계를 나타내었는데 즉, 직무만족도가 높을수록, 환자안전문화 인식이 높을수록 환자안전간호 활동을 잘 하는 것으로 나타났다. 5. 임상간호사의 환자안전간호 활동에 영향을 미치는 요인을 분석한 결과 근무부서 중 내과병동(β=-.44, p<.001)과 외과병동(β=-.40, p<.001) 안전교육 횟수 3회이상(β=.32, p=.015), 환자안전문화 인식의 하부영역인 간호단위의 근무환경(β=.17, p=.044)이 영향을 미치는 것으로 나타났고, 설명력은 20.3%로 나타났다. 본 연구에서는 임상간호사의 직무만족도와 환자안전문화 인식의 상승이 환자안전간호 활동에 긍정적인 영향을 미치는 것으로 나타났다. 이를 위해서 근무부서별 특성에 따른 차이를 파악하고, 부서 특성을 고려한 환자안전간호 활동 중재 프로그램의 개발이 필요하다. 또한 대상자의 눈높이에 맞춘 체계적이고 지속적인 교육이 환자안전간호 활동 향상에 도움을 줄 것이라 생각한다. 임상간호사들의 근무환경 정도를 파악하고, 그에 따라 조직적, 문화적 측면에서 근무 환경을 개선하여, 환자안전문화 인식을 높인다면 환자안전간호 활동을 통해 간호의 질을 향상시킬 수 있을 것이다.

주요어 : 직무만족도, 환자안전문화 인식, 환자안전간호 활동, 임상간호사