중소종합병원 간호사의 환자안전문화에 대한 인식과 안전간호활동수행 정도

Abstract

The purpose of this study was to identify factors influencing the perception of patient safety culture and the level of safety care activity among nurses working in small-medium sized general hospitals and to provide basic data for the development of hospital policy for preventing medical error and improving patient safety. By using a self-reported questionnaire, data were collected from 241 nurses who worked in five small-medium sized general hospitals in J province from April to May, 2011. The 'Hospital Survey on Patient Safety Culture', developed by AHRQ (2004) and translated in Korean and edited by Kim et al. (2007), was used to measure the patient safety culture which the nurses were perceived. To measure the level of safety care activity, 21 items of the safety evaluation criteria developed by Korea Institute for Healthcare Accreditation (2010) were used. Data were analyzed using frequencies, means, t-test, ANOVA, Pearson correlation coefficients, and stepwise multiple regression with SPSS Win 18.0 version.

The results of this study were as follows: 1. The nurses' perceptions on patient safety culture was a mid-level degree (mean=3.32, range=1-5). Of sub-factors of patient safety culture, 'reporting medical error' was the highest score (mean=3.84, range=1-5). The mean score of safety care activity was 2.11, which meant 'moderate' level. The most frequent safety care activity sub-factors was 'preventing fall down (mean=2.23, range=1-3)'. 2. There were significant differences of the level of the patient safety culture according to the subjects' age, the type of hospitals they worked, position, working department, and recognition about whether there is the Patient Safety Management Committee in their hospitals. 3. The higher the perceived level of the patient safety culture, the more the safety care activity performed. The factors influencing on the safety care activities were the general evaluation on patients' safety, whether safety-education experienced, patient-to-nurse ratio, employment status, and the level of reporting medical error. These factors explained 20.3% of the variance of the safety care activity (F=8.83, p<.001).

Based on these findings, the suggestions are made as follows: 1. In order to improve the nurses' perceived level of patient safety culture and safety care activity, the hospitals' efforts for establishing the Patient Safety Management Committee, and communication openness and system for reporting medical errors. 2. Also, the better working condition, which ensure a proper working time, regulate patient-to-nurse ratio, and develope and educate nursing standard and criteria, is required. 3. The nurses who are aged between 25 and 35, have five-to-ten year employment with no safety-education or lower perception of patient safety culture are important targets for education program patient safety care. 4. Further research is required to identify the factors-related to safety care activity.