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중소병원 간호사의 신체 억제대 사용에 대한 인식

A Study on perceptions about physical restraint use of nurse in small and medium sized hospitals

  • 김남석 (제주한라대학교 간호학과)
  • Kim, NamSuk (Dept. of Nursing, ChejuHalla University)
  • 투고 : 2017.07.26
  • 심사 : 2017.12.20
  • 발행 : 2017.12.28

초록

본 연구는 300병상 미만 중소병원 간호사의 신체 억제대 사용에 대한 인식을 확인하기 위한 서술적 조사 연구이다. SPSS 통계프로그램을 사용하여 서술통계, t-test, ANOVA, factor analysis로 연구 분석을 하였다. 연구결과 간호사의 신체 억제대 사용 인식에 대한 전체 평균은($3.91{\pm}0.54$)으로 높은 인식률을 나타내었다. 요인분석 결과 '문제행동관리($3.81{\pm}0.67$)', '의료적 처치 유지($4.11{\pm}0.60$)', '환자안전($4.13{\pm}0.63$)' 3개의 요인으로 분류되었다. 신체 억제대를 사용하는 이유 중 가장 중요하다고 인식하는 항목은 침대에서 떨어지지 않도록 환자를 보호하기 위해($4.37{\pm}0.68$)로 환자안전이었다. 중소병원에서 근무하는 간호사의 신체 억제대 사용에 대한 특성과 요인을 파악하고, 신체 억제대 사용에 대한 정확한 이해를 바탕으로 최소한의 신체적 억제대 사용 및 환자의 안전과 권리보장에 대한 인식 필요하다. 그러므로 이를 위해 다양한 상황에서 사용하는 신체 억제대에 대한 직무교육이 필요하며, 간호업무 실정에 맞도록 교육 및 중재프로그램 개발이 요구된다.

This study was conducted to investigate the perception of nurse's use of physical restraints. This study is a descriptive research study for 138 nurses who work at the small hospitals under 300 beds. Statistical analysis was performed using descriptive statistics, t-test, ANOVA, and factor analysis using the SPSS statistical program. The results of this study were as follows: The overall average of the nurses' perception of physical restraint was $3.91{\pm}0.54$, and the most important reason for using a physical restraint was to protect the patient from falling out of bed($4.37{\pm}0.68$). The factor analysis showed that 'behavior, psychological symptom management($3.81{\pm}0.67$)', 'maintain medical treatment($4.11{\pm}0.60$)' and 'patient safety($4.13{\pm}0.63$)'. It is necessary to understand the characteristics and factors of nurse's use of physical restraint in small and medium hospitals. Moreover, it is also required to use minimum physical restraints for patient's safeties and rights based on accurate understanding of physical restraint's use. Therefore, it is needed to provide job training for the physical restraint that is used in various situations and to develop education and intervention program to adjust in nurses' situation.

키워드

참고문헌

  1. A. P. Retsas, "Survey findings describing the use of physical restraints in nursing homes in Victoria Australia. International Journal of Nursing Studies", Vol. 35, No. 1, pp. 184-191, 1998. https://doi.org/10.1016/S0020-7489(98)00027-3
  2. G. Meyer, S. Kopke, B. Haastert, & I. Muhlhauser, "Restraint use among nursing home residents: Cross-sectional study and prospective cohort study. Journal of Clinical Nursing", Vol. 18, No.7, pp.981-990, 2009. https://doi.org/10.1111/j.1365-2702.2008.02460.x
  3. E. H. Kong, L. K. Evans, "Nursing Staff Views of Barriers to Physical Restraint Reduction in Nursing Homes. Asian Nursing Research", Vol. 6, No. 4, pp. 173-180, 2012. DOI: http://dx.doi.org/10.1016/j.anr.2012.10.007.
  4. D. Laurin, P. Voyer, R. Verreault, & P. J. Durand, "Physical restraint use among nursing home residents: a comparison of two data collection methods. BMC Nursing", 3, 5, 2004. DOI: http://dx.doi.org/10.1186/1472-6955-3-5.
  5. H. T. Huang, Y. H. Chuang, K. F. Chiang, "Nurses' physical restraint knowledge, attitudes and practices: the effectiveness of an in-service education program. Journal of Nursing Research", Vol. 17, No. 4, pp. 241-248, 2009. DOI: http://dx.doi.org/0.1097/JNR.0b013e3181c1215d. https://doi.org/10.1097/JNR.0b013e3181c1215d
  6. Y. A. Cho, J. S. Kim, N. Kim, H. J. Choi, J. K. Jo, H. J. Lee, R. I. Kim, Y. H. Seong, "A Study on the Use of Physical Restraints in ICUs. Journal of Adult Nursing", Vol. 18, No. 4, pp. 543-552, 2006.
  7. M. Brenner, "A need to protect: Parents' Experiences of the Practice of Restricting a Child for a Clinical Procedure in Hospital. Issues in Comprehensive Pediatric Nursing", Vol. 36, No. 1-2, pp. 5-16, 2013. DOI: http://dx.doi.org/10.3109/01460862.2013.768312
  8. S. Goethals, B. Dierckx de Casterle, C. Gastmans, "Nurses' decision-making in cases of physical restraint: a synthesis of qualitative evidence. Journal of Advanced Nursing", Vol. 68, No. 6, pp. 1198-1210, 2012. DOI:http://dx.doi.org/ 10.1111 /j.1365-2648.2011.05909. x.Epub 2011 Dec 28. https://doi.org/10.1111/j.1365-2648.2011.05909.x
  9. Y. H. Chuang, H. T. Huang, "Nurses' feelings and thoughts about using physical restraints on hospitalized older patients, Journal of Clinical Nursing", Vol. 16, pp 486-494, 2007. https://doi.org/10.1111/j.1365-2702.2006.01563.x
  10. M. Ralph, G. Meyer, "Attitudes of nurses towards the use of physical restraints in geriatric care: A systematic review of qualitative and quantitative studies. International Journal of Nursing Studies", Vol. 51, No. 2, pp. 274-288, 2014. DOI: http://dx.doi.org/10.1016/j.ijnurstu.2013.10.004
  11. K. S. Kwak, S. E. Kim, E. K. Bae, E. S. Lee, E. H. Lee, Y. J. Choi, Y. K. Lee, "Decreasing the application rate of unnecessary physical restraint through the establishment of a guideline for restraint application. Quality Improvement in Health Care", Vol. 15, No. 2, pp. 93-103, 2009.
  12. K. S. Kim, J. H. Kim, S. H. Lee, H. K. Cha, S. S. Jeong, S. A. Chi, "The physical restraint use in hospital nursing situation. Journal of Korean Academy of Nursing", Vol. 30, No. 1, pp. 60-71, 2000. https://doi.org/10.4040/jkan.2000.30.1.60
  13. J. E. Agens, "Chemical and physical restraint use in the older person. British Journal of Medical practitioners", Vol. 3, No. 1 pp. 302-307, 2010.
  14. C. Kruger, H. Mayer, B. Haastert, G. Meyer, "Use of physical restraints in acute hospitals in Germany: A multi-centre cross-sectional study. International Journal of Nursing Studies", Vol. 50, No. 12, pp. 1599-1606, 2013. https://doi.org/10.1016/j.ijnurstu.2013.05.005
  15. A. F. Minnick, L. C. Mion, M. E. Johnson, C. Cartrambone, R. Leipzig, "Prevalence and variation of physical restraint use in acute care settings in the US. Journal of Nursing Scholarship ", Vol. 39, No. 1, pp. 30-37, 2007. https://doi.org/10.1111/j.1547-5069.2007.00140.x
  16. Korea Institute for Healthcare Accreditation, Hospital Certification Criteria on 2015, available from https://www.koiha.or.kr/member/kr/board/ establish/establish_ BoardList.do, Retrieved May, 27, 2017. DOI: http://dx.doi.org/10.1016/j.ijnurstu.2013.05.005
  17. E. Choi, M. Song, "Physical restraint use in a Korea ICU. Journal of Clinical Nursing", Vol.12, No. 5, pp. 651-659, 2003. https://doi.org/10.1046/j.1365-2702.2003.00789.x
  18. J. S. Kim, H. Y. Oh, "Perceptions and attitude on use of physical restraints among caregivers in long term care facilities. Journal of the Korean Gerontological Society", Vol. 26, No. 2, pp. 347-360, 2006.
  19. H. K. Kang, "A Study on caregiver's perception of restraints. Journal of the Korea Academia-Industrial cooperation Society", Vol. 17, No. 5, pp. 452-458, 2016. DOI: http://dx.doi.org/10.5762/KAIS.2016.17.5.452
  20. K. Choi, J. Kim, "Effects of an Educational Program for the Reduction of Physical Restraint Use by Caregivers in Geriatric Hospitals. Journal of Korean Academy of Nursing", Vol. 39, No. 6, pp. 769-780, 2009. DOI: http://dx.doi.org/10.4040/jkan.2009.39.6.769
  21. D. H, Kim, C. Kim, E. M. Kim, M. S. Park, "Application of physical restraints by health personnel in nursing homes. Journal of Korean Gerontology Nursing", Vol. 13, No. 2, pp. 131-141, 2011.
  22. K. J. Lee, G. S. Park, Y. S. Park, "Family member's perceptions of side rail use in geriatric hospital. Journal of Digital Convergence", Vol. 14 No. 12, pp. 503-513, 2016. DOI: http://dx.doi.org/10.14400/JDC.2016.14.12.503
  23. J. M. Yeo, M. H. Park. "Effects of on education program for nurses on the use of restraints. Journal of Korean Academy of Nursing", Vol. 36, No. 3, pp. 532-541, 2006. https://doi.org/10.4040/jkan.2006.36.3.532
  24. S. H. Suk, "Improvements during the second cycle healthcare accreditation program in Korea: Toward the global standard for patient safety and quality of healthcare.Journal of the Korean Medical Association." Vol. 57, No. 8, pp. 646-649, 2014. http://dx.doi.org/10.5124/jkma.2014.57.8.646
  25. N. E. Strumpf, L. K. Evans, "Physical restraint of the hospitalized elderly: Perceptions of patients and nurses. Nursing Research", Vol. 37, pp. 132-137, 1988.
  26. R C. MacCallum, K. F .Widaman, S .B. Zhang, S. H. Hong, "Sample size in factor analysis. Psychological Methods", Vol. 4, No.1 pp. 84-99, 1999. http://dx.doi.org/10.1037//1082-989X.4.1.84
  27. D. E. McCabe, C. D. Alvarez, S. R. McNulty, J. J. Fizpatrick, "Perceptions of Physical Restraints Use in the Elderly Among Registered Nurses and Nurse Assistants in a Single Acute Care Hospital Journal of Geriatric Nursing", Vol. 32, No. 1, pp. 39-45, 2010. DOI: http://dx.doi.org/10.1016/j.gerinurse.2010.10.010
  28. K. J. Lee, M. S. Kwon, "Perceptions of nurses, nurse assistants, and families on the use of physical restraints with elderly people in care facilities. Journal of Korean Gerontological Nursing", Vol. 2, No. 2, pp. 158-168, 2001.
  29. E. J. Song, Y. S. Park, H. S. Ji, H. K. Lee, "Factors affecting on the Clinical nurse's safety nursing activity. Journal of Digital Convergence", Vol. 14, No. 11, pp. 469-479, 2016. DOI: http://dx.doi.org/10.14400/JDC.2016.14.11.469
  30. J. U. Kim, G. A. Yang, S. H. Yun, "Korean hospital environment associated with patient safety and communication process in recognition of a nurse." Healthcare Informatics Research. Vol. 10, pp. 130-135, 2004.
  31. M. R. Lee, "The Relationship among Dementia care Knowledge, Attitudes toward to dementia and Approach to dementia care of Nurses. Journal of Digital Convergence", Vol. 14, No. 12, pp. 357-367, 2016. DOI: http://dx.doi.org/10.14400/JDC.2016.14.12.357
  32. T. Lee, K. H. Kang, Y. K. Ko, S. H. Cho, E. Y. Kim, "Issues and Challenges of Nurse Workforce Policy: A Critical Review and Implication. Journal of Academy Nursing Administration." Vo1. 20, No. 1, pp. 106-116, 2014. DOI: https://doi.org/10.11111/jkana.2014.20.1.106
  33. J. K. Kim, M. J. Kim, S. Y. Kim, M. Yu, K. A. Lee, "Effects of general hospital nurses' work environment on job embeddedness burnout", Journal of Korean Academy of Nursing Administration, Vol. 20, No. 1, pp. 69-81, 2014. DOI: https://doi.org/10.11111/jkana.2014.20.1.69
  34. Y. G. Lee, E. H. Cho, S. A. Kim, J. K. Kim, M. H. Kim, H. E. Kim, "The study on physical restraint use in intensive care unit(ICU). Journal of Korean Clinical Nursing Research." Vol. 8, No. 2, pp. 117-130, 2003.