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요양병원 간호사의 도덕적 민감성, 감염관리 조직문화가 감염관리 수행도에 미치는 영향

The Effects of Moral Sensitivity and Organizational Culture for Infection Control on Infection Control Performance of Long-Term Care Hospital Nurses

  • 투고 : 2023.01.09
  • 심사 : 2023.02.14
  • 발행 : 2023.04.30

초록

Purpose: This study investigated the organizational culture in hospital for infection control, moral sensitivity, and the degree of infection control among long-term care hospital nurses, and to identified the factors associated with infection control perfomance. Methods: 186 nurses who directly care for patients at seven Long-Term Care Hospitals in D Metropolitan City participated in the survey. Data were collected using self-reported questionnaires and analyzed using the IBM SPSS 26.0 software. Results: Moral sensitivity showed statistically significant differences in age (F=5.473, p=.065), clinical experience (F=8.890, p=.031), nursing hospital work experience (F=6.520, p=.038), religion (t=-2.01, p=.046) and position (t=-2.96, p=.003). Correlation analysis revealed that with moral sensitivity and effect of organizational culture on infection control, there was a positive correlation between infection control and patient-centered nursing (r=.201, p<.006), professionalism (r=.149, p<.042), benevolence (r=.303, p<.001), infection control organizational culture (r=.556, p<.001). Benevolence of moral sensitivity (β=.21, p=.001) and infection control organizational culture (β=.54, p<.001) were associated with infection control perfomance. Moral sensitivity (including patient-centered nursing, professionalism, and benevolence) and infection control organizational culture explained 33.8% of the variance in infection control (F=24.57, p<.001). Conclusion: It is important to improve the moral sensitivity of nurses and a positive organizational culture for better infection control. We need to develop intervention strategies and establish systematic and administrative support.

키워드

참고문헌

  1. Kim YH, Kim YY, Yeom HS, Jang JH, Hwang IS, Park KS. et al. COVID-19 1-year outbreak report as of January 19, 2021 in the republic of korea. Public Health Weekly Report. 2021;14(9):472-481. 
  2. Kim OS, Jeong SY, Kim JY, So YR. Status of infection control and educational needs of nurses in long term care facilities in Korea. Korean Journal of Rehabilitation Nursing. 2018;21(1):1-11. https://doi.org/10.7587/kjrehn.2018.1 
  3. Jung HY, Jung YK. Recognition and performance level of hospital infection control in nur ses of long-term care hospital. The Korean Journal of Health Service Management. 2013;7(4):131-141. https://doi.org/10.12811/kshsm.2013.7.4.131 
  4. Park JY, Woo CH, Lee SY, Oh JE. Factors influencing the infection control practice of clinical nurses based on health belief model. Journal of the Korea Convergence Society. 2018;9(3):121-129. https://doi.org/10.15207/JKCS.2018.9.3.121 
  5. Hong MH, Park JY. Nurses' perception of accreditation, awareness and performance of infection control in an zccredited healthcare system. Journal of Korean Academy of Nursing Administration. 2016;22(2):167-177. https://doi.org/10.11111/jkana.2016.22.2.167 
  6. Jung YW, Lee YH, Yu BC. The relationship of nurse's awareness, performance for nosocomial infection control and psychological empowerment. Kosin Medical Journal. 2008;23(2):85-91. 
  7. Han DL, Seo KS, Kim ES, Kim HE. Influences of moral sensitivity and safety environment on compliance with standard precautions among nurses. Journal of the Korea Academia-Industrial cooperation Society. 2018;19(3):364-375. https://doi.org/10.5762/KAIS.2018.19.3.364 
  8. Jameton A. Dilemmas of moral distress: moral responsibility and nursing practice. Awhonn's Clinical Issues in Perinatal and Women's Health Nursing. 1993;4(4):542-551. 
  9. Lutzen K, Evertzon M, Nordin C. Moral sensitivity in psychiatric practice. Nursing Ethics. 1997;4(6):472-482. https://doi.org/10.1177/096973309700400604 
  10. Borhani F, Abbaszadeh A, Mohamadi E, Ghasemi E, Hoseinabad Farahani MJ. Moral sensitivity and moral distress in Iranian critical care nurses. Nursing Ethics. 2017;24(4):474-482. https://doi.org/10.1177/0969733015604700 
  11. Chang HY, Song JE, Kim YS, Yu MA. Moral sensitivity, attitude, and nursing practices for older people among nurses in long term care hospitals. The Korean Society for Medical Ethics. 2013;16(2):216-230. https://doi.org/10.35301/ksme.2013.16.2.216 
  12. Eom SH, Kim SS. Factors associated with nurses' moral sensitivity. The Korean Psychiatric and Mental Health Nursing, 2018;27(3):199-207. https://doi.org/10.12934/jkpmhn.2018.27.3.199 
  13. Do YJ, Kang YS. Influence of professional self-concept, moral sensitivity on elderly care performance of geriatric hospital nurses. Journal of the Korea Academia-Industrial cooperation Society. 2019;20(5):128-136. https://doi.org/10.5762/KAIS.2019.20.5.128 
  14. Moon JE, Song MO. A convergence study about the performance of healthcare-associated infection control guidelines of hospital nurses-based on the theory of planned behavior. Journal of the Korea Convergence Society. 2017;8(5):117-125. https://doi.org/10.15207/JKCS.2017.8.5.117 
  15. Moon JE, Jang KS. The performance of healthcare-associated infection control guideline among hospital nurses: a structural equation model. Iran Journal of Public Health. 2018;47(5):648-657. 
  16. Kim HH, Park HR. The effects of organizational culture for infection control and self-efficacy on compliance with standard precautions of emergency room nurses. Journal of Korean Biological Nursing Science. 2019;21(1):46-53. http://doi.org/10.7586/jkbns.2019.21.1.46 
  17. Kim SO, Ra JS. Influencing factors on nursing practices for healthcare-associated infections control in intensive care unit. Korean Journal of Healthcare-Associated Infection Control and Prevention. 2018;23(2):39-52. https://doi.org/10.14192/kjhaicp.2018.23.2.39 
  18. Han SS, Kim JH, Kim YS, Ahn SH. Validation of a korean version of the moral sensitivity questionnaire. Nursing Ethics. 2010;17(1):99-105. https://doi.org/10.1177/0969733009349993 
  19. Agency for Healthcare Research and Quality (2004a). Improving patient safety in hospitals_ a resource list for wsers of the AHRQ hospital survey on patient safety culture. [Internet]. Rockville: Agency for Healthcare Research and Quality; 2023[cited 2023 January 6]. Available from https://www.ahrq.gov/sops/resources/index.html. 
  20. Moon JE. A structural model of performance of healthcare-associated infection control guideline in hospital nurses [dissertation]. Gwangju: Chonnam National University; 2016. p. 1-226 
  21. Kim BH. Study on the degrees of awareness and performance of the hospital infection control among clinical nurses in a middle-sized and in a small-sized hospital[master's thesis]. Seoul:Yonsei University; 2004. 
  22. Kim JA, Kang YS. Moral distress and moral sensitivity of nurses working in long term care hospitals. Journal of the Korea Academia-Industrial cooperation Society. 2018;19(6):240-251. https://doi.org/10.5762/KAIS.2018.19.6.240 
  23. Kim HH. Impact of organizational culture for infection control on practice of standard precautions in general hospital nurses [master's thesis]. JeJu: JeJu National University; 2020. p. 1-64 
  24. Choi SA, Jeong SY. Factors influencing compliance in intravenous practice for infection prevention among nurses in small and medium hospitals. The Journal of Fundamentals of Nursing. 2020;27(4):344-355. https://doi.org/10.7739/jkafn.2020.27.4.344 
  25. Shim SA. The standard for the prevention of infections of a local medical workers; centered on the nurse's moral sensitivity, infection management, standard precaution [master's thesis]. GimHae: Kaya University; 2018. p. 1-60 
  26. Cho MY, Han YJ. Influence of multi-drug resistant organisms infection control knowledge and organizational culture on performance in general hospital nurses. The Korean Journal of Health Service Management. 2020;14(3):115-130. https://doi.org/10.12811/kshsm.2020.14.3.115 
  27. Lee JH, Lee GE. Perception and practice of hospital infection control of nursing staff depending on the supplementation of nurses in long-term care hospitals. Korean Journal of Occupational Health Nursing. 2012;21(3):308-316. https://doi.org/10.5807/kjohn.2012.21.3.308 
  28. Jung SY, How to prevent transmission of infectious agents in healthcare settings. Hanyang Medical Reviews. 2011;31(3):190-199.  https://doi.org/10.7599/hmr.2011.31.3.190
  29. Cho GL, Choi JS, Knowledge of and compliance with standard precautions by nurses in intensive care unit. Journal of Korean Academy of Fundamentals of Nursing, 2010;17(1):73-81. 
  30. Byun SH, Kang DHS. Perception of patient safety culture, knowledge and performance of standard precaution among long-yerm care hospitals nurses. The Society of Digital Policy and Management. 2019;17(9):231-240. https://doi.org/10.14400/JDC.2019.17.9.231