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수술실의료진의 환자안전문화 인식수준 및 관련요인

Perceived Level and Associated Factors of Patient Safety Culture among Health Care Providers in an Operating Room

  • 김숙경 (세브란스병원, 연세대학교 대학원) ;
  • 이혜정 (연세대학교 간호대학) ;
  • 오의금 (연세대학교 간호대학)
  • Kim, Suk Kyoung (Severance Hospital, Doctoral Student, College of Nursing, Yonsei University) ;
  • Lee, Hyejung (College of Nursing, Yonsei University) ;
  • Oh, Eui Geum (College of Nursing, Yonsei University)
  • 투고 : 2010.01.30
  • 심사 : 2010.06.21
  • 발행 : 2010.08.31

초록

Purpose: The purposes of this study were to compare the level of perception and to identify factors associated with perception on patient safety culture among health care providers working in an operating room(OR). Methods: A cross-sectional survey design was used. Data were collected conveniently from 154 RNs and 116 physicians working in a tertiary hospital in Seoul. Patient safety culture was measured using "The Hospital Survey on Patient Safety Culture" developed by the Agency for Healthcare Research and Quality (AHRQ). Descriptive statistics, t-test, ANOVA, and Spearman rank correlation coefficients were used for statistical analysis with the SPSS version 17.0. Results: The perception level of nurses and physicians on patient safety culture was "moderate" (3.14). Compared to physicians, nurses showed a significantly lower perception on the items of "teamwork within units" (t=-6.904, p<.001) and "overall perception of patient safety" (t=-4.327, p<.001), but had a higher perception about "frequency of events reported" (t=2.769, p=.006). The physicians' professional positions, years of working experience, age, and working hour per week were identified as factors associated with patient safety culture. Conclusion: Level of perception on patient safety culture may vary among health care providers working in the OR. The study finding suggests that a tailored education and training strategies should be considered to develop an effective safety culture for healthcare professionals working in OR.

키워드

참고문헌

  1. 강민아, 김정은, 안경애, 김윤, 김석화(2005). 환자안전 문화와 의료과오 보고에 대한 의사의 인식과 태도. 보건행정학회지, 15(4), 110-135.
  2. 김정은, 강민아, 안경애, 성영희(2007). 환자안전과 관련된 병원문화와 의료과오 보고에 대한 간호사의 인식조사. 임상간호연구, 13(3), 169-179.
  3. 김정은, 안경애, 윤숙희(2004). 환자안전과 관련된 병원 환경 및 의사소통 과정에 대한 한국 간호사의 인식조사. 대한의료정보학회지, 10(보완본 1), 130-135.
  4. 노이나(2008). 병원 근무 직종별 환자안전문화에 대한 인식 분석. 연세대학교 석사학위논문, 서울.
  5. 보건복지가족부. 한국보건산업진흥원(2009.4). 2009 의료기관 평가 지침서. 2009.12.1. http://www.khidi.or.kr/etcsite/medicalnotice.do?mode=view&code=1101&menuCd=30140101&no=286&type=ALL&cpage=1&searchItem=0&searchKey= 에서 인출
  6. 정준(2006). 병원의 환자안전관리활동 영향요인 연구: 간호부서를 중심으로. 연세대학교 석사학위논문, 서울.
  7. 제우영(2007). 환자안전문화에 대한 병원종사자들의 인식-일개 대학병원을 중심으로-. 성균관대학교 석사학위논문, 수원.
  8. Agency for Healthcare Research and Quality. (2004). Hospital survey on patient safety culture. Retrieved June 14, 2009, from http://www.ahrq.gov/qual/patientsafetyculture/hospsurvindex.htm.
  9. Aiken, L. H., Clarke, S. P., Sloane, D. M., Sochalski, J., & Silber, J. H. (2002). Hospital nurse staffing and patient mortality, nurse burnout, and job dissatisfaction. The Journal of the American Medical Association, 288(16), 1987-1993. https://doi.org/10.1001/jama.288.16.1987
  10. Blegen, M. A., Gearhart, S., O'Brien, R., Sehgal, N. L., & Alldredge, B. K. (2009). AHRQ's hospital survey on patient safety culture: Psychometric analyses. Journal of Patient Safety, 5(3), 139-144. https://doi.org/10.1097/PTS.0b013e3181b53f6e
  11. Catchpole, K., Mishra, A., Handa, A., & McCulloch, P. (2008). Teamwork and error in the operating room. Analysis of skills and roles. Annals of Surgery, 247(4), 699-706. https://doi.org/10.1097/SLA.0b013e3181642ec8
  12. Colla, J. B., Bracken, A. C., Kinney, L. M., & Weeks, W. B. (2005). Measuring patient safety climate: A review of surveys. Quality & Safety in Health Care, 14(5), 364-366. https://doi.org/10.1136/qshc.2005.014217
  13. Davenport, D. L., Henderson, W. G., Mosca C. L., Khuri, S. F., Mentzer R. M., et al. (2007) Risk-adjusted morbidity in teaching hospitals correlates with reported levels of communication and collaboration on surgical teams but not with scale measures of teamwork climate, safety climate, or working conditions. Journal of the American College of Surgeons, 205(6), 778-784. https://doi.org/10.1016/j.jamcollsurg.2007.07.039
  14. Flin, R., Burns, C., Mearns, K., Yule, S., & Robertson, E. M. (2006). Measuring safety climate in health care. Quality & Safety in Health Care, 15(2), 109-115. https://doi.org/10.1136/qshc.2005.014761
  15. Flin, R., Fletcher, G., McGeorge, P., Sutherland, A., & Patey, R. (2003). Anaesthetists' attitudes to teamwork and safety. Anaesthesia, 58(3), 233-242. https://doi.org/10.1046/j.1365-2044.2003.03039.x
  16. Gold, D. R., Rogacz, S., Bock, N., Tosteson, T. D., Baum, T. M., Speizer, F. E., et al. (1992). Rotating shift work, sleep, and accidents related to sleepiness in hospital nurses. American Journal of Public Health, 82(7), 1011-1014. https://doi.org/10.2105/AJPH.82.7.1011
  17. Kaafarani, H. M. A., Itani, K. M. F., Rosen, A. K., Zhao, S., Hartmann, C. W., & Gaba, D. M. (2009). How does patient safety culture in the operating room and post-anesthesia care unit compare to the rest of the hospital? The American Journal of Surgery, 198(1), 70-75. https://doi.org/10.1016/j.amjsurg.2008.09.017
  18. Kim, J., An., K., Kim, M. K., & Yoon, S. H. (2007). Nurses' perception of error reporting and patient safety culture in Korea. Western Journal of Nursing Research, 29(7), 827-844. https://doi.org/10.1177/0193945906297370
  19. MacDavitt, K., Chou, S. S., & Stone, P. W. (2007). Organizational climate and health care outcomes. The Joint Commission Journal on Quality and Patient Safety, 33(11 Suppl), 45-56. https://doi.org/10.1016/S1553-7250(07)33112-7
  20. Makary, M. A., Sexton, J. B., Freischlag, J. A., Holzmueller, C. G, Millman, E. A., Rowen, L., et al. (2006a). Operating room teamwork among physicians and nurses: Teamwork in the eye of the beholder. Journal of the American College of Surgeons, 202(5), 746-752. https://doi.org/10.1016/j.jamcollsurg.2006.01.017
  21. Makary, M. A., Sexton, J. B., Freischlag, J. A., Millman, E. A., Pryor, D., Holzmueller, C., et al. (2006b). Patient safety in surgery. Annals of Surgery, 243(5), 628-635. https://doi.org/10.1097/01.sla.0000216410.74062.0f
  22. Scherer, D., & Fitzpatrick, J. J. (2008). Perceptions of patient safety culture among physicians and RNs in the perioperative area. AORN Journal, 87(1), 163-175. https://doi.org/10.1016/j.aorn.2007.07.003
  23. Singer, S. J., Falwell, A., Gaba, D. M., & Baker, L. C. (2008). Patient safety climate in US hospitals: Variation by management level. Medical Care, 46(11), 1149-1156. https://doi.org/10.1097/MLR.0b013e31817925c1
  24. Singer, S. J., Falwell, A., Gaba, D. M., Meterko, M., Rosen, A., Hartmann, C. W., et al. (2009). Identifying organizational cultures that promote patient safety. Health Care Management Review, 34(4), 300-311. https://doi.org/10.1097/HMR.0b013e3181afc10c
  25. Stone, P. W., Mooney-Kane, C., Larson, E. L., Horan, T., Glance, L. G., Zwanziger, J., et al. (2007). Nurse working conditions and patient safety outcomes. Medical Care, 45(6), 571-578. https://doi.org/10.1097/MLR.0b013e3180383667
  26. Thomas, E. J., Sexton, J. B., & Helmreich, R. L. (2003). Discrepant attitudes about teamwork among critical care nurses and physicians. Critical Care Medicine, 31(3), 956-959. https://doi.org/10.1097/01.CCM.0000056183.89175.76
  27. Wong, D. A., Herndon, J. H., Canale, S. T., Brooks, R. L., Hunt, T. R., Epps, H. R., et al. (2009). Medical errors in orthopaedics. Results of an AAOS member survey. The Journal of Bone and Joint Surgery, 91(3), 547-557. https://doi.org/10.2106/JBJS.G.01439
  28. World Health Organization. (2008, July). Safe surgery saves lives: The second global patient safety challenge . Retrieved April 20, 2009, from http://www.who.int/patientsafety/en/
  29. Zohar, E., Noga, Y., Davidson, E., Kantor, M., & Fredman, B. (2007). Perioperative patient safety: Correct patient, correct surgery, correct side-a multifaceted, cross-organizational, interventional study. Anesthesia and Analgesia, 105(2), 443-447. https://doi.org/10.1213/01.ane.0000267521.75245.ad