Neonatal Medicine

The Korean Society of Neonatology (대한신생아학회)
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Comparison of Adverse Events due to Differences in NICU Nursing Expertise

NICU 간호 숙련성의 차이에 따른 위해 사건 비교

  • Han, Young-Mi (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Sung, Min-Jung (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Park, Kyung-Hee (Department of Pediatrics, Pusan National University School of Medicine) ;
  • Byun, Shin-Yun (Department of Pediatrics, Pusan National University School of Medicine)
  • 한영미 (부산대학교 의학전문대학원 소아과학교실) ;
  • 성민정 (부산대학교 의학전문대학원 소아과학교실) ;
  • 박경희 (부산대학교 의학전문대학원 소아과학교실) ;
  • 변신연 (부산대학교 의학전문대학원 소아과학교실)
  • Published : 2011.11.30
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Abstract

Purpose: Nursing quality influences patient' outcomes in the neonatal intensive care unit (NICU). We compared differences in adverse events (AEs) by differences in the level of nursing experience at the NICU, developed guidelines to prevent AE, and then investigated the change in AE. Methods: AEs related to nursing were investigated from January 1, 2009 to December 31 2009 at the NICU of the newly established A hospital and B hospital that has been operating for 14 years. We also assessed the level of nursing experience. Guidelines to prevent nursing-related AEs were prepared at A hospital, and the change in the incidence of AE was investigated after 1 year. Results: Twenty nurses (80%) had <2 years experience at A hospital, whereas 13 nurses (65%) had 2 years or longer but less than 4 years experience at B hospital (P<0.001). The number of incidences of AE that occurred in 2009 in A hospital was higher (46) than that at B hospital (10). Intravenous (IV) injection-related incidents had the highest share in both hospitals: 24 incidents (52.2%) at hospital A and eight incidents (80%) at hospital B. After the guidelines were instituted in 2009, the number of nursing AEs decreased to 17, of which the number of IV incidents was the highest (6, 35%), athough its share decreased. Conclusion: Supervision and prevention guidelines should be in place to reduce nursing AEs, which would improve the quality of NICU service.

목적: 신생아중환자실은 간호 요구도가 높은 곳으로 간호 수준이 환자 결과에 영향을 미치는 것으로 알려져 있다. 저자들은 신생아중환자실에서 간호 숙련성의 차이에 따른 위해 사건의 차이를 비교하고 간호 위해 사건에 대한 예방 지침 마련 후 위해 사건의 변화를 알고자 하였다. 방법: 새로 설립된 A병원과 14 년간 운영되어 온 B병원의 신생아중환자실을 대상으로 2009년 1월 1일부터 2009년 12월 31일 까지 1년간의 간호 위해 사건과 당시 근무한 간호 인력의 경력을 조사하였다. 그리고 A병원에서 간호 위해 사건 예방을 위한 지침을 마련한 후 1년 뒤의 사고 변화를 조사하였다. 결과: A병원의 간호 인력은 2년 이내 경력자가 20명(80%)인 반면 B병원의 간호 인력은 2년 이상 4년 미만의 경력자가 13명(65%)으로 많아 간호 숙련성에 있어 유의한 차이가 있었다(P<0.001). 2009년도에 확인된 간호 위해 사건은 A병원에서 46건, B병원에서 10건으로 전체적으로 A병원에서 많이 발생했고 두 병원에서 정맥주사 관련 사고가 각각 24건(52.2%), 8건(80%)으로 가장 많은 비율을 차지했다. 위해 사건 예방을 위한 간호 지침 마련 후 2010년도에 확인된 간호 위해 사건은 17건으로 총 발생빈도가 감소하였으며 정맥 주사 관련 사고가 6건(35%)으로 가장 많았으나 비율이 감소하였음을 확인하였다. 결론: 간호 숙련성이 높을수록 위해 사건의 빈도가 적었고 위해 사건을 예방하기 위한 지침 마련 후 사고 빈도가 감소함을 확인하였다. 예방 가능한 간호 위해 사건의 빈도를 줄이기 위하여 자체적인 감시와 예방 지침의 강구가 필요하며 이는 중환자실 서비스의 질을 높이는 방법이 될 것이다.

Keywords

References

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