DOI QR코드

DOI QR Code

수술실 간호사 안전역량 도구의 타당도 및 신뢰도 검증

The Validity and Reliability of Safety Competency Tool for Perioperative Nurses

  • 송미옥 (조선간호대학교) ;
  • 장금성 (전남대학교 간호대학.간호과학연구소)
  • Song, Mi-Ok (Chosun Nursing College) ;
  • Jang, Keum Seong (College of Nursing, Chonnam National University.Chonnam Research Institute of Nursing Science)
  • 투고 : 2016.07.27
  • 심사 : 2016.10.07
  • 발행 : 2016.10.31

초록

본 연구는 수술실 간호사의 안전역량 도구를 개발하고 타당도와 신뢰도를 검증하고자 시행되었다. 도구의 개발 과정은 문헌고찰을 통한 예비 문항 개발, 예비 문항의 개념적 기틀에 맞는 구성 타당도 검증으로 이루어졌다. 개발된 문항은 전문가 타당도를 거쳐 30개의 문항으로 확정하였다. 377명의 수술실 간호사를 대상으로 30개 문항으로 이루어진 예비 도구의 타당도와 신뢰도를 검증하였다. 도구의 구성요소를 확인하기 위해 탐색적 요인분석과 평행선 분석을 시행하였으며 그 결과 지식, 기술, 태도 3개 요인으로 이루어진 27개 문항을 도출하였다. 도구의 내적 구조를 도식화하기 위해 확인적 요인분석을 시행하였으며 최종 모델의 적합도는 TLI=.90, CFI=.91, RMSEA=.07 SRMR=.07 로 매우 적합하였다. 확인적 요인 분석 결과를 토대로 27문항 3개 요인(지식 6문항, 기술 13문항, 태도 8문항)으로 이루어진 최종 도구를 확정하였다. 최종 도구의 Cronabach' ${\alpha}$ 는 .94로 나타나 내적일관성을 확인하였다. 본 연구에서 개발된 수술실 간호사의 안전역량 도구는 환자 안전에 대한 수술실 간호사의 역량을 사정하고 환자 안전 연구나 경력 개발에 유용하게 사용될 수 있을 것으로 기대한다.

The purpose of this study was to develop a scale to evaluate the safety competency of perioperative nurses and to examine its validity and reliability. The research process included the development of preliminary items through literature reviews and the construct validity examination of the conceptual framework for the preliminary scale. The content validity of the identified items was evaluated by experts, resulting in 30 preliminary items. The participants involved in testing the validity and reliability of the preliminary scale were 377 perioperative nurses. The data were analyzed using exploratory factor analysis, parallel analysis, confirmatory factor analysis, and internal consistency. To verify the construction factor of the preliminary scale, exploratory factor analysis and parallel analysis were performed, resulting in 3 factors and 27 items. The internal structure of the scale was schematized using confirmatory factor analysis and the goodness of fit of the final research model was very appropriate, as shown by the values of TLI=.90, CFI=.91, RMSEA=.07, and SRMR=.07. The final scale consisted of 27 items and 3 factors including knowledge (6 items), skill (13 items), and attitude (8 items). Cronbach' ${\alpha}$ for the final scale was .94, showing good internal consistency. This safety competency scale can be used for assessing the competency of perioperative nurses regarding patient safety, for developing patient safety studies and for the career development of perioperative nurses.

키워드

참고문헌

  1. L. Henry, S. L. Hunt, M. Kroetch, T. Yang, "Evaluation of Patient Safety Culture: a survey of clinicians in a cardiovascular operating room", Innovations, vol. 7, no. 1, pp. 328-337, 2013. DOI: http://dx.doi.org/10.1097/IMI.0b013e31827e3625
  2. V. M. Steelman, P. R. Graling, Y. Perkhounkova, "Priority Patient Safety Issues Identified by Perioperative Nurses", AORN, vol. 97, no. 4, pp. 402-418, 2013. DOI: http://dx.doi.org/10.1016/j.aorn.2012.06.016
  3. S. K. Kim, H. J. Lee, E. G. Oh, "Perceived level and associated factors of patient safety culture among health care providers in an operating room", Journal of Korean Clinical Nursing Research, vol. 16, no. 2, pp. 57-67, 2010.
  4. S. J. Collins, R. Newhouse, J. Porter, A. Talsma, "Effectiveness of the Surgical Safety Checklist in Correcting Errors: A Literature Review Applying Reason's Swiss Cheese Model", AORN, vol. 100, no. 1, pp. 65-79, 2014. DOI: http://dx.doi.org/10.1016/j.aorn.2013.07.024
  5. H. K. Yum, "Management and perspectives of patient safety in healthcare", Journal of Korean Medicine Association, vol. 56, no. 6, pp. 454-458, June, 2013. DOI: http://dx.doi.org/10.5124/jkma.2013.56.6.454
  6. R. Schnall, P. Stone, L. Currie, K. Desjardins, R. M . John, S. Bakken, "Development of a self-report instrument to measure patient safety attitudes, skills, and knowledge", Journal of Nursing Scholarship", vol. 40, no. 4 pp. 391-394. 2008. DOI: http://dx.doi.org/10.1111/j.1547-5069.2008.00256.x
  7. L. Cronenwett. G. Sherwood, J. Barnsteiner, J. Disch , J. Johnson et al., "Quality and safety education for nurses", Nurse Outlook, vol. 55, no. 3, pp. 132-137, 2007. DOI: http://dx.doi.org/10.1016/j.outlook.2007.02.006
  8. Quality and Safety Education for Nurses. "Quality and Safety Competencies", 2012, Available from http://www.QSEN.org/competencies.php. (accessed June, 12, 2014)
  9. L. S. Leach, R. C. Myrtle, F. A. Weaver, S. Dasu, "Assessing the performance of surgical teams", Healthcare Management Review, vol. 34, no. 1, pp. 9-41, 2009. DOI: http://dx.doi.org/10.1097/01.HMR.0000342977.84307.64
  10. M. Silen-Lipponen, K. Tossavainen, H. Turunen, A. Smith, "Potential errors and their prevention in operating room teamwork as experienced by Finnish, British and American nurses", International journal of nursing practice. vol. 11, no. 1, pp. 21-32, 2005. https://doi.org/10.1111/j.1440-172X.2005.00494.x
  11. Klass D. "Reevaluation of clinical competency", American journal of physical medicine & rehabilitation, vol. 79, no. 5, pp. 481-486, 2000. DOI: http://dx.doi.org/10.1097/00002060-200009000-00018
  12. M. Fisher, M. Parolin, "The reliability of measuring nursing clinical performance using a competency based assessment tool: a pilot study", Collegian, vol. 7, no. 3, pp. 21-27, 2000. DOI: http://dx.doi.org/10.1016/S1322-7696(08)60373-X
  13. P. Dycus, L. McKeon, "Using QSEN to measure quality and safety knowledge, skills, and attitudes of experienced paediatric oncology nurses: an international study", Quality management in health care, vol. 18, no. 3, pp. 202-208, 2009. DOI: http://dx.doi.org/10.1097/QMH.0b013e3181aea256
  14. P. M. Ironside, P. R. Jeffries, A. Martin, "Fostering patient safety competencies using multiple-patient simulation experiences", Nursing Outlook, vol. 57, no. 6, pp. 332-337, 2009. DOI: http://dx.doi.org/10.1016/j.outlook.2009.07.010
  15. T. Walsh, N. Jairath, M. A. Paterson, C. Grandjean, "Quality and safety education for nurses clinical evaluation tool", Journal of Nursing Education, vol. 49, no. 9, 517-522, 2010. DOI: http://dx.doi.org/10.3928/01484834-20100630-06
  16. Canadian Patient Safety Institute, "The safety competencies: enhancing patient safety across the health professions", 2009, http://www.patientsafetyinstitute.ca/en/toolsResources/safetyCompetencies/Documents/Safety%20Competencies.pdf. (accessed 14, June, 2016).
  17. B. H. Munro, "Statistical methods for health care research. 4th ed", Philadelphia, PA: Lippincott Williams & Wilkins, 2001.
  18. D. L. Jackson, "Revisiting sample size and number of parameter estimates: Some support for the N:q hypothesis", Structural Equation Modeling, vol. 10, no. 1, pp. 128-141, 2003. DOI: http://dx.doi.org/10.1207/S15328007SEM10016
  19. D. F. Polit, C. T. Beck, S. V. Owen, "Is the CVI an acceptable indicator of content validity? Appraisal and recommendations", Research in Nursing and Health, vol. 30, no. 4, pp. 459-467, 2007. DOI: http://dx.doi.org/10.1002/nur.20199
  20. H. S. Lee, G. H. Lim, "SPSS Statistical package for the social sciences. Seoul: Soomonsa.
  21. M. Y. Um, S. W. Cho, "Scale development in social work practice", Hakjisa, Seoul, pp. 112-113, 2005
  22. J. W. Van Prooijen, W. A. Van der Kloot, "Confirmatory analysis of exploratively obtained factor structures", Educational and Psychological Measurement, vol. 61, no. 5, pp. 777-792, 2001 . https://doi.org/10.1177/00131640121971518
  23. I. J. Park, H. J. Eom, G. B. Lee, "Issues and concurrent solutions for the application of confirmatory factor analysis in physical education and exercise science research", The Korean Journal of measurement and Evaluation in Physical Education and Sport Science. vol. 16, no. 1, pp. 1-22, 2014. DOI: http://dx.doi.org/10.1177/00131640121971518
  24. J. C. Nunnally, "Psychometric theory", New York, NY: McGraw-Hill, 1978.
  25. J. A. Wahr, R. L. Prager, J. H. Abernathy III, E. A. Martinez, E. Salas et al., "Patient Safety in the Cardiac Operating Room: Human Factors and Teamwork: A Scientific Statement From the American Health Association", Circulation, vol. 128, no. 1, pp. 1139-1169, 2013. DOI: http://dx.doi.org/10.1161/CIR.0b013e3182a38efa
  26. E. A. Martinez, D. A. Thompson, N. A. Errett, G. R. Kim, L. Bauer et al., "Review article: high stakes and high risk: a focused qualitative review of hazard during cardiac surgery", Anesthesia and Analgesia, vol. 112, no. 5, pp. 1061-1074, 2011. DOI: http://dx.doi.org/10.1213/ANE.0b013e31820bfe8e
  27. J. Braithwaite, M. T. Westbrook, J. F. Travaglia, C. Hughes, "Cultural and associated enablers of, and barriers to, adverse incident reporting", Quality & safety in health care, vol. 19, no. 3, pp. 229-233, 2010. DOI: http://dx.doi.org/10.1136/qshc.2008.030213
  28. R. E. Mardon, K. Khanna, J. Sorra, N. Dyer, T. Famolaro, "Exploring relationships between hospital patient safety culture and adverse events", Journal of Patient Safety, vol. 6, no. 1, pp. 226-232, 2010. DOI: http://dx.doi.org/10.1097/PTS.0b013e3181fd1a00
  29. W. S. Madigosky, L. A. Headrick, K. Nelson, K. R. Cox, T. Anderson, "Changing and sustaining medical students' knowledge, skills, and attitudes about patient safety and medical fallibility", Academic Medicine, vol. 81, no. 1, pp. 94-101, 2006. DOI: http://dx.doi.org/10.1097/00001888-200601000-00022
  30. A. P. Gurses, A. A. Ozok, P. J. Pronovost, "Time to accelerate integration in of human factors and ergonomics in patient safety", BMJ quality & safety. vol. 21, no. 1, pp. 347-351, 2012. DOI: http://dx.doi.org/10.1136/bmjqs-2011-000421
  31. S. Y. Liaw, W. T. Zhou, T. C. Lau, C. Siau, S. W. Chan, "An interprofessional communication training using simulation to enhance safe care for a deteriorating patient", Nurse Education Today, vol. 34, Nol.2, pp. 259-264, 2014. DOI: http://dx.doi.org/10.1016/j.nedt.2013.02.019
  32. A. Bognar, P. Barach, J. K. Johnson, R. C. Duncan, D. Birnbach et al., "Errors and the burden of errors: attitudes, perceptions and the culture of safety in pediatric cardiac surgical teams", The annals of Thoracic surgery, vol. 85, no. 4, pp. 1374-1381, 2008. DOI: http://dx.doi.org/10.1016/j.athoracsur.2007.11.024
  33. J. I. Hwang, "What are hospital nurses' strength and weakness in patient safety competence? Findings from three Korean hospitals", International Journal for Quality in Health Care, vol. 27, no. 3, pp. 232-238, 2015. DOI: http://dx.doi.org/10.1093/intqhc/mzv027
  34. S. Schimpff, "Improving operating room and perioperative safety: back-ground and specific recommendations", Surgical Innovation. vol. 14, no. 2, pp. 127-135, 2007. https://doi.org/10.1177/1553350607301746
  35. N. J. Lee, J. Y. An, T. M .Song, H. Jang, S. Y. Park, "Psychometric Evaluation of a Patient Safety Competency Self-Evaluation Tool for Nursing Students", Journal of Nursing Education, vol. 53, no. 10, pp. 550-562, 2014. DOI: http://dx.doi.org/10.3928/01484834-20140922-01
  36. S. Singer, S. Lin, A. Falwell, D. Gaba, L. Baker, "Relationship of safety climate and safety performance in hospitals", Health Service Research, vol. 44, no. 1, pp. 399-421, 2009. DOI: http://dx.doi.org/10.1111/j.1475-6773.2008.00918.x
  37. H. R. Bruppacher, S. K. Alam, V. R. LeBlanc, D. Latter, V. N. Naik et al., "Simulation-based training improves physicians' performance in patient care in highstakes clinical setting of cardiac surgery", Anesthesiology, vol. 112, no. 4, pp. 985-992, 2010. DOI: http://dx.doi.org/10.1097/ALN.0b013e3181d3e31c
  38. A. Okuyama, K. Martowirono, B. Bijnen, "Assessing the patient safety competencies of healthcare professionals: a systematic review. BMJ Quality & Safety, vol. 20, no. 1, pp. 991-1000, 2011. DOI: http://dx.doi.org/10.1097/ALN.0b013e3181d3e31c
  39. K. M. Moran, I. B. Harris, A. L. Valenta, "Competencies for Patient Safety and Quality Improvement: A Synthesis of Recommendations in Influential Position Papers", Joint Commission journal on quality and patient safety / Joint Commission Resources, vol. 42, no. 4, pp. 162-169, 2016. https://doi.org/10.1016/S1553-7250(16)42020-9
  40. World Health Organization, "Patient safety curriculum guide: Multiprofessional edition", 2011, http://apps.who.int/iris/bitstream/10665/44641/1/9789241501958_eng.pdf(accessed June, 14, 2016)
  41. G. R. Baker, "Governance, Policy and System-Level Efforts to Support Safer Healthcare", Healthcare Quarterly, vol. 17, no. Spec, pp. 21-26, 2014. DOI: http://dx.doi.org/10.12927/hcq.2014.23955
  42. K. H. Lee, S. J. Shin, "Validity of instrument development research in Korean nursing research", Journal of Korean Academy of Nursing. vol. 43, no. 6, pp. 697-703, 2013. DOI: http://dx.doi.org/10.4040/jkan.2013.43.6.697
  43. J. J. Norcini, "Current perspectives in assessment: the assessment of performance at work", Medical education, vol. 39, no. 9, pp. 880-889, 2005. DOI: http://dx.doi.org/10.1111/j.1365-2929.2005.02182.x