Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
권호 표지
DOI QR코드

DOI QR Code

Influences of Moral Sensitivity and Safety Environment on Compliance with Standard Precautions among Nurses

간호사의 도덕적 민감성과 안전 환경이 감염 표준주의 이행도에 미치는 영향

  • Received : 2017.12.11
  • Accepted : 2018.03.09
  • Published : 2018.03.31
Download PDF
⟨ Previous Next ⟩

Abstract

This study was a descriptive investigation to identify the influence of nurses' moral sensitivity and safety of their environment on compliance with standard precautions. Participants consisted of 214 nurses in one general hospital and data were collected using a questionnaire that consisted of moral sensitivity, safety of environment and compliance with standard precautions from 1-15 August 2017. Data were evaluated by the independent t-test, ANOVA, Pearson's correlation coefficient, and multiple regression analysis. The mean scores of moral sensitivity, safety of environment and compliance with standard precautions were 5.05, 5.76 and 4.50, respectively. Moreover, compliance with standard precautions was significantly positively correlated with moral sensitivity and safety of environment. Additionally, multiple regression revealed an $R^2$ of 0.253 with the department (ER, ICU), age and safety environment serving as the major predictor variables for compliance with standard precautions. However, the influence of moral sensitivity on compliance was not identified. Therefore, to increase compliance with standard precautions among nurses, it is necessary to provide continuous educational programs for new nurses, customized programs considering departmental characteristics and administrative support of institutions to enhance safety of the environment.

본 연구는 간호사의 도덕적 민감성과 병원 안전 환경이 간호사의 감염 표준주의 이행도에 미치는 영향을 파악하기 위해 시행되었다. 연구대상자는 일 개 종합병원 간호사 214명이었으며 2017년 8월 1일부터 15일까지 도덕적 민감성, 표준주의 안전 환경, 감염 표준주의 이행도에 관한 자가 보고식 설문지로 자료 수집하였다. 수집한 자료는 평균과 표준편차, 빈도 등 서술통계, 독립표본 차이 검정, 피어슨 상관관계, 분산분석, 다중회귀분석 방법으로 분석하였다. 대상자의 도덕적 민감성 평균점수는 7점 만점에 5.05점이었으며, 표준주의에 대한 안전 환경은 7점 만점에 5.76점, 감염 표준주의 이행도는 5점 만점에 4.50점이었다. 감염 표준주의 이행도는 도덕적 민감성 및 표준주의 안전 환경과 유의한 양의 상관관계를 보였다. 감염 표준주의 이행도에 영향을 미치는 요인은 근무 부서(응급실, 중환자실), 나이, 표준주의 안전 환경이었다. 이들 변수의 설명력은 25.3%였으며, 도덕적 민감성은 영향 요인으로 확인되지 않았다. 따라서 감염 표준주의 이행도를 높이기 위해서는 신규간호사들을 대상으로 한 지속적인 교육프로그램, 부서별 특성에 따른 맞춤 증진활동이 필요하며 표준주의 안전 환경 확립을 위한 기관의 인적, 행정적 지원이 요구된다.

Keywords

References

  1. J. R. Choi, I. S. Ko, Y. Y. Yim. "Factors Influencing Nursing Students' Performance of Infection Control", Journal of the Korean Academy of Fundamentals of Nursing, vol. 23, no. 2, pp. 136-148, 2016. DOI: https://doi.org/10.7739/jkafn.2016.23.2.136
  2. The Steering Committee of the Korean Nosocomial Infections Surveillance System. Korean Nosocomial Infections Surveillance System (KOINS) report: data summary from July 2013 through June 2014 [Internet]. Chungcheongbuk-do: The Korean Nosocomial Infections Surveillance System; 2014[cited 2015 January 10]. Available From: http://konis.cdc.go.kr/konis/sub/reports_icu.htm.
  3. F. C. Lessa, L. G. Winston, L. C. McDonald. "Emerging Infections Program C. difficile Surveillance Team et al. Burden of Clostridium difficile infection in the United States", The New England Journal of Medicine, vol. 372, no. 24, pp. 2369-2370. 2015. DOI: https://doi.org/10.1056/NEJMc1505190
  4. Center for Disease Control and Prevention. American recovery and reinvestment act epidemiology and laboratory capacity(ELC) for infectious disease program healthcare-associated infections(HAIs) grantee meeting [Internet].2009. Available from: http://www.cdc.gov/hai/recoveryact/pdf/oct09/5-0130_srinivasan_HAI_prevention_day1.pdf
  5. O. M. Al-Rawajfah, A. Tubaishat. "A concealed observational study of infection control and safe injection practices in Jordanian governmental hospitals", American Journal of Infection Control, vol. 45, no. 10, pp. 1127-1132, 2017. DOI: https://doi.org/10.1016/j.ajic.2017.04.293
  6. S. S. Seyed Nematian, C. J. Palenik, S. K. Mirmasoudi, N. Hatam, M. Askarian. "Comparing knowledge and self-reported hand hygiene practices with direct observation among Iranian hospital nurses", American Journal of Infection Control, vol. 45, no. 6, pp. e65-e67, 2017. DOI: https://doi.org/10.1016/j.ajic.2017.03.007
  7. R. A. Kossover-Smith, K. Coutts, K. M. Hatfield, R. Cochran, H. Akselrod, M. K. Schaefer, J. F. Perz, K. Bruss. "One needle, one syringe, only one time? A survey of physician and nurse knowledge, attitudes, and practices around injection safety", American Journal of Infection Control, vol. 45, no. 9, pp. 1018-1023, 2017. DOI: https://doi.org/10.1016/j.ajic.2017.04.292
  8. A. John, M. E. Tomas, A. Hari, B. M. Wilson, C. J. Donskey. "Do medical students receive training in correct use of personal protective equipment?" Medical Education Online, vol. 22 no. 1, pp. 1-5, 2017. DOI: https://doi.org/10.1080/10872981.2017.1264125
  9. I. S. Jeong, J. Yu, M. J. Ha. "Workplace Response System Against Infectious Disasters based on the MERS Outbreak in Korea", Korean Journal of Occupational Health Nursing, vol. 26, no. 4, pp. 207-217, 2017. DOI: http://dx.doi.org/10.5807/kjohn.2017.26.4.207
  10. J. S. Choi, J. S. Kim. "Factors influencing emergency nurses' ethical problems during the outbreak of MERS-CoV", Nursing Ethics, May 2016. DOI: https://doi.org/10.1177/0969733016648205
  11. S. S. Han, J. Kim, Y. S. Kim, S. Ahn. "Validation of a Korean version of the Moral Sensitivity Questionnaire", Nursing Ethics, vol. 17, no. 1, pp. 99-105, 2010. DOI: https://doi.org/10.1177/0969733009349993
  12. F. Borhani, A. Abbaszadeh, E. Mohamadi, E. Ghasemi, M. J. Hoseinabad-Farahani. "Moral sensitivity and moral distress in Iranian critical care nurses", Nursing Ethics, vol. 24, no. 4, pp. 474-482, 2017 DOI: https://doi.org/10.1177/0969733015604700
  13. J. Y. Song, I. S. Jeong. "The Hawthorne Effect on the Adherence to Hand Hygiene", Perspectives in Nursing Science, vol. 12, no. 1, pp. 7-13, 2015. DOI: https://doi.org/10.16952/pns.2015.12.1.7
  14. J. Dwyer, D. F. Tsai. "Developing the duty to treat: HIV, SARS, and the next epidemic", J Med Ethics, vol. 34, no. 1, pp. 7-10, 2008. DOI: https://doi.org/10.1136/jme.2006.018978
  15. K. Lützén, M. Evertzon, C. Nordin, "Moral sensitivity in psychiatric practice", Nursing Ethics, vol. 4, no. 6, pp. 472-482, 1997. DOI: https://doi.org/10.1177/096973309700400604
  16. J. H. Kim, K. H. Lim, "The factors influencing compliance with multidrug-resistant organism infection control in intensive care units nurses", Korean Journal of Adult Nursing, vol. 27, no. 3, pp. 325-336, 2015. DOI: https://doi.org/10.7475/kjan.2015.27.3.325
  17. M. S. Yoo, Y. J. Son, H. M. Ham, M. M. Park, A. H. Um. "A comparative study of nurses' recognition and practice level of general nosocomial infection, MRSA and VRE infection control", Journal of Korean Academy of Fundamentals of Nursing, vol. 11, no. 1, pp. 31-40, 2004.
  18. S. Y. Hong, Y. S. Kwon H. O. Park. "Nursing students' awareness and performance on standard precautions of infection control in the hospital", Journal of Korean Academic Society of Nursing Education, vol. 18, no. 2, pp. 293-302, 2012. DOI: https://doi.org/10.5977/jkasne.2012.18.2.293
  19. J. S. Choi, J. S. Choi, S. M. Park. "Relationship of nurses' knowledge, attitude and practice in an influenza A (H1N1) base-zone hospital", Journal of Korean Clinical Nursing Research, vol. 15, no. 3, pp. 85-94, 2009.
  20. G. L. Cho. Influencing factors on the compliance about standard precautions among ICU and ER nurses, Seoul National University. Seoul, 2007.
  21. Y. H. Suh, H. Y. Oh. "Knowledge, Perception, Safety Climate, and Compliance with Hospital Infection Standard Precautions among Hospital Nurses", Journal of Korean Clinical Nursing Research, vol. 16, no. 1, pp. 61-70, 2010.
  22. K. A. Lee, H. S. Kim, Y. W. Lee, O. K. Ham. "Factors Influencing Compliance with Standard Precautions in Intensive Care Unit and Emergency Room Nurses", Journal of Korean Academy of Fundamentals of Nursing. vol. 19, no. 3, pp. 302-312, 2012. DOI: https://doi.org/10.7739/jkafn.2012.19.3.302
  23. M. S. Park. "Exposure to Blood and Body Fluids and Influencing Factors on Compliance with Standard Precautions among Nurses in General Hospital", Journal of the Korea Academia - Industrial cooperation Society, vol. 17, no. 11, pp. 563-572, 2016. DOI: https://doi.org/10.5762/KAIS.2016.17.11.563
  24. H. Y. Shin, K. H. Kim, K. S. Kim. "Study on pediatric nurses' attitudes and compliance with hospital infection standard precautions", Journal of Korean Academy of Child Health Nursing, vol. 17, no. 4, pp. 238-246, 2011. DOI: https://doi.org/10.4094/jkachn.2011.17.4.238
  25. M. Kermode, D. Jolley, B. Langkham, M. S. Thomas, W. Holmes, S. M. Gifford. "Compliance with universal/standard precautions among health care workers in rural north India", American Journal of Infection Control, vol. 33, no. 1, pp. 27-33, 2005. DOI: https://doi.org/10.1016/j.ajic.2004.07.014
  26. K. H. Yang. Awareness and Performance of the Nurses to Standard Precautions for Infection Control in a University Hospital, Chonbuk National University. JeonJu, 2010.
  27. M. Askarian, Z. A. Memish, A. A. Khan. "Knowledge, practice and attitude among Iranian nurse, midwives and students regarding standard isolation precautions", Infection Control and Hospital Epidemiology, vol. 28, no. 2, pp. 241-244, 2007. DOI: https://doi.org/10.1086/510868
  28. S. Y. Jeong, O. S. Kim, J. Y. Lee. "The status of Healthcare-associated Infection Control among Healthcare Facilities in Korea", Journal of Digital Convergence, vol. 12, no. 5, pp. 353-366, 2014. DOI: https://doi.org/10.14400/JDC.2014.12.5.353
  29. D. Pittet. "The lowbury lecture: Behaviour in infection control", Journal of Hospital Infection, vol. 58, no. 1pp. 1-13, 2004. DOI: https://doi.org/10.1016/j.jhin.2004.06.002
  30. S. H. Hong, Y. H. Park, J. S. Moon. "Relationship between moral sensitivity and elderly nursing practice of nurses", Journal of the Korean Bioethics Association, vol. 17, no. 1, pp. 75-87, 2016.
  31. K. H. Hwang, O. H. Cho, Y. S. Yoo, M. Y. Chung. "Attitudes, Stigma, and Moral Sensitivity of Nurses toward HIV and AIDS", Journal of Korean Academic Society of Home Care Nursing, vol. 24, no. 2, pp. 142-150, 2017.
  32. H. R. Kim, S. H. Ahn. "Moral Sensitivity and Moral Distress among Korean Hospital Nurses", Korean Journal of Medical Ethics, vol. 13, no. 4, pp. 321-336, 2010.
  33. H. K. Cho, S. A. Kim. "Moral Sensitivity, Empathy and Perceived Ethical Climate of Psychiatric Nurses Working in the National Mental Hospital", Journal of Korean Academy Psychiatric and Mental Health Nursing, vol. 26, no. 2, pp. 204-215, 2017. DOI: https://doi.org/10.12934/jkpmhn.2017.26.2.204