DOI QR코드

DOI QR Code

간호⋅간병통합서비스병동 간호사의 그릿, 환자안전역량, 환자안전문화가 환자안전간호활동에 미치는 영향

Effects of Grit, Patient Safety Competence, and Patient Safety Culture on the Patient Safety Nursing Activities of Nurses in Comprehensive Nursing Service Wards

  • 김지현 (동아대학교 간호학부) ;
  • 장해나 (동아대학교 간호학부)
  • Kim, Ji Hyun (College of Nursing, Dong-A University) ;
  • Jang, Haena (College of Nursing, Dong-A University)
  • 투고 : 2024.09.10
  • 심사 : 2024.10.08
  • 발행 : 2024.10.31

초록

Purpose : In this study, we aimed to assess the impacts of grit, patient safety competence, and patient safety culture on the patient safety nursing activities of nurses in comprehensive nursing service wards. Methods : Here, a self-reported survey of 179 nurses from three tertiary hospitals was performed. Data from 171 valid responses were analyzed using descriptive statistics, independent t -test, one-way analysis of variance, Pearson's correlation, and stepwise multiple regression analyses. Results : The key sub-factors influencing the patient safety nursing activities were attitude (𝛽=.30, p <.001) and skill (𝛽=.26, p <.001) in the patient safety competence factor and safety environment (𝛽=.26, p <.001) in the patient safety culture factor. The regression model explained 42.7% of the variance in patient safety nursing activities (F=43.29, p <.001). Conclusion : Overall, these findings highlight the importance of improving the nurse attitude and skills related to patient safety as well as the safety environment in hospitals to enhance the patient safety nursing activities in comprehensive nursing service wards. Targeted educational and training programs should be provided along with organizational support to establish a safe and supportive nursing environment in comprehensive nursing service wards.

키워드

과제정보

This work was supported by the Dong-A University research fund.

참고문헌

  1. Sherwood G. Driving forces for quality and safety. In: Sherwood G, Barnsteiner JH, editors. Quality and safety in nursing a competency approach to improving outcomes. 3rd ed. Hoboken, NJ: Wiley Blackwell; 2022. p. 3-32. 
  2. Stalpers D, de Brouwer BJ, Kaljouw MJ, Schuurmans MJ. Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: a systematic review of literature. International Journal of Nursing Studies. 2015;52(4): 817-35. https://doi.org/10.1016/j.ijnurstu.2015.01.005 
  3. Ministry of Health and Welfare. OECD health statistics 2023 [Internet]. Sejong: Ministry of Health and Welfare; 2023 [cited 2024 September 01]. Available from: https://www.mohw.go.kr/board.es?mid=a10107010000&bid=0037&act=view&list_no=378202&tag=&cg_code=&list_depth=1 
  4. Kim J, Kim S, Park E, Jeong S, Lee E. Policy issues and new direction for comprehensive nursing service in the national health insurance. Journal of Korean Academy of Nursing Administration. 2017;23(3):312-22. https://doi.org/10.11111/jkana.2017.23.3.312 
  5. Ministry of Health and Welfare. 2nd national health insurance plan implementation in 2024 [Internet]. Sejong: Ministry of Health and Welfare; 2024 [cited 2024 September 01]. Available from: https://www.mohw.go.kr/board.es?mid=a10401000000&bid=0008&act=view&list_no=1481215&tag=&nPage=1 
  6. Park KO, Yu M, Kim JK. Experience of nurses participating in comprehensive nursing care. Journal of Korean Academy of Nursing Administration. 2017;23(1):76-89. https://doi.org/10.11111/jkana.2017.23.1.76 
  7. Lee KA, Lee SH. A comparative study on the operation status of comprehensive nursing care ward. Journal of Muscle and Joint Health. 2018;25(3):196-204. https://doi.org/10.5953/JMJH.2018.25.3.196 
  8. Lee TH, Duckworth AL. Organizational grit [Internet]. Brighton, MA: Harvard Business Review; 2018 [cited 2024 September 01]. Available from: https://hbr.org/2018/09/organizational-grit 
  9. Kwak YH, Jang IS, Lee W, Baek SJ, Hyun SK, Kim SM. The effects of grit and nursing work environment of nurses in tertiary hospitals on nursing performance and retention intention: mediating effect of compassionate rationalism leadership. Journal of Korean Clinical Nursing Research. 2023;29(2):163-74. https://doi.org/10.22650/JKCNR.2023.29.2.163 
  10. Park H, Lee K, Shin N. Development and validation of the clinical nurses grit scale (CN-GRIT). Journal of Korean Academy of Nursing Administration. 2020;26(1):55-64. https://doi.org/10.11111/jkana.2020.26.1.55 
  11. Munro CL, Hope AA. Grit makes us unstoppable. American Journal of Critical Care. 2019;28(5):334-6. http://doi.org/10.4037/ajcc2019871 
  12. Jang HN. Evaluation and application of patient safety competence assessment tool [master's thesis]. Seoul: Seoul National University; 2013. p. 5-40. 
  13. Noh S, Kim TI. The effects of organizational commitment and perceived patient safety culture on patient safety nursing activities among nurses in comprehensive nursing care units. Journal of Korean Clinical Nursing Research. 2021;27(1):12-22. https://doi.org/10.22650/JKCNR.2021.27.1.12 
  14. Kim YE, Suh GH, Choi SH, Park SA. Effects of self-efficacy and safety culture perception on patient safety management activities among nurses in comprehensive nursing care units. Crisisonomy. 2020;16(4):33-44. https://doi.org/10.14251/crisisonomy.2020.16.4.33 
  15. Kizer KW. Large system change and a culture of safety. Paper presented at: Enhancing Patient Safety and Reducing Errors in Health Care. 1998; Annenberg Center for Health Sciences. Rancho Mirage, California, IL. 
  16. Neal A, Griffin MA. A study of the lagged relationships among safety climate, safety motivation, safety behavior, and accidents at the individual and group levels. Journal of Applied Psychology. 2006;91(4):946-53. http://doi.org/10.1037/0021-9010.91.4.946 
  17. Yang HM. Effects of the comprehensive nursing care service ward nurses occupational stress on safety control and patient safety-related nursing activities. Journal of the Korea Contens Association. 2019;19(7):444-55. https://doi.org/10.5392/JKCA.2019.19.07.444 
  18. Park KO, Kim JK. A study on experience of transition from new clinical nurse to competent step. The Journal of Korean Academic Society of Nursing Education. 2013;19(4):594-605. http://dx.doi.org/10.5977/jkasne.2013.19.4.594 
  19. Lee NJ, An JY, Song TM, Jang H, Park SY. Psychometric evaluation of a patient safety competency self-evaluation tool for nursing students. Journal of Nursing Education. 2014;53(10):550-62. http://doi.org/10.3928/01484834-20140922-01 
  20. Chang HE. Manojlovich M. Clinical nurses' patient safety competency, systems thinking and missed nursing care: a cross-sectional survey. International Journal of Nursing Practice. 2023;29(2):e13130. https://doi.org/10.1111/ijn.13130 
  21. Sexton JB, Helmreich RL, Neilands TB, Rowan K, Vella K, Boyden J, et al. The safety attitudes questionnaire: psychometric properties, benchmarking data, and emerging research. BMC Health Services Research. 2006;6:44. http://doi.org/10.1186/1472-6963-6-44 
  22. Jeong HJ, Jung SM, An EA, Kim SY, Yoon HY, Kim MJ, et al. Development of the safety attitudes questionnaire - Korean version (SAQ-K) and its novel analysis methods for safety managers. Biometrics & Biostatistics International Journal. 2015;2(1):8-17. http://doi.org/10.15406/bbij.2015.02.00020 
  23. Jeong HJ, Lee WC, Son DH, Lee JH, Ryu SS, Yoo SH, et al. An efficiency-oriented reform of safety attitudes questionnaire-Korean version (development of SAQ-K2). Biometrics & Biostatistics International Journal. 2019;8(3):93-9. http://doi.org/10.15406/bbij.2019.08.00277 
  24. Byun SH. The impact of ICU nurses' knowledge of IV injection to prevent infection and perception of patient safety culture on IV injection practices [master's thesis]. Asan: Soonchunhyang University; 2023. p. 11-19. 
  25. Han MY, Jung MS. Effect of hospital nurses' perceptions of organizational health and patient safety culture on patient safety nursing activities. Journal of Korean Academy of Nursing Administration. 2017;23(2):127-38. http://dx.doi.org/10.11111/jkana.2017.23.2.127 
  26. Nam JE, Kong SS. The impact of work-related factors of nurses on patient safety management activities in comprehensive nursing care service wards. Health & Welfare. 2024;26(1):33-63. https://doi.org/10.23948/kshw.2024.03.26.1.33 
  27. Kim HJ, Kim HJ. Influences of nursing workplace spirituality, organizational citizenship behavior, and perception of patient safety management on the patient safety nursing activities among a tertiary hospital nurses. Journal of Korean Academy of Nursing Administration. 2022;28(3):179-89. https://doi.org/10.11111/jkana.2022.28.3.179 
  28. Bang MR, Shim SS, Lee DS. Comparison of patient-sitter ward nurses and general ward nurses on workrelated musculoskeletal symptoms, occupational stress and nursing work environments. Journal of Korean Biological Nursing Science. 2015;17(2):169-78. https://doi.org/10.7586/jkbns.2015.17.2.169 
  29. Korea Institute for Healthcare Accreditation. Accreditation standards for acute care hospital [Internet]. Seoul: Korea Institute for Healthcare Accreditation; 2021 [cited 2024 September 01]. Available from: https://www.koiha.or.kr/web/kr/library/establish_board.do 
  30. Kim HS. Patient safety and healthcare quality. Korea Institute for Healthcare Accreditation. 2019;5(1):20-9. 
  31. Aust MP. Front line of defense: the role of nurses in preventing sentinel events. 2nd ed. Oakbrook Terrace, IL: Joint Commission Resources; 2007. p. 35-58. 
  32. Yang SH. The effects of GRIT and self-leadership on nursing performance. The society of Convergence Knowledge Transactions. 2023;11(2):93-108. https://doi.org/10.22716/sckt.2023.11.2.018 
  33. Yoo JB, Kim JS. Effect of patient safety competency on patient safety management activities in perianesthesia nurses. Journal of the Korean Data Analysis Society. 2021;23(4):1923-36. https://doi.org/10.37727/jkdas.2021.23.4.1923 
  34. Murray M, Sundin D, Cope V. New graduate registered nurses' knowledge of patient safety and practice: a literature review. Journal of Clinical Nursing. 2017;27(1-2):31-47. http://doi.org/10.1111/jocn.13785 
  35. Yoo JB, Chung SE, Oh J. Safety climate and organizational communication satisfaction among korean perianesthesia care unit nurses. Journal of Perianesthesia Nursing. 2021;36(1):24-9. http://doi.org/10.1016/j.jopan.2020.04.009 
  36. Kwon KN, Hwang SY. Impact of perception of patient safety culture and safety control on patient safety management activities among perioperative nurses in university hospitals. Journal of Korean Academy of Nursing Administration. 2022;28(3):285-96. https://doi.org/10.11111/jkana.2022.28.3.285 
  37. Ajzen I. The theory of planned behavior. Organizational Behavior and Human Decision Processes. 1991;50(2):179-211. https://doi.org/10.1016/0749-5978(91)90020-T 
  38. Kakemam E, Albelbeisi AH, Rouzbahani M, Gharakhani M, Zahedi H, Taheri R. Nurses' perceptions of patient safety competency: a cross-sectional study of relationships with occurrence and reporting of adverse events. PLoS One. 2024;19:e0297185. http://doi.org/10.1371/journal.pone.0297185 
  39. McLean SF. Case-based learning and its application in medical and health-care fields: a review of worldwide literature. Journal of Medical Education Curricular Development. 2016;3:JMECD.S20377. http://doi.org/10.4137/JMECD.S20377 
  40. Han IS. Patient safety competence and safe nursing activity in integrated nursing care unit nurses [master's thesis]. Seoul: Seoul National University; 2021. p. 28. 
  41. Durham CF, Alden KR. Enhancing patient safety in nursing education through patient simulation. In: Hughes RG, editor. Patient safety and quality: an evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality; 2008. p. 3-230. 
  42. Aranzamendez G, James D, Toms R. Finding antecedents of psychological safety: a step toward quality improvement. Nursing Forum. 2014;50(3):171-8. https://doi.org/10.1111/nuf.12084 
  43. Leroy H. Dierynck B, Anseel R, Simons T, Halbesleben JR, McCaughey D, et al. Behavioral integrity for safety, priority of safety, psychological safety, and patient safety: a team-level study. Journal of Applied Psychology. 2012;97(6):1273-81. http://doi.org/10.1037/a0030076