대한간호학회지 (Journal of Korean Academy of Nursing)

한국간호과학회 (Korean Society of Nursing Science)
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간호사의 침묵 행위가 투약안전 역량에 미치는 영향에서 그릿의 매개효과: 횡단적 조사연구

Mediating effect of grit on the influence of nurses' silence behavior on medication safety competence: a cross-sectional study

  • 김행숙 (경북대학교 수사과학대학원 법의간호학과) ;
  • 박완주 (경북대학교 간호대학)
  • Haengsuk Kim (Department of Forensic Nursing, Graduate School of Forensic and Investigative Science, Kyungpook National University) ;
  • Wanju Park (College of Nursing, Kyungpook National University)
  • 투고 : 2024.07.23
  • 심사 : 2024.12.30
  • 발행 : 2025.02.28
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초록

Purpose: This study investigated the mediating effect of grit in the relationship between silence behavior and medication safety competence among nurses. Methods: The study included 166 nurses from four university hospitals and general hospitals in Seoul and Gyeonggi-do, South Korea. Data were collected from March 1 to 10, 2024, using self-report questionnaires. Data were analyzed using the t-test, analysis of variance, Scheffé's test, and Pearson’s correlation coefficients with IBM SPSS Statistics ver. 23.0 (IBM Corp.). A mediation analysis was performed using Hayes's PROCESS macro model 4 and the bootstrapping method. Results: Medication safety competence showed significant correlations with silence behavior (r=-.21, p=.008) and grit (r=.43, p<.001). Furthermore, grit partially mediated the relationship between silence behavior and medication safety competence. Conclusion: This study indicates that grit is a significant mediator in the relationship between silence behavior and medication safety competence. Therefore, an integrated approach that reduces silence behavior and promotes grit is essential for strengthening nurses' medication safety competence. Ultimately, these strategies will help ensure patient safety by improving medication safety competence.

키워드

과제정보

This manuscript is a revision of the first author's master's thesis from Kyungpook National University. Year of 2024. This work was presented at the 2024 Korean Academy of Forensic Nursing Summer Conference, June 2024, Daegu, Korea.

참고문헌

  1. World Health Organization (WHO). WHO launches global effort to halve medication-related errors in 5 years [Internet]. WHO; 2017 [cited 2024 Mar 8]. Available from: https://www.who.int/news-room/detail/29-03-2017-who-launches-global-effort-to-halve-medication-related-errors-in-5-years
  2. Kim GH, Lee HJ. Factors influencing clinical nurses' medication safety competence. J Korean Acad Fundam Nurs. 2022;29(2):237-247. https://doi.org/10.7739/jkafn.2022.29.2.237
  3. World Health Organization (WHO); WHO Patient Safety. Conceptual framework for the international classification for patient safety: version 1.1: final technical report January 2009 [Internet]. WHO; 2009 [cited 2024 Jan 10]. Available from: https://apps.who.int/iris/handle/10665/70882 10665/70882
  4. Lee SE, Ha YJ. Effects of critical thinking disposition and clinical decision making ability of nurse in tertiary hospitals on medication safety competency. J Wellness. 2022;17(2):73-80. https://doi.org/10.21097/ksw.2022.5.17.2.73
  5. Korea Institute for Healthcare Accreditation (KOIHA). 2022 Patient safety statistics annual report [Internet]. KOIHA; c2023 [cited 2024 Jan 10]. Available from: https://www.kops.or.kr/portal/board/statAnlrpt/boardDetail.do
  6. Kim YS, Park KY. Nurses' awareness on healthcare accreditation, work overload, and professional self-concept and their influencing activities of patient safety management among nurses. J Korean Data Anal Soc [Internet]. 2014 [cited 2024 Jan 10];16(6):3377-3392. Available from: https://www.kci.go.kr/kciportal/ci/sereArticleSearch/ciSereArtiView.kci?sereArticleSearchBean.artiId=ART001941632
  7. Yoon SH, Kim HJ. The influences of transformational leadership of nurse manager, safety climate, and critical thinking disposition on medication safety competence in hospital nurse. J Learn Cent Curric Instr. 2023;23(16):557-566. https://doi.org/10.22251/jlcci.2023.23.16.557
  8. Escrivá Gracia J, Aparisi Sanz Á, Brage Serrano R, Fernández Garrido J. Medication errors and risk areas in a critical care unit. J Adv Nurs. 2021;77(1):286-295. https://doi.org/10.1111/jan.14612
  9. de Vries EN, Ramrattan MA, Smorenburg SM, Gouma DJ, Boermeester MA. The incidence and nature of in-hospital adverse events: a systematic review. Qual Saf Health Care. 2008;17(3):216-223. https://doi.org/10.1136/qshc.2007.023622
  10. Song G, Kim O. Influences of organizational communication satisfaction and safety climate on medication safety competence in hospital nurse. J Korean Acad Nurs Adm. 2022;28(3):297-306. https://doi.org/10.11111/jkana.2022.28.3.297
  11. Jember A, Hailu M, Messele A, Demeke T, Hassen M. Proportion of medication error reporting and associated factors among nurses: a cross sectional study. BMC Nurs. 2018;17:9. https://doi.org/10.1186/s12912-018-0280-4
  12. Park JK. Development of medication safety competence scale (MSCS) for nurses [dissertation]. Seoul: Korea University; 2019.
  13. Kohn LT, Corrigan JM, Donaldson MS. To err is human: building a safer health system [Internet]. National Academies Press; 2000 [cited 2024 Jan 10]. Available from: https://pubmed.ncbi.nlm.nih.gov/25077248/
  14. Maxfield D, Grenny J, McMillan R, Patterson K, Switzler A. Silence kills: the seven crucial conversations for healthcare [Internet]. Vital Smarts; 2005 [cited 2024 Jan 10]. Available from: https://psnet.ahrq.gov/issue/silence-kills-seven-crucial-conversations-healthcare
  15. Yi K, You M. Nurses' organizational silence in hospitals: a grounded theoretical approach. Korean J Occup Health Nurs. 2022;31(2):66-76. https://doi.org/10.5807/kjohn.2022.31.2.66.
  16. Morrow KJ, Gustavson AM, Jones J. Speaking up behaviours (safety voices) of healthcare workers: a metasynthesis of qualitative research studies. Int J Nurs Stud. 2016;64:42-51. https://doi.org/10.1016/j.ijnurstu.2016.09.014
  17. Chung S, Hwang JI. Development of the hospital nurses' silence behavior scale. J Korean Acad Nurs. 2024;54(2):279-295. https://doi.org/10.4040/jkan.23138
  18. Morrison EW, Milliken FJ. Organizational silence: a barrier to change and development in a pluralistic world. Acad Manag Rev. 2000;25(4):706-725. https://doi.org/10.5465/amr.2000.3707697
  19. Kang K, Kim JH. Factors related to the organizational silence of Korean nurses: a systematic review and meta-analysis. J Korean Acad Soc Nurs Educ. 2023;29(3):302-318. https://doi.org/10.5977/jkasne.2023.29.3.302
  20. Ji H, Lee SE. The influence of speaking up climate, psychological safety, organizational learning culture, and supervisor support for patient safety on clinical nurses' silence behavior. J Korean Acad Fundam Nurs. 2022;29(3):388-397. https://doi.org/10.7739/jkafn.2022.29.3.388
  21. Garon M. Speaking up, being heard: registered nurses' perceptions of workplace communication. J Nurs Manag. 2012;20(3):361-371. https://doi.org/10.1111/j.1365-2834.2011.01296.x
  22. Chung SJ. Development of the hospital nurses' silence behavior scale [dissertation]. Seoul: Kyung Hee University; 2021.
  23. Eriguc G, Ozer O, Turac İS, Songur C. Organizational silence among nurses: a study of structural equation modeling. Int J Bus Humanit Technol. 2014;4(1):150-162.
  24. Doo EY, Kim M. Effects of hospital nurses' internalized dominant values, organizational silence, horizontal violence, and organizational communication on patient safety. Res Nurs Health. 2020;43(5):499-510. https://doi.org/10.1002/nur.22067
  25. Duckworth AL, Peterson C, Matthews MD, Kelly DR. Grit: perseverance and passion for long-term goals. J Pers Soc Psychol. 2007;92(6):1087-1101. https://doi.org/10.1037/0022-3514.92.6.1087
  26. Lee J, Oh JE, Lee WJ, Hur Y. A concept analysis of nurses' grit. Crisisonomy. 2019;15(5):35-48. https://doi.org/10.14251/crisisonomy.2019.15.5.35
  27. Park H, Lee K, Shin N. Development and validation of the clinical nurses grit scale (CN-GRIT). J Korean Acad Nurs Adm. 2020;26(1):55-64. https://doi.org/10.11111/jkana.2020.26.1.55
  28. Ryu JL, Hong SH, Yang YS. Effects of nurses' grit on the nursing performance: multiple mediating effects of work engagement and job crafting. J Korean Acad Nurs Adm. 2023;29(4):468-477. https://doi.org/10.11111/jkana.2023.29.4.468
  29. Nisar A, Butt TH, Abid G, Farooqi S, Qazi TF. Impact of grit on voice behavior: mediating role of organizational commitment. Future Bus J. 2020;6:23. https://doi.org/10.1186/s43093-020-00028-7
  30. Kim SJ, Jang GJ. Grit and problem-solving ability in nursing students: the mediating role of distress tolerance and self-directedness. J Health Inf Stat. 2022;47(2):126-132. https://doi.org/10.21032/jhis.2022.47.2.126
  31. Shim E, Yang S. Psychiatric nurses' attitude toward the mentally ill effect of professional self-concept and self-control on patient-centered nursing: focusing on the mediating effect of the grit. J Learn Cent Curric Instr. 2023;23(3):829-842. https://doi.org/10.22251/jlcci.2023.23.3.829
  32. So YH. The structure relationship among elementary school teachers' perceptions of school organizational environment, grit and key competencies. Teach Educ Res. 2019;58(4):635-650. https://doi.org/10.15812/ter.58.4.201912.635
  33. Ro MO, Kwak MM. A study on the mediating effect of grit between job autonomy and job crafting. Korean Bus Educ Rev. 2019;34(5):109-129. https://doi.org/10.23839/kabe.2019.34.5.109
  34. Kim AS, Bea HJ, Kim Y. Mediating effect of grit on academic self-efficacy and clinical reasoning competence of college students. J Korea Acad Ind Coop Soc. 2022;23(1):149-157. https://doi.org/10.5762/KAIS.2022.23.1.149
  35. Ko JH, Gu MO. Convergence study on mediating effect of clinical competence on the relationship between grit and retention intention among new graduate nurses. J Korea Converg Soc. 2020;11(4):369-380. https://doi.org/10.15207/JKCS.2020.11.4.369
  36. Jeong JY, Seo YS, Choi JH, Kim SH, Lee MS, Hong SH, et al. The influence of grit on turnover intention of university hospital nurses: the mediating effect of job involvement. J Korean Acad Nurs. 2019;49(2):181-190. https://doi.org/10.4040/jkan.2019.49.2.181
  37. Kaplan L. True grit: New York achieves full practice authority. Nurse Pract. 2014;39(10):15-16. https://doi.org/10.1097/01.NPR.0000453649.23072.9f
  38. Munro CL, Hope AA. Grit makes us unstoppable. Am J Crit Care. 2019;28(5):334-336. https://doi.org/10.4037/ajcc2019871
  39. Duckworth A. Grit: the power of passion and perseverance. New York: Scribner; 2016. p. 135-259.
  40. Cho MS, Cho Y, Kim KH, Kwon IG, Kim MS, Lee JL. Development of clinical ladder system model for nurses: for tertiary care hospitals. J Korean Clin Nurs Res. 2015;21(3):277-292. https://doi.org/10.22650/JKCNR.2015.21.3.277
  41. Hayes AF. The simple mediation model. In: Hayes AF, editor. Introduction to mediation, moderation, and conditional process analysis, second edition: a regression-based approach. 3rd ed. Guilford Press; 2017. p. 77-112.
  42. Shrout PE, Bolger N. Mediation in experimental and nonexperimental studies: new procedures and recommendations. Psychol Methods. 2002;7(4):422-445. https://doi.org/10.1037/1082-989X.7.4.422
  43. Cohen J. The analysis of variance and covariance. In: Cohen J, editor. Statistical power analysis for the behavioral sciences. 2nd ed. Lawrence Erlbaum Associates; 1988. p. 284-288.
  44. Lee YH, Lee Y, Ahn JA, Kim HJ. Critical thinking disposition, medication error risk level of high-alert medication and medication safety competency among intensive care unit nurses. J Korean Crit Care Nurs. 2022;15(2):1-13. https://doi.org/10.34250/jkccn.2022.15.2.1
  45. Jeong DE, Lee YW, Ryu KM, Woo HS, Kim JD. Influence of problem-solving ability and self-efficacy on medication safety competence among clinical nurses. J Converg Inf Technol. 2022;12(5):21-31. https://doi.org/10.22156/CS4SMB.2022.12.05.021
  46. Alhadabi A, Karpinski AC. Grit, self-efficacy, achievement orientation goals, and academic performance in university students. Int J Adolesc Youth. 2019;25(1):519-535. https://doi.org/10.1080/02673843.2019.1679202
  47. Lv X, Gu Y, Solomon OM, Shen Y, Ren Y, Wei Y. Status and influencing factors of nurses' organizational silence in general hospitals in eastern coastal cities of China. BMC Nurs. 2024;23(1):757. https://doi.org/10.1186/s12912-024-02419-5
  48. Yu M, Kim EY, Kim JK, Lee Y. Development of a simulation program related to patient safety: focusing on medication error. J Korean Acad Nurs Adm. 2021;27(2):107-117. https://doi.org/10.11111/jkana.2021.27.2.107
  49. Lee DY, Je NJ, Kim YJ, Jang C, Kim HJ. Development and evaluation of passion continuation program based on GRIT theory for nurses in COVID-19 pandemic: a non-randomized experimental study. J Korean Acad Fundam Nurs. 2023;30(3):357-370. https://doi.org/10.7739/jkafn.2023.30.3.357