본 연구는 병원간호사의 환자안전역량을 알아보고, 환자안전역량과 관련된 요인을 규명하고, 요인 간의 경로 및 영향력을 확인하여 간호사의 환자안전역량을 향상시키는 방안을 마련하고, 환자가 안전한 환경에서 치료받을 수 있도록 돕는 안전과 관련된 간호 중재개발의 기초자료를 제공하고자 한다. 이를 위해 Holden et al. (2013)의 System Engineering Initiative for Patient Safer (SEIPS) 2.0 모델을 바탕으로 병원간호사의 환자안전역량을 예측하는 ...
본 연구는 병원간호사의 환자안전역량을 알아보고, 환자안전역량과 관련된 요인을 규명하고, 요인 간의 경로 및 영향력을 확인하여 간호사의 환자안전역량을 향상시키는 방안을 마련하고, 환자가 안전한 환경에서 치료받을 수 있도록 돕는 안전과 관련된 간호 중재개발의 기초자료를 제공하고자 한다. 이를 위해 Holden et al. (2013)의 System Engineering Initiative for Patient Safer (SEIPS) 2.0 모델을 바탕으로 병원간호사의 환자안전역량을 예측하는 구조모형을 구축하고 적합성을 검정하였다. 가설모형의 예측변수로는 환자안전문화인식, 환자안전역량을 내생변수로, 안전동기, 피로, 자율성, 직무요구, 의사소통능력을 외생변수로 하였으며, 측정변수는 15개였다. 대전광역시 소재 3개 종합병원에서 2018년 7월 9일부터 7월 20일까지 설문지를 통한 자료 수집을 실시하여 총 211부의 분석 자료를 사용하였다. 자료 분석은 SPSS Ver 21.0 프로그램으로 서술적 통계를 실시하였고, AMOS Ver 21.0 프로그램을 이용하여 구조모형의 적합지수를 기준으로 적합도 검정을 실시하였다.
본 연구의 결과를 요약하면 다음과 같다.
1. 본 연구의 가설모형의 적합지수를 검증한 결과는 x²=164.27(𝘱<.001), x²/df=2.28, 적합도 지수(GFI) .90, 평균제곱잔차제곱근(RMR) .01, 근사오차 평균제곱근(RMSEA) .08, 표준적합치(NFI) .90, 비교적합지수(CFI) .94, 비 표준적합치(TLI) .91로 나타났다.
2. 모델 수정은 수정지수(M.I)를 통해 적합도를 높이기 위하여 표준화계수 (S.R.W) 값이 0에 가까운 환자안전역량과 연결된 안전동기, 피로를 삭제해 적합지수를 확인하였다.
4. 수정모형의 검증 결과를 통해서 병원간호사의 환자안전역량에 직접효과를 주는 요인은 의사소통능력과 환자안전문화인식이였고, 간접효과를 주는 요 인은 안전동기, 피로, 자율성, 의사소통능력으로 나타났다.
위의 연구 결과를 보면 병원간호사의 환자안전역량을 증대시키기 위해서는 조직차원의 의사소통 능력을 향상시키고, 환자안전문화에 대한 인식을 높이기 위한 다양한 중재를 개발하고 적용하면서 간호사들의 안전에 대한 동기를 파악하고, 피로를 줄이면서 자율성을 발휘할 수 있는 기회를 제공함으로써 환자안전문화인식을 높이는 방법을 마련하여야 한다. 따라서 간호사들의 환자안전역량을 높이는 직‧간접 요인들을 고려하여 그에 따른 간호중재 개발을 마련하는데 본 연구의 결과를 활용할 것을 제안한다.
본 연구는 병원간호사의 환자안전역량을 알아보고, 환자안전역량과 관련된 요인을 규명하고, 요인 간의 경로 및 영향력을 확인하여 간호사의 환자안전역량을 향상시키는 방안을 마련하고, 환자가 안전한 환경에서 치료받을 수 있도록 돕는 안전과 관련된 간호 중재개발의 기초자료를 제공하고자 한다. 이를 위해 Holden et al. (2013)의 System Engineering Initiative for Patient Safer (SEIPS) 2.0 모델을 바탕으로 병원간호사의 환자안전역량을 예측하는 구조모형을 구축하고 적합성을 검정하였다. 가설모형의 예측변수로는 환자안전문화인식, 환자안전역량을 내생변수로, 안전동기, 피로, 자율성, 직무요구, 의사소통능력을 외생변수로 하였으며, 측정변수는 15개였다. 대전광역시 소재 3개 종합병원에서 2018년 7월 9일부터 7월 20일까지 설문지를 통한 자료 수집을 실시하여 총 211부의 분석 자료를 사용하였다. 자료 분석은 SPSS Ver 21.0 프로그램으로 서술적 통계를 실시하였고, AMOS Ver 21.0 프로그램을 이용하여 구조모형의 적합지수를 기준으로 적합도 검정을 실시하였다.
본 연구의 결과를 요약하면 다음과 같다.
1. 본 연구의 가설모형의 적합지수를 검증한 결과는 x²=164.27(𝘱<.001), x²/df=2.28, 적합도 지수(GFI) .90, 평균제곱잔차제곱근(RMR) .01, 근사오차 평균제곱근(RMSEA) .08, 표준적합치(NFI) .90, 비교적합지수(CFI) .94, 비 표준적합치(TLI) .91로 나타났다.
2. 모델 수정은 수정지수(M.I)를 통해 적합도를 높이기 위하여 표준화계수 (S.R.W) 값이 0에 가까운 환자안전역량과 연결된 안전동기, 피로를 삭제해 적합지수를 확인하였다.
4. 수정모형의 검증 결과를 통해서 병원간호사의 환자안전역량에 직접효과를 주는 요인은 의사소통능력과 환자안전문화인식이였고, 간접효과를 주는 요 인은 안전동기, 피로, 자율성, 의사소통능력으로 나타났다.
위의 연구 결과를 보면 병원간호사의 환자안전역량을 증대시키기 위해서는 조직차원의 의사소통 능력을 향상시키고, 환자안전문화에 대한 인식을 높이기 위한 다양한 중재를 개발하고 적용하면서 간호사들의 안전에 대한 동기를 파악하고, 피로를 줄이면서 자율성을 발휘할 수 있는 기회를 제공함으로써 환자안전문화인식을 높이는 방법을 마련하여야 한다. 따라서 간호사들의 환자안전역량을 높이는 직‧간접 요인들을 고려하여 그에 따른 간호중재 개발을 마련하는데 본 연구의 결과를 활용할 것을 제안한다.
The present study aimed to investigate the patient safety competence of hospital nurses, identify factors related to patient safety competence,
* A thesis submitted to the committee of Graduate School, KongJu Natioal University in partial fulfillment of the requirements for the degree ...
The present study aimed to investigate the patient safety competence of hospital nurses, identify factors related to patient safety competence,
* A thesis submitted to the committee of Graduate School, KongJu Natioal University in partial fulfillment of the requirements for the degree of Doctor of Philosophy Conferred in February 2019. prepare ways for improving the patient safety competence of nurses by verifying the pathways and influences between relatedfactors, and provide baseline data for the development of patient-safety-related nursing interventions in order that patients can be treated in a safe environment. To this end, a structural model for predicting the patient safety competence of hospital nurses was constructed based on the System Engineering Initiative for Patient Safer (SEIPS) 2.0 model by Holden et al. (2013), and its fit was tested. With respect to thepredictive variables of the hypothetical model,perception of patient safety cultureand patient safety competence were used as endogenous variables, while safety motivation, fatigue, autonomy, job demands, and communication competence were usedas exogenous variables. There were 15 measurement variables. Data were collected from three general hospitals located in Daejeon Metropolitan City, South Koreafrom July 9 toJuly 20, 2018using a questionnaire, and a total of 211 responses were used for analysis. Data analysis was performed with descriptive statistics using SPSS ver. 21.0. The fit of the structural model was tested based on the goodness of fit indices of the structural model using AMOS ver. 21.0.
The results of the present study are summarized as follows:
1. The results of testing the goodness of fit indices of the hypothetical model used in this study showed that χ2/df = 164.27 (𝘱<.001) and χ2/df = 2.28; further, the goodness of fit index (GFI) = .90, mean square root residual (RMR) = .01, root mean square error of approximation (RMSEA) = .08, normal fit index (NFI) = .90, comparative fit index (CFI) = .94, and Tucker-Lewis index (TLI) = .91. 2. In order to enhance the goodness of fit through modificationindices(MI), safety motivation and fatigue associated with patient safety competence, whose standardized regression weight (SRW) values were close to 0, were eliminated, and the goodness of the fit was determined accordingly.
3. The results of testing the goodness of fit index of the modified model showed that χ2 = 165.42 (𝘱<.001), χ2/df = 2.24, GFI = .90, RMR = .01, RMSEA = .08, NFI = 90, CFI = .94, and TLI = .92.
4. From the results of testing the modified model, it was found that the factors directly affecting the patient safety competence of hospital nurses were communication competence and perception of patient safety culture, and the factors indirectly affecting the patient safety competence of hospital nurses were safety motivation, fatigue, autonomy, and communication competence.
Based on the aforementioned study results, it is suggested that in order to enhance the patient safety competence of hospital nurses, it is necessary to enhance communication competence at the organizational level, develop and apply various intervention programs designed to raise the perception of patient safety culture, provide ways to increase their perception of patient safety culture by identifying their motivation for safety, and offer opportunities to exercise their autonomy while reducing their fatigue. Therefore, the author suggests that the results of the present study should be utilized to develop patient-safety-related nursing interventions considering the direct and indirect factors that can increase the patient safety competence of nurses.
The present study aimed to investigate the patient safety competence of hospital nurses, identify factors related to patient safety competence,
* A thesis submitted to the committee of Graduate School, KongJu Natioal University in partial fulfillment of the requirements for the degree of Doctor of Philosophy Conferred in February 2019. prepare ways for improving the patient safety competence of nurses by verifying the pathways and influences between relatedfactors, and provide baseline data for the development of patient-safety-related nursing interventions in order that patients can be treated in a safe environment. To this end, a structural model for predicting the patient safety competence of hospital nurses was constructed based on the System Engineering Initiative for Patient Safer (SEIPS) 2.0 model by Holden et al. (2013), and its fit was tested. With respect to thepredictive variables of the hypothetical model,perception of patient safety cultureand patient safety competence were used as endogenous variables, while safety motivation, fatigue, autonomy, job demands, and communication competence were usedas exogenous variables. There were 15 measurement variables. Data were collected from three general hospitals located in Daejeon Metropolitan City, South Koreafrom July 9 toJuly 20, 2018using a questionnaire, and a total of 211 responses were used for analysis. Data analysis was performed with descriptive statistics using SPSS ver. 21.0. The fit of the structural model was tested based on the goodness of fit indices of the structural model using AMOS ver. 21.0.
The results of the present study are summarized as follows:
1. The results of testing the goodness of fit indices of the hypothetical model used in this study showed that χ2/df = 164.27 (𝘱<.001) and χ2/df = 2.28; further, the goodness of fit index (GFI) = .90, mean square root residual (RMR) = .01, root mean square error of approximation (RMSEA) = .08, normal fit index (NFI) = .90, comparative fit index (CFI) = .94, and Tucker-Lewis index (TLI) = .91. 2. In order to enhance the goodness of fit through modificationindices(MI), safety motivation and fatigue associated with patient safety competence, whose standardized regression weight (SRW) values were close to 0, were eliminated, and the goodness of the fit was determined accordingly.
3. The results of testing the goodness of fit index of the modified model showed that χ2 = 165.42 (𝘱<.001), χ2/df = 2.24, GFI = .90, RMR = .01, RMSEA = .08, NFI = 90, CFI = .94, and TLI = .92.
4. From the results of testing the modified model, it was found that the factors directly affecting the patient safety competence of hospital nurses were communication competence and perception of patient safety culture, and the factors indirectly affecting the patient safety competence of hospital nurses were safety motivation, fatigue, autonomy, and communication competence.
Based on the aforementioned study results, it is suggested that in order to enhance the patient safety competence of hospital nurses, it is necessary to enhance communication competence at the organizational level, develop and apply various intervention programs designed to raise the perception of patient safety culture, provide ways to increase their perception of patient safety culture by identifying their motivation for safety, and offer opportunities to exercise their autonomy while reducing their fatigue. Therefore, the author suggests that the results of the present study should be utilized to develop patient-safety-related nursing interventions considering the direct and indirect factors that can increase the patient safety competence of nurses.
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