수술실 간호사의 안전한 수술에 대한 의사소통 경험

안신애,이남주 간호행정학회 2019 간호행정학회지 Vol.25 No.4

Purpose: The purpose of this study was to explore perioperative nurses’ communication experience within thesurgical team with regard to patient safety. Methods: Data were collected from December 2015 to September 2016,through in-depth individual interviews with 14 perioperative nurses. Individual interviews, once or twice, lasted from40 minutes to one hour for each session. The main interview question was “How do you describe your communicationexperience with surgical team members as a perioperative nurse?” Collected data were analyzed using a conventionalcontent analysis. Results: Two categories of the perioperative nurses’ experience of communication wereidentified: communication contributing to patient safety, communication hindering patient safety. Communicationin the surgical team reflected on the unique features of the operating room, such as urgency and a hierarchicalorganizational culture. However, the nurses recognized ineffective communication could impact on patient safety,and endeavored to overcome communication failures. Conclusion: The results indicate that sharing responsibility,open communication, assertiveness on safety issues, and interprofessional collaboration in the operating room arenecessary to ensure effective communication. Thus, respectful culture and an open communication climate basedon interprofessional understanding are required to improve communication. Training programs to enhance communicationskills should be implemented. 연구목적: 본 연구의 목적은 안전한 수술을 위한 수술실 간호사의 수술팀 내 의료인과의 의사소통 경험을 기술하고 이해하는 것이다. 연구방법: 2015년 12월부터 2016년 9월까지 수술실에서 1년 이상 근무한 경험이 있는 간호사 14명과 개별 인터뷰를 통해 자료를 수집하였다. 면담 시간은 약 40~60분 정도 소요되었으며, 참여자 한 사람당 1~2회의 면담을 실시하였다. 주요 인터뷰 질문은 “수술실 간호사로서 일할 때 수술에 참여하는 의료인과의 의사소통 경험에 대해서 이야기해 주십시오”로 시작하였다. 자료 분석은 전통적 내용분석 방법을 사용하였다. 연구결과: 수술실 간호사들의 의사소통 경험을 분석한 결과, ‘안전한 수술에 기여하는 의사소통’과 ‘안전한 수술을 방해하는 의사소통’의 2개의 주제가 도출되었다. 수술팀 내 의사소통에는 응급하고 긴급한 상황과 위계적인 조직문화와 같은 독특한 수술실의 특성이 반영되었다. 그러나, 수술실 간호사들은 비효율적인 의사소통이 환자안전에 영향을 미칠 수 있음을 인식하고 의사소통의 실패를 극복하고자 노력하였다. 결론: 본 연구결과, 수술실의 효과적인 의사소통을 위해서는 의료인 간 협력과 책임 공유, 개방적 의사소통, 안전 이슈에 대한 자기주장이 필요함이 확인되었다. 수술실의 의사소통을 향상시키기 위해서는 의료인 간 이해를 바탕으로 상호 존중하는 문화와 개방적으로 의사소통을 할 수 있는 분위기 형성을 위한 노력이 필요하다. 의사소통 기술 향상을 위해서 교육 및 훈련의 적용 또한 필수적이다.

수술실 의료진의 팀워크와 환자안전문화에 대한 인식이 수술환자안전 프로토콜 수행에 미치는 영향

안신애,이남주,Ahn, Shin-Ae,Lee, Nam-Ju 한국중환자간호학회 2016 중환자간호학회지 Vol.9 No.1

Purpose: The purpose of this study lies in investigating nursing and medical staff perceptions on the importance of surgical patient safety protocol, teamwork, and patient safety culture, and how their grasp of the factors affects the degree of their performance of the protocol. Methods: A survey was conducted on 249 nurses and medical staff participating in the operating rooms of one higher general hospital in Seoul, using a 5-point scale self-reported questionnaire. Logistic regression analyses were used. Results: Operating room nurses yielded the highest scores on both the importance of the patient safety protocol and its performance. In patient safety culture, the operating medical staff yielded significantly higher scores than those of operating room nurses. Perception of the importance of the patient safety protocol and teamwork had a significant effect on the nurses' complete performance of the protocol. Conclusion: It is important to create a safety culture, where all the staff can actively and freely communicate with one another through team-based training programs. By enhancing teamwork and patient safety culture, it will be possible to establish the surgical patient safety protocol and to improve the performance of the protocol by health professionals.

외래 의료서비스 이용 환자의 환자참여 경험이 환자만족에 미치는 영향

안신애 간호행정학회 2022 간호행정학회지 Vol.28 No.2

Purpose: This study examined outpatients’ experiences of patient participation, their level of patient satisfaction, and the factors that influence their patient satisfaction with outpatient care. Methods: This cross-sectional descriptive study utilized secondary data from the 2018 Survey on the Experience with Healthcare Service conducted in South Korea. Data from 6,684 outpatients over the age of 20 years who had visited hospitals were analyzed. Patient characteristics, health-related characteristics, and their experiences of patient participation were assessed as factors related to patient satisfaction. Factors that influenced patient satisfaction with outpatient care were identified using logistic regression analysis. Results: Overall, 84.9% of the participants were satisfied with the received outpatient care. Higher patient satisfaction with outpatient care was significantly associated with middle (40-59 years) and old age (≥60 years), good self-rated health status, and experience of patient participation in patient safety activities. Conclusion: Multiple factors were related to patient satisfaction with outpatient care. These factors need to be considered when evaluating patients’ satisfaction levels. To improve satisfaction with health care use, it is essential to provide more experiences and expand their opportunities for patient participation during the care process and establish healthcare policies and strategies to enhance patient participation in patient safety. 연구목적: 본 연구의 목적은 환자가 경험한 외래 의료서비스 이용 과정에서의 환자참여 경험 정도와 환자만족 현황을 파악하고 환자만족에 영향을 미치는 요인을 파악하기 위함이다. 연구방법: 본 연구는 ‘2018년 의료서비스경험조사’ 데이터를 사용하여 의원급과 병원급 의료기관의 외래 의료서비스 이용 경험이 있는 20세 이상의 성인 6,684명의 자료를 분석하였다. 환자만족에 영향을 미치는 요인은 환자 특성, 건강관련 특성, 환자참여 경험으로 분류하였으며 로지스틱 회귀분석을 통해 분석하였다. 연구결과: 대상자의 84.9%가 외래 의료서비스에 만족하는 것으로 나타났다. 외래 의료서비스를 이용하는 환자의 환자만족에는 연령, 주관적 건강수준, 환자참여 경험이 유의한 영향을 미치는 것으로 확인되었다. 결론: 환자만족에는 다양한 요인이 관련되어 있으며 이러한 요인을 고려하여 환자만족을 평가할 필요가 있다. 외래 의료서비스를 이용하는 환자의 만족을 높이려면 환자참여를 증진시키기 위한 의료정책 및 전략 수립을 통해 치료과정에서 환자가 참여할 수 있는 기회를 확대해 주는 것이 필요하다.

간호대학 교수의 환자안전 교육역량

안신애,이남주,장해나 한국간호과학회 2018 Journal of Korean Academy of Nursing Vol.48 No.6

Purpose: The purpose of this study was to investigate patient safety teaching competency of nursing faculty and the extent of teaching patient safety topics in the nursing curriculum. Methods: A national survey was conducted with full-time nursing faculty in 4-year nursing schools. Regional quota sampling method was used. An online survey was sent to 1,028 nursing faculty and 207 of them were completed. Among the 207, we analyzed data from 184 participants. The revised Health Professional Education in Patient Safety Survey was used. Data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, Pearson’s correlation analysis, and multiple linear regression analyses. Results: The faculty’s self-confidence was lower than their perceived importance of patient safety education. The mean score of teaching patient safety was 3.52±0.67 out of 5, and the contents were mostly delivered through lectures. The extent of faculty’s teaching varied depending on faculty’s clinical career, teaching subjects, participation in practicum courses, and previous experience of patient safety education. The significant predictors of the extent of teaching patient safety were the faculty’s self-confidence in teaching patient safety (β=.39) during clinical practicum, their perceived importance of patient safety education during lectures (β=.23), and the teaching subject (β=.15). Conclusion: To enhance the competency of nursing faculty for effective patient safety education, a patient safety education program tailored to faculty characteristics should be developed and continuously provided for faculty. In addition, it is necessary to improve patient safety curriculum, strengthen clinical and school linkages, and utilize various education methods in patient safety education.

병원급 의료기관에서의 낙상사고 위해 정도에 영향을 미치는 요인

안신애(Ahn, Shinae),김다은(Kim, Da Eun) 한국간호행정학회 2021 간호행정학회지 Vol.27 No.5

Purpose: This study aimed to examine the factors influencing the degree of harm caused by fall incidents in hospitals. Methods: This cross-sectional descriptive study used secondary data from the “Korean Patient Safety Incident Report 2019” and was based on the International Classification for Patient Safety conceptual framework. We analyzed a total of 4,176 fall incidents between January 1 and December 31, 2019, in Korea. Multinomial logistic regression analyses were conducted to identify the factors that influence the degree of harm from these incidents. Results: Among the fall incidents, 443 (10.6%) were sentinel events, 2,514 (60.2%) were adverse events, and 1,219 (29.2%) were near misses. The factors associated with sentinel events were old age (≥60 years), gender, patient diagnosis, medical department, early detection after falls, long-term care hospital, and reporters. Adverse events were significantly associated with diagnosis, medical department, nurses’ night shift time, large bed size, location (i.e., operating room, recovery room, and intensive care unit), and reporters. Conclusion: Both patient and incident characteristics are significantly associated with the degree of harm in hospitals. Therefore, multiple factors should be considered to establish healthcare policies and thus prevent fall risks and minimize damage following falls in hospitals.

환자안전 교육 역량 강화를 위한 정보자원 시스템 개발

이남주,안신애,장해나,이미선,손명지 한국간호과학회 2016 한국간호과학회 학술대회 Vol.2016 No.10

흑마늘과 미나리를 이용하여 제조한 음료의 품질 및 항산화 특성

정태성,김진학,안신애,원용덕,이신호 한국식품저장유통학회 2014 한국식품저장유통학회지 Vol.21 No.2

The quality and antioxidative characteristics of drinks prepared with different mixing ratios of black garlic and Oenanthe javanica DC., BD-1 (black garlic only), BD-2 (black garlic:Oenanthe javanica DC.=2:1), BD-3 (black garlic:Oenanthe javanica DC.=1:1), and BD-4 (black garlic:Oenanthe javanica DC.=1:2), were studied. The pH increased with the increasing concentration of Oenanthe javanica DC. extract in all the tested drinks, but the sugar contents decreased. The total polyphenol contents of the drinks were 28.48 μg/mL (BD-1), 41.91 μg/mL (BD-2), 42.36 μg/mL (BD-3), and 46.96 μg/mL (BD-4). The SOD-like activity was highest for BD-4 (18.60%), followed by BD-3 (15.53%), BD-2 (12.53%), and BD-1 (10.27%). The thiobarbituric acid reactive substances (TBARS) was highest for BD-4 (52.51%), followed by BD-3 (45.70%), BD-2 (39.44%), and BD-1 (28.72%). The ferrous ion chelating activity increased with the increasing concentration of Oenanthe javanica DC extract, and BD-4 showed the best activities among all the tested drinks. The water-soluble vitamin content (vitamins B1, B2, B6, and C) of BD-4 (1197.77 μg/mL) was higher than those of the other drinks (BD-1, 213.02 μg/mL; BD-2, 477.87 μg/mL; BD-3, 914.72 μg/mL), and the vitamin C (806.21 μg/mL) content of the water-soluble vitamins at BD-4 was higher than those of vitamins B1 (68.04 μg/mL), B2 (312.51 μg/mL), and B6 (11.01 μg/mL). BD-4 showed the best score in the sensory evaluations, such as in the evaluation of the color, flavor, taste, and overall acceptability.

흑마늘 첨가에 따른 청국장의 항산화 및 아미노산의 변화

정태성,김진학,안신애,원용덕,이신호 동아시아식생활학회 2013 동아시아식생활학회 학술발표대회논문집 Vol.2013 No.4

간호학 교수의 환자안전 교육역량 강화를 위한 정보자원 시스템 개발 및 평가

이남주(Lee, Nam-Ju),안신애(Ahn, Shinae),이미선(Lee, Miseon),장해나(Jang, Haena) 한국간호행정학회 2020 간호행정학회지 Vol.26 No.5

Purpose: This study aimed to develop an educational informatics system for nursing faculty to improve their competencies in teaching patient safety and to evaluate the effectiveness of the system. Methods: We developed a system called, ‘Resource to Enhance Safety Competency and Utilize for Education’ (RESCUE) based on the World Health Organization Multi-professional Patient Safety Curriculum Guide, and it was implemented with full-time nursing faculty in 4-year nursing schools. A one-group pretest-posttest design was used for evaluation. A total of 46 nursing faculty members used the system during a 3-month period. The effects of the RESCUE were measured using a survey including patient safety teaching competency, system usability and user satisfaction. Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. Results: After using the RESCUE, participants showed a significant increase in self-confidence in teaching patient safety during lectures (Z=-3.61, p<.001) and practica (Z=-3.14, p=.002). Conclusion: The developed informatics system was shown to be effective in improving the self-confidence of nursing faculty in teaching patient safety. To effectively integrate patient safety topics into the curriculum, it can be helpful to utilize the educational materials provided in this study with various clinical cases.

지역사회 거주 인지저하 노인의 미충족 의료 영향요인 분석

김다은(Kim, Da Eun),안신애(Ahn, Shinae) 한국간호행정학회 2020 간호행정학회지 Vol.26 No.2

Purpose: This study aimed to examine the prevalence of unmet healthcare needs and the factors that influence unmet healthcare needs among older people with cognitive impairment. Methods: A cross-sectional, descriptive design with secondary data from the 2017 National Survey of Older Koreans was used in this study. Data from 1,382 people over the age of 65 years with cognitive impairments were analyzed. Logistic regression analysis was conducted based on Andersen’s Behavioral Model of Health Services Use. Results: Overall, 9.6% of the participants reported unmet healthcare needs during the previous 12 months. The main reasons for unmet healthcare needs were financial constraints (45.4%), mobility limitation (18.0%), and mildness of symptoms (14.9%). Higher unmet healthcare needs were significantly associated with fewer years of education, no family members providing caregiving or assistance with hospital visits, fewer close relatives, lower income, greater impairment in activities of daily living, and presence of depressive symptoms. Conclusion: Our findings indicate that predisposing factors, enabling factors, and need factors were significantly associated with unmet healthcare needs among elderly individuals with cognitive impairment. Therefore, it is necessary to establish healthcare policies and strategies to improve the accessibility of healthcare services.