중환자실 간호사의 유치도뇨관, 중심정맥관 및 인공호흡기 감염관리에 대한 지식과 수행도

국문 초록 (Abstract)

본 연구의 목적은 유치도뇨관, 중심정맥관 및 인공호흡기 감염관리지침에 대한 중환자실 간호사의 지식과 수행도 정도를 파악하고자 하였다. 대상자는 2개의 상급종합병원과 3개의 종합병원의 중환자실에서 근무하는 간호사 175명이다. 자 료수집은 2013년 7월 1일부터 7월 31일까지로, 수집된 자료는 SPSS 18.0 통계 프로그램을 사용하여 기술통계, t-test, ANOVA 로 분석하였다. 각 지식수준은 유치도뇨 관리관(평균 0.87점), 중심정맥관(0.82점), 인공호흡기(0.82점)순으로 나타났으며, 수 행도는 유치도뇨 관리관(평균 4.18점), 인공호흡기(4.04점)중심정맥관(4.07점)순이었다. 지식과 수행도에서는 유치도뇨관 (r=.72, p<.00), 중심정맥관(r=.54, p<.001), 및 인공호흡기(r=.30, p<.001) 감염관리간 순 상관관계를 나타냈다. 유치도뇨관 감 염관리지침에 대한 지식과 수행도는 성별, 최종학력, 근무경력, 담당환자 수, 병원규모, 세미나 참석 여부에 따라 통계적으로 유의한 차이가 있었다. 중심정맥관 감염관리지침에 대한 지식과 수행도는 최종학력, 근무경력, 담당환자 수, 병원규모, 세미 나 참석 여부에 따라 통계적으로 유의한 차이가 있었다. 인공호흡기 감염관리지침에 대한 지식은 근무경력에 따라 통계적으 로 유의한 차이가 있었다. 본 연구결과를 기초로 감염관리지침에 대한 지식과 수행을 향상 시킬 수 있는 교육 및 훈련 프로그 램이 개발되어야 할 것이다.

다국어 초록 (Multilingual Abstract)

The purpose of this study is to identify the knowledge of and adherence to the infection control guidelines for indwelling urinary catheters, central venous catheters and ventilators among intensive care nurses. The subjects were 175 intensive care nurses working in 2 upper general hospitals and 3 general hospitals. Data were collected from July 1 to July 31, 2013. The collected data were analyzed by descriptive statistics, t-test and ANOVA using SPSS 18.0 for Windows. The mean scores of the knowledge of the infection control guidelines on indwelling urinary catheters, central venous catheters and ventilators were 0.87, 0.82 and 0.82 points, respectively. The average scores for the adherence to the infection control guidelines for indwelling urinary catheters, central venous catheters and ventilators were 4.18, 4.04 and 4.07 points, respectively. Statistically significant correlations were found between the knowledge of and adherence to the infection control guidelines for indwelling urinary catheters (r=.72, p<.00), central venous catheters (r=.54, p<.001) and ventilators (r=.30, p<.001). The knowledge of and adherence to the infection control guidelines for indwelling urinary catheters differed significantly according to gender, educational status, total career, number of patients, type of hospital, and attendance of seminar. The knowledge of and adherence to the infection control guidelines for central venous catheters differed significantly according to educational status, total career, number of patients, type of hospital, and attendance of seminar. The knowledge level of the infection control guidelines for the ventilator differed significantly according to the total career. The results of this study indicate that education and training programs for improving the knowledge of adherence to the infection control guidelines should be developed.

참고문헌 (Reference)

1 김경미, "한방병원 한의사와 간호사의 감염관리에 대한 지식과 수행도 비교" 성인간호학회 24 (24): 74-84, 2012

2 반금옥, "중환자실 인공호흡기 관련 폐렴 예방 프로그램의 개발 및 효과 평가" 성인간호학회 21 (21): 155-166, 2009

3 유재용, "중환자실 간호사의 근거기반 감염관리 지식과 수행 수준 및 영향 요인" 성인간호학회 24 (24): 232-243, 2012

4 전민혁, "전국병원감염감시체계 중환자실 부문 결과: 2010년 7월부터 2011년 6월" 대한의료관련감염관리학회 17 (17): 28-39, 2012

5 장은희, "일반병동과 특수병동의 핵심기본간호술에 대한 중요성인식과 수행 빈도 비교" 한국산학기술학회 16 (16): 1264-1272, 2015

6 정희자, "간호사의 병원감염 예방에 대한 지식과 실천" 병원간호사회 9 (9): 18-31, 2004

7 Tasnim Sinuff, "Ventilator-associated pneumonia: Improving outcomes through guideline implementation" Elsevier BV 23 (23): 118-125, 2008

8 Sheila O'Keefe-McCarthy, "Ventilator-Associated Pneumonia Bundled Strategies: An Evidence-Based Practice" Wiley-Blackwell 5 (5): 193-204, 2008

9 Hatler CW, "Using evidence and process improvement strategies to enhance healthcare outcomes for the critically ill: A pilot project" 15 (15): 549-555, 2006

10 M. Y. Kim, "The level of the awareness and the compliance on nosocomial infection control among clinical nurses in the hospital" 7 (7): 58-69, 2002

11 Haleyn RW, "The SENIC Project. “Study on the efficacy of nosocomial infection control(SENIC Project). Summary of study design”" 111 (111): 472-485, 1980

12 M. S. Yu, "Recognition, self and objective evaluations of nosocomial respiratory infection control practices by ICU nurses" 9 (9): 349-359, 2002

13 Alexandre R. Marra, "Preventing catheter-associated urinary tract infection in the zero-tolerance era" Elsevier BV 39 (39): 817-822, 2011

14 H. S. Oh, "National survey on nurses' knowledge of infection control in general hospitals and analysis of variables to impact on their knowledge" 10 (10): 78-86, 2005

15 Korea Institute for Healthcare Accreditation, "Medical certification standards investigation for upper general hospital 2nd ed" 2014

16 Blot SI, "Invasive devices: no need? No use!" 33 (33): 209-211, 2007

17 M. K. Lee, "Intensive care unit nurses' knowledge, recognition, and performance of hospital infection control" Eulji University 2012

18 Korean Society for Healthcare-associated Infection Control and Prevention, "Infection Management of Healthcare" Hanmibook 2011

19 S. W. Youn, "Infection Management" Orebook 2014

20 "Guidelines for Preventing Health-Care-Associated Pneumonia"

21 "Guideline for Prevention of Catheter-associated Urinary Tract Infections"

22 Labeau S, "Evidence-based guidelines for the prevention of ventilator-associated pneumonia: results of a knowledge test among European intensive care nurses" 70 (70): 180-185, 2008

23 K. S. Kim, "Effects of ventilator-associated pneumonia(VAP)control education on ICU nurses'infection control performance and incidence of pneumonia" 3 (3): 13-22, 2010

24 M. S. Lee, "Developing standard guidelines for infection control in intensive care units" Center for Disease Control & Prevention 2010

25 M. F. El-Khatib, "Critical Care Clinicians' Knowledge of Evidence-Based Guidelines for Preventing Ventilator-Associated Pneumonia" AACN Publishing 19 (19): 272-276, 2010

26 Korean Accreditation Board of Nursing Education, "Core nursing practice & skill check list for nursing education accreditation 3rd ed"

27 Sonia O. Labeau, "Centers for Disease Control and Prevention guidelines for preventing central venous catheter-related infection: Results of a knowledge test among 3405 European intensive care nurses" Ovid Technologies (Wolters Kluwer Health) 37 (37): 320-323, 2009

28 Bonello RS, "An intensive care unit quality improvement collaborative in nine Department of Veterans Affairs hospitals: Reducing ventilator-associated pneumonia and catheter-related bloodstream infection rates" 34 (34): 639-645, 2008

29 H. S. Kim, "A study of knowledge and practice on urinary track infection management of intensive care unit nurse" Graduate School Ajou University 2009

30 "2011 Guidelines for the Prevention of Intravascular Catheter-Related Infections"