간호원의 근육주사활동 수행 평가에 관한 일 연구

Abstract

[한글]

최근에 간호행정가와 연구가들은 간호원의 전문적능력과 수행정도를 사정하고 환자에게

질적인 간호를 제공하자는 것을 강조하면서 간호활동중심의 평가방안을 모색하는데 구체

적인 관심과 노력을 기울이고 있다.

본 연구에서는 우리나라 현 임상 간호업무에서 높은 비중을 차지하고 있고 전문적인 기

술과 책임을 필요로 하는 근육주사활동에 있어 간호원의 수행정도를 측정, 평가하는 도구

를 개발하고 이를 실제 임상에 적용하였다.

평가도구를 개발하기 위해 문헌고찰과 전문가들의 의견종합과, 현장 조사를 걸쳐 49개

항목으로 확정하였고 각 항목에 대해 최저 0점에서 최고 3점까지 평점화하였으며 도구의

신뢰도를 검정한 결과 0.95의 신뢰도를 얻었다.

연구대상은 서울 Y종합병원 내과·외과·소아과 13병동에 근무하는 151명의 간호원을

모집단으로 비례적 층별표집에 의해 50명의 간호원을 표본수로 정하고 1978년 10월 13일

부터 29일까지 근육주사활동을 직접 관찰하여 그 수행정도를 평가하였다.

통게적 분석방법으로는 전자계산조직을 이용하여 백분율, T검정, F검정과 Pearson상관

관계를 사용하였다.

본 연구의 결과를 요약하면 다음과 같다.

1. 대상자의 일반적 특성

연령은 평균 22.6세로 23∼26세가 52%이었으며 20∼22세가 48%이었다.

교육수준은 간호전문학교가 62%, 간호대학이 38%이었으며 임상경력은 평균 9.5개월로 1

년미만이 76%이었고 1년 이상이 24%이었다.

관찰된 업무번은 낮번인 경우가 60%, 저녁번이 40%이었고, 입원환자수는 평균 35.8명으

로 31명∼40명의 경우가 50%, 51명 이상인 경우가 2%이었다.

관찰당시 근무간호원수는 평균 5.9명으로 5∼8명인 경우가 48%, 1∼4명인 경우가 36%이

었다.

관찰당시 근육주사 환자수는 1∼10명인 경우가 72%, 11명∼20명의 경우가 22%로서 평균

9.6명이었다.

투약동안 소비시간은 31∼60초가 50%이었으며 평균 66.4초이었다.

각 특성은 임상과별로 유의한 차이가 없었으나 입원환자에 있어서 임상과별로 유의한

차이가 있었다. (F=12.464 df=2/47, P<0.05)

2. 투약활동의 수행정도

a. 투약준비 활동에서 평균 31.28점으로 수행지수 74.48의 수행정도를 보였다.

b. 투약후 활동영역에서 평균 46.66점으로 수행지수 57.6의 수행정도를 보였다.

c. 투약후 활동영역에서 평균 7.74점으로 수행지수 32.25의 수행정도를 보였다.

d. 전체활동에서 평균 85.68점으로 수행지수 58.29의 수행정도를 보였다.

이를 다시 간호영역별로 구분하였을 때

e. 안전투약방법 영역에서 평균 47.10점으로 수행지수 71.36의 수행정도를 보였다.

f. 내외과적 무균영역에서 평균 20.30점으로 수행지수 75.19의 수행정도를 보였다.

g. 심리적지지 및 의사소통영역에서 평균 10.50점으로 수행지수 35.0의 수행정도를 보

였다.

h. 주사기구 및 약정리영역에서 평균 4.84점으로 수행지수 32.27의 수행정도를 보였다.

i. 기록 및 보고영역에서 평균 2.94점으로 수행지수 32.67의 수행정도를 보였다.

3. 제 특성별 투약활동 수행정도

a. 투약준비활동에서 업무번간에는 유의한 차이가 있었다. (T=-2.39, df=48 P<0.05)

b. 투약동안 활동에서 임상경력간에 (T=-1.99 df=48 P<0.1), 입원환자수간에 (T=2.12 d

f=48 P<0.05) 유의한 차이가 있었다.

c. 투약후 활동에서 임상과간에 유의한 차이가 있었다. (F=5.6028 df=2/47 P<0.01)

d. 전체투약활동에서 임상경력간에 (T=-2.37 df=48 P<0.05), 입원환자수간에 (T=1.93 d

f=48 P<0.1) 유의한 차이가 있었다.

e. 안전투약방법영역에서 교육수준간에 (T=-1.97, df=48 p<0.1) 임상경력간에 (T=-2.31

df=48 P<0.05) 유의한 차이가 있었다.

f. 내외과적 무균영역에서 업무번간에 (T=-2.67 df=48 P<0.05) 근육주사환자수간에 (T=

1.97 df=48 P<0.1) 유의한 차이가 있었다.

g. 심리적지지 및 의사소통영역에서 입원환자수간에 유의한 차이가 있었다. (T=1.94, d

f=48 P<0.1)

h. 주사기구 및 약정리영역에서 근무 간호원수간에 유의한 차이가 있었다. (T=-2.31 df

=48 P<0.05)

4. 투약활동과 제특성간의 상관성

a. 투약준비활동과 임상경력은 유의한 순상관관계를 보였다. (r=0.2617 P<0.05)

b. 투약동안활동과 임상경력은 유의한 순상관관계를 보이고 (r=0.2571 P<0.05), 입원환

자수는 유의한 역상관관계를 보였다. (r=-0.2924 P<0.05)

c. 전체투약활동과 임상경력은 유의한 순상관관계를 보이고 (r=0.3541, P<0.01), 입원

환자수는 유의한 역상관관계를 보였다. (r=-0.2678 P<0.05)

이를 간호영역별로 구분하여 볼 때

d. 안전투약방법영역과 교육수준은 유의한 순상관관계를 보였다. (r=0.2735, P<0.05)

e. 내외과적 무균영역과 임상경력은 유의한 순상관관계를 보였으며 (r=0.2484, P<0.05)

, 근육주사환자수는 유의한 역상관관계를 보였다. (r=-0.2736 P<0.05)

f. 심리적지지 및 의사소통영역과 임상경력은 유의한 순상관관계를 보이고 (r=0.2488 P

<0.05), 입원환자수는 유의한 역상관관계를 보였다. (r=-0.2692, P<0.05)

g. 주사기구 및 약정리영역은 근무간호원수와 유의한 순상관관계를 보였다. (r=0.3323,

P<0.01)

이 결과에서 각 투약단계별 영역별에 따라 영향을 미치는 제특성이 일정하지 않은 것으

로 나타났다.

[영문]

In recent years, much emphasis has been place on assessing nurses professional

ability, evaluating nursing performance, and quality of nursing care. And so,

nursing administrators and researchers have been interested in seeking methods of

evaluating nursing performance.

This study developed an Evaluation tool for administration of Intramuscular

Injection. This activity needs much professional skill and responsibility, and is

highlighted as of prime importance among a variety of nursing procedures. And was

actually applicable in the clinical area.

The instrument which composed of 49 behavioral activities for evaluating the

performance level of the administration of Intramuscular Injection, was developed

through a Literature review, expert panel, and pilot test. Each item in the

instrument could be rated on a scale (minimum 0 point, maximum 3 points) by

performance incidents and the Reliability of this instrument was 0.95. The subjects

for this study were 50 nurses selected through systematic random sampling from 151

nurses engaged in-patient care representing medical, surgical, and pediatric units

of Y Hospital in Seoul. Data was collected for 17 days from October 13th to October

29th, 1978 through direct observation with the observation check list by well

trained observers.

Percentage, t-test, F-test, and pearson coefficient of correlation by use of EDPS

were employed for statistical analysis.

Results of this study can be summarized as follows.

1. General characteristics of nurses and wards.

Nurses Age; The average age was 22 years and 6 months. 52% of nurses were between

the ages of 3 to 26 years, the rest were between 20 to 22 years of age.

Type of nursing education; 62% graduated from 3 year diploma schools, and 38%

from Baccalaureate degree program.

Length of clinical experience; The average length was 9 months and 5 days. 76% of

nurses had less than 1 year, and 24% over than 1 year.

Type of shifts; 60% of Nurses observed were on Dat shifts and 40% were on Evening

shifts.

Number of patients in the ward; The average number was 35.8 patients 50% had over

31 patients and below 40 patients.

Number of nurses working; The average number was 5.9 nurses. 4% had over 5 nurses

and below 8 nurses.

Number of Intramuscular injection cases; The average number was 9.6 cases. 72%

had 11 to 20 cases.

Time spent during the administration of Intramuscular Injection.

The average time was 66.4 seconds. 50% took 31 to 60 seconds. No significance was

revealed in each characteristics according to types of unit, except number of

hospitalized patients (F=12.4646 df=2/47 P<0.05)

2. Nursing Performance level on the Administration of Intramuscular Injection.

a) Performance level on preparation for the administration of Intramuscular

Injection revealed that the average level was 31.28 points on a 74.48 performance

index.

b) Performance level during the administration of Intramuscular Injection

revealed that the average level was 46.66 points on a 57.6 performance ondex.

c) Performance level after the administration of Intramuscular Injection revealed

that the average level was 7.74 points on a 32.25 performance index.

d) Performance level on total administration of Intramuscular injection revealed

that the average level was 85.68 points on a 58.29 performance inex. By

distribution of 5 aspects of nursing.

e) Performance level in safe administration technique revealed that the average

level was 47.1 points on a 71.36 performance index.

f) Performance level in the medical-surgical aseptic technique revealed that the

average level was 20.30 points on a 75.19 performance index.

g) Performance level in psychological support technique revealed that the average

level was 10.50 points on a 35.0 performance index.

h) Performance level on Arrangement technique of syringe and/or medication

revealed that the average was 4.84 points on a 4.84 performance index.

i) Performance level on the Report and Record revealed that the average level was

4.84 points on 32.27 performance index.

3. Levels of nursing performance regarding general characteristics.

a) The performance level on preparation for the administration of Intramuscular

Injection was found to be significantly related to the shifts. (T=-2.39 df=48

P<0.05)

b) The performance level during the administration of Intramuscular Injection was

found to be significantly related to such as the length of clinical experience

(T=-1.0, df=48 P<0.1) and the number of patients in the ward. (T=2.12 df=48 P<0.05)

c) The performance level after the administration of Intramuscular injection was

found to be significantly related to the type of unit. (T=5.6028 df=2/47 P<0.01)

d) Total performance level after the administration of Intramuscular injection

was found to be significantly related to such as the number of patients in the ward

(T=1.93 df=48 P<0.1) and the clinical experience (T=-2.37 df=48 P<0.05)

e) The performance level on the safe administration technique was round to be

significantly related to the type of nursing education (T=-1.97 df=48 P<0.1)

f) The performance level on the medical-surgical aseptic technique related to the

type of shifts (T=-2.67 df=48 P<0.05) and the number of Intramuscular Injection

cases (T=1.97 df=48 P<0.1)

g) The performance level on the psychological support technique was found to be

significantly related to the number of patients in the ward. (T=1.94 df=48 P<0.1)

h) The performance level on the arrangement technique of the syringe and/or

medication was found to be significantly related to the number of nurses working

(T=-2.3 df=48 P<0.05)

4. Relationship between the Nursing Performance Level and the General

Characteristics

a) There was significantly positive correlation between the performance level for

the administration preparation and clinical experience (r=0.2717 P<0.05)

b) There was significantly positive correlation between the performance level

during the administration, and clinical experience(r=0.257 P<0.05) and

significantly negative correlation with the number of patients in the ward

(r=-0.2924 P<0.05).

c) There was significantly positive correlation between total performance level

and the clinical experience (r=0.3541 P<0.01), and significantly negative

correlation with the number of patients in the ward (r=-0.2678 P<0.05). by

distribution of 5 aspects of nursing.

d) There was significantly positive correlation between safe administration

technique, and the type of nursing education (r=0.2735 P<0.05)

e) There was significantly positive correlation between the medical-surgical

aseptic technique, and clinical experience (r=0.2735 P<0.05), and significantly

negative correlation the number of Intramuscal Injection cases (r=-0.2736 P<0.05).

f) There was significantly positive correlation between the psychological support

technique, and clinical experience (r=0.2488 P<0.05), and significantly negative

correlation with the number of hospitalized patients.

g) There was significantly positive correlation between the arrangement technique

of syringe and/or medication and the number of nurses working (r=0.3323 P<0.01).