간호관리자의 진성리더십과 팀 내 심리적 안전감, 간호사의 투약오류 보고의도

Abstract

투약오류보고는 투약오류를 감소시키기 위한 개선 활동 중 하나로 투약오류보고율을 예측할 수 있는 투약오류 보고의도를 향상시키는 것은 환자안전사고를 예방하고 재발을 방지하기 위한 방안 중 하나이다. 이에 본 연구에서는 간호사가 인식하는 간호관리자의 진성리더십, 팀 내 심리적 안전감과 투약오류 보고의도와의 관계를 파악하기 위한 서술적 조사연구를 시행하였다. 본 연구는 간호사 167명을 대상으로 구조화된 설문지를 이용하여 연구를 진행하였으며, 자료 분석은 SPSS statistics 26.0과 SPSS Process macro ver 3.4.1 프로그램을 이용하여 빈도분석, 기술통계, independent t-test, ANOVA, Pearson’s correlation coefficient, 다중회귀분석, 부트스트랩을 이용한 Process macro model 4로 분석하였다. 연구결과 진성리더십 3.41±.56점, 심리적 안전감 3.50±.52점, 투약오류 보고의도 71.06±19.13점으로 나타났고, 투약오류 보고의도에 영향을 미치는 요인으로는 3회 이상의 투약오류 관련 교육참여(β=.28, p=.003), 팀 내 심리적 안전감(β=.21, p=.004), 투약 근접오류경험(β=-.17, p=.041)으로 나타났다. 진성리더십이 투약오류 보고의도에 미치는 영향에서 심리적 안전감을 통한 간접효과가 검증되어(β=.2042, CI=.0025~.4892) 간호관리자의 진성리더십과 간호사의 투약오류 보고의도 사이에서 팀 내 심리적 안전감은 매개 역할을 하는 것으로 검증되었다. 이상의 연구결과를 종합하면, 투약오류 보고의도를 높이기 위해서는 투약오류에 관한 정의, 사례, 투약오류보고 체계, 오류 보고의 중요성이 포함된 체계적이고 반복적인 투약오류 관련 교육 프로그램을 구축하는 것이 필요하고, 투약오류보고로 겪은 간호사의 부정적인 경험을 극복하고, 심리적 안전감을 증진시키기 위한 조직적 접근 전략과 간호관리자의 진성리더십 개발을 위한 노력이 필요하다. The medication error report is one of the improvement activities to reduce medication error, and improving the intention of reporting medication error that can predict medication error rate is one of the measures to prevent patient safety accidents. Thus, in this study, a descriptive investigation study was conducted to identify the relationship between the authentic leadership of the nurse's perceived nursing manager, the psychological safety in work team, and the intent to report the medication error. This study was conducted on 167 nurses using structured questionnaires. The collected data were analyzed by the SPSS WIN 26.0 and SPSS process macro ver 3.4.1 software program and descriptive statistics, such as independent t-test, ANOVA, Pearson/s correlation coedfficient, multiple linear regressionanlysis, Scheff􌝸 test, and mediation analysis. Mediation alalysis was conducted using SPSS macro process model 4 to examine mediationi effect of psychological safety in work team on the relationship between authentic leadership of nursing managers and intention to medication error reporting of nurses. The study found that authentic leadership was 3.41±.56 points, psychological safety was 3.50±.52 points, and intention to medication error reporting was 71.06±19.13 points, and factors affecting the intention to medication error reporting of nurses were participation in education related to medication error (β =.28, p=.003), psychological safety in work team( =.21, p=.β 004), experience of near miss related medication error(β=-.17 and p=.041). The specific indirect effect through psychological safety in work team was β=.2042(CI=.0025-4892). Between the authentic leadership of nursing manager and the intention of the nurse to report an error in medication, psychological safety in the team has been verified to play a mediating role. These results showed that it is necessary to establish a systematic and repetitive medication error-related education program that includes the definition of medication error, cases, medication error reporting system, and the importance of error reporting, and to overcome the negative experiences of nurses who have experienced medication error reporting, and to make efforts to develop authentic leadership of nursing managers and to enhance psychological safety in work team.