좌심실보조장치(Left Ventricular Assist Device)를 가진 환자관리에 대한 간호사의 교육요구도

Abstract

Purpose The purpose of this study is to identify the educational needs of nurses in managing patients with a Left Ventricular Assist Device (LVAD). Methods For this cross-sectional descriptive study, we conducted an online survey of nurses from two tertiary medical centers in Seoul, Korea. Eligible nurses were required to have at least one experience in managing patients undergoing LVAD. A total of 128 nurses participated in the survey from May 12th, 2021, to May 21st, 2021. Nurses responded to questionnaires assessing sociodemographic data, their experience with LVAD education programs, and educational needs in managing patients with LVAD. Data were analyzed using descriptive statistics, independent sample t-test, and paired sample t-test. To prioritize the educational needs of managing individuals undergoing LVAD, we used Borich's demand assessment model and The Locus for Focus model. Results The results of this study are as follows. 1. Our sample consisted of 128 nurses. The vast majority of participants were women (n = 120, 93.75%), and the mean age was of 31.85 years (SD = 6.018, range 24-51). Nurses reported an average of 7.4 years of nursing experience (SD = 5.651, range 1-29) and an average of 5.18 years in working with patients with cardiovascular conditions (SD = 4.559, range 0.4-23). Nurses mostly worked in general wards (n = 65, 50.8%) or intensive care units (n = 57, 44.5%). Although 119 out of 128 nurses had educational experience managing LVAD patients, they still reported high educational needs. Attending a lecture once a year was the most commonly reported LVAD management training. Regarding nurses’ perception of LVAD, the item with the lowest agreement was 'I enjoy taking care of the LVAD patients.' The item with the highest agreement was 'I am always interested in learning more about LVAD therapy.' 2. Participants’ degree of retention (current level of competence) was lower than ‘the degree of importance’ (needed level of competence) in all items regarding education needs (p < 0.001). The priority topics that emerged through Borich’s Needs Assessment Model and The Locus for Focus Model include: ‘CPR of LVAD Patient,’ ‘Crisis management on Power outage,’ ‘Discharge education,’ ‘Post-operative Precautions before examination,’ ‘Recognition of Emergencies,’ ‘LVAD Controller Changing Method,’ ‘Preparation of Back-up controller,’ ‘LVAD alarm management,’ ‘Contraindications of LVAD,’ and ‘Dressing method of LVAD driveline. We additionally compared priorities in educational needs between nurses from general wards and nurses from intensive care units. In both general wards and intensive care units, the topics that emerged as top priorities were ‘CPR of LVAD Patient,’ ‘Crisis management on Power outage,’ ‘LVAD Controller Changing Method,’ and ‘Preparation of Back-up controller.’ In nurses working in general wards, other priorities were ‘Discharge education,’'Postoperative Precautions before an examination,’ 'Recognition of Emergencies,’ ‘LVAD alarm management,’ ‘Showering after LVAD surgery,’ and ‘Meaning and Types of LVAD alarms.’ ‘LVAD pump setting method’ was an additional priority for nurses working in intensive care units. Conclusion Overall, nurses were positive about LVAD as the last palliative option for people with end-stage heart failure. They reported that they needed to improve their competency in managing patients with LVAD. Nurses were very interested in pursuing additional education about LVAD management. Among the ten highest educational priorities, five topics were in the domain of ‘emergencies management.’ Developing future education programs needs to consider nurses’ priorities and training modalities to make more accessible and sustainable programming.

본 서술적 조사연구의 목적은 간호사의 좌심실보조장치(Left Ventricular Assist Device[LVAD])를 가진 환자관리에 대한 교육요구도를 파악하여, 이를 통해 간호사의 LVAD 환자관리 역량 강화를 위한 교육 프로그램 개발의 기초자료를 마련하는 것이다. 서울시에 소재한 2개의 상급종합병원에서 LVAD 환자간호를 담당한 경험이 있는 간호사 128명을 대상으로 설문을 시행하고, 자료를 분석하였다. 수집된 자료는 IBM SPSS Statistics ver. 25 프로그램을 사용하여 빈도 분석, Independent sample t-test, Paired sample t-test 검정을 실시하였으며, Borich의 요구사정모델과 The Locus for Focus 모델을 이용하여 LVAD환자관리 교육요구도 우선순위 항목을 도출하였다.