중환자실 간호사의 인공호흡기관련 폐렴 예방을 위한 감염관리 수행도및 관련 요인
Associated Factors with Performance of Infection Control for the Prevention of Ventilator-associated Pneumonia among Some Intensive Care Unit Nurses
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
Objectives: Ventilator-associated pneumonia (VAP) is the most common form of nosocomial infections in intensive care units. The purpose of this study was to measure infection control knowledge and practice for VAP, and investigate the factors associated with them among staff nurses in intensive care units. Methods: The 232 staff nurses working in three university hospitals were surveyed by closed ended questionnaires using scoring system about infection control knowledge, practice for VAP and general characteristics. Practice scores for VAP were compared in groups of nurse. The factors associated to practice for VAP were analyzed with multiple linear regression using a SPSS version 16.0 statistical program. Results: The score of knowledge and performance of infection control were 4.85±1.18 and 1.82±0.13, respectively. In multiple regression analysis, the level of performance of infection control was significantly higher in nurses who cared for less than 3 patients compared to nurses who cared for more than 4 patients (β=0.04, p=0.067). And nurses with experience of education for the VAP prevention within 2 years had higher performance for the VAP prevention (β=0.05, p=0.009). The level of knowledge was higher, performance of infection control better. Conclusions: Performance for the VAP prevention was associated with the number of patients in charge, experience of education and the level of knowledge for the VAP prevention. So the level of performance of the VAP prevention will be improved by the reasonable nurse-to-patient ratio in intensive care unit and supplying of education and increasing of the level of knowledge for the VAP prevention.
Abstract
Objectives: Ventilator-associated pneumonia (VAP) is the most common form of nosocomial infections in intensive care units. The purpose of this study was to measure infection control knowledge and practice for VAP, and investigate the factors associated with them among staff nurses in intensive care units. Methods: The 232 staff nurses working in three university hospitals were surveyed by closed ended questionnaires using scoring system about infection control knowledge, practice for VAP and general characteristics. Practice scores for VAP were compared in groups of nurse. The factors associated to practice for VAP were analyzed with multiple linear regression using a SPSS version 16.0 statistical program. Results: The score of knowledge and performance of infection control were 4.85±1.18 and 1.82±0.13, respectively. In multiple regression analysis, the level of performance of infection control was significantly higher in nurses who cared for less than 3 patients compared to nurses who cared for more than 4 patients (β=0.04, p=0.067). And nurses with experience of education for the VAP prevention within 2 years had higher performance for the VAP prevention (β=0.05, p=0.009). The level of knowledge was higher, performance of infection control better. Conclusions: Performance for the VAP prevention was associated with the number of patients in charge, experience of education and the level of knowledge for the VAP prevention. So the level of performance of the VAP prevention will be improved by the reasonable nurse-to-patient ratio in intensive care unit and supplying of education and increasing of the level of knowledge for the VAP prevention.
참고문헌 (32)
- Alhazzani W, "Toothbrushing for critically ill mechanically ventilated patients: a systematic review and meta-analysis of randomized trials evaluating ventilator-associated pneumonia", Crit Care Med, 41(2), pp.646~655 (2013)[DOI]
- 곽이경, "전국의료관련감염감시체계 중환자실 부문 결과 보고: 2014년 7월부터 2015년 6월", 의료관련감염관리, 21(2), pp.37~49 (2016), 대한의료관련감염관리학회
- Chastre J, "Ventilator-associated pneumonia", Am J Resp Crit Care Med, 165, pp.867~903 (2002)[DOI]
- Young PJ, "Ventilator-associated pneumonia diagnosis, pathogenesis and prevention", Anaesthesia, 54, pp.1183~1197 (1999)[DOI]
- Rello J, "Association between empirical antimicrobial therapy at the hospital and mortality in patients with severe community-acquired pneumonia", Intensive Care Med, 28(8), pp.1030~1035 (2002)[DOI]
- Kim KS, "Effects of ventilator-associated pneumonia (VAP) control education on ICU nurses' infection control performance and incidence of pneumonia", J Korean Crit Care Nurs, 3(2), pp.13~22 (2010)
- Lee JH, "Incidence and risk factors for ventilator-associated pneumonia in an intensive care unit of a tertiary hospital", Korean J Nosocomial Infect Control, 13(2), pp.105~112 (2008)
- Pettinger A, "Epidemiology of isolation precautions", Infect Control Hosp Epidemiol, 12(5), pp.303~307 (1991)[DOI]
- 나선경, "중환자실 간호사의 패혈증에 대한 지식 조사", 임상간호연구, 19(3), pp.455~467 (2013), 병원간호사회
- 하현정, "중환자실 간호사의 유치도뇨관, 중심정맥관 및 인공호흡기감염관리에 대한 지식과 수행도", 한국산학기술학회논문지, 17(6), pp.113~120 (2016), 한국산학기술학회[DOI]
- Park ES, "Multicenter ICU surveillance study for nosocomial infection in Korean", Korean J Nosocomial Infect Control, 8(1), pp.23~33 (2003)
- 서영희, "병원간호사의 감염예방 표준주의지침 지식, 인식, 안전환경 및 수행도에 관한 연구", 임상간호연구, 16(1), pp.61~70 (2010), 병원간호사회
- Cho WS, "Perceived importance and activated performance of nurses for the prevention of nosocomial infection", Inje Med J, 20(1), pp.357~367 (1999)
- 허선, "수술실 간호사의 병원감염관리 실천정도에 영향을 미치는 요인", 성인간호학회지, 20(3), pp.375~385 (2008), 한국성인간호학회
- 성미혜, "간호사의 병원감염 관리에 대한 수행도에 영향을 미치는 요인", 한국직업건강간호학회지, 16(1), pp.5~14 (2007), 한국직업건강간호학회
- Park SH, "Analysis of nursing outcome and direct nursing care activity related to nurse-to-patient ratio", pp.2001
- Plost G, "Empowering critical care nurses to improve compliance with protocols in the intensive care unit", Am J Critical Care, 16(2), pp.153~156 (2007)
- Labeau S, "Critical care nurse's knowledge of evidence-based guidelines for preventing ventilator-associated pneumonia: an evaluation questionnaire", Am J Crit Care, 16(4), pp.371~377 (2007)
- Park SH, "ICU nurse's knowledge, perception and nursing skill on the prevention of ventilator-associated pneumonia", pp.2016
- Ban KO, "A study on the level of recognition and performance of the critical nurses about the management of nosocomial respiratory infection", pp.2002
- 유재용, "중환자실 간호사의 근거기반 감염관리 지식과 수행 수준 및 영향 요인", 성인간호학회지, 24(3), pp.232~243 (2012), 한국성인간호학회[DOI]
- Stoller JK, "Weekly versus daily changes of in-line suction catheters: Impact on rates of ventilator-associated pneumonia and associated costs", Respir Care, 48(5), pp.494~499 (2003)
- Dodek P, "Evidence-based clinical practice guideline for the prevention of ventilatorassociated pneumonia", Ann Internal Med, 141(4), pp.305~313 (2004)[DOI]
- 박효진, "중환자실 간호사의 호흡기계 병원감염관리 수행도에 영향을 미치는 요인", Journal of The Korean Data Analysis Society, 15(2), pp.949~963 (2013), 한국자료분석학회
- Boyce JM, "Guideline for hand hygiene in health-care settings: recommendations of the healthcare infection control practice Advisory Committee and the HICPAC", SHEA, IDSA Hand hygiene Task Force, pp.Am J Infect Control, 2002[DOI]
- 김현주, "중환자실 간호사의 간호업무내용에 따른 손씻기에 관한 연구", 기본간호학회지, 12(1), pp.121~130 (2005), 기본간호학회
- 이지현, "간호사 확보에 따른 노인요양병원 간호인력의 병원감염관리 인지도 및 실천도", 한국직업건강간호학회지, 21(3), pp.308~316 (2012), 한국직업건강간호학회
- 조성현, "의료기관 및 중환자실 특성에 따른 간호사 배치수준", Journal of Korean Academy of Nursing, 36(5), pp.691~700 (2006), 한국간호과학회
- 정복선, "환자감시가 간호사의 말초혈관 카테터 관리지침 이행에 미치는 영향", 간호행정학회지, 15(2), pp.169~181 (2009), 간호행정학회
- Kohli E, "Variability in the hawthorne effect with regard to hand hygiene performance in high-and low-performing inpatient care units", Infect Control Hosp Epidemiol, 30(3), pp.222~225 (2009)[DOI]
- Korea Center for Disease Control and Prevention, "Standard guidelines for infection control in intensive care units", Korea Center for Disease Control and Prevention, 20~23 (2010)
- 강지연, "일 대학병원 간호사의 다약제 내성균 감염관리지침에 대한 지식과 수행정도", Journal of Korean Academy of Nursing, 39(2), pp.186~197 (2009), 한국간호과학회