노인 의료복지시설의 감염관리 체계에 대한 고찰: 한국과 선진 6개국의 비교
A Study on the Infection Control System of Medical Welfare Facilities for the Elderly: Comparison between Korea and the Six Advanced Countries
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본 연구는 우리사회의 노인 의료복지시설 감염관리 체계가 선진국 대비 얼마나 미흡한 수준인지를 밝히는데 목적을 두었다. 이를 위해 지난 수십년간 증거기반 시설 감염관리 체계 정비에 매진해 온 선진 6개국을 사례로 선정하고, 이들 국가의 감염관리 체계가 한국과는 어떤 차이가 있는지를 분석하였다. 감염관리 감독 및 평가체계와 운영체계를 기준으로 한 감염관리 체계에 대한 분석결과, 선진사회의 특징적 요소로는 첫째, 감염관리 감독 주체가 명확하고, 둘째, 감염관리 감독과 평가기능이 연계되어 있고, 평가에 대한 환류체계 작동이 원활하며, 셋째, 감염관리 평가지표가 시설 감염관리 인프라 구축이나 구성원의 역량 진단 위주로 구성되어 있고, 넷째, 감염관리 매뉴얼이 감독 및 평가기능과 연계되어 있고, 감염관리 활동 자체보다는 시스템에 기반한 감염관리를 강조하고 있으며, 다섯째, 시설의 감염관리 개선활동 지원에 매우 적극적이라는 사실이 확인되었다. 반면, 한국의 감염관리 체계는 감독주체가 명확하지 못하고, 평가지표가 시스템이 아닌 실무차원에만 한정되어 있으며, 감독기관과 평가기관의 연계성 부족으로 평가결과에 대한 사후관리 기능이 미흡하고, 매뉴얼 구성체계도 지나치게 실무위주로만 되어 있다는 한계를 보였다. 이러한 선진 사례국가와의 비교결과를 토대로 본 연구에서는 우리사회 노인 의료복지시설의 감염관리 체계 개선에 필요한 방향 및 향후 과제에 대해 논의 하였다.
Abstract
This study aimed to clarify the level of infection control system of elderly medical welfare facilities of our society compared to advanced countries. To this end, this study selected six advanced countries, which have been devoted to the establishment of data based infection control system for the past several decades, and analyzed the differences from korea. As a result of the analysis of the infection control system, characteristic elements of the advanced society were as follows. First, infection control supervision subject was clear. Second, infection control supervision and evaluation function were linked. Third, infection control evaluation index of elderly medical welfare facilities were focused on the diagnosis of infection control infrastructure and members' competency. Fourth, infection control manual was linked with supervision and evaluation function. Fifth, it was very active in supporting infection control improvement activities of facilities. On the other hand, Korea's infection control system was not clear on the subject of supervision, and the evaluation index were limited only to the practical level not the system. The linkage of the infection control supervision and evaluation function was limited. Based on these results, the present study discussed the direction and future tasks for improvement of the infection control system of medical welfare facility for the elderly in Korea.
참고문헌 (51)
- 경상일보, "노인요양시설 결핵감염 뒤늦게 확인", ~ (2016)
- 대전일보, "부여지역 한 요양시설에서 결핵･옴 의심환자 소식에 술렁", ~ (2015)
- 보건복지부, "장기요양기관 안전관리 매뉴얼", ~ (2017)
- 2018 노인복지시설 현황, "보건복지부", ~ (2018)
- 의료관련감염 예방관리 종합대책 ‘18-’22, "보건복지부", ~ (2018)
- 연합뉴스, "결핵, 후진국형 질병이라는데... 전남 꾸준히 증가", ~ (2014)
- 유진홍, "의료 관련 감염관리의 원론과 전망", 대한의사협회지, 61(1), pp.5~12 (2018), 대한의사협회[DOI]
- 임소연, "살기 좋은 나라 호주의 장기요양제도는 어떨까?", 건강보험, ~ (2013)
- 장기요양기관 실태 점검결과 및 개선방안, "정부합동부패척결추진단", ~ (2016)
- 중부일보, "안성 노인요양원 결핵환자 속출...발병원인･감염경로 오리무중", ~ (2016)
- 쿠키뉴스, "직원 아프면 해고하라고 강요하는 장기요양제도?", ~ (2018)
- 한국일보, "장기요양시설 후진국병 옴 진드기에 무방비", ~ (2016)
- "노인요양시설서 잠복결핵 집단 감염", MBC 뉴스, ~ (2018)
- Newsis, "진천 요양시설 옴 환자 5명 발생... 격리･소독 조치", ~ (2013)
- "감염병 사각지대 노인 요양원", TJB 뉴스, ~ (2017)
- "충남 부여 요양원에서 생활하던 노인 2명 결핵 확진", YTN News, ~ (2017)
- 宮城県, "第三者評価 共通 評価基準 ガイドライン における 各 評価項目の判断基準に関する: 高齢者福祉サービス解説版", ~ (2017)
- 特別養護老人ホーム 評価の判断基準・評価のポイント・評価の着眼点, "宮城県", ~ (2017)
- 厚生労働省, "高齢者介護施設における 感染対策マニュアル", ~ (2013)
- 介護サービス事業者の業務管理体制の監督について, "厚生労働省", ~ (2015)
- 厚生労働省, "第三者評価制度・情報公表制度について", ~ (2017)
- Accreditation Canada, "Required Organizational Practices", ~ (2017)
- Aged Care Standards and Accreditation Agency Ltd, "Agency Resources and Planned Performance", ~ (2018)
- Australian Aged Care Quality Agency, "Result and Processes Guide", ~ (2014)
- Australian Commission on Safety and Quality in Healthcare, "National Safety and Quality Health Service Standards", ~ (2011)
- Care Quality Commission, "Essential Standards Of Quality & Safety Outcome 8 - Regular 12 - Cleanliness Care Quality Self Assessment", ~ (2010)
- Care Quality Commission, "Guidance about Compliance: Essential1 Standards of Quality and Safety", ~ (2010)
- Centers for Disease Control And Prevention, "Infection Prevention and Control Assesment Tool for Long-Term Care Facilities", ~ (2016)
- Centers for Medicare & Medicaid Services, "QAPI at a Glance: A Step by Step Guide to Implementing Quality Assurance and Performance Improvement(QAPI) in Your Nursing Home", ~ (2012)
- Centers for Medicare & Medicaid Services, "Long-Term Care Hospital Prospective Payment System", ~ (2017)
- Centers for Medicare & Medicaid Services, "CMS Manual System", ~ (2017)
- Cook. E., "Development of an Infection Control Program for Long-Term Care Facilities", Statewide Program for Infection Control & Epidemiology, ~ (2015)
- Cook. E., "Basic Infection Prevention In Long Term Care Facilities", Statewide Program for Infection Control & Epidemiology, ~ (2015)
- Damani, N., "Manual of Infection Control Procedures" (2003), Greenwich Medical Media Limited
- Department of Health, "Prevention and Control of Infection in Care Homes: An Information Resource", ~ (2013)
- Felemban. O., "Infection Prevention and Control Programs in Community -Based Home Visiting Nursing in Southeast Queensland, Australia: A Case Study", PhD, pp.2014
- Herrick, S., "Minding our Business: Designing an Infection Control Program", Home Care Provider, 1(3), pp.153~156 (1996)
- IPAC Canada, "Infection Prevention and Control(IPAC) Program Standard", ~ (2016)
- IPAC Canada, "IPAC Canada Core Competencies for Infection Control Professionals", ~ (2016)
- IPAC Canada, "Infection Prevention and Control Core Competencies for Health Care Workers: A Consensus Document", ~ (2016)
- McCulloch, J., "Infection Control Science, Management and Practice" (2000), Whurr
- Medizinischer Dienst des Spitzenverbandes Bund der Krankenkassen, "Qualitätsprüfungs-Richtlinien Transparenzvereinbarung, Grundlagen der Qualitätsprüfungen nach den §§ 114 ff SGB XI Teil 2 -" (2018), Stationäre Pflege
- National Center for Emerging and Zoonotic Infectious Diseases, "NHSN 2017 Training : Long Term Care Session", ~ (2017)
- National Center for Emerging and Zoonotic Infectious Diseases, "The National Healthcare Safety Network(NHSN). Long Term Care Facility Component:Tracking Infectious in Long-Term Care Facilities", ~ (2018)
- National Health and Medical Research Council, "Australian Guidelines for the Prevention and Control of Infection in Healthcare", ~ (2010)
- Long Term Care Facility Component : Annual Facility Survey, "National Healthcare Safety Network", Centers for Disease Control And Prevention, ~ (2017)
- Nova Scotia, "Infection Prevention and Control: Guideline for Long-Term Care Facility", ~ (2015)
- Ontario, "Best Practices for Infection Prevention and Control Programs in Ontario", ~ (2012)
- Rhinehrt, E., "Infection Control in Home Care and Hospice" (2006), Jones and Bartlett Publisher
- Infection Prevention in Long Term Care Facilities, "Robert Koch Institut", ~ (2011)
- World Health Organization, "Instructions for National Infection Prevention and Control Assessment Tool 2 (IPCAT2)", ~ (2017)