안전한 진료지원업무 수행을 위한 전문간호사 표준업무기술서 제안
Standard Job Description for Advanced Practice Nurses to Ensure Safe Medical Support Tasks
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목적: 본 연구는 간호사가 수행하는 진료지원업무의 적정 운영 방안을 찾아보고자 수행되었다. 방법: 본 연구는 크게 3단계로 수행되었다. 1) 진료지원업무를 수행하는 20명의 간호사를 대상으로 한 인터뷰 결과와 문헌 분석을 통해 진료지원업무 수행도 측정 설문지 개발, 2) 총 625명(전문간호사 248명, 전담간호사 254명, PA간호사 123명)을 대상으로 진료지원업무 수행도 조사, 3) 전문간호사 표준업무기술서 도출. 결과: 인터뷰와 문헌고찰을 통해 총 65문항의 진료지원업무가 추출되었고, 최종 61문항의 진료지원업무 수행도 측정 설문지를 개발하였다. 설문조사 결과, 전담간호사와 PA간호사의 임상 경력과 교육수준이 전문간호사에 비해 유의하게 낮았으며, 43개의 업무에서 전문간호사와 전담간호사(PA간호사 포함) 간 수행도의 차이를 보였다. 설문결과를 바탕으로 총 38개의 task, 76개의 업무가 전문간호사의 표준업무기술서로 정리되었다. 결론: 환자안전을 위해 자격을 갖춘 전문간호사제도를 활성화하는 방안에 대한 논의가 필요하다. 또한 본 연구를 통해 제시된 전문간호사 표준업무기술서를 바탕으로 각 병원별 상황에 맞춘 업무지침을 개발하고, 수가 개발 등에 활용할 것을 제안한다.
Abstract
Purpose: This study aimed to assess a nurse's performance of medical support tasks (MST) and to propose optimal management strategies for these tasks. Methods: This study was conducted in three stages: 1) Development of a questionnaire to measure the performance of MST through interviews with 20 nurses performing the tasks and literature analysis, 2) A survey on the performance of MST among a total of 625 nurses (248 advanced practice nurses (APNs), 254 clinical practice nurses (CPNs), and 123 physician assistant (PA)), and 3) Derivation of a standard job description for APN. The survey data were collected between 7 February and 15 March 2024. Results: A total of 65 items of MST were identified by interviews and literature review, and a final questionnaire consisting of 61 items was developed to measure the performance of the tasks. The results showed that the clinical experience and education level of CPNs and PA were significantly lower than those of APNs. There were differences in performance across 43 tasks between APNs and CPNs (including PA). Based on the survey results, 13 tasks and 76 activities were organized into a standard job description for APNs. Conclusion: It is necessary to discuss how to promote the system of qualified APN system for patient safety. Additionally, we suggest developing guidelines tailored to the specific circumstances of each hospital based on the standard job description for APNs presented in this study and utilizing the guidelines in developing reimbursement models
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