간호 ‧ 간병통합서비스 병동에서의 환자참여 침상인계 프로토콜 적용 효과
The Effect of Patient-Engaged Bedside Handoffs Protocol in Comprehensive Care Units
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목적: 본 연구의 목적은 간호∙간병통합서비스 병동에서 환자참여 침상인계 프로토콜을 적용하고, 환자참여 침상인계가 간호사와 환자에게 미치는 효과를 파악하고자 함이다. 방법: 본 연구는 무작위 집락 배정교차실험연구로, 서울소재 S의료원의 간호∙간병통합서비스를 시행하는 4개 병동 30개 집락(인수인계 팀)에 속한 104명의 환자에게 EMR 기반 인계와 환자참여 침상인계를 번갈아 적용한 후 각각의 인수인계 방법에 대해 평가하도록 하였다. 같은 병동의 139명의 간호사에게도 각각의 인수인계 방법에 대해 평가하도록 하였다. 자료는 t-test, Wilcoxon rank sum test, ANOVA, Kruskal-Walls test를 이용하여 분석하였다. 결과: 환자참여 침상인계에 대한 환자의 만족도는 EMR 기반 인계보다 높았다(Z=-5.16, p<.001). 한편, 간호사의 만족도는 환자참여 침상인계가 EMR 기반 인계보다 유의하게 낮았다(t=13.21, p<.001). EMR 기반 인계와 환차참여 침상인계의 소요시간은 통계적으로 유의미한 차이를 보이지 않았다(t=-0.48, p=.634). 결론: 환자참여 침상인계 적용에 대한 환자 만족도는 EMR 기반 인계보다 높았고, 간호사 만족도는 EMR 기반 인계보다 유의하게 낮았다. 환자참여 침상인계의 참여 경험의 이점을 확인하여 의료의 질 향상에 미치는 영향 등에 대한 연구도 함께 진행되어야 할 것이다.
Abstract
Purpose: The purpose of this study was to apply patient-engaged bedside handoffs in comprehensive care units, and to evaluate the effects of bedsides to nurses and patients. Methods: This study employed a cluster randomized cross-over design.Electrical Medical Record (EMR)-based handoffs and patient-engaged bedside handoffs were alternatively applied to 104 patients, who were assigned to a total of 30 clusters (nursing handoff teams) in 4 comprehensive care units at the S medical center in Seoul, and the patients evaluated each type of handoffs. A total of 139 nurses were also participated in the same units and evaluated each type of handoffs. Data were analyzed using t-test, Wilcoxon rank sum test, ANOVA, and Kruskal-Walls test. Results: The patient's satisfaction of the patient-engaged bedside handoffs was higher than that of the EMR-based handoffs (Z=-5.16, p<.001). On the other hand, the nurse's satisfaction of the patient-engaged bedside handoffs was significantly lower than that of the EMR-based handoffs (t=13.21, p<.001). There were no differences in length of the reporting time between two types of handoffs (t=-0.48, p=.634). Conclusion: Patient satisfaction with the patient-engaged bedside handoffs was higher than that of EMR-based handoffs, and nurses' satisfaction with the patient-engaged bedside handoffs was significantly lower than that of EMR-based handoffs. Future studies are needed regarding the impacts of patient-engaged bedside handoffs on the quality of healthcare by identifying the benefits of the handoffs.
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