상급종합병원과 종합병원의 근거기반 임상간호실무지침의 활용도
Utilization of Evidence-Based Clinical Nursing Practice Guidelines in Tertiary Hospitals and General Hospitals
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목적: 본 연구는 전국의 500병상 이상의 상급종합병원과 종합병원을 모집단으로 하여 병원간호사회에서 개발하여 보급한 11종, 14개의 간호실무지침의 비치 실태와 활용 실태를 파악하고 간호실무지침의 채택 이유를 파악하여 실무지침의 활용을 증가시킬 수 있는 전략을 마련하고자 시도되었다. 방법: 전국 500병상 이상의 상급종합병원과 종합병원 79개 중 70개 병원으로부터 자료를 수집하였다. 결과: 간호부의 간호실무지침 비치 실태는 약 72.9~90.1% 수준이었으며, 병동 내 비치는 24.3~35.8% 수준이었다. 병원별로 활용되고 있는 11종의 실무지침은 평균 3.96±3.88종이었다. 근거기반지침의 활용도는 평균 2.85±0.79점으로 ‘때때로 사용’ 하는 수준이었다. 근거기반지침 활용전략의 1순위중 첫번째는 ‘간호부서장의 근거기반간호실무의 가치인식’, 두번째는 ‘실무표준수정을 통해 지침의 내용을 간호사에게 교육하는 것’, 세번째는 ‘수간호사들이 병동간호사들의 지침 사용을 독려’하는 것이었다. 결론: 간호실무지침의 활용을 증가시키기 위하여 간호부서장의 근거기반간호실무에 대한 가치인식을 증가시키고, 간호부가 근거기반간호실무에 대한 적극적인 의지를 갖고 간호실무지침을 병동에 배포하고, 실무적용을 독려할 수 있도록 간호부서장을 대상으로 하는 근거기반간호실무에 대한 워크샵 등을 통해 근거기반간호실무의 중요성, 근거기반지침의 실무적용 방법, 실무적용 시의 효과 등에 대한 인식 개선을 유도하는 것이 필요하겠다. 또한 병동 간호사의 근거기반지침 활용을 증진시키기 위해서는 근거기반지침에 대한 동영상 교육, 지침에 대한 휴대폰 앱을 개발하는 것 등이 필요하며 이에 대한 효과를 검증하는 추후 연구가 필요하겠다.
Abstract
Purpose: The purpose of this study was to investigate the actual utilization of clinical practice guidelines developed by Hospital Nurses Association. Methods: The subjects were 70 nurses who were in charge of guideline distributions in 70 advanced general hospital and general hospitals with 500 beds or more nationwide. Data were collected between June and August, 2020 by mail (return rate: 88.6%). Data were analyzed using descriptive statistics, t-test, and ANOVA with SPSS/WIN 24.0. Results: Among the clinical practice guidelinesdeveloped by Hospital Nurses Association, 72.9~90.1% were placed with book and electronic file in nursing department and 24.3~35.8% were placed with book and electronic file in each nursing unit at hospital. The average number of utilized clinical practice guidelines were 3.96±3.88, and average score of guideline utilization was score 2.85±0.79 which means ‘use sometimes’. Conclusion: To improve the distribution and utilization of the clinical practice guidelines, it is necessary to enhance the recognition of values of evidence based nursing practice targeting head of nursing department and to stimulate the distribution and utilization of the clinical practice guidelines using diverse education programs for staff nurses.
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