한국형 환자참여 간호사 침상인계 프로토콜 개발 및 평가
Development and Evaluation of a Protocol for Bedside Nursing Handoff with Patient Engagement in a Tertiary Hospital in South Korea
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목적: 본 연구의 목적은 한국형 환자참여 간호사 침상인계 프로토콜을 개발하여 국내 종합병원에 적용하여 임상 적용 효과를 평가하기 위함이다. 방법: 한국형 환자참여 침상인계 프로토콜은 문헌고찰과 전문가 그룹의 자문을 기반으로 개발되었다. 임상 적용 효과평가는 국내 일 종합병원 내·외과 3개의 병동에서 시행되었다. 프로토콜의 적용 효과를 평가하기 위해 한국형 환자참여 간호사 침상인계 적용 전후의 환자용 간호사 침상인계 평가, 간호사용 간호사 침상인계 평가와 인계 소요시간을 측정하였다. 자료수집은 2018년 6월부터 8월까지 이루어졌으며, 수집된 자료를 분석하기 위해 SPSS 25.0 프로그램을 사용하여 기술통계와 One-way ANOVA로 분석하였다. 결과: 본 연구를 통해 개발된 한국형 환자참여 간호사 침상인계는 2단계로 이루어졌다. 1단계는 간호사-간호사 인계, 2단계는 두 명의 간호사가 환자의 침상 옆에서 실시하는 인수인계이다. 간호사용 간호사 침상인계 평가 항목 중 프로토콜 적용 후 환자참여에 대한 점수가 유의하게 증가하였다(F=17.85, p<.001). 환자용 간호사 침상인계 평가 항목 중에는 퇴원계획(F=7.86, p<.001), 개인 건강 정보의 보호(F=4.46, p=.012), 담당 간호사 확인(F=3.19, p=.042)에 대한 항목이 적용 후 유의하게 증가한 것으로 확인되었다. 한국형 환자참여 간호사 침상인계와 일반적 인수인계의 소요시간 차이에 있어서는 유의한 차이가 없었다(F=0.61, p=.054). 결론: 한국형 환자참여 간호사 침상인계 프로토콜 적용 후 환자용 간호사 침상인계 평가는 유의하게 점수가 증가한 반면 간호사용 침상인계 평가에서는 유의한 차이를 보이지 않았다. 간호사용 침상인계 평가결과에 따르면 프로토콜 적용에 대한 적절한 교육이 선행되어야 간호사의 적응력을 높이고, 간호인력에 대한 문제 또한 개선되어야 간호사들이 환자참여 간호사 침상인계 프로토콜의 활용에 적극적으로 참여할 수 있는 것으로 나타났다. 환자참여 간호사 침상인계는 환자참여를 증진시킴으로써 환자안전과 건강성과에 기여할 수 있을 것이다.
Abstract
Purpose: This study aimed to develop a bedside nursing shift report protocol and evaluate the effect of the protocol in a tertiary hospital in South Korea. Methods: The bedside nursing handoff protocol with patient engagement was developed based on the literature review and the validation of an expert group. The effect of the protocol on clinical implication was tested in three medical-surgical units in a tertiary hospital. Outcomes were assessed by patient perception, nurse perception, and reporting time. Data collected from June to August in 2018 and analyzed with descriptive statistics and One-way ANOVA using SPSS version 25.0. Results: The bedside nursing shift report protocol with patient engagement consisted of two steps: nurse to nurse report and bedside report with patients. Nurse’s perception with patient engagement was significantly increased after applying protocol (F=17.85, p<.001). Patient’s perception was significantly improved in the areas of discharge plan (F=7.86, p<.001), health information privacy (F=4.46, p=.012) and identify attending nurse (F=3.19, p=.042). There were no differences in reporting time between the bedside nursing shift report and a traditional shift report (F=0.61, p=.054). Conclusion: Patient perception was significantly increased, while nurse perception was not different after applying this protocol. For the change in the perception of nurses, education may be preceded to improve nurses' competence for the bedside shift report. Furthermore, the support in enough nurse staffing should be needed for encouraging the bedside shift report. The bedside shift report may enhance patient engagement. Therefore it may improve patient safety and health outcome in clinics.
참고문헌 (30)
- The world health report 2007: A safer future: Global public health security in the 21st century, "World Health Organization", World Health Organization, ~ (2007)
- "2012 Joint commission. national patient safety goals" (2012)[URL]
- Manojlovich M, "Healthy work environments, nurse-physician communication, and patients' outcomes", American Journal of Critical Care, 16(6), pp.536~543 (2007)
- "Guide to patient and family engagement in hospital quality and safety" (2017)[URL]
- Olsson E, "Pharmacist-patient communication in Swedish community pharmacies", Research in Social and Administrative Pharmacy, 10(1), pp.149~155 (2014)[DOI]
- "Global strategic directions for strengthening nursing and midwifery 2016-2020" (2016)[URL]
- Mokoka KE, "Factors influencing the retention of registered nurses in the Gauteng Province of South Africa", Curationis, 34(1), pp.E1~E9 (2011)[DOI]
- Sibiya MN, "Nursing", pp.19~ (2018), IntechOpen Limited
- Friesen MA, "Patient safety and quality: An evidence-based handbook for nurses" (2008), Agency for Healthcare Research and Quality
- "Handoffs in hospitals: A review of the literature on information exchange while transferring patient responsibility or control" (2009)[URL]
- "Bedsiderapportering: Inneliggande patienters upplevelse" (2018)[URL]
- Ernst KM, "Nurse-to-nurse shift handoffs on medical-surgical units: A process within the flow of nursing care", Journal of Clinical Nursing, 27(5-6), pp.e1189~e1201 (2018)[DOI]
- Hospital survey on patient safety culture: 2010 user comparative database report, "Sorra J", US Department of Health and Human Services, Agency for Healthcare Research and Quality, ~ (2010)
- Guide to patient and family engagement: Environmental scan report, "Maurer M", US Department of Health and Human Services, Agency for Healthcare Research and Quality, ~ (2012)
- "Hot topics in health care: Transitions of care:The need for a more effective approach to continuing patient care" (2012)[URL]
- Friesen MA, "Patient safety and quality: An evidence-based handbook for nurses" (2008), Agency for Healthcare Research and Quality
- Mardis T, "Bedside shift-to-shift handoffs: A systematic review of the literature", Journal of Nursing Care Quality, 31(1), pp.54~60 (2016)[DOI]
- Radtke K, "Improving patient satisfaction with nursing communication using bedside shift report", Clinical Nurse Specialist, 27(1), pp.19~25 (2013)[DOI]
- Sand-Jecklin K, "A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation", Journal of Clinical Nursing, 23(19-20), pp.2854~2863 (2014)[DOI]
- Bradley S, "Adopting a patient-centred approach: An investigation into the introduction of bedside handover to three rural hospitals", Journal of Clinical Nursing, 23(13-14), pp.1927~1936 (2014)[DOI]
- Thomas L, "Blending evidence and innovation: Improving intershift handoffs in a multihospital setting", Journal of Nursing Care Quality, 27(2), pp.116~124 (2012)[DOI]
- Trossman S, "Shifting to the bedside for report", The American Nurse, 41(2), pp.7~ (2009)
- Dearmon V, "Transforming Care at the Bedside(TCAB):Enhancing direct care and value-added care", Journal of Nursing Management, 21(4), pp.668~678 (2013)[DOI]
- Laws D, "Incorporating bedside reporting into changeof-shift report", Rehabilitation Nursing, 35(2), pp.70~74 (2010)[DOI]
- 김진현, "간호·간병통합서비스 운영성과 및 향후 정책방향", 간호행정학회지, 23(3), pp.312~322 (2017), 간호행정학회[DOI]
- Health care personnel policies and measures for securing workforce, "Lim J", Korean Health and Medical Industry Workers' Union, ~ (2017)
- Ferguson TD, "Bedside reporting: Protocols for improving patient care", Nursing Clinics of North America, 50(4), pp.735~747 (2015)[DOI]
- Baker SJ, "Bedside shift report improves patient safety and nurse accountability", Journal of Emergency Nursing, 36(4), pp.355~358 (2010)[DOI]
- Johnson C, "Communicate with me:Information exchanges between nurses", Canadian Nurse, 111(2), pp.24~27 (2015)
- Schirm V, "Evaluation of bedside shift report: A research and evidence-based practice initiative", Applied Nursing Research, 40, pp.20~25 (2018)[DOI]