전국 의료기관의 냉 요법 실무지침 및 임상간호사의냉 요법 실무 현황
Nursing Protocols of Cold Application in Different Medical Institutions in Korea
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연구목적: 이 연구의 목적은 국내 의료기관의 냉요법 실무지침과 냉요법 실무 현황을 파악하기 위하여 전국적인 실태조사를 하는 것이다. 연구방법: 본 연구는 서술적 조사연구로, 전국의 의료기관을 대상으로 종합병원, 병원, 요양병원을 각각 50개 기관씩 무작위 선정하였다. 연구대상은 의료기관과 간호사로 구분되는데, 간호사는 무작위 선정된 해당 의료기관 중 126개 의료기관의 435명이 참여하였고, 의료기관은 총 124개 기관이 참여하였다. 자료수집 기간은 2014년 12월부터 2015년 7월까지였다. 연구결과: 전체 의료기관의 39.5%인 42개 기관에서 기관차원의 냉요법 실무지침을 사용하고 있었으며, 간호사들이 보고한 냉요법 적용시간은 2분부터 5시간까지 큰 편차를 보였다. 가장 흔히 사용하는 냉요법 기구는 냉동 젤팩과 얼음팩, 얼린 수액백 순으로 나타났다. 기관의 유형(χ2=7.78, p=.020), 간호단위(χ2=26.42, p<.001)에 따라 냉요법 적용시간이 유의한 차이가 있었으며, 간호단위(χ2=12.23, p=.032)에 따라 적용 간격이 유의한 차이를 보였다. 또한 냉요법 기구는 지역(χ2=70.38, p<.001)에 따라 편차가 있는 것으로 조사되었다. 연구에 참여한 간호사의 95.6%가 전국 차원의 냉요법 실무지침이 필요하다고 응답하였다. 결론: 근거기반 간호지침의 부재와 국내의 주요 의료기관에서의 냉 요법 적용 방법의 큰 편차로 인해 일관된 간호중재를 제공하는 것이 쉽지 않다. 이에 본 연구자는 냉 요법 기구에 대한 안전성과 효과성을 확인할 수 있는 기초연구와 함께 전국적으로 활용 가능한 냉 요법 간호 실무 지침을 개발할 것을 제언한다.
Abstract
Purpose: The purpose of this study was to evaluate nursing protocols for superficial cryotherapy in different medical institutions. Methods: The study was conducted with a cross-sectional descriptive design. The medical institutions including general hospitals, hospitals, and geriatric hospitals were randomly selected. A total of 435 nurses from 126 institutions completed a questionnaire. Data were collected from December 2014 to June 2015. Results: Forty-two institutions (39.5%) had nursing protocol for cryotherapy. The nurses reported that durations of cold application were 2 minutes to 5 hours. Frequently used cold therapy devices in order of frequency were frozen gel packs, ice packs, and frozen IV fluid bags. There were variances in the duration of cold application according to the types of institution (x2=7.78, p=.020) and nursing units (x2=26.42, p<.001). In addition, intervals of cold application were different according to the nursing units (x=12.23, p=.032). There were differences in cold application instruments by regional groups (x=70.38, p<.001). Most of the nurses (95.6%) responded that national nursing protocol for superficial cryotherapy were needed. Conclusion: There were difficulties in providing consistent nursing interventions because of the practical differences and absence of evidence-based guidelines for cryotherapy. The researchers recommend that basic studies with various instruments be conducted and proper nursing protocols be developed for cryotherapy.
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