임상간호사의 실금관련피부염에 대한 지식, 태도 및 수행 정도
The Clinical Nurses' Knowledge, Attitudes, and Performance on Incontinence Associated Dermatitis
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목적: 실금관련피부염은 소변이나 대변에 의한 자극으로 나타난 피부 손상으로 이는 배설물에 포함된 효소와 같은 화학적 자극과 물리적 자극으로 인하여 발생한 것을 의미한다. 실금관련피부염은 임상에서도 흔히 볼 수 있는 피부 문제로 조기에 발견하여 치료하지 않으면 피부가 벗겨지고 세균이나 진균에 의한 이차 감염이 유발될 수 있으며, 압력, 마찰력 및 전단력에 취약해지기 때문에 욕창으로 쉽게 진행될 수 있다. 이에 본 연구는 임상간호사들의 실금관련피부염에 대한 지식, 태도 및 수행 정도를 파악하여 수준 높은 간호를 제공하고 이에 맞는 교육 프로그램을 개발 하기 위한 객관적 자료를 마련하고자 수행되었다. 방법: 2022년 8월부터 11월까지 서울, 경기도, 전북 및 부산에 소재한 6개 의료기관을 대상으로 하였으며, 수간호사와 외래에서 근무하는 간호사를 제외한 간호사 656명을 대상으로 하였다. 결과: 실금관련피부염에 대한 지식 점수는 25점 만점에 17.98±2.91로 71.9% 정답률을 보였으며, 태도는 100점 만점에 76.34±7.85점으로 긍정적인 태도를 보였다. 수행 정도는 125점 만점에 91.53±16.18점으로 높은 정도의 수행 정도를 보였다. 실금관련피부염에 대한 지식, 태도 및 수행과의 상관관계는 모두 양의 상관관계를 보였다. 결론: 실금관련피부염은 환자 안전 지표인 욕창 발생의 주된 원인이자 악화 요인으로 병원에서 발생하는 실금관련피부염을 감소시키는 것은 결국 욕창 발생 위험을 감소시킬 수 있기 때문에 이를 예방하고 조기 발견하는 것은 무엇보다도 중요하다고 할 수 있다. 따라서 간호사의 지식을 향상시키고 수행도를 높이기 위해 실금관련피부염으로만 특화된 교육 프로그램이 필요하며, 욕창과의 감별 진단 능력을 향상시키기 위한 사례 기반 교육 및 임상 술기 교육이 필요하겠다.
Abstract
Purpose: Incontinence-associated dermatitis (IAD) is widespread and a common problem in healthcare settings, It is defined as irritation of the perineal skin due to contact with urine, feces, or both. It is one of the major risk factors for the development of pressure injuries are regarded as a quality indicator of nursing care. It is important to understand the knowledge and attitudes of nurses who are primarily responsible for providing appropriate nursing care that includes differentiation of IAD from other skin breakdowns, and appropriate management. Therefore, the purpose of this study was to determine the knowledge, attitudes, and performance of IAD among clinical nurses in Korea. Methods: Data about IAD knowledge, attitudes, and performance were collected from August to November 2022. 656 nurses from six hospitals participated in the study. Results: The mean scores of nurses’ knowledge, attitudes, and performance were 17.98±2.91, 76.34±7.85, and 91.53±16.18, respectively. Nurses' knowledge showed a positive correlation in both attitudes (r=0.27, p<.001) and performance (r=0.09, p=.02), and attitudes and performance (r=0.34, p<.001) also showed a positive correlation. Conclusion: To improve the knowledge and performance of nurses, an educational program consisting only of incontinence-related dermatitis is needed, and case-based education and clinical skills education are needed to enhance the ability to differentiate from pressure injury.
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