Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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The Survey on the Influence of Clinical Nurse's Critical Thinking Disposition, Problem-solving Skill and Self-efficacy on Patients Safety Competencies

간호사의 비판적 사고성향, 문제해결능력 및 자기효능감이 환자안전역량에 미치는 영향

  • Received : 2016.05.16
  • Accepted : 2016.06.02
  • Published : 2016.06.30
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Abstract

This study examined the relationships among patient safety competence, critical thinking disposition, problem-solving competence, and self-efficacy of clinical nurses to identify the factors influencing the patient safety competence. A convenience sample of 373 nurses working in 4 general hospitals in a Metropolitan area in Korea was selected. After obtaining IRB approval, data collection was done with a structured self-administered questionnaire from October 14th to November 4th, 2014. The data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficient and multiple regression analysis using the SPSS WIN 21.0 program. The participants showed a moderate level of patient safety competence ($3.75{\pm}0.37$), of critical thinking disposition ($3.43{\pm}0.27$), of problem solving competence ($3.54{\pm}0.30$), and of self-efficacy ($3.58{\pm}0.47$). The patient safety competence of the participants showed a significant correlation with the critical thinking disposition (r=.493, p<.001), problem solving competence (r=.616, p<.001), and self-efficacy (r=.475, p<.001). The significant factors influencing the patient safety competence were problem solving competence (${\beta}=.403$, p<.001), self-efficacy (${\beta}=.156$, p=.005), critical thinking disposition (${\beta}=.130$, p=.018), and having the experience of reporting patient safety accidents (${\beta}=.137$, p=.002). The results suggest that educational programs to enhance the critical thinking disposition, problem-solving competence, and self-efficacy would develop the patient safety competence of clinical nurses. In addition, more effort should be placed into reinforcing the patient safety competence by activating the report of patient safety accidents.

본 논문은 임상간호사의 환자안전역량 강화를 위한 기초자료로 제공하기 위해 환자안전역량에 영향을 미치는 요인을 파악하고자 비판적 사고성향, 문제해결능력 및 자기효능감을 독립변수로 정하여 서술적 조사연구를 시행하였으며, 중소병원에 근무하는 6개월 이상 경력의 임상간호사 373명을 대상으로 하였다. 자료분석 결과 환자안전역량에 영향을 미치는 요인은 문제해결능력(${\beta}=.403$, p<.001)이 가장 큰 것으로 나타났으며 자기효능감(${\beta}=.156$, p=.005), 환자안전사고 보고 경험(${\beta}=.137$, p=.002), 비판적 사고성향(${\beta}=.130$, p=.018) 순으로 영향을 미치는 것으로 나타났다. 이들 변수는 대상자의 환자안전역량에 대해 42.3%(adj $R^2=.423$) 설명하였다(F=20.305, p<.001). 비판적 사고성향, 문제해결능력, 자기효능감은 학부과정에서부터 강조되는 것으로 실제 의료현장에서 환자의 안전을 최일선에서 다루는 임상간호사에게는 더욱이 필요한 요인이라고 볼 수 있다. 따라서 환자안전역량 강화를 위해서는 의료기관 자체 내에서 임상간호사를 위한 비판적 사고성향, 문제해결능력 및 자기효능감을 높이기 위한 교육프로그램과 같은 다양한 전략과 활동들이 요구된다고 생각된다. 또한 환자안전을 최우선으로 생각하고 환자안전사고 발생 시 적극적인 보고를 독려하는 한편 환자안전사고 보고를 저해하는 요인들을 면밀히 사정하여 보완하여 보고율 향상과 더불어 환자안전역량 강화에도 힘써야 할 것이다.

Keywords

References

  1. J. Jeong, Y. J. Seo, E. W. Nam, "Factors Affecting Patient Safety Management Activities at Nursing Divisions of Two University Hospitals", The Journal of Korean Society of Hospital Management, Vol.11, No.1, pp.91-109, 2006.
  2. World Health Organization, Final technical report for the conceptual framework for the international classification for patient safety version 1.1[Internet], World Health Organization, 2009[cited 2014. Aug], Available From: http://www.who.int/patientsafety/taxonomy/icps_full_report.pdf (accessed Mar, 2012)
  3. Walton. M. M, Shaw. T, Barnet. S, Ross. J, "Developing a national patient safety education framework for Australia", Quality and safety in Health care, Vol. 15, No. 6, pp.437, 2006. DOI: http://dx.doi.org/10.1136/qshc.2006.019216
  4. A. C. Greiner, E. Knebel(Eds.), Health Professions Education: A Bridge to Quality, pp.83-98, National Academe Press, Washington DC, 2003.
  5. H. N. Jang, "Evaluation and application of patient safety competence assessment tool - survey for nurses", Unpublished master's thesis, Seoul National University, Seoul, 2013.
  6. Y. M. Lee, "Safety Accident Occurrence to Perceptions of Patient Safety Culture of Hospital Nurses", Journal of the Korea Academia-Industrial cooperation Society, Vol.13, No.1, pp.117-124. 2012. DOI: http://dx.doi.org/10.5762/KAIS.2012.13.1.117
  7. Cronenwett. L, Sherwood. G, Barnsteiner. J, Disch. J, Johnson. J, Mitchell. P, Warren. J, "Quality and safety education for nurses", Nursing Outlook, Vol. 55, No.3, pp.122-131, 2007. DOI: http://dx.doi.org/10.1016/j.outlook.2007.02.006
  8. Korea Institute for Healthcare Accreditation, Standard of Healthcare Accreditation, pp.17-171, 2011.
  9. Rogal. S. M, "Exploring critical thinking in critical care nursing education : A pilot study", Journal of Continuing Education in Nursing, Vol.39, No.1, pp.28-33, 2008. DOI: http://dx.doi.org/10.3928/00220124-20080101-08
  10. S. M. Park, I. G. Kwon, "Factors influencing nurses' clinical decision making - focusing on critical thinking disposition", Journal of Korean Academy of Nursing, Vol.37, No.6, pp.863-871, 2007. https://doi.org/10.4040/jkan.2007.37.6.863
  11. J. A. Park, "Critical thinking disposition and clinical competence in general hospital nurses", Unpublished master's thesis, Ulsan University, Ulsan, 2008.
  12. Chartier. L, "Use of metacognition in developing diagnostic reasoning skills of novice nurses", International Journal of Nursing Terminologies and Classifications, Vol.12, pp.55-60, 2001. DOI: http://dx.doi.org/10.1111/j.1744-618X.2001.tb00119.x
  13. M. J. Kang, "Relationship between self-esteem and social problem solving of adolescent", Unpublished Master's thesis, Sogang University, Seoul, 2000.
  14. Y. H. Shin, "Influencing factors for nurses' problem solving ability related to dysfunctional beliefs and emotion regulation strategy", Unpublished mater's thesis, Yonsei University, Seoul, 2012.
  15. S. K. Chaung, "Critical thinking disposition, problem solving ability, and clinical competence in nursing students", The Journal of Fundamentals of Nursing, Vol.18, No.1, pp.71-78, 2011.
  16. Y. A. Song, "Effect of simulation-based practice by applying problem based learning on problem solving process, self-confidence in clinical performance and nursing competence", Korean Journal of Women Health Nursing, Vol.20, No.4, pp.246-254, 2014. DOI: http://dx.doi.org/10.4069/kjwhn.2014.20.4.246
  17. H. J. Choi, "The effects of PBL(Problem-Based Learning) on the metacognition, critical thinking, and problem solving process of nursing students", Journal of Korean Academy of Nursing, Vol.34, No.5, pp.712-721, 2004. https://doi.org/10.4040/jkan.2004.34.5.712
  18. A. Bandura, In A. Baum, S. Newman, J. Wienman, R. West, & C. McManus (Eds.), Cambridge Handbook of Psychology, Health and Medicine : Self-Efficacy and Health Behaviour, pp.160-162, Cambridge University Press, Cambridge, 1997.
  19. Parker, E. Louise, "When to fix it and when to leave: Relationships among perceived control, self-efficacy, dissent, and exit", Journal of Applied Psychology, Vol.78, No.6, pp.949-959, 1993. DOI: http://dx.doi.org/10.1037/0021-9010.78.6.949
  20. Paul. R, Pintrich and Elisabeth. V, De. Groot, "Motivational and self-regulated learning components of classroom academic performance", Journal of Educational Psychology, Vol.82, pp.33-40, 1990. DOI: http://dx.doi.org/10.1037/0022-0663.82.1.33
  21. M, D. Snyder, "Factors related to registered staff nurse clinical competency", Unpublished doctoral dissertation, Loyola University of Chicago, 1994.
  22. E. S. Park, "The relation between self-efficacy and work performance ability of the operation room nurse", Unpublished master's thesis, Hanyang University, Seoul, 2014.
  23. H. Y. Yang, "Study on the Effect of Perception of Hospital Nurses Toward the Patient Safety Culture on the Safety Nursing Activity : Focusing on suncheon region", Unpublished master's thesis, Sunchon National University, Chonnam, 2009.
  24. N. J. Han, "The awareness on patient safety culture and the degree of safe nursing activity of hospital nurses', Unpublished master's thesis, Kyung book National University, Daegu, 2012.
  25. Y. J. Lee, "Patient safety culture and management activities perceived by hospital nurses", Unpublished master's thesis, Eulji University, Daejeon, 2011.
  26. N. J. Lee, "Perception of patient safety culture and safety care activity among nurses in small-medium sized general hospitals", Unpublished master's thesis, Jeju University, Jeju, 2011.
  27. J. E. Kim, M. A. Kang, K. E. Ahn, Y. H. Sung, "A survey of nurses' perception of patient safety related to hospital culture and reports of medical errors", Clinical Nursing Research, Vol.13, No.3, pp.169-179, 2007.
  28. Donley. Sr. R, "Health care reform: Implications for staff development", Nursing Economics, Vol.12, No.2, pp.71-74, 1994.
  29. S. H. Park, "The effects of the program for the improvement of college students' critical thinking ability", Unpublished doctoral dissertation, Sookmyung Woman's University, Seoul, 1999.
  30. Heppner, P. Paul, and Chris H. Petersen, "The development and implications of a personal problem solving inventory", Journal of Counseling Psychology, Vol.29, No.1, pp.66-75, 1982. DOI: http://dx.doi.org/10.1037/0022-0167.29.1.66
  31. S. K. Chun, "The social skills training for social adjustment of the schizophrenic patients", The Korean Academy of Mental Health Social Work, Vol.2, pp.33-50, 1995.
  32. M. Sherer, J. E. Maddux, B. Mercandante, S. Prentice-Dunn, B. Jacobs, R. W. Rogers, "The self-efficacy scale: construction and validation", Psychological Reports, Vol.51, pp.663-671, 1982. DOI: http://dx.doi.org/10.2466/pr0.1982.51.2.663
  33. H. Y. Hong, "(The) Relationship of perfectionism, self-efficacy and depression", Unpublished master's thesis, Ewha Womans University, Seoul, 1995.
  34. N. J. Lee, "Development of questionaries to measure baccalaureate nursing student's patient safety competencies", The 11th International Congress on Nursing Informatics, Montreal, Quebec, Canada, 2012.
  35. J. S. Park, "Critical thinking disposition of preceptor nurse and professional nursing competence of new graduate nurse", Journal of Nursing Education, Vol.35, pp.12-18, 2008.
  36. J. W. Hwang, "(A) Study on the relationships between critical thinking disposition and professional nursing competence", Unpublished master's thesis, Ewha Womans University, Seoul, 1998.
  37. H. R. Choi, D. S. Cho, "The Influence of nurses' performance with critical thinking disposition and problem solving process", Unpublished master's thesis, Eulji University, Daejeon, 2011.
  38. M. Y. Kim, "Affecting Factors on Clinical Competence of Nursing Students", Journal of the Korea Academia-Industrial cooperation Society. Vol. 16, No.3, pp.1884-1893, 2015. DOI: http://dx.doi.org/10.5762/KAIS.2015.16.3.1884
  39. M. S. Lee, & Y. O. Ha, "Critical Thinking Disposition, Professional Self-Concept and Satisfaction of Clinical Practice in Nursing Students," Journal of the Korea Academia-Industrial cooperation Society. Vol.16, No.12, pp.8737-8744, 2015. DOI: http://dx.doi.org/10.5762/KAIS.2015.16.12.8738
  40. J. Yoon, "Development of an instrument for the measurement of critical thinking disposition : In nursing", Unpublished doctoral dissertation, the Catholic University, Seoul, 2004.
  41. A. N. Park, K. H. Chung, W. G. Kim, "A study on the critical thinking disposition, self-directed learning readiness and professional nursing competency", The Journal of Korean Nursing Administration Academic Society, Vol.22, No.1, pp.1-10, 2016. DOI: http://dx.doi.org/10.11111/jkana.2016.22.1.1
  42. S. Yang, G. J. Lee, S. J. Yu, "Self-evaluative awareness of problem solving ability in psychiatric nurse practitioners", Journal of Korean Public Health Nursing, Vol.16, No.2, pp.378-387, 2002.
  43. R. W. Ma, "Critical thinking disposition and problem solving ability of nursing students", Unpublished master's thesis, Ewha Woman's University. Seoul, 2009.
  44. A. S. Jung, "A study on the relations between a health promoting behaviors and self-efficacy in general hospital nurse", Unpublished master's thesis, Hanyang University, Seoul, 2007.
  45. Y. S. Bong, "(The) Factors influencing the job satisfaction of nurses", Unpublished master's thesis, Chonnam National University, Gwangju, 2007.
  46. A. Bandura, "Self-efficacy. In R. J. Corsini (Ed.)", Encyclopedia of psychology, Vol.3, pp.368-369, 1994.
  47. A. K. Lee, "Comparison of self-efficacy, clinical performance and communication ability between clinical nurses and oncology nurses", Unpublished master's thesis, Kyungsang University, Kyungsangnamdo, 2013.
  48. M. H. Nam, "The cognition level on the patient safety and safe nursing activities among hospital nurses in busan", Unpublished doctoral dissertation, Injae University, Kyungsangnamdo, 2010.
  49. M. J. Sohn, "(The) effects of perception of hospital nurses toward safety climate on safety performance", Unpublished master's thesis, Seoul National University, Seoul, 2012.
  50. S. S. Huh, H. Y. Kang, "The Attitude of Patient Safety and Patient Safety Management Activity in Nursing Students," Journal of the Korea Academia-Industrial cooperation Society. Vol.16, No. 8, pp.5458-5467, 2015. DOI: http://dx.doi.org/10.5762/KAIS.2015.16.8.5458
  51. J. H. Park, "Knowledge, attitude, and confidence on patient safety of undergraduate nursing students", Unpublished master's thesis, Kyemyung University, Daegu, 2011.
  52. S. J. Park, "A study on hospital nurses' perception of patient safety culture and safety care activity", Unpublished master's thesis, Donga University, Busan, 2009.
  53. J. H. Choi, K. M. Lee, M. A. Lee, "Relationship between hospital nurses' perceived patient safety culture and their safety care activities", The Journal of Korean Academy Fundamental nursing, Vol.17, No.1, pp.64-72, 2010.
  54. S. H. Kang, "The cognition level on the patient safety and safe nursing activities among hospital nurses in busan", Health and Social Science, Vol. 28, pp.197-221, 2010.
  55. Y. H. Kim, Y. M. Lee, "Relationship of Learning Motivation, Self-Directed Learning Ability and Problem Solving Process of Nursing Students after Practice Evaluation of Fundamentals of Nursing Course using Role Play", Journal of the Korea Academia-Industrial cooperation Society. Vol.13, No. 1, 147-155, 2012. DOI: http://dx.doi.org/10.5762/KAIS.2012.13.1.147
  56. K. H. Lee, J. S. Song, "The effect of emotional intelligence on self-efficacy and job stress of nurses : mediating role of self-efficacy", The Journal of Korean Nursing Administration Academic Society, Vol.16, No.1, pp.17-25, 2010. DOI: http://dx.doi.org/10.11111/jkana.2010.16.1.17
  57. M. R. Song, "Effects of organizational communication and incident reports on patient safety management activities in nurses", Unpublished master's thesis, Hanyang University, Seoul, 2014.
  58. M. S. Kim, Y. H. Kim, "Development and Evaluation of Patient Safety Reporting Promoting Education Program", Journal of the Korea Academia-Industrial cooperation Society. Vol.13, No.1, pp.284-295, 2012. DOI: http://dx.doi.org/10.5762/KAIS.2012.13.1.284
  59. JCAHO, Sentinel Event Data: Root Causes by Event Type, [cited 2015 Oct], Available From: http://www.jointcommission.org/assets/1/18/Root_Causes_by_Event_Type_2004-2014.pdf, (accessed Oct., 2015)