Journal of Korean Critical Care Nursing (중환자간호학회지)

Korean Society of Critical Care Nursing (한국중환자간호학회)
권호 표지

Path Analysis of Performance of Multidrug-Resistant Organisms Management Guidelines among Intensive Care Unit Nurses : With Focus on the Theory of Planned Behavior and Patient Safety Culture

중환자실간호사의 다제내성균 감염관리지침 수행에 영향을 미치는 요인에 관한 경로 분석 ; 계획된 행위이론과 환자안전문화를 중심으로

  • Gu, Ji Eun (Emergency Intensive Care Unit, Pusan National University Hospital) ;
  • Ha, Yi Kyung (College of Nursing, Pusan National University) ;
  • Hwang, Su Ho (Emergency Intensive Care Unit, Pusan National University Hospital) ;
  • Gong, Kyung Hee (Emergency Intensive Care Unit, Pusan National University Hospital)
  • 구지은 (부산대학교병원 응급중환자실) ;
  • 하이경 (부산대학교 간호대학) ;
  • 황수호 (부산대학교병원 응급중환자실) ;
  • 공경희 (부산대학교병원 응급중환자실)
  • Received : 2018.01.17
  • Accepted : 2018.02.05
  • Published : 2018.02.28
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose : The purpose of this study was to analyze factors influencing the adherence to guidelines for intensive care unit (ICU) nurses to control infections due to multidrug-resistant organisms (MDRO). Method : Participants were 194 ICU nurses at 3 university hospitals. Questions for the survey inquired about attitude, subjective norms, perception of patient safety culture to carry out MDRO management guidelines, perceived behavior control (PBC), and intention, based on the theory of planned behavior. Path analysis were utilized. Results : The path analysis presented that PBC, perception of patient safety culture, and intent had a direct effect on MDRO management guidelines. Attitude towards following the manual did not have any correlation. The hypothetical model based on the theory of planned behavior was revealed as applicable; the degree of the variance in explaining adherence to the manual was 23 %, and the variance in explaining intention to fulfill the manual was 33 %. Conclusion : The results of this study suggest that we should develop a program to improve PBC to increase adherence to MDRO management guidelines. ICU nurses' perceptions of patient safety culture should also be surveyed.

Keywords

References

  1. Agency for Healthcare Research and Quality. (2017). Hospital survey on patient safety culture. Retrieved May 1, 2017, from http://www.ahrq.gov/sops/qualitypatient-safety/patientsafetyculture/hospital/index.html
  2. Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50 (2), 179-211. https://doi.org/10.1016/0749-5978(91)90020-T
  3. Ajzen, I. (2002). Perceived behavioral control, self efficacy, locus of control, and the theory of planned behavior. Journal of Applied Social Psychology, 32 (4), 665-683. https://doi.org/10.1111/j.1559-1816.2002.tb00236.x
  4. Allegranzi, B., Storr, J., Dziekan, G., Leotsakos, A., Donaldson, L., & Pittet, D. (2007). The first global patient safety challenge "clean care is safer care": From launch to current progress and achievements. Journal of Hospital Infection, 65, 115-123. https://doi.org/10.1016/S0195-6701(07)60027-9
  5. Armitage, C. J., & Conner, M. (2001). Efficacy of the theory of planned behaviour: A meta analytic review. British Journal of Social Psychology, 40 (4), 471-499. https://doi.org/10.1348/014466601164939
  6. Cho, G. L., & Choi, J. S. (2010). Knowledge of and compliance with standard precautions by nurses in intensive care unit. Journal of Korean Academy of Fundamentals of Nursing, 17 (1), 73-81.
  7. De Wandel, D., Maes, L., Labeau, S., Vereecken, C., & Blot, S. (2010). Behavioral determinants of hand hygiene compliance in intensive care units. American Journal of Critical Care, 19 (3), 230-239. https://doi.org/10.4037/ajcc2010892
  8. Fedorowsky, R., Peles-Bortz, A., Masarwa, S., Liberman, D., Rubinovitch, B., & Lipkin, V. (2015). Carbapenem-resistant Enterobacteriaceae carriers in acute care hospitals and postacute-care facilities: The effect of organizational culture on staff attitudes, knowledge, practices, and infection acquisition rates. American Journal of Infection Control, 43 (9), 935-939. https://doi.org/10.1016/j.ajic.2015.05.014
  9. Jeong, S. Y., & Kim, O. S. (2012). The structural model of hand hygiene behavior for the prevention of healthcare-associated infection in hospital nurses. Korean Journal of Adult Nursing, 24 (2), 119-129. https://doi.org/10.7475/kjan.2012.24.2.119
  10. Jeong, S. Y., & Kim, K. M. (2016). Influencing factors on hand hygiene behavior of nursing students based on theory of planned behavior: A descriptive survey study. Nurse Education Today, 36, 159-164. https://doi.org/10.1016/j.nedt.2015.09.014
  11. Jun, J., Kovner, C. T., & Stimpfel, A. W. (2016). Barriers and facilitators of nurses' use of clinical practice guidelines: An integrative review. International Journal of Nursing Studies, 60, 54-68. https://doi.org/10.1016/j.ijnurstu.2016.03.006
  12. Kang, J., Cho, J., Kim, Y., Kim, D. H., Lee, J., Park, H. K., . . . Lee, E. N. (2009). Hospital nurses' knowledge and compliance on multidrug-resistant organism infection control guideline. Journal of Korean Academy of Nursing, 39 (2), 186-197. https://doi.org/10.4040/jkan.2009.39.2.186
  13. Kim, J. E., Kang, M. A., An, K. E., & Sung, Y. H. (2007). A survey of nurses' perception of patient safety related to hospital culture and reports of medical errors. Clinical Nursing Research, 13 (3), 169-179.
  14. Kim, J. H., & Lim, K. H. (2015). The factors influencing compliance of multidrug-resistant organism infection control in intensive care units nurses. Korean Journal of Adult Nursing, 27 (3), 325-336. https://doi.org/10.7475/kjan.2015.27.3.325
  15. Kim, S., & Cha, C. (2015). Factors related to the management of multidrug-resistant organisms among intensive care unit nurses: An application of the health belief model. Journal of Korean Academic Fundamental Nursing, 22 (3), 268-276. https://doi.org/10.7739/jkafn.2015.22.3.268
  16. Korea Centers for Disease Control and Prevention. (2016). Healthcare-associated infection control guideline. Retrieved May 10, 2017, from http://cdc.go.kr/CDC/notice/CdcKrTogether0302.jsp?menuIds=HOME001-MNU1154-MNU0005-MNU0088&cid=71755
  17. Korean Institute of Health and Social Affairs. (2016). Patient safety in Korea: Current status and policy issues. Report No 2016-02.
  18. Kwon, H. K., Jeong, J. S., Lee, B. I., & Kim, J. H. (2015). Awareness and Correlation of Patient Safety Culture and Standard Precautions among Health Care Personnel. Quality Improvement in Health Care, 21 (2), 58-72. https://doi.org/10.14371/QIH.2015.21.2.58
  19. Lee, M. R., So, H. Y., & Cho, M. K. (2005). Determinants of nurses' handwashing practice. Journal of Korean Academy of Adult Nursing, 17 (2), 268-275.
  20. Lim, J., & Bang, K. S. (2016). Effect of education on infection control for multidrug resistant organism on infection control by NICU nurses. Child Health Nursing Research, 22 (3), 172-181. https://doi.org/10.4094/chnr.2016.22.3.172
  21. Madden, T. J., Ellen, P. S., & Ajzen, I. (1992). A comparison of the theory of planned behavior and the theory of reasoned action. Personality and Social Psychology Bulletin, 18 (1), 3-9. https://doi.org/10.1177/0146167292181001
  22. Moon, J. E., & Song, M. O. (2017). A Convergence study about the performance of healthcare-associated infection control guidelines of hospital nurses-based on the theory of planned behavior. Journal of the Korea Convergence Society, 8 (5), 117-125. https://doi.org/10.15207/JKCS.2017.8.5.117
  23. O'Boyle, C. A., Henly, S. J., & Duckett, L. J. (2001). Nurses' motivation to wash their hands: A standardized measurement approach. Applied Nursing Research, 14 (3), 136-145. https://doi.org/10.1053/apnr.2001.24412
  24. Oh, H. S. (2005). National survey on nurses' knowledge of infection control in general hospitals and analysis of variables to impact on their knowledge. Korean Journal of Nosocomial Infection Control, 10 (2), 78-86.
  25. Pittet, D. (2001). Improving adherence to hand hygiene practice: A multidisciplinary approach. Emerging Infectious Diseases, 7 (2), 234-240. https://doi.org/10.3201/eid0702.010217
  26. Pittet, D., & Donaldson, L. (2006). Challenging the world: Patient safety and health care-associated infection. International Journal for Quality in Health Care, 18 (1), 4-8. https://doi.org/10.1093/intqhc/mzi093
  27. Shon, J. A., & Park, J. H. (2016). Knowledge and compliance level of the multi-drug resistnat organisms of ICU nurses. Journal of the Korea Academia-Industrial Cooperation Society, 17 (7), 280-292. https://doi.org/10.5762/KAIS.2016.17.7.280
  28. Siegel, J. D., Rhinehart, E., Jackson, M., & Chiarello, L. (2007). Management of multidrug-resistant organisms in health care settings, 2006. American Journal of Infection Control, 35 (10), S165-S193.
  29. Whitby, M., McLaws, M. L., & Ross, M. W. (2006). Why healthcare workers don't wash their hands: A behavioral explanation. Infection Control & Hospital Epidemiology, 27 (5), 484-492. https://doi.org/10.1086/503335