Factors influencing clinical nurses’ intention to report medication administration errors

Abstract

This study aims to identify factors that influence clinical nurses’ intention to report medication administration errors. Data were collected from 121 nurses in charge of administering medication at a university hospital in Gyeonggi-do, Korea, using structured questionnaires from November 25 to December 2, 2020. The intention to report medication administration errors was measured using the tool developed and modified by Kim M. (2010, 2013). Further, the Hospital Survey On Patient Safety Culture (HSOPSC) tool, which was developed by the Agency for Healthcare Research and Quality (AHRQ) and translated into Korean by Kim J. et al. (2007), was also used to assess patient safety culture. Additionally, a tool translated by Kim Y. (2017) was used to assess nurses’ attitude toward reporting medication administration errors. The tool was modified by Hung et al. (2016) by integrating Wu & Lin’s (2007) nurse evaluation for medication error reporting and Teng et al. (2009) on medication error results. In accordance with the study’s objectives, the collected data were analyzed using descriptive statistics, independent t-test, one-way ANOVA, pearson's correlation coefficient, and multiple linear regression. Additionally, the scale level of the measurement variables was determined using the IBM SPSS statistics 26.0 program. The following are the study’s main findings. 1. The subjects’ average age was 26.90±3.99 years, and 108 (89.3%) were female. Regarding the final education, 106 (83.5%) had a bachelor's degree in nursing or higher, and the average job experience was 3.88±4.26 years. 2. The average score for the main variables was 7.51±1.63 out of 10 for intention to report medication administration errors, 3.36±0.33 out of 5 for patient safety culture, and 4.85±0.58 out of 6. 3. Patient safety culture (r=.27, p=.003) and attitude toward reporting medication administration errors (r=.27, p=.003) had a statistically significant positive correlation with the intention to report medication administration errors. Additionally, within the sub-area of patient safety culture, there was a statistically significant positive correlation between patient safety culture within the department (r=.27, p=.003), safety perception and incident reporting within the department (r=.23, p=.013), and the intention to report medication administration errors. 4. The multiple regression analysis results indicated that the regression model was statistically significant (F=7.80, p=.001), and a 12% explanatory power. The statistically significant influencing factors comprised patient safety culture (β=.21, p=.018) and attitude toward reporting medication administration errors (β=.22, p=.015). In conclusion, this study confirmed that the factors influencing nurses' intention to report medication administration errors comprised patient safety culture and attitude toward reporting these errors. Therefore, to improve the intention to report medication administration errors, a patient safety culture must be established, as well as education provision to improve the attitude toward reporting medication administration errors.

본 연구는 임상간호사의 투약오류보고의도에 영향을 미치는 요인을 파악하기 위한 서술적 조사연구이다. 본 연구는 경기도 소재 대학병원에서 투약 관련 업무를 맡고 있는 간호사 121명을 대상으로 2020년 11월 25일부터 12월 2일까지 구조화된 설문지를 이용하여 자료를 수집하였다. 투약오류보고의도는 김명수(2010, 2013)가 개발 및 수정한 도구를 사용하여 측정하였고, 환자안전문화는 미국의 보건의료 연구 및 질 관리 기구(AHRQ)에서 개발한 환자안전문화 조사 도구(HSOPSC)를 김정은 등(2007)이 번안한 도구, 투약오류보고태도는 Wu & Lin (2007)의 투약오류보고에 대한 간호사 평가도구와 Teng 등(2009)의 투약오류 결과에 대한 평가도구를 Hung 등(2016)이 통합하여 수정·보완한 도구를 김예슬(2017)이 번안한 도구를 사용하여 측정하였다. 수집된 자료는 IBM SPSS statistics 26.0 프로그램을 이용하여 연구의 목적 및 측정변수의 척도 수준에 따라 기술통계, independent t-test, one-way ANOVA, pearson’s correlation coefficien 및 multiple linear regression으로 분석하였다. 본 연구의 주요 결과는 다음과 같다. 1. 대상자의 평균 연령은 26.90±3.99세이며, 성별은 여자 간호사가 108명(89.3%)으로 많았다. 최종학력은 간호학사 이상이 106명(83.5%)으로 많았고, 근무경력은 평균 3.88±4.26년이었다. 2. 주요 변수들의 평균점수는 투약오류보고의도가 10점 만점에서 7.51±1.63점이었고, 환자안전문화는 5점 만점에서 3.36±0.33점이었으며, 투약오류보고태도는 6점 만점에 4.85±0.58점이었다. 3. 투약오류보고의도는 환자안전문화(r=.27, p=.003), 투약오류보고태도(r=.27, p=.003)와 환자안전문화 하위영역 중 부서 내 환자안전문화(r=.27, p=.003), 부서의 안전인식 및 사건보고(r=.23, p=.013)가 유의한 양의 상관관계가 있었다. 4. 대상자의 투약오류보고의도에 영향을 미치는 요인을 확인하기 위해 다중 회귀분석을 실시한 결과 회귀모형은 통계적으로 유의하였고(F=7.80, p=.001), 설명력은 12%이었으며, 환자안전문화(β=.21, p=.018)와 투약오류보고태도(β=.22, p=.015)가 유의한 영향 요인으로 나타났다. 본 연구결과를 통해 임상간호사가 인식하는 환자안전문화와 투약오류보고태도가 투약오류보고의도에 영향을 미치는 요인임을 확인하였다. 따라서 투약오류보고를 촉진시키기 위한 환자안전문화를 조성하려는 노력이 필요하고, 간호사의 투약오류보고에 대한 태도를 긍정적으로 변화시키기 위한 인식 개선 교육을 강화하여 임상간호사의 투약오류보고의도를 증진시켜야 한다.