醫院安全氣候與個人因素對 護理人員感染控制知識及行為的影響

Impact of safety culture and personal factors on knowledge and behaviors of infection control among nurses

林春金(Chuen-Jin Lin)

指導教授 ： 李素幸

長榮大學/健康科學學院/職業安全與衛生研究所/碩士(2008年)

摘要

中文摘要
本研究目的在了解護理人員感染控制的知識及行為之現況，並進一步探討個人因素及醫院安全氣候等因素對護理人員感染控制的知識及行為之影響。本研究以結構式問卷進行資料收集，內容包括人口學特徵、醫院安全氣候、感染控制知識及感染控制行為，以立意取樣方式選取南部地區醫院，地區級以上醫院之護理人員作橫斷研究調查。共發出問卷523 份，回收有效問卷508份，有效問卷回收率99.6 %，所得資料以SPSS 10.0 for Windows 統計軟體為分析工具。研究結果顯示如下：
一、護理人員感染控制知識答對率超過七成，以「感控概念」得分最高，「隔離政策」與「汙物處理流程」得分最低。多因子分析結果顯示與感染控知識相關的影響因素包括職稱、護理總年資、宗教信仰、和安全氣候。
二、護理人員感染控制行為以「建康管理行為」及「針扎防護行為」得分最低。多因子分析結果顯示安全氣候是影響整體感染控制行為的重要因素，相對的個人因素及感染控制知識的重要性則不大。
三、護理人員對醫院安全氣候感受在「溝通」與「管理者支持態度」上感受最差。多因子分析結果顯示與醫院安全氣候相關的影響因素包括醫院類型、護理總年資、及是否有針扎與是否有傳染病經驗。
醫院安全氣候感受不僅與護理人員的感染控制知識有重要相關，且與感染控制行為間的相關性也相形重要於個人因素與感染控制知識等因素，其重要性可見一斑。而在安全氣候感受上，護理人員普遍在「溝通」與「管理者支持態度」上感受最差，因此醫院管理者在感染控制努力上，不能只侷限在感染控制知識的訓練及防護計畫或設備的添置，在心理層次上也要兼顧對護理人員的支持及溝通。
關鍵字：感染控制、感染控制知識、感染控制行為、安全氣候、護理人員、個人因素

關鍵字

感染控制 ； 感染控制知識 ； 感染控制行為 ； 安全氣候 ； 護理人員 ； 個人因素

並列摘要

Abstract
This study was designed to evaluate current knowledge and behavior regarding to infection control among nurses, and to further investigate the relations between personal factors, hospital safety climate and infection control knowledge/behavior. This study utilized a structured questionnaire as measurement tool to collect information on demographics, hospital safety climate, infection control knowledge and behavior. Study subjects were purposively and cross-sectionally selected from nurses who worked at medical center, regional and local hospitals in southern Taiwan. Five hundred and twenty three questionnaires were administered to the selected nurses, and, in the end, 508 questionnaires were returned, which accounted for 99.6% response rate. Statistical software, SPSS 10.0 for Windows, was used to analyze data. The results show as followed:
a. In average, study subjects in this study answered correctly for 70% of the infection control questions. For constructs, study subjects scored higher in the construct of infection control concept and lower in the constructs of quarantine policy and contaminated material handling procedures. Results of multivariate analysis showed that job title, years of nursing experience, religion and safety climate were importantly related to infection control knowledge.
b. For constructs of infection control behaviors, study subjects scored lower in constructs of health management behavior and needle-stick injury protection behavior. Results of multivariate analysis showed that safety climate was importantly related to infection control behavior.
c. For constructs of safety climate, study subjects scored lower in constructs of communication and attitude of management supports. Results of multivariate analysis showed that types of hospitals, years of nursing experience, events of needle-stick injury, and experiences of nursing for infectious-disease patients were importantly related to hospital safety climate.
This study showed that hospital safety climate not only importantly related to infection control knowledge, but also appeared more influential to infection control behavior than personal factors and infection control knowledge. The significance of hospital safety climate in infection control leaves no doubt. Since study subjects scored lower in constructs of communication and attitude of management supports, for hospital managers, therefore, efforts in infection control may not limit to only trainings in infectious control knowledge, design of infectious control plan and procurement of protection equipments, but also need to pay attention to psychological aspects of communication and mental supports.
Keywords: infection control, infection control knowledge, infection control behavior, safety climate, nurses, personal factors

並列關鍵字

nfection control ； infection control knowledge ； infection control behavior ； safety climate ； nurses ； personal factors

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