護理主管對感染管制認知、態度與行為及其相關因素探討

A Survey of the Facotrs Associated with Cognition, Attitude, and Behavior of Nursing Administrators in Infection Control

護理人員是醫院裡執行感染管制工作第一線的人員，而護理主管則是監督這些基層人員最重要的單位主管。本研究目的是探討護理主管對感染管制的認知、 態度和行為，三者的影響因子和其相關性。本研究採用橫斷式問卷調查法，從 2008年6月至8月對台灣四家地區醫院級以上的醫院進行調查。總共發出160 問卷，實際回收150份，回收率為93.8％，有效問卷共149份。研究結果發 護理主管對消毒滅菌和禽流感的防護措施認知較為不足。幾乎所有的護理主管都認為感染管制是重要的事，但執行上很麻煩。任職非教學醫院和接受感染管制教育課程的動機較弱的護理主管，其態度量表的分數較差。主管年資小於一年的 行為量表分數較差。以Pearson's積差相關分析發現，認知會影響態度，態度會影響行為(p<0.05)，但認知卻無法直接影響行為。本研究建議，除了調整感染控制課程來彌補護理主管的認知較不足的部分外，將認知轉化成態度才是落實感染控制行為最重要的部分。另外主管年資不足一年的新主管，則需要在感控方面提供協助和指導，以落實感控行為。藉由護理主管的帶領作用，將感染管制落實到單位部屬的行為中，提升醫院整體的照護品質。

In a hospital, nurses are the first-line members involved in controlling infection, and nursing administrators are directors of that daily practice. The purpose of this study was to explore the relevant factors and relationships of cognition, attitude, and behavior among the nursing administrators while controlling infection. The research design involved a cross-sectional questionnaire survey in the four hospitals assessed above the level of regional hospital, from June to August 2008. We sent out 160 questionnaires, 150 of which were returned. The rate of return was 93.8% and 149 of the returned questionnaires were valid. This study showed that the nursing administrators had poor cognition regarding disinfection and precautionary procedures for avian flu. Nearly all of them considered infection control as important but not sufficiently convenient to be executed. The nursing administrators of the regional hospital and those with little concern for teaching infection control programs had worse scores on attitude questionnaires. Those administrators with experience of less than 1 year had worse scores on behavior questionnaires. On analysis with Pearson’s product-moment correlation, it was found that cognition can affect attitude, and that attitude can in turn affect behavior. However, cognition does affect behavior directly. This research suggests that the transformation from cognition to attitude is most important for strengthening behavior in infection control. For the nursing administrators with experience of less than 1 year, special guidance or supervising may be needed to improve their behavior in infection control. With the help of nursing administrators, infection control can be an everyday practice, promoting the quality of medical care in hospitals.