Moon Jeong Eun, Jang Keum Seong
Chosun Nursing College, Gwangju, Republic of Korea.
College of Nursing, Chonnam National University, Chonnam Research Institute of Nursing Science, Gwangju, Republic of Korea.
Iran J Public Health. 2018 May;47(5):648-657.
To improve efficient and systematic management and following of healthcare-associated infection guidelines, the relationship among various factors must be understood. Efforts should be made to strengthen or reduce relevant factors. We developed a structural equation model for following HAI-control guidelines.
Overall, 388 Korean registered nurses participated in this study and data collection was conducted Jul 21-Aug 31, 2014 using a self-reported questionnaire, and 392 of 400 copies were collected (98% recovery rate). Data were analyzed using descriptive statistics, reliability, and Pearson's coefficient. Model identification evaluation was conducted by goodness-of-fit index and impact analysis.
Results of goodness-of-fit of modified model were as follows: χ=120.57 (df=16, <.001), GFI (Goodness of Fit Index)=.95, RMSEA (Root-Mean-Square Error of Approximation)=.10, SRMR (Standardizes Root-Mean-Square residual)=.06, NFI (Normal Fir Index)=.90, CFI (Comparative Fit Index)=.90. Factors with a statistically significant direct impact on behavioral intention are as follows; perceived behavior control (β=.35, =.008), subjective norm (β=.27, =.002), and job demands (β=-.08, =.083). Organizational factors directly influenced following guidelines. Explanatory power of organizational factors on guideline compliance was greatest (C.R. [Critical Ratio] =5.67, <.001).
Supportive leadership and a positive organizational culture development strategy are essential. The hospital leader group should provide adequate resources to facilitate compliance with guidelines as well as create an atmosphere of on-site support that ensures guidelines will be followed, and engage in continuous monitoring and feedback regarding following of guidelines.
为了改善医疗相关感染指南的高效和系统管理及遵循情况，必须了解各种因素之间的关系。应努力加强或减少相关因素。我们开发了一个用于遵循医院感染控制指南的结构方程模型。
总体而言，388名韩国注册护士参与了本研究，2014年7月21日至8月31日使用自填式问卷进行数据收集，400份问卷中收集到392份（回收率98%）。使用描述性统计、信度和皮尔逊系数对数据进行分析。通过拟合优度指数和影响分析进行模型识别评估。
修正模型的拟合优度结果如下：χ=120.57（自由度=16，<.001），拟合优度指数（GFI）=.95，近似均方根误差（RMSEA）=.10，标准化均方根残差（SRMR）=.06，规范拟合指数（NFI）=.90，比较拟合指数（CFI）=.90。对行为意向有统计学显著直接影响的因素如下：感知行为控制（β=.35，p=.008）、主观规范（β=.27，p=.002）和工作需求（β=-.08，p=.083）。组织因素直接影响指南遵循情况。组织因素对指南合规性的解释力最大（临界比[C.R.] =5.67，<.001）。
支持性领导和积极的组织文化发展战略至关重要。医院领导团队应提供充足资源以促进指南的遵循，营造现场支持氛围以确保指南得到遵循，并对指南遵循情况进行持续监测和反馈。
