中・小規模病院に勤務する看護師の看護基本技術の革新経験と影響要因

Experiences of Basic Nursing Technique Innovation and Their Influencing Factors among Nurses at Small-to-medium-sized Hospitals

要旨

　中・小規模病院に勤務する看護師の、看護基本技術の革新経験の実態とそれに影響する要因を明らかにするため質問紙調査を実施した。200床未満の病院32施設1,082名を対象にし、449名（回収率80.3％・有効回答率51.7％）を分析対象とした。看護基本技術の革新の必要性を認識しており、実際に革新経験のある人は57.9％（260名）であった。きっかけは「受け持ち患者等に実施して問題があった」、「教育的役割についた」であり、問題解決や役割遂行の必要性に迫られて革新していた。影響する要因は「年齢」、「経験年数」、「看護研究発表（院内）」、「看護研究発表（院外）」、「研修参加」、「学会参加」、「転職」、「異動」、「教育系役割」、「学生指導役割」、「雑誌購読」の11項目であった。多重ロジスティック回帰分析により、革新に対して「看護研究発表（院内）」、「転職」、「看護研究発表（院外）」、「学生指導役割」が影響しており、これらの役割や経験を持つ人の支援や活用が、革新の促進につながる可能性が示唆された。

　We conducted a questionnaire survey of nurses working in small-to-medium-sized hospitals in order to understand their experiences of innovation in basic nursing techniques and the factors that influenced these experiences. We sent questionnaire forms to 1,082 nurses at 32 hospitals each with less than 200 beds, and analyzed the responses of the 449 nurses who returned the completed questionnaire (80.3% response rate, 51.7% valid response rate). As a result, 57.9% of respondents (260 nurses) were aware of the need for innovation in basic nursing techniques and had actually experienced such innovation. The impetus for this innovation came from “encountering problems after implementing (basic nursing techniques) on assigned patients” and “being appointed to an educational role,” showing that innovation arose from the need for problem solving and fulfilling a particular role. Influential factors were classified into the following 11 categories: age, years of experience, nursing research presentations (within the hospital), nursing research presentations (outside the hospital), participating in training, participating in academic meetings, changing jobs, personnel transfers, educational roles, student guidance roles, and reading journals. After performing multiple logistic regression analysis, we found that innovation of basic nursing techniques was influenced by “nursing research presentations (within the hospital),” “changing jobs,” “nursing research presentations (outside the hospital),” and “student guidance roles.” These findings suggest that supporting and utilizing nursing personnel with these roles and experience could help to promote innovation.