INTRODUCTION
Healthcare-associated infections (HAIs) are related to medical practices performed within healthcare institutions, including hospitalization and outpatient services [1]. It is estimated to occur in 5∼10% of hospitalized patients [2]. Considering the elderly as well as the increase in immunocompromised patients, the number of patients vulnerable to infection is continuously increasing, empha-sizing the importance of prevention and management of HAIs [2].
The most important part of infection control is manpower, and manpower must have the ability to prevent infections [3]. Nurses comprise the most significant proportion of manpower resources in healthcare institutions [4], and the level of nursing services significantly impacts the quality of medical care in clinical aspects [5]. Nurses generally have close contact with patients in the hospital, so the proper infection control performance of nurses who directly care for patients and the ICC of nurses can be said to be important factors [6]. Therefore, nurses must have infection control competency (ICC) to protect patient safety and provide the best nursing by preventing HAIs. Tertiary hospitals have a high severity of patient admissions. They are reported to have a relatively high number of HAIs [7], so the ICC of nurses working in these hospitals is important. Competency is the ability to perform tasks effectively using knowledge and skills [8]. On the other hand, core competency is a decision-making tool that clarifies the abilities required to perform essential roles in a particular field effectively and includes competencies that cover knowledge, skills, attitudes, and intellectual strategies necessary to maximize performance [9].
The Association for Professionals in Infection Control (APIC) Inc. in the United States first presented a competency model for infection preventionists in 2012 and stated that the ultimate goal of having ICC to prevent HAIs is patient safety [10]. Based on this, research on the ICC of infection control nurses (ICNs) has also been conducted in Korea [9,11-14]. Research on the ICC of nurses in Korea has developed a tool to measure the ICC of clinical nurses [15], confirming seven competencies: basic microbiology, risk assessment, infection control practice, leadership, critical thinking, communication, and education. However, most research on nurses’ competencies in Korea mainly consisted of general nursing competence [4,16]. There is also insufficient research on the ICC of general nurses overseas. Through research to confirm that the ICC included the basic infection control knowledge and skills that new nurses should have, Liu et al.[6] confirmed that eight competencies are needed, including hand hygiene, standard precautions and precautions by transmission route, donning and doffing of personal protective equipment (PPE), cleaning, disinfection, sterilization, and critical assessment skills.
The competency stage is a system in which nurses in professional nursing practices can develop through a series of stages based on competency in practice [17]. Benner stated that the problem-solving ability of nurses lies in the difference between skills through experience and intuitive abilities and presented a model that classifies nursing practice abilities into five stages: novice, advanced beginner, competent, proficient, and expert [8]. However, in Jang's research [18], it was expected that the level of the proficient stage would be similar to the level of the expert stage, so the stages were divided into four categories: novice, advanced beginner, competent, and proficient. Based on these competency stages [8], Kim and Choi [14] conducted a study to understand the self-perceived ICC stage of ICNs and the level of ICC by competency stage.
Self-awareness is an individual's ability to respond based on their behavior and the variables controlling it [19]. Evaluating self-awareness competency can indicate an individual's motivation to maintain and improve related skills [20]. The competency stage that one self-re-ports or perceives reflects a more accurate level of competency than the competency stage distinguished by career [14]. However, there are reports in which the objectively measured competency is lower than expected compared to self-perceived ICC [20]. Recognizing one's competency stage can be an opportunity to establish various strategies to achieve one's competency development plan and goals and enhance competency itself. Therefore, understanding the ICC stage that nurses perceive and comparing it with the ICC measured objectively will help establish educational strategies to enhance the ICC of nurses directly caring for patients.
The purpose of this study is to understand the level of ICC according to the self-perceived ICC stage of nurses working in tertiary hospitals and the difference between the self-perceived ICC stage and the level of ICC. It aims to provide basic data for developing a nurse's ICC-based ed-ucation and ICC enhancement program.
METHODS
1. Study Design
This study is a descriptive survey aimed at understanding the level of ICC and the self-perceived ICC stage recognized by nurses working in tertiary hospitals and understanding the relation between the self-perceived ICC stage and the level of ICC.
2. Subjects
The subjects were nurses working in general wards, in-tensive care units, and emergency rooms of a tertiary hospital in C province. Nurses who understood the purpose of the study and voluntarily agreed to participate were included. Nurses in the central supply room, as well as the administrative and outpatient departments, were excluded.
The sample size of this study was calculated using the G*power 3.1.9.4 program. When calculated with a medium effect size of .30, a test power of .95, and a signifi-cance level of .05 in the correlation analysis, the minimum sample size was 134. Considering a dropout rate of about 10%, a total of 150 people were selected. Out of 150 questionnaires, 150 were collected (Collection rate 100%) and used for the final data analysis.
3. Data Collection
The data collection period was from March 27, 2023, to April 5, 2023. For data collection, the researcher directly visited the nursing department of a tertiary hospital in C province, submitted a research proposal, questionnaire, and a request form for collecting research paper data, ex-plained the purpose and intent of the research, and ob-tained permission before proceeding. A small gift was provided to increase the fidelity and recovery rate of the survey responses. The first page of the questionnaire stated that only those who agreed to participate in the research could participate and that they could withdraw from the research at any time without any disadvantage due to withdrawal. After receiving the research partic-ipation consent form, the study was conducted. To protect the personal information of the participants, a return enve-lope was provided to insert the questionnaire after re-sponding, which was then sealed and collected. The collected data were stored, with the exception of personal identification information for the protection of the participants.
4. Tools
1) General characteristics
The general characteristics assessed included gender, age, marital status, the highest level of education, clinical experience, current department, position, and experience with infection control education.
2) Self-perceived infection control competence stage
Based on Benner's 5-stage competence model [8], the measurement tool developed by Kim and Choi [14] was used to measure the self-perceived ICC level of ICNs. A novice is a nurse with less than one year of clinical experience. ‘ Novice’ is a nurse with less than one year of clinical experience. ‘ Advanced beginner’ is a nurse with more than one year but less than two years of clinical experience. ‘ Competent’ is a nurse with more than two years but less than three years of clinical experience. ‘ Proficient’ is a nurse with more than three years but less than five years of clinical experience, and an ‘ expert’ is a nurse who has more than five years of clinical experience. After the participants were presented with the definition of each stage, they were asked to indicate their own ICC stage as they perceived it.
3) ICC
The items of essential ICC for new nurses developed by Liu et al.[6] were translated and used with the permission of the original authors. It consists of a total of 83 items, with sub-areas including Basic Microbiology (7 items), Hand Hygiene (13 items), Standard Precautions and Ad-ditional Isolation Guidelines (30 items), Personal Protective Equipments (PPEs) (12 items), Cleaning, Disinfection, and Sterilization (9 items), and Critical Assessment Skills (12 items).
The translation of the tool related to ICC used in this study was conducted based on the procedure suggested by Oh [21] (Figure 1). 1) Step 1 (Translation considering content equivalence): A professional translator who is a nursing major with a translation certification translated it into Korean. 2) Step 2 (Back translation considering content equivalence): A translation expert with an English lit-erature major back-translated the tool translated into Korean into English. 3) Step 3 (Comparison of content and meaning equivalence of the original, translation, and back translation): Two bilingual nurses whose mother tongue is English compared the content and meaning equivalence of the back-translated English tool. The researcher revised the Korean translation based on the back translation, which was reviewed and evaluated for translation accuracy and cultural differences that required modification. 4) Step 4(Final translation review): Three nursing professors who use English and Korean and have certificates in speci-alized infection control reviewed the content and meaning equivalence of the Korean translation revised by the researcher. 5) Step 5 (Revision and supplementation of the tool through a preliminary survey): Three infection control specialist nurses evaluated the appropriateness, ease of understanding, and accuracy of the content of the final tool translated into Korean. 6) Step 6 (Review of the final readability level): Five staff nurses evaluated the readability and understanding of the revised and supple-mented final tool.
ICC was measured on a 5-point Likert scale, ranging from ‘ cannot perform at all’(1 point) to ‘ performs very well’(5 points). The reliability of the tool was Cronbach's ⍺=.98, and the reliability of each sub-area was basic microbiology Cronbach's ⍺=.90, hand hygiene .92, standard precautions and additional isolation guidelines .97, personal protective equipment PPEs), cleaning, disinfection, and sterilization .92, and critical assessment skills .94.
5. Ethical Considerations
This study was conducted after receiving approval from the Institutional Review Board of C University Hospital (CBNUH 2023-01-015).
6. Data Analysis
The collected data were analyzed using the SPSS/WIN 29.0/windows program (IBM Corp., USA). The self-perceived ICC stage was analyzed by frequency and percent-age, and the ICC was analyzed by mean and standard deviation. The difference in the self-perceived ICC stage according to general characteristics was analyzed by Fisher's exact test and the difference in ICC was analyzed using a t-test or ANOVA. The difference in ICC according to the self-perceived ICC stage was analyzed using ANOVA, and post-hoc analysis using the Scheffé test.
RESULTS
1. Difference in Self-Perceived ICC Stage According to General Characteristics
The difference in self-perceived ICC stage according to general characteristics is shown in Table 1.
Table 1.
Difference in Self-perceived ICC Stage According to General Characteristics (N=150)
| Characteristics | Categories | Self-perceived ICC stage | p† | |||||
|---|---|---|---|---|---|---|---|---|
| Total | Novice | Advanced beginner | Competent | Proficient | Expert | |||
| n (%) or M± SD | n (%) | n (%) | n (%) | n (%) | n (%) | |||
| Total | 13 (8.7) | 78 (52.0) | 40 (26.7) | 17 (11.3) | 2 (1.3) | |||
| Gender† | Man | 17 (11.3) | 3 (17.6) | 9 (52.9) | 4 (23.5) | 1 (5.9) | 0 (0.0) | .628 |
| Woman | 133 (88.7) | 10 (7.5) | 69 (51.9) | 36 (27.1) | 16 (12.0) | 2 (1.5) | ||
| Age (year)† | 20∼24 | 21 (14.0) | 1 (4.8) | 15 (71.4) | 5 (23.8) | 0 (0.0) | 0 (0.0) | .118 |
| 25∼29 | 82 (54.7) | 8 (9.8) | 45 (54.9) | 20 (24.4) | 9 (11.0) | 0 (0.0) | ||
| 30∼34 | 28 (18.7) | 4 (14.3) | 11 (39.3) | 8 (28.6) | 4 (14.3) | 1 (3.6) | ||
| ≥35 | 19 (12.7) | 0 (0.0) | 7 (36.8) | 7 (36.8) | 4 (21.1) | 1 (5.3) | ||
| 29.63±6.83 | ||||||||
| Marital status† | Married | 29 (19.3) | 3 (10.3) | 8 (27.6) | 11 (37.9) | 6 (20.7) | 1 (3.4) | .019 |
| Unmarried | 121 (80.7) | 10 (8.3) | 70 (57.9) | 29 (24.0) | 11 (9.1) | 1 (0.8) | ||
| Highest level of education† | Diploma | 35 (23.3) | 5 (14.3) | 19 (54.3) | 6 (17.1) | 5 (14.3) | 0 (0.0) | .004 |
| Bachelors | 107 (71.3) | 8 (7.5) | 58 (54.2) | 32 (29.9) | 7 (6.5) | 2 (1.9) | ||
| Masters | 8 (5.4) | 0 (0.0) | 1 (12.5) | 2 (25.0) | 5 (62.5) | 0 (0.0) | ||
| Clinical experience†‡(year) | ＜1 | 6 (4.0) | 1 (16.7) | 5 (83.3) | 0 (0.0) | 0 (0.0) | 0 (0.0) | .508 |
| 1∼＜2 | 22 (14.7) | 2 (9.1) | 14 (63.6) | 4 (18.2) | 2 (9.1) | 0 (0.0) | ||
| 2∼＜3 | 12 (8.0) | 1 (8.3) | 8 (66.7) | 1 (8.3) | 2 (16.7) | 0 (0.0) | ||
| 3∼＜5 | 42 (28.0) | 5 (11.9) | 19 (45.2) | 15 (35.7) | 3 (7.1) | 0 (0.0) | ||
| ≥5 | 68 (45.3) | 4 (5.9) | 32 (47.1) | 20 (29.4) | 10 (14.7) | 2 (2.9) | ||
| 6.72±6.85 | ||||||||
| Current department† | General ward | 67 (44.7) | 5 (7.5) | 33 (49.3) | 19 (28.4) | 9 (13.4) | 1 (1.5) | .861 |
| Intensive care unit | 64 (42.7) | 6 (9.4) | 35 (54.7) | 17 (26.6) | 5 (7.8) | 1 (1.6) | ||
| Emergency room | 19 (12.7) | 2 (10.5) | 10 (52.6) | 4 (21.1) | 3 (15.8) | 0 (0.0) | ||
| Position† | Staff nurse | 140 (93.3) | 13 (9.3) | 76 (54.3) | 37 (26.4) | 13 (9.3) | 1 (0.7) | .028 |
| Manager | 10 (6.7) | 0 (0.0) | 2 (20.0) | 3 (30.0) | 4 (40.0) | 1 (1.0) | ||
| Education experience of infection control† | Yes | 141 (94.0) | 8 (5.7) | 75 (53.2) | 39 (27.7) | 17 (12.1) | 2 (1.4) | .002 |
| No | 9 (6.0) | 5 (55.6) | 3 (33.3) | 1 (11.1) | 0 (0.0) | 0 (0.0) | ||
The self-perceived ICC stage of the participants was as follows: 13 subjects (8.7%) identified at the novice stage, 78 subjects (52.0%) at the advanced beginner stage, which was the largest, 40 subjects (26.7%) at the competent stage, 17 subjects (11.3%) at the proficient stage, and two subjects (1.3%) at the expert stage.
The self-perceived ICC stage showed statistically significant differences according to marital status (x2=10.84, p=.019), the highest level of education (x2=19.64, p=.004), position (x2=18.46, p=.028), and experience in infection control education (x2=14.95, p=.002).
2. Difference in the Level of ICC According to General Characteristics
The difference in self-perceived ICC stage according to general characteristics is shown in Table 2.
Table 2.
Differences in the Level of ICC According to General Characteristics (N=150)
| Characteristics | Categories | ICC Level | ||
|---|---|---|---|---|
| M± SD | t or F | p | ||
| Gender | Man | 3.88±0.49 | -0.74 | .463 |
| Woman | 3.98±0.53 | |||
| Age (year) | 20∼24 | 4.09±0.50 | 1.55 | .205 |
| 25∼29 | 3.95±0.51 | |||
| 30∼34 | 3.82±0.54 | |||
| ≥35 | 4.08±0.53 | |||
| Marital status | Married | 3.96±0.51 | -0.04 | .968 |
| Unmarried | 3.97±0.53 | |||
| Highest level of education | Diploma | 3.92±0.52 | 1.76 | .176 |
| Bachelors | 3.96±0.52 | |||
| Masters | 4.29±0.48 | |||
| Clinical experience (year)† | ＜1 | 3.92±0.67 | 2.52 | .044 |
| 1∼＜2 | 4.17±0.47 | |||
| 2∼＜3 | 4.25±0.42 | |||
| 3∼＜5 | 3.96±0.51 | |||
| ≥5 | 3.86±0.52 | |||
| Current department | General ward | 4.00±0.55 | 1.07 | .346 |
| Intensive care unit | 3.97±0.49 | |||
| Emergency room | 3.81±0.51 | |||
| Position | Staff nurse | 3.94±0.52 | -2.22 | .028 |
| Manager | 4.31±0.49 | |||
| Education experience of infection control | Yes | 3.98±0.50 | 1.90 | .059 |
| No | 3.65±0.71 | |||
The level of ICC showed statistically significant differences according to clinical experience (F=2.52, p=.044) and position (t=-2.22, p=.028).
3. Difference in the Level of ICC According to Self-Perceived ICC Stage
The difference in the level of ICC of participants according to their self-perceived ICC stage is shown in Table 3.
Table 3.
Differences in ICC Levels According to Self-perceived ICC Stage (N=150)
The ICC of the participants was an average of 3.96±0.86 points out of a maximum of 5 points. The average scores for each sub-area of ICC were as follows: hand hygiene scored 4.35±0.75 points; standard precautions and additional isolation guidelines scored 4.06±0.76 points, PPEs scored 4.02±0.81 points, cleaning, disinfection, and sterilization scored 3.87±0.91 points, the critical assessment skills scored 3.74±0.90 points, and basic microbiology scored 3.26±0.86 points (Table 3).
There was a statistically significant difference in ICC according to the self-perceived ICC stage (F=16.87, p<.001). In terms of the detailed items of ICC according to the self-perceived ICC stage, there were statistically significant differences in the basic microbiology area (F=17.28, p<.001), standard precautions and additional isolation guidelines area (F=14.54, p<.001), PPEs (F=11.90, p<.001), cleaning, disinfection, and sterilization area (F=9.59, p< .001), and critical assessment skills area (F=11.87, p<.001).
The results of the post-hoc analysis are as follows: In terms of overall ICC, the competent, proficient, and expert groups had statistically significantly higher competence than the novice and advanced beginner groups. Among the detailed items of ICC, in the basic microbiology area, the novice and advanced beginner groups had statistically significantly lower competence than the competent, proficient, and expert groups. In the standard precautions and additional isolation guidelines area, the novice group had statistically significantly lower competence than the advanced beginner group, the advanced beginner group had statistically significantly lower competence than the competent and proficient groups, and the competent and proficient groups had statistically significantly lower competence than the expert group. In the PPEs area, the competent and proficient groups had statistically significantly lower competence than the expert group but statistically significantly higher competence than the novice and advanced beginner groups. In the cleaning, disinfection, and sterilization area, the novice and advanced beginner groups had statistically significantly lower competence than the competent and proficient groups. In the critical assessment skills area, the novice and advanced beginner groups had statistically significantly lower competence than the competent, proficient, and expert groups.
DISCUSSION
The self-perceived ICC stage of nurses working in tertiary hospitals matched the stages distinguished by Benner's classification [8]. The match between the novice, according to Benner [8], and the novice of the self-perceived ICC stage was 16.7%, the match between the advanced beginner, according to Benner [8], and the advanced beginner of the self-perceived ICC stage was 63.6%, the match between the competent according to Benner [8] and the competent group of the self-perceived ICC stage was 8.3%, the match between the proficient according to Benner [8] and the proficient of the self-perceived ICC stage was 7.1%, and the match between the expert according to Benner [8] and the expert group of the self-perceived ICC stage was 2.9%. Although more than 45% of the participants in this study had a clinical career of over 5 years, which corresponds to the expert group according to Benner's classification [8], most of them perceived themselves as belonging to the advanced beginner group. In the study by Kim and Choi [14], even though more than half of the ICNs had an infection control experience of over 5 years, most of them responded that their self-perceived ICC stage was at the competent level. From this research's results, many nurses evaluated their competence stage lower than the competence stage distinguished by career. Nurses are required to engage in nu-merous activities to learn and acquire knowledge about the rapidly changing healthcare environment in order to improve the quality of medical services. As a result, it is believed that they tend to perceive their self-assessed competency level as lower than their actual level of competence. This suggests that there may be a gap between nurses’ self-perception of their competence and their actual competence level, which could have implications for training and development programs in infection control.
In this study, it was found that marital status, the highest level of education, position, and experience in infection control education had a statistically significant difference with the self-perceived ICC stage. In the study by Alber et al. [22], which targeted psychiatric nurses, there was a statistically significant difference in the self-perceived ICC stage according to actual clinical experience. In the study by Bobay et al. [23], which targeted clinical nurses, it was reported that clinical experience, age, and certification had a statistically significant difference with competency, but there was no significant difference in education. In the study by Kim and Choi [14], which targeted ICNs, there was a statistically significant difference in the self-perceived ICC stage according to clinical experience, age, position, the highest level of education, certification in speci-alized infection control, and experience of infection control conferences and training courses. In this study, it was found that the highest level of education, position, and experience in infection control education, which were significantly shown, partially matched the results of previous studies, but the results of clinical experience did not match, which is thought to be due to other factors such as leaves of absence, department transfers, and job changes. Therefore, additional research is needed on these variables and the self-perceived ICC stage.
The ICC of nurses working in tertiary hospitals was measured at an average of 3.96 points out of a maximum of 5 points, indicating a relatively high level. The detailed areas of ICC were ranked as follows: hand hygiene, standard precautions and additional isolation guidelines, PPEs, cleaning, disinfection, sterilization, critical assessment skills, and basic microbiology. In the case of microbiology, which showed the lowest competence, it has been reported that nursing students find the subject matter difficult to the point that they believe learning it is unnecessary [24]. This is also related to the fact that the frequency of providing education on clinical microbiology is very low in clinical nursing practical education compared to patho-physiology, anatomy, and function of the human body, and the mechanism and effects of drugs [25]. Recently, infection problems due to zoonotic diseases and emerging infectious diseases have been reported in hospitals. Therefore, there is a need to provide more education on clinical microbiology [24].
It is indeed challenging to compare this study directly with previous studies conducted using the same ICC tool both domestically and internationally as there is a lack of research integrating infection control knowledge, skills, and behaviors targeting general nurses. When comparing the results of this study with research on infection control topics that reflect the degree to which one believes they can accomplish or perform a certain task (known as performance confidence), some interesting observations can be made. For instance, in a study conducted among nurses in small and medium-sized hospitals, hand hygiene and PPEs ranked highest in terms of infection control performance confidence, while isolation ranked the lowest. Furthermore, in a study conducted among medical and nursing students, respiratory etiquette ranked highest in infection control performance confidence, while personal hygiene ranked the lowest. This suggests that the ranking of specific areas can vary depending on the research participants [26]. It is believed that this difference arises because the ICC considered important vary depending on factors such as job type, hospital size, and department, with the focus often placed only on developing competencies in areas deemed most important. These findings can provide valuable insights for developing targeted training programs to enhance ICC among nurses. It underscores the importance of considering the specific context and characteristics of the target group when designing such programs [27].
In this study, the ICC of nurses working in tertiary hospitals showed significant differences depending on clinical experience and position. A previous study targeting ICNs found that ICC was highest in those with over 5 years of experience [9]. However, in this study, among the stages distinguished by Benner's classification [8], those with clinical experience of more than two years but less than three years, which corresponds to the competent stage, showed high ICC. This is thought to be because nurses with a clinical experience of more than two years but less than 3 years are able to perform nursing tasks on their own to some extent, moving away from being a new nurse, and can accumulate a lot of practical nursing ability based on job knowledge [28]. Also, managers had higher ICC than staff nurses, which is thought to be because managers have had longer clinical experience than staff nurses and have had many opportunities to receive infection control education.
In this study, the self-perceived ICC stage increased, and the level of ICC also increased, not only in total ICC but also in all sub-areas of infection control. Among the detailed areas of ICC, there were statistically significant differences in basic microbiology, standard precautions and additional isolation guidelines, PPEs, cleaning, disinfection, and sterilization, and critical assessment skills according to the self-perceived ICC stage. Additionally, there was a statistically significant difference in total ICC. In other words, it was found that as the group moved from novice to competent, proficient, and expert, self-perceived ICC was higher in most areas, which was consistent with the results of previous studies conducted on ICNs [14,29]. Therefore, in this study, it was possible to confirm similar results with the competence stages distinguished by Benner's clinical career [8] based on the self-perceived ICC stages, and it is believed this will help develop an infection control education program for nurses based on the competence according to the self-perceived ICC stage. In all self-perceived ICC stages, it was found that nurses lack knowledge about microbiology, which is the basis for infection control, as the score was lower than other items in the detailed areas of ICC. Microbiology is a subject that provides a theoretical basis for infection control [24], which is the basis for nursing performance. However, some nursing colleges in Korea designate microbiology as an elective rather than a required subject. In a study on the experience of nursing students taking clinical microbiology, it was found that nursing students believe it is unnecessary to learn clinical microbiology and that the subject matter is difficult compared to their abilities [24]. This coincides with the findings that clinical nurses and nursing professors think that microbiology is the least important subject [30]. In a situation where patient safety in the hospital is threatened due to multidrug-resistant bacteria and new emerging infectious diseases, both nursing colleges and clinical sites should provide education to equip knowledge that serves as the basis for infection control in the clinical field by providing appropriate knowledge about hospital pathogens.
This study is significant in identifying the need to understand the self-perceived ICC stage and the level of ICC among clinical nurses in Korea, where there is no research on the relation between the self-perceived ICC stage and ICC. Furthermore, by understanding the relationship between the self-perceived ICC stage and ICC of clinical nurses, it provided basic data for developing a career-stage-based infection control curriculum and competence-based education program for nurses, thereby suggesting the need for effective and systematic competence-stage-based education to enhance the ICC of clinical nurses. However, since this study only recruited and surveyed nurses working in a tertiary hospital located in C province, there are limitations in generalizing the results of this study. In addition, since the competency measurement was conducted in a way that had the participants self-per-ceive their own competencies, there may be a difference from the actual ICC. Various other variables that affect the self-perceived ICC stage and ICC were also not included, so their interpretation within the results is required.
CONCLUSION
This study aimed to understand the self-perceived ICC stage and the level of ICC of nurses working in tertiary hospitals, as well as to identify the relationship between the two. It was found that there were differences in the level of ICC according to the self-perceived ICC stage, and as the self-perceived ICC stage increased, the ICC significantly increased. Through this study, it was found that the self-perceived ICC stage, according to Benner's classification, was useful for classifying the competence stage level of clinical nurses. Therefore, the self-perceived ICC stage can be used as basic data for developing ICC-based education and infection control competency enhancement programs. Based on the results of this study, the following suggestions are made. First, since this study was conducted at a single tertiary hospital, it is suggested to expand the subjects and conduct research on the relationship between the self-perceived ICC stage and the level of ICC targeting clinical nurses in other institutions. Second, as this study targeted nurses working in general wards and special departments, it is suggested to expand the subjects and conduct research on ICC targeting nurses in various departments such as endoscopy rooms and central supply rooms. Also, since the areas of basic microbiology and critical assessment skills were measured low in the sub-areas of ICC in this study, activities to enhance ICC in these areas are required. It is suggested to develop a competence enhancement program for these areas when applying infection control interventions. As the self-perceived ICC stage in this study is evaluated lower than the competence stage classified by Benner, it is suggested to conduct further research on the factors affecting the self-perceived ICC stage. Finally, since it was confirmed in this study that there is a significant difference in the level of ICC according to the self-perceived ICC stage, it is suggested to develop and apply an ICC-based education and ICC enhancement program reflecting the self-perceived ICC stage and to conduct evaluation by means of research for nurses.
PDF Links
PubReader
ePub Link
XML Download
Full text via DOI
Download Citation 
Print 
