分级护理决策护士的资质评定和培训提纲制订的研究

Study on qualification assessment of decision-making nurses of grading nursing care and make-out of training outline

[目的]进一步论证分级护理决策护士的资质,并制订培训提纲,为分级护理的系统培训提供指导和依据。[方法]通过文献调研以及对国外和我国港澳地区的17名护理专家进行深度访谈,获得国内外分级护理发展状况,初步设计分级护理决策护士资质专家预测问卷及培训提纲咨询问卷;选择省内32名医疗、护理专家,应用专家预测法,对分级护理决策护士的资质进行专家论证;应用德尔菲法对分级护理决策护士培训提纲各课程及其教学内容进行初筛并确定其权重;利用克朗巴赫系数、相关系数等进行培训提纲的信效度检验;运用Mi-crosoft Excel数据库和SPSS13.0forWindows软件进行数据处理。[结果]专家对决策分级护理护士的资质预测结果:主管护师认同率最高(87.5%),本科认同率最高(58.1%),认同率最高的为本科5年(64.5%)、硕士3年(38.7%);专家对决策分级护士培训提纲咨询结果:经两轮咨询后形成专家一致性意见,最终形成分级护理决策护士培训提纲的课程依次是:新的分级护理制度--《综合医院分级护理指导原则》,分级依据评价方法,护理问诊和护理体检,本科室常见疾病、药物知识和疾病危险因素评估方法,临床检验结果的理解,护理临床决策的相关知识,考核课程;咨询专家的代表性强、积极性高、权威程度高、协调性好。[结论]分级护理决策护士的最低资质为在具有主管护师职称资格的基础上,同时具备护理本科学历且有5年的临床工作经验或者是具备护理硕士学历且有3年的临床工作经验。只有符合该最低资质及以上的护士经过分级护理的相关培训、考核、认证合格后才可在临床上独立决策分级护理;制订的分级护理决策护士培训提纲共有七节课,包括23项教学内容48个条目。

Objective：To demonstrate the qualification of decision-making nurses of grading nursing care and to make out training outline so as to provide some instruction and evidences for systematic training of grading nursing care.Methods：A total of 17 nursing specialists from abroad and Hong Kong and Macao regions in China had accepted depth interviews through literature research.The status quo of development of grading nursing care both at home and abroad was obtained.And both prediction questionnaire of qualification specialists of decision-making nurses of grading nursing care and consultation questionnaire of training outline were preliminary designed.Then 32 medical and nursing specialists were selected and demonstrated on their qualification of decision-making nurses of grading nursing care by applying experts prediction.To use Delphi method to do preliminary screening of the curriculum and teaching content of the training outline of decision-making nurses of grading nursing care so as to decide its weight.Both the reliability and validity test of the training outline had been carried out by applying Cronbach coefficient and correlation coefficient.All data were processed by Microsoft Excel database and SPSS13.0 for Windows software.Results：The experts＇ predictions results for the qualification of decision-making nurses of grading nursing care were：nurses-in-charge had the highest recognition rate of 87.5%.The highest recognition rate among undergraduates was 58.1%.The highest recognition rates among 5-year bachelor degree nursing students was 64.5% and among 3-year master＇s degree was 38.7%.The experts＇ predictions results for the consultation of training outline were：experts had consistency opinions after two rounds of consultation.The training outline was formed finally as：the first lesson was the latest classification of grading nursing care,that was ＂Guiding principles of grading nursing care in general hospitals＂,the second lesson was assessment methods of grading bases;the third lesson was nursing interrogation and nursing health examination;the fourth lesson was assessment methods of common diseases,knowledge about drugs and disease risk factors of the department;the fifth lesson was the comprehension of clinical test results;the sixth lesson was the related knowledge of nursing clinical decision making;and the seventh lesson was the examination curricula.Consultation experts had strong representativeness,high activity,high authority level and good coordination.Conclusion：The minimum qualification of decision-making nurses of grading nursing care is with 5-year-clinical experience for nursing bachelor degree or 3-year-clinical experiences for nursing master＇s degree based on the professional title of nurse-in-charge.Nurses meet to these conditions could do independent decision-making of grading nursing care after related training,examination and qualified certification.The training outline totally include 7 lessons about the decision-making nurses of grading nursing care including 23 teaching contents and 48 items.