陕西省县级医院透析室建设项目培训效果评价

Evaluation on Training Effect of Dialysis Room Construction Project in County Hospitals in Shaanxi Province

目的通过对陕西省县级医院血液透析室建设项目4期的培训及效果分析,以探索更好的培训方式。方法对2013年6月～2015年12月由陕西省政府出资,陕西省血液净化质量控制中心承办的陕西省县级医院透析室建设项目培训班,每期6个月,共4期,共有800多名学员进行系统培训,培训后进行理论、技能考试,并在对培训后1年的学员实际开展工作情况进行调查及问卷调查。结果 (1)培训学员包括医师、护士及技师,以大专(54.32%)为主,低于5年工作经验的占60.49%,极个别医院设立了肾内科,多为综合内科;技师人数极少,存在没有学历的现象。(2)医护技理论课成绩在75～90分的学员数量最多,在90分以上的学员中,医生组高于护士及技师组,差异具有统计学意义(P<0.05)。(3)医生中心静脉留置导管技术、动静脉内瘘成形技术、医师和技师的规范化操作各组中,教学医院和非教学医院比较,差异具有统计学意义(P<0.05)。(4)教学医院医护技临床实践掌握情况优于非教学医院,差异具有统计学意义(P<0.05)。(5)培训结束后1年开展血液透析的县级医院及县级医院新增透析患者数增加非常显著。(6)6.25%的医生、5.80%的护士、特别是33.33%的技师学成返回医院后没有从事血液透析的工作。结论进行集中理论培训,参加实际个体技能操作培训,是一种有效的培训方式,加强了陕西省血液净化的力量,方便患者,节省资源。

Objective To explore a better training method through the training and effect analysis of the fourth phase of the hemodialysis room construction project of county hospitals in Shaanxi Province.Methods From June 2013 to December 2015, four training courses for dialysis room construction in county hospitals of Shaanxi Province,funded by Shaanxi Provincial Government and undertaken by Shaanxi Provincial Center for Blood Purification Quality Control,were conducted, each of which lasted 6 months,with more than 800 trainees undergoing systematic training.After the training,the theory,skills test,and 1 year after the training of the actual work carried out investigation and questionnaire survey.Results ①Trainees including doctors, nurses and technicians were mainly junior college students （54.32%）,accounting for 60.49% of those with less than 5 years of work experience.Very few hospitals have established nephrology,mostly comprehensive internal medicine;the number of technicians is extremely small and exists.No education. z②The number of trainees with the scores of 75-90 points in the medical technology theory class was the highest.Among the students with 90 points or more,the doctor group was higher than the nurses and technicians group,the difference was statistically significant （P〈0.05）. ③There were significant differences between teaching hospital and non-teaching hospital in doctors＇ central venous indwelling catheter technique,arteriovenous fistula forming technique, standardized operation of physician and technician in each group（P〈 0.05）.④The clinical practice of medical practice in teaching hospitals was better than that in non-teaching hospitals,and the difference was statistically significant （P〈0.05）. ⑤The number of new dialysis patients in county-level hospitals and county-level hospitals that started hemodialysis one year after the completion of training was very significant. ⑥6.25% of the doctors,5.80% of the nurses,and especially 33.33% of the technicians did not engage in hemodialysis after returning to the hospital.Conclusion It is an effective training method to carry out centralized theoretical training and participate in actual individual skill operation training.It strengthens the blood purification power of Shaanxi Province,facilitates patients and saves resources.