高质量胸外按压护理技能学习曲线分析

Learning curve for high quality chest compression nursing skills

目的高质量的胸外按压(chest compression,CC)在抢救心搏骤停患者中起到关键作用,本研究应用学习曲线法分析护生掌握高质量CC技能所需练习最少次数,为CC教学或培训提供参考。方法选择南阳医学高等专科学校护理系2016级护理专业3班共54名护生为研究对象,运用情景模拟和仿真simMan综合模拟人进行实训教学,练习2次为1个学习阶段,分成6个阶段;比较6个阶段CC 6项内容达标率、操作时间、操作得分及操作合格率,并分析护生CC操作次数。结果 54名护生6个阶段按压时间、按压部位、按压姿势、按压深度、按压频率、胸廓完全回弹达标率比较差异均有统计学意义,χ~2值分别为26.53、15.22、24.73、23.51、16.42和20.58,均P<0.001;6个阶段操作时间(F=5.96,P=0.008)、操作得分(F=8.52,P=0.006)和操作合格率(χ~2=29.37,P<0.001)比较差异均有统计学意义;学习曲线显示,8次培训后,操作时间、得分及合格率趋于平稳。结论 CC护理技能教学可提升护生CC技能达标率及操作水平,护生掌握高质量CC技能所需至少练习8次。

OBJECTIVE High-quality chest compression plays a key role in rescuing patients with cardiac arrest.This study used learning curve method to analyze the minimum number of exercises needed by nursing students to master high-quality chest compression skills,providing a reference for teaching or training of chest compression.METHODS A total of 54 nursing students from 3 classes of nursing class 2016 in Nanyang Medical College were selected as the research subjects.Situational simulation and simMan simulation were used to carry out the training and teaching.The two exercises were divided into six stages,and the six contents of chest compression in six stages were compared,and analyze the number of breast compression operation of nursing students.RESULTS There were significant differences in pressing time,pressing position,pressing posture,pressing depth,pressing frequency and thoracic complete rebound rate among 54 nursing students at 6 stages（χ~2 values were 26.53,15.22,24.73,23.51,16.42 and 20.58,The Pvalues were all less than0.001）;There were significant differences in the scores of operation time（F=5.96,P=0.008）,operating points（F=8.52,P=0.006）and passing rate of operation between the 6 stages.The learning curve indicated that operative time was obviously shortened,whereas operating quality and qualification rate of the operation were dramatically increased in the first eight times of training and then reached plateaus.The learning curve shows that after the 8 training,the operation time,score and passing rate tend to be stable.CONCLUSIONS The teaching of chest compression nursing skills can improve the standard rate and operation level of nursing students＇ chest compression skills.Nursing students need to practice at least 8 times to master high quality chest compression skills.