脑卒中急救护士岗位的设立与实践

Post-setting and clinical practice of stroke emergency nurse

目的探讨脑卒中急救护士岗位的设立与临床实践方式。方法通过对脑卒中急救护士选拔,并进行系统的脑卒中急救理论和技能培训、考核,设立我院脑卒中急救护士岗位,明确脑卒中急救护士岗位的工作职责和流程。结果脑卒中急救护士需具备本科学历及急诊科、神经内外科、脑血管内外科、介入手术室、康复科相关专科2年以上工作经历或大专学历及上述专科5年以上工作经历。共32名学员参加培训,培训后理论考核成绩由培训前的(73.75±11.73)分提高至(84.31±8.63)分,溶栓药物使用考核成绩由培训前的(82.91±2.75)分提高至(92.69±2.78)分,急性脑卒中流程模拟考核成绩由培训前的(82.25±3.81)分提高至(92.56±2.94)分,介入护理培训考核成绩由培训前的(82.44±3.59)分提高至(92.00±2.93)分,差异均有统计学意义(t=14.91、21.09、14.34、16.39,P均<0.01)。培训前脑卒中超急性期和急性期理论考核优秀、良好、合格、不合格人数分别为4、6、17、5名,培训后分别为9、14、9、0名,培训前后比较差异有统计学意义(χ~2=12.585,P=0.006)。结论通过临床初筛、理论培训、临床实训等方式层层选拔设置脑卒中急救护士岗位在临床上是切实有效且可行的,但其培训及岗位推广机制仍需进一步完善。

Objective To explore the post-setting and clinical practice of stroke emergency nurse.Methods Through selecting stroke emergency nurses,systematic training and assessing stroke first-aid theory and skills,we set up a new post in our hospital called stroke emergency nurse and developed a series of duties and procedures of work.Results The stroke emergency nurses with undergraduate degree were required to have more than 2 years of work experience in the Emergency,Neurosurgery,Cerebrovascular Surgery,Interventional Operation Room,Rehabilitation Department,and those with college education were required to have more than 5 years of work experience.A total of 32 trainees participated in the training.The theoretical assessment scores increased from 73.75±11.73 before training to 84.31±8.63 after training,the assessment scores of thrombolytic drug use increased from 82.91±2.75 to 92.69±2.78,the assessment scores of simulated stroke test increased from 82.25±3.81 to 92.56±2.94,and the assessment scores of interventional nursing training increased from 82.44±3.59 to 92.00±2.93;and the differences were statistically significant(t=14.91,21.09,14.34 and 16.39;all P<0.01).The numbers of excellent,good,qualified and unqualified trainees in the theoretical examination of hyperacute and acute stroke before training were 4,6,17 and 5,respectively,and the numbers after training were 9,14,9 and 0,respectively;and the difference was statistically significant(χ2=12.585,P=0.006).Conclusion It is clinically effective and feasible to set up a post of stroke emergency nurse through clinical screening,theoretical training,and clinical training.However,the training and post promotion mechanism need to be further improved.