基于动态病例的多元化培训在神经重症轮转护士规范化培训中的应用

Application of diversified training based on dynamic case in standardized training of new nurses in Neurological Intensive Care Unit

目的探讨基于动态病例模拟的多元化培训方法在神经重症轮转护士规范化培训中的应用效果。方法选取温州医科大学附属第一医院2017年和2018年神经重症监护室轮转的规范化培训新护士62名,其中2017年的30名新护士为对照组,2018年的32名新护士为观察组。对照组采用传统培训方式进行分阶段培训,观察组在此基础上于每个培训阶段增加1个动态病例,实施情景模拟培训、视频教学、导师制教学等多元化培训和考核方式。比较两组护士的理论成绩、技能成绩、不良事件发生和护理综合能力达标情况。结果观察组护士经过多元化培训后,理论考核(92.58±2.55)分,技能考核(94.72±2.67)分,均高于对照组,差异有统计学意义(t值分别为-8.018、-10.151;P<0.01)。观察组发生不良事件的护士2名,对照组6名,但差异无统计学意义(χ^2=1.525,P>0.05)。出科时观察组护士护理综合能力全部达标,对照组有2名未达标,两组教学达标率比较差异有统计学意义(Z=-3.473,P<0.05)。结论基于动态病例模拟的多元化培训策略有助于提高轮转护士的理论和操作成绩,提高教学效果达标率、护理综合能力和从业信心,值得在神经重症新入科护士规范化培训中进一步应用。

Objective To explore the application effect of diversified training based on dynamic case in standardized training of new nurses in Neurological Intensive Care Unit.Methods Totally 62 new nurses were selected from the First Affiliated Hospital of Wenzhou Medical University in 2017 and 2018.A total of 30 nurses in 2017 were assigned into the control group and 32 new nurses in 2018 were in the observation group.The control group was trained in stages by traditional training methods,while the observation group added one dynamic case to each training stage,and implemented diversified training and assessment methods such as scenario simulation training,video teaching,tutorial system teaching,etc.The theoretical assessment,skill assessment,adverse event and comprehensive nursing ability were compared between the two groups.Results After diversified training,the scores of theoretical assessment(92.58±2.55)and skill assessment(94.72±2.67)in the observation group were higher than those in the control group with statistical differences(t=-8.018,-10.151;P<0.01).There were 2 nurses with adverse events in the observation group and 6 nurses in the control group,but there was no significantly statistical difference(χ^2=1.525,P>0.05).The nurses in the observation group were all qualified in terms of the comprehensive nursing ability while 2 nurses the control group were not qualified,there was significant difference between the two groups(Z=-3.473,P<0.05).Conclusions The diversified training based on dynamic case can effectively improve the theoretical and operational performance of rotating nurses,the qualified rate of teaching,the comprehensive ability of nursing and the confidence of practitioners.It is worthy of further application in the standardized training of newly admitted nurses in Neurological Intensive Care Unit.