分级诊疗下以问题为导向的基层伤口造口专科护士实践能力提升模式探讨

Discussion on the improvement model of practice ability of professional nurse with implementing primary wound and ostomy under hierarchically diagnosing and treating the following issues as the guidance

目的探讨基层伤口造口专科护士实践能力提升模式,使分级诊疗模式下转基层的慢性伤口肠造口患者得到同质化专科护理服务,适应分级诊疗模式需求。方法通过文献查阅及现状调研方法,收集基层伤口造口专科护士临床实践中存在问题,通过开办为期6周以临床实践为主,理论为辅的临床实践培训基地,临床实践以WCET“一对二导师制”模式,保证足够的临床实践案例,确保学员的实践质量。并对学员回院后开展的专科护理质量延续追踪,对比培训前后满意率。结果培训后提高了基层伤口造口专科护士在专业理论、专业技能、教育指导、沟通与协作能力等方面的满意率。结论对基层伤口造口专科护士以临床实践为主,理论为辅“一对二导师制”实践基地培训模式进行培训及延续质量追踪能有效提升基层伤口造口专科护士临床实践能力,使下转基层的慢性伤口造口患者专科护理质量同质化,适应分级诊疗需求。

Objective To discuss the improvement model of practice ability of professional nurse with implementing primary wound and ostomy,so that patients with chronic wound intestinal stoma who were transferred to the primary level under the graded diagnosis and treatment mode could get homogenized specialized nursing services to meet the needs of the graded diagnosis and treatment mode.Methods Through literature review and current status investigation methods,we collected the problems in clinical practice of professional nurse with implementing primary wound and ostomy,and established a clinical practice training base based on clinical practice and supplemented by theory for a period of 6 weeks.The WCET"one-on-two-mentor system"model guarantees sufficient clinical practice cases and ensures the quality of students'practice.The follow-up of the quality of specialized nursing was carried out after the trainees returned to the hospital,and compared the satisfaction rate before and after the training.Results After training,the satisfaction rate of nurse with implementing primary wound and ostomy in professional theory,professional skills,education guidance,communication and collaboration skills were improved.Conclusion The nurse with implementing primary wound and ostomy were mainly based on clinical practice,and the theory was supplemented by the"one-on-two-mentor system"practice base training model.Training and continuous quality tracking could effectively improve the basic practice skills of nurse with implementing primary wound and ostomy.The quality of specialized nursing of patients with chronic wounds and stoma transferred to the grassroots level was homogenized to meet the needs of graded diagnosis and treatment.