案例教学法联合情景演练在实习护生入科医院感染与预防控制培训中的应用

The application of case-based learning combined with scenario exercise in hospital infection prevention and control training for nursing students

目的探讨案例教学法联合情景演练在临床实习护理学生(护生)入科医院感染与预防控制(院感防控)培训中的应用效果。方法选取2018年9月-2019年11月以组为单位进入中西医结合科实习的临床实习护生作为研究对象。根据组别奇偶数分为试验组和对照组。2组均由科室院感防控专项护理小组于护生入科第1天进行入科院感防控培训。试验组采取案例教学法联合情景演练,对照组采取传统讲授法。比较2组手卫生依从率、手卫生正确率、医疗废物分类与处置正确率、职业暴露发生情况、院感防控理论考核成绩、对教学方法的满意度。结果共纳入10组63名实习护生。其中,对照组5组32人,试验组5组31人。试验组手卫生依从率(χ^2=8.434,P=0.004)、医疗废物分类与处置正确率(χ^2=4.196,P=0.041)、院感防控理论考核成绩(t=3.145,P=0.003)、对教学方法的满意度得分(t=2.446,P=0.017)均高于对照组。试验组未发生职业暴露,对照组发生1例职业暴露;两组手卫生正确率均为100%。结论案例教学法联合情景演练有助于实习护生在入科进行院感防控培训中提高其院感防控的意识、知识和技能的掌握程度与培训效果,并可增加对临床带教的满意度。

Objective To explore the effect of case-based learning combined with scenario exercise on nosocomial infection prevention and control training. Methods Clinical nursing students who entered the Department of Western & Traditional Chinese Medicine between September 2018 and November 2019 were selected. These students entered in groups. According to the entry number, the groups were divided into trial group and control group by odd or even numbers. The two groups of nursing students were trained by the infection prevention and control nursing group of the department to prevent nosocomial infection on the first day of entering the department. The trial group adopted casebased learning combined with scenario exercise, while the control group adopted traditional lecture-based learning. The two groups were compared by hand hygiene compliance rate, hand hygiene accuracy rate, clinical waste classification and disposal accuracy rate, occupational exposure, nosocomial infection prevention and control assessment scores, and teaching method satisfaction. Results A total of 63 nursing students from 10 groups were enrolled. There were 32 students from 5 groups in the control group and 31 students from 5 groups in the trial group. The hand hygiene compliance rate(χ^2=8.434, P=0.004), clinical waste classification and disposal accuracy rate(χ^2=4.196, P=0.041),nosocomial infection prevention and control assessment scores(t=3.145, P=0.003) and satisfaction scores of teaching methods(t=2.446, P=0.017) in the trial group were all higher than those in the control group. There was no occupational exposure in the trial group, but 1 case in the control group. The correct hand hygiene rates of the two groups were both100%. Conclusion Case-based learning combined with scenario exercise can effectively improve the awareness of nosocomial infection prevention and control, improve the knowledge and skills of nosocomial infection prevention and control, improve the effectiveness of nosocomial infection prevention and control training, and increase the satisfaction of clinical teaching.