三级综合医院新护士规范化培训的现状调查

Investigation on the status of standardized training for new nurses in tertiary general hospitals in China

目的调查全国三级综合医院落实《新入职护士培训大纲(试行)》的现状,以及新护士对培训的感受和意见,为进一步完善培训方案提供参考。方法采用方便抽样法,于2018年8月-9月抽取31个省、自治区、直辖市的1 421所三级综合医院以及62 031名新护士为调查对象。采用自行设计的调查问卷,以问卷星的形式进行调查。结果 91.6%的医院开展了新护士规范化培训项目。基础培训时长为4.0(2.0,6.0)周,专业培训时长为11.0(3.0,23.8)个月。基本理论知识培训落实率为88.8%~98.6%,常见临床护理操作技术培训落实率为81.6%~97.7%;临床科室轮转落实情况为内科(91.0%)、外科(91.8%)、重症监护病房(85.8%)、急诊(85.1%)、妇产科(72.7%)、手术室(71.3%)、儿科(70.6%)。培训方法主要为操作示教(96.8%)、课堂讲授(95.5%)、临床查房(91.5%)及个案护理(82.0%);临床实践能力考核方式为标准化病人(76.7%)、高仿真情景模拟(63.4%)。78.0%的新护士认为培训内容符合大纲要求,55.8%的新护士认为规范化培训的时长合适,52.0%的新护士认为临床科室的轮转频率合适。新护士对规范化培训的认可程度较高(84.2%),其中对带教教师的满意度最高;影响新护士感受的主要因素由高到低依次为集体归属感(65.2%)、工作强度(65.0%)、带教规范性(58.3%)、薪酬分配(56.5%)、病房人际关系(45.4%)和个人发展(45.2%)。结论《新入职护士培训大纲(试行)》发布以来,我国三级综合医院的新护士规范化培训开展率较高,但在培训时长、培训内容、考核方式等方面需要进一步贴近临床需求,以提高全国新护士规范化培训的效果,同时,建议医院在培训中重视新护士的个体感受,促进新护士的职业发展。

Objective To investigate the training of newly recruited nurses in tertiary general hospitals,as well as feelings and suggestions of newly recruited nurses in China after the announcement of the Training Outline for Newly Recruited Nurses. Methods From August to September 2018,1 421 tertiary general hospitals and 62 031 newly recruited nurses in China were investigated by convenient sampling. A self-designed questionnaire was used and lauuched through the platform of Wenjuanxing. Results Among the investigated hospitals,91.6% had standardized training programs for newly recruited nurses. The basic training lasted 4.0 weeks(2.0 to 6.0 weeks),while the professional training lasted 11 months(3.0 to 23.8 months). The training rate of basic theoretical knowledge ranged from 88.8% to 98.6%,and the training rate of clinical nursing technology ranged from 81.6% to 97.7%.Rotation rates in clinical departments were internal medicine(91%),surgery(91.8%),intensive care unit(85.8%),emergency department(85.1%),obstetrics and gynecology(72.7%),operating room(71.3%) and pediatrics(70.6%). The training methods mainly included demonstration(96.8%),lecture(95.5%),nursing rounds(91.5%) and case nursing(82.0%). Evaluation methods were standardized patients(76.7%) and scenario simulation(63.4%). Among investigated nurses,78% thought the training content met the Outline;55.8% thought the training duration was appropriate,and 52.0% thought the rotation in clinical departments was appropriate. The recognition rate for training program was 84.2% and newly recruited nurses were most satisfied with the teachers. Group sense of belonging(65.2%),work intensity(65.0%),teaching standardization(58.3%),salary allocation(56.5%),interpensonal relationship(45.4%)and personal development(45.2%)were factors influencing feelings. Conclusion With the instruction of The training Outline for Newly Recruited Nurses,most of the tertiary general hospitals had implemented standardized training programs. However,length of training,training contents and evaluation methods should be further improved to meet clinical practicing needs. Feelings of nurses should also be emphqsized to promote development of newly recruited nurses.