复杂自适应系统理论在麻醉科护士继续教育培训中应用的研究进展

Research progress of application in continuing education and training of anesthesia nurses based on the application of complex adaptive system theory

目的对国外麻醉科护士(CRNA)继续教育培训现状进行文献回顾,并探讨基于复杂自适应系统理论(CAS)在CRNA继续教育培训中的应用。方法根据CAS模型的3个概念(即基于关系的护理,领导力和创造性的探究),分析阐述CAS在CRNA继续教育培训中的应用与建议。每个概念对应不同的结果,基于关系的护理对应的是与患者、同行和组织合作,以促进创新解决方案的护理;创造性的探究对应动态结果;领导力对应变革推动者,建立信任,授权、激励和启发团队建设者,并指导改善结果。结果CRNA在临床中面临着众多的护理问题,在一个复杂的适应性系统中,基于关系的护理通过小组互动和多样性来实现过渡。围手术期护理小组需要和麻醉、手术、护理和患者/家属等根据个案情况形成,符合CAS框架和原则。结论我国CRNA继续教育培训及资格认证等有待进一步完善。提示可应用CAS框架完善课程设置,增加领导力及创造性探究培养,规范CRNA继续教育,强化所学知识和概念、学习新的麻醉技能和理念及锻炼领导和沟通能力等,建立系统化的CRNA继续教育管理模式。

Objective To review the current situation of continuing education and training of certified registered nurse anesthetists(CRNA)abroad,and to explore the application of CRNA continuing education and training based on Complex Adaptive Systems Theory(CAS).Methods According to the three concepts of the CAS model(relationship-based nursing,leadership and creative inquiry),the application and recommendations of CAS in CRNA continuing education and training were analyzed.Each concept corresponded to a different outcome,relationship-based nursing corresponded to care that collaborates with patients,peers and organizations to promote innovative solutions;creative inquiry corresponded to dynamic outcomes;leadership corresponded to change agents,building trust,empowerment,motivate,and inspire team builders.Results CRNA faced numerous nursing issues in the clinic,in a complex adaptive system where relationship-based nursing transitions through group interaction and diversity.The perioperative care team should be formed with anesthesia,surgery,nursing,and patients/family members based on individual circumstances,in line with the CAS framework and principles.Conclusion China’s CRNA continuing education training and qualification certification need to be further improved.Prompt that the CAS framework can be used to improve the curriculum,increase leadership,and creative inquiry training,standardize CRNA continuing education,strengthen the knowledge,and concepts learned,learn new anesthesia skills and concepts,and exercise leadership and communication skills,etc.,to establish a systematic CRNA continuing education management model.