护理文书书写教学在实习生护理水平中的应用

Application of Nursing Document Writing Teaching in Interns'Nursing Level

目的:探讨护理文书书写教学在提高实习生护理水平中的效果及对教学工作的价值。方法:选取2020年6月-2022年4月普宁市人民医院护理实习生50名为观察对象,其中2020年6-12月护理实习生22名纳入对照组,2021年1-4月护理实习生28名纳入干预组,对照组采用传统带教护理教学,干预组在此基础上强化护理文书书写教学。比较两组实习生护理文书书写质量、综合能力评分考核、应急抢救能力及个人素质水平。结果:干预组实习生在首次护理记录、体温单、护理记录单、病室报告、医嘱处理要求项目考核中错误、缺陷发生率均低于对照组,差异具有统计学意义(P<0.05);干预组理论知识、实践操作、应急抢救及个人素质水平考核得分均优于对照组,差异具有统计学意义(P<0.05)。结论:强化护理实习生护理文书书写的带教培训,有助于护理水平的提高,强化对患者病情、体征等情况掌握,促进患者临床治疗中的康复进展。

Objective:To explore the effect of nursing document writing teaching on improving the nursing level of interns and its value on teaching work.Methods:From June 2020 to April 2022,50 nursing interns in Puning People's Hospital were selected as the observation subjects,among them,22 nursing interns from June to December in 2020 were included in the control group,28 nursing interns from January to April in 2021 were included in the intervention group.The control group used traditional teaching nursing teaching,and the intervention group strengthened the teaching of nursing document writing on this basis.The nursing document writing quality,comprehensive ability score assessment,emergency rescue ability and personal diathesis level of the interns in the two groups were compared.Results:The incidences of errors and defects in the first nursing record,temperature sheet,nursing record sheet,ward report and medical order processing requirements of the interns in the intervention group were lower than those in the control group,and the difference was statistically significant(P<0.05);the scores of theory knowledge,practical operation,emergency rescue and personal quality level of the interns in the intervention group were better than those in the control group,and the difference was statistically significant(P<0.05).Conclusion:Strengthening the teaching training of nursing intern on writing nursing documents will help improve the level of nursing,strengthen the grasp of the patient's condition and physical signs,and promote the progress of the patient's rehabilitation in clinical treatment.