连续性肾脏替代治疗联合体外膜肺氧合护理操作技术培训的设计与实践研究

Design and practice of nursing technical training in continuous renal replacement therapy combined with extracorporeal membrane oxygenation

目的设计针对连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)联合体外膜肺氧合(extracorporeal membrane oxygenation,ECMO)护理操作技术的培训方案,并分析其培训效果。方法结合文献分析和临床实践需求,总结归纳CRRT联合ECMO护理操作技术的核心知识点和技能要求,基于掌握性理论设计培训方案,包括理论授课、模拟操作和实践操作三部分。针对2021年—2023年重庆市卫生健康委重症医学专科护士培训班学员开展4期培训,通过比较培训前后学员的理论知识、模拟操作、临床实践考核成绩及临床技能学习自我效能量表得分,评价培训效果。结果培训后20名学员的各项成绩均高于培训前(P<0.05),培训后学员临床技能学习自我效能量表得分(33.70±2.98)高于培训前(24.10±2.27),差异具有统计学意义(P<0.05)。结论该培训能够有效提高护理人员的CRRT联合ECMO护理操作理论及技术水平,提高学员的临床技能学习自我效能,为进一步完善重症专科护士培训提供参考。

Objective To devise and implement a comprehensive training program for nursing staffs specializing in continuous renal replacement therapy(CRRT)and extracorporeal membrane oxygenation(ECMO)operations,and subsequently analyze the effectiveness of this training in enhancing their theoretical knowledge and practical skills.Methods Through a synthesis of literature analysis and according to clinical practice requirements,the core knowledge points and technical competencies necessary for CRRT and ECMO nursing were identified.Based on mastery learning theory,a structured training program was designed,incorporating theoretical lectures,simulation exercises,and hands-on practical sessions.This program was then administered to nursing trainees from the Chongqing Health Commission over a period of 2021 to 2023,with a total of four training sessions conducted.The training’s impact was evaluated by comparing pre-and post-training scores in theoretical knowledge assessments,simulation operation tests,clinical practice evaluations,and self-efficacy scores on a clinical skills learning scale.Results Statistically significant improvements were observed in the performance of the 20 trainees across all assessment categories.Specifically,post-training scores in theoretical knowledge,simulation operation,and clinical practice evaluations were significantly higher than their pre-training scores(P<0.05).Furthermore,the trainees’self-efficacy scores increased from 24.10±2.27 to 33.70±2.98,with a statistically significant difference(P<0.05),indicating a substantial boost in their confidence and perceived competence in performing CRRT and ECMO nursing tasks.Conclusion The tailored training program effectively enhanced the theoretical understanding and technical proficiency of nursing staffs in CRRT and ECMO operations.It not only improved the trainees’clinical skills but also boosted their self-efficacy,demonstrating its potential as a valuable framework for further refining the training of intensive care nurses in these advanced therapeutic modalities.