层级多元化培训模式在医院护理员中的应用效果观察

目的探讨层级多元化培训模式在医院护理员中的应用效果。方法选择本院2019年1月—2019年12月100名医院护理员为研究对象,将其随机均分成对照组和干预组,对照组接受常规模式培训,干预组接受层级多元化培训,比较两组护理员胜任力得分、理论与实践考核得分、住院患者满意度。结果干预组接受培训后医院核心胜任力得分(539±40.58)分,高于对照组(476±60.37)分;理论考核成绩(78.82±4.72)分,高于对照组(71.33±7.51)分;实践考核成绩(87.77±5.81)分,高于对照组(82.49±6.21)分;住院患者满意度高于对照组,差异有统计学意义(P<0.05)。结论对医院护理员实行层级多元化培训,临床效果较好,值得推广。

医院护理员队伍建设的问题与对策

通过分析研究目前全国医院护理员队伍建设的现状,旨在帮助人们认清医院护理员队伍建设的必要性和可行性,以及目前护理员队伍建设中存在的问题,并提出可以采取的对策,进一步规范医院护理员队伍的建设,以全面提高医院护理水平。

医院护理陪护员现状调查表的设计与应用

目的:了解医院护理陪护员目前现状及心理,便于进一步统一管理。方法:调查正在我院做陪护工作的人员,共发放250张医院护理陪护员现状调查表,收回243,占97.2%,并对反馈情况进行综合分析。结果:半数以上护理陪护员觉得加入公司还是合理的,病人问卷调查满意率达90%以上。讨论:我院陪护员的这种双向管理还是比较可行的,通过表格的设计,便于日后的管理和督促,还待于进一步的提高中。

Multicenter application of a nursing workload measurement scale in adult hospitalization units

Objectives:The study aimed to the multicenter application of a nursing workload measurement scale in the internal medicine and surgery adults hospitalization units.Methods:The study design was a multicenter,observational,and descriptive study.A multicenter application of the MIDENF®nursing workload measurement scale was carried out,which consists of 21 items,and covers the four nursing functions(patient care items,teaching,manager,and researcher),in units of hospitalization of adults of internal medicine and surgery of four different hospitals.Each item contains one or more of the nursing interventions of Nursing Interventions Classification(NIC)and has an assigned time,after comparing the real time it takes to perform each intervention with the North American Nursing Diagnosis Association(NANDA)standardized time.The study was carried out during nine months of the year 2020,measuring two days each month in the three work shifts(morning,evening,and night)to all patients admitted on the days of measurement in the indicated units.Results:The descriptive and inferential analysis of 11,756 completed scales,5,695 in general surgery and 6,061 in internal medicine,showed a greater care load for the two units during the morning shift(227,034 min in general surgery,261,835 min in internal medicine),especially in the items of“self-care”,“medication”,“common invasive procedures”,“fluid therapy”,and“patient and family support”,while the managerial function was similar during the three work shifts in the two units studied,getting values between 57,348 and 62,901min.In the analysis by shift and unit,statistical significance was obtained both for the total workload and the four nursing functions(P<0.001).Conclusions:It is shown that the use of validated scales with the standardized language of nursing functions,adapted to the units,provides objective information to adjust the nursing staff to the real situation of care in any hospital and unit where it is applied,improving quality and patient safety.

Reliability and validation of the Arabic version of the Conditions for Workplace Effectiveness Questionnaire-Ⅱ

Objective:This study aimed to examine the psychometric properties of the Conditions for Workplace Effectiveness Questionnaire-Ⅱ-Arabic Version(CWEQ-Ⅱ-AV),which measures structural empowerment among nurses.To enhance the usability and credibility of the CWEQ-Ⅱ among researchers within Arabicspeaking countries,a valid and reliable Arabic version of the measure is necessary.Methods:A cross-sectional research design was used.From December 2018 to June 2019,275 nurses working in 4 hospitals participated in the study.Reliability was assessed by examining internal consistency and split-half reliability.A confirmatory factor analysis was performed to evaluate the factor structure of the CWEQ-Ⅱ-AV.Results:The psychometric properties of the CWEQ-Ⅱ-AV were excellent regarding the six-factor model(opportunity,information,resources,support,formal power,and informal power).The results showed the following fit indices meet the criteria set a priori:comparative fit index(CFI)=0.96,root mean square of error approximation(RMSEA)=0.06,andХ^(2)/df=2.08.Cronbach's a coefficient was 0.95 for the total questionnaire and ranged between 0.83 and 0.89 for the individual subscales.The split-half reliability was 0.91 for the total questionnaire and ranged from 0.83 to 0.87 for individual subscales.Conclusion:This study provides evidence that CWEQ-Ⅱ-AV is both a reliable and valid measure of structural empowerment among Arab nurses.

Frequency and barriers of reporting workplace violence in nurses:An online survey in China

Objectives:This study aimed to explore the reporting of workplace violence against nurses and the reasons why they did not reported.Methods:A self-designed questionnaire regarding workplace violence and reporting was used to conduct a cross-sectional survey on nurses who submitted a manuscript to a Chinese nursing journal from 2016 to 2017.A total of 324 nurses agreed to participate in this study and 266 participants from 165 hospitals in 72 cities returned questionnaires.Results:A total of 172 nurses(64.7%)experienced violent incidents during the past year.Of these incidents,45.5%were reported;and the reporting rate of physical assaults(69.0%)was higher than those of verbal abuse(36.9%),threatening behavior(51.7%),and sexual harassment(60.0%).Formal reporting accounted for 25.4%(15.4%in written form and 10.0%through a computer-assisted reporting system).Almost half of the nurses(49.6%)stated that the hospital had no reporting system or they were uncertain about the reporting system.For reasons of not reporting,51.9%of the nurses were unware of how and what types of violence to report,and 50.6%of the nurses believed that the hospital paid greater attention to patients rather than staff.Conclusions:A clear definition of workplace violence and reporting procedures,establishment of a facile system for reporting,and supervisory support following a reporting are urgently required.

A study of the relationship between nurses'experience,structural empowerment,and attitudes toward computer use

Objective:This study examined the relationship between structural empowerment and nurses’experience and attitudes toward computer use.Methods:This study was conducted using a cross-sectional quantitative design.A total of 184 registered nurses from four hospitals in Jordan participated in the current study.Data were collected using a demographics questionnaire,the Conditions for Work Effectiveness Questionnaire-II(CWEQ-II),and the Pretest for Attitudes toward Computers in Healthcare(PATCH).Results:The median of experience in years among nurses was 5.0,ranging from one to 26 years.The mean score for the attitudes toward computer use was 61.90±11.38.Almost half of the participants,45.11%,were in the category of“feel comfortable using user-friendly computers.”The participants’mean average of the total structural empowerment was 12.40±2.43,and the values for its four subscales were:opportunity 3.57±0.87,resources 2.83±0.85,information 3.06±0.79,and support 2.95±0.86.The frequencies analysis revealed that most participants had a moderate level of empowerment(n¼127,69.02%).The bivariate correlation between nurses’experience and attitudes toward computer use was significant(r¼0.17,P<0.05).The relationship between the total structural empowerment score and attitudes toward computer use was positive but weak(r¼0.20,P<0.01).Conclusion:The results indicated that more experienced nurses are more reluctant toward computer use.However,creating an empowering work environment can facilitate nurses’attitudes toward computer use.

A study of the relationship between professional values and ethical climate and nurses'professional quality of life in Iran

Objective:To explore the relationship between nursing professional values and ethical climate and nurses'professional quality of life.Methods:The present study is a descriptive,cross-sectional work in which 400 nurses from various wards of hospitals in the south-east of Iran were studied.Data were collected using a questionnaire consisting of four sections:demographics,Nurses'Professional Values Scale-Revised(NPVS-R),the Hospital Ethical Climate Survey(HECS),and the Professional Quality of Life Scale(ProQOL).Results:The total mean scores for professional values were 105.29±15.60.The total mean score for the ethical climate was 100.09±17.11.The mean scores for the indexes of compassion satisfaction,burnout,and secondary traumatic stress were 45.29±8.93,34.38±6.84,and 32.15±7.02 respectively.The relationships between professional values and the indexes of compassion satisfaction(r=0.56),burnout(r=0.26),and secondary traumatic stress(r=0.18)were found to be positive and significant(P<0.001).Also,the relationships between ethical climate and the items of compassion satisfaction(r=0.60,P<0.001),burnout(r=0.15,P=0.002)were found to be positive and significant.Conclusion:An understanding of nurses'perception of professional values and improving the ethical climate at work can help nursing administrators identify more effective strategies toward increasing compassion satisfaction and lessening bumout and work-related stress.

Patient safety culture and handoff evaluation of nurses in small and medium-sized hospitals

Objectives:This study was conducted to investigate the current status of handoffs,perception of patient safety culture,and degrees of handoff evaluation in small and medium-sized hospitals and identified factors that make a difference in handoff evaluation.Methods:This is a descriptive study.425 nurses who work at small and medium-sized hospitals in South Korea were included in our study.They completed a set of self-reporting questionnaires that evaluated demographic data,handoff-related characteristics,perception of patient safety culture,and handoff evaluation.Results:Results showed that the overall score of awareness of a patient safety culture was 3.65±0.45,the level was moderate.The score of handoff evaluation was 5.24±0.85.Most nurses experienced errors in handoff and most nurses had no guidelines and checklist in the ward.Handoff evaluation differed significantly according to the level of education,work patterns,duration of hospital employment,handoff method,degree of satisfaction with the current handoff method,errors occurring at the time of handoff,handoff guidelines,and appropriateness of handoff education time(P<0.05).Conclusion:For handoff improvement,guidelines and standards should be established.It is necessary to develop a structured handoff education system.And formal handoff education should be implemented to spread knowledge uniformly.

Challenges for rear hospital care of Wenchuan Earthquake casualties： experience from West China Hospital

To review the challenges and countermeasures in the hospital care for Wenchuan earthquake casualties and draw lessons for the protective response in the future. Medical records and laboratory findings of the victims admitted in West China Hospital （WCH） were retro- spectively analyzed. Related data were compared between beforemath and aftermath of the earthquake and between WCH and frontier county hospitals. One thousand and thirty-one earthquake survivors were hospitalized, 1 358 victims underwent surgery and 142 victims were transferred to intensive care unit. The incidence of infection, crush syndrome and multiple organ dysfunction syndrome （MODS） was 39.6%, 20,7% and 2.3% respectively. Wound classification showed that the incidence of extremity damage was 72%, while the incidence of chest trauma, abdominal trauma and brain trauma was less than 10% respectively. Isolating rates of environmental pathogens were increased in the aftermath of earthquake, and the spectrum of the pathogens and related antibiotic sensitivities were quite different from those in the beforemath of earthquake. The social economic and population conditions in the earthquake-stricken areas affected the composition of the victims and the geographic features restricted the efficiency of rescue. Trauma-induced MODS, crush syndrome and severe infections all constituted the dilemma for the hospital care, to resolve whether the multidiscipline team work was proved to be an optimizing choice. For a more effective disaster protective response in the future, the study on rescue plan and the ladder therapies for massive casualties should be potentiated.