Discussion on the Graduation Practical Ability Assessment Model for Master of Nursing Specialist Students

Objective: To explore graduation practical ability assessment mode of graduate students in nursing (Master of Nursing Specialist, MNS). Methods: All 28 MNS 2020th graduate students in a university were selected as subjects by convenient sampling method, using the improved 4-station objective structured examination (Objective Structured Clinical Examination, OSCE) model. The assessment content included nursing assessment, nursing diagnosis, basic nursing operation, specialist nursing operation, theoretical written test and oral test and overall evaluation. And self-made questionnaire was used to evaluate the effect of the assessment model and the improvement of clinical practice ability of graduate students. Results: The overall satisfaction rate of graduation assessment was 89.51%, the overall satisfaction rate of graduation assessment mode and practical ability improvement evaluation was 84.66%, the pass rate of assessment results was 100%, and the excellent rate was 71.42%. Conclusion: The MNS graduation practical ability assessment model has a high degree of satisfaction, objectively evaluates the knowledge, skills, attitudes and emotions of graduate students, promotes the comprehensive quality and ability of graduate students, which is worthy of promotion.

Practical effect of different teaching modes in teaching gastrointestinal surgery nursing

BACKGROUND With the continuous development and progress of medical technology,the position of surgical nursing in the field of clinical medicine is becoming in-creasingly prominent.As an important branch of the surgical field,the nursing requirements and difficulty of gastrointestinal surgery are also increasing.In order to improve the teaching quality of nursing care in gastrointestinal surgery,many educators and researchers are actively exploring new teaching methods.Among them,the teaching method case-based learning(CBL),scene-simulated learning(SSL),task-based learning(TBL),combining self-evaluation and training mode is considered as an effective method.This method aims to help students to better master knowledge and skills and improve their comprehensive quality by cultivating their self-evaluation ability.AIM To explore the practical effect of CBL-SSL-TBL combined with training mode and student self-assessment in nursing teaching of gastrointestinal surgery.METHODS Seventy-one nursing interns in our hospital from December 2020 to December 2021 were selected.According to different teaching modes,they were divided into observation group CBL-SSL-TBL combined with training mode combined with student self-assessment and control group(conventional teaching mode),of which 36 were in observation group and 35 were in control group.The results of operational skills,theoretical knowledge,nursing students'satisfaction,learning effectiveness questionnaire and teaching effect were compared between the two groups.RESULTS Compared between the two groups,the operational skills and theoretical knowledge scores of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05).Compared between the two groups,the total satisfaction ratio of the observation group was higher than that of the control group,the difference was statistically significant(P<0.05).Compared between the two groups,the observation group was lower than the control group in the questionnaire results of learning efficacy,and the difference was statistically significant(P<0.05).Compared between the two groups,the proportion of thinking ability,subjective initiative and understanding of theoretical knowledge in the observation group was higher than that in the control group,the difference was statistically significant(P<0.05).CONCLUSION The use of CBL-SSL-TBL combined with training mode and student self-assessment in gastrointestinal surgery nursing teaching can improve the operational skills of nursing interns,theoretical knowledge and satisfaction scores of nursing students,improve the results of learning efficiency questionnaire and teaching effect,which can be popularized in clinical teaching.

The concept and characteristics of clinical practice ability in Master Degree of Nursing (specialty)

The concepts of ability, practice ability, and professional practice ability were analyzed using a theoretical research method. Based on the results of the analysis, the concept of clinical practice ability for Master Degree of Nursing（specialty） students was de？ned, and the characteristics were interpreted to provide references for future in-depth studies.

改良Nursing-Mini-CEX教学模式对本科护生临床实践能力和临床思维的影响

目的:探讨改良Nursing-Mini-CEX教学模式在本科护生实习中的实践效果。方法:整群抽样方法抽取我院2019年7月至2020年3月本科实习护生设为对照组,2020年7月至2021年3月本科实习护生设为试验组。对照组护生实行传统一对一临床带教,试验组护生在对照组基础上采用改良Nursing-Mini-CEX教学模式进行带教。比较两组护生出科考核成绩、改良Nursing-Mini-CEX评估量表和医学生临床思维能力评估量表得分。结果:试验组平时考核成绩、操作考核成绩均高于对照组(P<0.05);试验组改良Nursing-Mini-CEX评估量表各维度得分均高于对照组(P<0.05);试验组医学生临床思维能力评估量表中批判性思维与系统思维得分均高于对照组(P<0.05)。结论:改良Nursing-Mini-CEX教学模式能提高护生实习成绩和临床护理教学质量,提升护生临床实践能力,培养临床思维。

Investigation on the Clinical Readiness of Nurses’Evidence-Based Practice in a 3A-Level General Hospital in Beijing

Objective:To understand the evidence-based practice readiness of developing evidence application projects in a 3A-level general hospital in Beijing,to identify barriers to evidence-based practice and to promote the successful application of evidence.Methods:All the clinical nurses who were going to participate in the application units of the evidence-based practice project were selected as the survey objects,and the self-made“Basic Information Questionnaire”and“Clinical Readiness to Evidence-based Nursing Assessment(CREBNA)”were used to conduct the survey.The total amounts and subscales were calculated.The factors that influence the score of the total scale were scored and analyzed.Results:The CREBNA total score was(119.87±19.18),the evidence subscale score was(47.94±8.54),the organizational environmental subscale score was(36.09±6.11),and the facilitator subscale score was(35.83±7.56).Univariate analysis showed that the total score of the scale was related to years of work,scientific research experience,knowledge of evidence-based care,and participation in evidence-based practice.Conclusion:The current evidence-based practice preparation situation is good.It is feasible to carry out evidence-based practice activities in the hospital.The follow-up development plan should be made based on the corresponding obstacle factors.

The Factors Associated with the Attitudes of Nurses Working in Medical Facilities towards Family Nursing

The aim of this study was to clarify the attitudes of nurses working in medical facilities towards family nursing and the related factors. A quantitative cross-sectional design was used. The study period was from December 2017 to February 2018. 638 nurses with more than 5 years clinical experience were recruited from seven medical facilities. The questionnaire included the Families’ Importance in Nursing Care-Nurses’ Attitudes (FINC-NA), the Family Sense of Coherence (FSOC), and items on nursing practice ability, job satisfaction, and background characteristics. A multiple regression analysis with FINC-NA as the dependent variable and a path analysis of nursing practice ability as the dependent variable were performed. Responses from 416 nurses (effective response rate, 65.2%) were analyzed. Variables that were significantly related to FINC-NA (p < 0.05) were nursing practice ability, FSOC, job satisfaction, family nursing learning experience, presence of a partner and experience in family nursing. Multiple regression analysis with FINC-NA as the dependent variable revealed significant regression coefficients for nursing practice ability, FSOC and job satisfaction. Moreover, path analysis with nursing practice ability as the dependent variable showed job satisfaction, FSOC, managerial experience, family nursing learning experience were significant. In addition, it was revealed that the direct effect of FSOC on FINC-NA to mediate nursing practice ability was higher than the indirect effect, but the direct effect of job satisfaction on FINC-NA was lower than the indirect effect. It was suggested that it is important that nurses recognize their own thoughts, behaviors and ways of coping with stress within their family, and establish a good work environment and strive to enhance their nursing practice ability.

理论-实践-互动式教学法在儿科护理教学中的应用探究

目的探究理论-实践-互动式教学法(theory-practice-interactive teaching method,TPI)在儿科护理教学中的应用效果。方法选择2020年9月—2022年10月中国医科大学附属盛京医院进行儿科实习的护理本科生为研究对象。实习时间在2020年9月-2021年9月者为传统教学组,给予传统教学方式教学,实习时间在2021年10月—2022年10月者为TPI教学组,给予TPI法教学。2组教学内容、授课教师及教学时间相同,统计2组教学后理论及实际操作技能成绩,教学前、后给予2组学生批判性思维能力量表(critical thinking disposition inventory-Chinese version,CTDI-CV)评价,通过学生自主学习评价量表评价2组学生学习动机、学习合作能力、信息素质、自我管理能力,比较2组教学满意度。结果TPI教学组理论知识、实际操作技能评分较传统教学组高,差异有统计学意义(P<0.001)。TPI教学组学生学习动机、学习合作能力、信息素质、自我管理能力、CTDI-CV评分较传统教学组高,差异有统计学意义(P<0.001)。TPI教学组教学满意度(97.78%)较传统教学组高(84.44%),差异有统计学意义(P<0.001)。结论在儿科护理教学中运用TPI教学法,可提升学生教学成绩、实践能力、自学能力及批判性思维能力,提升教学满意度。

临床护理教师教学能力与护理信息能力及循证实践能力关系模型的研究

目的:分析临床护理教师的教学能力、护理信息能力及循证实践能力的现状,明确三者的关系,为提高临床护理教师教学能力提供参考。方法:采用方便抽样法,于2022年10月至2024年3月在广东省5个城市15家三级医院选取具有本科生带教经验的740名临床护理教师作为研究对象。用一般资料调查表、护理信息能力量表、中文版循证实践能力评估量表及护理本科生临床带教老师教学能力问卷进行调查,运用Person相关分析和结构方程模型进行数据分析。结果:临床护理教师护理信息能力、循证实践能力及教学能力条目均分分别为(3.60±0.55)分、(3.16±0.74)分、(3.05±0.58)分,护理信息能力对教学能力具有直接效应(β=0.368,P<0.05);循证实践能力对教学能力有直接效应(β=0.590,P<0.05);护理信息能力可以通过循证实践能力间接影响教学能力(β=0.238,P<0.05)。结论:临床护理教师护理信息能力、循证实践能力处于中等水平,护理管理者应采取多项措施提升临床护理教师护理信息能力、循证实践能力,进而提高临床护理教师教学能力。

区域医联体医院ICU护士核心能力现状及影响因素研究

目的调查区域医联体医院ICU护士核心能力,并分析其影响因素,为制定针对性的措施提高医联体内ICU护士核心能力提供参考。方法采用整群抽样方法纳入黄冈地区医联体内19所医院的285名ICU护士作为研究对象,采用一般资料调查表、护士职业获益感量表、ICU护士核心能力调查表进行调查。结果ICU护士核心能力总分为(258.79±65.11)分,条目均分(3.50±0.88)分,其中临床实践能力维度条目均分最高(3.70±0.92),专业发展能力维度条目均分最低(3.28±0.95);职业获益感总分为(53.75±10.86)分。医院等级、职称、参加过ICU专科培训、获得ICU专科护士证书、工作保障、工作价值是区域医联体医院ICU护士核心能力的主要影响因素(均P<0.05)。结论医联体医院ICU护士核心能力处于中等水平,需开展ICU专科培训及提高职业获益感,从而提高其核心能力。

产教融合背景下护理硕士专业学位研究生实践创新能力培养实践

护理硕士专业学位研究生的实践创新能力培养已成为高校教育改革实践的重点。而在实际培养过程中存在培养模式的系统性及课程体系有待增强,多元主体间的协作融合深度不够,产教融合保障机制和评价体系欠完善等问题。课题组以建构主义、行为主义和协同理论为理论基础,构建“多元—交叉—融合—协同”四位一体的培养体系;建设基于决策导向评价模式(CIPP评价模式)的实践创新能力评价体系,为高校护理硕士专业学位研究生实践创新能力培养提供新思路。

护理专业硕士研究生临床实践能力培养现状研究

护理专业硕士研究生教育是为了培养高层次、应用型和专科型高级护理人才,培养其岗位胜任能力,即能够直接从事临床专门领域护理实践,且在某一专科领域具备高级护理实践、咨询、教育、管理和研究等能力。文章采用内容研究法、比较研究法,对31所院校2022年护理专业硕士研究生招生方向和临床实践培养方案进行比较,并对照目前相关研究发现的问题进行分析。结果发现,多数院校存在培养目标不明确、临床实践考核方式单一、临床实践内容和时间安排不合理等问题。因此,需要规范护理专业硕士研究生教育二级学科名称,专业设置注重临床化趋向;明确临床实践能力培养目标;积极探索护理专业硕士研究生教育与临床专科护士培养相结合的模式,建立适合我国国情的护理专业硕士研究生临床实践培养模式;构建高层次应用型护理专科人才的岗位胜任能力评价指标体系,改革护理专业硕士考核评价方式;合理安排临床实践内容和时间,从而有效促进护理专业硕士研究生临床实践能力提高。

吉布斯反思循环在护理硕士研究生腹膜透析临床教学中的应用

目的探讨吉布斯反思循环对腹膜透析中心护理硕士研究生反思洞察力与学习获得感的干预效果。方法采用便利抽样法选取临床实践的护理硕士研究生64名为研究对象,按照入科时间分成对照组33名与试验组31名。对照组采用传统带教方法,试验组在此基础上采取吉布斯反思循环进行临床实践教学,为期4周,研究生根据吉布斯反思循环要求完成反思日记,汇报与分享反思成果并应用于临床实践。比较干预前后两组的反思洞察力与学习获得感。结果干预后对照组的反思洞察力得分为(67.82±2.80)分,试验组为(85.29±2.39)分;干预后对照组学习获得感得分为(92.36±2.53)分,试验组为(98.48±4.36)分,两组比较差异有统计学意义(均P<0.05)。结论吉布斯反思循环能够在一定程度上提高腹膜透析中心护理硕士研究生的反思洞察力及学习获得感。

高职高专院校实习护生人文执业能力现状调查及影响因素分析

目的:调查高职高专实习护生人文执业能力水平及其影响因素,为职业院校人文护理教育教学改革提供依据。方法:采取多阶段便利抽样法,对全国18所高职高专护理专业的1256名实习生进行线上问卷调查,调查工具包括一般资料调查表、护士人文执业能力量表。结果:实习护生人文执业能力总分为(100.47±15.94)分,标准分为77.28分;其中伦理与法律实践能力维度得分为(11.70±1.98)分,标准分为77.97分;人文关怀实践能力维度得分为(38.73±6.23)分,标准分为77.46分;人际沟通能力维度得分为(23.25±3.82)分,标准分为77.49分;心理调适能力得分为(15.48±2.48)分,标准分为77.39分;自我管理能力维度得分为(11.32±1.80)分,标准分得分75.47分。多元线性回归分析显示,报考志愿选择、成绩排名、护理人文教育重要性认知、学校或实习医院人文环境和氛围、教师人文素养和人文示范进入回归方程,能解释32.9%的变异,是影响实习护生人文执业能力的主要因素。结论:高职高专院校实习护生人文执业能力处于中等水平,但自我管理能力较弱。护理教育者应加强高职高专护生专业兴趣的培养,提高学生对护理人文教育的认识;要注重学校和实习单位人文环境建设,营造人文氛围,重视护理人文师资队伍建设,提升教师人文素养和人文示范作用,多途径促进护生人文执业能力提高。

“一树四位六步”的理实一体教学模式在五年一贯制高职内科护理教学中的应用

目的:构建“一树四位六步”的理实一体教学模式并探讨其在五年一贯制高职护理专业内科护理课程中的教学效果。方法:选取五年一贯制高职护理专业一年级的121名学生为研究对象,分为试验组59人和对照组62人。对照组采用线上线下混合式教学,试验组采用基于“一树四位六步”的理实一体教学,即以“智慧树”形式整合知识点,采用学生本位、理实一体、线上线下混合、情景模拟教学的四位一体教学模式,通过课前感知-课中情景模拟-小组讨论-反思总结-课后主题活动-感悟内化的六步教学方法。比较两组学生的课程成绩和自主学习能力。结果:试验组实训成绩、期末卷面成绩、期末总评成绩高于对照组,自主学习能力优于对照组,差异均有统计学意义(P<0.05)。结论:基于“一树四位六步”的理实一体教学模式有助于提高五年一贯制高职护理专业学生的学习成绩和自主学习能力。

实习护生临床归属感在职场适应度与人文执业能力间的中介效应

目的探讨实习护生临床归属感在职场适应度和人文执业能力间的中介效应,为护理教育者提高实习护生人文执业能力提供依据。方法采用临床归属感量表、护士职场适应度量表、护士人文执业能力测评量表对300名实习护生进行调查。结果实习护生临床归属感总分(103.65±18.46)分,职场适应度总分(67.58±12.24)分,人文执业能力总分(108.78±18.03)分。实习护生临床归属感、职场适应度和人文执业能力三者之间呈正相关(均P<0.05),临床归属感在职场适应度和人文执业能力间中介效应占比为61.52%。结论实习护生临床归属感在职场适应和人文执业能力中起部分中介作用,可通过提高实习护生的临床归属感及职场适应度,提高其人文执业能力。

“5W1H”教学分析法结合视频教学在普外科护理本科实习生临床实践中的应用

目的:探讨“5W1H”教学分析法结合视频教学在普外科本科护生临床实践中的应用效果。方法:选取我院普外科本科护生138名为研究对象,分为两组,对照组接受传统教学,试验组在此基础上采用“5W1H”教学分析法结合视频教学,比较两组护生考核成绩、临床护理实践能力及教学满意度。结果:试验组护生考核成绩、临床护理实践能力、教学满意度均高于对照组(P<0.05)。结论:“5W1H”教学分析法结合视频教学能提升普外科本科护生临床实践能力,提升教学满意度。

融合课程思政的BOPPPS联合情景模拟法对胸外科临床护理教学的作用

目的探讨融合课程思政的BOPPPS联合情景模拟法在胸外科临床护理教学中的应用。方法选取2021年1月—2023年1月南昌大学第一附属医院胸外科临床护理实习生76名作为研究对象,按照组间基线资料具有可比性原则将护理实习生分为对照组和观察组各38例。对照组采用传统课堂教学,观察组实施融合课程思政的BOPPPS联合情景模拟法教学。对两组护理实习生的考核成绩、学习投入量程度、学习压力和疲倦情况、批判性思维能力、学习态度和教学满意度进行比较。结果所有课程结束后,观察组考核成绩高于对照组,组间比较差异有统计学意义(P<0.05);观察组学习投入程度评分高于对照组,组间比较差异有统计学意义(P<0.05);在学习压力和疲惫情况方面,观察组付出和过度投入评分低于对照组,回馈评分高于对照组,组间比较差异有统计学意义(P<0.05);观察组批判性思维能力评分高于对照组,组间比较差异有统计学意义(P<0.05);观察组护生继续教育学习态度评分、教学满意度评分均高于对照组,组间比较差异有统计学意义(P<0.05)。结论将融合课程思政的BOPPPS联合情景模拟法应用在胸外科临床护理教学中,能够有效提高胸外科护生考核成绩、学习投入量程度和批判性思维能力,激发实习护生的学习兴趣和潜能,改善其学习压力和疲倦情况,加强学习和掌握胸外科临床护理的知识技能,护理实习生整体学习态度和教学满意度高。

TTM与OSCE考核对新入职产科护士实践技能培养的研究

目的探讨行为阶段转变理论模型(the transtheoretical model and stages of change,TTM)与客观结构化临床考核(objective structured clinical examination,OSCE)模式对于新入职产科护士实践技能培训的指导价值。方法选取2020年1月—2021年3月南京医科大学附属妇产医院接收的新入职产科护士78名作为对照组,选取2021年4月—2022年9月南京医科大学附属妇产医院接收的新入职产科护士78名为作观察组。对照组采取常规的集中培训方法,观察组采取TTM与OSCE考核培训方法。对比2组新入职产科护士的实践技能考核评分情况、经培训后综合能力以及满意度情况。结果观察组培训后的实践技能考核得分高于对照组[(93.33±2.42)分vs.(88.52±2.71)分],差异有统计学意义(P<0.001);观察组产科护士经培训后在护理评估、临床思维、沟通技能、人文关怀、整体评价各个方面综合能力得分高于对照组,差异有统计学意义(P<0.001);观察组产科护士总满意率(94.87%)高于对照组(83.33%),差异有统计学意义(P<0.05)。结论针对新入职产科护士,实施TTM与OSCE考核培训方式可以提高护士实践技能及综合能力,并提高满意度。

基于知信行模式的3H护理在慢性阻塞性肺疾病急性加重期患者中的应用

目的探究基于知信行模式的3H护理在慢性阻塞性肺疾病急性加重期(AECOPD)患者中的应用价值。方法选取医院2019至2022年收治的73例AECOPD患者作为研究对象,随机分为观察组(n=37)和对照组(n=36)。对照组采用常规护理方式,观察组采用基于知信行模式的3H护理,比较2组患者心理弹性、生活质量、自护能力、自我效能。结果干预后2组患者心理弹性、生活质量、自护能力、自我效能得分较干预前均有升高(P<0.05),且观察组更高(P<0.05);结论相比于应用常规护理,应用基于知信行模式的3H护理对于AECOPD患者而言,更能提升心理韧性、改善生活质量、提升自护能力、提高自我效能,适合在临床推广使用。

知信行健康教育护理在冠状动脉旁路移植术患者中的应用效果

目的:观察知信行健康教育护理在冠状动脉旁路移植术(CABG)患者中的应用效果。方法:回顾性分析2021年3月至2022年2月该院收治的92例CABG患者的临床资料,按照护理方法不同将其分为观察组与对照组各46例。对照组实施常规护理,观察组在对照组基础上实施知信行健康教育护理,两组均护理至患者出院。比较两组护理依从率,护理前后应对方式[医学应对问卷(MCMQ)]评分、自护能力[自我护理能力测定量表(ESCA)]评分,护理满意度,以及主要心血管不良事件发生率。结果:观察组护理依从率为95.65%(44/46),高于对照组的78.26%(36/46),差异有统计学意义(P<0.05);护理后,观察组面对评分高于对照组,回避、屈服评分均低于对照组,差异有统计学意义(P<0.05);护理后,观察组自我概念、自我责任感、自我护理技能、健康知识水平等ESCA各维度评分均高于对照组,差异有统计学意义(P<0.05);观察组护理满意度为97.83%(45/46),高于对照组的82.61%(38/46),差异有统计学意义(P<0.05);观察组心脏不良事件发生率为4.35%(2/46),低于对照组的19.57%(9/46),差异有统计学意义(P<0.05)。结论:在常规护理基础上实施知信行健康教育护理可提高CABG患者护理依从率、自护能力评分和护理满意度,改善应对方式评分,降低主要心血管不良事件发生率,效果优于单纯常规护理。