多元化培训在整形外科专科急诊技能培训中应用

目的探讨提高整形外科专科急诊技能的培训方法。方法将除颤仪、心电图机、心电监护仪、氧气罐、简易呼吸器的使用及CPR技术、吸氧技术、吸痰技术的应用共8项操作,制定多元化培训计划。自2013年10月至2014年12月,对12名整形外科专科急诊护师进行多元化培训,并对培训成绩进行考核;同时,将此多元化培训成绩与2012年10月至2013年10月的传统培训的10名护师的成绩进行对比。结果多元化培训14个月后,12名护师对心电监护仪、心电图机、除颤仪、氧气罐(枕)的操作熟练掌握程度达到98%,吸痰技术、吸氧技术、CPR技术、简易呼吸器考核平均95分,考核成绩均优于传统培训法,差异有统计学意义(P<0.05)。结论多元化培训方法可以有效提高整形外科专科护师急诊技能,拓宽了其学习的视野,增加了其主动参与的机会,提高了其对学习内容的掌握程度。     

士官护士卫勤保障救援综合能力调查

目的 探讨士官护士卫勤保障救援能力的培养方法.方法 采用个人访谈、问卷调查、素质测试等方法对10省（市）武警部队医院的162名士官护士分类调查.结果 士官护士卫勤保障救援能力薄弱.表现在37.50％的士官护士对现阶段承担的卫勤保障救援任务不明确,不了解具体工作,对保障救援任务自我认知程度不够;应急处置方面表示“知识欠缺”的102名占62.96％;现场救援的动手能力方面表示“知识欠缺”的79名占48.77％;急救知识和急救技能测试合格率偏低,急救技术理论成绩优秀率最低,仅为7.27％;军事体能素质下滑.结论 士官护士急救技术不过硬,缺乏对突发事件的应对能力,有必要采取多样化继续培训等方式提升士官护士卫勤保障救援综合能力.     

Patient preparation for diagnostic nuclear medicine imaging procedures: an analysis of ward nurse knowledge

Purpose This study examined ward nurse understanding of diagnostic nuclear medicine imaging procedures in order to assess whether they were adequately informed to prepare their patients for nuclear medicine imaging examinations.Method A questionnaire was used to establish ward nurse knowledge and understanding of nuclear medicine. The questionnaire had two sections: nurse characteristics and nurse knowledge of information sources about nuclear medicine; knowledge assessment. The knowledge assessment had two elements—self-assessment of knowledge and objective assessment of knowledge based upon multiple choice questions. One hundred questionnaires were distributed to nurses of varying grades on six wards in a district general hospital. The six wards routinely referred patients for nuclear medicine imaging examinations. For the past four years each of these wards had been provided with information booklets for ward staff. These booklets were to provide ward staff with adequate background knowledge to prepare, physically and psychologically, their patients for diagnostic nuclear medicine imaging procedures.Results Knowledge varied considerably between nurses. Overall the nurses had a poor understanding of nuclear medicine, however their self-assessment ratings suggested they generally considered themselves inadequately informed to prepare their patients for the nuclear medicine imaging procedures. Several factors were identified to explain their lack of understanding. These included lack of specific training and education basic nursing courses and the ward nurses not knowing that information booklets were available on the ward for them.Conclusions/recommendations Ward nurse knowledge needs to be improved and inter-nurse knowledge variations need to be minimised. This may help ward nurses prepare their patients more adequately for the diagnostic nuclear medicine imaging procedures. Selection of nurses, through self-selection, may be a reliable method of deciding which nurses require additional training. However the data suggests that those nurses with a better knowledge and understanding may underrate their true ability.     

护理人员对生命质量认知及实践情况调查

目的了解临床护士对生命质量的认知状况及其影响认知的因素,探讨改善措施,以提高护理人员对生命质量的认知及应用,更好地为患者服务,从而促进护理质量的提高,推动优质护理服务深入开展。方法采用自行编制的调查问卷,内容包括一般资料、对生命质量的认知和态度以及临床护士开展评价生命质量的困难等,对某三甲医院心内科、肿瘤科、呼吸科、消化内科、神经内科、内分泌科护士共200人进行问卷调查,并对调查结果进行统计分析。结果共收回有效问卷135份,其中：（1）42．2％的护士知道生命质量的概念,45．9％的护士不知道生命质量的概念,有66．7％的护士不知道目前国内生命质量的研究方向。（2）有80．7％的护士没有把生命质量理念运用于临床护理。（3）61．5％的护士愿意进一步了解学习生命质量,有64．4％的护士希望通过专题讲座的方式来学习。结论目前,临床护理人员对生命质量认知不足,有必要加强在职培训,充实护理教育内容。可以通过专题讲座和发放书面资料等方式,有效地组织在职培训,提高护理人员对生命的认知能力及整体素质。     

Insulin resistance and glucose tolerance in obese women: the effects of a recreational training program

AIM: This study was designed to investigate whether recreational physical activity based on aquatic training may improve lipid profile and glucose tolerance in obese subjects. Additionally, we intended to assess a possible correlation between insulin resistance index HOMA(IR) with another index including serum adiponectin concentrations. METHODS: Study population consisted of 12 obese women aged 44-61, who volunteered for an aquatic training 1 h twice a week for 3 months. Before entering the training program, and after completing it patients' oral glucose tolerance test was performed. Glucose, insulin and adiponectin concentrations, levels of antibodies to oxidatively modified low-density lipoproteins (oLAB), and lipid profiles were measured in blood samples collected before the oral glucose tolerance test (OGTT). Glucose and insulin concentrations were also assessed in blood samples collected at 30 and 120 min of OGTT. Atherogenic index of plasma (AIP), and insulin sensitivity indexes HOMA(IR) and HOMA(AD) were calculated on the basis of the obtained data. RESULTS: The 3-month, recreational aquatic training had no influence on body mass, but it resulted in improved glucose tolerance (at t = 0 and t = 120 min), decreased index (HOMA(IR)), and decreased levels of total and LDL-cholesterol (P<0.05). Adiponectin concentrations and values of HOMA(AD) remained unchanged. We found a significant correlation between adiponectin levels and concentrations of total and LDL cholesterol, and between insulin indexes HOMA(IR) and HOMA(AD) both before, and after the training (P<0.01). CONCLUSION: The results of our study indicate that a 3-month recreational training consisting in water aerobic results in favorable changes in glucose and lipid metabolism in obese subjects, even despite the lack of improvement in body mass.     

Factors influencing selection of an interventional radiology training program

PurposeTo understand factors influencing the choice and ranking of Interventional Radiology (IR) training programs among a cohort of medical students and diagnostic radiology residents pursuing careers in IR.Materials and methodsAn IRB approved, 34 question online survey (surveymonkey.com) evaluated the impact of twenty-two different factors and demographics on IR training program selection for medical students and residents. The factors analyzed included programmatic features, location characteristics, academic reputation, program size, benefits/financial incentives, emphasis on clinical care, and future job opportunities. Comparison of Likert scale responses between medical students and residents were performed by using unpaired two-sample t-tests.Results181 (145 male, 35 female) individuals responded to the survey, 74 medical students (40.9%) and 107 residents (59.1%). Medical students and residents both selected variety of IR cases as the most important and highest rated factor when choosing an IR program. Medical students ranked availability of a mentor (p = .03), inpatient consultation service (p = .003), outpatient clinic experience (p = .003), and ICU rotation experience (p < .001) significantly higher. Residents rated job placement/accomplishments of prior fellows (p = .03) and opinion of spouse/significant others (p = .002) significantly higher than medical students.ConclusionsThe top rated factors are similar among medical students and residents however medical students value the clinical aspects of the program (ICU experience, inpatient consultation service, outpatient clinic) more than residents. Residents placed more value on job placement opportunities in selecting an IR program.     

三级综合医院介入导管室男护士急救工作体验的质性研究

目的深入了解三级综合医院介入导管室男护士在临床工作中遇突发抢救时的真实感受,为制订更加完善的管理流程,提高介入导管室临床抢救能力提供参考依据。 方法2021年8月至2021年9月,运用现象学研究法对广东省6家三级综合医院介入导管室12名男护士进行半结构深度访谈,将获取的资料进行分析、总结、归纳。 结果提炼出介入导管室男护士遇突发抢救时工作体验的4个主题：介入导管室的整体氛围较好、压力的来源与应对、男护士在抢救过程的优势、对管理者的期望。 结论男护士普遍对介入导管室的工作氛围比较满意,但在遇突发抢救时男护士在肯定自身优势的同时,也承认来自患者家属、抢救技能和相互配合等方面的工作压力较大、任务重。建议护理管理者应保持并借助介入导管室的良好氛围,创造条件增加男护士外出进修、学习机会,不定期进行情景模拟抢救培训,制订更完善、更规范的突发抢救流程和护理管理对策,提高介入导管室男护士在遇突发抢救时的应对能力。     

案例培训法在提高年轻护士病情观察能力中的应用研究

目的:为了弥补年轻护士观察能力不足的现状,探讨以案例为基础的护理培训法在年轻护士护理观察能力提高中的效果.方法:对我院127名年轻护士病情观察能力进行了案例培训,通过培训前后对年轻护士病情观察能力及护理评估能力考核对比分析,比较培训前、后的差别.结果:培训后年轻护士病情观察能力和护理评估能力较培训前有显著提高(P<0.01).结论:案例培训法对提高年轻护士病情观察能力有明显促进作用.     

How informed are community psychiatric nurses (CPNs) of their role in the implementation of supervised discharge?

A questionnaire was delivered to community psychiatric nurses (CPNs) (n = 23) in order to determine whether they had received adequate training in relation to the 1995 Mental Health (Patients in the Community) Act. Data collected were analyzed. The findings suggest that there is a lack of knowledge in relation to the documentation. The research suggests that more formal training in relation to policy documents should be provided by employers.     

Distance assisted training in sub-Saharan Africa: a program evaluation

Technologists working in nuclear medicine departments in sub-Saharan African countries do not have access to formal training in nuclear medicine and have been recruited mostly from related fields of radiologic technology. Because of the nature of the specialty, the numbers that require training are small, and it is therefore not cost-effective for higher-education institutions in these countries to set up training programs. There is also a lack of expertise in this field in Africa. Assessing the feasibility of running a distance assisted training program to provide training where none exists was undertaken as part of a project sponsored by the International Atomic Energy Agency and the African Co-Operative Agreement for Research, Development, and Training related to Nuclear Science and Technology. Seven countries were nominated, but only 3 centers in 2 countries, Sudan and Tanzania, had the infrastructure to support training. Twenty-one students received the first modules in November 1999, and 13 completed the course in December 2001. All students except one were examined in their own departments. Students received an IAEA Certificate of Achievement at the end of the course, at which time the program was evaluated. Analysis of the data indicated that the conceptualization and design of the material were excellent. There were, however, some problems with the implementation of the program, notably the lack of preparedness of the supervisors, limited departmental resources, and a range of nuclear medicine investigations inadequate for clinical competency. The course was seen to have a positive impact, as it not only allowed technologists to develop skills necessary for the profession but also encouraged critical thinking, reflection, and problem solving. One third of untrained nuclear medicine technologists working in sub-Saharan Africa have now received cost-effective, structured on-site training.     

Contemporary cardiovascular computed tomography (CCT) training: Serial surveys of the international CCT community by the Fellow and Resident Leaders of the Society of Cardiovascular Computed Tomography (SCCT) Committee (FiRST) and SCCT Future Leaders Program (FLP)

BackgroundAs cardiovascular computed tomography (CCT) practice evolves, the demand for specialists continues to increase. However, CCT training remains variable globally with limited contemporaneous data to understand this heterogeneity. We sought to understand the role of CCT globally and the training available to underpin its use.MethodsWe performed two consecutive surveys of cardiology and radiology physicians, two years apart, utilizing the Society of Cardiovascular Computed Tomography (SCCT) website, weblinks, social media platforms, and meeting handouts to maximize our response rate. We compared United States (US)-based vs. international responses to understand global similarities and differences in practice and training in the surveys.Results235 respondents (37% trainees and 63% educators/non-trainees) initiated the first survey with 174 (74%) completing the core survey, with 205 providing their work location (114 US and 91 international). Eighty-four percent (92/110) of educator respondents stated a need for increased training opportunities to meet growing demand. Dedicated training fellowships are heterogenous, with limited access to structural heart imaging training, despite structural scanning being performed within institutions. The lack of a standardized curriculum was identified as the main obstacle to effective CCT learning, particularly in the US, with web-based learning platforms being the most popular option for improving access to CCT training. 148 trainees initiated the second survey with 107 (72%) completing the core components (51% North America, 49% international). Only 68% said they would be able to meet their required CCT education needs via their training program. Obstacles in obtaining CCT training again included a lack of a developed curriculum (51%), a lack of dedicated training time (35%), and a lack of local faculty expertise (31%). There was regional variability in access to CCT training, and, in contrast to the first survey, most (89%) felt 1:1 live review of cases with trained/expert reader was most useful for improving CCT training alongside formal curriculum/live lectures (72%).ConclusionsThere is a need to expand dedicated CCT training globally to meet the demand for complex CCT practice. Access to CCT education (didactic and 1:1 case-based teaching from expert faculty), implementation of recently published global training curricula, and increased teaching resources (web-based) as an adjunct to existing experiential learning opportunities, are all deemed necessary to address current educational shortfalls.     

Nucleating emergency radiology specialization in India

Emergency radiology is being recognized as an important and distinct specialty of radiology which merits utmost attention of educators, radiology program curricula committees, and radiology practices in India. Providing an accurate but timely diagnosis requires a skilled judgement and a strong process framework, particularly in acute trauma setting or a life-threatening acute illness. However, due to a shortage of radiologists in India and lack of awareness and suitable opportunities, there has been no concerted movement towards emergency radiology subspecialty training or dedicated emergency radiology positions. It was with these gaps in mind that the Society for Emergency Radiology was envisioned in 2012 and formulated in 2013. The proposed role of the Society for Emergency Radiology is to identify deficiencies in the field, namely, lack of adequate exposure, lack of mentorship by experienced emergency radiologists, lack of suitable opportunities for emergency radiologists; establish standards of practice; and promote education and implementation research to bridge the gaps. Through collaboration with other societies and partnership with the journal Emergency Radiology, the Society for Emergency Radiology hopes to promote a free exchange of ideas, protocols, and multi-institutional trials across continents.     

Assessing Medical Students’ Knowledge of IR at Two American Medical Schools

PurposeTo determine if there was a difference in the level of knowledge about interventional radiology (IR) between medical students in preclinical years of training compared with medical students in clinical years of training at two medical schools and to compare awareness of IR based on the curriculum at each school: one with required radiology education and one without such a requirement.Materials and MethodsAn anonymous survey was distributed to students at two medical schools; the survey assessed knowledge of IR, knowledge of training pathways, and preferred methods to increase exposure. Responses of the preclinical and clinical groups were compared, and responses from the clinical groups at each school were compared.Results“Poor” or “fair” knowledge of IR was reported by 84% (n = 217 of 259) of preclinical students compared with 62% of clinical students (n = 110 of 177; P < .001). IR was being considered as a career by 11% of all students (15%, n = 40 of 259 preclinical; 5%, n = 9 of 177 clinical). The main reason respondents were not considering IR was “lack of knowledge” (65%, n = 136 of 210 preclinical; 20%, n = 32 of 162 clinical). Students in the clinical group at the institution with a required radiology rotation reported significantly better knowledge of IR than clinical students from the institution without a required clerkship (P = .017).ConclusionsThere are significant differences in knowledge of IR between preclinical and clinical students. Required radiology education in the clinical years does increase awareness of IR.     

Opportunities for Excellence in Interventional Radiology Training: A Qualitative Study

ObjectiveThe training experience in interventional radiology (IR) residency programs varies widely across the country. The introduction of an IR training pathway has provided the impetus for the specialty to better define outstanding IR education and for programs to rethink how their curricula prepare IR trainees for real-world practice. Although ACGME competencies define several training components that are necessary for independent practice, few quantitative or qualitative studies have explored current perceptions on what constitutes optimal IR training. Our goal was to qualitatively explore program training features deemed most important to adequately prepare IR physicians for practice and assess whether there were differences in perception between academic and nonacademic practices.MethodsSemistructured interviews were conducted with 71 IR attending physicians, trainees, and support staff across the United States. All interviews were performed over the telephone by a single researcher for consistency and systematically coded by two independent coders for common themes. Frequency and prevalence of themes and facilitating features were analyzed.ResultsThe most frequently perceived facilitating features included longitudinal patient care experience, practice-building education, interspecialty collaboration exposure, broad case mix, clinical decision-making exposure, diagnostic radiology training, procedural skills training, and graduated autonomy. Comparing nonacademic versus academic practice settings, significantly more nonacademic IR attending physicians expressed practice-building education (prevalence 72% versus 42%, frequency 2.2 versus 0.7, P < .01) as an important training experience.DiscussionAn understanding of perceived facilitating features for optimal IR trainee preparation, including potentially different needs between academic and nonacademic practices, can help programs prepare their trainees for a successful transition into practice.     

Training by the Numbers: A Survey-Based Analysis of the Number of Positions Available in New Interventional Radiology Training Pathways

ObjectiveAs of June 30, 2020, interventional radiology (IR) fellowships will cease to exist and will be replaced by the integrated IR, independent IR, and early specialization in IR (ESIR) pathways. The objective of this study is to determine the alignment in the number of available positions between the ESIR and independent IR pathways.MethodsAn analysis was performed of 150 residency programs offering at least 1 of the 3 IR training pathways. Information regarding the most up-to-date list for integrated IR, independent IR, ESIR, and IR fellowship programs were obtained from the Society of Interventional Radiology (SIR), the Electronic Residency Application Service (ERAS), and the Accreditation Council for Graduate Medical Education (ACGME) websites. A 4-question survey was distributed to residency program directors and residency program coordinators to confirm the number of positions offered in each of the training pathways at their institution.ResultsNinety-nine of 113 ESIR programs (87.6% response rate) reported a total of 176 approved ESIR positions. One hundred and eleven fellowship programs in the United States currently offer a total of 331 positions. Seventy-seven integrated IR programs and 48 independent IR programs offer 150 and 133 positions, respectively, for a total of 283 advanced IR training positions.DiscussionA substantial discrepancy currently exists with IR training pathways, as the number of available ESIR positions far outnumbers the available independent IR pathway positions. There is a continuing need for communication with residency programs and frequent reevaluation of the various IR training pathways to maintain the most accurate database.     

介入专科护士核心能力的质性研究

目的探讨介入专科护士的核心能力，为完善介入专科护士核心能力考核和评价体系提供指导依据。 方法应用目的抽样法选取参加广东省护理学会首届介入专科护士培训班的8名介入专科护士、4名介入专科医生、4名介入专科护理管理者为研究对象，采用质性研究对其进行面对面、半结构式的深入访谈。 结果提炼出6个核心能力，即专业知识与专业实践能力、评判性思维能力、应急抢救能力、沟通与协调合作能力、临床科研能力、临床管理能力。 结论专业知识、专业技能、应急抢救能力是介入专科护士必备的核心能力，介入专科护士核心能力评价标准、培训模式和培训目标需要进一步统一标准。     

护士自我状态与临床沟通能力的研究

 目的 探讨临床护士的功能自我状态特征,以及与临床沟通能力之间的关系。方法 2015-05对某医院全部临床科室700名护理人员发放研究问卷(基本信息、自我状态问卷及临床沟通能力问卷),并对护士群体自我状态进行分析、比较科室和培训背景的护士自我状态的差异及自我状态与临床沟通能力之间的关系。结果 整体上,护士群体五种自我状态水平差异有统计学意义(P<0.05),养育型父母得分最高(17.14±3.00);适应型儿童得分最低(9.36±3.97),控制型父母次低(11.13±2.80);成人和自由型儿童得分位于中间;干部科室的护士养育型父母高于其他科室;相对未受过心理培训的护士,受过专业心理培训的护士成人更高,而适应型儿童更低;养育型父母和成人对临床沟通能力有正向影响,适应型儿童和控制型父母对临床沟通有负面影响。结论 护士自我状态对临床沟通能力有显著影响,可通过心理培训建设护士自我状态,此外可通过匹配不同科室与不同自我状态特点的护士,优化护理服务。     

N1级护士规范化培训方法和效果

 目的 探讨N1级护士在职规范化培训的方法和效果。方法 将2011-2014年使用《N1级护士培训考核手册》、接受在职规范化培训的护士设为研究组,将2007-2010年采取原传统带教考核方式培训的护士设为对照组,对两组技术操作、理论考核,综合素质测评及护理岗位胜任情况等进行比较。结果 护士技术操作、理论考核及综合素质测评年度平均成绩,研究组分别为(93.43±4.11)分、(92.19±4.26)分、(93.26±3.67)分,对照组分别为(91.06±5.82)分、(87.03±7.48)分、(84.12±8.02)分,研究组各项得分均高于对照组,差异有统计学意义(P均＜0.05)。N1级护士护理岗位平均胜任时间,研究组为(109.6±30.1)d,对照组为(175.0±29.6)d,前者比后者明显缩短,差异有统计学意义(P＜0.05)。研究组护士对培训认可率达到100%,对照组护士对培训认可率为84.4%,两组比较,差异有统计学意义(P＜0.05)。结论 通过对N1级护士早期有计划、有目标、有针对性的规范化培训,能够明显提高其基本素质和执业能力,有利于新毕业护士尽快适应临床岗位,促进其专业成长。     

Development of an advanced life support patient transfer training program

Bayne-Jones Army Community Hospital is relatively isolated from major military or civilian medical centers. Patients there who require a higher level of care are transferred to tertiary facilities. It is standard for nurses or physicians to accompany patients requiring Advanced Cardiac Life Support care during transfer to another facility. A 2-day course was developed to provide nurses and physicians with advanced training in caring for patients during transport. The purpose was to develop a pool of nurses and other health care providers who would be trained and experienced as medical attendants on ground ambulance, rotary-wing aircraft, and fixed-wing aircraft. Nurses were awarded 16.6 contact hours of continuing education, and the course has been submitted for continuing medical education units. On after-action reports, students indicated favorable results but needed more scenario and intubation training. The course is being offered quarterly, has been updated, and continues to be evaluated.