新进助产士规范化培训的效果评价

目的探讨对新进助产士3年规范化培训的效果。方法 2009年起,同济大学附属第一妇婴保健院对新进助产士实施3年规范化培训,包括1年基础培训和2年强化培训,涉及基础护理及专科护理理论与操作;内容有职业防护培训、基础培训、强化培训、"一四四培训"及人文关怀培训。以2006年新进助产士为对照组。对助产士在操作及理论考核、母婴保健资格考合格率、产房质量控制和护理差错等方面进行比较。结果实施规范化培训后,助产士理论及操作考成绩均提高,产房护理质量控制改善,母婴保健资格合格率提高,与对照组比较差异有统计学意义(P0.05)。结论对新进助产士进行规范化培训,有助于提升助产人员专业技术水平和提高产房护理质量,使新进助产士能尽快融入临床,全面提升产科质量,保障了母婴安全。     

培训清单加情景模拟在新助产士临床能力培养中的应用

目的:探讨培训清单加情景模拟新助产士临床能力培养的效果。方法:选择2015年1月~2016年5月新进产房的助产士,实行培训清单加情景模拟训练的培养方法。结果:实施培训清单加情景模拟训练后助产士的独立值班时间、专业理论成绩、操作考核成绩、会阴侧切率、产妇满意度均在中上水平。结论:通过培训清单加情景模拟实战训练的方法,提高了新助产士的考核成绩,提高了产妇的满意度。     

基础护理规范化培训效果分析

目的:探讨护士进行基础护理规范化培训的效果.方法:对2010年4～6月10个病区进行为期1个月的基础护理理论及基础护理操作培训,并与2009年4～6月10个病区基础护理质量合格病区数和住院患者对基础护理操作的满意度进行对比分析.结果:经规范化培训后,基础护理理论、基础护理操作合格率均提高(P<0.01,P<0.05);2010年4～6月病区基础护理质量合格率、住院患者对护士的服务态度、护士技术操作熟练程度、告知注意事项、患者感觉舒适安全、操作过程正确规范有效的满意度均高于2009年4～6月(P<0.01,P<0.05).结论:基础护理规范化培训可提高护士的理论和操作水平、基础护理质量,增加患者对基础护理操作的满意度.     

客观结构化临床考试在助产士规范化培训中的应用研究

目的 将客观结构化临床考试(OSCE)考核模式应用在助产士规范化培训中,探讨助产士规范化培训的效果。方法 将2019年3月—6月参加助产士规范化培训的助产士25人设为对照组,2020年3月—6月参加助产士规范化培训的助产士25人设为试验组,比较两组助产实践能力、助产质量指标。结果 试验组的护理评估、助产技术、专科操作、应急抢救、健康教育、专科知识考核分数高于对照组(P<0.05)。试验组的产后出血、新生儿窒息、会阴侧切发生例数少于对照组(P<0.05)。结论 将OSCE应用在助产士规范化培训中,能客观全面地评价助产士规范化培训效果,有利于提升助产士助产实践能力,提高自然分娩的助产质量。     

产房护士长晨间护理查房的效果评价

[目的] 探讨产房护士长晨间护理查房的效果.[方法]产房护士长每天晨交班后对孕产妇进行护理查房,包括实践性查房和技术操作性查房,在查房中提出主要护理问题、制订护理措施、开展健康教育等.[结果] 产房护士业务水平增高,专科理论知识与操作考核合格率100%;护患纠纷减少;夜班护理质量提高,基础护理及重病护理质量检查平均分99分.[结论]产房护士长晨间护理查房对提高助产士业务水平和提高临床护理质量起到积极的作用.     

国内外助产士临床培训研究进展

母婴健康问题是全世界关注的热点,是全民健康的基础。助产士在产科中承担重要角色,为孕产妇提供全方位孕期保健服务,良好的孕期保健能有效降低孕产妇和新生儿相关疾病的发生率和病死率,也是提高自然分娩的重要因素。为了提升助产士在临床实践中的各项能力,培训是重要途径。文章对国内外助产士准入资格、临床培训内容、培训方式和途径进行了综述,并分析了国内临床助产士培训中存在的不足,为我国医疗机构建立助产士培训体系提供参考依据。     

新助产士进行强化培训的探讨

目的 探讨新助产技术士强化训练后的效果.方法 护理部通过重视管理、注重岗前培训及师资的培训、制定培训和训练计划、培养新护士的动手能力的方法来强化培训新助产士.结果 新助产士在母婴保健合格证考试、考核中通过率达到98%,16名新助产士成为科室的技术骨干.结论 通过注重强化培训新的助产士,提高了新助产士助产技术服务水平,使新助产士达到了母婴保健技术服务所要求的相应资质.     

产房助产士护理风险因素分析与防范对策

随着科学的发展、医学知识和法律知识的普及,人们的法律意识不断增强,患者对医疗质量及护理质量的要求越来越高.产房是医院高风险科室,护理工作与孕产妇、新生儿的生命息息相关,要求必须同时保证母婴的安全.因此,科学地识别产房助产士的护理风险、及时准确地发现并防范各种缺陷、隐患,是保证产科护理安全的基础,也是提高产科护理质量的重要举措.现将产房助产士护理风险因素分析及防范对策报告如下.     

助产士分级授权管理模式对产房质量控制的临床疗效观察

目的 探讨助产士分级授权管理模式对产房质量控制的临床效果。方法 选取 2020 年 05 月至 2021 年 05 月期间我院接收 的产妇 80 例作为研究对象。采用随机数字表达法将产妇分为实验组与对照组,每组各 40 例。对照组采用常规管理模式干预, 实验组采用助产士分级授权管理模式干预。分析对比两组的产房质量控制情况、护理满意度与职业成就感、护理事故发生率。 结果 对于产房质量控制,实验组的会阴侧切、伤口愈合不良、会阴撕裂、新生儿窒息、会阴血肿、肩难产以及产后出血率均 显著低于对照组（P<0.05）。实验组护理满意明显高于对照组（P<0.05）。干预前,两组助产士职业成就感评分无明显差异（P>0.05）。 干预后,实验组助产士职业成就感评分明显高于对照组（P<0.05）。实验组护理事故发生率明显低于对照组（P<0.05）。结论 助产士分级授权管理有助于提高产房质量,提升护理满意以及助产士职业成就感,降低护理事故发生率。     

护理风险管理在产房中的应用

[目的]探讨产房护理工作中存在的或潜在的风险事件及预防方法,提高产房护理质量.[方法]评估产房护理工作中可能存在的风险,完善相应的工作制度,改善工作流程,通过严格准入、加强培训、提高技术;增强法律意识、严格各项规章制度的执行;加强环境及设施的管理;加强护患沟通等方式强化助产士的风险意识,加大风险监控.[结果]提高了助产士的护理风险意识,促进了护患关系,减少了护患纠纷及差错事故,提高了产房护理质量.[结论]强化助产士的风险意识,加强风险监控,能有效预防和减少护理风险的发生,为产妇提供更加安全、有序、优质的护理.     

基于核心胜任力的助产方向专科护士培训实践

目的探讨基于核心胜任力的助产方向专科护士培训效果。方法以2019年参加助产方向专科培训的39名学员为研究对象,以助产士核心胜任力为框架,从孕前保健、孕期保健、分娩保健、产后保健、新生儿保健、公共卫生保健对其进行理论(7周)与技能(9周)的培训,培训前后评价学员的理论知识、临床技能及助产士核心胜任力。结果培训后学员的理论成绩与临床技能成绩均较培训前提高(P<0.05),学员的助产士核心胜任力由(3.79±0.47)分提升至(4.16±0.43)分,差异有统计学意义(P<0.05)。结论基于核心胜任力的助产方向专科护士培训可有效提升助产士核心胜任力。     

Perspectives on the past,view of the present: relationship between nurse-midwifery and nursing in the United States

Relationships between U.S. nurses and nurse-midwives developed during the Progressive Era around two major points: the knowledge that lower maternal and infant mortality in England and Europe was associated with well-educated midwives, and the desire of some nursing leaders to substitute nurse-midwives for traditional midwives. In the process, traditional midwives were labeled dirty and dangerous and the practice of nurse-midwifery was marginalized. At the same time, research on nurse-midwifery showed excellent maternal and infant outcomes at the only two demonstration sites where nurse-midwifery was practiced between 1925 and 1941. This data helped the Children's Bureau and MCA push the expansion of nurse-midwifery in the South and Southwest. As their numbers expanded, nurse-midwives organized nationally within the national public-health nursing association. When the association merged with other nursing organizations, however, nurse-midwives were denied their request to maintain an autonomous section on the grounds that they practiced medicine. This rejection caused a split between nursing and nurse-midwifery that continues to affect interactions between the two groups of professionals. In the 1970s, the ANA, which by now supported the nurse practitioner role, embraced nurse-midwifery as an extension of nursing practice. This permitted regulation of nurse-midwifery under nurse-practice acts in all but a handful of states. Unfortunately, in the majority of these states nurse-midwives were not named in statute and their practice became legally invisible. Today, many state boards require a master's of nursing for licensure even though research has shown no difference in certification exam scores between master's- and nonmaster's-prepared nurse-midwives. During the 1970s, middle-class women began to seek the services of a new group of apprentice-trained midwives, and, eventually, these midwives created their own national organization. In the early 1990s, the two national midwifery organizations met formally to craft recommendations for the education and certification of non-nurse midwives and a single standard of midwifery care. Although both organizations had developed processes for accrediting educational programs and certifying non-nurse midwives, the job of drafting a single standard of care remains incomplete. As a result, one of the major tasks facing U.S. nurse-midwives is the need to redefine their relationships with both nursing and apprentice-trained direct-entry midwives. Completion of this task holds the promise of boosting the public image of midwifery, elevating the place of midwives in the care of women and infants, and improving maternal and child health outcomes in America.     

孕产期分级保健照护方案的构建与应用研究

目的 探讨孕产期分级保健照护方案对提高母婴保健服务质量及改善妊娠结局的作用。方法 基于信息平台建设,通过医联体内区域协作,构建孕产期分级保健照护方案。选取在我院医联体内社区医院建档的312名孕产妇作为研究对象,随机分为试验组和对照组,试验组实施信息化孕产期分级照护方案的保健服务,对照组实施基础孕产期保健服务,收集相关指标并进行分析比较。结果 试验组助产士保健服务覆盖率、孕早中期助产士保健服务覆盖率、孕产期保健知识平均得分、自然分娩率、6个月内纯母乳喂养率、孕期体重增长达标率以及孕产妇对保健服务的满意度均高于对照组（P<0.05）;试验组孕产妇失访率、妊娠期糖尿病及妊娠合并贫血的发生率低于对照组（P<0.05）。结论 孕产期分级保健照护方案可有效提高孕产期保健服务质量,促进自然分娩及母乳喂养,减少不良妊娠结局的发生。     

A Nurse-Led Population-Based Health Education Project to Improve Infant Care Knowledge for an Old Order Mennonite Community

Population health is changing the focus of nursing practice as nurses are challenged to focus on health promotion and education for communities rather than limiting their practice to restorative care for individual acute care patients. This new focus is necessary to improve knowledge of maternal and infant health among vulnerable populations. One particularly vulnerable population is members of Old Order Mennonite communities, who frequently rely on self-trained local midwives in the community for home births and home remedies when caring for their infants. Providing evidence-based education to members of this isolated population can be a challenge because they do not typically access information outside of the community. The purpose of this article is to share the process of developing, publishing, and disseminating a culturally sensitive infant care manual for an Old Order Mennonite community using a community-based participatory model and to highlight the impact nursing outreach can have on improving health knowledge.     

急诊抢救室护理晨间查房提升新护士工作能力的效果

目的通过急诊抢救室护理晨间查房,提升急诊科新护士的综合能力。方法2007年7月至2009年7月对11名新护士培训方法进行改进,在原培训基础上每天8：00～9：00,选择抢救室前1d急危重症抢救病例1—2份进行护理晨间查房,讨论抢救措施是否及时有效、抢救记录是否准确、全面,沟通协调是否到位,讲解该病例的相关知识及急救护理进展,并与未开展该培训方法时进行比较。结果实施前急诊科新护士理论成绩总分为（67．8±10．8）分,实施后为（81．2±7．0）分,两组比较差异有统计学意义（t=2．54,P〈0．05）;实施前后的操作成绩比较,差异无统计学意义（t=0．84,P〉0．05）。结论急诊抢救室护理晨间查房是提升急诊科新护士综合能力的有效方法。     

中医护理技术难度分级及准入管理

目的对中医护理技术进行难度分级,确立准入管理机制,以提高护理人员中医护理技术水平,实现分层次培训。方法采用德尔菲专家咨询法对36名专家进行3轮问卷调查,形成中医护理技术的难度分级并给出准入管理建议。结果中医护理技术操作难度分级结果:中医护理技术项目的平均难度水平在5.57,68%属于中、低难度水平的项目。其中耳针法等7项针刺法为高难度操作;穴位按摩等8项技术操作为中难度操作;中药煎煮等7项技术操作为低难度操作。中医护理技术准入机制:(1)高难度技术操作准入建议本科及以上学历、主管护师、10年以上中医临床护理工作经验,且必须接受过1年以上中医护理技术操作理论和实践专项培训;(2)中难度技术操作准入建议大专及以上学历、护师以上职称、从事中医护理工作5年以上、经过6个月以上中医理论和技能系统培训;(3)低难度技术操作准入建议中专及以上学历、护士以上职称、从事中医护理工作2年以上、经过3个月以上中医理论和技能系统培训。结论中医护理技术难度分级及准入机制的确立,为护理人员资质培训内容的界定、中医临床护理技术操作的规范化管理提供了有益的借鉴。     

Mississippi Public Health Nurses and Midwives: A Partnership That Worked

Abstract At the turn of the century maternal and infant mortality rates were high in this southern state. Untrained midwives conducted many of the deliveries. Initial support for locating and training midwives by public health nurses was provided by the American Red Cross and the United States Public Health Services. Later, funding from a philanthropic organization (Rockefeller International Foundation) provided a mechanism that brought Mississippi public health nurses and midwives to a partnership that endured for over a half a century, and contributed to better maternal-infant health care outcomes for that state.     

Introduction and development of NCP using ICNP in Pakistan

BACKGROUND: Traditionally, nursing care has been described as performing nursing tasks and often focused on nurses carrying out doctors' orders. In many countries of the world, including Pakistan, nurses do not document care in a standardized manner. Because of this limitation many health administrators, policy makers, and consumers make inadequate assumptions about nursing work, often regarding nurses as any other 'health care technician' who can be easily replaced by more economical health care workers. PURPOSE: To overcome this problem, standardized documentation is being introduced into the Aga Khan University School of Nursing and hospital, Aga Khan Health Services, Public Health School in Karachi, and government colleges of nursing, using the International Classification for Nursing Practice (ICNP). The purpose of this paper is to highlight the process of introducing and developing standardized nursing care plans (NCP) using ICNP in Pakistan. PROCESS: The process for introducing ICNP consists of four components, including administrative planning, development, teaching and training, and testing. Subsets of the ICNP for (i) maternity: antenatal, postnatal and natal care; and (ii) cardiology were developed using standardized NCPs. The subsets were developed by nurse experts and introduced at the testing sites. The testing will be conducted as a pilot project. Findings from the pilot will be used to continue and expand standardized nursing documentation using the ICNP across Pakistan. CONCLUSION: Through this project, nurses, midwives and lady health visitors (midwives, vaccinator and health educators) will test standardization of documentation and begin to evaluate efficiency and effectiveness of clinical practice.     

标准化疗养护理服务管理模式对持续提升护理质量的实践与效果分析

目的探讨疗养院标准化护理服务管理模式对持续提升护理质量的效果。方法从建立护理服务标准制度、规范护理人员培训机制、落实疗养护理质量管理等方面规范疗养护理服务,实现军队疗养院优质护理服务的标准化管理。结果疗养员满意度提高,在疗区管理合格率、健康教育达标率、护理文书合格率、护理安全质量合格率、责任制护理质量合格率等方面的护理质量均明显提高(P<0.01)。结论标准化护理服务管理模式的建立有利于疗养工作的有序展开,提高人员整体素质,降低离职率,促使护理质量持续改进。