对中国模式的护理专科化发展之路的探讨

2007年6月在香港举行的“护理新动向国际学术会议”上,新加坡的Premarani Kannusamy博士、美国的Rosemary Goodyear博士、英国的Anna Boon女士以高级临床护理为主题,分别介绍了各自的工作和经验。在聆听这些演讲和阅读其文稿的时候,感到其中有许多经验值得学习和借鉴。同时,也感到由于各国各地区的社会背景和卫生服务体系不同,因而“高级临床护理”的发展情形各异。如何从中国的国情、中国社会对护理服务的需求出发,有选择地学习和借鉴,探索中国模式的护理专科化/高级临床护理发展之路,是我们必须思考的问题。1根据各国的卫生服务需求发…     

美国护理专业化发展回顾及对我国护理发展的启示

通过对美国护理专业化发展的形式、专科护理向临床高级护理发展演变和临床高级护理发展的特点的阐述,对中国护理专业化发展提出见解,认为发展护理专科高等教育,强化护理专业团体的管理和领导力,规范专科能力评价和资格认证,建立必要的护理法规是我国护理专业化发展的必经之路。     

中医护理专科化发展之路的思考

<正>随着医学分科的细化和现代护理模式的转变,护理专科化已成为全球临床护理发展的策略和方向。20世纪初,美国专科护理以"specialties in nursing"[1]一文最先进入公众视野,其后的专科护理发展如雨后春笋,其护理专科设立(recognition)、授权许可(licensure),专科认证(accreditation),专科注册(certification)以及教育机制(education)都得到了     

国内手术室外科专科护理组发展现状

从专科护理分组、组长和组员的选定、专科组的工作内容及效果方面综述国内手术室外科专科护理组的发展现状并对未来的展望,认为手术室护理专科化是手术护理发展的必然结果,而手术室护理专科培训也会从共通性培训逐渐走向专科化培训,对各医院手术室护理专科护士进行更为专业的专科培训。     

国外糖尿病专科护理的发展现状

专科化护理工作模式是临床护理实践发展的策略和方向.卫生部为研究制定《中国护理事业发展规划纲要2005-2010》,于2005年进行的有关专科护士发展需求调查的结果表明,今后5年内应优先开展的专科护理领域依次为：急诊急救、糖尿病、感染管理、手术室、肿瘤化疗、社区专科.我国作为糖尿病第2大国,发展糖尿病专科护理是适应卫生体制改革和医疗护理服务走向市场化需求的一项有益而积极的举措,也是促进护理专业自身发展、深化护理内涵的有效途径.     

具有专科特色的护理硕士专业学位培养模式构建

在我国护理硕士专业学位研究生培养方案的指导下,结合本校院系一体化管理的优势,制订培养护理专门人才的培养目标,围绕培养目标设置课程和临床实践方案;建立团队制导师和基于临床能力的考评方法;构建了具有专科特色的护理硕士专业学位培养模式,并顺利完成在校护理专业硕士研究生的阶段培养。该培养模式符合我国护理专科化的发展需求及护理学和专业学位的特点。     

妇科肿瘤健康教育门诊做法与探讨

随着专科护理内涵不断的拓展与延伸,护理的人群由病人扩展到健康人群。现阶段我国高级临床护理的发展,应以护理专科化为主,而在医院设立专科护理门诊是专科护士（clinical nurse specialist,CNS）的一种工作方式。我院是一所三级甲等医院,在专科护理的建设过程中不断适应学科发展的需求，创新管理思路。2007年3月我科开设了肿瘤专科护理门诊，其主要作用是对不同要求的患者提供健康指导，至2008年2月，肿瘤健康教育门诊共接诊患者48人次，得到了患者的好评，取得了良好的社会效益。     

实施手术室专科化护理的体会

目的：探讨专科化护理对提高手术室工作质量的意义。方法：根据临床专科的特点，手术室从2002年起实施专科化护理，对护理人员采取专科分组，相对固定，并对实施手术配合专科前后的质量效果进行比较。结果：实施专科化护理后手术室工作质量明显提高。结论：临床手术专科要求护理专业化，只有实施手术护理专科化，才能适应临床三级分科的需要。     

专科护士培养模式在胃肠外科中的应用

<正>随着医学的飞速发展和人们对健康需求的不断增加,护理专科化发展已成为临床护理实践发展的重要策略,专科护士越来越受到关注。国家卫健委发布的《全国护理事业发展规划(2016-2020年)》中明确指出:以社会需求为导向,加强专科护士队伍建设。大量研究证明,专科护士在解决患者疑难护理问题、满足民众健康需求、促进护理专业发展等方面发挥了     

我国心血管专科护士培养的相关问题研究

护士是医疗保健队伍的主要力量之一[1],其数量和质量直接关系到卫生服务的水准。专科护士(clinical nurse specialist,CNS)是为适应社会民众对健康服务的需求而发展起来的一种特殊护理人才。在我国经济快速发展的今天,发展专科化护理和培养专科护理人才两个问题成为护理学界讨论的焦点[2]。专科护士在缩短病人住院时间、提供高质量和符合成本效益的护理服务方面发挥了显著作用[3],但仍存在问题。本研究在广泛查阅国内外专科护士培养文献的基础上分析我国心血管专科护士培养面临的问题,探讨解决该问题的对策。1我国专科护士培养现状     

Advanced nursing practice: policy, education and role development

Aims and objectives. This paper aims to explore the critical elements of advanced nursing practice in relation to policy, education and role development in order to highlight an optimal structure for clinical practice. Background. The evolution of advanced nursing practice has been influenced by changes in healthcare delivery, financial constraints and consumer demand. However, there has been wide divergence and variations in the emergence of the advanced nurse practitioner role. For the successful development and implementation of the role, policy, educational and regulatory standards are required. Conclusion. The paper highlights the value of a policy to guide the development of advanced nursing practice. Educational curricula need to be flexible and visionary to prepare the advanced nurse practitioner for practice. The core concepts for the advanced nursing practice role are: autonomy in clinical practice, pioneering professional and clinical leadership, expert practitioner and researcher. To achieve these core concepts the advanced nurse practitioner must develop advanced theoretical and clinical skills, meet the needs of the client, family and the community. Relevance to clinical practice. In a rapidly changing people‐centred healthcare environment the advanced nurse practitioner can make an important contribution to healthcare delivery. The challenges ahead are many, as the advanced nurse practitioner requires policy and appropriate educational preparation to practice at advanced level. This will enable the advanced practitioner articulate the role, to provide expert client care and to quantify their contribution to health care in outcomes research.     

Advanced practice nursing: A principle-based concept analysis

Purpose: To analyze and clarify the conceptual basis of advanced practice nursing to determine the state of the knowledge from the perspective of four overarching principles derived from the philosophy of science: epistemological, pragmatic, linguistic, and logical.
Data sources: Written discourse regarding advanced practice nursing from refereed journals published between 2000 and 2007.
Conclusions: Conceptualization of a core definition of advanced practice nursing will enhance external legitimacy and recognition; understanding advanced practice nurse (APN) roles, sub-roles, and competencies will enhance internal cohesion. The outcome of this concept analysis is a greater understanding of the conceptual basis of advanced practice nursing and a current best estimate of the probable truth surrounding advanced practice nursing.
Implications for practice: A greater understanding of the conceptual basis of advanced practice nursing will help to gain clarity, internal cohesion, external legitimacy, and acceptance of APN roles by society and other healthcare professions.     

对我国护理学硕士研究生需掌握核心知识的调查与分析

目的初步调查护理学硕士研究生应具备的核心知识,以便根据核心知识组织该专业的基础课程体系。方法采用访谈法对8名护理教育专家、临床管理专家进行个人访谈,对25名学习者分别进行焦点小组访谈。结果受访者认为,护理学硕士研究生的核心知识应涵盖临床护理实践、教育、管理、研究方法及促进专业发展5个领域,护理学硕士教育应避免与其他医学专业研究生课程知识重复。结论护理学硕士研究生的核心知识体系应基于高级护理实践、教育、管理、研究和促进专业发展5个关键学习领域来构建,尽快建立具有专业特色的护理学硕士课程体系。     

Confusion prevails in defining 'advanced' nursing practice

The Australian nursing profession has accepted the challenge to support and encourage advanced nursing practice role development. A critical review of national and international literature highlights that there is no singular definition or understanding of 'advanced' nursing practice. Instead difficulty with nomenclature and clarification of levels of nursing are perpetuated by unclear distinction between 'advanced', 'specialist' and 'expert' nursing practice. This paper presents the findings of a review of the literature and posits that ambiguity and lack of consistency in defining 'advanced' nursing practice is hampering the progression of the profession towards the development of consistent advanced practice roles in Australia. It is proposed that a universally accepted definition would provide a vehicle for future Australian role development so that all advanced practice roles have a common genesis and national consistency results.     

Advanced nursing practice: an idea whose time has come

Aims and objectives. This paper aims to analyse the concept of advanced nursing practice critically and to demonstrate an appreciation of the development of the role of the advanced nurse practitioner in the Irish context. Background. The concept of advanced nursing practice has existed in the US since the 1960s and in the UK since the early 1980s. The first signs of the advanced nurse practitioner began to emerge in Ireland in the late 1990s as a result of increasing demands and changes occurring within nursing and health care. Currently, there are 31 advanced nurse practitioners in the country, many of whom practice in the general setting. Strategies are in place to introduce advanced nursing practice into other nursing disciplines in the future. Methods. A literature review was conducted to address the various issues inherent within this concept. Results. There is a body of evidence indicating that advanced nursing practice has brought about an improvement in patient outcomes. In light of this, the advanced nurse practitioner has a valuable role to play in providing a beneficial contribution and filling a gap in healthcare services. Conclusion. This paper has demonstrated that nursing continues to be a dynamic and ever‐changing phenomenon where the onus is firmly on the advanced nurse practitioner as expert, leader and collaborator, to capture the hearts and minds of nurses and healthcare workers, so as to challenge traditional values and transform clinical practice. Failure to do so may allow medicine or other interested parties to shape the future of nursing or even absorb it. Relevance to clinical practice. Nurses working at an advanced level are striving to develop their expertise, initiate nurse‐led services and practice, in collaboration with other professionals in an effort to provide the highest quality care to the patient. Although the idea of the advanced nurse practitioner is relatively new to nursing in Ireland, it is the result of an idea whose time has come and there is nothing more powerful than an idea whose time has come.     

大专护理教育中的社区护理教学

社区护理教育是护理教育的新课题。作通过《社区护理》理论大专课程的讲授实践,对学习目标、教学内容、见习安排以及教学评价进行探讨。体会到教师要不断提高自身素质,充分发挥老师与学生的主观能动性,才能提高教学质量;提高学生的综合分析能力和独立工作能力是社区护理教育的重要内容;注重教书育人是培养适应护理学发展的未来人才的关键。     

Advanced nursing practice and Newton's three laws of motion

This article considers the reasons for the development of advanced practice roles among nurses and other healthcare professions. It explores the implications of financial constraints, consumer preferences and the development of new healthcare services on the reorganization of professional boundaries. It makes use of Sir Isaac Newton's three laws of motion to demonstrate how professional development in nursing has taken place in response to a number of external influences and demands. It also considers the significance of skill mix for the nursing profession, in particular the development and likely expansion of the physician assistant role. The application of different professionals and grades within a healthcare team or organization is central to the Government's Agenda for Change proposals and nurses have successfully adopted a number of roles traditionally performed by doctors. Nurses have demonstrated that they are capable of providing high quality care and contributing directly to positive patient outcome. Advanced nursing roles should not only reflect the changing nature of healthcare work, they should also be actively engaged in reconstructing healthcare boundaries.     

Telemedicine: benefits to advanced practice nursing and the communities they serve

PURPOSE: To review the use of telemedicine in a variety of advanced nursing practice settings, its contribution in expanding the service and role of the nurse practitioner, and the regulatory issues of reimbursement and licensure. DATA SOURCES: Literature review of relevant journals, research articles, case examples, and web searches. CONCLUSIONS: Although telemedicine has been utilized for many years, it has historically been used primarily by physicians. In recent years, telemedicine has been demonstrating its growing potential in advanced nursing practice in terms of economy, efficacy, and quality of care. When used appropriately, telemedicine complements advanced nursing practice in cost-effective ways and improves healthcare access to the populations served. IMPLICATIONS FOR PRACTICE: Incorporating telemedicine into the advanced nursing practice can be rewarding for both clinicians and their patients. Because of the high variability that exists among state regulations and payer reimbursements, clinicians are advised to verify their respective Board of Nursing Examiners, State, and payers' policies prior to investing in the establishment of telemedicine in practice.     

我国护理人力资源管理现状及发展

综述了护理人力资源管理的概述及我国护理人力资源管理的现状、研究进展及我国护理人力资源的开发与使用对策。指出要开发我国护理人力资源,要从建立规范入手,逐步实现从行业规范管理为主到依法管理的转变,要以人为本,吸取国外先进的管理理念和方法,大胆实践,勇于创新。