北京市社区护理骨干的培训实践

目的探讨北京市某区社区护理骨干培训项目的实施效果。方法对44名来自北京某区不同社区卫生服务站的护理骨干进行培训,内容包括护理管理、技术操作、疾病管理3个模块,培训结束后对参加培训者进行综合能力考核,同时采用自制的满意度调查表对培训对象进行满意度调查,并设有开放性的问题了解其对培训的意见和建议。结果培训对象考核成绩为(79.96±10.85)分。参加培训的社区骨干,超过70%的人员对培训的满意程度较高,但仍有20.5%的培训对象认为培训不能增加其自信程度,2.3%的培训对象认为培训不能满足其工作需求。结论护理骨干培训是在有限时间和条件下进行社区护士全员培训的一种途径。为提高培训效率和效果,培训的内容、方式、时间等都是需要考虑和实践的要素。     

物理治疗从业人员现状调查分析

摘要 目的：为了解我国物理治疗从业人员的实际情况，通过抽样调查收集数据，分析职业现状和发展需求等，对物理治疗从业人员提出合理化建议，为推动我国物理治疗学科建设和行业发展提供参考意见。 方法：2017年5月在我国大陆范围内通过网络形式发放就业现状调查问卷，对物理治疗从业人员群体进行横断面的随机抽样调查。调查内容包括个人基本信息、专业基本信息和专业期望及认同感。具体调查条目涵盖地区分布情况、工作单位性质、教育背景、职称和工作年限、工作服务范畴、收入水平、继续教育需求和工作满意度等。 结果：经过筛查，回收有效问卷5630份，被调查者分布在除西藏自治区以外所有的省份/直辖市/自治区（未含港澳台地区），物理治疗从业人员的男女比例较均衡。物理治疗师队伍偏年轻，其中68.0%的从业人员年龄段在21—30岁；本科学历占68.3%，初级或以下职称占比高达76.5%，高级职称的治疗师仅有4.4%；85.3%的治疗师就职于公立医院，日常工作范畴涵盖神经、骨科、儿童和心肺等疾患；25.1%的治疗师有承担教学任务，11.5%的治疗师有从事科研工作。57.7%的治疗师平均每年进修学习次数在1次或以下。薪酬方面，72.3%的治疗师月收入在6000元以下，仅有25.9%对薪酬待遇感到满意。另外，治疗师对于工作独立和自主性的满意度为61.6%，对于单位提供继续深造、学习机会的满意度只有33.9%。 结论：物理治疗师在我国分布广泛，但地域差别明显；从业人员整体学历层次偏低，高层次人才数量有限；现有的继续教育培训体系不够完善，不能满足从业人员外出进修学习的需求；尽管被调查者的职业认同感偏高，然而薪酬待遇水平较低，对职业现状满意度不足。针对以上的调查结果，建议完善物理治疗师的规范化培训和继续教育体系，提高整个队伍的综合能力水平，通过培养师资队伍、规划职业目标、提高薪酬待遇等方式增加从业人员的满意度。     

组内合作式培训模式在医疗护理员实操培训中的应用

目的 :调查组内合作式培训模式在医疗护理员实操培训中的应用效果。方法 :采用组内合作式培训模式对我院招募的60名医疗护理员进行实操训练,结束后对学员进行实操技能考核及培训认同度调查,并对服务对象和医务人员进行满意度调查。结果 :医疗护理员实操技能考核成绩为(88.51±7.19)分。患者及家属、医务人员对医疗护理员的服务满意度均不低于95%,总体满意度为95.8%。医疗护理员对组内合作式培训模式的认同率为96.7%。结论 :将组内合作式培训模式应用于医疗护理员实操培训中,强化了实操技术实施能力,充分调动了其学习积极性,激发了团队合作意识,而且丰富了实操培训内容,活跃了课堂氛围,值得推广。     

湖北省老年护理从业人员培训需求分析

[目的]了解湖北省各机构老年护理从业人员对老年护理培训需求,为老年护理培训提供依据。[方法]采用自行设计的老年护理从业人员对老年护理培训需求的调查问卷,对湖北省部分三级临床医院、社区卫生服务机构及养老院从事老年护理工作人员392人进行调查。[结果]被调查者认为非常愿意和愿意参加相关老年护理培训的比例为78.6%;培训目的主要是提高工作能力(54.6%);参加培训的时间比例最高的是3个月(41.8%),培训方式比例最高是系统培训(72.4%),影响参加培训的因素主要是工作繁重(69.9%);培训内容前3位分别是老年护理心理学(78.3%)、老年营养学(74.0%),人际沟通(72.4%)。不同工作单位、职称老年护理工作人员培训需求内容比较差异有统计学意义(P0.05)。[结论]老年护理从业人员愿意参加培训,建议护理相关部门开展老年护理培训,提高老年护理从业人员能力。     

干休所保健护士老年护理能力现状与培训需求调查

目的了解干休所保健护士的老年护理能力现状,以及对继续教育培训内容及教学形式的需求,为干休所护士继续教育的科学化、合理化开展提供科学依据。方法自行设计"干休所保健护士护理现状与学习需求调查"问卷,对由83个干休所选送并参与培训的骨干保健护士共163名进行无记名调查。包括老年护理能力现状、老年护理知识培训需求、教学形式需求等。结果干休所保健护士的老年护理能力普遍较低;对老年急危重症患者救护知识与技能(65.0%)、老年病情观察能力(60.8%)、老年保健护理新知识、新业务、新技术(60.1%)、老年用药知识(60.1%)、老年心理护理(58.3%)等方面的培训内容需求较大;在教学形式上,以课堂理论讲授与临床观摩与见习相结合,论文写作与答辩作为最终考核方式的需求较大。结论注重加强干休所保健护士的老年护理能力,合理设置培训内容,科学设计教学形式,进一步落实保健护士培训的实用性。     

护生对实习前校内强化技能培训满意度的调查分析

[目的]了解护生对实习前校内强化技能培训的满意度。[方法]采用自行设计的校内实习前强化技能培训满意度问卷对397名护生进行调查。[结果]98.7%护生认为开展实习前强化技能培训是有必要的。大约80%的护生对培训项目安排及培训内容实用性持满意态度,对于实验环境、用物准备满意度和仪器设施满意度分别为68.3%,63.0%,51.6%。68.8%的护生认为校内强化技能培训达到预期效果,63.7%的护生总体评分在80分~100分。[结论]通过满意度调查,可总结出一套规范的实习前培训方案,并不断完善和改进,以确保培训质量。     

西南及华东地区养老护理员培训满意度的影响因素

目的探讨养老机构养老护理员培训满意度的影响因素,为养老护理员的培训提供参考依据。方法2020年7月选取华东和西南地区570名养老护理员作为调查对象。采用自行设计的问卷对养老机构养老护理员的培训频率、对养老护理知识和技能培训的理解程度、对养老护理知识和技能培训的需求度以及培训满意度进行调查。采用单因素分析及多因素Logistic回归模型分析影响养老护理员培训满意度的因素。结果单因素分析显示,养老护理员的文化程度、对养老护理知识和技能的培训需求程度、培训内容的理解程度对培训满意度有影响(P<0.05)。多因素Logistic回归分析的结果显示,培训内容的理解程度和相关学习或工作经历是培训满意度的影响因素(P<0.05)。结论养老护理员对养老护理知识和技能培训的需求学习或工作经历影响其对养老护理知识和技能培训的满意度。     

基于岗位工作分析的护士岗位培训实践

目的总结并评价医院护士岗位培训模式的建立和实施成效,为各级医院护士岗位培训提供参考。方法通过岗位工作分析,编写临床各类护士岗位说明书,包括岗位描述、岗位职责、岗位任职条件、岗位应知应会等;以岗位说明书为依据,确定岗位培训方案,开展岗位培训的具体实践。比较培训前后护士岗位职责、应知知识和技能,调查护士对该岗位培训模式的满意度。结果各工作岗位护士对岗位职责熟悉度、岗位应知知识、应会技能在培训模式实施后均好于实施前,差异有统计学意义(P<0.05),且培训对象对该岗位培训的兴趣、内容、形式、实用性等满意度较传统培训方法高,差异有统计学意义(P<0.05)。结论实施以岗位工作分析为基础的护士岗位培训模式,贴近临床,具有针对性和实用性,是一种有效、可行的在职培训方法。     

骨科专科护士岗位管理现状的调查

目的 调查国内骨科专科护士岗位管理现状,为制订专科护士管理制度提供参考和依据。方法 自制问卷,便利抽取国内28个省份的560名骨科专科护士,调查其岗位管理现状及满意度。 结果 在专科护士管理制度方面,49.29%的调查对象所在医院专门设立专科护士管理制度,20.89%的医院专科护士管理制度不透明,各医院在岗位聘用要求、直接管理部分、聘期、专项绩效考核指标、专项激励政策等管理细则上各不相同;在岗位实践方面,74.64%的调查对象培训后岗位未发生变化,仍以临床护理实践为主要工作,骨科高级护理实践活动开展有限;56.96%的调查对象对岗位管理现况表示满意或非常满意,9.46%的调查对象有离职意愿,但大多数（72.86%）调查对象对骨科专科护士的发展前景有信心。 结论 骨科专科护士岗位管理满意度处于中等水平,其岗位管理工作已经起步,高级护理实践活动逐步开展,骨科专科护士队伍职业承诺度高,发展前景较好。未来还需要国家、医院、个人三方共同努力,建立完善、科学、合理的专科护士岗位管理制度,促进骨科专科护士的合理使用。     

影响护理质量督导员工作质量的调查研究

目的探讨影响护理质量督导员工作质量的原因。方法对全院95名护士进行问卷调查,调查内容包括:一般情况,影响督导员工作质量的因素、提高工作质量的方法、质量检查的内容、范围及时间等。结果92.63%的调查对象认为有必要增设督导员;78.95%的调查对象认为能否掌握质量控制检查方法影响督导员的工作质量;92.63%的调查对象认为质量督导员要进行不断培训;89.47%的调查对象认为督导员工作重点应放在危重患者护理上。结论质量督导员应主要负责本科室范围内护理质量的检查指导,需要不断进行理论培训并对质量控制的方法进行逐一帮带。     

Exploring the role and perspectives of mental health nurse practitioners following psychosocial interventions training

Psychosocial interventions (PSI) offer a range of problem-centred activities designed to improve the health and quality of life of clients and their carers. The paper reports the findings of a study on the roles and perspectives of mental health nurse practitioners towards clients with enduring mental illness and their carers following completion of PSI training. Focus groups interviews were conducted with PSI mental health nurse practitioners ( n  = 8) and data were analysed for thematic content. The results of the study indicated that PSI practitioners developed positive attitudes towards their client following PSI training and this attitudinal change enabled clients to develop more confidence and autonomy in managing the symptoms of their illness in a more empowered way. Focus group participants observed reduced levels of anxiety among clients and their carers. This was attributed to the 'sense of hope' within the caring milieu which was established as a result of collaborative working with the client and family. The findings suggest that there is a need for further exploration of the PSI practitioner role with a particular focus on the centrality of positive attitudes on the development of the therapeutic milieu for clients with severe and enduring mental ill health.     

农村社区护理人员心肺复苏技能掌握及培训的现状

目的了解基层（农村社区服务站）护理人员心肺复苏（cardiopul monary resuscitation,CPR）技能掌握及培训的现状,为实施CPR技能培训提供依据。方法对45名农村社区服务站护理人员进行CPR技能掌握和培训情况的问卷调查。结果农村社区服务站的护理人员CPR技能掌握不佳,75.56%的护理人员认为会CPR操作,能独立规范完成CPR操作的仅为5.88%;从没有参加过急救技能培训的护理人员占53.33%;表示＂非常需要＂或＂需要＂急救技能培训的有42名,占93.33%。结论基层护理人员CPR技能和相关理论知识薄弱,但护理人员对培训的需求较高,应尽快给予规范的急救技能培训。     

全科医生规范化培训制度实践分析

目的通过对中国全科医生规范化培训（规培）制度现状的调研,为政府管理机构完善全科医生规培制度提供依据。方法2012年11月-2013年11月,采用自行设计的问卷和访谈方式对中国东、西部地区25家规培基地和社区卫生中心的师资（456人）、学员（281人）、教学管理（166人）人员就规培制度和教学方法满意与否进行调查。结果师资、学员、管理人员对规培制度的满意度分别为76．2％、71．3％、86．3％,差异有统计学意义（2,2=92．372,P〈0．001）。调研对象对规培模式、教学大纲、教材、教学安排、考试制度、培训质量、配套政策等满意度分别为95．7％、92．1％、73．8％、65．7％、72．5％、86．8％、48．9％,差异有统计学意义（X2=813．196,P〈0．001）。师资、学员和管理人员对教学方法的满意度分别为81．1％、74．4％、67．7％,差异有统计学意义（X2=40．159,P〈0．001）。结论教师、学员和管理人员对全科医生规培制度及教学法满意度较低。主要存在教材实用性不强,教学安排不合理,教学内容专科化,政府支持力度不够等问题。     

Community health practitioner’s practice guideline for a changing health care: Korean contribution

Aims and objectives. The specific aims of the study were (1) to identify community residents’ health problems and community health practitioners’ activities, (2) to explore community health practitioners’ perception of the practice guidelines and (3) to provide recommendations for the development of a new practice guideline in the future. Background. Community health practitioners in Korea are recognised as a critical component of the public health workforce in rural areas. Community health practitioners are registered nurses with six months special training, who have the chief responsibility of delivering primary health care to remote or isolated communities. Although there has been numerous changes in focus of community health practitioners practice over the two decades, community health practitioners guidelines have never been updated since being first developed in 1981. Design. This investigation employed a cross‐sectional survey and focus group interview. Methods. The samples included two different groups: 1003 community health practitioners participated in a survey and a group of 12 community health practitioners participated in a focus group interview. A measure of perception of the guideline was developed from Mansfield’s work. Goolsby’s criteria were revised and used to guide the focus group interview. Results. The participants recognised that the role of community health practitioners is in a process of transition and expect to use well developed guidelines that will allow an appropriate response to the needs of the community. Community health practitioners are generally supportive of practice guidelines although they report various contextual, social and resource barriers to the use of practice guidelines. Finally, the researchers have provided recommendations for the development of new community health practitioners practice guidelines. Conclusion. A newly developed community health practitioners guideline should assist in articulating new roles and responsibilities in the practice of community health practitioners and establish a foundation for knowledge, skills and training necessary for them to work independently. Relevance to clinical practice. New services made available for under‐recognised health problems may be a direct outcome of newly developed guidelines.     

Australian mental health care practitioners’ practices and attitudes for encouraging smoking cessation and tobacco harm reduction in smokers with severe mental illness

Reducing the burden of physical illness among people living with severe mental illnesses (SMI) is a key priority. Smoking is strongly associated with SMIs resulting in excessive smoking related morbidity and mortality in smokers with SMI. Smoking cessation advice and assistance from mental health practitioners would assist with reducing smoking and smoking‐related harms in this group. This study examined the attitudes and practices of Australian mental health practitioners towards smoking cessation and tobacco harm reduction for smokers with SMI, including adherence to the 5As (ask, assess, advise, assist and arrange follow up) of smoking cessation. We surveyed 267 Australian mental health practitioners using a cross‐sectional, online survey. Most practitioners (77.5%) asked their clients about smoking and provided health education (66.7%) but fewer provided direct assistance (31.1–39.7%). Most believed that tobacco harm reduction strategies are effective for reducing smoking related risks (88.4%) and that abstinence from all nicotine should not be the only goal discussed with smokers with SMI (77.9%). Many respondents were unsure about the safety (56.9%) and efficacy (39.3%) of e‐cigarettes. Practitioners trained in smoking cessation were more likely (OR: 2.9, CI: 1.5–5.9) to help their clients to stop smoking. Community mental health practitioners (OR: 0.3, CI: 0.1–0.9) and practitioners who were current smokers (OR: 0.3, CI: 0.1–0.9) were less likely to adhere to the 5As of smoking cessation intervention. The results of this study emphasize the importance and need for providing smoking cessation training to mental health practitioners especially community mental health practitioners.     

干部健康体检患病情况跟踪调查

目的了解目前干部和知识分子患病情况及发展趋势。方法2004年5 823名受检者在三家省级医院由统一组织的医务人员进行常规健康体检,资料专人汇总。结果血脂异常、高血压、前列腺增生、脂肪肝和白内障为这些人群中患病较高的前五位,与2002年相比明显不同,其中高血压2004年患病率32%明显高于2002年29%(P<0.01)。结论生活方式和工作节奏的改变对常见病的患病率变化有明显影响。健康生活方式和适当药物治疗对防治心血管疾病十分重要。     

Linking social work agency perspectives on interprofessional education into a school of nursing and midwifery

Recent policy documents have highlighted the importance of developing interprofessional education to support interprofessional practice. In particular improving communication between health and social care agencies has been highlighted as an educational and practice priority. This study set out to explore the interprofessional training needs of social work practitioners with social work agencies in North East London to ensure that the interprofessional courses were relevant to social work. Findings from 15 qualitative interviews with key health and social care professionals in eight London boroughs will be presented. The findings suggest that there is great diversity in the budgets, resources and approaches taken to post qualifying training across the boroughs and between agencies and that training needs analysis for experienced practitioners is at an early stage of development workforce planning to the commissioning of education. Social work services identified bespoke training and the accreditation of their existing programmes as important. Responding to rapid organizational change and immediate training needs was a key priority in the services interviewed. However, limited funding to release social workers to take up interprofessional post-qualifying training remains a constraint for training officers, and how training was planned and organized by both practitioners and providers was considered important.     

四川大学华西医院全科医师培养现状及探索

培养大批合格的全科医生是深化医疗卫生体制改革、实现人人享有基本医疗的重要保证。全科医生的培养在我国处于探索阶段,综合性教学医院在全科医生的培养中扮演着重要的角色。近年来,四川大学华西医院在全科医生培养方面做了一些积极尝试与探索,现就其培养现状、成效及存在的问题逐一进行阐述剖析,以期与同行共同探索大型教学医院开展全科医师培养的有效途径。     

Interprofessional training on resilience-building for children who experience trauma: Stakeholders’ views from six low- and middle-income countries

Children exposed to multiple adversities are at high risk of developing complex mental health and related problems, which are more likely to be met through integrated interprofessional working. Combining the expertise of different practitioners for interprofessional care is especially pertinent in low- and middle-income countries (LMIC) in the absence of specialist resources. The aim of this study was to work with practitioners who deliver care to vulnerable children in six LMIC (Turkey, Pakistan, Indonesia, Kenya, Rwanda, and Brazil) to understand their perspectives on the content of an interprofessional training programme in building resilience for these children. Seventeen participants from different professional backgrounds, who were in contact with vulnerable children were interviewed. A thematic analytic framework was used. Four themes were identified, which were the benefits of a tiered approach to training, challenges and limitations, perceived impact, and recommendations for future training. The findings indicate the importance of co-ordinated policy, service, and training development in an interprofessional context to maximize resources; the need for cultural adaptation of skilled-based training and interventions; and the usefulness of new technologies to enhance accessibility and reduce costs in LMIC.