中职护生临床实习前开展模块化岗前培训的探索与实践

[目的]通过在临床实习前开展岗前培训,提高护生的护理综合技能,以适应当前护理岗位需求.[方法]在360名中职护生进入临床实习前,开展为期2周的岗前培训,将护理技能分为5个模块,结合案例进行综合训练.在培训结束后,对护生护理综合技能进行考核,并调查临床带教老师对实习护生的评价.[结果]培训后与培训前比较,护生护理综合技能明显提高(P＜0.01).临床带教老师对护生的各方面评价均比培训前明显提高(P＜0.05).[结论]护生临床实习前开展岗前培训可提高护生的护理综合技能.     

高等教育护理专业学生基本技能全程培养的研究与实践

[目的]探讨护理技能全程培养模式,培养临床实用型护理人才。[方法]选聘双项导师从护生入校到毕业进行全程护理技能培训与指导,内容主要包括理论讲授、技能训练、学习辅导等,同时将我校2004级四年制护理本科护生112人随机分为跟踪组52人和对照组60人,收集其护理理论、技能与综合素质考核成绩进行对比研究。[结果]跟踪组护生在临床实习后理论、操作、临床技能考核成绩与对照组比较均有统计学意义（P〈0．001）;跟踪组临床实习前后理论和操作考核成绩自身对照比较差异均有统计学意义（P〈0．001）,而对照组仅操作考核成绩差异有统计学意义（P〈0．05）;两组部分护生岗前培训前理论、操作、综合能力考核成绩比较有统计学意义（P〈0．001）。[结论]双项导师护理技能全程培养模式,有利于护生树立牢固的专业思想,早接触临床提高了护生专业实践能力和护生的综合素质,缩短了护生岗前培训周期。     

培养护生防范护理纠纷的做法与效果

目的探讨临床实习护生引发护理纠纷的防范措施，提高护生防范护理纠纷的能力。方法观察组78例，重视带教老师的选择及培训；强化护生职业道德及法律法规教育；开展评教评学活动；注重护生综合能力的培养；重视护士礼仪及护患沟通技巧的培训、培养护生书写护理病历的能力、强化护生护理理论及技能的培训、加强急救技术的训练；定期进行综合考评。对照组72例，采用传统的临床护理带教方法。结果与对照组比较，观察组在患者满意度、带教老师满意度、综合考核成绩方面均提高（P〈0．01），护理投诉、护理纠纷减少（P〈0．01或P〈0．05）。结论重视带教老师整体素质的培训，加强实习护生职业道德、法律意识教育，采用教学考评，注重护生综合能力的培养及考评，是提高护生防范护理纠纷能力的关键。     

对实习护生实施分层次带教的教学效果观察

[目的]探讨适应分层次护理管理发展的临床护理带教模式。[方法]选取2012年8月-2013年4月在我院进行实习的护生222人，随机分为观察组与对照组，观察组应用分层次带教方式，对照组应用传统的带教方式；实习结束前对两组护生进行综合能力考核，内容包括理论知识、专业技术操作考核等，并对实习护生与带教老师进行双向教学评价。[结果]观察组护生考核成绩、带教老师对护生的满意度、护生对带教老师的满意度均明显优于对照组（P〈0．01）。[结论¨盘床推行分层次带教效果良好，提高了临床带教质量。     

高职高专护理实习生实习需求的调查研究

[目的]结合高职高专学校实习教学大纲要求和护理实习生(护生)对专科医院临床带教需求,探讨专科医院临床护理带教的方法。[方法]选取来自10所院校在肿瘤专科医院实习的279名护生为研究对象,自制调查问卷,从临床护理带教需求、带教老师需求、带教方式需求、带教内容需求方面对护生开展调查。[结果]大部分护生认为实习开展岗前培训、兴趣小组、专科班培训重要;其中岗前培训内容中急救知识、医院管理制度、医院感染安全排在前3位;护生大部分对带教老师学历、职称、工作年限没有需求而是对带教老师的护理操作能力、理论专业能力、讲授能力有需求;护生实习期间想学到的知识以护理操作技能和临床疾病护理知识为主,带教内容需求排在前5位的为危重病人的急救技术、沟通技巧的掌握、常用药物知识、各种常见疾病的护理常规、健康教育和心理护理。[结论]从高职高专护生的学校实习教学大纲要求与护生实际需求出发制定临床带教方案,培养护生护理操作技能和临床疾病护理知识的同时加强高职高专护生科研、教育能力的培养,提高临床带教质量。     

Seminar教学法在临床护理带教老师小讲课能力培训中的应用

[目的]探讨Seminar教学法在临床护理带教老师小讲课能力培训中的应用效果。[方法]应用Seminar教学法对59名临床护理带教老师进行为期1年的培训,比较培训前后实习护生对临床护理带教老师小讲课质量评价以及临床护理带教老师小讲课能力自我评价。[结果]培训后临床实习护生对临床护理带教老师小讲课质量评价得分(36.21±0.62)分,高于培训前的(33.15分±1.04分)(P0.05),临床护理带教老师小讲课能力自我评价培训前后比较差异有统计学意义(χ~2=30.35,P=0.000)。[结论]应用Seminar教学法可有效提高临床护理带教老师的授课能力。     

临床带教老师护理教学查房能力培训的方法与效果

目的探讨对临床带教老师进行护理教学查房能力培训的方法与效果。方法对临床带教老师实施系统、规范的护理教学查房能力培训，并对培训前后的护理教学查房效果进行比较。结果培训前后护生对教学查房质量满意度由88.21％提高到95．19％（P〈0．05）；培训后参与者评价、带教老师自评、点评小组评价以及外科实习护生理论操作成绩均明显高于培训前（P〈0．05）。结论实施系统、规范的培训可增强临床带教老师对护理教学查房的自信心；使临床老师的护理教学查房能力得到锻炼和提高；激发其教与学的兴趣，提高护理教学质量。培训方法具有可行性和推广性。     

《护理岗位能力综合实训》课程的开发与实施

[目的]通过开发并实施基于岗位能力的《护理岗位能力综合实训》课程,提高护生的临床综合能力。[方法]于实习前对2010级护理专业(三年制)468名护生开设60学时的《护理岗位能力综合实训》课程,课程开设前后采用统一的方式对护生进行护理综合技能考核;实习后采用问卷调查护生对课程实施效果的评价,并随机抽取160名临床带教老师对护生的临床综合能力进行评价。[结果]课程结束后,护生的护理综合技能较课程开设前明显提高(P0.01);护生对实训课程持肯定态度,除创新能力以外,其余各项指标的认同度均在90%以上;临床带教老师对护生综合能力的评价中,除应变能力外,其余各条目认可度均在90%以上。[结论]实习前开设基于岗位能力需求的《护理岗位能力综合实训》课程,激发了护生的学习兴趣,提高了护生的临床综合能力和适应能力,缩短了护生从学校到临床的距离。     

临床路径在脑病心理科护理带教中的应用

[目的]探讨临床路径在脑病心理科护理带教中的应用。[方法]将120名实习护生随机分为观察组和对照组,每组60名,对照组采用传统的临床实习带教方法,观察组采用临床路径带教方法。比较两组护生出科考试成绩、护生对带教老师的满意度、病人对护生的满意度。[结果]观察组护生出科考试成绩优于对照组（P〈0．05）;观察组护生对带教老师的满意度、病人对护生的满意度均高于对照组（P〈0．05）。[结论]在脑病心理科护理带教中应用临床路径教学法可提高临床教学效果。     

护理软技能训练在高职护理实践教学中应用的效果观察

[目的]观察护理软技能训练在高职护理实践教学中应用的效果。[方法]对广西卫生职业技术学院2012届高职护理专业的学生融入护理软技能训练,用抽签法随机抽取在同一家医院实习的2011届、2012届护生各30人,对两届护生分别进行病人满意度、带教老师综合评价调查,对2011届、2012届护生的就业率、护士执业资格考试通过率进行比较。[结果]融入护理软技能训练后的2012届护生在实习期间病人的满意度及临床带教老师的综合评价均优于2011届护生,差异有统计学意义（P〈0．05）;护生就业率及护士执业资格考试通过率2012届均较2011届高。[结论]在高职护理实践教学中融入护理软技能训练,可提高护生的综合素质和就业竞争力。     

Developing practice protocols for advanced practice nursing

In most states, the role of an advanced practice nurse is dependent on practice protocols that provide an organized method for analyzing and managing a disease or major symptom. They are also used to control the process of medical care and to specify steps in the delivery of that care. Creating appropriate practice protocols is one of the most important precursors to implementing the advanced practice role, because they virtually drive the clinician's ability to treat or manage clinical situations or disease states. This article outlines the steps involved in developing practice protocols and discusses the content that should be included in a protocol, providing an example of narrative and algorithm format protocols. Pros and cons, as well as legal issues related to practice protocols, are also presented.     

Redescribing reflective practice and evidence-based practice discourses

This paper provides an analysis on the discourses of reflective practice and evidence-based practice. It commences by examining the role of discourse in describing and defining our beliefs and attitudes. Consequently, it argues that each discourse is based on a certain epistemology, which in effect are language constructs that create realities and like all language constructs, the epistemology of each discourse is open to the possibility of being restructured. Sequentially, any discourse can (re)describe a different type of reality by providing a set of different words, values and beliefs. Eventually, by exposing the language play and the engineered binary of the reflective practice and the evidence-based practice discourses it is concluded that these discourses are not mutually exclusive as they have been portrayed by most of the literature, but complementary ones. Finally, reflective practice and evidence-based practice are re-described as supplementary discourses and practitioners can simultaneously utilize both through the process of critical reflexivity.     

Clinical practice opportunities for advanced practice nurses

With approximately 132,000 practicing APNs and a continued need for APNs, the role will continue to expand. Many different business options and models for healthcare practice exist for the APN. Commonly thought of professional practice options for APNs include private practice, joint or collaborative practice, and group practice. Each model of professional practice brings with it different roles and responsibilities, rewards and challenges, and criteria for success. When evaluating different practice opportunities. APNs must be aware of each of these factors and evaluate each factor based on his or her chosen lifestyle. This article has presented an overview of common practice models and the roles and responsibilities, challenges and rewards, criteria for success, and lifestyle considerations inherent in each.     

高级护理实践工作坊的建立及实践

目的 建立高级护理实践工作坊,并探讨其在教学中的实践效果。方法 对某高校2016级—2018级88名护理硕士专业学位研究生采用工作坊教学法开展高级护理实践课程,并采用高级护理实践课程成绩、学生反思日记及对18名护理硕士的质性访谈进行效果评价。结果 工作坊教学后,护理硕士专业学位研究生综合能力考核的总分为（87.19±4.61）分。对学生反思日记和访谈结果进行分析,提取出工作坊培养了学生的综合素质、工作坊促进了学生的自我反思、工作坊的教学模式还需要进一步探索三大主题。结论 工作坊不仅提高了护理专业硕士的综合能力,而且有利于学生的职业成长,学生普遍反馈较好。     

Consensual validation of clinical practice model practice guidelines

Clinical Practice Model (CPM) Practice Guidelines facilitate the delivery of consistent, high-quality patient care by clarifying nursing services and supporting the practice and documentation of each step of the nursing process. CPM Practice Guidelines are unique because they are part of an integrated interactive systems thinking framework to support professional practice; they are reviewed and improved routinely using multiple sources of data and are used by hundreds of nurses daily throughout the United States and Canada. Guidelines are developed using a rigorous standardized format and process. Consensual validation is an important part of establishing and maintaining the credibility of these Guidelines.