Clinical nursing leaders', team members' and service managers' experiences of implementing evidence at a local level

kitson a., silverston h., wiechula r., zeitz k., marcoionni d. & page t. (2011) Journal of Nursing Management 19 , 542–555
Clinical nursing leaders’, team members’ and service managers’ experiences of implementing evidence at a local level Aim To describe the experiences of 14 clinical nursing leaders introducing a knowledge translation (KT) project into one metropolitan acute care hospital in South Australia. The study also explored team members’ and service managers’ experiences. Background KT strategies assume that local (nursing) clinical leaders have the capacity and capability to champion innovation combining positional leadership roles (ward leader) with a project lead role. There is limited evidence to support these assumptions. Method Semi-structured interviews of clinical nursing leaders and managers were undertaken at month 4 and 12 of the project. Data were also collected from the interdisciplinary team members (n = 28). Results Clinical nursing leaders identified risks and anxieties associated with taking on an additional leadership role, whereas managers acknowledged the multiple pressures on the system and the need for local level innovation. Team members generally reported positive experiences. Conclusions With support, clinical nursing leaders can effectively embrace KT project leadership roles that complement their positional leadership roles. Clinical nursing leaders’ experiences differed from nursing and medical managers’ experiences. Implications for nursing management Managers need to be more attuned to the personal risks local leaders experience, providing support for leaders to experiment and innovate. Managers need to integrate local priorities with broader system wide agendas.     

患者对医师角色行为认知测量工具的研制

目的 构建患者对医师角色行为认知的测量工具,为了解我国患者对医师角色行为认知现状提供有效工具.方法 将患者对医师角色行为认知体验的半结构式访谈结果,结合国内外文献分析,构建患者对医师角色行为认知的初始问卷.方便抽样对上海市9家综合性医院住院患者512人开展大样本调查.通过项目分析、探索性因子分析等对问卷修订,并进行信效度检验.结果 探索性因子分析抽出3个因子共可解释总变异的61.731％,由此形成患者对医师角色行为认知测量工具的3个维度,该工具共24项条目,Cronbach's α系数为0.957,折半信度0.912.结论 患者对医师角色行为认知测量工具具有较好的信效度,可作为测量患者对医师角色行为认知的有效工具.     

对新护士进行积极心理健康知识培训的效果研究

目的：探讨对新护士进行积极心理健康(PMH)知识培训的效果。方法选择本院2014年7~9月新入职的26名护士,对其进行PMH知识培训,于培训前后采用幸福进取者问卷(HEIQ)和护生职业认同调查问卷(NSPIQ)评价培训效果。结果培训前,新护士HEIQ、NSPIQ评分的总分为(3.48±0.41)、(101.43±12.85)分,培训后分别为(4.21±0.58)、(127.05±15.16)分,培训前后比较,差异有统计学意义(t=5.24、6.57,P<0.01)。结论对新护士进行PMH知识培训能够提高其职业认同感。     

科研型实验室在研究型医院研究工作主体人员科研能力培养中的作用探讨

研究型医院在医疗卫生事业的临床诊疗水平、科研、教学工作中起到引领作用。其科研的主体为临床医生和专业型研究生,科研能力的培养对于研究型医院主体工作人员具有重要意义。科研型实验室是医学院校及其教学医院培养研究生和临床医生科研创新能力和开展科学研究的平台基地之一。就科研型实验室在临床专业型研究生和临床医生继续教育中科研能力培养的补充作用进行讨论,探讨科研型实验室如何通过搭建有利于医学专业型研究生和临床医生的开展科研工作的平台、促进专业型研究生和临床医生科研能力的培养和提高以及加强研究生和临床医生科研中合作意识,进而对临床医生和专业型研究生科研能力培养起到积极作用。     

我校医科新生专业思想状况调查的分析和思考

调查显示,大多数医学新生虽然出于自愿选择了本专业,但对专业认识较为模糊,受外部社会环境的影响较多,对本专业缺少深刻的情感认知,并且对大学的学习缺少明确的规划,专业思想的稳定程度不平衡。及时纠正新生专业思想中存在的问题,需要从新生入学之时,建构个性化的专业思想教育体系,包括医学生普遍入学教育和重点指导,以及专业思想动态监测系统,适时调整教育安排。     

回访5462人次出院患者的护理体会及对临床管理工作的启示

目的探索护理临床管理和患者健康教育工作的新思路。方法统计2011年6月~2013年12月份出院患者回访记录资料,从患者对自我疾病的管理、患者或家属对回访工作的认识、患者对医疗护理工作的意见或建议等三方面进行汇总分析。结果患者对自我疾病的管理方面:能对自身病情进行出院后自我疾病管理者2531人次(占46.3%);执行治疗方案依从性差者有354人次(占6.4%);能定期门诊随访2089人次(占38.2%);日常生活管理差434人次(占7.9%)。患者或家属对回访工作的认识方面:患者或家属对回访的专科护士态度友好,对其健康教育欣然接受,并表示感谢。患者对医疗护理工作的意见或建议方面:医生与患者沟通的时间少。结论专科护士的专业回访受到患者或家属的认可,能增进患者和医护人员之间的信任感,延伸健康教育工作个体化指导,增加患者或家属的被尊重感,有利于临床管理工作的改进。     

‘I feel like a salesperson’: the effect of multiple‐source care funding on the experiences and views of nursing home nurses in England

The difficulties faced in the recruitment and retention of nursing staff in nursing homes for older people are an international challenge. It is therefore essential that the causes of nurses’ reluctance to work in these settings are determined. This paper considers the influence that multiple‐source care funding issues have on nursing home nurses’ experiences and views regarding the practice and appeal of the role. The methodology for this study was hermeneutic phenomenology. Thirteen nurses from seven nursing homes in the North East of England were interviewed in a sequence of up to five interviews and data were analysed using a literary analysis method. Findings indicate that participants are uncomfortable with the business aspects that funding issues bring to their role. The primary difficulties faced are: tensions between care issues and funding issues; challenges associated with ‘selling beds’; and coping with self‐funding residents’ changing expectations of care. The findings of the study suggest that multiple‐source care funding systems that operate in nursing homes for older people pose challenges to nursing home nurses. Some of these challenges may impact on their recruitment and retention.     

全国听力语言康复系统听力学教育现状与思考

近年来,我国听力语言康复事业取得长足发展的同时仍面临诸多挑战,听力学专业人才匮乏是其中最重要的问题之一。作为全国听力语言康复专业技术资源中心,中国聋儿康复研究中心通过学历教育、认证教育、继续教育等多种形式开展全国听力语言康复专业人才的培养工作,取得了显著成效。但我国听力语言康复系统的听力学教育仍面临着供需矛盾突出、专业人才欠缺、系统培训能力弱、从业人员管理配套政策不完善等问题。需要从推进教育-从业一体化建设、分层次培养专业人员、完善课程设计、培养听力学学科骨干等方面努力。