临床护理专家角色作用评价的研究进展

国外对有关CNS角色作用的评价体系已进行了深入研究，并已形成了不同的评价模式，建立了有关CNS行为评价的数据库，充分证明了CNS在卫生保健工作中的重要作用。而我国对于CNS角色作用的评价体系研究还处于初级阶段，提出今后应针对CNS的角色职能多样化的特点，制定出系统、精确、实用的评价指标体系。     

护理本科毕业生临床能力的社会评价与分析

目的:了解用人单位对护理本科毕业生临床能力的评价,以指导高等护理教育教学改革。方法:采用自行设计的护理本科毕业生临床能力评价问卷对8所医院的250名护理管理者进行调查。结果:护理本科毕业生临床护理能力、自主学习能力、护理教育能力得分相对较高;沟通交流与合作能力、护理科研能力和护理管理能力得分相对较低。结论:高等护理教育应进一步完善护理本科生的培养目标,同时加大课程设置、教学方法等的改革力度,以提高护理本科毕业生的临床能力,特别是护理科研和管理能力。     

Physical assessment: a continuing need for clarification

PROBLEM. Physical assessment skills are a mainstay of the nursing process and are taught to pre‐licensure learners. Little research has been conducted on the skills that are actually used in practice compared to those that are taught in pre‐licensure education. METHOD. This article provides an integrated literature review regarding physical assessment skills and their practical application. FINDINGS. Physical assessment skills are consistently referred to as part of the first step of the nursing process, but further clarification about which skills are included in the definition is needed. CONCLUSIONS. Further research is needed to clarify if what is taught is actually used and to what extent in clinical practice.     

An assessment form for clinical nursing education: a Delphi study

AIM: This paper reports a study to develop further the existing assessment form and to capture new aspects of assessment for the nursing profession of the future for inclusion in the form. BACKGROUND: Since nursing education became part of the higher education system, the assessment of clinical periods of the programme has become more complicated and requirements are more demanding. Changes in the health care sector, such as demographic changes and shorter hospitalization, create demands upon the independent nursing role of the future. Many educational documents, such as an assessment form, must continuously be up-dated and adapted to changes in society. METHOD: A Delphi study concerning the content of this assessment form was carried out using two rounds. Through this process, an expert panel gave their opinions about the form and possible changes to it. RESULTS: There was general acceptance of the content in the current assessment form. Suggested changes were the addition of two factors concerning collaboration with the family and society, and development of the student's independence. Two new area headings were suggested: one about ability to use the nursing process, and the other about development of a professional stance. CONCLUSIONS: The suggested changes in the assessment form match expected changes in the health care sector and the demands of an academic nursing education.     

临床决策能力测评研究进展

临床决策能力是护生和护士必须掌握的核心能力之一。现就临床决策能力测评的意义、方法、现状和趋势进行综述,旨在为护理教育和护理管理工作提供参考。     

护理本科实习生临床能力评价方法研究

对护理本科实习生临床能力评价方法进行总结和评价,预测本科护生临床能力评价的发展趋势,以期为本科护生临床教学评价改革提供参考。     

护理本科实习生临床能力评价方法研究

对护理本科实习生临床能力评价方法进行总结和评价,预测本科护生临床能力评价的发展趋势,以期为本科护生临床教学评价改革提供参考.     

高职学生急诊分诊评估教学实践与效果观察

目的探讨急诊分诊评估实践在急救护理教学中的应用及效果。方法对护理高职2年级学生开展急诊分诊评估临床实践,经过分诊实践培训,在临床带教老师指导下参与分诊工作,急诊分诊实践前后分别对学生分诊理论知识掌握程度和教学效果进行测评。结果①实践后高职学生的分诊知识应用评价成绩明显提高(P0.01);②高职学生对教学效果的评价总分为(101.31±5.29)分,各条目均值均大于4.00分。结论通过急诊分诊评估临床实践,有效地提高高职学生对急诊知识的实践应用能力,提升了高职学生自主学习的主观能动性,有利于高职学生进入临床实习时,更快地实现角色转变。     

Clinical nurse leaders' and academics' perspectives in clinical assessment of final‐year nursing students: A qualitative study

The nature of nursing practice is diverse; therefore, clinical assessment is a complex process. This study explores the perceptions of clinical nurse leaders and academics on clinical assessment for undergraduate nursing education during transition to practice. An explorative qualitative approach was applied. Eight nurse managers, six clinical nurse educators, and eight academics from two tertiary hospitals and a university in Singapore participated in four focus group discussions. Thematic analysis was conducted. Four overriding themes were revealed: the need for a valid and reliable clinical assessment tool, preceptors' competency in clinical assessment, challenges encountered by the students in clinical assessment, and the need for close academic and clinical collaboration to support preceptors and students. Closer academic‐clinical partnership is recommended to review the clinical education curriculum. Clinical and educational institutions need to work closely to design a learning program to enhance preceptors' competence in clinical pedagogy and assessment. Furthermore, a stress management program could build students' resiliency in coping with unfamiliar clinical environments. Ongoing support needs to be provided for both preceptors and students to enrich the preceptorship and learning experiences.     

Evaluation by nurses and students of a new assessment form for clinical nursing education

An assessment form was developed, based on Swedish higher education regulations and international guidelines for nursing education, to be used during clinical education regardless of the level of the programme or clinical specialty. Nurses who acted as supervisors for students used the form for continuous and formal assessment, and students used it for self-assessment. Once developed, the assessment form covered 18 professional and academic areas. After one semester nurses (n = 323) and students (n = 154) from two university colleges evaluated their experiences of using the form by answering a questionnaire. In addition, the completed assessment forms filled in by the nurses were reviewed and analysed. The evaluation showed that the nurses and the students considered the assessment form highly valuable. Both groups believed that the form highlighted the requirements for clinical education and was useful in assessing the students' development. Almost all 18 factors were found to be important to assess. Least important and most difficult to assess were 'the use of research and developmental work' and 'the ability to inform and teach co-workers and students'. Some areas that were regarded as difficult to assess were also marked by the nurses in the assessment form as 'not possible or relevant to assess'. The form was found to be useful in assessing students' development towards the goals of nursing education. The study also revealed that essential areas in nursing education have unclear educational demands for those involved.     

对本科实习护生体格检查带教现状的调查与分析

目的了解本科护生临床实习期间体格检查带教情况，并针对存在的问题提出相应对策。方法在实习结束后，采用自设问卷对99名本科护生进行有关实习期间体格检查带教情况的调查，并对结果进行汇总与分析。结果护生临床实习期间的体格检查带教存在较明显的缺陷，未取得良好的实习效果。结论带教老师带教意识及能力欠缺、医疗基础实习的作用未完全发挥、护生学习主动性不足足造成体格检查带教效果不佳的主要原因。有针对性地采取措施，可提高护生的体格检查能力。     

785名临床护士年度绩效考核结果分析与对策

目的 分析临床护上年度绩效考核结果,掌握临床护士在实施护理时所存在的问题,探讨有效的解决方法。方法 从临床护士对病人进行直接护理的质量、护理文件书写记录的质量、个人专业成长、职业道德等四方面,共21条内容对我院785名临床护土进行年度绩效考核。结果 缺陷问题有3820条,占总条数的23.17％。其中专业成长方面的缺陷占8.66％;护理文件记录方面的缺陷占7.89％;直接护理病人方面的缺陷占4.84％;职业道德方面的缺陷占1.78％。结论 不同学历、不同职称的临床护士绩效考核的缺陷项目不同,护理主管部门应根据绩效考核结果,结合临床护士的职称及学历来进行适当的人力分配与专业培养,以有效地提高护理质量。     

Fall risk assessment: a prospective investigation of nurses' clinical judgement and risk assessment tools in predicting patient falls

A prospective cohort study was used to determine the reliability and validity of two fall risk assessment tools and nurses' clinical judgement in predicting patient falls. The study wards comprised two aged care and rehabilitation wards within a 570 bed acute care tertiary teaching hospital in Western Australia. Instrument testing included test-retest reliability and calculations of sensitivity, specificity, positive predictive value, negative predictive value and accuracy. The test retest reliability of all methods was good. In this setting, the three methods of assessing fall risk showed good sensitivity but poor specificity. Also, all methods had limited accuracy, and overall, exhibited an inability to adequately discriminate between patient populations at risk of falling and those not at risk of falling. Consequently, neither nurses' clinical judgement nor the fall risk assessment tools could be recommended for assessing fall risk in this clinical setting.     

Clinical nursing competency assessment: a scoping review

Objective: To ensure that only competent graduates are licensed to practice nursing, councils conduct licensing examinations, which may include among others clinical competency assessment. This review explored current practices in clinical competency assessment of nursing students as part of a larger study aimed at developing an evidence-based, context-specific framework for clinical competency assessment in a sub-Saharan African (SSA) country.Methods: A scoping guided by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) was conducted.Results: Findings from 28 out of 1151 studies identified from Scopus, PubMed, CINAHL, Wiley Online Library, and ProQuest were included and synthesized. Results show that a good assessment system must be valid, reliable, transparent, feasible, fair, objective,and must provide feedback and continually improve to have an educational impact. Clinical competency assessment systems must be developed on sound empirical evidence, pilot tested, and involve thorough training and evaluation of the examiners. Continuous evaluation of the assessment system is also essential to ensure the quality and relevance of the assessment system. Only one of the included studies was conducted in Africa.Conclusions: The paucity of clinical competency assessment research in sub-Saharan Africa may lead to benchmarking assessment systems on research conducted outside the context. Sub-Saharan Africa has a set of circumstances that demand a context-specific clinical competency assessment framework to guide clinical competency assessment.     

医院护理绩效考核研究进展

本文综述了目前国内外医院护理绩效考核的常见指标及评价方法,分析并指出现阶段护理绩效考核存在的问题,提出科学确定考核指标及权重、界定各级别护理人员层次、加强护理绩效考核的信息化管理的建议。     

口腔门诊患者专科护理评估表的构建与应用

目的探讨口腔门诊患者专科护理评估表的构建与应用情况。方法应用Cordon的FHPS理论,结合口腔专科的临床护理特点设计口腔专科护理评估表,运用改良的Delphi法进行专家咨询,并采用Likert 5点计分法,确定口腔门诊专科护理评估的内容。结果专科护理评估表包括5个一级指标和10个二级指标。通过专家的评定认为,85%一级指标和90%二级指标为重要和很重要。通过临床应用,85%～90%的护士认为采用专科护理评估表能准确了解患者的护理问题;能促进护患沟通。结论口腔门诊患者专科护理评估表所涵盖的评估内容全面、实用,能预见性地发现患者存在的护理问题,及时采取相应措施,促进护患沟通,提高患者满意度。