PBL护理查房对护士评判性思维能力影响

目的：探讨PBL护理查房对外科不同层次护士评判性思维能力的影响。方法：以外科13个病区的全体注册护士为对象,以病区为单位,用抽签的方式,随机分为实验组和对照组。实验组采用PBL护理查房模式每2周1次,持续8个月,对照组采用传统护理查房模式。观察两组护士评判性思维能力的影响,并采用评判性思维能力测量表（CTDI—CV）,对外科护士的评判性思维进行测量。结果：教学方案实施后实验组外科不同层次护士的评判性思维能力有不同程度的提高,差异有统计学意义（P〈0.05）。结论：运用PBL护理查房模式,对外科不同层次护士评判性思维能力的提高有明显的效果。     

基于问题的学习在预防血标本溶血中的实践与效果

目的分析问题式学习预防血标本溶血的效果。方法采用问题式学习模式,对22名护士进行避免血标本溶血相关措施的培训,比较培训前后血标本溶血的发生情况。结果培训后血标本溶血的发生率为4．36％,低于培训前（8．63％,P〈0．01）。结论问题式学习是一种有效降低血标本溶血的培训方法。     

A strategy to identify the learning needs of staff nurses

Rapidly changing technology and the trend toward specialization make continuing education (CE) vital for today's nurses. Various methods to assess CE needs of nurses are described in the literature. This article outlines an assessment strategy implemented to determine staff nurses' perceptions of their learning needs. In addition, head nurses and clinical directors were surveyed regarding their perceptions of the staff nurses' learning needs. The chosen strategy used limited resources to contact a large number of nurses within a short time frame. Results indicated that the three groups surveyed perceived similar learning needs for staff nurses.     

Developing an E-learning education programme for staff nurses: processes and outcomes

OBJECTIVE: To describe the Instructional System Design Processes (analysis, design, development, implementation, and evaluation) used to develop an e-learning education programme for staff nurses at a 700-bed teaching medical center in Taiwan. BACKGROUND: Evidence has shown that education via e-learning improves knowledge and skills; however, with cost constraints and limited resources, finding effective alternatives is critical for health professionals. METHODS: Five courses required for N2 to N3 level nurses were designed for both e-learning and traditional in-classroom programmes. Multiple-choice written test questions and a satisfaction questionnaire were used to compare outcomes between programmes. Nursing care skills were rated as pass or fail. Both programmes were begun at the same time and completed within a 3-month period. RESULTS: Forty-two staff nurses participated in this study. All nurses' knowledge scores were >70 points (out of 100) and all passed nursing care skills. In five courses, only teaching and learning and communication were statistically significantly different (p=0.001). Nearly all nurses (97.6%) felt satisfied or very satisfied with the programmes. CONCLUSIONS: Instructional System Design Processes provide an alternative delivery system for in-service nursing education which allows for individualized leaning.     

A multi-generational staff development model for registered nurses

The paper focuses on a significant nursing initiative for staff development undertaken in South Australia The initiative arose out of Health Commission funded consultancy which sought to develop a staff development model for registered nurses The outcome of this consultancy was the development of a multi-generational staff development model, known as the DPS Staff Development Model This model provides a framework through which staff development activities can be analysed, consolidated and extended The paper outlines the DPS Staff Development Model, the context in which it was developed and its implications for nursing staff development programmes The development of the model was premised on a number of assumptions These included the need to ensure flexibility, longevity, offer a perspective of staff development that is realistic and practical, and facilitate in registered nurses a sense of ownership and personal responsibility with respect to their development The model comprises six broad areas of focus the Career Development Model for registered nurses in South Australia, the structure of the model, locations in which staff development occurs, elements which assist in maintaining skills and knowledge, elements which enhance growth and development and the processes and relationships necessary for the successful implementation of staff development programmes     

Seven years on: distance learning courses for first level registered nurses and midwives

There is a recognized need to increase the accessibility and flexibility of post-registration course provision for first level registered nurses and midwives. Distance learning courses were developed and implemented at the University of Dundee in response to this need. The courses provide a range of learning opportunities from single module certificate courses to Bachelor, Honours and Masters level studies. The courses are well received by nurses and midwives and experience, over the last 7 years, has highlighted important aspects for distance learning education for both professional groups. Different educational strategies such as Work-based Learning and Problem-based Learning are incorporated into distance learning course design to facilitate the integration of theory and practice and develop cognitive and meta-cognitive skills. The relationship between course assessment and clinical environment is also a key feature of course design, with assessment methods built around work-based learning opportunities in clinical practice. Experience has shown that students require support throughout the learning process. This is achieved through text-based study guides and a range of other support strategies. It is concluded that distance learning can be individualized to meet the professional and personal needs of students and provide quality, flexible learning opportunities for nurses and midwives, facilitating practice development and benefiting patient care.     

护医合作PBL教学法在手术室新入科护士带教中的应用

目的探讨护医合作的以问题为基础的教学法（problem—based learning,PBL）在手术室新人科护士带教中应用的效果。方法以无瘤操作为例,采用5步骤护医合作PBL教学法对16名新人科护士进行带教,每2人为一学习小组;从以下3方面评价带教效果：新人科护士对PBL教学法的评价,带教老师对新人科护士综合能力的评价,手术医生对新人科护士手术配合情况的评价。结果参加PBL教学的新人科护士均参与4次肿瘤外科手术,担当洗手和巡回护士各2次。新人科护士对PBL教学方法的评价较高,总平均分为（8．4±0．8）分;带教老师对新人科护士综合能力评价的总平均分为（7．6±0．8）分;手术医生对新人科护士手术配合评价的总平均分为（8．0±0．9）分。结论护医合作PBI。教学法有利于提高新人科护士专业知识水平、实践技能及综合能力,有利于促进带教老师自身素质的提高,并营造良好的科室学习氛围,进一步融洽了医护关系。     

Move to the head of the class: developing staff nurses as teachers.

Nurses, while clinical experts in their specific fields, rarely have an opportunity to learn and practice teaching skills needed in an educator role. Clinical experts experience anxiety when asked to make the transition from a clinical environment to the teaching role. This article describes a 4-hour program developed to train nurses to become teachers. Adult learning principles, learning styles, and curriculum development were included to demonstrate the skills necessary to help nurses become proficient teachers.     

我国临床护理人员分层培训研究现状

以护理模式的转变为背景,对我国临床护理人员分层培训现状进行分析,为完善我国临床护理人员培训体系提供依据。结果发现,目前我国护士分层培训现状已不能满足当今护理事业发展需求,相关部门须规范护士分层培训方案和评价体系,以提高我国护理队伍整体水平。     

翻转课堂在肿瘤科护理人员姑息护理培训中的应用

目的探讨翻转课堂在肿瘤科护理人员姑息护理培训中的应用效果,拓展临床护理培训方法。方法选取南京市第二医院肿瘤科临床护士60名。按照随机数字表法分为对照组和试验组,各30名。分别对两组护士进行姑息护理专项培训,对照组采取传统理论授课的培训方法,试验组采取翻转课堂的教学培训方法。采用姑息护理知识问卷及教学培训满意度测评表对两组护士的培训效果进行测评。结果试验组护理人员姑息知识平均得分(17.19±2.85)分,对照组平均(14.25±3.92)分,试验组理论知识测试在疼痛及其他症状的控制、心理精神社会支持和总分得分明显高于对照组;试验组授课模式激发主动学习兴趣、学习内容有助于知识的理解和掌握、课堂互动交流提高分析解决问题的能力及教学培训方法总体评价的满意度明显高于对照组,差异均有统计学意义(均P<0.05)。结论翻转课堂的教学培训方法有助于提升护理人员学习的主动性及评判性思维能力,加深对姑息护理培训知识的理解与固化,提高了教学满意度。     

Health education: an important role for school nurses.

Health education is an important, yet challenging and time-consuming, nursing intervention. It is one of the most important tools school nurses have in teaching students, families, and staff about health. To be effective health educators, nurses need skills in planning and implementing attractive and effective programs to students. They also need to develop skills in evaluating the effectiveness of their efforts to emphasize the impact school nursing can have on the health of children. This editorial highlights the school nurse's role in health education in schools and gives a brief overview of the health education process. Health education provides many opportunities for school nurses to reach out in new and creative ways to students in their quest to promote health and success in the school environment.     

A nurse transition program for orthopaedics: creating a new culture for nurturing graduate nurses

Successful training and initiation of new graduate nurses is a critical concern for the entire healthcare industry. Current literature reports that as many as 80-90% of new graduate nurses will leave their job within the first year of employment (Bradley, 2001). In summer 2001, the inpatient orthopaedic department of a large community hospital in the southeastern United States was faced with significant recruitment and retention issues. In response, a new nurse graduate transition program was developed for the orthopaedic specialty. This program uses an adult learning model and a single dedicated preceptor. In addition to clinical experience, the program provides special attention to the development of professional behavior, relationship building, and critical-thinking skills. During the next 2 years, the program produced eight new orthopaedic nurses with a first-year turnover rate of 0%. In addition, this program has positively influenced other areas of importance for RN recruitment and retention, including quality of care, patient satisfaction, and staff satisfaction.     

Developing a learning pathway for student nurses

It is essential to ensure equity and consistency of clinical learning for student nurses who will inevitably work in a variety of practice settings. This article describes the development of a learning pathway in response to the need to improve the quality of learning outcomes in the clinical environment. The North Devon and Exeter model uses a three-step approach, with particular emphasis on the preparation for clinical placements. The model gives equal responsibility to students and clinical staff, promoting a partnership, which takes the student through a quality learning experience. The philosophy that clinical learning should be enjoyable, stimulating and inspirational underpins the structure of the pathway.     

男护士职业发展需要的量性研究

目的 探讨男护士职业发展需要的现状及影响因素.方法 以自行编制的男护士职业发展需要问卷对福州和厦门两地160名男护士进行问卷调查,分析男护士职业发展需要的现状及影响因素.结果 男护士职业发展需要平均得分为(4.01±0.49)分,7种职业需要依次为被接受与肯定需要、医院职业管理需要、培训与学习需要、职业规划与发展需要、管理者的帮助需要、临床专业权威需要和教学科研晋升需要;婚姻状况、工作年限、聘用性质和所在医院性质不同,男护士职业发展需要差异具有统计学意义(P<0.01或P<0.05);多元逐步回归分析表明婚姻状况是男护士职业发展需要的预测因子.结论 男护士具有强烈的职业发展需要,渴望获得职业认同,追求职业发展,医院和护理管理者应采取措施满足其职业发展的需求.     

The issue of death and dying: employing problem-based learning in nursing education

Caring for dying patients can be an emotionally painful, distressing and sometimes threatening experience for nurses as the illness is incurable and death is imminent. The avoidance of discussion of dying in the presence of patients in Chinese culture further increases nurses' anxiety. The purpose of this article is to provide an example of how nurses can be helped when caring for dying patients by using a problem-based learning (PBL) approach in Hong Kong. The process and value of using PBL is discussed from the students' perspective. Students went through the PBL process and documented their learning throughout the course in journals. A total of 96 sets of journals were collected and analysed. The case analysis explored the perception of learning in the process of PBL. Three themes, related to nurses' attitudes and caring behaviours towards death and dying, have been derived from the findings. They were (a) increased self-awareness (b) positive attitudes towards death (c) providing culturally sensitive care. Problem-based learning as a pedagogical strategy for achieving learning in death and dying was well received. Problem-based learning was found to be a highly satisfactory method for enabling nurses to reflect on their own attitudes towards death and understanding of the emotional aspects of death and dying. Independent finding of information not only prompted nurses to find information from books and journals, but nurses also interviewed experts and patients for updated and experiential knowledge. Tutorials serve as a safe environment for discussion and sharing of feelings and information. The results definitely support PBL as an effective teaching strategy for nursing educators in the area of death education.     

Preparing adult branch students for their management role as staff nurses: an action research project

AIM: This action research project aimed to investigate students', newly qualified staff nurses' and ward managers' views about the management skills and knowledge required by staff nurses, and how best students could be prepared for their management role. BACKGROUND: The importance of the staff nurse's management role is increasingly being recognized but the literature highlights the difficulties in preparing students for management, and personal experience confirmed this. METHODS: Focus group interviews were held with senior students and newly qualified staff nurses. A questionnaire was then developed which was completed by 23 ward managers. FINDINGS: A good insight into the management skills and knowledge expected of newly qualified staff nurses, and useful ideas about preparation for the role emerged. An extra 2 weeks in practice, supernumerary and with specific management learning outcomes, was implemented and evaluated well. CONCLUSIONS: Preparation of students for their management role as staff nurses benefits from being closely linked to practical experience, with clear learning outcomes and supportive clinical staff. Using an action research approach to investigate the problem and develop a strategy was found to be an appropriate methodology.     

New opportunities for nurses in medical education: facilitating valuable community learning experiences

A new 4 week community programme, developed through a successful Department of Health Bid in partnership with the Community NHS Trust, provides a vital clinical learning block for all medical students at the Leicester/Warwick Medical school. The course owes its success to the pivotal role played by nurses. Working with an Academic co-ordinator the course was operationalised in the county's market towns and provided student access to the work of the entire front line community workforce in the care of people with life limiting diseases and disabled people. Senior nurses in each locality led the work with both community hospital and community nurses sharing their expertise with a wide range of front line health and social care professionals. The lead nurses and their teaching teams attended university training days prior to developing a locality student programme and played a key role in identifying preparing and supporting suitable patients for student learning. Students highly praised the work of the lead nurses who supported their learning throughout the course. All nurses felt the educational involvement was worthwhile, having overcome identified barriers and with funding support nurses have been able to assimilate the teaching into their annual workload.     

Magnet hospital staff nurses describe clinical autonomy

BACKGROUND: Considerable and longstanding confusion abounds as to what is meant by the concept "autonomy." The 2 dimensions of autonomy-rooted in the clinical act and the autonomy of the discipline or profession-are used interchangeably and measured with the same tools. PURPOSE: The purpose of this research was to ascertain staff nurses' concept of autonomy, to empirically quantify nurse autonomy, and to determine the relationship between degree of autonomy and staff nurses' rankings of quality care on their units and their own job satisfaction. METHOD: Two hundred seventy-nine volunteer staff nurses from 14 magnet hospitals were interviewed individually with the open-ended question and request, "Can you practice autonomously? Give an example of a typical situation that illustrates that you practice autonomously," and with two 10-point rating scales on job satisfaction and quality of care given on their units. Responses were subjected to constant comparative and thematic analyses. On the basis of 3 themes-frequency, organizational sanction, and scope-a 5-category ranked autonomy scale was developed. These magnet hospital staff nurses restrict the concept of autonomy to the clinical act. There is a strong relationship between degree of autonomy as measured by the ranked scale and rankings of job satisfaction and quality of care. An unexpected finding was that 26% of these nurses working in magnet hospital reported situations of unsupported or no autonomy. DISCUSSION: This research is particularly meaningful for nurse managers and researchers. Nurse managers must empower nurses, provide support, provide opportunities for nurses to increase competence, and reward and sanction staff nurse autonomy. After further refinement, the ranked-category scale will be useful in studying the effect of educational efforts and organizational support on the development of clinical autonomy.     

Ward management: education for senior staff nurses

The key professional challenges for senior staff nurses relate to managerial rather than clinical issues, but there appears to be a lack of educational preparation for the managerial roles expected of them. An educational service was developed, implemented and evaluated in a specialist paediatric unit to address senior staff nurses' concerns related to managerial aspects of their role. An organisational development model was used to negotiate a work-based learning programme that incorporated practice competencies. This was undertaken at an Agenda for Change implementation site, which enabled the Knowledge and Skills Framework (KSF) to be trialled in practice. The educational programme was evaluated positively and practice competency evaluations highlighted how the KSF dimensions provided a usable and relevant breakdown of managerial and leadership issues. The framework provided a professional development tool for staff wishing to progress their managerial knowledge and skills while under supervision.     

Online learning communities can provide support for nurses preparing for certification examinations

Achieving certification is a benefit to the nurses, to their patients, and to the organizations that support them. Developing an online learning community is a simple way for the institution to offer support to the nursing staff. Providing the resources for creation of online learning communities demonstrates the facility's commitment to communication, education, and professional development.