PBL教学法在内科护理教学查房中的应用体会

本文通过PBL教学法在内科护理教学查房的具体实施，分析了PBL教学运用于内科护理教学查房的优越性及存在的问题。     

PBL教学法在综合内科护理教学查房中的应用

目的探讨PBL教学法提高综合内科护理教学查房质量的效果。方法在综合内科开展本次研究,单月采用PBL教学法模式查房,作为实验组,双月采用传统法教学查房,作为对照组。比较护士对2种查房方法的效果评价结果。结果PBL模式查房与传统教学方法相比,可提高护士多方面能力,提高了查房质量,比较差异有统计学意义（P〈0．05）。结论PBL教学查房模式是一种较好的、值得推广的教学查房方法。     

PBL教学法在骨科护理教学查房中的应用

目的探讨PBL教学法在骨科护理教学查房中的应用效果。方法以2009--2011年105名实习护生为研究对象,在骨科护理教学查房中实施PBL教学模式。采用问卷调查方式综合评价教学效果,分析PBL教学模式在临床带教中的优势和存在的问题。结果97．15％的护生接受PBL教学查房模式;90．48％的护生通过查房能够明确学习目的、掌握教学重点和难点;91．43％的护生认为提高了自学能力;92．38％的护生认为PBL教学法激发了学习兴趣,加深了知识的理解和记忆;94．29％的护生认为有助于树立整体护理观。结论PBL教学法在激发学习兴趣、培养自学能力和评判性思维能力、强化服务意识方面有明显效果,是提高护生综合素质的良好途径。     

PBL教学法运用于中医护理教学查房的尝试

本文论述了PBL教学法运用于中医护理教学查房的实施方案及效果评价，并分析了PBL教学运用于中医护理教学查房的优越性及存在问题。     

PBL查房与病程护理查房在临床教学中的应用

[目的] 探讨以问题为基础的学习(pproblem-based learning，PBL)查房与病程护理查房在临床教学中的应用与实践。[方法] 将220名实习护生分为对照组和实验组，对照组单纯采用PBL查房的模式，实验组采用PBL结合病程护理查房的模式。[结果] 实验组在专科理论知识、健康教育指导以及病人对护生的满意率等方面均优于对照组。[结论] PBL查房结合病程护理查房有利于护生评判性思维的形成，有利于护生独立解决临床实际问题能力的培养。     

PBL教学法在临床护理教学中的应用研究

目的 探讨PBL教学法在临床护理教学中的应用效果,以提高临床护理教学水平.方法 采用等组实验研究法,将138名护生分为实验组和对照组.对照组运用传统临床护理教学法,实验组采用促进学习的PBL教学法,进行一学年的临床护理教学实验,对结果用SPSS检验.结果 两组护生的平时成绩、专科理论成绩、专科操作以及护理病历书写成绩比...     

以问题为导向的教学法运用于内科护理教学查房中的体会

本文通过PBL教学法在内科护理教学查房的具体实施，分析了PBL教学运用于内科护理教学查房的优越性及存在问题。     

运用PBL教学法进行临床护理业务查房的探讨

目的:通过运用PBL教学法进行临床护理业务查房,提高查房效果。方法:将6个病区分成两组,其中试验组3个病区,参与护士累计420人次;对照组3个病区,参与护士累计396人次。试验组采用PBL教学法查房,对照组采用传统查房法,并对其效果进行统计学分析。结果:对两组业务查房效果对比分析,10项评价指标中,8项具有统计学意义。结论:PBL教学法是较为理想的护理查房方法,运用这种方式查房后,护士主动参与意识更强,培养了护士运用评判性思维解决问题的能力,护理措施更有针对性,落实率更高。     

PBL查房与病程护理查房在临床教学中的应用

[目的 ]探讨以问题为基础的学习 (problem -basedlearning ,PBL)查房与病程护理查房在临床教学中的应用与实践。 [方法 ]将2 2 0名实习护生分为对照组和实验组 ,对照组单纯采用PBL查房的模式 ,实验组采用PBL结合病程护理查房的模式。 [结果 ]实验组在专科理论知识、健康教育指导以及病人对护生的满意率等方面均优于对照组。 [结论 ]PBL查房结合病程护理查房有利于护生评判性思维的形成 ,有利于护生独立解决临床实际问题能力的培养。     

SSP与PBL整合模式在妇产科护理教学查房中的应用研究

[目的]研究学生标准化病人(SSP)与以问题为基础的学习法(PBL)整合模式在妇产科护理教学查房中的应用效果.[方法]选择2009年5月-2010年4月实习的大专护生90名为实验组,采用SSP与PBL整合模式进行护理教学查房;同时随机选择80名接受传统教学方法的护生做对照组,实习结束后对两组护生进行问卷调查及考试.[结果]两组护生的理论考试和操作考试成绩比较差异有统计学意义;实验组护生认为自身专业能力有所提高.[结论]SSP与PBL整合模式的教学方式能够有效提高妇产科护理查房的教学质量.     

品质管理圈在妇产科优质护理服务中的应用

目的了解品质管理圈(QCC)在妇产科开展优质护理服务的作用。方法成立妇产科QCC组织,确立"提高妇产科优质护理服务质量"为圈名,按照PDCA循环法,对妇产科优质护理服务进行具体实践。结果开展QCC活动半年前后患者对护士满意度、患者知晓率比较有显著性差异(P<0.05,P<0.01)。结论在妇产科开展QCC活动,不仅能提高优质护理服务质量,还能充分调动护士工作积极性和培养护士参与护理管理的意识。     

以团队为基础的教学法在妇产科护理教学中的应用

目的探讨以团队为基础的教学法（team—basedlearning,TBL）在妇产科护理教学中的应用效果。方法在宫颈癌病人和卵巢癌病人的护理教学中实施TBL,内容包括做好课前准备、课堂讨论、评估、总结等,同时了解学生对教学的反馈情况。结果71名学生测试平均成绩为（83．3±8．3）分。85．9％以上学生认可TBL教学作用。结论TBL能够提高学生的自主学习以及人际沟通和团队合作能力。     

基于工作过程的高职妇产科护理课程说课设计

说课是教师以先进的教育理念为指导,向同行和专家叙述课程的教学设计及其依据的一种教学研究活动。本文以妇产科护理课程为例,以"工作过程"为导向对该课程的课程定位、课程内容、教学方法、课程特色等方面进行了探讨。     

以问题为基础的学习模式在整形外科实习护生带教中的应用

目的探讨以问题为基础的学习(problem-based learning,PBL)模式在整形外科实习护生带教中的应用效果。方法便利抽样法选择2013年8月至2014年7月在第二军医大学长海医院整形外科实习的160名护生为研究对象,按入科先后分为观察组和对照组各80名,分别采用PBL模式和传统教学模式,比较两组护生的教学效果及考核成绩。结果观察组护生教学效果及考核成绩均高于对照组护生,差异有统计学意义(均P0.05)。结论将PBL模式应用于整形外科实习护生的带教中,有利于促进带教质量和护生学习能力的提高。     

Provider Adherence to a Clinical Practice Guideline for Acute Asthma in a Pediatric Emergency Department

Critics of the use of clinical practice guidelines (CPGs) in an emergency department (ED) setting believe that they are too cumbersome and time-consuming, but to the best of the authors' knowledge, potential barriers to CPG adherence in the ED have not been prospectively evaluated. OBJECTIVES: To measure provider adherence to an ED CPG based on National Asthma Education and Prevention Program (NAEPP) recommendations, and to determine factors associated with provider nonadherence. METHODS: Prospective, cohort study of children aged 1-18 years with the diagnosis of an acute exacerbation of asthma who were seen in a pediatric ED and requiring admission, as well as a random selection of children discharged to home following pediatric ED care. The following adherence parameters were assessed: at least three nebulized albuterol treatments in the first hour; early steroid administration (after the first nebulizer treatment); clinical assessments using pulse oximetry and peak expiratory flow (PEF) (for children >6 years old); and use of a clinical score to assess acute illness severity (Asthma Severity Score). Nonadherence was defined as any deviation of the above parameters. RESULTS: Between July 1, 1998, and June 30, 1999, 369 patients were studied. Of these, 38% (139) were discharged to home, 38% (140) were admitted to the observation unit, and 24% (90) were admitted to the inpatient unit. Illness severities at initial presentation to the ED were: 24% (86) had mild exacerbations, 59% (212) had moderate exacerbations, and 17% (62) had severe exacerbations. Sixty-eight percent (95% CI = 63% to 73%) of the patients were managed with complete adherence to the CPG. Of the 32% with some form of nonadherence, most (63%) were children older than 6 years; in this group 64% (48/75) were nonadherent due to lack of PEF assessment. When PEF assessment was disregarded, an 83% (95% CI = 79% to 87%) adherence to the CPG was achieved. Other nonadherence factors included: lack of at least three nebulized albuterol treatments provided timely within the first hour (5%); delay in steroid administration (6%); lack of pulse oximeter use (0.5%); and failure to record clinical score to assess severity (1.1%). Patient age, illness severity (acute and chronic), first episode of wheezing, and high ED volume periods (evenings and weekends) did not worsen adherence. CONCLUSIONS: Clinical practice guidelines can be used successfully in the pediatric ED and provide a more efficient management and treatment approach to acute exacerbations of childhood asthma. With a systematic and concise CPG, barriers to adherence in a pediatric ED appear to be minimal, with the exception of using PEF in the routine ED assessment.     

基于案例和问题的临床带教方法在培养护理实习生评判性思维能力中的应用

目的探讨基于案例和问题的(case and problem based learning,CPBL)临床带教方法在培养护理实习生评判性思维能力中的应用效果。方法便利抽样选择2014年6月至2015年6月在南通海安医院骨科、神经内科实习的应届护理实习生45人,随机分为CPBL教学组(观察组)和传统教学组(对照组),观察两组评判性思维能力及对两种不同教学方法的满意度。结果观察组护理实习生评判性思维能力及满意度均高于对照组(均P0.05)。结论 CPBL临床带教方法有利于培养与提高护理实习生的评判性思维能力,并提高教学满意度。     

我院精神科优质护理服务实践与成效

目的:总结在精神科开展优质护理服务的实践经验和成效。方法:该院对精神科开展优质护理服务的情况进行回顾性总结。结果:实施优质护理服务后住院病人护理满意度由原来的93.2%提升到99.5%,护士的职业价值感提高了。结论:优质护理服务能提高护理技能水平和质量,增强护士服务意识,提高病人满意度。     

本科护生临床实习适应情况的调查与分析

目的 了解本科护生临床实习适应情况,分析存在的问题并探讨解决办法.方法 采用问卷调查法对85名本科实习护生进行无记名调查,问卷主要分总体评估、护患沟通、技能操作和专业知识等4个部分.结果 本科护生临床实习适应情况良好;72.5%的本科护生认为护患沟通情况良好,影响沟通的首要因素是专业知识不足;影响护理操作的主要因素是自身操作能力和恐惧心理;92.5%的本科护生感到对临床新理论、新技术、新设备的相关知识缺乏,多数认为有必要在实习前增加学习内容.结论 本科护生临床适应及护患沟通情况均良好,消除恐惧心理、加强护理新理论新技术的学习与掌握,是进一步提高护生临床实习适应能力的重要措施.     

重庆市重症医学专科护士培训临床实践模式的构建

目的构建重庆市重症医学专科护士培训的临床实践模式。方法采用德尔菲法对符合纳入标准的30名重症医学专科医疗及护理专家进行两轮函询,确定重庆市重症医学专科护士临床实践模式并进行权重分析。结果两轮函询问卷的有效回收率皆为100%;两轮专家权威系数均为0.928,其中判断依据为0.937,熟悉程度为0.920;一、二、三级肯德尔协调系数分别为0.283、0.204、0.283,P0.001;最终构建的专科护士临床实践模式包括6项一级指标、28项二级指标和50项三级指标。结论本研究构建的重症医学专科护士培训临床实践模式函询专家意见集中,研究结果科学可信,能为重庆市重症医学专科护士的培训临床实践提供可借鉴的科学理论依据。     

Introducing the Learning Practice--I. The characteristics of Learning Organizations in Primary Care

RATIONALE, AIMS AND OBJECTIVES: This paper is the first of three related papers exploring the ways in which the principles of Learning Organizations (LOs) could be applied in Primary Care settings at the point of service delivery. Here we introduce the notion of the Learning Practice (LP) and outline the characteristics and nature of an LP, exploring cultural and structural factors in detail. METHODS: Drawing upon both theoretical concepts and empirical research into LOs in health care settings, the format, focus and feasibility of an LP is explored. RESULTS AND CONCLUSIONS: Characteristics of LPs include flatter team-based structures that prioritize learning and empowered change, involve staff and are open to suggestions and innovation. Potential benefits include: timely changes in service provision that are realistic, acceptable, sustainable, and owned at practitioner level; smoother interprofessional working; and fast flowing informal communication backed up by records of key decisions to facilitate permanent learning. Critical comment on potential pitfalls and practical difficulties highlights features of the present system that hinder development: tightly defined roles; political behaviours and individual-oriented support systems; plus the ongoing difficulties involved in tolerating errors (whilst people learn). This paper contributes to the wider quality improvement debate in the area in three main ways. First, by locating Government's desires to create health systems capable of learning within the theoretical and empirical evidence on LOs. Second, it suggests what an LP could be like and how its culture and structures might benefit both staff and patients in addition to meeting externally driven reforms and health priorities. Third, it extends the application of LO concepts to the health care sector locating the principles in bottom-up change.