约翰·霍普金斯大学护理硕士研究生教育特点及启示

目的分析总结约翰·霍普金斯大学护理硕士研究生教育的特点,为我国护理硕士研究生教育改革发展提供参考。方法通过登录约翰·霍普金斯大学护理学院官方网站、寻求国外硕士留学生帮助、购买相关书籍及文献回顾等收集资料,分析其护理硕士项目类型、入学条件、课程设置和教学方法等。结果霍普金斯大学护理硕士研究生教育的特点概括为:项目目标具体明确,项目实施注重合作;入学条件灵活,资料审查全面;课程设置注重学科交叉,重视"学"和"用"的结合;多种教学方法相结合,重视高质量的在线护理教育。结论对我国护理硕士研究生教育的启示包括:开设统一规范的专业方向,拓展合作项目;设置综合全面的入学条件,明确审核内容;加强课程设置的针对性,强调理论与实践相融合;综合使用多种教学方法,提高对在线教育的重视程度。     

“互联网+母婴护理”精准服务模式的构建与实践

目的 构建“互联网+母婴护理”精准服务模式,为母婴人群提供不同类型的专业居家护理服务。方法 通过中山市“互联网+护理服务”线上平台,构建“互联网+母婴护理”精准服务模式,采取标准化培训,落实同质化护理管理,实践“互联网+母婴护理”精准服务。结果 我院“互联网+母婴护理”精准服务自2020年6月开展来,电话咨询评估215次,上门母婴护理服务103次,其中接受评价的产妇满意度（4.41±0.66）分,31名出诊护士职业满意度对该模式自评赞成率61.29%~100%。结论 构建的“互联网+母婴护理”精准服务模式,满足了人民群众延续性护理需求;同时拓展护士执业空间,提升护士专业价值,对促进护理服务业的改革与发展起到积极推动作用。     

可视化“护士指南针”交接班制度在神经外科的应用

目的 探讨可视化“护士指南针”护理交接班制度在神经外科的应用效果。方法 将2019年1—4月和2019年5—8月在神经外科住院的患者分别设为对照组（实施传统交接班制度）和观察组（实施可视化“护士指南针”护理交接班制度）,各130例,在实施干预前后调查2组患者对管床护士的认识率和对护理服务满意度。结果 观察组的管床护士认识率和护理服务满意度均明显高于对照组。管床护士认识率从62.3%提高至86.2%,护理服务满意度的7个维度：感知质量、患者预期、医院品牌、疾病压力、患者满意、患者抱怨和患者忠诚分别从（37.15±4.05）、（12.77±1.71）、（4.22±0.83）、（4.18±0.93）、（8.42±1.26）、（4.21±0.88）、（8.67±1.24）分提升至（44.73±0.61）、（14.86±0.41）、（4.96±0.19）、（4.92±0.27）、（9.95±0.21）、（4.95±0.21）、（9.93±0.28）分,差异均有统计学意义（P<0.001）。结论 可视化“护士指南针”护理交接班制度能有效提升住院患者及家属对管床护士的认识率和对护理服务满意度,值得临床推广和应用。     

221名养老机构老年人护理安全风险认知现状分析

目的 了解养老机构老年人对护理安全风险认知的现状。方法 采用便利抽样法,2018年2—3月选取东莞市9家公办养老机构的老年人作为调查对象。采用一般情况调查表、自行设计的养老机构老年人护理安全风险知识调查问卷对其进行调查。结果 221名养老机构老年人安全风险知识总分为（114.31±15.55）分,得分最高的维度为进食安全（23.06±4.46）分,维度条目均分为（3.35±0.71）分;得分最低的维度为跌倒安全（26.67±5.49）分,维度条目均分为（2.96±0.61）分。得分最高的条目为“您有流涎的现象吗”（3.89±1.27）分;得分最低的条目为“老人可以穿拖鞋下床活动”（2.06±0.98）分。单因素分析结果显示,不同年龄的老年人,其护理安全风险知识总分比较,差异有统计学意义（P<0.05）。结论 养老机构老年人护理安全风险知识得分处于较低水平,跌倒安全认知得分最低。81~90岁的养老机构老年人,护理安全风险知识得分越高。养老机构管理者应重视老年人的护理安全风险知识教育,有针对性地制定综合健康教育方案,提高养老机构老年人护理安全风险认知水平。     

神经外科家庭参与式交班模式的实践

目的 探讨神经外科家庭参与式交班模式的效果。方法 依据神经外科专科疾病护理特点,设计神经外科家庭交班日志,比较分析实施前后交班护士对“病情十知道”掌握情况、交班缺陷发生率、患者及家属满意度。结果 运用家庭参与式交班模式后,护士病情交班缺陷率由44.2%降低至15.8%（P<0.001）,“患者十知道”掌握情况得分由实施前的（84.2±6.7）分提高到实施后的（90.7±4.7）分,P<0.001,患者/家属满意度由实施前的（87.4±5.8）分,提升到实施后的（93.2±4.3）分,P<0.001。结论 神经外科家庭参与式交班模式的实践证明家庭参与式交接班能减少护士交班信息遗漏,提高护士对患者的病情掌握度,改进护理工作质量,促进患者安全,提升患者满意度。     

“雨课堂”小规模限制性混合式教学在专升本基础护理学教学中的应用效果

目的 探索“雨课堂”小规模限制性混合式教学在专升本基础护理学教学中的应用效果。方法 选取某学院2018级护理专升本的一个教学班级（n=121）作为对象,借助“雨课堂”平台进行混合式教学,比较混合式教学前后学生的学习自我效能感,并且通过半结构式访谈了解学生对混合式教学模式的评价。结果 采用混合式教学后学生的学习自我效能感得分（68.89±5.82）,显著高于干预前（60.86±6.51）,差异有统计学意义（P<0.001）。学生对混合式教学的体验可归纳为4个主题：主动、互动、轻松、挑战。结论 “雨课堂”小规模限制性混合式教学在专升本基础护理学中应用效果较好,能够激发学习兴趣提高学习能力,有利于学生综合素质的提高。     

“三主”视角下《妇产科护理学》的课程思政教学实践

目的 探讨“三主”视角下《妇产科护理学》“课程思政”的教学实践及效果。方法 围绕教师队伍主力军、课程建设主战场、课堂教学主渠道3方面,采取强化教师思政育人意识与能力,完善课程思政系统、构建“LOVE”和“HEART”2大思政模块、丰富课堂教学方法等措施,在2019级护理本科生中进行《妇产科护理学》“课程思政”教学改革。结果 学生和督导评价中,教师德育能力均分超过上一年度,且获得了一些奖项;学生课堂互动参与度好、线上学习积极、期中考试和期末考试平均分超过80分,思政素养得分超过90分者占比超过80%。结论 “三主”视角下“课程思政”教学可提升教师思政育人能力,激发学生课程学习投入、提升学习效果和思政素养。     

心理韧性在护理硕士研究生情绪智力与职业认同间的中介作用

目的 了解护理硕士研究生职业认同现状,探讨心理韧性在情绪智力与职业认同间的中介作用。方法 2020年1—2月通过便利抽样法,采用一般资料问卷、护生职业认同量表、中文版情绪智力量表、中文版10条目心理韧性量表,对我国8个省12所高等院校共160名护理硕士研究生进行问卷调查。结果 160名护理硕士研究生职业认同得分为(58.91±9.48)分,情绪智力(65.83±13.10)分,心理韧性(25.98±5.91)分;不同年龄、择业意向、工作经验的护理硕士研究生职业认同得分差异有统计学意义(P<0.05)。护理硕士研究生情绪智力、心理韧性均与职业认同呈正相关(r=0.517、0.545,P<0.01),心理韧性在情绪智力与职业认同间存在部分中介作用,效应值为0.197,占总效应的53.10%。结论 护理硕士研究生职业认同处于中等水平,仍有较大提升空间,提示应采取措施培养护理硕士研究生情绪智力、增强心理韧性,以提高职业认同水平,减少护理人才的流失。     

山西省1546名养老护理员培训认同感现状及影响因素分析

目的 调查养老护理员培训认同感并分析其影响因素,为提高养老护理员培训认同感提供参考。方法 采用方便抽样的方法抽取山西省7所养老护理员培训基地共1 546名养老护理员,用自行设计的养老护理员培训认同感调查问卷对其进行调查。结果 养老护理员总体培训认同感得分为（4.35±0.62）分,处于认同（4分）与非常认同之间（5分）之间;多元回归结果显示,养老护理员是否有职业规划、培训基地认定时间、办学性质、是否开设护理专业、教学方法是养老护理员培训认同感的影响因素（P<0.05）。结论 养老护理员的培训认同感整体较高,其中“培训师资”的认同感最高,“培训设施及日常管理”的认同感最低,应在培训过程中采用理实一体化的教学方法,注重培训内容的实用性,加强培训基地的考察评价并不断完善管理体系和教学设施,进一步提升养老护理员的培训质量,增强其培训认同感。     

“以人为本”重症护理量表的汉化及信度效度检验

目的 翻译韩文版“以人为本”重症护理量表（Person-centered Critical Care Nursing,PCCN）,形成中文版“以人为本”重症护理量表,并分析其信度效度。方法 按照量表汉化的程序,得到原作者授权后,将韩文版“以人为本”重症护理量表翻译为中文,并接受跨文化调试,对天津市375名重症监护室护士进行调查,完成信度效度检验。结果 中文版“以人为本”重症护理量表表面效度与内容效度较好;共提取出共情、个性、尊重、舒适4个公因子,各因子的条目载荷均≥0.4,累计总变异率的解释率为70.113%,结构效度良好;总体Cronbach α系数为0.897,各维度的Cronbach α系数为0.816、0.766、0.771、0.871。验证性因子模型拟合度良好。结论 中文版“以人为本”重症护理量表具有良好的信度效度,适合中国ICU护士共情、个性、尊重、舒适等方面人文关怀能力的评估。     

Getting started: Needs and preferences of Colorado faculty for graduate education in nursing

The projected shortage of nurses is greatly influenced by the shortage of nursing faculty. This is of significant concern in Colorado due to increasing requirements for master's-prepared instructors at all levels. While there are many reasons for the faculty shortage, this study looked specifically at the needs and preferences of current nursing instructors related to obtaining graduate education in nursing. The survey results paint a picture of nurse faculty who need new approaches to managing graduate course work in addition to teaching and family responsibilities. Help with expenses through grants, scholarships, and loan forgiveness is vital. Potential graduate students rarely consider full-time or on-campus study, instead favoring online, one-per-semester, year-round courses. They are concerned about practicum hours, less concerned about graduate-level academic work, and not very concerned about online methods. There were no evident differences in needs and preferences for further education based on rural/urban location or community college/university setting.     

Developing community partnerships in nursing education for children's health

Community partnerships are central to educating nurses and providing much-needed services to underserved children in Baltimore City. Johns Hopkins University School of Nursing (JHUSON) collaborates with Head Start programs and a local elementary school for faculty practice and child-health clinical Service Learning experiences. At local Head Start programs, undergraduate nursing students annually screen > 1000 children for height, weight, hearing, vision, and blood pressure. Results are sent to parents with referral information if indicated. In addition, graduate and baccalaureate nursing students implement skills and knowledge learned in the classroom in a nurse-run clinic in a local elementary school, a faculty practice site. The Service Learning community partnerships benefit nursing students because they can apply principles of growth and development while providing important health screening to children in underserved populations. All students gain from practicing in the community and applying their classroom instruction to the care of children.     

粤港澳大湾区护理本科临床实践教学现状及启示

目的 比较粤港澳大湾区护理本科实践教学的优势与不足,为湾区内护理本科实践教学改革提供参考。方法 采用网络资料调查法、文献分析法与访谈法对粤港澳大湾区10所全日制护理本科院校实践教学体系进行横向比较。结果 广东高校与香港高校分别参照国标、香港护士管理局规定设立培养目标,澳门无统一标准;港澳高校较注重临床实践教学,实践课程设置体现了循序渐进的教学理念;澳门临床师资准入标准明确,具有相对完善的临床教学架构;港澳实习基地注重与社会的联系,重视学生国际视野的培养,广东高校临床资源丰富,实习护生承载量大;港澳高校实践方法与评价方式的运用始终服务于人才培养目标的实现。结论 港澳高校实践教学设置值得广东高校商榷与借鉴,三地应加强合作与交流,促进三地高等护理教育深度融合与发展。     

Pursuing graduate studies in nursing education: driving and restraining forces

This article articulates the growing shortage of nursing faculty and identifies factors that impact nurses' decisions to pursue graduate studies in nursing education. Kurt Lewin's Force Field Analysis and a Decision Matrix are applied to the process of pursuing graduate studies in nursing education. When driving forces outweigh restraining forces, nurses are more likely to pursue graduate studies in nursing education. Innovative solutions to strengthen driving forces and overcome restraining forces include: offering more programs with a focus in nursing education; financial support; flexible program delivery options, including more online graduate programs; mentoring; and collaborations between employers and academic institutions. The implications of this analysis for nurses, academic nurse leaders and nursing faculty, nurse employers, and governing bodies are presented.     

我国高仿真情景模拟护理课程教学设计存在的问题及对策

目的 通过对国内外文献回顾,针对我国高仿真情景模拟教学设计存在的问题进行阐述,并提出相应的对策。方法 复习国内外文献,分析我国高仿真情景模拟教学设计的模式、存在的不足并提出对策。结果 我国高仿真情景模拟在实施过程中存在教师、学生和实验室准备不足,情景的仿真程度不够,高仿真模拟系统利用不足,情景模拟实施时间不够,教学评价方法不统一,缺乏对能力的评价等问题。并提出相应对策,包括：教学目标和参与者需求是教学组织设计的基础,教师、学生和案例的充分准备,学生事先熟悉情景病例有助于提高教学效率,保证高仿真模拟的真实,统一情景模拟教学的评价标准和方法。结论 虽然我国护理高仿真情景教学还存一些不足,但在未来的护理教学和实践应用中仍具有很大潜力,必将是促进护理教育发展、引领护理教学改革的一个重要发展方向。     

An evaluation framework for faculty practice

Faculty practice is promoted in schools of nursing for the purposes of strengthening the clinical expertise of faculty, maintaining clinically relevant curricula, fostering student learning, and generating revenue. For clinical faculty, this practice often provides the foundation for academic scholarship. The integration of this scholarship into the traditional academic triad of education, research, and service has proved difficult. Pohl et al notes, "In promotion and tenure decisions, 68 percent of faculty reported that practice was weighted less than teaching and research in their institutions." There appears to be an inherent tension between the requirements for scholarly faculty practice and the academic missions of schools of nursing. The purpose of this article is to describe a framework for the evaluation of faculty practice at the Johns Hopkins University School Nursing (JHUSON) and the actions taken to align the scholarship of faculty practice with the academic research mission of the School.     

成年患者结直肠镜检查肠道准备不充分的预防及管理证据总结

目的 检索并获取行结直肠镜检查的成年患者肠道准备不充分的预防及管理的相关证据,为临床护理工作提供参考依据。方法 运用循证护理方法,针对行结直肠镜检查的成年患者肠道准备不充分的预防及管理提出问题,按照证据资源的“6S”金字塔模型检索文献,采用英国2012版的《临床指南研究与评价系统》、JBI循证卫生保健中心的文献评价标准和证据分级系统（2014版）以及Johns Hopkins医院的循证实践项目管理工具对各类文献进行质量评价和分级评定。结果 结合相关专业人员评定,汇总出22 条肠道准备不充分的预防及管理的证据,包括肠道准备不充分的评估;相关因素;方案的选择;不良事件的处理;饮食护理及健康教育6个方面。结论 本研究总结了结直肠镜检查的成年患者肠道准备质量不充分的预防及管理的最佳证据,为肠道检查患者实施机械肠道准备提供了循证依据,以科学的方法来管理肠道准备不充分的问题,提升护理质量。     

Clinical nurse specialist and nurse practitioner core curricula survey results

The American Nurses' Association's Council of Clinical Nurse Specialists and Council of Primary Health Care Nurse Practitioners conducted a survey of all graduate nursing programs in the United States that prepare nurse practitioners and/or clinical nurse specialists. One hundred eight schools responded (73.5 percent), yielding data on 317 programs that could be further analyzed. For the 60 NP and 195 CNS programs analyzed, information was obtained on the following: required courses, number of hours of the required courses, students' clinical training settings and graduates' employment settings. Findings revealed marked similarity between the core curricula of NP and CNS graduate programs. The only significant differences found were that NP programs placed greater emphasis on pharmacology, primary care, physical assessment, health promotion, nutrition and history-taking in their curricula. In both the student clinical settings and graduate employment settings, NPs focused on primary care settings while CNSs focused on secondary or tertiary care settings. Based on the marked similarities between the core curricula of NP and CNS graduate programs, it is suggested that further investigations be conducted to determine whether objectives and/or teaching methods differ, and to further investigate the effects of practice setting on role development. Further, it is suggested that NPs and CNSs continue to interact through forums and conferences to continue the evolution and definition of graduate nursing education and advanced practice.