运用Delphi法构建护理本科生核心护理技能体系的研究

目的 探讨护理专业本科毕业生应该具备的核心护理技能.方法 采用Delphi专家萌询法对29名专家进行函询.结果 经过两轮函询,最终确定护理本科毕业生应该具备基础护理技能、重症急救护理技能、专科护理技能3方面的核心护理技能.其中,基础护理技能领域包括14方面共59个具体的核心护理技能条目;重症急救护理技能领域包括2方面共...     

智力残疾青少年生活技能训练

生活技能的掌握对于促进智力残疾人适应性行为的发展很有帮助,而青春期则是对生活技能进行系统训练的关键时期。生活技能训练应主要从独立生活、寻找并维持工作以及沟通与参与3方面展开,以提高智力残疾青少年的日常生活技能、个人与社会技能、工作技能、人际沟通技能和社会参与技能。为确保有效性,训练的实施应遵循标准的训练程序,选择恰当的训练策略和训练情景。     

Association of cardiopulmonary resuscitation psychomotor skills with knowledge and self‐efficacy in nursing students

Effective cardiopulmonary resuscitation (CPR) skills are essential for better patient survival, but whether these skills are associated with knowledge of and self‐efficacy in CPR is not well known. The purpose of this study was to assess the quality of CPR skills and identify the association of the psychomotor skills with knowledge and self‐efficacy at the time of CPR skills training. A convenience sample of 124 nursing students participated in a one‐group posttest‐only study. The quality of CPR psychomotor skills, as assessed by structured observation using a manikin, was suboptimal. Nursing students who performed correct chest compression skills reported higher self‐efficacy, but there was no association between CPR psychomotor skills and total knowledge. Rigorous skills training sessions with more objective feedback on performance and individual coaching are warranted to enable mastery learning and self‐efficacy.     

实习护生护患沟通能力培养的研究进展

护患沟通能力是护生在实习过程中必须掌握的基本技能之一。从实习护生沟通能力测评工具、沟通能力现状、沟通能力影响因素、沟通能力培养实践等方面阐述实习护生护患沟通能力培养的现状,讨论在临床实习过程中如何提高护生的护患沟通水平。     

护士长应具备的管理技能的研究

目的探讨护士长应具备的管理技能,为培训护士长的课程设置提供依据。方法应用Delphi法就护士长应具备的管理技能进行两轮函询。结果护士长应具备的管理技能包括系统性思维及沟通技能、计划及监控技能、组织技能、领导技能4个一级指标,24个二级指标。专家意见较一致的条目为人际沟通与协调能力、及时发现及解决问题能力、突发事件的应急处理能力、时间管理和安排工作重点、指导与监督、创建高效率工作团队和激励员工。结论专家对确定的护士长应具备的管理技能的意见集中程度较高,可将其作为护士长的培训重点,以提高护士长的管理能力。     

临床技能强化培训对提高医学生临床技能和实习效果的影响

目的评价强化技能培训对医学生临床技能提高和实习效果的影响。方法在首都医科大学附属北京友谊医院的2007级七年制学生本科阶段临床实习初期,利用业余时间进行临床技能强化培训,并对培训效果和满意度进行评估。结果受强化培训的学生总共有34名,在首都医科大学组织的临床医学专业学生临床技能考核中,获得一等奖5名,二等奖8名,三等奖12名。两名同学代表获得华北地区医学院校临床技能大赛团体总分第2名和全国医学院校临床技能大赛一等奖。参与强化培训的学生实习期间的工作量与前一批未全面强化培训的实习生工作量比较,实习期间书写大病历数、非手术操作次数、作为助手上台手术次数往届比较没有显著性差异(P0.05)。受培训学生对培训老师满意者占89.7%,对培训时间满意者65.5%,对培训科目满意者93.1%,认为对实习有帮助者75.9%,认为对技能提高有帮助者96.6%,对培训总体满意度评价69.0%。同期临床科室实习老师对强化培训了解情况者占84.6%,对所带教学生工作量完成情况满意者为61.5%,认为对该批学生临床技能以往学生有提高者占86.2%,认为培训对实习总体有帮助的占78.5%。结论利用业余时间对医学生实行强化培训有助于临床技能的提高,有助于提升实习效果。采取临床技能强化培训方式可作为医学生临床实习初期提高临床技能水平的途径之一。     

The learning and application of generic skills by CLSs/MTs who have 'left the field'.

OBJECTIVE: To determine whether generic skills that dinical laboratory scientists (CLSs)/medical technologists (MTs) learned as students and/or practitioners are applied to jobs outside the field of CLS/MT; and to determine if there are any significant differences in learning and/or doing these skills by CLS/MT majors vs. non-CLS/MT majors. DESIGN: An Occupational Change Survey was sent to CLS/MT practitioners who had identified themselves as having left the field (LTF) of CLS/MT. The participants were asked whether or not they were CLS/MT majors as undergraduates, whether they utilized generic baccalaureate level skills in their LTF jobs, and whether or not they learned these skills as CLS/MT students and/or practitioners. The skills were: problem solving, decision making, troubleshooting, analytical reasoning, data correlation, precision studies, quality assessment, teaching, research, communication, technical writing, computer use, utilization review, and supervision. SETTINGS AND PARTICIPANTS: The survey was sent to 105 participants of an ongoing longitudinal study who identified themselves as having LTF. MAIN OUTCOME MEASURES: Responses for doing/utilizing the skills were grouped as 'Yes' if participants indicated they frequently or sometimes used the skills in their LTF jobs, and 'No' if they indicated they rarely or never used the skills in their LTF jobs. Responses for learning the skills were grouped as 'Yes' if participant indicated they learned the skills as CLS/MT students, practitioners or both and 'No' if they indicated they never learned the skills as CLS/MT students, practitioners, or both. Participants indicated whether or not they were CLS/MT majors in college. Chi square analyses were performed to test for any statistical significant (p = 0.05) differences between: doing and learning the skills, doing the skills and being a CLS/MT major, and learning the skills and being a CLS/MT major. RESULTS: The response rate for the survey was 48% (50/103). Chi square analyses could not be performed for doing the skills in the LTF jobs for three variables: problem solving, analytical reasoning, and computer use because all respondents reported that they used these skills. Chi square analyses indicated there were no significant differences between doing and learning the skills in the LTF job for the entire sample group for all remaining skills except supervision. There were no significant differences between doing the skills in the LTF job and being a CLS/MT major. A statistically significant difference in learning the skills was observed between CLS/MT majors and non-CLS/MT majors for the following skills: problem solving, correlating data, precision studies, research, analytical reasoning, and troubleshooting. The 'Yes' answer frequencies for learning the skills was higher for the CLS/ MT majors for all the generic skills except teaching, where they were equal, and utilization studies where they were lower. CONCLUSION: The results indicate that, in general, for this sample group, generic skills learned as CLS/MT students and/or practitioners can be and are applied to a wide variety of LTF jobs. Furthermore, CLS/MT majors learned the generic skills at least as well, if not better, than other baccalaureate level laboratory practitioners who obtained degrees in other areas.     

Revitalization of clinical skills training at the University of the Western Cape

Most educational institutions that offer health related qualifications make use of clinical skills laboratories. These spaces are generally used for the demonstration and assessment of clinical skills. The purpose of this paper is to share our experiences related to the revitalization of skills training by introducing the skills lab method at the School of Nursing (SoN), University of the Western Cape (UWC). To accommodate the contextual changes as a result of the restructuring of the higher education landscape in 2003, the clinical skills training programme at UWC had to be reviewed. With a dramatic increase in the student numbers and a reduction in hospital beds, the skills lab method provided students with an opportunity to develop clinical skills prior to their placement in real service settings. The design phase centred on adopting a skills training methodology that articulates with the case-based approach used by the SoN. Kolb's, experiential learning cycle provided the theoretical underpinning for the methodology. The planning phase was spent on the development of resources. Eight staff members were trained by our international higher education collaborators who also facilitated the training of clinical supervisors and simulated patients. The physical space had to be redesigned to accommodate audio visual and information technology to support the phases of the skills lab method. The implementation of the skills lab method was phased in from the first-year level. An interactive seminar held after the first year of implementation provided feedback from all the role players and was mostly positive. The results of introducing the skills lab method include: a move by students towards self-directed clinical skills development, clinical supervisors adopting the role of facilitators of learning and experiential clinical learning being based on, amongst others, the students' engagement with simulated patients. Finally, the recommendations relate to tailor-making clinical skills training by using various aspects of teaching and learning principles, i.e. case-based teaching, experiential learning and the skills lab method.     

Teaching and learning about skills in minor surgery

The aim of this study was to assess the feasibility of a scenario-based approach to learning minor surgery skills. After learning component technical skills for ellipse excision and wound closure, nurses were provided with an opportunity to integrate these skills with communication skills and contextual factors in a quasi-clinical environment. Feasibility was assessed using observation of procedures and a group interview with participants, simulated patients and tutors. The scenario-based approach to teaching and learning about technical and communication skills proved feasible and was valued by participants in this course on minor surgery. Although all participants expressed anxiety about integrating skills in the quasi-clinical setting, they valued the opportunity to undergo a formative assessment prior to working in supervised settings with real patients. Learners valued highly the opportunity to reflect on their performance and to receive feedback on technical and communication skills. Future courses should include focused teaching on communication skills prior to the scenario-based exercise. Limitations of the study centre on the small numbers of participants and the novelty of the course. Repeating the evaluations on a subsequent course will provide insight into the ways in which nurses acquire and integrate new skills.     

Can effective teaching and learning strategies help student nurses to retain drug calculation skills?

Student nurses need to develop and retain drug calculation skills in order accurately to calculate drug dosages in clinical practice. If student nurses are to qualify and be fit to practise accurate drug calculation skills, then educational strategies need to not only show that the skills of student nurses have improved but that these skills have been retained over a period of time. A quasi-experimental approach was used to test the effectiveness of a range of strategies in improving retention of drug calculation skills. The results from an IV additive drug calculation test were used to compare the drug calculation skills of student nurses between two groups of students who had received different approaches to teaching drug calculation skills. The sample group received specific teaching and learning strategies in relation to drug calculation skills and the second group received only lectures on drug calculation skills. All test results for students were anonymous. The results from the test for both groups were statistically analysed using the Mann Whitney test to ascertain whether the range of strategies improved the results for the IV additive test. The results were further analysed and compared to ascertain the types and numbers of errors made in each of the sample groups. The results showed that there is a highly significant difference between the two samples using a two-tailed test (U=39.5, p<0.001). The strategies implemented therefore did make a difference to the retention of drug calculation skills in the students in the intervention group. Further research is required into the retention of drug calculation skills by students and nurses, but there does appears to be evidence to suggest that sound teaching and learning strategies do result in better retention of drug calculation skills.     

The effectiveness of an education program to teach Australian nurses comprehensive physical assessment skills

This study investigates the effectiveness of an educational program to teach 22 registered nurses comprehensive physical assessment skills. Administration of questionnaires and tests provided measures of the nurses: a) use of physical assessment skills; b) knowledge of physical assessment; c) changes in nursing practice since learning the skills; d) barriers to the use of these learned skills. The major post program findings regarding increases in the nurses' knowledge and use of physical assessment skills, positive changes in their nursing practice and lack of barriers to their use of these skills indicates that the participants did benefit from this educational experience.     

大、中专护生在实习不同阶段对技能操作需求的调查分析

目的调查大、中专护生在实习不同阶段对l临床技能操作的需求现状。方法根据实习大纲和《新编护理学基础》编制问卷,在实习初期与后期对大、中专护生技能操作的需求进行调查。结果大、中专护生在实习初期、后期对技能操作需求排前5项的以基础技能操作为主,后5项以基础护理中的生活护理为主。实习初期,中专护生有2项基础技能操作需求高于大专护生;大专护生有5项专科技能操作需求高于中专护生。实习后期,大专护生有5项基础技能操作需求高于中专护生,中专护生有1项基础技能操作需求高于大专护生;大专护生有2项专科技能操作需求高于中专护生,差异均具有统计学意义（P〈0．01）。结论大、中专护生对技能操作的需求在各个时期不一致,带教老师应根据护生的需求采取适当的教学方法引导和帮助护生在操作技能上取得进步。     

改革文职护士技能考核的实践与效果

目的 改革我院文职护士技能考核方法，为文职护士的聘用提供依据。方法 在模拟环境中考核护上的工作水平，将操作技能和综合技能作为考核内容，常规护理、操作和急救技能作为评分项目。结果 根据考核结果对护士的工作进行调整，有6名护士满意此考核模式。结论 新的技能考核方法不仅考核文职护士的护理技能操作水平，还考察她们的工作能力和综合素质，对保证护士的聘用质量具有重要作用，值得进一步研究和推广。     

实习前基础护理技术培训模块化教学模式的构建研究

针对目前基础护理技术在本科生实习前培训的重要性和传统模式存在的问题,提出模块化教学模式在实习前培训基础护理技术中的构建思路,将各项基础护理技术优化整合成4个模块(新入院患者护理模块、手术患者护理模块、危急重症患者护理模块及感染患者护理模块),并更新教学理念、改进教学方法和建立全面客观的考评系统。     

A systematic review of retention of adult advanced life support knowledge and skills in healthcare providers

ObjectiveAdvanced life support (ALS) guidelines are widely adopted for healthcare provider training with recommendations for retraining every two years or longer. This systematic review studies the retention of adult ALS knowledge and skills following completion of an ALS course in healthcare providers.MethodsWe retrieved original articles using Medline, CINAHL, Cochrane Library, and PubMed, and reviewed reference citations to identify additional studies. We extracted data from included articles using a structured approach and organized outcomes by evaluation method, and knowledge and skills retention.ResultsAmong 336 articles retrieved, 11 papers were included. Most studies used multiple-choice questionnaires to evaluate knowledge retention and cardiac arrest simulation or other skills tests to evaluate skills retention. All studies reported variable rates of knowledge or skills deterioration over time, from 6 weeks to 2 years after training. Two studies noted retention of knowledge at 18 months and up to 2 years, and one reported skills retention at 3 months. Clinical experience, either prior to or after the courses, has a positive impact on retention of knowledge and skills.ConclusionThere is a lack of large well-designed studies examining the retention of adult ALS knowledge and skills in healthcare providers. The available evidence suggests that ALS knowledge and skills decay by 6 months to 1 year after training and that skills decay faster than knowledge. Additional studies are needed to help provide evidence-based recommendations for assessment of current knowledge and skills and need for refresher training to maximize maintenance of ALS competency.     

Correlation between work experiences and physical assessment in Japan

Abstract The purpose of this study was to obtain baseline data of Japanese nurses' knowledge, skills and attitudes concerning physical assessment. The design of the study was survey research, using a self-administered questionnaire. Nurses with more experience were more knowledgeable about almost all physical assessment skills. Fourteen of the physical assessment skills were used more often by respondents with more experience in nursing practise. Ten of the physical assessment skills were cited as more difficult to carry out by respondents with less experience in nursing. The group with more clinical practise experience had more knowledge of physical assessment skills, used the skills more frequently and had less difficulty in using them. The results of this study indicated that Japanese nurses learn physical assessment skills 'on the job'.     

Psychomotor Skills in Medical Ultrasound Imaging

Sonographers use psychomotor skills to perform medical ultrasound examinations. Psychomotor skills describe voluntary movements of the limb, joints, and muscles in response to sensory stimuli and are regulated by the motor neural cortex in the brain. We define a psychomotor skill in relation to medical ultrasound imaging as “the unique mental and motor activities required to execute a manual task safely and efficiently for each clinical situation.” Skills in clinical ultrasound practice may be open or closed; most skills used in medical ultrasound imaging are open. Open skills are both complex and multidimensional. Visuomotor and visuospatial psychomotor skills are central components of medical ultrasound imaging. Both types of skills rely on learners having a visual exemplar or standard of performance with which to reference their skill performance and evaluate anatomic structures. These are imperative instructional design principles when teaching psychomotor skills.     

What constitutes a nursing practical skill?

Practical nursing skills ensure patients' physical comfort, hygiene, and safe medical treatment. The learning, performance, or significance of nursing practical skills are seldom a theme in theoretical and philosophical debate or the topic of research within nursing. This might be due to a long-standing behavioristic tradition in nursing of viewing nursing practical skills in a simplistic way, only as correctly sequenced motor movement. The purpose of this article is to bring forth an argument for a broader understanding of the constitution of nursing practical skills. This argument is substantiated by a review of past and present conceptualizations of nursing practical skills as well as by philosophical reflections on the value of practical skills in the nursing profession. Nursing practical skills embrace dimensions of performance, intention, and nursing "disciplined" understanding.     

临床护士职业软技能现状调查分析

目的了解广东省护士职业软技能现状及其影响因素,为护理职业软技能培训提供依据。方法采用自行设计问卷,对广东省5所医院165名护士进行调查。结果广东省护士职业软技能总分为(117.78±8.43)分,其中人际关系技能维度得分最高,为(4.36±0.44)分,而认知技能维度得分最低,为(2.71±0.40)分。不同文化程度的护士认知技能维度得分差异具有统计学意义(P0.05)。结论广东省护士职业软技能处于中等水平,护理管理者应从改善护士的工作量、工作待遇、职业培训、职业规划、社会地位等方面着手,进一步提高护士的职业软技能水平。