ICU护士跨专业协作能力现状及其影响因素研究

目的 探讨ICU护士跨专业协作能力现状及其影响因素。方法 对270名ICU护士采用护士一般资料调查表、千叶跨专业协作能力量表、护理工作环境量表进行调查。结果270名ICU护士跨专业协作能力总分为（124.79±16.76）分。多元线性回归结果 显示,学历、近3年院外学习交流经历、有兴趣参加跨专业合作学习的培训课程、认为有必要了解除护理以外其他医学专业知识、护理工作环境进入回归方程（P<0.05）,共解释ICU护士跨专业协作能力总变异的55.7%。结论 270名ICU护士跨专业协作能力处于中等偏上水平,护理管理者应根据ICU特征制订相应制度与措施改善ICU的护理工作环境,从而提高ICU护士的跨专业协作能力。     

临床护士核心能力现状及影响因素分析

[目的]了解临床护士核心能力水平,分析其影响因素,为护理管理提供依据。[方法]采用分层抽样的方法,对120名护士应用注册护士核心能力量表进行调查。[结果]护士核心能力总分为184.96分±35.35分,均分为3.36分,处于高能力水平。伦理和法律实践得分最高(3.52分±0.62分),评判性思维和科研得分最低(3.17分±0.71分)。多元回归分析显示,护士职称及养育孩子情况是影响临床护士核心能力的主要因素并与临床护士的核心能力呈正相关。[结论]管理者结合实际情况,在护士培训中应注重评判性思维和科研能力的培养,加强对低职称及未婚未孕护士的培养,以提升护士的核心能力。     

护理人员跨专业协作能力理论研究现状及进展

<正>自2011年护理学成为一级学科以来,我国护理学者开始探讨护理学学科体系的发展趋势。张艳[1]从生态学视域提出我国护理学学科体系的发展框架;该框架是围绕"促进人的健康反应达到最适状态"为学科主线,在教育、科研、跨学科协作等六种关键生态因子的作用下,学科知识点逐步扩展为研究领域,直至成长为一门独立的分支学科。循证证据[2]证实,跨专业协作是安全有效医学实践的重要措施,能改善临床环境、患者安全及健康结局。因此越来越多的研究者着眼于发展最佳跨专业协作能力     

武汉市临床护士文化能力现状及影响因素调查

[目的]探讨武汉市临床护士的文化能力水平概况及影响因素,为提高护士文化能力及今后其他文化能力研究提供基础分析和参考。[方法]应用目的取样法选取武汉市3所三级甲等医院的护士,采用文化能力评估量表(CCA)、Marlow Crowne社会期望值量表(MCSDS)评测其文化护理能力、意识与行为。[结果]武汉市三级甲等医院的临床护士的文化能力得分为4.59分±0.63分,文化意识及敏感度得分为5.11分±0.54分,文化能力行为得分为4.06分±1.11分。自评文化能力得分与文化能力得分和文化能力行为得分均呈正相关(P<0.01)。[结论]武汉市临床护士文化能力水平中等,文化意识及敏感度高于其文化能力行为,影响因素主要有自评文化能力。     

临床护士临床护理决策能力的影响因素

目的了解临床护理决策能力的影响因素,为促进护士临床决策能力的提高提供对策。方法 2009年9-12月采用便利抽样的方法选择重庆市5所三级甲等医院432名护士进行临床护理决策能力影响因素的问卷调查。结果临床护理决策能力受5个因素的影响,依次为胜任感、自信、人际关系、护理教育、管理者的支持,各因素的影响力均处于较高水平。结论护士临床决策能力受到多个因素的影响,有必要通过增强护士的胜任感和自信心、构建和谐人际关系、提高护理教育水平、加大管理者支持力度等措施提高护士的临床决策能力。     

护士人文执业能力现状及影响因素分析

目的了解本院临床一线护理人员人文执业能力的现状,分析相关影响因素,为提高人文执业的重视度、提升护理服务质量、促进优质护理服务的实施提供依据。方法采取便利抽样的方法抽取多科室一线护理人员,进行问卷调查。测评工具为自行设计的一般资料问卷和护士人文执业能力测评量表,数据录入Epidata数据库,应用SPSS 22.0进行统计学分析,采用均数±标准差、频数及百分比进行描述,影响因素采用多元线性回归的方法进行分析。结果护士人文执业能力总得分中,得分最高的维度为关怀实践能力,其次为法律实践能力,心理承受能力维度得分最低,是否独生子女(β=-0.195,P=0.011)以及工作年限(β=0.356,P=0.003)是影响护士人文执业能力总分的因素。结论护士人文执业能力有待进一步提高,护理管理者应注重加强对于独生子女护士以及新护士的相关能力培养,以提高护患沟通水平,增强患者的满意度,提升护理质量。     

我国硕士学位临床护士核心能力现状及影响因素研究

目的 了解我国硕士学位临床护士核心能力现状并分析其影响因素。方法 采用分层整群抽样法,于2018年9-10月在全国抽取40所医院的670名硕士学位临床护士为调查对象,采用一般资料调查表、高级实践护士核心能力自评量表对其进行调查。结果 (1)调查的670名硕士学位临床护士核心能力总分为(208.04±23.77)分,各维度条目均分由高到低依次为法律/伦理实践能力维度、条目均分为(4.46±0.51)分,专业发展能力维度、条目均分为(4.23±0.52)分,临床护理实践能力维度、条目均分为(4.14±0.54)分,研究/循证实践能力维度、条目均分为(4.13±0.52)分,组织管理能力维度、条目均分为(3.85±0.62),咨询指导能力维度、条目均分为(3.83±0.67)分。(2)多元回归分析显示：工作年限、工作岗位、硕士毕业的院校类型是硕士学位临床护士核心能力的主要影响因素。结论 我国硕士学位临床护士核心能力处于较高的水平,但临床护理能力、咨询指导能力尚不足。建议护理硕士毕业生的培养单位与用人单位可根据此特点,制定个性化的培养计划,以进一步提高我国硕士学位临床护士的核心能力。     

三级甲等医院临床护士叙事能力的影响因素

目的:调查三级甲等医院临床护士叙事能力的影响因素。方法:采取便利抽样法,采用一般资料调查表和叙事能力量表对214名三级甲等医院临床护士进行问卷调查。结果:临床护士叙事能力总分为(145.77±21.72)分;关注倾听、理解回应、反思再现3个维度得分分别为(49.33±7.51)分、(63.90±9.82)分、(32.50±5.78)分;关注倾听、理解回应、反思再现各条目均分为(5.48±0.83)分、(5.33±0.82)分、(5.42±0.96)分;多元线性回归分析结果表明,工作年限、叙事能力熟悉程度和同事关怀程度是影响护士叙事能力的主要因素。结论:临床护士叙事能力处于中等水平,提示护理教育者和管理者应加强叙事护理教育,强化叙事护理培训,提供多方位的社会支持,提高临床护士叙事能力。     

临床护士社会智能现状及影响因素分析

[目的]了解临床护士社会智能的总体现状,为提高临床护理服务质量提供参考依据.[方法]运用中文版Troms？ 社会智能量表,采用便利抽样法抽取茂名市2所三级甲等医院临床护士进行问卷调查,分析361名临床护士社会智能和各维度得分情况及其影响因素,利用SPSS13.0软件对数据进行统计学处理.[结果]临床护士社会智能得分为99.17分±12.59分;年龄、婚姻、护龄、职称、职务和受聘形式是影响临床护士社会智能的因素,差异有统计学意义（P〈0.05）.[结论]临床护士社会智能处于中等偏上水平,主要影响因素包括年龄、婚姻、护龄、职称、职务和受聘形式.     

304名临床护士隐性缺勤现状及影响因素分析

目的 了解临床护士隐性缺勤现状,并分析其影响因素。方法 采用一般资料调查表、斯坦福隐性缺勤量表、临床护士工作满意度评定量表及一般自我效能感量表,对大连市某三级甲等医院的304名临床护士进行横断面问卷调查,并通过单因素及多元逐步回归分析隐性缺勤的影响因素。结果 临床护士隐性缺勤得分为（14.58±4.56）分,多元逐步回归分析显示婚姻状况、所在科室、工作满意度中的工资及福利、工作本身及与同事关系维度及自我效能感为临床护士隐性缺勤的影响因素（P<0.05）,可解释总变异的42.8%。结论 临床护士隐性缺勤总体处于中等水平,管理者需关注已婚、外科、急诊、低工作满意度及低自我效能感的临床护士,制定相应的干预策略以降低不同特征临床护士的隐性缺勤水平。     

Development and validation of a tool to assess self-efficacy for competence in interprofessional collaborative practice

ABSTRACT

Although interprofessional education and collaborative practice have gained increasing attention over the past five decades, development of rigorous tools to assess related competencies is still in infancy. The purpose of this study was to develop an instrument to evaluate health professions students’ self-efficacy in interprofessional collaborative competency and to assess the instrument’s psychometric properties. We developed a new instrument based on the Interprofessional Education Collaborative’s (IPEC) Core Competencies for Interprofessional Collaborative Practice. In a cross-sectional study design, 660 students from 11 health programmes at an urban university in the Midwest USA completed the Interprofessional Education Collaborative Competency Self Efficacy Tool (IPECC-SET). Rasch analysis evaluated the following: (1) functioning of the instrument; (2) fit of items within each subscale to a unidimensional construct; (3) person-response validity; (4) person-separation reliability; and (5) differential item functioning in relation to gender and ethnicity. After removing seven items with suboptimal fit, each subscale demonstrated high internal validity. Two items demonstrated differential item functioning (DIF) for “Gender” and none for “Race/Ethnicity.” Our findings provide early evidence of IPECC-SET as a valid measure of self-efficacy for interprofessional competence for health professions students. Additional research is warranted to establish external validity of the new instrument by conducting studies across institutions.     

Different perceptions of interprofessional collaboration and factors influencing the one-stop service for sexual assault victims in Taiwan

The purpose of interprofessional collaboration is to bring better services for sexual assault victims. In order to avoid secondary victimisation and improve the quality of forensic examination and prosecution rate, a one-stop service has been developed recently in Taiwan. However, whether the collaboration is successful may depend on participants’ professional backgrounds and personal experiences and can be influenced by a number of factors. This study used the Index of Interdisciplinary Collaboration to examine the different perceptions of collaboration in team members and the related influences on collaboration. Surveys were conducted in 140 team members including social workers, doctors, nurses, and police officers. The result indicated that collaboration was perceived differently in different professionals and significantly lower by social workers in the domain of interdependence and reflection on process. Factors such as professional roles, structural characteristics, personal characteristics, and history of collaboration were positively associated with the overall perception of collaboration. Only structural and personal characteristics predicted the type of profession. This study highlights the importance to acknowledge different experiences. Additional efforts and investments for improving mutual help and trust by the organisations are recommended.     

社区护士手卫生知识知晓情况及影响因素研究

目的 了解社区护士对手卫生知识的知晓率情况,深度分析影响社区护士手卫生的相关因素.方法 采用便利抽样的方法选取长春市的4个行政区,用整群抽样法抽取25家社区卫生机构的252名护士,对手卫生知识进行问卷调查.应用单因素和多元线性回归法对调查结果进行统计学分析.结果 社区护士手卫生知晓率总分为16.73±2.15,单因素分...     

A review of the evidence for the maximization of clinical placement opportunities through interprofessional collaboration

Interprofessional collaboration has been suggested as a potential solution to clinical placement shortages. This review was designed to compile the evidence on the use of interprofessional and nursing intraprofessional collaboration to maximize clinical placement opportunities for undergraduate/pre-licensure health professional students. A worldwide search of the published and grey literature was conducted, supplemented by 28 interviews across Canada. Results revealed only two articles, both in nursing – one that described an intraprofessional nursing collaboration consisting of a clinical placement consortium for finding placements, and one that described a unique program that provided a seamless transition from a practice nurse program to associate degree nursing program and that included collaboration with clinical placements. The interviews revealed various types of collaborations designed to maximize placements and various mechanisms by which these collaborations served to maximize placements including easing the pressure to find preceptors and increasing the number of placements. The authors concluded that while collaborations exist specifically to maximize placements, at least in Canada, it was neither happening within the context of research nor being formally evaluated. More evaluation is needed in order to clarify the evidence by which collaboration works or does not work to maximize placement opportunities.     

Attitudes towards interprofessional collaboration among primary care physicians and nurses in Singapore

Interprofessional collaboration (IPC) has been shown to improve patient outcomes, cost efficiency, and health professional satisfaction, and enhance healthy workplaces. We determined the attitudes of primary care physicians and nurses towards IPC and factors facilitating IPC using a cross-sectional study design in Singapore. A self-administered anonymous questionnaire, based on the Jefferson Scale of Attitudes toward Physician-Nurse Collaboration (JSAPNC), was distributed to primary healthcare physicians and nurses working in National Healthcare Group Polyclinics (N = 455). We found that the mean JSAPNC score for physicians was poorer than that for nurses (50.39 [SD = 4.67] vs. 51.61 [SD = 4.19], respectively, mean difference, MD = 1.22, CI = 0.35–2.09, p = .006). Nurses with advanced education had better mean JSAPNC score than nurses with basic education (52.28 [SD = 4.22] vs. 51.12 [SD = 4.11], respectively, MD = 1.16, CI = 0.12–2.20, p = .029). Male participants had poorer mean JSAPNC score compared to females (50.27 [SD = 5.02] vs. 51.38 [SD = 4.22], respectively MD = 1.11, CI = 0.07–2.14, p = .036). With regression analysis, only educational qualification among nurses was independently and positively associated with JSAPNC scores (p = .018). In conclusion, primary care nurses in Singapore had more positive attitudes towards IPC than physicians. Among nurses, those with advanced education had more positive attitudes than those with basic education. Greater emphasis on IPC education in training of physicians and nurses could help improve attitudes further.     

Case-based interprofessional learning for undergraduate healthcare professionals in the clinical setting

Interprofessional learning (IPL) within the healthcare setting has well documented positive outcomes for patients, yet it is not widely offered at the undergraduate level, particularly in a clinical setting. We set up case-based teaching scenarios involving a real patient, aimed at small groups of four students representing two or more healthcare professions. The aim of the sessions was to give students a greater awareness of the roles of all the different healthcare professions involved in patient care in a hospital setting. Weekly sessions were offered on six wards covering different clinical specialties. Three hundred and twenty-nine undergraduate students from different healthcare professions (nursing, medicine, pharmacy, midwifery, physician associate, physiotherapy, occupational therapy, speech, and language therapy) each attended one IPL session during the current academic year. Students were given an evaluation sheet at the end of each session to be filled out anonymously. Forty per cent of the students reported experiencing interprofessional case-based learning for the first time. Over 90% of students agreed or strongly agreed with a list of statements promoting the advantages and benefits of case-based IPL for undergraduate students and many of them requested more sessions. Seventy per cent of all respondents stated they would alter their future professional behaviour as a result of this session. We propose to introduce the sessions into the undergraduate curriculum across all healthcare related professions.     

Development of competence scale for senior clinical nurses

Aim: The aim of this study was to develop a new scale, the Competence Scale for Senior Clinical Nurses (CS‐SCN), to assess and evaluate senior clinical nurses in hospitals, and to confirm the validity and reliability of the scale. Method: A cross‐sectional questionnaire survey was undertaken at a hospital in Japan, using an anonymous self‐administered questionnaire administered to clinical nurses (n = 374). A useable sample of 218 was achieved, which was used in the analysis. Statistical analysis examined exploratory/confirmatory factor analysis, internal consistency, and construct validity. Results: A five factor solution with 22 items was extracted for nursing competence in senior clinical nurses, which was the interpretable questionnaire. In the confirmatory factor analysis, the indices of fitness supported these results. Cronbach's alpha coefficient was 0.93 for the total score and varied between 0.63 and 0.90 in the five factors. Five factors emerged from an oblique factor analysis, with a cumulative variance of 66.7%: “role accomplishment”; “self‐management”; “research”; “practice and coordination”; and “work implementation”. The five factors had only a moderate correlation (0.30–0.77, P < 0.001) with each other, which indicated construct validity. Conclusion: The CS‐SCN, a concise scale to measure and evaluate the competence of senior clinical nurses, was developed. Results suggest initial support for the new instrument as a measure of competence of senior clinical nurses, but it must be further refined, tested, and evaluated. Both the validity and reliability of the scale were verified. Future studies using the CS‐SCN might lead to improvement in the competence of senior clinical nurses.     

A multiple-group measurement scale for interprofessional collaboration: Adaptation and validation into Italian and German languages

This article presents a study that aimed to validate a translation of a multiple-group measurement scale for interprofessional collaboration (IPC). We used survey data gathered over a three month period as part of a mixed methods study that explored the nature of IPC in Northern Italy. Following a translation from English into Italian and German the survey was distributed online to over 5,000 health professionals (dieticians, nurses, occupational therapists, physicians, physiotherapists, speech therapists and psychologists) based in one regional health trust. In total, 2,238 different health professions completed the survey. Based on the original scale, three principal components were extracted and confirmed as relevant factors for IPC (communication, accommodation and isolation). A confirmatory analysis (3-factor model) was applied to the data of physicians and nurses by language group. In conclusion, the validation of the German and Italian IPC scale has provided an instrument of acceptable reliability and validity for the assessment of IPC involving physicians and nurses.     

Every team needs a coach: Training for interprofessional clinical placements

Despite growing awareness of the benefits of interprofessional education and interprofessional collaboration (IPC), understanding how teams successfully transition to IPC is limited. Student exposure to interprofessional teams fosters the learners’ integration and application of classroom-based interprofessional theory to practice. A further benefit might be reinforcing the value of IPC to members of the mentoring team and strengthening their IPC. The research question for this study was: Does training in IPC and clinical team facilitation and mentorship of pre-licensure learners during interprofessional clinical placements improve the mentoring teams’ collaborative working relationships compared to control teams? Statistical analyses included repeated time analysis multivariate analysis of variance (MANOVA). Teams on four clinical units participated in the project. Impact on intervention teams pre- versus post-interprofessional clinical placement was modest with only the Cost of Team score of the Attitudes Towards Healthcare Team Scale improving relative to controls (p = 0.059) although reflective evaluations by intervention team members noted many perceived benefits of interprofessional clinical placements. The significantly higher group scores for control teams (geriatric and palliative care) on three of four subscales of the Assessment of Interprofessional Team Collaboration Scale underscore our need to better understand the unique features within geriatric and palliative care settings that foster superior IPC and to recognise that the transition to IPC likely requires a more diverse intervention than the interprofessional clinical placement experience implemented in this study. More recently, it is encouraging to see the development of innovative tools that use an evidence-based, multi-dimensional approach to support teams in their transition to IPC.