护士职业尊严与知识积累

现代护理学理论的形成和不断完善，形成自己独特的知识体系，是护士职业获得社会尊重的根本原因。知识积累是护士个人不断自我完善、实观自我价值的必由之路。护理工作者必须掌握全面的专业知识和文化知识，才能满足工作需要。积累知识内容包括实践知识和理论知识，主要方法：读书、参加各种进修班学习、从互联网获取信息和参加科研活动。     

知识积累与护士职业尊严

现代护理学理论的形成和不断完善，形成自己独特的识别体系，是护士职业获得社会新生的根本原因。知识积累是护士个人不断自我完善、实现自我价值的必由之路。护理工作者必须掌握全面的专业知识和文化知识，才能满足工作需要。积累知识的内容包括实践知识和理论知识。主要方法有：读书，参加各种进修班，从互联网获取信息和参加科研活动。     

社区护士继续教育现状调查分析

目的了解社区护士继续教育的现状。方法采用自设问卷形式,对北京市146名社区护士进行继续教育现状调查。结果社区护士获得继续教育学分的方式是参加医院组织继续教育项目(63.73%);社区护士参加继续教育的内容是社区护理知识(82.88%)和临床护理知识(82.19%);参加继续教育的主动性差;影响参加继续教育的主要原因是工作太忙(74.66%);社区护士希望每周进行短期培训(82.88%);社区护士急需人际沟通知识(69.86%)和护理基本技能(69.86%)的继续教育内容。结论鼓励学历教育,丰富社区护士继续教育形式,提高社区护士的整体素质,优化社区护理队伍,以满足社区护士的工作需要。     

临床护士口服降糖药物知识掌握情况的调查分析

目的了解某医院临床护士对口服降糖药物知识的掌握情况。方法运用一般资料调查表、临床护士口服降糖药物知识掌握情况调查问卷对北京市某三级甲等医院195例临床护士进行调查。结果临床护士口服降糖药物知识掌握情况得分为(44.89±4.29)分。不同职称、不同参加糖尿病培训的意愿,降糖药物知识掌握情况不同(P0.05)。年龄、工作时间与口服降糖药物知识掌握情况有明显的相关性(P0.05)。结论临床护士对口服降糖药物知识的掌握情况处于中等水平;建议护理管理者加强对临床护士的继续教育管理,通过各种方法改善临床护士因工作时间、年龄增长等所致的职业倦怠感,促进临床护士知识的积累及临床护理质量的提高。     

影响临床护士掌握肺血栓栓塞症知识的相关因素分析

目的了解临床护士掌握肺血栓栓塞症(PTE)知识的现状及其影响因素,为合理组织培训、提高护士的PTE知识水平提供依据。方法采用方便取样对176名护士进行PTE知识问卷调查。结果参加过抢救的护士PTE提高知识题得分明显高于未参加抢救的护士(P<0.01);参加过培训的护士基础知识、提高知识、总分得分均明显高于未培训的护士(P<0.01);均参加过抢救、培训的护士提高知识、总分得分明显高于均未参加抢救、培训护士,差异有统计学意义(P<0.01)。护士PTE知识得分与护士的年龄、工作年限、职称、学历等方面无相关性(P>0.05)。结论护士对PTE知识掌握欠缺。参加培训及实践能提高护士的PTE知识水平。建议为在职护士提供形式多样的PTE知识培训,并将PTE知识课程纳入护理学课程体系。     

内外科病房护士营养知识的调查

目的了解内外科病房护士对营养学知识掌握情况及营养知识来源、培训和需求情况，为今后提供有针对性的相关知识培训提供依据。方法采用问卷调查方法，对北京2家三级甲等医院内外科病房220例护士进行调查分析。结果护士很少有机会参加营养知识培训，知识主要来源于在校学习和工作中摸索。营养知识均分为（71．15±9．88）分，职称以及对营养知识态度与其知识分值有关。结论在学校学习中，适当增加营养学的课时，在护士继续教育中增设有关营养知识的培训，满足临床护士对营养知识的需求，为确保继续教育的质量，将营养知识考核纳入到护士的整体考核中，提高护士的营养学知识水平。     

影响临床护士掌握心电监护知识的相关因素分析

目的了解临床护士掌握心电监护知识的现状及其影响因素，为合理组织培训，提高护士的心电监护知识水平提供依据。方法采用方便抽样对296例护士进行心电监护知识问卷调查。结果到过重症监护室上班的护士心电监护提高知识题得分明显高于未到过重症监护室的护士（P〈0．01）；参加过培训的护士的基础知识、提高知识、总分得分均明显高于未培训的护士（P〈0．01）；均到过重症监护室及培训的护士提高知识、总分得分明显高于均未到过重症监护室及培训的护士（P〈0．01）。护士心电监护知识得分与护士的年龄、工作年限、职称、学历等方面无相关性（P〉0．05）。结论护士对心电监护知识掌握欠缺。参加培训及实践能提高护士心电监护知识水平。     

护士压疮相关知识的掌握现状调查

目的了解护士对压疮相关知识的掌握现状。方法运用压疮相关知识的自设问卷对290名护士进行问卷调查。结果护士有关压疮的知识问卷总体正确率为67.73%;相对于压疮的预防和处理,压疮风险及程度评估部分的平均正确率较低;护士工作科室、是否参加压疮培训是压疮风险及程度评估得分的影响因素,职称、工作领域是压疮处理得分的影响因素,是否参加压疮培训是压疮预防得分的影响因素(P0.01或P0.05)。结论护士对压疮相关知识认知水平仍有待提高,应根据护士特点进行针对性培训,提高护士的压疮知识水平。     

广西二级医院神经内科护士失禁性皮炎预防管理知识现状和需求调查

[目的]了解二级医院神经内科护士失禁性皮炎(IAD)预防管理知识现状和需求情况。[方法]采用自行设计的神经内科护士失禁性皮炎预防管理知识和需求问卷对14所二级医院神经内科护士进行调查。[结果]共收回303份问卷,二级医院神经内科护士IAD预防管理知识得分为(21.06±6.29)分;不同年龄、工作年限、职称、职务、是否是伤口造口失禁小组成员之间IAD预防管理知识得分比较差异有统计学意义(P<0.05),不同学历IAD预防管理知识得分比较差异无统计学意义(P>0.05);87.3%二级医院神经内科护士认为目前所掌握的IAD预防管理知识未能满足临床护理需求;76.3%护士获取IAD预防管理知识的主要来源为临床经验积累;91.1%护士很少甚至没有机会参加过IAD相关知识培训。[结论]二级医院神经内科护士IAD预防管理知识欠缺,医院应重视相关知识培训,以提高护士IAD的护理水平,降低IAD发生。     

护士麻醉师的产生与发展

护士麻醉师（ntlrse anesthetist）是经过特殊教育与培训的、为手术病人提供术前评估、麻醉期管理和术后复苏管理等围术期护理的高级注册护士，是高级实践护士的一种。高级实践护士给临床护士在专业发展上提供了一个全新的领域，她们在各个专科领域积累的经验丰富了护理学知识体系，对护理学科的发展起到举足轻重的作用，可以说高级实践护士的形成和确立是护理专业化发展的一个标志。为了更好地进行高级护理实践，有必要了解护士麻醉师的过去，并在此基础上促进它的发展。     

The Contribution of Nursing Theory to Nursing Administration Practice

The requisite theoretical base of nursing administration has been defined as a synthesis of knowledge from nursing and other disciplines. The purpose of this paper is to explore the contribution made by nursing knowledge to the distinctive epistemology of nursing administration. The value of nursing theory to administration practice is articulated as well as levels of theory development and their relationship to the knowledge base of nursing administration practice.     

The nature of philosophy of science, theory and knowledge relating to nursing and professionalism

It appears that nursing has devoted an extravagant amount of concentration to the subject of professionalism and professionalization. Consequently, it has created and persists to create some proportion of controversy amid nursing authors, particularly in the Western World at the present time. According to Silva, philosophy, knowledge and theory are intrinsically linked. These notions are important to consider independently and to clarify their relationships, if nursing's knowledge base is to be built on a strong foundation. Perhaps then, if nursing wishes to continue on the trail of professionalization, nurses need to return to and reconsider its foundations and accomplishments. The aim of this discussion paper is to explore the nature of the philosophy of science, knowledge and theory and their interrelationships, with particular reference to professionalization by considering where nursing has come from and consequently the way forward to ascertaining professional status.     

Nursing based evidence: moving beyond evidence-based practice in mental health nursing

Various authors suggest mental health nursing is dominated by knowledge borrowed from psychiatry, pharmacology and the behavioural sciences. These disciplines favour knowledge developed using quantitative methodologies so they and evidence-based practice (EBP) and evidence-based nursing (EBN), increasingly called for in mental health nursing, fit seamlessly together. Nevertheless, as these movements dismiss qualitative approaches to knowledge (evidence) development, I argue against the move toward EBP/EBN in mental health nursing. This is because the specialty's primary interests - human experiences of illness/health care and human relationships, often do not lend themselves to being quantitatively researched. Using nursing examples, I demonstrate how qualitative research, wholly unacceptable in relation to EBP/EBN quality of evidence scales, is indispensable to mental health nursing. The need for evidence arising from qualitative research in no way precludes the need for quantitatively derived evidence. Indeed, the specialty's twofold interest - the work of nurses with clients and the explication of phenomena which inform practice, require diverse knowledge and thus, diverse research approaches. This twofold interest defines the area of mental health nursing practice, and knowledge informing it is referred to as nursing based evidence (NBE). Because it values multiple approaches to knowledge development, NBE provides a way to articulate the specialty's distinct contribution to the health care of people experiencing mental illness and advances mental health nursing.     

Mapping social processes at work in nursing knowledge development

In this paper, we suggest a blueprint for combining bibliometrics and critical analysis as a way to review published scientific works in nursing. This new approach is neither a systematic review nor meta‐analysis. Instead, it is a way for researchers and clinicians to understand how and why current nursing knowledge developed as it did. Our approach will enable consumers and producers of nursing knowledge to recognize and take into account the social processes involved in the development, evaluation, and utilization of new nursing knowledge. We offer a rationale and a strategy for examining the socially‐sanctioned actions by which nurse scientists signal to readers the boundaries of their thinking about a problem, the roots of their ideas, and the significance of their work. These actions – based on social processes of authority, credibility, and prestige – have bearing on the careers of nurse scientists and on the ways the knowledge they create enters into the everyday world of nurse clinicians and determines their actions at the bedside, as well as their opportunities for advancement.     

护理学向科学迈进的沿革--介绍美国护理科学探索过程

专业的关键特征之一是拥有一个完整的理论知识体系。护理要从一个职业发展成为一门专业,必须建立和发展能够指导护理实践的科学知识体系。然而,什么是护理学所特有的、能够作为护理实践基础的知识体系呢?其实质又是什么呢?护理界,尤其是美国的护理界,为了寻找这两个问题的答案,进行了孜孜不倦的探索,为护理学科的发展做出了很大的贡献,但在发展过程中同时也出现了一些误区。美国的护理学科发展主要经历了5个不同的时期,从建立护理专业知识体系的思想形成,到改革护理教育的课程设置和课程内容、大力开展护理科研、进行护理研究生教育以及建立和发展护理理论,虽然每个发展时期的努力重点各不相同,但其努力的目标和方向始终是一致的,那就是要建立和发展护理学科特有的理论知识体系,使护理学成为一门专业。     

整体护理病房三级护理查房的体会

我院自1999年7月开始在整体护理模式病房中实施三级护理查房。1年多来,对800例危重病人进行了护理查房,查房的形式为责任护士每天查,主管护师或护士长每周查,副主任护师以上或科护士长每月抽查,护理部主任每季抽查。通过查房,明显提高了危重病人的护理质量,病人得到了更为优质的服务,护理服务满意率提高;对护理人员来说,提高了业务水平,锻炼了口头表达能力;对护理管理来说,及时了解护士对护理程序的应用情况,掌握危重病人的护理质量,对护理中存在的不足及时提出指导意见。     

Foucault and nursing: a history of the present

While a commitment to the development of nursing theory has been a significant force in nursing scholarship, particularly in the US, the authors have noted a recent trend among nurses in different countries to develop Foucauldian interpretations of nursing. The objective of this paper is to identify those publications by nurses that employ a Foucauldian perspective and to provide a useful summative review of these works to date, which illustrate the potential contribution of a Foucauldian reading of nursing. The authors have reviewed 27 publications written by nurses which present a Foucauldian analysis. These publications were issued between 1987 and 1998 in English, Portuguese and German. The most frequent concepts treated in the literature reviewed are power/knowledge, surveillance, discourse, discipline, resistance, docile bodies, clinical gaze, and panopticon. The literature reviewed illustrates that Foucault's concepts can have a profound impact on the way we conceive of nursing as a discipline and as a profession. Nursing care becomes a political event, nursing knowledge contributes to the dissemination of regimes of truth, and nurses, rather than being powerless, are perceived as professionals who exercise power over life in society. A Foucauldian reading of nursing enables nurses to move into a broader interdisciplinary and critical scholarship.     

临床护理带教老师持续培训的实践与体会

我院自2004年开始对符合要求的临床护理带教老师进行培训,每2年1次,经考试合格后授予临床带教资格证书,继续从事临床带教工作。通过培训,实现了带教老师的知识更新,丰富了她们的理论知识,规范了护理技能操作标准,提高了带教意识和自身素质,增加了学习的自觉性,提高了教学能力。实施临床护理带教老师持续培训是适应护理教育发展,提高临床带教水平的有效方法。     

Research and the configuration of nursing services

• ? This paper is concerned with the way in which nursing research has influenced changes in the organization of nursing services, particularly the shift from so-called traditional nursing to new nursing. To this end published research and professional literature are selectively reviewed.
• ? The case is made to support the view that change in nursing has been driven forward by the evangelical zeal of opinion leaders rather than evidence.
• ? It is suggested that holistic care as embodied in new nursing is no longer affordable. Market pressures have precipitated a revisiting of the task basis of nursing. An effective anchor would have been a solid body of research evidence pointing up the value new nursing may have. Regrettably not enough research was done prior to the diffusion of new nursing. What was done was not always adequate, and what was adequate was not effectively deployed by nurse leaders.
• ? Nursing is the largest workforce in the NHS and has attracted a great deal of policy interest. It is suggested that it will become increasingly important for nursing to be more strategic, and develop its own professionally driven research agenda.
• ? The future of the nursing profession is uncertain. It is clear that evidence-based practice is centre stage, and there is a need for nursing to re-negotiate its professional boundaries and to develop intellectual partnerships in order to move the knowledge base of practice forward.